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Biomedical subjects

R R Jacobson

Publications and source records attributed to R R Jacobson.

At least 37 records · Page 2Linked to original sources
PubMed1990

Patterns of neuropsychological deficit in alcoholic Korsakoff's syndrome.

Twenty-five male and 13 female patients with alcoholic Korsakoff's syndrome (AKS) were compared with age- and sex-matched non-Korsakoff chronic alcoholics and healthy volunteers in a neuropsychological study, which included computer-administered tests of cognitive function. The performance of male Korsakoff patients was significantly inferior to that of healthy male controls, not only in tests of memory, but also in visuo-perceptual tasks with a speed or motor component, and on category sorting and verbal fluency measures. Compared with male alcoholics, the performance of male Korsakoff patients was again inferior on similar tests. Female Korsakoff patients showed more extensive deficits compared with female controls, but differed less from matched female alcoholics. The results suggest that, in addition to their amnesia, many Korsakoff patients have sustained widespread cognitive deficits, affecting particularly visuo-perceptual and abstracting functions, which are sensitive to cortical lesions. The range of deficits falls short of what may be regarded as 'global' in male, but probably not in female, Korsakoffs. The implications for a dual aetiology of AKS involving thiamine deficiency and other features associated with alcoholism, probably direct alcohol neurotoxicity, are discussed.

Adult↗
PubMed1989

Single lesion subpolar lepromatous leprosy and its possible mode of origin.

Three case reports of patients with a single, nodular, subpolar lepromatous skin lesion, one on the left elbow, another on the posterior aspect of the left leg, and the third on the extensor ulnar aspect of the right forearm, are presented. The lesions, clinically and histopathologically, resemble lepromas which develop at the site of experimental inoculation of Mycobacterium leprae in armadillos. These are sites on the body which are likely to be traumatized. With the distinct possibility of the presence of viable M. leprae in the soil of Louisiana and Texas from wild armadillos with the natural disease, it is suggested that these three patients acquired the infection from the environment and had inoculation lepromas.

Adult↗
PubMed1987

Memory and ventricular size in alcoholics.

The relationship between memory performance and CT scan measures of ventricular size was investigated in a sample of 39 chronic alcoholics and 39 controls. Measures of verbal, non-verbal, recognition and recall memory were derived from the tests administered and were viewed in relation to the lateral ventricle and third ventricular size measurements. The results showed that the memory performance of male alcoholics was significantly related to measures of third ventricular size, but probably not to measures of the lateral ventricles. An association between verbal memory performance and CT scan measures was found in the male controls.

Adult↗
PubMed1987

Selective memory loss and global intellectual deficits in alcoholic Korsakoff's syndrome.

The principle of distinguishing between selective memory deterioration and global intellectual decline has been applied to 38 patients with alcoholic Korsakoff's syndrome. Indices were developed for each type of deficit and their distributions explored. Considerable variation was seen in both parameters, the transition from pure memory loss to global intellectual deficits appearing to be gradual. Differences were found in the sex and CT scan associations of the indices. The implications of the distinction for future research are discussed.

Adult↗
PubMed1987

Brain damage in alcoholism: current concepts.

Current views concerning the brain damage occasioned by alcohol abuse are reviewed. Diffuse cerebral changes appear to be common and partially reversible with prolonged abstinence. The possible determinants of such changes, and their relevance to functional deficits are discussed, with illustrations from work currently proceeding at the Institute of Psychiatry. Possible interactions between cortical and subcortical pathologies in contributing to the cognitive deficits shown by alcoholic patients are emphasised.

Age Factors↗
PubMed1986

A fully-automated computer-assisted method of CT brain scan analysis for the measurement of cerebrospinal fluid spaces and brain absorption density.

Computer-assisted methods of CT brain scan analysis offer considerable advantages over visual inspection, particularly in research; and several semi-automated methods are currently available. A new computer-assisted program is presented which provides fully automated processing of CT brain scans, depending on "anatomical knowledge" of where cerebrospinal fluid (CSF)-containing spaces are likely to lie. After identifying these regions of interest quantitative estimates are then provided of CSF content in each slice in cisterns, ventricles, Sylvian fissure and interhemispheric fissure. Separate measures are also provided of mean brain density in each slice. These estimates can be summated to provide total ventricular and total brain volumes. The program shows a high correlation with measures derived from mechanical planimetry and visual grading procedures, also when tested against a phantom brain of known ventricular volume. The advantages and limitations of the present program are discussed.

Absorption↗
PubMed1985

Densitometric analysis of scans: important sources of artefact.

Computed tomography (CT) research in psychiatry often relies on the assessment of minor structural changes. Recently, it has come to encompass changes in regional brain X-ray absorption density. The artefacts prone to be encountered in density measurements are reviewed, and illustrated by a series of studies carried out using a CT 1010 scanner. They are shown to be more important than hitherto assumed in the interpretation of CT scan research.

Adolescent↗
PubMed1985

Child firesetters: a clinical investigation.

The demographic, symptomatic, psychosocial and diagnostic profile of 104 child firesetters was investigated in a controlled case note and item sheet study of all children referred to an Inner London clinic between 1973 and 1981. Firesetters form a subgroup of severe conduct disorders, and are distinguished by a younger peak age of 8, higher boy/girl ratio and more marked psychosocial disturbance. The paper focuses on the relationships between background factors and firesetting, and also examines the relevance of enuresis and situational antecedents as specific determinants.

Adolescent↗
PubMed1985

The subclassification of child firesetters.

The possibility that child firesetters are a heterogeneous group was investigated in a cross-sectional case note and item sheet study of all children referred to an Inner London clinic between 1973 and 1981. Firesetters were most usefully subdivided by age, and secondarily by reason for referral. There were no links between enuresis and dangerousness or cruelty to animals. Methodological issues and the implications of the findings are discussed, with particular reference both to the development of the disorder and to the subclassifications drawn for conduct disturbance.

Adolescent↗
PubMed1985

A single skin lesion--an unusual presentation of lepromatous leprosy.

Lepromatous leprosy presenting as a solitary lesion with a high bacterial count is a rare occurrence. Such a case has been followed at the National Hansen's Disease Center, Carville, Louisiana, U.S.A., since 1977. The lesion was located on the left elbow and had been present for about nine months. The bacterial index in the lesion was 5+ and the morphological index was 0%, but slit-skin smears elsewhere were negative. The histopathology of the lesion was that of subpolar lepromatous leprosy, and the lepromin skin test was negative. Growth of the organism in the mouse foot pad was characteristic of Mycobacterium leprae, and the patient's response to dapsone monotherapy has been excellent. Therefore, this patient with a single skin lesion has lepromatous leprosy histologically, immunologically, and bacteriologically. This case illustrates the importance of slit-skin scrapings and biopsy in new cases with unusual lesions and, secondly, suggests that there are factors yet undetermined which play a significant role in determining host response to M. leprae.

Biopsy↗
PubMed1984

Cancer mortality among patients with Hansen's disease.

For the evaluation of cancer risks associated with immunodeficiencies experienced by patients with Hansen's disease (leprosy) and for the assessment of possible adverse effects of dapsone therapy, a follow-up study was conducted of 1,678 patients admitted to the National Hansen's Disease Center in Carville, La., between 1939 and 1977. Overall, no substantial cancer mortality was observed (standardized mortality ratio = 1.3), nor was there any excess among patients exhibiting defects in cellular immunity by virtue of lepromatous forms of the disease. Notable was the absence of any significant excess of lymphoma (5 observed vs. 2.3 expected), despite the predominance of this tumor in certain other immunodeficiency states. Several cancer sites (oral, bladder, and kidney) occurred excessively, but reasons for the elevations were obscure. Although dapsone has been implicated as a carcinogen in laboratory animals, the use of sulfones, including dapsone, did not appear to affect significantly the risk of any cancers in this population.

Black or African American↗
PubMed1982

Aberrant immunoregulatory control of B lymphocyte function in lepromatous leprosy.

The capacity of peripheral blood mononuclear (PBM) cells from patients with leprosy to generate immunoglobulin-secreting cells in response to pokeweed mitogen (PWM) was evaluated by a reverse haemolytic plaque forming cell (PFC) assay. The PFC responses of PBM cells from patients with lepromatous (Lpr) leprosy were significantly higher (P less than 0.01) than those of PBM cells from normal controls and patients with tuberculoid leprosy. Co-culture of T lymphocytes from normal donors with PBM cells from Lpr patients reduced the PFC response of these cells to the normal range. T4+-helper lymphocytes from Lpr donors did not induce supranormal responses to PWM by normal PBM cells enriched for B lymphocytes. T8+-suppressor lymphocytes from normal donors greatly reduced the response of cultures containing normal allogeneic B cells plus T4+ cells. Conversely, when T8+ cells from Lpr donors were cocultured with normal B cells plus T4+ cells, they failed to suppress the response to PWM. In summary, these studies have demonstrated abnormally high PWM-stimulated PFC responses by B lymphocytes from patients with Lpr leprosy. This aberration, in turn, is associated with a loss of regulatory function by T8+-suppressor cells in Lpr patients.

Adult↗
PubMed1980

Decreased suppressor cell activity in disseminated granulomatous infections.

The effect of granulomatous infections upon the activity of a T lymphocyte subclass in human peripheral blood that can be induced by concanavalin A (Con A) to function in a suppressor mode was studied. Peripheral blood lymphocytes (PBL) from eleven patients with disseminated mycotic or mycobacterial infections or from controls were preincubated with and without Con A, washed and cultured with allogeneic PBL freshly drawn from healthy donors sensitive to histoplasmin. DNA synthesis was then measured in co-cultures stimulated by Con A, histoplasmin, or by the mixed lymphocyte culture (MLC) reaction alone. As compared with cells preincubated without Con A, the Con A-pretreated cells were significantly less effective in suppressing the responses of normal PBL to histoplasmin (P < 0.01), and in a one-way MLC reaction (P < 0.05). The Con A-induced suppressor activity of PBL from nine patients with localized granulomatous infections did not differ significantly from that exerted by PBL of normal controls in two of the three co-culture systems employed. These studies suggest that either dysfunction or a reduction of the Con A-inducible T-suppressor cell subpopulation in peripheral blood is frequent among patients was disseminated granulomatous infections.

Adolescent↗