myelopathy and other spinal cord disorders

... emotion, and behavior A systematic testing of these mental functions is necessary for the effective clinical assessment of the association cortex and its diseases Figure 27-1 Lateral (top) and medial ... cognition; an occipitotemporal network for face and object recognition; a limbic network for retentive memory; and a prefrontal network for attention and behavior ... temporopolar cortex; W, Wernicke's area.According to current thinking, there are no centers for "hearing words," "perceiving space," or "storing memories." Cognitive and behavioral functions (domains)...

Ngày tải lên: 06/07/2014, 13:20

... right handers and 60% of left handers, aphasia occurs only after lesions of the left hemisphere In some individuals no hemispheric dominance for language can be discerned, and in some others ... meaning-appropriate syntax (grammar) Wernicke's and Broca's areas are interconnected with each other and with additional perisylvian, temporal, prefrontal, and posterior parietal regions, making up ... relative paucity of substantive nouns and action verbs versus function words (prepositions, conjunctions); and if word order, tenses, suffixes, prefixes, plurals, and possessives are appropriate Comprehension...

Ngày tải lên: 06/07/2014, 13:20

... reading Wernicke's Aphasia Comprehension is impaired for spoken and written language Language output is fluent but is highly paraphasic and circumlocutious The tendency for paraphasic errors may be ... his dentures: "We don't need it anymore, she says And with it when that was downstairs was my teeth-tick a den dentith my dentist And they happened to be in that bag see? How could ... Table 27-1 Clinical Features of Aphasias and Related Conditions Comprehe nsion Repeti tion Nami of ng Fluen cy Spoken Language Wernicke's...

Ngày tải lên: 06/07/2014, 13:20

... is common, and mild right nasolabial flattening may be found, but otherwise the examination is often unrevealing The paraphasic, neologistic speech in an agitated patient with an otherwise unremarkable ... conjunctions and pronouns The last two features indicate that Broca's aphasia is not just an "expressive" or "motor" disorder and that it may also involve a comprehension deficit for function words and ... facial weakness, hemiparesis or hemiplegia, and a buccofacial apraxia characterized by an inability to carry out motor commands involving oropharyngeal and facial musculature (e.g., patients are...

Ngày tải lên: 06/07/2014, 13:20

... isolated from other regions of the brain Broca's and Wernicke's areas tend to be spared, but there is damage to the surrounding frontal, parietal, and temporal cortex Lesions are patchy and can be ... understanding written language and can express themselves well in spoken or written language They have no difficulty interpreting and reacting to environmental sounds since primary auditory cortex and ... comprehension, and repetition are intact, but confrontation naming, word finding, and spelling are impaired Speech is enriched in function words but impoverished in substantive nouns and verbs denoting...

Ngày tải lên: 06/07/2014, 13:20

... dysfunction and that does not arise from the patient's failure to understand the nature of the task The form that is most frequently encountered in clinical practice is known as ideomotor apraxia Commands ... movements of the face and mouth Limb apraxia encompasses apraxic deficits in movements of the arms and legs Ideomotor apraxia is almost always caused by lesions in the left hemisphere and is commonly ... aphasia and conduction aphasia Its presence cannot be ascertained in patients with language comprehension deficits The ability to follow commands aimed at axial musculature ("close the eyes," "stand...

Ngày tải lên: 06/07/2014, 13:20

... melodic stress and intonation influence the meaning and impact of spoken language For example, the two statements "He is clever." and "He is clever?" contain an identical word choice and syntax but ... two contexts: CVAs and degenerative diseases Aphasias caused by CVAs start suddenly and display maximal deficits at the onset The underlying lesion is relatively circumscribed and associated with ... earliest and most profound neuronal loss in memory-related parts of the brain such as the entorhinal cortex and the hippocampus This is why progressive forgetfulness for recent events and experiences...

Ngày tải lên: 06/07/2014, 13:20

... car and drive my car into chicago You will back get your car and my car park in my driveway Love, Mom." Comprehension deficits, if present, start with an occasional inability to understand ... different patterns According to a classification proposed by GornoTempini and colleagues, three variants of PPA can be recognized: an agrammatical variant characterized by poor fluency and impaired syntax, ... variant characterized by preserved fluency and syntax but poor single word comprehension, and a logopenic variant characterized by preserved syntax and comprehension but frequent word-finding...

Ngày tải lên: 06/07/2014, 13:20

... lesser impact on overall awareness; there is a paucity of exploratory and orienting acts directed toward the neglected hemispace; and the patient behaves as if the neglected hemispace was motivationally ... the frontal eye fields (F), and the cingulate gyrus (CG) The activations are predominantly in the right hemisphere (Courtesy of Darren Gitelman, MD; with permission.)According to one model of spatial ... more common, severe, and lasting after damage to the right hemisphere than after damage to the left hemisphere Severe neglect for the right hemispace is rare, even in left handers with left hemisphere...

Ngày tải lên: 06/07/2014, 13:20

... (oculomotor apraxia) and in accurate manual reaching toward visual targets (optic ataxia) The third and most dramatic component of Bálint's syndrome is known as simultanagnosia and reflects an inability ... the visual identification of objects and scenes For example, a patient who is shown a table lamp and asked to name the object may look at its circular base and call it an ash tray Some patients ... manifestation of hemispatial neglect; in others, there is a more universal deficit in reproducing contours and three-dimensional perspective Dressing apraxia and construction apraxia represent special...

Ngày tải lên: 06/07/2014, 13:20

... hemisphere and object agnosia with lesions in the left The Limbic Network for Memory: Amnesias Limbic and paralimbic areas (such as the hippocampus, amygdala, and entorhinal cortex), the anterior and ... The deficit in prosopagnosia is therefore modality-specific and reflects the existence of a lesion that prevents the activation of otherwise intact multimodal templates by relevant visual input ... entorhinal cortex), the anterior and medial nuclei of the thalamus, the medial and basal parts of the striatum, and the hypothalamus collectively constitute a distributed network known as the...

Ngày tải lên: 06/07/2014, 13:20

... the greatest phylogenetic expansion in primates and especially in humans The dorsolateral prefrontal, medial prefrontal, and orbitofrontal areas, and the subcortical structures with which they ... hypothalamus, and the limbic thalamus Occasionally, unilateral left-sided lesions can give rise to an amnestic state, but the memory disorder tends to be transient Depending on the nature and distribution ... acutely disoriented and repeatedly ask who they are, where they are, what they are doing The spell is characterized by anterograde amnesia (inability to retain new information) and a retrograde...

Ngày tải lên: 06/07/2014, 13:20

... initiative, creativity, and curiosity and displays a pervasive emotional blandness and apathy In the frontal disinhibition syndrome, the patient becomes socially disinhibited and shows severe impairments ... of the prefrontal network and the ascending reticular activating system Retentive memory, on the other hand, depends on the stable (offline) storage of information and is associated with the ... one criterion to another in sorting or matching tasks) is impoverished; distractibility by irrelevant stimuli is increased; and there is a pronounced tendency for impersistence and perseveration...

Ngày tải lên: 06/07/2014, 13:20

... frontal lobe and leads to a gradual dissolution of behavior and complex attention Primary progressive aphasia is characterized by a gradual atrophy of the left perisylvian language network and leads ... diagnosis and treatment of these patients requires an understanding of the principles that link neural networks to higher cerebral functions FURTHER READINGS Catani M, Ffychte H: The rises and falls ... syndromes in animals and man Brain 88:237, 1965 [PMID: 5318481] Grensham GE et al: Post-Stroke Rehabilitation U.S Department of Health and Human Services Agency for Health Care Policy and Research,...

Ngày tải lên: 06/07/2014, 13:20

... Anemia Evaluation / Anemia and Age / 28 Anemia and Ethnicity / 38 Anemia and Pregnancy / 45 Cancer and Anemia / 58 Malaria and the Red Cell / 81 SECTION II: NUTRITION AND ANEMIA Iron Deficiency ... ANEMIAS AND OTHER RED CELL DISORDERS NOTICE Medicine is an ever-changing science As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy ... people, and is addressed in the chapter on age and anemia Additional sections of the book explore other common concerns in anemia that sometimes fall into a nosologic no man’s land Ease and utility...

Ngày tải lên: 10/08/2014, 08:20

... in Europe and the rest of the world and is currently the standard of care Since 1989 three ESAs have been approved and marketed for use in cancer anemia: epoetin alfa, epoetin beta, and darbepoetin ... pain, and depression as a negative factor in their lives Other problems associated with fatigue were decreased motivation or interest, difficulty concentrating, and difficulty remembering dates and ... increases hemoglobin levels and improves quality of life in patients with cancer-related anemia who are not receiving chemotherapy and patients with anemia who are receiving chemotherapy J Clin Oncol...

Ngày tải lên: 10/08/2014, 08:20

... serum By current standards the technique was time consuming and labor intensive, with a consequent high cost On the other hand, the growth assay was well standardized, sensitive, and reproducible ... ulcer and 112 NUTRITION AND ANEMIA SECTION II reduced blood loss Bleeding hemorrhoids are another common cause of gastrointestinal blood loss in adults The lesions can cause perianal pain and itching, ... course limit erythropoiesis secondarily.138 The other cytokines listed modify iron metabolism and erythropoiesis both directly and indirectly Crosstalk and feedback between these cytokines creates...

Ngày tải lên: 10/08/2014, 08:20

... range of disorders that arise during infancy and childhood disrupt cell production by one or more of the three hematopoietic lines Some of the disorders affect a single lineage while others produce ... Complications of synthetic androgen therapy include masculinization, severe acne, and hepatic damage (hepatic peliosis and liver tumors) Supportive treatment with red cell and platelet transfusions ... patients with FA can combine to eliminate the Fanconi phenotype In other words, cells from the two FA patients complement each other and correct the defect Of the 11 currently known complementation...

Ngày tải lên: 10/08/2014, 08:20

... hypotension and 250 HEMOGLOBIN DISORDERS SECTION V shock and very severe anemia (Hb as low as 2–4 gm/dL) and death in some cases Fluid therapy and blood transfusion to correct anemia and hypovolemic ... swelling of the hands and feet The so-called “hand-foot syndrome” occurs in about a third of infants After the second and third year of age, painful episodes involving the extremities, back and abdomen ... aberrations and prognostic factors in therapy-related myelodysplasia and acute nonlymphocytic leukemia Blood 76:1083–1091 Mauritzson N, Albin M, Rylander L, et al 2002 Pooled analysis of clinical and...

Ngày tải lên: 10/08/2014, 08:20

... appear on the smear along with other nonspecific shape anomalies Small bulges exist along the edge of some of the cells (From Kapff CT and Jandl JH 1991 Blood: Atlas and Sourcebook of Hematology, ... with frontal and parietal bossing In contrast to thalassemia, PK deficiency does not stunt general growth and maturation Cholelithiasis is a common sequela of long-standing hemolysis and hyperbilirubinemia ... regions, such as Sardinia, the economic and social burden of favism was enormous The particulars of the syndrome are puzzling and suggest that factors other than exposure to the bean contribute...

Ngày tải lên: 10/08/2014, 08:20