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Biomedical subjects

H Binder

Publications and source records attributed to H Binder.

At least 109 records · Page 6Linked to original sources
PubMed1984

Osteogenesis imperfecta: rehabilitation approach with infants and young children.

A rehabilitation approach, consisting of initial handling and positioning followed by functional and formal strengthening exercises, was developed for the child with severe progressive osteogenesis imperfecta (OI). The program was developed because of the increased life expectancy for infants and children with severe progressive OI, combined with the lack of published reports dealing with their rehabilitation. The program can be followed easily by parents or therapists with regular monitoring by a psychiatrist. The goals are to improve the life span as well as the quality of life of these children by preventing the following: (1) positional contractures and deformities, (2) muscle weakness and osteoporosis, and (3) malalignment of the lower extremity joints prohibiting weight-bearing. Implementation of the program requires full cooperation of the parents. The initial results in four children between the ages of 3 and 11 years are encouraging. The benefits of increased strength and mobility leading to more age-appropriate activities and behaviors outweigh the only observed negative result, that is trauma-related lower extremity fractures in children with milder disease, and therefore greater mobility and higher activity levels.

Braces↗
PubMed1984

Spinal muscular atrophy: experience in diagnosis and rehabilitation management of 60 patients.

Sixty patients with spinal muscular atrophy (SMA) are presented. Although the life span with Type I SMA (Werdnig-Hoffmann disease) may be short, children with the disease can be made more comfortable with appropriate medical care and parental support. Despite electrodiagnostic findings which are not always pathognomonic and muscle biopsies which can be difficult to interpret, the clinical presentation of these infants is so typical and the natural course of the disease so predictable that management can be telescopically designed. findings and muscle biopsies are more definitive. In these more benign forms of SMA, anticipatory medical management focuses on possible In SMA-II (Childhood) and SMA-III (Kugelberg-Welander), electrodiagnostic findings and muscle biopsies are more definitive. In these more benign forms of SMA, anticipatory medical management focuses on possible dislocating hips, scoliosis, pulmonary compromise, and sudden increase in weakness associated with intercurrent illness or prolonged immobilization due to fractures or surgery. Further considerations include maintenance of strength and endurance, independence in self-care, psychosocial, educational, and vocational endeavors. These more chronically affected children are eminently habilitable.

Adolescent↗
PubMed1982

[Rare primitive motor patterns of the oral sense (author's transl)].

This case report presents two types of primitive motor patterns of the oral sense, the rooting reflex in an apallic patient due to encephalitis and a cobra-bite-like motor pattern in a patient with a hypoxic apallic syndrome. In the apallic syndrome the disintegration of cerebral functions to a mesodiencephalic level is a characteristic feature. The reappearance of primitive motor patterns of the oral sense in the apallic syndrome thus gives further evidence for the integration of primitive motor patterns (e.g. rooting reflex) in the brainstem reticular formation. The cobra-bite-like motor pattern combined with aggressive actions might be due to the connection between brainstem functions and limbic structures.

Adult↗
PubMed1982

[The practice of ethylene oxide sterilization].

Complete and rapid removal of ethylene oxide used for fumigation and its conversion products are of critical importance when reusing gas-sterilized parts of instruments. Evaluation of desorption is possible by means of gaschromatographic analyses of the atmosphere in packs containing the instruments for fumigation and storage. Residual amounts for a number of selected parts of instruments shown suggest latent sources of danger. The dimension of the instruments, the differences in plastic materials and ethylene oxide permeability of packing materials play a significant, though not obvious, role. Since no general rules concerning the duration of desorption can be established in view of these various factors, occasional examinations by means of gaschromatographic analyses are necessary.

Catheterization↗
PubMed1982

[Head and brain injury in a patient with familial paroxysmal hypokalaemic paralysis (author's transl)].

The case of severe skull and brain injury is reported in a patient with known familial paroxysmal hypokalaemic paralysis. Multiple cerebral contusions were seen in the brain trauma. The central nervous function could not be clearly determined since the patient had a hypokalaemic state at the time of admission to the hospital. Only electroencephalographic follow-up studies could reveal the central nervous function at that time.

Adolescent↗
PubMed1982

[Neuropsychiatric symptoms of hepatic encephalopathy].

The words "hepatic encephalopathy" and "hepatic coma" are used synonymously to describe the course of a disease state which is characterized by at least transient, gradual or complete loss of consciousness. Own results regarding the incidence of various neurological and psychiatric symptoms are described. Evaluation of these symptoms in a longitudinal study allows to differentiate between an acute and a subacute form of this disease state. The prominent neuropsychiatric symptoms are characterized by a disintegration of complex neuronal functions. A rating scale comprising four different symptoms is proposed, allowing grading of the disease state. Such a scale cannot replace a careful neurological work up; such work ups have to be done in regular intervals in these patients, so that neurological symptoms can be recognized at an early state.

Consciousness Disorders↗
PubMed1981

[Neurological signs in diphenylhydantoin intoxication (case reports and review) (author's transl)].

Five patients who were treated with long-term diphenylhydantoin for epilepsy developed neurological signs of poisoning. In 4 cases the symptoms appeared following treatment of status epilepticus with additional phenytoin medication. All patients had an acute symptomatic psychosis and a diffuse slowing of the curves in the EEG. All 5 patients showed cerebellar signs and two of them complained additionally of objective polyneuropathy, a third case complaining of itching only. An axonal polyneuropathy with minimal reduction in motor nerve conduction and a considerable extension of distal latency and diminution of compound action potential was found. In one case the biopsy showed concentric lamellar bodies coming from the axon, with intact myelin sheaths. All alterations were reversible. The pathogenesis of toxicity is discussed. Cumulation of toxic products in the plasma arising from delayed elimination of DPH metabolites is pointed out. However, one case with cerebellar signs had normal DPH levels.

Adult↗
PubMed1981

Leg function after radiotherapy for Ewing's sarcoma.

Twenty-nine patients with Ewing's sarcoma of the lower extremity who survived for two or more years following therapy (5000 rad locally and systemic chemotherapy) were studied to assess functional status of the affected leg. Twenty-two of twenty-nine were alive and were reexamined; the deceased patients were evaluated by record review. Twenty-two of the twenty-nine had serial radiographs, which were reviewed to assess growth change induced by radiation. The living patients were divided on the basis of clinical examination into four functional groups with Group I comprising patients with minor functional limitations and leg length discrepancy 1.5 cm or less. Group II patients had moderate functional limitations with 2.5-cm leg-length discrepancy or less. Group III patients had severe functional limitations with up to 4-cm leg length discrepancy. Group IV patients had severe complications, sufficient enough to warrant amputation. Thirteen of twenty-two patients were classified as functional Group I, five as Group II, three as Group III, and one as Group IV. Radiographic changes in growing bone did not correlate with functional results. Although a femoral fracture and an age less than 16 years at diagnosis were found to be less favorable prognostic factors for the functional treatment result, these results show that neither femoral location nor young age justify primary amputation for Ewing's sarcoma of the lower leg extremity.

Adolescent↗
PubMed1981

[On the neuro-psychiatric symptomatology of the so-called "hepatic coma" (author's transl)].

The definition of hepatic coma has been used for the most severe course of hepatic insufficiency, independent from the pathogenesis. This means, that from the psychiatric point of view the hole survey of the exogen reaction type was subdivided. The neurologic symptomatology was rather neglected. In this study an attempt is made to show--using the reports of 77 patients with severe hepatic insufficiency of different etiology--that with very exact and repeated examinations a typical course of neuro-psychiatric symptoms can be observed. A distinct hierarchy of symptoms is existing, which is similar to the well known princip of dissolution (Jackson). As a main factor one has to differentiate between an acute and a subacute course. The acute course is characterized by a rapid decrease of vigilance and increase of neurologic symptoms, which end in most of the cases with an acute midbrain- and bulbarbrain-syndrome, while the subacute course shows primary a disturbance of thymo- and noopsychic function in different relations. In addition to the organic "Achsensyndrom" amnestic or amentiell symptoms can be found, which might be covered by a decrease of the vigilance--if the primary noxis continoues--end up with unconsciousness. The parallel developing neurologic symptomatology shows a distraction of the general motoric, including so-called basic movements. later stereotypies and automatismes, and the delicate distal movements change into rough general-rotation-and pointing movements of the hole body. There is also a temporary bending of all extremities and at this time also a rigidospasticity. In the following course preponderate transient bending or stretching, finally there exists a lack condition, which does not respond to external provocations. The symptomatology is not always symmetric. Transient or longstanding hemiparetic symptoms and also crossed brainstem symptoms can be seen frequently. Sometimes there are general or focal epileptic seizures. If a brain edema occurs it leads to a tentorial herniation with the symptoms of an acute midbrain- or bulbarbrain syndrome, which exists in nearly every second patient. If the course turns, the clinical symptomatology is passed in reverse direction. A good relation exists to the known biochemical changes. The disturbed monoaminmetabolism influences the structures, which are important for the vigilance. The serotonin and 5-hydroxyindolaminoacid level in the tegmentum and the hippocampus are increased. Worth to mention, that this is not a specific hepatic disturbance. Additional one can find false transmitters, for example octopamin, which are concerning the excitation, less potent than dopamin or noradrenalin and also a decrease of the latter in the extrapyramidal structures, which corresponds very well with the motoric deficiency and defectsymptoms. Not all of the symptoms can be explained by disturbances of the catecholaminmetabolism. It seems, that electrolyt and acid-base disturbances are also of some value...

Acetoin↗
PubMed1980

Computerized tomography in cerebral-palsied children.

Of a total of 160 patients with cerebral palsy, 80 were studied by computerized tomography. In the congenital group, abnormal studies were found in two of the 12 patients with diplegia, 16 of 18 with hemiplegia, 14 of the 18 with quadriplegia and five of the seven with atonic diplegia. 18 of 21 patients with acquired disease had abnormal CT scans. Computerized tomography is a useful tool for demonstrating the anatomical lesion responsible for cerebral-palsied patients' clinical findings. It is also useful in making a prognosis of functional outcome, and in defining lesions which are correctable by neurosurgery.

Adolescent↗
PubMed1979

The symptomatology with the most severe clinical course of spontaneous subarachnoid hemorrhage.

The symptomatology of 18 patients with the severest clinical course after subarachnoid hemorrhage (SAH) is described and analyzed. Seventeen patients died, five with an acute bulbar syndrome with cardiac arrest, and 12 with irreversible breakdown of brain function. One patient had an apallic syndrome with minimal signs of remission, who died 4 months after the first rebleeding. The cases are divided into five clinical groups on the basis of the acute brainstem symptomatology which set in instantly or after temporary adaptation, or following a second hemorrhage. Pathological examination revealed that 16 patients had a brainstem pressure cone, 14 with marked edema and signs of herniation; one patient had only cisternal tamponade while another had predominantly brain edema with herniation. There was striking parenchymatous damage of the brain of the patient with the apallic syndrome. There was a marked analogy between the material reported and the symptomatology described by Plum and Posner (1972).

Adult↗
PubMed1978

[The application of guanidine hydrochloride to the treatment of degenerative nervous and muscular diseases. I. Clinical results (author's transl)].

This paper reports the results obtained on using guanidine hydrochloride in the treatment of patients with amyotrophic lateral sclerosis, degenerative diseases of the spinocerebellar system or the peripheral nervous system and dystrophic muscle diseases. A long-term effect of the substance was a diminution in the rate of progression of the diseases, with the exception of the group with dystrophic muscle diseases. Initial clinical improvement occurred in certain patients of both groups. The substance seems to be more effective in less-advanced cases than on administration in the later stages of the disease. The therapeutic dosage was 20 to 40 mg/kg/day. The most frequent side-effect was paraesthesia and sometimes gastric disturbance was reported. Therapy had to be discontinued in 3 patients due to leucopenia. In these patients the symptoms rapidly increased in severity after discontinuation of treatment. This supports the assumption that guanidine hydrochloride treatment slows down the progress of the disease.

Adult↗