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Biomedical subjects

L Jacobs

Publications and source records attributed to L Jacobs.

At least 127 records · Page 7Linked to original sources
PubMed1985

Intrathecal interferon in the treatment of multiple sclerosis. Patient follow-up.

Follow-up observations on patients with multiple sclerosis who were treated with human fibroblast interferon (interferon beta) administered intrathecally for six months revealed a persisting beneficial effect in terms of a reduction in exacerbation rates. At the time of our last report in 1982, ten interferon beta recipients had shown a reduction in their mean exacerbation rate from 1.8/yr before the study to 0.2/yr during the study while ten control patients with multiple sclerosis showed no change in their rates during the study (0.69/yr) compared with before it (0.68/yr). That report was based on observations made for means of 1.9 years in the recipients and 1.6 years in the controls. The recipient patients have now been followed up for 4.4 years (mean) and their exacerbation rates have continued to decrease to a current mean level of 0.16/yr. The control patients were "crossed over" and began receiving interferon beta intrathecally after they had been in the study for two years without showing any change in their rate. During the 2.0 years since crossover they also have shown a reduction in exacerbation rate to a mean of 0.30/yr. The toxic side effects of interferon beta administered intrathecally were acceptable in view of the benefit achieved. Interferon was identified in the cerebrospinal fluid (but not the serum) of two patients prior to treatment, which is probably a manifestation of de novo production of interferon by the central nervous system in response to the multiple sclerosis disease process.

Adolescent↗
PubMed1985

Subcortical arteriosclerotic encephalopathy (Binswanger's disease). Computed tomographic, nuclear magnetic resonance, and clinical correlations.

Twenty-three elderly patients were found to have a consistent pattern of leukoencephalopathy by computed tomography and nuclear magnetic resonance imaging. Eight patients presented with vague, nonspecific symptoms and had no neurologic deficits. The other 15 patients had neurologic deficits that presented in one of three ways: stroke, seven patients; slowly progressive dementia and gait disturbance, five patients; or slowly progressive dementia alone, three patients. Risk factors for arteriosclerosis (hypertension, diabetes) were present in 18 patients (78%). The necropsy of one patient revealed arteriosclerotic vasculopathy characteristic of subcortical arteriosclerotic encephalopathy (SAE) or Binswanger's disease. Subcortical arteriosclerotic encephalopathy may be a relatively common affliction of elderly patients, most of whom have risk factors for arteriosclerosis. The modes of presentation and associated clinical signs are variable, and more than one third may have no neurologic deficit. In some cases SAE overlaps with normal pressure hydrocephalus by clinical and neuroimaging criteria. Some patients with normal pressure hydrocephalus who do not respond to ventricular shunting may actually have SAE.

Aged↗
PubMed1985

Factor analysis of the aftereffects of drinking in alcoholics.

Research that deals with the causes of alcoholism has been hampered by the absence of factor analyses that deal specifically with ethanol's aftereffects. We factor analyzed 100 alcoholics' reports of the effects that they experience after alcohol consumption. Five factors emerged--Hangover, Euphoria, Flushing, Seizures, and Sleepiness. They are described and discussed. Future investigators may find them helpful in assessing theories on the etiology of alcoholism and in studies of ethanol's effects on subsets of alcohol abusers.

Adult↗
PubMed1985

Selective paralysis of downward gaze caused by bilateral lesions of the mesencephalic periaqueductal gray matter.

A patient who had selective paralysis of downward gaze caused by bilateral lesions of the dorsolateral mesencephalic periaqueductal gray (PAG) matter is reported. Her necropsy findings differed from all previous reports of the syndrome, in that regions of the mesencephalon that have been considered as critical for executing downward gaze (dorsomedial to red nuclei, rostral interstitial nuclei of the medial longitudinal fasciculus [ri MLF]) were normal. These lesions may have produced the syndrome by involving the caudal portions of the nuclei of the posterior commissure (subcommissural), from which one of the commissural systems used by the ri MLF originates. It is also possible that the syndrome was produced by selective destruction of PAG neurons that generate downward impulses or by interruption of posterior commissure fibers containing downward impulses that travel through the dorsolateral PAG before terminating in the more ventral mesencephalon.

Adult↗
PubMed1984

Megakaryoblastic transformation in myeloproliferative disorders.

Megakaryoblastic transformation, with cells showing characteristic morphology and ultrastructural cytochemistry, developed in two patients with agnogenic myeloid metaplasia or myelofibrosis, and in one with chronic granulocytic leukemia. From the onset of the leukemic phase, all three have followed a relatively benign clinical course, surviving for 48, 29, and 24 months, respectively; only hydroxyurea has been necessary to control thrombocytosis. This experience emphasizes that it is possible for a patient to have an improved quality of life with minimum chemotherapy. In contrast, megakaryoblastic leukemia or acute myelofibrosis, where splenomegaly and a leukoerythroblastic blood picture are typically absent, responds poorly to any form of chemotherapy, and survival is short.

Blood Cell Count↗
PubMed1984

Altitudinal hemianopia caused by occipital infarctions. Clinical and computerized tomographic correlations.

Two patients with altitudinal homonymous hemianopia caused by bilateral occipital infarctions were studied. Their clinical-computerized tomographic correlations showed the anatomic representation of the superior and inferior visual fields in the lower and upper banks of the calcarine fissure, respectively. The patient with the superior-field defect was unusual because he retained normal color vision and facial recognition abilities, despite having bilateral lesions that have classically produced central achromatopsia and prosopagnosia.

Aged↗
PubMed1984

Schizophrenic birth seasonality in relation to the incidence of infectious diseases and temperature extremes.

Previous research has indicated that schizophrenics are particularly likely to have been born during the winter months. In the present investigation, we studied the relationships of this birth-seasonality effect to year-to-year variations in the incidences of eight seasonal diseases and climatological temperature extremes in 3,246 schizophrenics. The winter birth-seasonality effect was greater in the years directly following those marked by high levels of infectious disorders than in years directly following those with low incidences of these diseases. Winter diseases (particularly diphtheria, pneumonia, and influenza) appeared to be more involved than others. These effects appeared among unmarried (presumably severe) schizophrenics but not among married patients, suggesting that the relationship is specific to process schizophrenia. The fact that most of the significant and near-significant relationships paired strength of birth seasonality to previous-year disease incidences suggested a prenatal rather than postnatal effect. Birth seasonality did not vary with winter or summer temperature extremes.

Adult↗
PubMed1984

The birth seasonality effect in nonschizophrenic psychiatric patients.

Several studies have suggested that patients with affective, neurotic, and personality disorders are particularly likely to have been born during the early months of the year. They suggest that seasonal factors may play a role in the etiologies of these disorders. However, Lewis and Griffin (1981) have suggested that the reported seasonal exaggerations in psychiatric patients' birthrates simply may reflect artifacts. We searched for seasonal trends in the birth patterns of neurotics (N = 989), alcoholics (N = 2,870), affective disorders (N = 320) and personality disorders (N = 713), both before and after controlling for these artifacts. No significant effect appeared.

Adult↗
PubMed1984

The relationship of beliefs about controlled drinking to recidivism in alcoholic men.

A total of 100 men were studied to determine the relationship between belief in the abstinence theory and outcome after treatment of alcoholism. Twenty-seven subjects reported believing that at least some alcoholics can tolerate a single drink without losing control or can learn to drink in moderation and the remaining 73 rejected both contentions. The mean alcohol-consumption ratings of the two groups over 10 evaluations covering the first 18 months after treatment did not differ. The Groups X Time interaction effect, which would have indicated a difference in the rates at which recidivism developed in the two groups, was also nonsignificant. Finally, the percentages of the two groups who were rated as abstinent, in complete control of their drinking or in control most of the time were compared at each of 10 follow-up points. Only a chance number of these differences were significant. The results suggest that there is little relationship between belief in or rejection of the abstinence theory and recidivism.

Adult↗
PubMed1984

Do alcoholics give valid self-reports?

Self-reports on drinking among alcoholics (100 men inpatients) were compared with descriptions of their consumption given by collaterals (one friend or relative each) at 10 points during an 18-month follow-up study. The correlations between the two were only moderate; barely one-half of the variance in the alcoholics' self-reports corresponded to the collaterals' assessments. Patients underestimated collaterals' descriptions about three times as often as they overestimated them, but their over- and underestimations appeared to be of roughly equal size. The relationships between alcoholics' and collaterals' reports tended to be curvilinear. Among subjects whom the collaterals had described as abstinent or controlled drinkers, patients' and collaterals' assessments were similar but patients' descriptions grossly underestimated collaterals' reports when uncontrolled consumption was reported by the latter. The results support a moratorium on the use of patients' self-reports in follow-up studies on alcohol consumption.

Adult↗
PubMed1983

Optimal phenotypic expression times for HPRT mutants induced in foreskin-, skin-, and lung-derived human diploid fibroblasts.

A series of paired lung- and skin-derived fibroblast cultures has been established from human embryonic tissues under carefully controlled, identical conditions, providing the unique opportunity to study differences between normal diploid fibroblast populations from skin and lung without the confusion of genetic differences between donors. To reliably assess differences in the induced mutation frequencies observed among different cell populations, optimal phenotypic expression times in the HPRT mutagenesis system were determined for neonatal foreskin, fetal skin, and fetal lung cultures. Cell populations were mutagenized with several doses of N-methyl-N'-nitro-N-nitrosoguanidine and were replated in 6-thioguanine selective medium at intervals over 14 days. Survivals following MNNG exposure ranged from 1.6% to 45.5%. For all doses and survivals tested a 7-day expression period was the optimal value for cultures from the three different tissue sources in six independent experiments. Mutant frequency data derived from untreated control populations confirmed that spontaneous mutations during the expression period contributed negligibly to the final mutant frequency. Differences between the mutation frequencies obtained using an in situ and a replating protocol were approximately twofold for lung-, skin-, and foreskin-derived cultures.

Cell Line↗
PubMed1983

External noninvasive cardiac pacing in out-of-hospital cardiac arrest.

External noninvasive cardiac pacing was applied outside the hospital to 19 patients who had experienced cardiopulmonary arrest and 1 patient with life-threatening bradycardia. Seven patients developed electrocardiographic evidence of pacemaker capture, although only 2 had palpable pulses. The patient with bradycardia was successfully paced. This study demonstrates the feasibility of cardiac pacing in out-of-hospital cardiac arrest but confirms the poor prognosis of asystolic cardiac arrest even with the application of pacing.

Adult↗