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Biomedical subjects

C Auer

Publications and source records attributed to C Auer.

At least 37 records · Page 2Linked to original sources
PubMed1999

Low-frequency repetitive transcranial magnetic stimulation of the motor cortex in writer's cramp.

OBJECTIVE: To study the short-term effects of slow repetitive transcranial magnetic stimulation (rTMS) of the motor cortex on cortical excitability and handwriting in patients with writer's cramp. BACKGROUND: Cortical excitability of the primary motor cortex is abnormally enhanced in patients with writer's cramp. Therefore, reducing cortical excitability by low-frequency rTMS of the motor cortex might result in beneficial effects on handwriting in writer's cramp. DESIGN/METHODS: We studied the effects of subthreshold 1-Hz rTMS on motor threshold and cortico-cortical excitability using the paired-pulse technique in seven patients and seven controls. In another 16 patients and 11 age-matched controls we evaluated changes in cortical excitability by measuring the stimulus-response curve and the postexcitatory silent period before and after subthreshold 1-Hz rTMS. In addition, we analyzed the handwriting before and 20 minutes after 1-Hz rTMS. RESULTS: In the first experiment, low-frequency rTMS resulted in a normalization of the deficient cortico-cortical inhibition in the patients without affecting motor threshold. In the second experiment, 1-Hz rTMS resulted in a significant prolongation of the postexcitatory silent period without affecting the stimulus-response curve in the patient group. Moreover, the dystonic patients showed a significant reduction of mean writing pressure after subthreshold 1-Hz rTMS that was associated with clear but transient improvement in six patients. CONCLUSIONS: In some patients 1-Hz rTMS can reinforce deficient intracortical inhibition and may improve handwriting temporarily. Our data support the notion that reduced intracortical inhibition plays a part in the pathophysiology of focal dystonia.

Adult↗
PubMed1998

Imaging brain activation induced by long trains of repetitive transcranial magnetic stimulation.

Using positron emission tomography (PET), we measured the relative changes in regional cerebral metabolic rate of glucose (rCMRglc) during 2 Hz repetitive transcranial magnetic stimulation (rTMS) of the left sensorimotor cortex (SM1) and during imitation of rTMS-induced arm movements. Such stimulation caused an rCMRglc increase of about 8% within the SM1. The relative rCMRglc increase within SM1 was significantly greater in magnitude and larger in area during voluntary imitation of rTMS-induced arm movements. Moreover, the rostral part of the SMA was significantly more activated by voluntary movements than during rTMS. Combining rTMS and PET has the potential to visualize rTMS-related net brain activation, and may open up new possibilities for functional network analysis by comparing willed brain activation with electromagnetic brain activation.

Adult↗
PubMed1998

Continuous intrathecal baclofen infusions induced a marked increase of the transcranially evoked silent period in a patient with generalized dystonia.

We observed a marked prolongation of the transcranially evoked silent period during continuous intrathecal administration of high doses of the gamma-aminobutyric acid (GABA)B receptor agonist baclofen in a patient with generalized dystonia. Size of motor evoked potentials and central conduction time remained unchanged during intrathecal baclofen administration. The selective prolongation of the silent period during high-dose continuous intrathecal baclofen therapy supports the notion that GABA(B)-ergic intracortical interneurons play a part in the generation of the transcranially evoked silent period.

Adult↗
PubMed1998

Toxoplasmic retinochoroiditis: resolution without treatment of the perilesional satellite dark dots seen by indocyanine green angiography.

PURPOSE: Satellite dark dots (SDD) seen by indocyanine green angiography (ICGA) around the main retinochoroiditis focus are described in 75% of cases. Whether SDDs represent subclinical infectious foci or just a perilesional inflammatory reaction is not known. The purpose here was to report a case giving additional information on this question. METHODS: We analysed the evolution of ICGA SDDs in a patient with recurrent toxoplasmic retinochoroiditis who received no antitoxoplasmic treatment because the lesion was located outside the areas where treatment is classically recommended. RESULTS: The patient had a recurrence of retinochoroiditis on the nasal aspect of the disc about 2 disc diameters away from the disc. It was decided to observe the recurrence before introducing treatment. Diminution of SDDs occurred by 3 weeks after the initial ICGA, and complete resolution was observed on a follow-up ICG angiogram obtained 8 weeks after the initial visit. CONCLUSION: Resolution of ICGA SDDs in toxoplasmic retinochoroiditis seems to occurring a similar fashion whether or not the retinochoroiditis is treated by anti-toxoplasmic drugs, indicating that SDDs probably represent a non-infectious perilesional inflammatory reaction.

Acute Disease↗
PubMed1998

Indocyanine green angiographic findings in sympathetic ophthalmia.

PURPOSE: To analyze indocyanine green angiography (ICGA) features in two cases of sympathetic ophthalmia using a standard angiography protocol for posterior uveitis. METHODS: Report on two patients who suffered from penetrating ocular injuries 45 and 8 years before sympathetic ophthalmia was diagnosed and confirmed by histopathological examination of the enucleated eye. In addition to routine examination and fluorescein angiography, initial and follow-up ICGAs were performed. RESULTS: The first patient, with a phthisic right eye following s shotgun injury, consulted 6 months after cataract extraction in his good left eye for progressive visual loss due to a neovascular membrane in a moderately inflamed eye. The second patient consulted 8 years after a perforating injury of his right eye by a metallic foreign body because of recent visual loss and inflammation in his good left eye. ICGA of both patients showed numerous hypofluorescent dark dots visible at the intermediate phase, some becoming isofluorescent at the late phase and resolving after long-term corticosteroid therapy, others remaining hypofluorescent until the late phase. CONCLUSION: The two patterns of hypofluorescent areas, either persisting throughout angiography or fading in the late phase, were interpreted respectively as cicatricial and active lesions. ICGA gave determining additional information on choroidal involvement and on subsequent evolution of lesions.

Adult↗
PubMed1998

Indocyanine green angiographic features in posterior scleritis.

PURPOSE: To determine choroidal involvement in posterior scleritis by examining indocyanine green angiographic features. METHODS: Indocyanine green angiography was performed according to a standard uveitis angiographic protocol in eight consecutive patients with posterior scleritis. Indocyanine green angiography data were compared to fundus color photographs, red-free photographs, and fluorescein angiography. RESULTS: The principal indocyanine green angiographic feature was diffuse zonal choroidal indocyanine green hyperfluorescence in the intermediate (+/-10 minutes) and late (+/-40 minutes) phases of angiography present in all eight patients who regressed in response to anti-inflammatory therapy. In four patients (two with massive subretinal exudation), additional fluorescing pinpoints were present in the zonal hyperfluorescent areas. Additional features included irregular delayed choroidal perfusion (five of eight patients)--irregularly distributed dark dots that were present up to the intermediate phase and becoming isofluorescent in the late phase that gave a mottled aspect to the choroid--and enlargement of draining choroidal veins. In bilateral patients, clinical features and indocyanine green angiography signs were roughly symmetric. CONCLUSIONS: In posterior scleritis, indocyanine green angiography allowed us to identify areas of choroidal hyperfluorescence, possibly indicating areas of maximal inflammatory activity, and demonstrated regression of hyperfluorescence in response to therapy. Indocyanine green angiography was useful in assessing the extent of choroidal involvement and will probably serve as one of the follow-up parameters for disease evolution and response to therapy.

Adult↗
PubMed1998

Hyperalphalipoproteinemia: characterization of a cardioprotective profile associating increased high-density lipoprotein2 levels and decreased hepatic lipase activity.

The aim of the present study was to investigate the high-density lipoprotein (HDL) structural characteristics and metabolism in hyperalphalipoproteinemic (HALP) patients (HDL-cholesterol [HDL-C], 92 +/- 14 mg/dL) with combined elevated low-density lipoprotein-cholesterol (LDL-C) levels (LDL-C, 181 +/- 33 mg/dL). Patients were subjected to a complete cardiovascular examination, including ultrasonographic investigation of carotid arteries. Two HALP profiles were identified according to the HDL2/HDL3 ratio. HALP profile A was characterized in 28 patients by increased HDL2/HDL3 ratio, HDL2b, and lipoprotein (Lp)A-I levels compared with normolipidemic subjects, and HALP profile B, including the 12 remaining patients, was characterized by a HDL2/HDL3 ratio within the normal range and by the increase of all HDL subclasses (HDL(2b,2a,3a,3b,3c)), LpA-I, and LpA-I:A-II levels. With regard to the exploration of carotid arteries, in HALP profile A, 20 patients were free from lesions and eight had only intimal wall thickening. In HALP profile B, only one patient was free from lesions, four had intimal wall thickening, and seven displayed plaques, but none had stenosis. Taking into account the number of patients with plaques within each group, HALP profile A was associated with a low prevalence of atherosclerotic lesions, whereas HALP profile B was less cardioprotective (odds ratio, 77.7 [95% confidence interval, 3.7 to 1,569.7]; P < .0001). For both HALP profiles, cholesteryl ester transfer protein (CETP) deficiency was discarded and activities of phospholipid transfer protein (PLTP) and lipoprotein lipase (LPL) were normal. However, hepatic lipase (HL) activity was significantly decreased in HALP profile A, but within the normal range for HALP profile B. In conclusion, an HALP profile A with a low prevalence of atherosclerosis was characterized by an increased HDL2/HDL3 ratio, HDL2b, and LpA-I levels associated with decreased HL activity.

Adult↗
PubMed1998

A case report of breastfeeding quadruplets: factors perceived as affecting breastfeeding.

The number of higher-order multiple births in the United States quadrupled between 1970 and 1994. The number of women choosing to breastfeed their higher-order multiples also has risen. In this report, a mother of quadruplets identifies factors and interventions she perceived as having a positive or negative impact on breastfeeding. Maternal motivation coupled with a mother's personal approach to breastfeeding quadruplets may be key factors in shaping breastfeeding outcomes, such as in this case where one quad weaned at 12 months and the remaining three breastfed for 2 1/2 years. With increased discussion of this select population, lactation consultants and other health professionals will be able to develop breastfeeding care plans which reflect this population's unique needs and concerns from the prenatal through postpartum periods.

Adult↗
PubMed1998

Rapid electrophoretic separation of pre-beta-migrating high density lipoproteins using automated PhastSystem: application to analysis of lecithin:cholesterol acyltransferase-deficient plasma.

To identify pre-beta-high density lipoproteins, a rapid two-dimensional separation by electrophoresis (1 hour 30 minutes) was performed on an automated Phast System. This procedure used commercially available polyacrylamide gradient gels (4-15%) and allows sensitive and reproducible results. Pre-beta-1- and pre-beta-2-high density lipoproteins were clearly identified by this method. In addition, our procedure was successfully applied to diagnosis of a patient with familial lecithin:cholesterol acyltransferase deficiency, characterized by the absence of alpha-high density lipoproteins.

Automation↗
PubMed1997

[Voluntary mercury poisoning: biological consequences and psychiatric significance].

A young patient suffering from schizophrenia had intense headaches and photophobia which were induced by intra-ocular injections of mercury. The clinical diagnosis was established once foreign bodies were visualized on regular X-rays of the patients skull. The mercury intoxication in combination with the secondary irreversible lesions to the eyes necessitated a bilateral enucleation and the use of a chelating treatment with sodium-dimercapto-1-propane sulfate (DMP). Automutilation is a very rare and dramatic complication of schizophrenia. The psychiatric handling and meaning of such dramatic automutilation is discussed in this case report together with a recent review of the toxicologic treatment of mercury intoxication in humans.

Adult↗
PubMed1997

Toxoplasmic retinochoroiditis: new insights provided by indocyanine green angiography.

PURPOSE: To analyze features of indocyanine green angiography associated with recurrent toxoplasmic retinochoroiditis. METHODS: Indocyanine green angiography was performed according to a standard protocol and correlated with clinical signs and fluorescein angiography in 12 eyes of 12 consecutive patients with recurrent toxoplasmic retinochoroiditis. RESULTS: In 10 of 12 eyes with recurrent toxoplasmic retinochoroiditis, indocyanine green angiography showed multiple satellite dark dots not seen on fluorescein angiography or clinical examination of the fundus. CONCLUSION: Indocyanine green angiography shows that recurrent toxoplasmic retinochoroiditis is more widespread than clinically visible lesions indicate. Indocyanine green angiography is useful in assessing the extent of involvement of recurrent toxoplasmic retinochoroiditis and the evolution of lesions and might also provide insights into the pathophysiology of the disease.

Angiography↗
PubMed1997

Recurrent toxoplasmic retinochoroiditis. Significance of perilesional satellite dark dots seen by indocyanine green angiography.

PURPOSE: To suggest an explanation for the satellite dark dots seen by indocyanine green angiography (ICGA) around the main focus of a toxoplasmic retinochoroiditis. METHODS: The authors analysed the evolution of ICG satellite dark dots in two cases of recurrent toxoplasmic retinochoroiditis receiving anti-toxoplasmic treatment not including corticosteroids. RESULTS: Both patients had a recurrence on the peripheral aspect of scars from previous retinochoroiditis and were treated with pyrimethamine (50 mg/day) and sulfadiazine (4 g/day) for seven weeks. Resolution of satellite ICG dark dots was observed in both cases on the follow-up ICG angiogram performed at the end of treatment. CONCLUSION: Resolution of ICG satellite dark dots after anti-toxoplasmic treatment not including corticosteroids tends to indicate that there is probably an infectious component in these hypofluorescent dots and that they probably do not represent a purely inflammatory perilesional reaction.

Adult↗
PubMed1995

Influence of baclofen upon the alpha-motoneuron in spasticity by means of F-wave analysis.

Intrathecal baclofen dramatically improves severe spastic syndromes. This improvement is likely related to reduced excitability of alpha-motoneurons. To investigate the influence of baclofen upon the alpha-motoneuron, we analyzed F-waves before and after intrathecal baclofen bolus injection (usually 50 micrograms) as well as after administration of different, constantly delivered doses (60-200 micrograms/day). Intrathecal baclofen bolus decreased the maximum F-wave amplitude (Fp) from an initial value of 9% of the maximum M amplitude (Mmax) (= F/M-ratio) to 2.4% of the Mmax after 130-180 min, reduced the mean F-wave amplitude 60% within 150 min, and shortened the mean duration by 40-60% after 130-180 min. Constantly delivered baclofen of 100 micrograms/day reduced the F/M-ratio from 5% to 2%, the mean F-wave amplitude by 40-80%, and the F-wave mean duration by 40-80%. The minimum F-wave latency did not change after bolus or during steady state administration. The findings indicate that the F-wave mean and maximum amplitude as well as the mean duration are altered in a quantifiable manner following intrathecal baclofen application.

Baclofen↗
PubMed1995

[Silicone one piece intraocular implant and anterior capsule fibrosis].

BACKGROUND: Foldable plate haptic silicone intraocular lenses (IOLs) were surmised to produce greater anterior capsule fibrosis than poly(methyl metacrylate) (PMMA) intraocular lenses. MATERIAL AND METHODS: A retrospective study of 34 eyes was carried out 12 to 15 months after phacoemulsification. All surgical procedures were performed by the same surgeon (M.G.) using two different techniques: 17 eyes were operated on through a temporal clear-cornea incison and implanted with a foldable plate haptic silicone IOL (STAAR AA4203); 17 eyes were operated on through a superior sclerocorneal incision and received a PMMA IOL (Kabi Pharmacia 809P). Secondary opacification of the anterior capsule was compared between the two groups. RESULTS: Seventy percent of eyes (12/17) with plate haptic silicone IOL had moderate or important anterior capsule fibrosis or shrinkage. Only 18% of eyes (3/17) with PMMA IOL presented with this complication. However, posterior capsule opacification was almost similar in both groups. CONCLUSION: Foldable plate haptic silicone IOLs seem to produce a more important anterior capsule fibrosis or shrinkage than PMMA IOL one year after phacoemulsification and saccular implantation. Although etiology is unknown, either huge contact between IOL and anterior capsule, or lack of contact between anterior and posterior capsules are hypotheses advanced. Posterior capsule opacification is similar in the two groups.

Fibrosis↗
PubMed1994

[Indications and complications of systemic corticosteroid therapy in treatment of uveitis].

PURPOSE: Systemic steroids is often the first choice of immunosuppressive therapy for severe endogenous uveitis. The aim of this study was to analyse the indications of steroid therapy, complications and side-effects. PATIENTS AND METHODS: Charts from all patients that received oral steroid therapy were reviewed for this purpose and a questionnaire was sent out to all patients to record their subjective complaints. RESULTS: From January 1990 to March 1993, 63 out of the 435 new patients seen at the uveitis clinic received oral prednisone. In 4 cases severe complications occurred that did however not lead to discontinuation of therapy. In 2 cases of intolerance cyclosporine (CsA) had to be added to the treatment regimen to lower the steroid doses and in one case steroids had to be stopped because of intolerance. The questionnaire showed a high rate of subjective side-effects to steroids. CONCLUSIONS: In our collective oral steroids were associated with complications, intolerance and side-effects in a high proportion of cases. It is important to explain the possible side-effects to the patient before starting the therapy. The preventable collateral effects like weight gain and decalcification should be addressed by diet recommendations and modern calcium sparing therapy.

Administration, Oral↗