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Biomedical subjects

E Kokmen

Publications and source records attributed to E Kokmen.

At least 109 records · Page 6Linked to original sources
PubMed1989

Morphometric alteration of rat myelinated fibers with aging.

The number, size, density and pathologic alterations of myelinated fibers (MF) of ventral and dorsal roots and of peroneal and sural nerves in groups of female Fischer 344 rats at 10, 20, and 30 months of age were evaluated to characterize nerve changes with old age. Except for minimal changes in the peroneal nerve, no statistically significant alteration in number of MF/nerve or in the fascicular area was associated with aging. The unaltered number was misleading since striking changes in MF size distribution, pathologic alterations of fibers and the presence of regeneration clusters suggested age-related degenerative and regenerative events. These changes were most dramatic in the ventral root, where myelin infolding, myelin separation from axon and ballooning, macrophagia and hyperplasia of Schwann cell nuclei were pronounced. Concomitant with these alterations, axonal atrophy (a reduction in caliber of axons relative to myelin spiral length or number of myelin lamellae) was demonstrated in MF of the ventral root in old age.

Aging↗
PubMed1989

Head trauma with loss of consciousness as a risk factor for Alzheimer's disease.

We identified all incident cases of clinically diagnosed Alzheimer's disease among the population of Rochester, MN, with onset from 1965 through 1974. A control (selected from the same community) was matched to each case by age, race, sex, and length of stay in Rochester. We studied 274 case-control pairs. Using the records linkage system available for residents of this community, we abstracted information on the occurrence of head trauma with loss of consciousness (LOC) from the medical records of both cases and controls. There were 5 pairs in which the case suffered an episode of head trauma with LOC but the control did not, and 4 pairs in which the control suffered an episode of head trauma with LOC but the case did not. We failed to detect a statistically significant difference between the 2 groups. This study overcomes many problems encountered in previous case-control studies reporting this association. The sample size was large; severity of head injury was documented in high-quality medical records; data about head injury were recorded before the onset of dementia: equal quality of data were available for cases and controls; and, since the study was population-based, there was no selection bias for cases or controls.

Alzheimer Disease↗
PubMed1989

Prevalence of medically diagnosed dementia in a defined United States population: Rochester, Minnesota, January 1, 1975.

Using the centralized diagnostic data resource for the population of Rochester, Minnesota, we determined the prevalence of medically diagnosed dementia for this community. There were 289 individuals with dementia who were residing in Rochester on January 1, 1975: 208 women and 81 men. The overall age- and sex-adjusted rates per 100,000 population were 342 for all dementias and 227 for Alzheimer's disease. Prevalence rates increased with age for both sexes. Limiting the denominator to persons greater than or equal to 65 years, age-adjusted rates per 100,000 population for men and women were 3,452 and 3,466 (or about 3.5%), respectively, for dementia and 2,007 and 2,675 (2.0 and 2.7%), respectively, for Alzheimer's disease.

Age Factors↗
PubMed1988

Cardiopulmonary metastatic lesions of osteosarcoma and associated cerebral infarction.

Osteogenic sarcoma frequently disseminates by hematogenous routes. A 32-year-old patient underwent evaluation for an acute cerebral infarction. Cardiac auscultation disclosed an abnormal diastolic sound. Echocardiographic examination revealed a large left atrial mass, which was found at thoracotomy to be metastatic osteogenic sarcoma. Cerebral computed tomographic scans at the time of initial examination and 3 months later demonstrated new cerebral lesions consistent with metastatic growths. The abrupt cerebral infarction, other clinical findings, and results of diagnostic studies strongly suggested that the acute cerebrovascular event was the result of metastatic cerebral embolization from the tumor material found in the thorax. Cerebral infarction is an unusual and catastrophic complication of thoracic metastatic lesions of osteogenic sarcoma.

Adult↗
PubMed1988

Trends in incidence of dementing illness in Rochester, Minnesota, in three quinquennial periods, 1960-1974.

We ascertained the incidence of dementias of all causes between 1960 and 1975 among citizens of Rochester, Minnesota. Study of all medical records yielded incidence rates for the quinquennial periods of 1960-1964, 1965-1969, and 1970-1974. In the population at risk (30 years or older), the age-adjusted rates (per 100,000 population/year) for Alzheimer's disease (clinically diagnosed or pathologically confirmed, or both) in the three periods were: 104.9, 80.8, and 96.6. The rates for dementia of all causes were: 160.6, 122.0, and 136.8. Calculation of 95% confidence intervals showed that the incidence rate for dementia or Alzheimer's disease has not changed in this 15-year period in Rochester, Minnesota. Assuming no demented patients younger than 29 years, the incidence rates in the three quinquennial periods for all dements were 79.4, 60.3, and 67.7; for Alzheimer's disease they were 51.9, 40.0, and 47.8.

Alzheimer Disease↗
PubMed1987

Alzheimer's disease and other dementing illnesses in a defined United States population: incidence rates and clinical features.

In this study, for the first time to our knowledge all new cases of Alzheimer's disease and other dementing illnesses have been documented in a well-defined United States community. A total of 178 patients in an average annual at-risk population of 18,991 persons over age 29 developed dementia during 1960 through 1964 in Rochester, Minnesota, yielding an average annual incidence rate of 187.5 new cases/100,000/year. The corresponding rate for clinically and/or pathologically diagnosed Alzheimer's disease (the most common cause of dementia in this community) was 123.3 new cases/100,000/year, based on 117 cases. The incidence rates for both dementia in general and Alzheimer's disease in particular rise dramatically with age. All patients were followed to death or to 1982, and the median survival was 63 months. These data include only those in the community who came to medical attention, but they yield higher rates than studies in Scandinavia, indicating a relatively high level of case ascertainment.

Adult↗
PubMed1987

A short test of mental status: description and preliminary results.

A short test of mental status (encompassing about 5 minutes) was administered to 93 consecutive neurologic outpatients without dementia, 67 outpatients with Alzheimer-type dementia, and 20 outpatients with dementia of miscellaneous causes. The mean scores for patients with Alzheimer-type dementia were lower than those for the nondemented patients in the total scoring and on all subtests (P less than 0.001). When a total score of 29 or less (maximal attainable score, 38) was used as a screen for dementia, a sensitivity of 92% and a specificity of 91% were reached. For patients older than 60 years of age, a score of 29 or less resulted in a sensitivity of 95% and a specificity of 88%. Thus, in general, this easily administered test distinguishes demented from nondemented patients, but it should not be used as the sole means of diagnosing dementia.

Aged↗
PubMed1987

A clinical and autopsy study of dementia in Olmsted County, Minnesota, 1980-1981.

The clinical records and autopsy protocols were studied from 350 cases in which an autopsy was done in Olmsted County, MN, in 1980 and 1981. Overall autopsy rate was 33.6%, and autopsy rate for those aged 60 years or more was 29%. Preselected criteria were used for diagnosis of dementia. Thirty-two demented and 68 nondemented patients had complete autopsies; all were more than 60 years old. Twenty-three of 32 (72%) demented patients had Alzheimer's disease. The frequency of cerebral infarcts among the nondemented patients was significantly higher than among the demented patients (p = 0.02).

Aged↗
PubMed1986

Subcortical crossed aphasia: a case report.

A 74-year-old, right-handed woman suffered acute aphasia and left hemiplegia secondary to a cerebral infarction in the right cerebral hemisphere. The lesion was located deep in the parietal lobe and extended to the posterior limb of the internal capsule and the head of the caudate nucleus. The patient's aphasia was characterized by severe impairment in auditory and visual comprehension and auditory retention span, as well as by anomia, agraphia, and dyscalculia. She showed rapid recovery from her aphasia, with residual deficits in writing, naming, calculation, and memory.

Aged↗
PubMed1985

Magnetic resonance imaging in syringomyelia.

Myelography and myelography assisted with computed tomography have been the most commonly used radiographic methods in the study of syringomyelia. These studies have never been entirely reliable in demonstrating the syrinx cavity and its relationship to other intracranial structures. During the 1st year of operation of the magnetic resonance imaging facility, the syringomyelic cavity was demonstrated in 15 patients who all had typical clinical signs and symptoms associated with syringomyelia. Nine cases were syringomyelia with Chiari malformation. One case showed additional hydrocephalus. Four cases were idiopathic, and 1 case was remotely posttraumatic. Magnetic resonance imaging, although it is in its infancy, already promises to be the most important radiographic technique for syringomyelia because it provides an anatomically truthful visualization of the sagittal plane of the cervical cord and can demonstrate the syrinx cavity and its relationship with the cerebellar tonsils, the 4th ventricle, and other related structures.

Adolescent↗
PubMed1984

Dementia--Alzheimer type.

At least half of the patients who present with progressive decline in their memory, cognitive, and intellectual abilities will eventually be diagnosed as having Alzheimer's disease. The diagnosis is reached by clinical and ancillary evaluation and exclusion of all other causes of dementia. Recently, considerable advances have been made in our understanding of the neurobiologic features of Alzheimer's disease. Cortical neurons contain paired helical filaments with a very specific electron microscopic appearance. These filaments contain proteins with unusual properties. A severe decline in cholinergic activity in the cortex is related to a marked loss of cholinergic neurons in deep cerebral structures, such as the nucleus basalis of Meynert in the substantia innominata. No specific treatment is available for Alzheimer's disease. Patients and the relatives who take care of them require substantial help and assistance in coping with the disease.

Acetylcholine↗
PubMed1978

Quantitative evaluation of joint motion sensation in an aging population.

Fifty-two neurologically normal subjects from 61 to 84 years in age were evaluated for sensitivity of perception of joint motion. Right and left metacarpophalangeal and metatarsophalangeal joints were passively moved in an ever-increasing amplitude in a sinusoidal flexion-extension mode. Precise measurements of the amplitude of the angle of deviation where the subjects felt motion were made and stored with the help of a computer. A younger cohort 19 to 34 years in age was also tested. The older subjects did less well in perceiving motion at the lowest frequency in the metatarsophalangeal joints. When the older cohort was separated in semidecades and compared to each other, as well as the younger cohort, all differences of motion threshold perception lost significance. It is concluded that there is no major decline in joint motion sensation with aging.

Adult↗
PubMed1977

Superior Sagittal Sinus Thrombosis.

Seven patients had superior sagittal sinus thrombosis diagnosed by cerebral arteriography. We recommend that anticoagulants not be used in the therapy of this entity, but rather that one should rely on antiedematous agents and anticonvulsants.

Adult↗
PubMed1977

Lymphomatoid granulomatosis clinically confined to the CNS. A case report.

A 38-year-old man developed pain and peripheral-type weakness on the right side of his face and was discovered to have decreased hearing bilaterally, as well as optic nerve swelling on the right. The pain and optic nerve swelling subsided over a period of six weeks, but hearing loss and facial weakness persisted. Thirty months later, he developed dysphagia, ataxia, dysarthria, nystagmus, and progressive spastic quadriparesis. He died approximately four years after the onset of the illness. Although no evidence of disease was found other than in the central nervous system during life, two nodules in the right lower lung were found on autopsy. The examination of these nodules, as well as the brain stem, showed an angiocentric and angionecrotic process with lymphoreticular and plasmacytoid invasion.

Adult↗
PubMed1977

Quantitation of motion perception in the digits: a psychophysical study in normal human subjects.

Threshold perception of motion of the digits was obtained in 14 normal subjects. The metacarpophalangeal joint of the index and the fifth finger of each hand and the metatarsophalangeal joint of the hallux of each foot were passively moved up and down with respect to a horizontal plane defined by the palmar or plantar surface. The motion was sinusoidal at frequencies of 0.5 and 5.0 Hz. A mpdified von Békésy paradigm similar to that used in audiometry was utilized to yield threshold levels of motion sensation. There was little difference in the thresholds obtained for the different joints. The difference between high- and low-frequency stimulation, however, was significant (p less than 0.001): the 0.5 Hz threshold was found to range from 0.8 to 1.0 degree, whereas the 5.0 Hz threshold varied from 0.4 to 0.6 degree. It is thought that motion sense is largely dependent on joint receptor contributions, but muscle and cutaneous receptors may also contribute to this proprioceptive sensation.

Adolescent↗