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Biomedical subjects

C Fischer

Publications and source records attributed to C Fischer.

At least 253 records · Page 14Linked to original sources
PubMed1989

Middle latency auditory evoked potentials in cortical lesions. Critical of interhemispheric asymmetry.

Middle latency auditory evoked potentials after monaural stimulation have been recorded in 16 normal subjects and in 21 patients with unilateral cortical or subcortical lesions determined by computed tomographic scan examination. An interhemispheric index was studied to quantify the asymmetry of Na and Pa middle latency auditory evoked potential components recorded over each hemisphere. This index has been calculated for each ear separately and after adding the responses of both ears. Its reliability is shown to be better in the latter situation. In all of the patients the interhemispheric asymmetry index was in the normal range for the Na component. For the Pa component this index was abnormal in 11 patients with cortical temporal lobe or subcortical lesions interrupting acoustic radiations. These results confirm that the Pa is dependent on the integrity of acoustic radiations and auditory cortex in the supratemporal plane, whereas the Na component would be generated at a subcortical level. Unilateral extinction of the dichotic listening test was found to correlate with abnormal Pa component asymmetry in the case of lesions involving the auditory structures.

Adult↗
PubMed1989

Attention deficit disorder symptoms and urine catecholamines.

The symptoms of hyperactivity, impulsivity, and concentration deficits associated with attention deficit disorder (ADD) may be related, in part, to alterations in dopaminergic and noradrenergic functioning. In this study we correlate the above symptoms with 24-hour urinary catecholamines and their metabolites in emotionally disturbed boys divided into two groups based on their plasma dopamine-beta-hydroxylase (DBH) activities and also divided into the following diagnostic groups: conduct disorder, undersocialized; conduct disorder, socialized; and subjects without conduct disorder. Boys in the low DBH group showed significant correlations between the ADD symptoms and the biochemical measures. The low DBH group may be more genetically homogeneous with regard to catecholamine function, making relationships between catecholamine function and behavior more visible. The group of boys with conduct disorder, socialized had higher 24-hour urinary norepinephrine and vanillylmandelic acid output. The relationship between monoamines and their metabolites appeared to differ among diagnostic groups.

Attention Deficit Disorder with Hyperactivity↗
PubMed1989

[Anomalies in early somatosensory evoked potentials in brain stem lesions (study of 64 cases)].

Short latency somatosensory evoked potentials (SEPs) have been recorded in 64 patients with brainstem lesions documented by neuroimaging techniques. Patients were classified in four groups according to the lesion topography: cervico-medullary junction and medulla (16 cases), pons (19 cases), mesencephalon (8 cases), extensive (21 cases). SEPs were abnormal in 57.8% of cases either bilaterally (17.2%), or unilaterally (40.6%). The different components were affected as follows, P14: 34.4%; N20: 56.9%; P22 and N30: 54.7%, peripheral and spinal responses were always spared: N18 and P14 abnormalities were highly correlated. In cervico-medullary lesions P14 and N20 were constantly abnormal, P14 was normal in strictly mesencephalic lesions but could be abnormal in cases of subthalamic lesions with mesencephalic extension; in pontic lesions, P14 could be normal or not, and N20 was always very reduced. These results confirm that P14 has a supra-spinal origin and may have two generators. SEPs detected a subclinical dysfunction of the lemniscal pathways in 18% of patients with normal somatosensory performances and, as BAEPs (abnormal in 54% of the 54 recordings performed in this series) deserve to be recorded for the routine investigation of brainstem function.

Adolescent↗
PubMed1989

Stereoselective disposition of flecainide in relation to the sparteine/debrisoquine metaboliser phenotype.

1. The disposition of the enantiomers of the antiarrhythmic drug flecainide has been studied in five extensive (EM) and five poor (PM) metabolisers of sparteine/debrisoquine after administration of 50 mg of racemic flecainide acetate under conditions of high urinary flow rate and acidic urinary pH. 2. In the EM subjects there were no significant differences in the oral clearance, half-life or urinary excretion of (+)-S- and (-)-R-flecainide. 3. In the PM subjects differences in the pharmacokinetics of S- and R-flecainide were observed. The oral clearance of R-flecainide (467 +/- 109 ml min-1) was less (P less than 0.03) than that of the S-enantiomer (620 +/- 172 ml min-1). The half-life of R-flecainide (12.9 h) was longer (P less than 0.03) than that of S-flecainide (9.8 h). The renal clearance of the two enantiomers was, however, comparable and similar to that observed in the EM subjects. The urinary recovery of R-flecainide (15.6 +/- 3.7 mg) was greater (P less than 0.03) than that of the S-enantiomer (12.0 +/- 3.7 mg). The enantioselective disposition observed in PMs is therefore due to greater impairment in the metabolism of R- than S-flecainide. 4. The urinary recoveries of two major metabolites of flecainide, meta-O-dealkylated flecainide (MODF) and the meta-O-dealkylated lactam of flecainide (MODLF) were lower (P less than 0.05) in PMs, 12.0% +/- 3.1% and 8.2% +/- 3.2% of the dose administered, respectively, than in EMs of 17.7% +/- 3.3% and 16.5% +/- 3.3%, respectively. 5. One PM subject had a greatly diminished flecainide metabolic capacity and a rare genotype, as assigned by Xbal RFLP analysis.

Debrisoquin↗
PubMed1989

Changes of middle latency auditory evoked potentials during natural sleep in humans.

During natural nocturnal sleep, Na and Pa middle latency auditory evoked potentials (MLAEPs) underwent significant variations which were related to sleep stages. The deepening of sleep from stage II to stage IV was paralleled by a latency shift and an amplitude decrease of Na and Pa, while MLAEPs were similar in wakefulness and REM sleep. Moreover, Na and Pa components tended to shift over the hemisphere contralateral to the stimulated ear during sleep. These findings demonstrate that the responsiveness of the auditory cortex to acoustic stimuli is modulated during sleep. Vigilance should be monitored during MLAEP recordings in patients.

Adult↗
PubMed1989

Normal brainstem auditory evoked potentials in adult hypothyroidism.

Nervous system dysfunction and hearing loss are part of the clinical picture of hypothyroidism. Several studies on visual evoked potential and two brainstem auditory evoked potential studies have shown abnormalities in this disease that are reversible with treatment. It has been suggested that visual evoked potential and brainstem auditory evoked potential could be useful to evaluate the effects of hypothyroidism on the central nervous system and to monitor the response to treatment. We recorded brainstem auditory evoked potentials in 15 adult hypothyroid patients immediately before treatment. All patients were women, ranging in age from 34 to 82 years. Fourteen also had an audiometric study. In five patients, both tests were repeated 20 to 22 months after treatment. Audiometry showed that hearing loss increased with age, suggesting that hearing loss in these patients could be secondary more to aging than to hypothyroidism. When compared to sex-matched controls of similar ages, our patients showed no statistically significant differences in brainstem auditory evoked potentials before treatment. Brainstem auditory evoked potential values were not modified in the five patients whose tests were repeated after treatment. The normality of these results raises serious objections to the clinical use of brainstem auditory evoked potential for central nervous system evaluation and therapy monitoring in adult hypothyroidism.

Adult↗
PubMed1989

Prospective multicentre study on the prediction of relapse after antithyroid drug treatment in patients with Graves' disease.

Graves' disease is an autoimmune disease characterized by a course of remission and relapse. Since the introduction of antithyroid drug treatment, various parameters have been tested for their ability to predict the clinical course of a patient with Graves' disease after drug withdrawal. Nearly all these studies were retrospective [corrected] and often yielded conflicting results. In a prospective multicentre study with a total of 451 patients, we investigated the significance of a variety of routine laboratory and clinical parameters for predicting a patient's clinical course. Patients who had positive TSH receptor antibodies activity at the end of therapy showed a significantly higher relapse rate than those without (P less than 0.001). However, the individual clinical course cannot be predicted exactly (sensitivity 0.49, specificity 0.73, N = 391). The measurement of microsomal (P = 0.99, sensitivity 0.37, specificity 0.63, N = 275) or thyroglobulin antibodies (P = 0.76, sensitivity 0.18, specificity 0.84, N = 304) at the end of antithyroid drug therapy did not show a statistically significant difference in the antibody titre between the patients of the relapse and those of the remission group. Additionally, HLA-DR typing (HLA-DR3: P = 0.37, sensitivity 0.36, specificity 0.58, N = 253) was proven to be unsuitable for predicting a patient's clinical course. Patients with abnormal suppression or an abnormal TRH test at the end of antithyroid drug therapy relapse significantly more often (P less than 0.001) than patients with normal suppression or normal TRH test. Patients with a large goitre also have a significantly (P less than 0.001) higher relapse rate than those with only a small enlargement. The sensitivity and specificity values of all these parameters, however, were too low to be useful for daily clinical decisions in the treatment of an individual patient. This is also true for the combinations of different parameters. Though the highest sensitivity value (0.94) was found for a combination of the suppression and the TRH test at the end of therapy, the very low specificity value (0.13) for this combination reduced its clinical usefulness.

Follow-Up Studies↗
PubMed1989

Magnetic resonance imaging in refractory focal epilepsy with normal CT scans.

One hundred patients suffering from focal epilepsy with complex partial seizures refractory to medical treatment and showing no abnormality at CT were explored by MRI with an 0.5 Tesla magnet. MRI detected an abnormality in 25 patients with, in 17 of them, good correlation between MRI and clinical as well as electroencephalographic findings. Abnormal morphology and signal was found in 5 patients, with positive CT results on reexamination of previous CT images or on new CT scans in 4 of them. There was a diffuse temporal lobe high-intensity signal in 3 cases and a localized high-intensity signal in 9 cases (temporal lobe 4, occipital lobe 3, frontal lobe 1, fronto-parietal and parietal lobes 1). Thus, in 13% of the cases MRI demonstrated a lesion that had not been detected at CT, and the location of the lesion was concordant with clinical and electroencephalographic data.

Adolescent↗
PubMed1989

[The attachment and function of the infrahyoid muscles].

The insertion of the infrahyoid muscles to the hyoid bone with special remark to the topographical relations to each other was studied in 102 specimen. Many variations were found in the omohyoid muscle. 6 healthy test persons came in for electromyographical investigations. The involvement of these muscles in head movements could be recorded and studied.

Adult↗
PubMed1989

[Osteoid osteoma in childhood (a case report)].

It is reported upon diagnostics, therapy as well as observation on course of an Osteoid-osteoma of femur in a girl now 11 years old in the period of 7 1/2 years. After en-bloc-resection recurrence-free restitutio integrum.

Child, Preschool↗
PubMed1988

Stereoselectivity of the 4-hydroxylation of debrisoquine in man, detected by gas chromatography/mass spectrometry.

A stable isotope assay for the quantification of debrisoquine (1) and its major urinary metabolite 4-hydroxydebrisoquine (2) is described. The method consists of extractive derivatization of 1 and 2 by use of 1,3-diketones, chiral derivatization of the 4-hydroxy group of 2, and gas chromatography/negative ion chemical ionization mass spectrometry in the presence of deuterated analogues of 1 and 2. In comparison with synthetic R-(-)-2 and S-(+)-2 it is shown that in vivo benzylic 4-hydroxylation of 1 is highly stereoselective, leading predominantly to S-(+)-4-hydroxydebrisoquine (enantiomeric excess greater than or equal to 90%).

Arsenicals↗
PubMed1988

Adaptation of the rat kidney to altered water intake and urine concentration.

Previous experiments in Brattleboro rats with hereditary diabetes insipidus revealed that absence of ADH led to several alterations in kidney anatomy, which could be reversed by chronic ADH treatment. Present experiments were undertaken to determine if similar alterations were observable in normal Wistar rats when endogenous ADH level was varied by manipulating water intake or when exogenous ADH was infused. Water intake was increased by giving food with a high water content ad libitum and offering 5% glucose solution to drink (HWI rats), or decreased by reducing water intake to 1/3 of spontaneous intake (RWI rats). An additional group received chronic ADH infusion with Alzet osmotic minipumps (ADH rats). Results were compared to those obtained in control rats (CON) drinking ad libitum. RWI, CON, and ADH rats ate dry pellets ad libitum. After 6 weeks on these regimens kidneys were perfusion fixed and serial sections were cut for morphometric measurements by light microscopy. Results in the four groups showed that kidney weight relative to body weight was influenced by the operation of urinary concentrating mechanism, with HWI less than CON less than RWI less than ADH. The increase in kidney weight in rats with high urine concentration was not homogeneously distributed throughout the different kidney zones and the different nephron segments. The inner stripe of the outer medulla (IS) increased more in relative height and volume than other kidney zones and, within this zone, the volume of epithelium of thick ascending limb of Henle's loops (TAL) increased more than expected from the whole kidney weight increase. In outer stripe of outer medulla (OS) and in cortex (C), TAL hypertrophy was equal to or lower than expected from whole kidney weight increase. Collecting duct epithelium in C, OS, and IS increased in proportion to whole kidney weight. The MTAL hypertrophy in IS was due to an increase in size of preexisting cells, except in the ADH group where an increase in cell number was also observed. Internephron heterogeneity with regard to glomerular size was greater in RWI and ADH than in CON and HWI rats. The marked hypertrophy of the deep TAL in the IS of rats in which urine concentration was stimulated could be related to an increase in salt transport in this nephron segment, triggered both by a direct stimulation by ADH, and by an increased salt recycling. The elongation of the inner stripe provides a greater length for the operation of the countercurrent multiplier system responsible for building up of the osmotic pressure gradient in the medulla.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗