Neurology June 1999 [antikvár]

Changes • People • Comments Dr Alfréd W. Gordon CHANGES The National Institute of Neurological Disorders and Stroke (NINDS) has established a new Office of Special Programs in Neuroscience. Alfréd W. Gordon, PhD, an 11-year veterán of NINDS, has been appointed to head this new office. It was created to assist institutions with largely minority enrollments in fostering competitive basic and clinical neuroscience research programs and training opportunities thereby improving service to those regions of the country that rely on these health institutions. Dr. Gordon has been chair of the Equal Opportunity Committee at NINDS since 1996 and most recently served as Oflicer of the NINDS Special Initiatives and Developmental Programs. PEOPLE Juhn Wada has been, and continues to be, a leader in the field of epilepsy and clinical neurophysiology. His name is inextricably linked with the test for determining the cerebral hemisphere responsible for language dominance. Dr. Wada was in the Hokkaido University medical school in Japan during World War II. He and his classmates had no long-term plans, assuming their service in the military was imminent. The war ended leaving Wada with no job and an uncertain future. Wada was a medical student when EEG was first introduced. After medical school, he built an amplifier and obtained somé of the first EEGs in the country. This brought him into contact with patients with neurologic disease, many of whom had epilepsy and brain tumors. Dr. Wada approached the Professor of Surgery about operating on somé of these patients, but because there were neither neurosurgeons available nor interest on the part of the generál surgeons, the Professor suggested to Dr. Wada that he should do this. Dr. Wada had only 3 months of experience in surgery as an intern, but he asked his brother in Boston to send him Dandy's textbook on brain surgery. (Dr. Wada's brother, Juro, performed the first heart transplant in Japan in 1968.) After the book arrived, Wada. with the help of the surgica! residents, started operating. He performed over 300 Dr. Juhn Wada craniotomies. He felt uneasy about his lack of formai training, but there was no other treatment available for these patients. Wada observed that many patients receiving electroconvulsive therapy (ECT) became confused after a series of treatments, and noted that there was a particular poverty of speech. He suggested somé unilateral ECT to see if speech function could be lateralized and disruption minimized but it proved unsuccessful as seizures always became secondarily generalized. He continued to pursue this, especially after removing a right frontal lobé tumor in a patient that produced an unexpected aphasia. Somé time later, he saw a patient with a buliét wound in the head who had a right hemiparesis and focal onset status epilepticus. The military hospitál had somé amytal available. He injected somé into the left carotid artery and the seizures stopped but produced an aphasia when the patient awoke. He then performed a series of these procedures in patients prior to brain surgery. He reported this finding in an abstract in a Japanese journal. Dr. Wada said it attracted no attention. Wada asked for further training and went to Dr. Abe Baker's program at Minnesota for a year. There he alsó worked in neurophysiology with Dr. Ernst Gellhorn. Because of his interest in epilepsy, he then spent a year at the Montreal Neurological Institute with Dr. Francis MacNaughton, where he met Drs. Wilder Penfield, Ted Rasmussen, and Herbert Jasper. Wada then filled an opening at the University of British Columbia in Vancouver, continuing his work in neurology and establishing an epilepsy center and a laboratory for clinical neurophysiology. He never again operated after leaving his position in Japan. At Montreal, the residents presented weekly seminars. Dr. Wada resurrected his old paper on the series of patients injected with amytal. The significance of the procedure was immediately recognized. It was a great boon for preoperative evaluation of patients for epilepsy surgery. It was alsó a vindication for Dr. Wada's astute observation and persistence. COMMENTS Every author would like his or her work published immediately, and every editor would like to fulfill this dream. Journals pride themselves on a quick time from acceptance to publication. Indeed, there are "Expedited Publication" sections in many scientific journals, including Neurology. Certainly, the publication date is important for establishing priority. It is that priority that drives the researcher. Copyright © 1999 by the American Academy of Neurology 17A