Silent Area Research Articles

Topographic reorganization in the striate cortex of the adult cat and monkey is cortically mediated

In primary sensory and motor cortex of adult animals, alteration of input from the periphery leads to changes in cortical topography. These changes can be attributed to processes that are intrinsic to the cortex, or can be inherited from alterations occurring at stages of sensory processing that are antecedent to the primary sensory cortical areas. In the visual system, focal binocular retinal lesions initially silence an area of cortex that represents the region of retina destroyed, but over a period of months this area recovers visually driven activity. The retinotopic map in the recovered area is altered, shifting its representation to the portion of retina immediately surrounding the lesion. This effectively shrinks the representation of the lesioned area of retina, and expands the representation of the lesion surround. To determine the loci along the visual pathway at which the reorganization takes place, we compared the course of topographic alterations in the primary visual cortex and dorsal lateral geniculate nucleus (LGN) of cats and monkeys. At a time when the cortical reorganization is complete, the silent area of LGN persists, indicating that changes in cortical topography are due to alterations that are intrinsic to the cortex. To explore the participation of thalamocortical afferents in the reorganization, we injected a series of retrogradely transported fluorescent tracers into reorganized and surrounding cortex of each animal. Our results show that the thalamocortical arbors do not extend beyond their normal lateral territory and that this physical dimension is insufficient to account for the reorganization. We suggest that the long-range intrinsic horizontal connections are a likely source of visual input into the reorganized cortical area.

Daughters, Fathers, and the Novel: The Sentimental Romance of Heterosexuality , and: Seductions: Studies in Reading and Culture (review)

Reviewed by: Daughters, Fathers, and the Novel: The Sentimental Romance of Heterosexuality, and: Seductions: Studies in Reading and Culture Katherine V. Snyder Lynda Zwinger . Daughters, Fathers, and the Novel: The Sentimental Romance of Heterosexuality. Madison: U of Wisconsin P, 1991. 174 pp. No price given. Jane Miller . Seductions: Studies in Reading and Culture. Cambridge: Harvard UP, 1991. 193 pp. $22.95. Lynda Zwinger and Jane Miller both embark from what has become a familiar starting point of feminist theory and criticism: the paradox of heterosexual seduction. Why do many women take, and even want, what men—both fictiional male charecters and male theorists—have to offer? Both critics explore the ways that women are complicit in, and yet resist, the seductions of men in male-dominated worlds. While Zwinger takes this paradox to the heart of the novel as genre, Miller lights out for the border that has divided feminism from male-articulated theories of social difference. In Daughters. Fathers, and the Novel, Zwinger argues that behind the Oedipal myth we accept as a given of Western culture lies a different seduction narrative—the father/daughter romance—which has shaped the genre of the modern bourgeois family novel and the figure of the sentimental daughter. According to Zwinger, "the daughter of sentiment" occupies a unique place in our representations of sexual difference; because this fictional type is not subject to the polarizations of the feminine typically used to manage the anxiety provoked by sexual difference, she must play out the devastating paradox of being "the submissive daughter who must refuse to submit." Richardson's Clarissa provides an archetype whose predilections are fulfilled in Dickens's Dombey and Son, Louisa May Alcott's Little Women, James's The Golden Bowl, and The Story of O. Zwinger's final chapter examines daughter-written novels by Austen, Emily and Charlotte Brontë, and George Eliot, whose heroines disrupt the exogamous requirements of heterosexual marriage plotting by staying home. In describing the intersections among power, the erotic, and the sentimental, Zwinger provocatively demonstrates how the sentimental has been used as a coverup by novelists and literary critics alike. In novels, the "daughter of sentiment" is both alibi and scapegoat for paternal desire; in criticism, the charge of "sentimentality" is one way that critics elude the stories they would prefer not to see . . . or tell. By attending to the gendered asymmetries of power in the family romance, Zwinger accounts for elements of plot and reception which are otherwise inexplicable, such as Dombey's desperate rejection of his daughter or the critics' emphatic rejection of the sequel to The Story of O. Zwinger limits her discussion to a relatively small number of novels, thus permitting the sustained analysis that helps to make her argument convincing, but her omission of any discussion of the selection process by which she settled upon these apparently representative texts is troubling. Also, the chronological movement of her chapters implies change over time, but the final chapter posits daughterly resistance by nineteenth-century British women novelists while only [End Page 993] gesturing towards the future. What happens to the father-daughter plot in the twentieth century, for male and female authors, for British and American authors? Has it been challenged in new ways, or does the story remain essentially the same? Miller's Seductions ranges more widely in its choice of texts and in the discourses it uses to examine seduction, which it describes as both a metaphor and "the means by which sexual relations can be inserted into any understanding of how power is experienced in societies built on inequality." Her first chapter analyzes the different histories of use that separate the meanings of "hegemony" and "seduction," attempting to explain why hegemony is "at once so tantalizingly attractive to feminist analysis and yet so wholly undeveloped in its potential relevance to women." The seductiveness of men and their theories to women, and the neglect of the specificities of women's lives and feminist theory by male theorists, are revisited in chapter two which discusses "The One Great Silent Area" in Raymond Williams's accounts of literature and culture, in chapter four which treats Said's "Orientalism" and Fanon's "négritude," and...

Intracranial Abscesses in Western Saudi Arabia

The clinical symptoms of brain abscesses are indistinguishable from those of other intracranial space-occupying lesions. The underlying etiology is generally found to be spread of infection from an...

Abducens Nerve Paralysis: A Potential Presentation of Sphenoid Sinus Cancer

The sphenoid sinus is the paranasal sinus most commonly implicated when cranial neuropathies are present. Two patients presenting with sixth nerve paralysis secondary to sphenoid sinus involvement are presented. One patient had a primary sphenoid sinus tumor, and the other a metastasis from a bronchogenic carcinoma. Of the two patients, one carried the diagnosis of idiopathic sixth nerve paresis and had had a normal sinus x-ray film and CAT scan done previously. Even in the absence of positive radiographic findings, the high clinical suspicion of sinus malignancy must be maintained in patients manifesting abducens nerve paralysis. In these patients, the petrous apex and cavernous sinus "silent area" must be diligently evaluated. For the patient to have any chance for palliation or potential cure, the tumor must be diagnosed as soon as possible.

The value of electrostimulation in epileptic focus localization.

The ES is a non-physiological stimulus of the brain. However it represents an important and indispensable part of stero-EEG investigation since it is an easily adjustable method, capable of inducing typical electro-clinical seizures. From the clinical and electrical responses elicited by ES and from the data of the stimulation tresh-old, we are in agreement with other authors, we feel we can also distinguish several different reacting zones in the epileptic brain: 1. The epileptogenic zone from which the complete or almost complete electro-clinical seizure is reproducible immediately by ES or with short latency. These pathological responses show the severe dysfunction of the given structures. 2. The irritative zones from which seizure elements can be evoked, but the complete electro-clinical seizure does not. "Physiological" clinical responses can also be elicited, but by a very low threshold stimulus pointing to the pathological excitability of this zone. 3. The area reacting to "normal" stimulus threshold with a physiological response. 4. The silent area without any electro-clinical response in the functional state of the nervous system. One of the practical values of ES is that makes possible to separate these zones from each other in a given patient within certain limits, and it may help to reveal the localization, the multiplicity and the degree of the "seizure disposition" in epilepsy.

Formens semantik – en teori om den kulturhistoriske udstilling

The Semantics of Forms - an Exhibition Theory The article argues that a predominantly silent area of museology, that is to say the exhibition, can be described through an aesthetic theory about the semantics of form.

Evaluation of the "opto-kinetic pattern test (OKP test)"--results on the vestibulo-oculomotor dysfunction and local diagnosis

The author reported on the results of the 0KP test in 474 cases of vestibulo-oculomotor dysfunction. Some cases of the lesions in the CNS were verified by surgical operation and autopsy. In some cases of the peripheral vestibular lesions, diagnosis was given by precise neurological examinations. 1. OKP test is a examination for the pure oculomotor function and the test reveals typical pattern in the CNS lesions. The test plays an important role for the diagnosis of the lesion in the tegmentum of the brain stem i.e. so called Silent area 2. OKP in the peripheral vestibular disorder reveals typical pattern and is usefull for the deection of the side of the lesion as well. 3. Further OKP test is a usefull tool not only for the observation of the recovery process of the vestibular imbalance, central compensatory process and the evaluation of the postoperative relapse of the brain tumor, but also usefull for the differential diagnosis of nystagmus and for the evaluation of the dynamic oculomotor disturbances. Special attention should be paid on the result of the examination to eliminate the diseases of the eye ball itself and the accessory apparatus of the eye ball. Age, state of the alertness interfare the result occasionally, so that the examination should be carried out under interested gaze.'

Cerebrospinal Fluid Free Cholesterol as Index of Activity of Multiple Sclerosis and Allied Diseases

One of the vexing problems in neurology is the lack of objective criteria for evaluating the degree of activity of the demyelinizing process in patients with multiple sclerosis and allied diseases. The very nature of these diseases makes it extremely difficult to translate signs and symptoms into terms of activity. An actively demyelinizing lesion may be hidden in a silent area of the nervous system, while symptoms which appear to indicate progression of the disease may actually be manifestations of the reparative process of gliosis. The various disability scales that have been proposed for measuring the severity of the disease fail to take into account the fact that old lesions, which are quiescent or healed, may prevent the appearance of new symptoms and signs indicative of renewed demyelinization. The evaluation of proposed therapeutic regimens has been hindered by the fact that prolonged periods of observation are necessary for appreciation of

Massive hemorrhage due to aberrant pancreatic tissue in the cardia of the stomach

T HE presence of aberrant pancreatic tissue in the gastrointestinal tract is not rare. It was described in 1859 and some authors state that it was first mentioned as far back as 1727. Approximately 900 cases have been reported, most of them within the past fifteen years. This condition is detected frequently today because of better laboratory procedures and because of the increased amount of surgery being performed on the gastrointestinal tract. The condition is rarely diagnosed preoperatively because the more common conditions of ulcer and cancer are usually considered by the examiner. The incidence in a group of over 4,000 autopsies was approximately I.9 per cent. Barbosa et a1. [r] stated that in a series of surgica1 cases it was encountered in approximateIy one of every 500 operations on the gastrointestinal tract. The origin of aberrant pancreatic tissue in the gastrointestina1 tract is congenita1. The tissue probabIy becomes detached from the primary anIage and is transpIanted during development to the IongitudinaI growing gut and becomes invoIved with the muscIe coats of the waI1 just beneath the mucosa. As a resuIt, pancreatic tissue can be encountered anywhere in the gastrointestina1 tract. However, because of the location of the anIage the more common site is naturaIIy in the duodenum where it occurs approximateIy 80 per cent of the time, in the stomach approximateIy IO per cent of the time, and in the jejunum and iIeum approximateIy 9 per cent of the time; in I per cent it may be found in either MeckeI’s diverticuIum, the spIeen, gaIIbIadder or liver. The case presented herein invoIves the presence of aberrant pancreatic tissue in the cardia of the stomach. The symptoms are variable and naturally depend on the Iocation of the aberrant tissue. If the tissue is in the duodenum, symptoms of uIcer may be present; if the tissue is in the cardia, there may be no symptoms because this is the so-calIed “silent area” of the stomach. Symptoms aIso depend on the pathologic condition within the aberrant tissue, the most common being inff ammation, fat necrosis, ulceration, hemorrhage and carcinoma. The diagnosis is seIdom made preoperatively unIess this condition is kept in mind when patients are seen who have an atypica1 historyof ulcer or who have had several attacks of hemorrhage from the stomach followed \vith asymptomatic intervals. If the aberrant tissue is in the duodenum, x-rajexamination ma? show a defect, usually in the second portion. If the aberrant tissue is in the cardia of the stomach, x-ray examination will most likely be negative. If the aberrant tissue is polypous, x-ray examination may revea1 a mass which resembles gastric polyps. Gastroscop,v ma>be more accurate than the x-ray in the diagnosis. It may reveaI a submucosa1 tumor which has a benign appearance. The usua1 diagnosis is either ulcer or cancer, and onIy after surgery is the diagnosis made. It is important to keep this condition in mind at the time of surgery, for if it is mistaken for carcinoma the patient wiI1 be subjected to a radical procedure which may jeopardize his chances for survival when under the circumstances only segmenta resection is curative. The gross pathologic examination shows a mass, usually Iobulated. The mass may be in the waI1 of the stomach or may project as a poIyp, or may be in the muscuIaris, the submucosa or the mucosa which may be ulcerated.

Electroencephalographic findings associated with subdural hematoma; review of forty-five cases.

IN PAST years the literature on subdural hematoma has been steadily increasing. Since Walter's1original description of a silent area over an extradural hematoma as evidenced in the electroencephalogram, and the description, by Jasper and co-workers,2of a silent area on the side of a subdural hematoma, several series of cases of subdural hematoma have been reviewed by various authors. These reviews have resulted in varied pictures. This discrepancy may be due to two factors: One is a matter of terminology. Both Walter and Jasper and co-workers employed the term silent area, but Walter described under this term a delta focus, whereas Jasper and co-workers employed it for a marked lowering of the amplitude. A second factor is the small number of cases in most of the series. Glaser and Sjaardema3reported 3 cases; Cohn and co-workers,46 cases; Marsh and co-workers,513 cases; Smith

Pott's disease affecting a silent area of the spine: Case report

Pott's disease affecting a silent area of the spine: Case report

MENINGIOMA OF THIRTY YEARS' DURATION

The age and rate of growth of primary tumors arising from the meninges can seldom, if ever, be accurately determined. To judge the approximate age of neoplasms in other parts of the body, one usually depends on the duration of symptoms produced. Unfortunately, this criterion cannot be applied to intracranial tumors, particularly meningiomas. A lesion arising in the epileptogenic zone may manifest its presence early, whereas one involving a silent area of the brain may grow for a long time, often reaching an enormous size before its presence is suspected. The age of secondary, or recurrent, tumors, on the other hand, can be accurately determined when the onset of growth, i. e., the time of the first operation, is known. The rate of growth of these recurrent lesions is variable and depends on the pathologic variety of the tumor, its location and the extent of the operative and postoperative treatment.

ATYPICAL MASSIVE ABSCESS OF THE FRONTAL LOBE

The wide variation of symptoms of abscess of the frontal lobe is well recognized. O. Jason Dixon, 1 described the thoroughness of the brain in concealing an abscess within itself; Dan McKenzie 2 called attention to the frequently latent signs of abscess in the silent frontal area of the brain and to the fact that a usual event is for the abscess to be discovered accidentally at operation or at autopsy. Infection and trauma have been well recognized as definite etiologic factors by such authoritative otorhinologists as Eagleton, 3 Myers 4 and Skillern and Coates. 5 The specific symptoms and signs to look for, recently recalled by William Gordon, 6 are: ( a ) initial vague chill, ( b ) headache, ( c ) vomiting, ( d ) general malaise, ( e ) slow pulse, ( f ) subnormal temperature, ( g ) papilledema, ( h ) abnormalities of the cerebrospinal fluid, ( i ) convulsions and ( j ) coma. In addition, as reported by Dan McKenzie, 2 symptoms of slow cerebration, loss of memory and

Primary Carcinoma of the Ileum

Apart from the duodenum, the small intestine in the adult may Le justly considered a surgical “silent area.” The rare intrinsic lesions are either inflammatory strictures or benign polyps, gar-comas, and cancers. Various estimates place the incidence of car-cinoma in this region at 3 per cent of all carcinoma of the gastro-intestinal tract (1) but the number of recorded caseg, the hospital records, and individual experience would suggest that this figure is too high. In view of the variety and high siirgical mortality of the condition, the following case of primary carcinoma of the ileum seems worthy of record. Case Report S. S., aged thirty-two years, single, Japanese, was admitted to St. Bartholomew's Hospital on January 15, 1924. Twenty-four hours previously he was suddenly seized with severe lower abdominal pain followed by nausea and vomiting. At first the pain was confined to the lower abdomen, but later became generalized. Since the onset of pain, the bowels had acted once; the stool was apparently normal. Previous History: Constipation had been marked over an indefinite period. One year previously a similar but milder attack of abdominal pain had caused the patient to spend five days in the hospital. At that time a roentgenogram of the alimentary tract showed some deformity of the duodenum and delay in the passage of barium from the ileum. The diagnosis was “intestinal stasis and toxemia.” Examination: The patient was acutely ill, with a distended, firm abdomen. No coils were observed. On rectal examination a firm mass was felt above the prostate, apparently in front of the rectum. The temperature was 101° F.; pulse 104; respiration 24. The urine was essentially negative. The blood count showed 4,200,000 red cells, 13,500 white cells, with 80 per cent polynuclears. Under expectant treatment, the patient improved steadily. On the third day he was seen in consultation by the author and operation was advised, on a diagnosis of partial intestinal obstruction. A barium enema on the tenth day revealed a constriction in the sigmoid colon. The patient left the hospital the following day and returned for operation three weeks later. Operation: A low median incision was made under ether anesthesia. Several loops of adherent ileum and sigmoid formed a cone-shaped, inflammatory mass buried in a very narrow cul-de-sac. The entire mass was separated from the bladder and the cul-de-sac packed temporarily. About 15 cm. of ileum and mesentery with a growth at its center were resected. End-to-end anastomosis was done. On account of the adhesions in the pelvis, a side-to-side anastomosis of ileum to transverse colon proximal to the site of the resection was carried out to obviate postoperative obstruction. The packing was removed, 600 c.c. of 8 per cent glucose solution was left in the peritoneal cavity, and the abdomen was closed with a cigarette drain at the lower angle of the incision. During the anastomosis the patient stopped breathing and artificial respiration was necessary for five minutes.

ACUTE FRONTAL SINUSITIS, ORBITAL CELLULITIS, OSTEOMYELITIS AND ABSCESS OF THE BRAIN, WITH RECOVERY

Abscess of the brain occurs most frequently in the temporosphenoidal lobe, secondary to otitic infection. The frontal lobe is the next most common location, and the nidus is usually in the frontal sinus. Less than 180 cases of abscesses of the frontal lobe have been reported. The mortality rate has been about 75 per cent. In 1900, Denker1reported the first recovery from operation on an abscess of the frontal lobe. Recently, Skillern and Coates2reported a case in which recovery was complicated by osteomyelitis of the frontal bone. Marked improvement in the surgical intervention for this condition has been made during the past few years, but the diagnosis offers much resistance to progress. Obviously, this is due to the so-called silent area that is involved. Foster Kennedy3said that in the absence of etiologic factors pointing to a source from which the formation of an abscess

RECOGNITION OF SOME OF THE LESS COMMON DISEASES

By means of constant effort and the correlation of experimental and clinical observations, neurologists have given us an amazingly precise topography of the brain. In recent years, with the aid of x-rays, the gastro-intestinal tract is the subject of a similar survey. Today only the small intestine can truly be called the silent area of the alimentary tract. In presenting the following cases, I am making an attempt to encroach on this uncharted sea. The duodenal-jejunal junction has been relatively little studied. In a vast majority of cases it is hidden by the barium-laden stomach, and its anatomic position renders it relatively inaccessible to examination. Chomel, 1 in 1710, first described diverticulum of the duodenal-jejunal junction anatomically. In 1778 Morgagni 1 and in 1815 Fleischmann 1 added additional references to the anatomic data. In 1896 Hauseman 2 reported the observation at autopsy of a single diverticulum of the upper jejunum

TUMORS OF THE BRAIN WITH ACUTE ONSET AND RAPIDLY PROGRESSIVE COURSE

The symptoms of intracranial tumor may appear suddenly and may advance rapidly, due either to bleeding into a growth, to the precipitate occurrence of obstructive hydrocephalus, swelling or edema, or to interference with the blood supply of a part of the brain. The onset of symptoms may be sudden as the result of hemorrhage into a tumor in a relatively silent area of the brain. Acute dilatation of the ventricular system is not rare when a growth, especially one in the posterior cranial fossa, begins to cause pressure on some part of the ventricular channels. Swelling of the brain may come on quickly in infiltrating tumors. Growths, especially those situated in or near a temporal lobe, not infrequently interfere with the circulation of blood in a middle cerebral artery or one of its main branches, the result of which is a large area of encephalomalacia with the sudden appearance of

CEREBELLAR PHENOMENA IN LESIONS OF THE TEMPORAL LOBE

The temporal lobe is generally designated as a silent area owing to the fact that, aside from the superior temporal convolution which, as indicated by the experimental studies of Ferrier 1 and Munk, 2 is the center for the perception of auditory stimuli, this part of the brain is not known to represent a specific function. Extirpation of this part in animals (the dog and the ape) is found to produce, not a loss of motor or sensory functions, but only a state of mental torpor, the animal losing its initiative and becoming tardy in reactions to environmental stimuli. In other words, the animal apparently does not lose an individualized function, but only fails to perform properly the functions presided over by other parts of the brain. Clinicopathologic studies in man have likewise localized a specific function in the superior convolution of the lobe only. This convolution, in addition to

VENTRICULOSCOPY AND INTRAVENTRICULAR PHOTOGRAPHY IN INTERNAL HYDROCEPHALUS

In an attempt to find a means of relief in cases of hydrocephalus in children, some interesting observations have been recorded relative to the appearance of the functioning ventricle in the living subject. With the object of establishing an outlet through the corpus callosum for the relief of the acute internal hydrocephalus presented in the case reported below, an approach through the dilated ventricle with an operating cystoscope was suggested. An opening through the thinned cortex in a silent area of the brain was planned, as being a far safer procedure than the more formidable midline approach between the hemispheres. 1 REPORT OF CASE A baby boy, aged 10 months, Italian, was brought to the neurosurgical clinic, Nov. 5, 1922, by his mother, who requested that something be done to check the progressive growth of the baby's head. The child's birth had been difficult, labor having continued for three days

THE SYMPTOMATOLOGY OF TEMPOROSPHENOIDAL TUMORS

INTRODUCTION In a paper on the Localization of Intracranial Tumors, Byrom Bramwell 1 has stated that in two cases reported by him in which the tumor involved the temporosphenoidal lobe, there were, practically speaking, no localizing symptoms: I have been in the habit of regarding the temporosphenoidal lobe as, par excellence, the silent area of the brain. In the relative order with which they can be most easily and certainly diagnosed . . . I would place tumors in the following situations: (1 and 2) pons Varolii and medulla oblongata; (3) centrum ovale (cases in which the optic radiations of Gratiolet are directly implicated) ; (4) tumors of the occipital lobe, involving the half-vision center or the optic radiations; (5) tumors of the motor area, in which the tumor produces irritation and gives rise to localized epileptiform convulsions; (6) tumors of the cerebellum; (7) tumors of the frontal lobe; (8) tumors of