Changes in muscular proteins during simulated microgravity.
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Humans↗
Biomedical subjects
F Gerstenbrand
Publications and source records attributed to F Gerstenbrand.
Extensive meningeal involvement as the primary manifestation of a systemic small lymphocytic lymphoma: favourable outcome after neuraxial irradiation without chemotherapy.
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Aged↗
Post-traumatic segmental myoclonus associated with bilateral olivary hypertrophy.
We present clinical and magnetic resonance (MR) findings in three patients with segmental myoclonia occurring 11-18 months after severe brainstem injury. Palatal myoclonus and vertical ocular myorhythmia were present in all three patients and synchronous involuntary movements of the upper extremities ("wing beating") in two patients. MR-imaging showed multiple post-traumatic lesions within the dentato-rubro-olivary pathway ("myoclonic triangle"), associated with bilateral enlargement and increased signal intensity of the inferior olives. The signal abnormality was more prominent on proton density weighted images than on T2-weighted images, suggesting underlying pathological changes different from typical gliosis.
Adolescent↗
[Space medicine and life sciences in space].
The examination of pathophysiological disturbances and the process of adaptation in man during space flight is not for optimizing of the biological systems during the training of cosmonauts and astronauts for their stay in space only. These results are also important for medical application on patients. In real microgravity disturbances of motor performances, coordination of movements, accuracy of movements, muscle function as well as structural changes in muscles is found in real microgravity. Spinal reflexes and the control of vestibular system on eye movements are also afflicted. Higher brain functions, especially associative reactions, critical abilities, memory, as well as high brain function like space orientation, body scheme control, geometric and arithmetic analysis and its reproduction, at last speech production, writing and reading are decreased. Vegetative disorders, bone decalcification, primary muscular atrophy occur as well as changes in sleep--wake regulation and diminishing of vigility. Disturbances of blood and body fluid circulation and biologic radiation damage are further effects of man space flight. Several problems of space adaptation can be studied with the methods of the simulated microgravity using the dry water immersion, examination and the bed rest model in special laboratories. The routine medicine is learning from the scientific results of the research in real and simulated microgravity.
Adaptation, Physiological↗
[Movement disorders in weightlessness].
The system MONIMIR has been developed to study the coordination of eye, head and arm movements as well as spinal reflexes in microgravity and was used during three spaceflights on board of the station MIR. The following investigations in the course of the experiment MONIMIR were performed: (1) slow head movements in three planes, (2.3) fast pointing movements of eyes, head and arm to acoustic and visual targets, (4) tracking movements of eyes, head and arm to visual targets, (5) head and arm movements based on short term memory and (6) patellar-tendon-reflex. In microgravity different functions and effectors showed different nature and degree of disturbance and different courses in adaptation; in most of the tests exactness and velocity of head and arm movement was decreased; head movements were more disturbed than arm movements; fast pointing movements were more severely affected than slow tracking movements which partly improved; visual controlled movements showed better adaptation as only proprioceptive controlled movements; the patellar-tendon-reflex was highly increased. Disturbances were most pronounced in the early stage of the spaceflights; at later stages most of the performances improved. Methods and results can be used not only for improvement of election and health control of cosmonauts/astronauts for future longterm space missions but also for diagnostics and research of adaptational processes in course of diseases or extreme conditions on earth.
Extraterrestrial Environment↗
Space and cognition: the measurement of behavioral functions during a 6-day space mission.
We measured nonspecific (attention, mental flexibility, psychomotor speed) and visuospatial cognitive processing in a single case study during a 6-d visit on the Russian orbital complex MIR, using computer-based psychometric tasks. Reaction times and accuracy scores showed only minor, nonsignificant changes between preflight, flight, and postflight assessments. These results suggest that several behavioral functions, among them complex visuospatial processing skills, remain essentially intact on short space visits, provided that the performing subject experiences no symptoms of space motion sickness or other physical impairments. Computerized psychometric tasks are a sensitive and flexible tool to measure behavioral functions in space life sciences.
Cognition↗
Magnetic resonance studies in stroke.
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Cerebrovascular Disorders↗
Superficial siderosis of the central nervous system: report of three cases and review of the literature.
We present 3 cases and a review of the literature to demonstrate the current state of clinical diagnosis and therapy of superficial siderosis of the central nervous system. Typical symptoms were progressive cerebellar ataxia, spasticity and hearing loss. Repeated subarachnoid hemorrhage was indicated by persistent xanthochromia of the cerebrospinal fluid and confirmed by the presence of erythrophages, siderophages and iron-containing pigments. Deposition of free iron and hemosiderin in pial and subpial structures leads to intoxication of the central nervous system and represents the pathophysiological mechanism of superficial siderosis. Hypointensity of the marginal zones of the central nervous system on T2 weighted MR images indicates an iron-induced susceptibility effect and seems pathognomonic for superficial siderosis. In 39 of the 43 previously described cases superficial siderosis was verified by biopsy or autopsy. Today magnetic resonance imaging enables diagnosis at an early stage of the disease. Therapeutic management requires the elimination of any potential source of bleeding. In patients with unknown etiology no proofed therapy is yet available.
Aged↗
Combined magnetic resonance imaging and proton magnetic resonance spectroscopy of patients with acute stroke.
BACKGROUND AND PURPOSE: The prospect for a therapeutic window for treatment of ischemic stroke encourages the noninvasive investigation of metabolic changes in acute ischemia. Recently, localized proton spectroscopy became available at 1.5-T magnetic resonance systems. In this study we evaluated the usefulness of combined magnetic resonance imaging and spectroscopy on the diagnosis of acute and chronic infarctions. METHODS: Combined magnetic resonance imaging and spectroscopy investigations were carried out with a 1.5-T system in 16 volunteers, eight patients with chronic infarction (greater than 8 months), and 10 patients with acute ischemic stroke (less than 8 hours). We used a stimulated echo sequence to acquire localized spectra from image-guided volumes of interest (16-27 ml). RESULTS: There were no significant interindividual differences of choline, creatine, phosphocreatine, and N-acetyl aspartate resonances in the spectra from volunteers. In chronic infarctions, N-acetyl aspartate was decreased in relation to choline. Acute ischemic infarctions were characterized by decreased N-acetyl aspartate resonances and elevation of lactate. CONCLUSIONS: The study demonstrates the feasibility of proton spectroscopy in stroke patients. Metabolic alterations in ischemic tissue can be monitored and can distinguish acute from chronic lesions.
Aged↗
Indication, efficiency and complications of intrathecal pump supported baclofen treatment in spinal spasticity.
In 19 patients, who suffered from severe spinal spasticity of different etiologies and did not respond sufficiently to oral antispastic therapy, intrathecal Baclofen test boli were administered. In 11 patients a DAD (Drug Administration Device) [SynchroMedR Model 8611 H, Medtronic Inc. Minneapolis, USA] was implanted. Catheter dislocation or torsion was the most common complication to be observed in these 11 patients. Long term intrathecal Baclofen application was effective in all patients, as reducing spasticity, flexor spasms and spasm induced pain. In some cases the motor performance ameliorated.
Adult↗
Long-term intrathecal baclofen treatment in supraspinal spasticity.
Baclofen, a derivate of gamma-amino butyric acid (GABA), is known to be a useful drug in spasticity treatment. To achieve a good therapeutic response higher oral dosages have to be administered related with central side effects. Intrathecal application of Baclofen in microgram range dosages is proved to be effective in spinal spasticity. The efficiency of intrathecal Baclofen in patients suffering from supraspinal spasticity is discussed controversially. We report on 9 patients with long-term intrathecal Baclofen treatment, all of them responding well presenting a marked reduced muscle tone. In most cases an improvement of motor performance and in two cases improved bladder function was observed. The therapeutical dosages administered to patients with supraspinal spasticity exceed those administered to patients with spinal spasticity by approximately 100% without provoking central side effects. Despite the risks connected with this method it has to be considered as treatment of choice in cases of severe supraspinal spasticity.
Adult↗
Modern therapy of Parkinson's disease.
The article summarizes historical aspects and current concepts of the treatment of Parkinson's disease. Antiparkinsonian therapy varies with the progression of the disease, age and clinical subtypes. Levodopa, anticholinergic substances, direct dopamine agonists, amantadine, L-deprenyl are used to treat motor symptoms of Parkinson's disease. Novel substances and therapeutic concepts are currently investigated. Treatment of non-motor symptoms of Parkinson's disease and supportive therapies are discussed in the article.
Antiparkinson Agents↗
Double-tracer SPECT in patients with AIDS encephalopathy: a comparison of 123I-IMP with 99Tcm-HMPAO.
Single photon emission computed tomography (SPECT) using N-isopropyl-p-(123I)iodoamphetamine (123I-IMP) and 99Tcm-hexamethylpropyleneamine oxime (99Tcm-HMPAO) was performed in 25 patients with different clinical stages of AIDS encephalopathy. The average interval between the two examinations was 7 days. In 15 of the 25 cases (60%) 99Tcm-HMPAO scans were different from 123I-IMP scans. Uptake defects of different extent were observed in 8 of 25 cases (32%), of different extent and different location in 3 of 25 cases (12%) and of identical extent but of different location in 4 of 25 cases (16%). Differences in the uptake patterns of 123I-IMP and 99Tcm-HMPAO with regard to extent and/or location were more commonly shown in patients with early acquired immunodeficiency syndrome (AIDS) encephalopathy (P = 0.0372). In this group, 99Tcm-HMPAO showed uptake defects of greater extent more frequently than did 123I-IMP (P = 0.0156). Our data indicate different brain uptake mechanisms of 123I-IMP and 99Tcm-HMPAO in early and advanced AIDS encephalopathy.
AIDS Dementia Complex↗
[Neuroradiologic treatment possibilities of intervertebral disk displacement].
A CT assisted method for automated percutaneous lumbar discectomy (APLD) is described. With this technique and introduction of a "pull and push" method as well extruded and sequestrated herniated lumbar discs as cervical herniated discs can be treated. The CT assisted discectomy was performed in 70 patients. The success rate was 86% in the lumbar region and 93% for cervical herniated discs. We believe that this percutaneous technique will increase the importance of interventional neuroradiology for this common disease.
Adult↗
[Orthostatic tremor].
Two men, aged 57 and 77 years old, reported increasing unsteadiness on standing upright for the past 2 and 5 years, respectively. It had become impossible for them to remain standing for more than 10 seconds, as otherwise they might fall down. Walking, sitting and lying were possible without difficulty. Both patients were found to have a fine tremor in both legs on standing only. There were no other neurological signs or symptoms. Electromyography of the leg muscles demonstrated tremor activity at 14-16 Hz. Propranolol, 40 mg three times daily, in the 57-year-old patient brought no improvement. However, on taking primidone, in slowly increasing doses up to 250 and 500 mg daily, respectively, the condition lastingly improved in both patients.
Aged↗
Intracranial germ cell tumor mimicking anorexia nervosa.
A previously healthy seventeen-year-old boy developed loss of weight, poor appetite, and aversion to food. Physical examination being normal, anorexia nervosa was suspected. Thirteen months later a CT scan revealed a mass in the third ventricle histologically proven to be a malignant teratoma. To our knowledge anorexia nervosa is only extremely rarely the presenting feature of intracranial germ cell tumors.
Adolescent↗
Memory dysfunction in Parkinson patients: an analysis of verbal learning processes.
The German version of the California verbal learning test (Münchner Gedächtnis-Test) was administered to compare memory functions of 45 Parkinson patients and 32 healthy controls. Although the Parkinson patients were within their age norm in their performance on standard intelligence and memory tests, a significant pattern of impaired learning was observed with the MGT. While learning capacity showed a linear increase, it was altogether lower than that of healthy normals. Parkinson patients have difficulty organizing new material and applying useful strategies. When offered useful cues, they can apply these for a while, but soon loose these strategies again. They are more irritated by distractors than healthy people. Once material is learned and stored, it hampers the learning of new material. Also, new information disturbs the reproduction of formerly acquired information.
Female↗
Neuropsychological outcome after traumatic temporal lobe damage.
The most frequent sequelae after severe brain injury include changes in personality traits, disturbances of emotional behaviour and impairment of cognitive functions. In particular, emotional changes and/or verbal and non verbal dysfunctions were found in patients with bilateral or unilateral temporal lobe lesions. The aim of our study is to correlate the localization of the brain damage after severe brain injury, in particular of the temporal lobe, with the cognitive impairment and the emotional and behavioural changes resulting from these lesions. The patients with right temporal lobe lesions showed significantly better scores in verbal intelligence and verbal memory in comparison with patients with left temporal lobe lesions and those with other focal brain lesions or diffuse brain damage. In contradistinction, study of the personality and the emotional changes (MMPI and FAF) failed to demonstrate pathological scores in the 3 groups with different CT lesions, without any significant difference being found between the groups with temporal lesions and those with other focal brain lesions or diffuse brain damage. The severity of the brain injury and the prolongation of the disturbance of consciousness could, in our patients, account for prevalence of congnitive impairment on personality and emotional changes.
Adolescent↗