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Biomedical subjects

D Kurtz

Publications and source records attributed to D Kurtz.

At least 91 records · Page 5Linked to original sources
PubMed1982

Stuporous episodes during treatment with sodium valproate: report of seven cases.

Of 13 patients with complex partial seizures who experienced stuporous states during treatment with sodium valproate (VPA), 4 received VPA only, 4 VPA and phenobarbital (PB) and 5 VPA, PB, and a third anticonvulsant. Seven cases were described in detail. Side effects-stupor or confusion-appeared a few days after efficacious drug plasma levels were attained, persisted until therapy was readjusted, and disappeared 24 to 72 h after VPA withdrawal. Therapeutic trials established the role of VPA in the onset of stuporous states. The adverse effects of VPA were potentiated by the concomitant administration of other anticonvulsants. Stupor was not due to VPA overdoses, and plasma concentration of the drugs were not correlated with the electroclinical signs. The EEG showed spike and wave discharges or continuous sharp theta and delta waves persisting during VPA treatment. The fact that all 13 stuporous, VPA-treated patients were subjected to partial seizures with complex symptomatology, and none were cases of generalized epilepsy, together with the observations that the disturbances of consciousness started with focal symptoms and EEG signs resembling those of spontaneously occurring partial seizures, suggest that VPA given alone or in association with other antiepileptics has a paradoxical epileptogenic effect in certain forms of epilepsy.

Anticonvulsants↗
PubMed1981

[A study of spontaneous arousal in the newborn (author's transl)].

Awakening was studied in 15 newborn babies using polygraphic recording to monitor the EEG, eye movements, the EMG activity of muscles of the face (frontal, periorbital and jaw) and to study the respiratory and cardiac rhythms. Twenty arousals, characterized by crying or by eye opening, lasting 2 min were isolated. The two sorts of awakening could be observed in the same child. The study of different parameters during the minutes which precede waking shows that this always happens in agitated sleep, either in a phase of muscular relaxation (9 times), or in a phase of agitation (11 times) characterized by the presence of a phasic EMG activity in the face muscles and brusque movements of the head, the limbs and the body, without tonic activity. This isolated phasic muscle activity, however, was typical of agitated sleep and did not constitute a sign of pre-awakening. Awakening was unpredictable, characterized essentially by a prolonged opening of the eyes, crying, and by the return to tonic muscular activity associated with phasic activity. No relation was observed between the mode of awakening and the type of agitated sleep which preceded.

Electroencephalography↗
PubMed1981

[Frequency and semeiological evolution of epileptic seizures occurring between 40 and 65 years of age (author's transl)].

458 patients who had their first epileptic fit between the ages of 40 and 65 are classified into 5 groups according to the seizure symptomatology: when the symptomatology remains unchanged, the frequency of fits is less than 1 per month in 84% of generalized fits and more than 1 per month in 52% of focal fits. When the symptomatology changes, the frequency of fits is less than 1 per month when the inaugural fit is generalized (23 out of 27) and more than 1 per month when the inaugural fit is focal (15 out of 21). Modifications of the symptomatology correlate positively with a prevalence of tumor aetiology. Primary generalized epilepsies are rare (4.4%). Non-specific secondary generalized epilepsies (including vascular, metabolic or toxic encephalopathies) account for 24.4% of the cases. Focal epilepsies are the most common form (40.7%), elementary fits being four times more frequent than complex fits.

Adult↗
PubMed1981

[Stuporous states during treatment with sodium valproate. Pathogenetic hypotheses].

In 11 patients with complex partial epileptic seizures stuporous states were observed during treatment with valproate (VPA) (2 cases), with VPA and phenobarbitone (PB) (4 cases), or with VPA, PB and a third anti-epileptic drug (5 cases). Based on 3 characteristic cases, an attempt is made to define the role of VPA, the nature of the stuporous states, and the origin of digestive disorders which often herald the onset of behavioural disorders. Several clinical studies have suggested the direct responsibility of VPA even if the adverse effects are potentiated by many other anti-epileptic drugs. Stuporous states are not due to VPA overdose and do not depend on the mode of administration. No correlation has been found between electroclinical signs and plasma or CSF levels of the different anti-epileptic drugs. Reported data and the present cases suggest a paradoxical epileptogenic role for VPA on complex partial seizures: there exists a close similarity of electroclinical findings between spontaneous epileptic seizures and stuporous states during DPA treatment. Digestive disorders appear to result from a central mechanism and not from digestive tract intolerance. In some cases, it is likely that partial seizures with digestive symptoms and signs do occur.

Adult↗
PubMed1980

Impairments in visual discrimination performance and gaze shifts in monkeys with superior colliculus lesions.

Eye movements of monkeys were recorded while they performed a visual discrimination task before and after superior colliculus (SC) lesions or control surgery. The monkeys with SC lesions were impaired in orienting their eyes toward the visual stimuli when they were presented eccentrically 15 degrees to 32 degrees from the center of the display screen, toward which their heads were directed. This impairment in shifting the gaze to eccentric stimuli may account for the concomitant deficit in discriminating between these eccentric stimuli. The eye movement deficit appears to depend on destruction of the deep as well as more superficial layers of the SC and may reflect a disturbance in visual-oculomotor coordination.

Animals↗
PubMed1980

Transformation of mammalian cells with an amplifiable dominant-acting gene.

We have transferred a mutant hamster gene coding for an altered dihydrofolate reductase to wild-type cultured mouse cells by using total genomic DNA from methotrexate-resistant Chinese hamster ovary A29 cells as donor. By demonstrating the presence of hamster gene sequences in transformants we have provided direct evidence for gene transfer. Transformants selected for increased resistance to methotrexate contain increased amounts of the newly transferred gene. We have used this mutant dhfr gene to introduce the Escherichia coli antibiotic resistance plasmid pBR322 into animal cells. Amplification of the dhfr sequences results in amplification of the pBR322 sequences as well. The use of this gene may allow the introduction and amplification of virtually any genetic element in various new cellular environments.

Animals↗
PubMed1978

EMG activity of cricothyroid and chin muscles during wakefulness and sleeping in the sleep apnea syndrome.

The authors studied the direct and integrated EMG activities of the cricothyroid (CT) and chin muscles in 7 patients with the sleep apnea syndrome. They noted: (1) A tonic activity with phasic inspiratory reinforcements in the CT during wakefulness. (2) A decrease in the tonic activity without any modification of the phasic inspiratory reinforcement during sleep. (3) A decrease or even disappearance of the phasic activity during sleep-induced hypopneas. (4) A complete cessation of both the tonic and the phasic activities of the CT during obstruction apneas: resumption of respiration is marked by the reappearance first of the phasic inspiratory activity and secondly of the tonic one. (5) In some patients similar activities are recorded in the chin muscles during wakefulness, sleep and sleep apnea. These results favor possible obstruction of the upper airway at the laryngeal level: the conjunction of inhibition of the inspiratory activity of the laryngeal muscles with the subsequent closing of the glottis and inspiratory depressure could produce an obstruction.

Adult↗
PubMed1978

[Respiratory arrest during sleep. Facts and hypothyses].

The writers analyze 29 nyctohemeral recordings in 20 patients with sleep apneas. In addition to the standard polygraphy, use is made of pneumotachography and capnography. The results (central apnea with open or secondarily closed glottis; obstructive apnea with closed glottis or with expiratory valve phenomenon) raise the hypothesis of a central physiopathological mechanism common to the various types of apneas through a more or less dissociated inhibition of the activity of the respiratory, laryngeal, intercostal, and diaphragmatic muscles:--in central apnea: inhibition of the thoracoabdominal activity and maintenance of the tonicity of the laryngeal muscles, keeping the glottis open;--in obstructive apnea: persistence of the thoracic and/or abdominal activity with inhibition of the activity of the laryngeal muscles, leading to a passive obstruction due to the effect of inspiratory depression.

Airway Obstruction↗
PubMed1977

Isolation of specific messenger RNA by adsorption of polysomes to matrix-bound antibody.

A procedure is presented for the purification of specific mRNAs, which exploits the ability of antibodies prepared against a native protein to bind to the nascent polypeptide on the polysome. Rather than precipitating these soluble antibody-polysome complexes with anti-antibody, which can lead to nonspecific trapping of polysomes, we have linked the anti-antibody to an insoluble matrix. Thus, the antibody-polysome complex binds to the anti-antibody support and nonspecific polysomes can easily be removed by several washes. We have found para-aminobenzyl cellulose (PAB cellulose), to be a suitable matrix for this purpose. This support can bind large quantities of anti-antibody and it displayed no detectable nonspecific affinity for polysomes or RNA. Using this procedure, we have obtained an apparently homogeneous preparation of ovalbumin mRNA.

Animals↗
PubMed1977

Cerebral edema, mass effects, and regional blood volume in man.

The authors conducted quantitative analysis of computerized tomography (CT) scans to measure tumor size, cerebral edema, and regional blood volume in man. Mass lesions without edema caused a local reduction in blood volume. Cerebral edema also reduced blood volume in proportion to its severity. Consideration of the electrolyte changes and water shifts in white-matter edema suggested that the decrease in absorption coefficient seen in CT scans was due to the increase in water content. Thus, in cerebral edema separation of blood vessels as well as increased interstitial pressure decrease blood volume, and the regional differences in turn reflect pressure gradients within the brain.

Adult↗
PubMed1977

[Electroencephalographic study of functional metabolic encephalopathies and comas during parenteral alimentation].

This review deals with the common E.E.G. characteristics of dysmetabolic encephalopathies and described the particular features of hepatic, respiratory and renal encephalopathies, as well as those resulting from a disturbance in carbohydrate, water and electrolyte metabolism. These now classical data are compared with the principal electroclinical appearances seen during parenteral alimentation : slow, ample wases, non-reactive, associated with a calm coma; overall depression of basal rhythm, with excessive myogram activity and corresponding to paroxysms of muscular hypertonia seen during the coma.

Chronic Disease↗
PubMed1976

[Hyperosmolar comatose states].

A recently determined entity, hyperosmolar coma is a good example of a clinical candition attributable to a fundamental alteration, namely extracellular hyperosmolarity. The principal stages in its history are summarised. The laws governing osmosis are recalled and the various features of the sndrome are studied. Attention is drawn to the clinical peculiarities (skin dehydration), biological features (record glycaemia value), and EEG data noted in 17 cases treated in a resuscitation centre over a period of seven years, along with the treatment employed-this being still a matter of debate. Reference is also made to 52 cases of acute drunkenness in a study of the relation between blood alcohol values and plasma hyperosmolarity.

Adult↗
PubMed1976

[Hyperosmolar Coma].

For some little time it has been known that hyperosmolar coma is a clinical condition which may arise from various causes and yet is based on a fundamental pathophysiological disturbance: extracellular hyperosmolarity, usually accompanied by hyperglycemia or hypernatremia. The clinical and biological picture is easily recognizable and requires immediate and massive rehydration with hypotonic solutions. Many pathological uncertainties still exist, but one thing is certain and of great importance: in many cases, hyperosmolar coma is the result of errors or negligence: for this reason it is essential know this syndrome so that it may be better avoided.

Adult↗