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Biomedical subjects

R Grant

Publications and source records attributed to R Grant.

At least 127 records · Page 7Linked to original sources
PubMed1987

Magnetic resonance imaging in the management of resistant focal epilepsy: pathological case report and experience of 12 cases.

Clinical improvement in epilepsy following temporal lobectomy is more often obtained when an abnormality is found on subsequent histological examination. Pre-operative MRI demonstrated an abnormal signal in the temporal lobe of a patient with pathologically proven mesial temporal sclerosis with microvascular anomaly. MRI may therefore be helpful in the selection of patients for temporal lobectomy. MRI findings of 12 patients with resistant focal epilepsy are reviewed. A wide range of T1 and T2 weighting is suggested to maximise selection of patients.

Adult↗
PubMed1987

MRI measurement of syrinx size before and after operation.

When patients with syringomyelia fail to improve after operation, factors such as incomplete cyst decompression or type of operation are often implicated. MRI has been used to confirm adequate syrinx decompression post-operatively and to compare the degree of collapse with the type of operation. Foramen magnum decompression was at least as effective in reducing cyst size as syringo-subarachnoid shunting. MRI may also provide a better classification of syringomyelia.

Foramen Magnum↗
PubMed1987

Nifedipine in the treatment of myotonia in myotonic dystrophy.

Abnormal calcium transport may be implicated in the membrane defect in myotonic dystrophy. A single blind crossover trial of placebo (t.i.d.), nifedipine 10 mg (t.i.d.) and nifedipine 20 mg (t.i.d.), was performed in 10 patients with myotonic dystrophy. The severity of myotonia was assessed by measuring finger extension time after maximum voluntary finger flexion. A significant improvement in myotonia, after nifedipine, was recorded by this technique and supported by a subjective improvement in 50% of patients and clinical improvement of greater than 20% in five patients. Initial grip strength and muscle fatiguability measured by grip strength ergometry were not significantly altered.

Clinical Trials as Topic↗
PubMed1987

Syringomyelia: cyst measurement by magnetic resonance imaging and comparison with symptoms, signs and disability.

The severity and distribution of symptoms and signs in patients with syringomyelia is considered to be dependent on the longitudinal and transverse dimensions of the syrinx and it is thought that clinical examination can identify the extent of the cyst. Magnetic resonance imaging has made the anatomical localisation of intramedullary spinal lesions more exact and probably more specific than previous methods of investigation. Syrinx length, diameters, cyst:cord and cord:canal ratios have been studied in 12 patients with syringomyelia to assess whether the dimensions of the syrinx relate to the clinical findings. The length of syrinx appeared to be related to cyst diameter, cyst:cord and cord:canal ratios. Patients with a small syrinx tended to have a small cyst diameter, and small cyst:cord and cord:canal ratios. No significant relationship was found between muscle wasting or weakness, distribution of sensory loss, degree of disability or distress and the dimensions of the syrinx. These findings should be borne in mind when surgical management is being considered.

Adult↗
PubMed1987

The neurological assault on the great toe (1893-1911).

The late 19th/early 20th century heralded a period in neurology when there was claim and counter claim about the founders of new reflex movements of the great toe. The cutaneous plantar reflex is undoubtedly one of the most important signs in clinical neurology, and there have been several methods described of eliciting this sign, each with its own eponymous name. This article reviews the background to these claims and the contribution of the various authors, to the discovery, clinical relevance and ease of eliciting reflex movements of the great toe.

Germany↗
PubMed1986

Use of magnetic resonance imaging to measure intracranial cerebrospinal fluid volume.

Magnetic resonance imaging was used to measure intracranial extraventricular and ventricular cerebrospinal fluid (CSF) volume. In 10 normal subjects lateral ventricular and extraventricular intracranial CSF volumes were 25.3 +/- 4.6 ml (mean +/- SD) and 97.6 +/- 6.6 ml, respectively (total 122.8 +/- 38.7). These volumes were measured in 4 patients and the results were: 11.0 ml ventricular volume, 68.7 ml total cranial CSF in the patient with benign intracranial hypertension; 606.6 ml ventricular, 174.1 ml total in the patient with hydrocephalus due to a blocked ventriculo-peritoneal (V-P) shunt; 83.4 ml ventricular, 108.5 ml total in the patient with normal pressure hydrocephalus; and 52.7 ml ventricular, 181.0 ml total in the patient with cerebral atrophy due to Alzheimer's disease. The technique gave highly reproducible results (SD less than 5.7% of mean value). It may be useful in differential diagnosis and as an objective means of monitoring therapy or progress in conditions such as cerebral atrophy, hydrocephalus, and benign intracranial hypertension.

Adolescent↗
PubMed1986

Nocturnal penile tumescence and serum testosterone levels.

Ten patients with chronic epilepsy were selected; five had high and five had low total serum testosterone levels. Each patient slept for two nights in the sleep laboratory. EEG monitoring and measurements of nocturnal penile tumescence were carried out during sleep. A clear relationship between both total and free serum testosterone levels were found with nocturnal penile tumescence. FSH, LH, SHBG, and prolactin showed no relationship. The five patients with low serum testosterone levels all showed reduced sexual activity.

Adolescent↗
PubMed1986

The consistency of thought disorder in mania and schizophrenia. II. An assessment at consecutive admissions.

Manic (N = 8) and schizophrenic (N = 14) acute admissions were assessed 10 days after they arrived at the hospital. These assessments were conducted on two consecutive acute admissions for each patient. Interview-based clinical ratings were collected and examined for the stability of both positive and negative thought disorders. For schizophrenics, negative thought disorder, particularly poverty of speech, was relatively consistent across admissions. In the manic sample, much less consistency was observed. The results are evaluated in terms of the statements that they make regarding the validity of the thought disorder construct and for their implications regarding causal factors in communication disorders.

Acute Disease↗
PubMed1985

Sexual behaviour in a centre for epilepsy.

The sexual behaviour and hormonal profiles in 97 patients with chronic epilepsy from an epilepsy centre were studied. Sexual behaviour relating to numbers of sexual contacts, orgasms, spontaneous erections, and early morning erections, whether there was difficulty in obtaining or maintaining an erection, or in ejaculation, was assessed at interview. Hormonal profiles consisted of LH, FSH, prolactin, total testosterone, free testosterone, and SHBG. Information was obtained relating to type of seizure, seizure frequency, age of onset, likely pathology, IQ, and medication. The study showed that this patient group was profoundly hyposexual and had a high level of sexual dysfunction. Serum free testosterone levels were low, and it is suggested that the high level of sexual dysfunction and lack of sexual interest may well have a hormonal basis. The reasons for this are discussed.

Adolescent↗
PubMed1983

The role of mammography in the evaluation of advanced breast cancer treated by initial endocrine therapy.

Fifty-five patients with locally advanced breast cancer treated with initial endocrine therapy have been followed up for periods of between 6 and 64 months (median 17 months) with regular clinical and radiological examination. The aim of the study was to evaluate the role of mammography in initial assessment, and subsequent follow-up. Fifty patients were available for evaluation and were classified by clinical, and by mammographic data independently. The clinical assessment, using UICC criteria of response, estimated 36 patients (72 per cent) as responders (complete response, partial response and no change). Mammographic assessment of response, using 8 radiological features of malignancy, agreed with the clinical estimate in 48 per cent of cases and 32 patients (64 per cent) were assessed as responders. Where clinical and mammographic assessment differed, it was usually due either to a smaller radiological reduction in tumour size, or mammography demonstrating features of progressive disease not observed clinically. Two other mammographic features studied were of prognostic significance. In 70 per cent of the responders in which microcalcifications were present, they became reduced in number but increased in size, a change not seen in non-responders. A curvilinear band, or 'rainbow sign', is described which is an early sign of localized skin infiltration and was associated with a poor prognosis.

Breast Neoplasms↗
PubMed1983

Sex hormones, sexual activity and plasma anticonvulsant levels in male epileptics.

Testosterone, LH, FSH, PRL, and sex hormone binding globulin (SHBG) were measured in 72 male epileptic patients on chronic anticonvulsant drug regimes. Sexual activity was estimated and plasma anticonvulsants measured. Total testosterone (TT), LH, FSH, PRL, and SHBG were increased; free testosterone (FT) was decreased. Sexual activity appeared diminished particularly in relation to reduced FT.

Adolescent↗
PubMed1982

Plasma concentrations of fibrinopeptide A, fibrinogen fragment B beta 1-42 and beta-thromboglobulin following total hip replacement.

Plasma concentrations of thrombin sensitive peptide fibrinopeptide A (FpA), plasmin sensitive fibrinogen fragment B beta 1-42 and the platelet release product beta-thromboglobulin (beta TG) have been measured in 36 patients before and after total hip replacement. Statistically significant elevations of all three activation products were observed in the days following operation. There were small differences in plasma concentrations of FpA, B beta 1-42 and beta TG in patients who did (n = 13) and did not (n = 23) develop post operative deep vein thrombosis, as assessed by ascending venography on post operative day 10, but these differences were not statistically significant. It is concluded that coagulation and fibrinolytic systems and also blood platelets are activated following total hip replacement operations. However, the formation of post operative deep vein thrombosis can not be effectively monitored by measurement of the activation products.

Adult↗
PubMed1980

Formaldehyde as a pre-treatment for dermal collagen heterografts.

The preparation, stability both in vitro and in vivo and resistance to bacterial collagenase of trypsin-purified pig dermal collagen cross-linked with a range of concentrations of formaldehyde in phosphate-buffered saline, was studied using 14C-labelled formaldehyde as a tracer. Washing in phosphate-buffered saline at 37 degrees C produced rapid loss of formaldehyde over 6 weeks before stability was reached. After 19 weeks washing, 12-20% of the initial radioactivity remained, representing 6, 18 and 35 mumol formaldehyde/g of collagen after 21 days reaction with 0.1, 1 and 5% formaldehyde, respectively. Collagen, incorporating stable-bound formaldehyde arising from reaction with formaldehyde in concentrations of 0.5% or over, was totally resistant to bacterial collagenase. The stabilizing effect of formaldehyde cross-linking was also demonstrated by implants of fibrous pig dermal collagen in rats. After 8 weeks a significant constant amount of formaldehyde was retained in all implants. There was no net loss of mass over a 24 week period when pre-treated with 1% formaldehyde but some loss when pre-treated with 0.1% formaldehyde.

Animals↗