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Biomedical subjects

D A Jacobs

Publications and source records attributed to D A Jacobs.

7 recordsLinked to original sources

Neuro-ophthalmology for neuroradiologists.

Combining an understanding of neuro-ophthalmologic anatomy with proper imaging techniques provides a powerful method to detect lesions involving the afferent and efferent visual pathways. Precise documentation of the extent of injury within the nervous system is becoming increasingly important to assess and monitor the effect of neurologic therapies. This review will focus on those common neuro-ophthalmologic problems that have exquisite localizing value on neuro-imaging.

Brain↗

Contrast letter acuity as a visual component for the Multiple Sclerosis Functional Composite.

BACKGROUND: Visual dysfunction is one of the most common causes of disability in multiple sclerosis (MS). The Multiple Sclerosis Functional Composite (MSFC), a new clinical trial outcome measure, does not currently include a test of visual function. OBJECTIVE: To examine contrast letter acuity as a candidate visual function test for the MSFC. METHODS: Binocular contrast letter acuity testing (Sloan charts) was performed in a subgroup of participants from the International Multiple Sclerosis Secondary Progressive Avonex Controlled Trial (IMPACT Substudy) and in MS patients and disease-free control subjects from a cross-sectional study of visual outcome measures (Multiple Sclerosis Vision Prospective cohort [MVP cohort]). High-contrast visual acuity was measured in both studies; MVP cohort participants underwent additional binocular testing for contrast sensitivity (Pelli-Robson chart), color vision (D-15 desaturated test), and visual field (Esterman test, Humphrey Field Analyzer II). RESULTS: Contrast letter acuity (Sloan charts, p < 0.0001, receiver operating characteristic curve analysis) and contrast sensitivity (Pelli-Robson chart, p = 0.003) best distinguished MS patients from disease-free control subjects in the MVP cohort. Correlations of Sloan chart scores with MSFC and Expanded Disability Statue Scale (EDSS) scores in both studies were significant and moderate in magnitude, demonstrating that Sloan chart scores reflect visual and neurologic dysfunction not entirely captured by the EDSS or MSFC. CONCLUSIONS: Among clinical measures, contrast letter acuity (Sloan charts) and contrast sensitivity (Pelli-Robson chart) demonstrate the greatest capacity to identify binocular visual dysfunction in MS. Sloan chart testing also captures unique aspects of neurologic dysfunction not captured by current EDSS or MSFC components, making it a strong candidate visual function test for the MSFC.

Adult↗

The Heidenhain variant of Creutzfeldt-Jakob disease: clinical, pathologic, and neuroimaging findings.

We report two patients who developed isolated visual symptoms and signs as initial manifestations of Creutzfeldt-Jakob disease (CJD). Both patients had normal conventional T1- and T2-weighted brain magnetic resonance (MR) images; in one patient, early cortical abnormalities were detected by diffusion-weighted and fluid attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI). Results from the cerebrospinal fluid assay for the 14-3-3 brain protein were also negative in one patient, despite pathologic confirmation of CJD at autopsy. The Heidenhain variant of CJD should be considered in all patients who present with isolated visual manifestations, including homonymous hemianopsia and normal conventional brain MRI. Diffusion-weighted and FLAIR MRI may demonstrate early cortical abnormalities in patients with CJD. The CSF assay for the 14-3-3 protein may be normal, even in pathologically confirmed cases.

14-3-3 Proteins↗

Unusual findings in the inguinal canal: a report of four cases.

Masses in the inguinal canal other than hernias are rare occurrences, and their preoperative diagnosis requires a high index of suspicion. A soft, partly reducible groin mass in a 3-month-old boy proved to be a cystic lymphangioma within the inguinal canal. A 15-month-old female who presented with an irreducible inguinal mass was found to have a neuroblastoma metastasis in the groin. An irreducible groin mass in a 6-year-old female proved to be an inguinal canal epidermal inclusion cyst. A 14-year-old female presented with a painful groin swelling that represented an incarcerated hemorrhagic ovarian cyst. An awareness of the wide spectrum of entities other than the standard bowel, testicle, and ovary in the inguinal canal can help to identify uncommon pathologies preoperatively.

Adolescent↗

Fast count-dependent digital filtering of nuclear medicine images: concise communication.

The formulation of an "optimal" filter for improving the quality of digitally recorded nuclear medicine images is reported in this paper. The method forms a Metz filter for each image based upon the total number of counts in the image, which in turn determines the average noise level. The parameters of the filter were optimized for a set of simulated images using the minimization of the mean-square error as the criterion. The speed of the image formation results from the use of an array processor. In a study of localization receiver operating characteristics (LROC) using the Alderson liver phantom, a significant improvement in tumor localization was found in images filtered with this technique, compared with the original digital images and those filtered by the nine-point binomial smoothing algorithm. The technique has been found useful for the filtering of static and dynamic studies as well as the two-dimensional pre-reconstruction filtering of images from single photon emission computerized tomography.

Computers↗

The acute and chronic effects of alcohol on the human immune system.

The immunologic status of 24 male patients admitted for acute alcoholic detoxification was evaluated by in vivo and in vitro parameters. In vivo reactivity, as measured by skin testing with a denovo antigen, dinitrochlorobenzene, as well as a recall antigen, tuberculin, was inact. However, both qualitative and quantitative defects were seen in vitro in the thymus-derived lymphocyte population. These defects were not seen in recovered alcoholics, that is, they appear reversible. The defects seen in the cell-mediated immunity of alcoholics may, in part, be responsible for the high incidence of head and neck cancer observed in this patient population.

Adult↗