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Biomedical subjects

J D Mann

Publications and source records attributed to J D Mann.

At least 19 recordsLinked to original sources
PubMed1992

Octanoic acid produces accumulation of monoamine acidic metabolites in the brain: interaction with organic anion transport at the choroid plexus.

Effects of octanoic acid on monoamines and their acidic metabolites in the rat brain were analyzed by HPLC. Octanoic acid (1,000 mg/kg i.p.) elevated homovanillic acid levels by 54% in the caudate and 338% in the hypothalamus but increased 5-hydroxyindoleacetic acid (5-HIAA) levels in both the caudate and the hypothalamus by approximately 50% compared with the control. A lower dose of octanoic acid (500 mg/kg) increased 5-HIAA levels by 29% in the caudate and 20% in the hypothalamus. However, it did not produce any changes in the concentration of homovanillic acid in either the caudate or the hypothalamus. Treatment with octanoic acid also failed to change the level of dopamine, serotonin, and 3,4-dihydroxyphenylacetic acid in the caudate and the hypothalamus. The role of carrier-mediated transport in the clearance of 5-HIAA from the rabbit CSF was also evaluated in vivo by ventriculocisternal perfusion. Steady-state clearance of 5-HIAA from CSF exceeded that of inulin and was reduced in the presence of octanoic acid. Because this transport system in the choroid plexus is normally responsible for the excretion of the serotonin metabolite from the brain to the plasma, accumulation of endogenously produced organic acids in the brain, secondary to reduced clearance by the choroid plexus, could be a contributing factor in the development of encephalopathy in children with medium-chain acyl-CoA dehydrogenase deficiency who have elevated levels of octanoic acid systematically.

Acids↗
PubMed1991

Relationship between perceived self-control of pain, pain description and functioning.

Recent research has shown an association between preferred coping style and pain report. The present study explores in a sample of 51 patients with chronic pain of myofascial origin the relationship between a dispositional measure of coping, the internality dimension of the Pain Locus of Control Scale (PLOC), and ratings of pain intensity, frequency, and pain-related behavioral functioning. Patients above the median on the internality dimension of the PLOC reported their pain as less intense and frequent than those below the median. No differences were noted on the behavioral functioning measures. Results are consistent with previous studies and indicate an association between ability to control pain and variations in magnitude and periodicity of pain. The clinical implication of the data is that strategies which provide reduction in pain intensity and frequency might be expected to result in increased perception of personal control of pain.

Adaptation, Psychological↗
PubMed1991

Relationship of pain drawing scores to ratings of pain description and function.

We examined the relationship between pain distribution and measures of self-reported behavioral functioning, pain intensity, frequency, and quality in 51 patients with chronic pain. Results indicate that patients with more distributed pain report their pain as more disruptive to important areas of functioning and also report their pain as more intense and frequent. These results corroborate previous findings and suggest that pain distribution may be used as a useful clinical marker of disability status in chronic pain patients.

Adult↗
PubMed1985

A nonlinear least-squares method for determining cerebrospinal fluid formation and absorption kinetics in pseudotumor cerebri.

Data from 14 patients with benign intracranial hypertension (pseudotumor cerebri) have been analyzed using a nonlinear least-squares regression model which was developed and programmed from in-hospital microcomputer use. The method of analysis permits rapid estimation of cerebrospinal fluid (CSF) formation and absorption rates as functions of pressure in individual patients using data from constant-rate infusion manometrics. The analysis predicts that prednisone therapy in pseudotumor cerebri reduces resting CSF pressure by increasing CSF absorption at all intracranial pressures studied, and decreasing CSF formation at high pressures. This result is in accordance with evidence suggesting that impaired CSF absorption plays a major role in the pathogenesis of increased intracranial pressure in pseudotumor cerebri.

Absorption↗
PubMed1979

Diazepam and dialysis encephalopathy.

A patient with the clinical and electroencephalographic features of dialysis encephalopathy exhibited dramatic improvement with the initiation of diazepam therapy. Although improvement was sustained for a period of several weeks, her clinical condition eventually deteriorated despite continued treatment with diazepam and dialysis. Dialysis encephalopathy in this patient is compared with other cases recently reported in the medical literature as having a similar dramatic response to diazepam. It is concluded that diazepam transiently reverses a component of the dialysis encephalopathy syndrome, but it does not appear to change the ultimate prognosis for patients with this condition.

Brain Diseases↗
PubMed1979

Clearance of macromolecular and particulate substances from the cerebrospinal fluid system of the rat.

Arachnoid villi in the intracranial dural sinuses constitute the principal sites for absorption of proteins and particulates from the cerebrospinal fluid (CSF) system. Although arachnoid villi in the rat are morphologically less complex than those found in other mammals, their resistance to CSF outflow, as assessed by a graded series of contstant flow manometric infusions, is similar to that found in other species. Moreover, inulin and polystyrene beads, when infused into the spinal subarachnoid space of rats, are rapidly cleared from the CSF system into intracranial dural sinuses. Inulin appeared in sinus blood 3 minutes after onset of infusion and reached concentrations 26 times greater than those found in the systemic circulation; particulate matter in the form of 0.5 micrometer polystyrene beads showed similar efflux characteristics. Hence, the CSF system of the rat is functionally similar to that found in other mammalian species, with arachnoid villi constituting a major efflux route for clearance of macromolecular and particulate substances.

Absorption↗
PubMed1978

Aspirin prophylaxis in migraine.

A prospective double-blind trial of aspirin prophylaxis demonstrated a reduction of more than 50% in headache frequency in 9 of 12 migraine patients. Response to aspirin did not correlate with age, duration of headache history, family history, or platelet ultrastructure. There is some evidence that response to aspirin is associated with raised platelet aggregation. This pilot study indicates that aspirin is effective in migraine prophylaxis.

Adolescent↗
PubMed1978

Regulation of intracranial pressure in rat, dog, and man.

Intracranial resistance and compliance were assessed in the cerebrospinal fluid system of rat, dog, and man by means of low-volume, short-duration infusions of artificial CSF into the subarachnoid space. A family of pressure/time response curves was obtained for each species: at low flow rates, steady-state pressure elevations were associated with normal neurological function; at high flow rates, rapid linear pressure elevations were associated with marked neurological dysfunction. From these curves a mathematical model was developed which describes transport and pressure-dependent valvelike characteristics of the CSF outflow resistance. This resistance shows a progressive phylogenetic change in rat, dog, and man which increasingly enhances the species' abilities to vent fluid from the intracranial cavity into the venous circulation. Arachnoid villi appear to be the major structures modulating sustained, nonlethal elevations of intracranial pressure.

Animals↗
PubMed1978

Intracranial pressure regulation: a comparative model of cerebrospinal fluid systems.

A comparative model of the cerebrospinal fluid (CSF) system in rat, dog and man was derived from manometric data using low volume, short duration infusions into the subarchanoid space in order to describe the mechanisms governing intracranial pressure dynamics. The mathematical model indicates that steady-state elevations of intracranial pressure are regulated primarily by a nonlinear, pressure dependent outflow resistance to CSF reabsorption. While the form of the resistance relationship is similar for the three species tested, differences in the magnitude of CSF outflow parameters are apparent. Model stimulation on a digital computer suggests that parameter changes within the resistance relationship can have a profound effect on the intracranial pressure. In contrast, intracranial compliance acts only to buffer transient changes in volume prior to the establishment of steady-state CSF pressures.

Animals↗
PubMed1976

Long-term prednisone followed by thymectomy in myasthenia gravis.

The present series of thirty patients has led us to certain conclusions concerning the management and treatment of patients with myasthenia gravis. The use of cholinesterase inhibitors alone is reserved for those patients with purely ocular myasthenia whose deficits can be satisfactorily corrected with those agents. Some of those with ocular involvement may be disabled; and in light of our excellent results with that small group, as well as similar findings presented by Fischer et al., patients with disabling or refractory ocular myasthenia should be considered for treatment with prednisone. All other patients with myasthenia are given a course of oral corticosteroids (prednisone) initially at high doses, with subsequent tapering to maintenance, alternate-day low-dose therapy. Cholinesterase inhibitors are used as needed while the patient is receiving corticosteroids. We now anticipate that patients will exhibit sustained improvement within the first two weeks, reaching maximal improvement at about three months. Exacerbations of myasthenic weakness may occur in the early phases of treatment. Such exacerbations have been commonly mild and occur with a mean onset at 5 days, and have a mean duration of 6 days. Most patients have been able to tolerate an alternate-day schedule of prednisone therapy when maintenance levels were achieved. The effective maintenance dose has been determined as the smallest dose of prednisone which allows the patient to maintain maximal improvement. Following the establishment of maximal improvement, patients have been considered for thymectomy. In our experience, the sternum-splitting procedure has been tolerated extremely well by patients exhibiting marked imporvement or remission while on corticosteroids. In those patients where thymectomy is contraindicated, irradiation of the thymus might be considered. Patients are continued on maintenance steroid therapy following surgery for a period of time that has been arbitrary. Currently, we consider an attempt to discontinue steroids at approximately one year reasonable. Should the patient relapse after discontinuation of the medication, oral corticosteroid treatment is reinitiated. Consideration is given to the possibility of recurrent thymus in patients who repeatedly fail to maintain a remission when steroids have been stopped. Our experience has not permitted us to draw firm conclusions concerning how long a time high-dose daily steroid treatment should be continued in patients who show no favorable response to that therapy. Other modes of treatment, such as courses of parenteral ACTH, methyl prednisolone, dexamethazone, or antimetabolites might be considered if there is no response after 12 weeks of high-dose, daily corticosteroid therapy.

Adolescent↗
PubMed1976

Long-term administration of corticosteroids in myasthenia gravis.

Favorable results were obtained in 30 patients with myasthenia gravis treated initially with high daily doses of prednisone and subsequently maintained on lower doses for a protracted period. In 45 incidents of treatment, complete remission occurred in 69 percent, marked improvement in 20 percent, and moderate improvement in 17 percent. Nineteen patients proceeded to thymectomy, with negligible morbidity and sustained improvement. In four patients, it was possible to discontinue prednisone 1 year or more after thymectomy.

Adolescent↗