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Biomedical subjects

Daniel L Menkes

Publications and source records attributed to Daniel L Menkes.

9 recordsLinked to original sources

Murine central and peripheral nervous system transcriptomes: comparative gene expression.

The central and peripheral nervous systems exhibit significant embryological, morphological, and functional differences. Moreover, the pathology of most acquired and hereditary neurological diseases preferentially targets specific components of the nervous system. In order to test the hypothesis that central and peripheral neural transcriptomes show fundamental quantitative differences, Affymetrix GeneChip expression arrays were used to compare murine lumbar spinal cord (SC) and dorsal root ganglion (DRG) gene expression. As the crucial component of a novel technique to preserve RNA integrity, mice were perfusion-fixed with RNAlater before the SC and DRG were harvested. As per Affymetrix terminology, a total of 111 transcripts were present (P) on all DRG arrays, absent (A) on all SC arrays, and demonstrated at least 10-fold greater expression in DRG than in SC. Conversely, a total of 112 transcripts were present on all SC arrays, absent on all DRG arrays, and showed at least 10-fold greater expression in SC than in DRG. For a subset of transcripts, quantitative real-time RT-PCR was used to corroborate and validate microarray results. Among those genes enriched in DRG, many belonged to a few distinct functional classes: G-protein coupled receptor-protein signaling pathways, potassium transport, sodium transport, sensory perception, and cell-surface receptor-linked signal transduction. In contrast, genes associated with synaptic transmission, organic acid transport, neurotransmitter transport, and circulation were enriched in SC. Notably, the majority of genes causally associated with hereditary neuropathies were highly enriched in DRG. These differential neural gene expression profiles provide a robust framework for future molecular and genetic studies of neuropathy and SC diseases.

Animals↗

Amusia after right frontal resection for epilepsy with singing seizures: case report and review of the literature.

Although many authors consider aprosodia and amusia to be synonymous, they actually represent two distinct communication disorders. Amusia refers to a profound deficit involving musical abilities, whereas aprosodia refers to deficits regarding the emotional content of speech. Many authors have presumed a similar etiology and localization for these conditions and assumed that these disorders would not occur independently. We report the case of a 31-year-old choir director who developed amusia without aprosodia after a right frontal lobe resection for intractable seizures. His ictal onset manifested with rhythmic slapping of his thighs while communicating with melodic speech. Video EEG monitoring documented right hemispheric discharges that occurred simultaneously with this ictal behavior. While a right frontal lobe resection made him seizure-free, his postoperative amusia was so profound that he could no longer continue his occupation as a choir director. This case suggests that the right frontal cortex has different sites for musical ability distinct from the centers regarding prosody. Patients scheduled to undergo right frontal lobectomy ought to be counseled regarding the potential loss of musical abilities.

Adult↗

Pregnancy-related increases in sensory perception thresholds are not correlated with serum progesterone levels.

BACKGROUND: Why pregnant women require smaller doses of anesthetic agents still remains speculative. One hypothesis proposes that pregnancy raises sensory perception thresholds, perhaps through a progesterone-mediated effect. This study was undertaken in order to quantify any changes in sensory perception thresholds after parturition and to correlate these changes with the expected decrease in postpartum serum progesterone levels. METHODS: Nineteen gravid women scheduled to undergo an elective Cesarean section consented to participate. Sensory current perception threshold (CPT) testing was performed before and 7 days after an elective Cesarean section. CPT was defined as the minimum amount of constant current stimulation that can be reproducibly detected at a particular frequency. CPT values were determined on the distal phalanx of the nondominant index finger at 2000 Hz, 250 Hz, and 5 Hz monofrequency stimulation. Seven women permitted serum progesterone level determinations at the prepartum and the postpartum CPT testing sessions. RESULTS: Parturition resulted in a statistically significant decrease in the sensory CPT at all 3 frequencies tested, (p < 0.05). However, there was no significant correlation between the postpartum reduction in serum progesterone levels and the observed postpartum decrease in CPT for any frequency, (r < 0.5). CONCLUSIONS: CPTs are significantly reduced after parturition. However, this reduction does not appear to be significantly correlated with the reduction in serum progesterone levels.

Journal Article↗

Undiagnosed patent foramen ovale presenting as a cryptogenic brain abscess: case report and review of the literature.

A 43-year-old man with no significant medical history but poor oral hygiene presented with fever and new-onset tonic-clonic seizures secondary to a left parieto-occipital brain abscess defined by computed tomography, magnetic resonance imaging, and surgical evacuation. A comprehensive workup looking for a source of infection was unremarkable including computed tomography of the chest, abdomen, and pelvis; blood cultures; and a tagged white blood cell scan. A transesophageal echocardiogram bubble study revealed the presence of a patent foramen ovale (PFO) but no other abnormalities. Culture of the material obtained at surgery revealed flora commonly found in the oropharynx that responded to antibiotic therapy. A review of the literature revealed three other cases in which a brain abscess from flora commonly found in the oropharynx was associated with a PFO. We hypothesize that the underlying mechanism is a significant bacterial load from poor dentition that enters the arterial circulation through a PFO and forms the nidus for a brain abscess. Surgical evacuation is the preferred method for diagnosis and initial treatment. If a brain abscess is identified without any adjacent source of infection, a recent head trauma, or a neurosurgical procedure, then a transesophageal echocardiogram is indicated to exclude a PFO. If a PFO is found, then hematogenous spread of flora normally found in the oropharynx through a right to left shunt should be suspected. Surgical evacuation followed by intravenous antibiotics specific to the identified organisms is warranted. Once the infection is eliminated, anatomic closure of the PFO with good oral hygiene practices may be the best course of action for preventing recurrences.

Adult↗