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Biomedical subjects

D M Dawson

Publications and source records attributed to D M Dawson.

At least 55 records · Page 3Linked to original sources

Primary cerebral venous thrombosis in patients with cancer--a rarely diagnosed paraneoplastic syndrome. Report of three cases and review of the literature.

Idiopathic thrombosis of the cerebral venous structures is a rare complication of malignancy. The clinical, radiologic, pathologic, and laboratory findings in the 15 previously reported cases are reviewed, and three additional cases are reported. The clinical syndrome that develops in such patients is similar to that seen in other patients with cerebral venous or sinus thrombosis. However, the diagnosis is often not made clinically because cerebral involvement by neoplastic disease provides a more common and readily acceptable explantation of the observed phenomena. If venous thrombosis involving the brain is suspected, angiography provides the only certain method of diagnosis. The relationship of this thrombotic process to a cancer-associated hypercoagulable state is discussed.

Adenocarcinoma↗

Mechanisms of calcification in Peyronie's disease.

Scanning and transmission electron micrographs demonstrate a calcification process in the penile plaques of patients with Peyronie's disease. Osteoid formation originates from vascular lumina via osteoblast-like cells, which align the calcified plaque. These cells are surrounded gradually by calcified connective tissue. Collagen fibers demonstrate calcification and decreased periodicity.

Calcinosis↗

Cell culture of Peyronie's disease plaque and normal penile tissue.

Cell cultures derived from Peyronie's disease plaque and normal penile tissue were characterized morphologically and examined by immunofluorescence for actin cable formation, and their growth properties were compared. Relative to normal penile cell cultures which grew as contact inhibited, poorly refractile fibroblast-like cells, plaque derived cell cultures consisted of round and spindle shaped cells that were more refractile and exhibited random crisscross growth patterns. Scanning electron microscopy of plaque derived cell cultures revealed changes in cell surface topography characterized by the appearance of surface membrane blebs amd microvilli. Transmission electron microscopy demonstrated cells containing organized cytoplasmic microfilament bundles and nuclear indentations which resembled myofibroblasts. Such alterations were less extensive or absent in normal penile cell cultures. The amount and extent of actin cable formation was increased in plaque derived compared to normal penile cell cultures. Plaque derived cells also exhibited differences in growth properties and grew to higher saturation densities than their normal counterparts. These results demonstrate that cells derived from Peyronie's disease plaque can be grown in vitro and that these cells are morphologically altered and have an enhanced proliferative capacity. The availability of these cell cultures will permit studies directed at understanding the etiology and pathogenesis of Peyronie's disease.

Actins↗

Electro-oculographic findings in Machado-Joseph disease.

Electro-oculographic recordings (EOG) were made on 26 patients with Machado-Joseph disease or at genetic risk for that disease. All patients with clinically apparent disease (ataxia, dysarthria, spasticity, or ophthalmoparesis) had abnormal eye movements. Defects in caloric response, sinusoidal tracking, opticokinetic nystagmus (OKN), refixation saccades, and presence of gaze paretic nystagmus were detected in that order of frequency. Fourteen subjects were clinically at risk but had normal neurologic examinations or minor equivocal signs. Nine of the fourteen had abnormal EOG, with sinusoidal tracking, calories, refixation saccades, OKN, and gaze paretic nystagmus being abnormal in that order. EOG may be useful in early case detection and may contribute to genetic counseling.

Adolescent↗

Peripheral source of MB band of creatine kinase in alcoholic rhabdomyolysis. Nonspecificity of MB isoenzyme for myocardial injury in undiluted serum samples.

The MG isoenzyme of creatine kinase (CK MB) was strongly positive in the serum of a patient with alcoholic rhabdomyolysis, and it remained detectable by a standard qualitative assay over a two-year period without clinical or laboratory evidence of myocardial disease. MB isoenzyme was also demonstrated in a homogenate of skeletal muscle. Isoenzyme determinations in serum and tissue were repeated after dilution of toal CK activity to the range optimal for the assay (300 IU/L). Such dilution before isoenzyme separation rendered these samples negative for CK MB. The MB isoenzyme may be detectable in serum from peripheral sources in the presence of high total CK concentrations.

Adult↗

CNS involvement in the non-Hodgkin's lymphomas.

Instances of central nervous system (CNS) lymphomatous involvement occurring amongst 592 cases of non-Hodgkin's lymphoma (NHL) seen between 1967 and 1977 were reviewed. Lymphomatous complications of the CNS were found in 52 patients (9%): 24 with meningeal lymphoma, 20 with epidural compression and 8 with intracerebral lymphoma. Intracerebral lymphoma presented clinically as large parenchymal deposits of tumor unrelated to leptomeningeal disease. Ninety-eight percent (50/52) of all patients had a diffuse histologic subtype and 82% (42/52) had either histiocytic or diffuse, poorly differentiated lymphocytic lymphoma. Bone marrow involvement was an additional determinant of risk and aided in the selection of patients for possible CNS prophylaxis. Either meningeal or intracerebral lymphoma developed in 35% (6/17) of patients with diffuse histiocytic lymphoma and positive bone marrow biopsies. This subgroup was particularly felt to warrant CNS prophylaxis. Further diagnostic and therapeutic management regarding CNS involvement in NHL is discussed.

Brain Neoplasms↗

Plasmapheresis in multiple sclerosis: preliminary study.

In six of eight patients with chronic progressive multiple sclerosis (MS) who were previously unresponsive to corticosteroid medication, moderate but unequivocal improvement occurred after short-term plasmapheresis, prednisone, and azathioprine therapy. In four patients, improvement gradually disappeared in the 2 to 3 months after therapy, and two patients have remained improved. There were no exacerbations during the treatment period. No consistent improvement in evoked response batteries was seen after plasmapheresis; IgG levels in cerebrospinal fluid were lowered by plasmapheresis. A controlled trial to determine the efficacy of plasmapheresis in the treatment of MS is warranted.

Adult↗

The cervical myelopathy associated with rheumatoid arthritis: analysis of patients, with 2 postmortem cases.

The clinical findings in a group of 32 rheumatoid patients with symptomatic myelopathy are described. The myelopathy appeared in late middle age after many years of rheumatoid disease (average duration, 18 years). The most common radiological abnormality was anterior subluxation of C1. Other patterns occurred in about half the cases. The most common neurological findings were those of a mild to moderate spastic paraplegia, often with atrophy of muscles of the hands and sensory changes in the hands. Symptoms originating above the foramen magnum (nystagmus, diplopia, slurred speech) appeared to have a vascular cause and were sometimes associated with upward as well as posterior movement of the odontoid process. Root pain into the arms was not present, and its absence helped to distinguish these disorders from cervical spondylosis. Root pain into the territory of the C2 root was common. Medical or conservative therapy was not effective, and the preferred approach was use of a halo traction device followed by posterior fusion, with or without laminectomy. Pathologically, in 2 autopsy cases, the maximal change had occurred in the central gray matter and adjacent posterior and lateral columns. We postulate that direct pressure caused intermittent compression and narrowing of distal transverse branches of the anterior spinal artery.

Arthritis, Rheumatoid↗

Paraparesis following intrathecal cytosine arabinoside: a case report with neuropathologic findings.

A 65-year-old white male with acute myelogenous leukemia received whole brain irradiation (2550 rads) and intrathecal cytosine arabinoside for CNS prophylaxis. Bone marrow remission had been previously achieved with systemic chemotherapy (vincristine, Adriamycin, prednisone, and cytosine arabinoside). Two weeks following the last intrathecal cytosine arabinoside treatment, the patient developed a spastic paraparesis requiring the use of a walker. A gas myelogram was normal and CSF examination revealed a protein of 50 mg/100 ml but was otherwise unremarkable. Five months later, the patient had improved in that he could stand on his own. A relapse of his leukemia subsequently occurred and the patient died the following month. Striking degenerative changes were found in the spinal cord at postmortem examination. These included microvacuolization, axonal swellings, and loss of myelin with scattered macrophages laden with fat.

Aged↗

Neurologic complications of cardiac catheterization.

A retrospective survey was made of neurologic complications of cardiac catheterization. Of 10 patients, only one had a diffuse disorder, with seizures of a type associated with reaction to contrast agents. Disorders in the other nine patients appeared to be embolic in nature. Five of these nine involved deficits indicating damage in the vertebrobasilar territories, suggesting local trauma to vessels as a source of the embolic material.

Adolescent↗