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Biomedical subjects

N Gordon

Publications and source records attributed to N Gordon.

At least 73 records · Page 4Linked to original sources
PubMed1996

Speech, language, and the cerebellum.

The cerebellum can affect speech and language in a number of ways. The most obvious is dysarthria when motor movements are deprived of the regulatory control, which is one of the main functions of the cerebellum. Less well-known is cerebellar mutism, which most often occurs after the removal of a cerebellar tumour. It is unlikely that this is simply the result of dysarthria. The most controversial aspect of cerebellar function, and the main stress of this paper, is the contribution it may make to language production. A number of studies have suggested that the cerebellum can, indeed, be involved in both cognition and language. A number of these are reviewed, in particular, the results of diffuse and focal lesions of the cerebellum, and how these can affect the function of the cerebrum; and conversely how cerebral lesions can cause changes in the cerebellum. Positron emission tomography (PET) has been essential in the assessment of these patients. During human evolution parts of the cerebellum and their connections have enlarged enormously, and it would be surprising if these parts of the brain had not taken on new roles. To regard the cerebellum as only serving motor function is too narrow a concept.

Brain Diseases↗
PubMed1996

Monoclonal B-cell population mimicking lymphoma in a patient with multiple sclerosis.

BACKGROUND: Diagnosis of intraparenchymal brain lesions has usually required invasive diagnostic procedures, because too few cells are shed into cerebrospinal fluid to permit cytologic diagnosis. Polymerase chain reaction technology makes it possible to identify cell populations that are present at a much lower frequency than traditional techniques. CASE REPORT: A young woman presented with multiple brain lesions raised the question of primary central nervous system lymphoma. Polymerase chain reaction analysis of cerebrospinal fluid showed evidence of a monoclonal B-cell population heightening suspicion of lymphoma. Brain biopsy showed acute demyelination most consistent with multiple sclerosis. CONCLUSION: Although T-cell restriction has been demonstrated in multiple sclerosis lesions, the finding of a monoclonal B-cell population was unexpected and to our knowledge has not been previously reported. This case emphasizes that monoclonality is not always indicative of a neoplastic process, particularly in the central nervous system.

Adult↗
PubMed1996

Benign paroxysmal positional vertigo.

Benign paroxysmal positional vertigo should be considered when a patient complains of attacks of dizziness of brief duration, that seem to occur under particular circumstances related to the position of the head. The true nature of the disorder may be missed unless examination is carried out in a certain way: the head must be positioned below the rest of the body and turned to one or other side. Diagnosis then depends on the occurrence of vertigo and on noting the transient nystagmus. There are a number of causes of benign paroxysmal positional vertigo-head injury is a relatively frequent one. It has been suggested that this disorder is due to deposits on the cupula of the precipitating posterior semicircular canal. Indeed, exercises designed to dislodge such deposits can be successful. If not, and the vertigo lasts for more than a few months, surgery can be considered.

Humans↗
PubMed1995

The prevalence of side effects with regular and sustained-release nicotinic acid.

PURPOSE: To document the prevalence and nature of the side effects that occur with the use of regular and sustained-release nicotinic acid in everyday clinical practice. PATIENTS AND METHODS: One hundred and ten patients seen in a private medical clinic who were given 133 separate trials of nicotinic acid during a 5-year period. The occurrence of side effects, particularly those severe enough to warrant discontinuing the drug, were carefully monitored. RESULTS: Forty-three percent of individuals given regular nicotinic acid and 42% of those given sustained-release nicotinic acid were forced to discontinue the medication because of side effects; some of these side effects necessitating discontinuing nicotinic acid did not occur until the patient had been taking the drug for 1 or 2 years. CONCLUSION: Nicotinic acid in both regular and sustained-release forms is a powerful drug when used in doses needed to treat lipid disorders and causes disturbing side effects a very high percentage of the time. No one should use nicotinic acid in these doses without continued careful supervision of a physician.

Adult↗
PubMed1995

Rapid detection of hereditary and acquired platelet storage pool deficiency by flow cytometry.

Platelet aggregation is commonly used to investigate patients with possible dense granule storage pool deficiency (delta SPD), but recent studies have shown that this investigation is not specific or sensitive for this disorder. We describe a simple one-step technique to detect mepacrine loaded platelets by flow cytometry and found a good correlation (r = 0.83) between this method and the enumeration of platelet dense granules by conventional fluorescent microscopy. Seven patients with congenital delta SPD had significantly (P < 0.001) reduced mepacrine labelling detected by flow cytometry (mean 15%; range 5-23%) compared to normal controls (mean 48%; normal range 32-64%). Six patients with other hereditary platelet disorders had normal mepacrine labelling (mean 49%; range 34-66%) and were clearly distinguished from patients with delta SPD despite similar platelet aggregation patterns. Acquired delta SPD is frequently associated with the platelet function defect described in the myeloproliferative and myelodysplastic disorders (MPD/MDS) and we compared platelet aggregation and mepacrine labelling in 15 of these patients. The results confirm that delta SPD occurs commonly in MPD/MDS with 7/15 patients having reduced mepacrine staining but, like the findings in hereditary delta SPD, 3/7 patients with normal platelet aggregation had delta SPD. Similarly abnormal platelet aggregation was not diagnostic of delta SPD as 4/8 of these patients had normal mepacrine levels. These results may contribute to the known lack of correlation between the limited assessment of platelet function and bleeding events in MPD/MDS. We found mepacrine labelling of platelets detected by flow cytometry to be a useful, simple and inexpensive method to detect hereditary and acquired delta SPD which will improve the definition of the platelet defect in these disorders in the clinical laboratory.

Adult↗
PubMed1995

Halting hiccups.

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Hiccup↗
PubMed1995

Mutant K-ras oncogenes in colon cancers Do not predict Patient's chemotherapy response or survival

One half of human colon cancers bear mutant c-K-ras oncogenes. Mutant K-ras oncogenes are associated with shortened survival in non-small cell lung cancers, and, in cell line models, with resistance to cis-platinum and to ionizing radiation. This study examines whether mutant K-ras alleles in colon cancer alter patients' response to chemotherapy or survival. We studied 37 patients who received chemotherapy with 5-fluorouracil and leucovorin, Exon 1 of the c-K-ras gene was PCR amplified from DNA extracted from paraffin-embedded tumor blocks. The presence of mutant or wild-type c-K-ras alleles was determined by dideoxy sequencing of the PCR-amplified c-K-ras DNA. c-K-ras mutations at codons 12 or 13 were present in 19 and absent in 18 cases. Responses to chemotherapy were equally likely in patients with either wild-type or mutant c-K-ras, occurring in 28% of patients with wild-type ras and 32% of patients with mutant ras (P = 0.8). Survival was also indistinguishable among both groups. Median survival from diagnosis was 35 months for ras wild-type patients and 31 months for ras mutant patients (P = 0.96). Median survival from starting chemotherapy was 14 months for ras wild-type patients and 17 months for ras mutant patients (P = 0.26). Patients with colon cancers bearing either wild-type or mutant c-K-ras alleles are indistinguishable in overall survival and are equally likely to respond to 5-fluorouracil-based chemotherapy.

Journal Article↗
PubMed1994

Differences in postoperative pain severity among four ethnic groups.

Subjects (N = 543) reporting on acute postoperative dental pain were classified into four major ancestral groups: Asian (N = 96), black American (N = 65), European (N = 296), and Latino (N = 88). Pain severity was measured using a 10-cm visual analogue scale following a standardized operative procedure. The subjects of European descent reported significantly less severe pain than those of black American or Latino descent. They also reported less pain than Asians, although this finding did not reach significance. Evaluation of covariates, including gender, age, education, generation in the United States, and difficulty of the surgical extraction, demonstrated that gender was significant, with men reporting less pain than women regardless of ancestry. Possible implications of these findings are discussed in terms of potential differences in physiology, in addition to social learning.

Adolescent↗