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Biomedical subjects

H Ebel

Publications and source records attributed to H Ebel.

At least 73 records · Page 4Linked to original sources
PubMed1995

[Modified Kirschner wire insertion for direct ventral screw fixation of dens fractures].

Since 1985 25 patients with a fracture of the odontoid process (dens) were operated in the Neurosurgical Department of the Justus-Liebig-University in Giessen. An early stabilization through an anterior approach was favoured for type II fractures, and for displaced type III injuries, according to the classification of Anderson and d'Alonzo. Two double threaded screws were implanted to reach a compression between the fragments and a stabilization of rotation. With patients having a large thoracic volume and/or a short neck there are often problems, to insert the K-wires in the correct angle, before the screw fixation is performed. For these cases we have developed a new device for the K-wire insertion. After technical examinations in specimen the device was successfully applied in clinical use. This device with its inherent advantages is presented and discussed in this paper.

Bone Screws↗
PubMed1995

[Correlation between the gradient constant of the theoretical pressure volume diagram (PVD) and the pressure volume index (PVI) in relation to brain pulse amplitude-mean pressure function].

In 54 neurosurgical patients--suffering from intracranial tumors, hydrocephalus or different kinds of brain injury--a catheter was implanted in the lateral ventricle for continuously monitoring of the intracranial pressure (ICP). The intraventricular injection of defined amounts of sodium clearance (1-2 cm3) was followed by increased values of intracranial mean pressure--(pm) and pulse-amplitude- (PA). The recorded data showed a high significant correlation after regression analysis. After determination of the pressure-volume-index (PVI) and the theoretical pressure-volume-diagram it was examined whether there is a linear correlation between the parameters of the craniospinal space (id) reserves (constant of gradient, (PVI, K of PVD)) and the gradients (CA) of the linear PA-PM-function. A significant linear relationship, however of weak degree, could be found between these two parameters. The linear PA-PM-function, therefore, can only be understood in restricted circumstances as a direct parameter of the intracranial spacial reserves. The underlying facts of these problems are dealt within this paper.

Brain Injuries↗
PubMed1994

Oleic acid inhibition of Na+/D-glucose transport in isolated renal brush-border membranes: role of lipid physical parameters and trans Na(+)-inhibition.

UNLABELLED: Inhibition of Na+/D-glucose transport by oleic acid was investigated in renal brush-border membrane vesicles (BBMV). Lipid physical parameters were determined by spectrofluorometry. cis-Unsaturated C16-C22 long-chain fatty acids (LCFA) as oleic acid reduced nonzero limiting anisotropy r infinity with DPH and 12-AS as probes and decreased rotational correlation time phi of 12-AS. At 8 s and 15 s Na+/D-glucose transport was competitively inhibited. A positive correlation existed between decrease in r infinity (acyl chain order) or decrease in rotational correlation time phi (= increase in 'fluidity') and inhibition of Na+/D-glucose transport. Except elaidic acid trans unsaturated and saturated LCFA had no effect on fluorescence anisotropy and Na+/D-glucose transport. Per cent transport inhibition was unaffected by 0 voltage clamping and by FCCP. Ki for trans Na(+)-inhibition of D-glucose transport was 29 mmol/l. Na(+)-transport was stimulated by oleic acid, exceeding the Ki value for trans Na+ inhibition. CONCLUSION: oleic acid inhibits Na+/D-glucose transport by a decrease in lipid acyl chain order and an increase in 'fluidity', by trans Na(+)-inhibition and presumably by a third unknown mechanism.

Animals↗
PubMed1994

Stereotactic cysto-ventricular shunting in diencephalic (arachnoid) cysts.

Stereotactic cysto-ventricular shunting in three patients with congenital (subependymal cyst of the 3rd ventricle, subependymal cyst of foramen of Monroi, cyst of cavum septi pellucidi) is dealt with in this paper. The first operation was performed in May 1992 and the latest, being considered in this paper, in January 1993. All patients were admitted to our hospital suffering from increased intracranial pressure. CT-scans revealed an obstructive hydrocephalus subjected to the cystic lesions. After stereotactic puncture of these cysts, aspiration of their contents as well as biopsy of the wall a silicone catheter was implanted, thus constructing a permanent communication between the cyst and the lateral or 3rd ventricle. The internal catheter was connected to a subcutaneous burr-hole reservoir. All patients recovered uneventfully without neurological deficits. There were no operative complications. Follow-up CT-scans showed no recurrences of the cysts and obstructive hydrocephalus. Resulting from our experiences, it is quite obvious that the stereotactic internal shunt implantation seems to be a safe, proper and reliable method in the treatment of such cystic lesions. Open craniotomy or intracorporal shunting procedures and their immanent complications can be avoided for most cases of congenital intracranial cysts. It should, therefore, be the aim of further clinical investigations to prove the value of this method in additional cases.

Arachnoid Cysts↗
PubMed1994

[Severe "late" dystonia after neuroleptic anxiolysis with fluspirilene].

The development of severe tardive dystonia after short-term use of low-dose Fluspirilen is described. A 39-year-old woman was treated with Fluspirilen IM by her family doctor for reactive depression. She did received no other neuroleptic agents and no risk factors for the development of tardive dyskinesia (e.g. old age or organic brain damage) were present. For the first time a relation between short-term monotherapy with Fluspirilen and tardive dyskinesia appears highly probable. The use of Fluspirilen for the treatment of psychogenic disturbances should therefore be considered carefully.

Adjustment Disorders↗
PubMed1993

[Solitary intracranial late metastasis of a granulosa cell tumor of the ovary. Case report and review of the literature].

A 75-year old patient was admitted to hospital in June 1989. She was suffering from headache since three months. In the neurological examination a mild hemiparesis on the left side, personal changes and apractic disturbances could be found. 10 years before a granulosa-cell tumour of the left ovary was extirpated, postoperatively the patient received radiation and polychemotherapy. CT-scan and MRI of the head showed a tumour parieto-occipital on the right hemisphere with multiple cystic and solid areas. The tumour was extirpated in toto. The postoperative course was uneventful. Primary tumour of the left ovary and intracranial metastasis showed the same histological findings.

Aged↗
PubMed1993

[Initial experiences with implantable pump systems for intrathecal therapy of chronic pain conditions].

The therapeutic concept of local administration of opioids into the perimedullar and cerebrospinal fluid is the result of fundamental studies concerning the discovery and localization of specific binding sites. These studies provoked considerable clinical interest, because they suggested a non-destructive and fully reversible method. In our department we have been gathering experience with an implantable pump system for various indications of chronic pain on a sample of 25 patients. The first implantation was performed in February 1987 and the latest included in this study in February 1991. The sample of patients consisted of two groups: (A) Chronic non-malignant pain (13 cases), (B) Chronic pain due to cancer (12 cases). We used two different pump devices: the gas-filled continuous infusion pump (Infusaid, Mod. 400) in 10 cases and the manually tractable micro pump (Cordis) in 15 cases. In 23 cases we decided in favour of an intraventricular drug administration, mainly because of the site of the pain; in each of these a ventricular catheter was placed in the frontal horn of the lateral ventricle. In the remaining two cases, the catheter was placed intraspinally, the catheter tip terminating at thoracic segments. Nine of the patients with cancer-related pain experienced from excellent to acceptable pain relief, as did also 10 patients with chronic non-malignant pain. Side effects were rare. Our findings also indicate that, in carefully selected patients, both malignant and non-malignant pain may be managed satisfactorily with this technique.

Adult↗
PubMed1992

Extracorporeal elimination of carbamazepine by haemoperfusion.

The clearance of the haemoperfusion cartridge H 200 C Tekin was determined in vitro for blood dissolved carbamazepine to test the efficiency of haemoperfusion treatment. In the first hour of in vitro haemoperfusion test of pig blood (concentration of carbamazepine 1084 mg/l) a clearance of 190 ml/min was obtained, which declined slightly to 150 ml/min after 4 hours. In a second test the elimination of carbamazepine from albumin solution was proven to be more than 1000 mg of carbamazepine after a four hour perfusion period using teflon coated charcoal. These results are in accordance with the clinical course of a 30 years old male patient who presented with severe hypoxaemia due to acute intoxication by 6 g carbamazepine. The carbamazepine blood level was 33.7 mg/l. Charcoal haemoperfusion was started immediately. A dramatic improvement of clinical symptoms was already observed during haemoperfusion. The carbamazepine serum level was 18.6 mg/l after 4 hours of haemoperfusion.

Adult↗
PubMed1992

[Chronic schizophreniform psychosis in primary hyperparathyroidism].

We delineate the case history of a 74-year-old female patient. On the occasion of acute physically established psychoses in this case, we were able to detect a primary hyperparathyroidism due to adenoids of the epithelial body. This critical psychopathological condition developed from a psychosyndrome, most likely seeming as senile schizophrenia, and which had previously existed for four years. It will be discussed whether these chronic schizophrenia-like symptoms and signs can be explained by hyperparathyroidism.

Aged↗
PubMed1991

Fluid-shift during computer-modulated profile hemodialysis (CMP-HD).

Computer-modulated profile hemodialysis was examined for patients' comfort and fluid-shift. Fifteen patients were studied after two weeks of dialysis with each of the following profiles: A): constant ultrafiltration (UF) and dialysate sodium (138 mmol/l); B): decreasing UF; C): decreasing UF and decreasing high dialysate sodium (starting 10% above serum-sodium, with a gradual reduction to 138 mmol/l in the fourth hour). Patients with a calculated increase of intracellular volume (ICV) during dialysis had more complaints after dialysis than the others. ICV decreased in all patients with low serum-sodium (less than 136 mmol/l) during all profiles, whereas in patients with higher sodium, only profile C led to a decrease of ICV. However, interdialytic weight gain increased about 75% in patients with low serum-sodium under profile C. The sodium profile could help in preventing imbalance without side effects in patients with high sodium.

Aged↗
PubMed1990

Lycanthropy and demonomania: some psychopathological issues.

Modern reports on lycanthropy mainly concentrate on the content of patients' beliefs in being transformed into an animal. By contrast, an interest in the form of the symptomatology is usually minimal. This paper draws on Karl Jaspers' phenomenological views and focuses on some important albeit neglected psychopathological issues related to form which are relevant to any comprehensive consideration of lycanthropic phenomena.

Awareness↗
PubMed1990

[Psychopathology of person misidentification--a multidimensional concept].

The misidentification of person or Personenverkennung (PV) is provisionally redefined in this paper by focusing on four important points of view offered by German-speaking authors, all more or less based on an analysis of content. These deal with the extent of "craziness" of a PV (Leonhard), the degree of personal relationship of the person misidentified with respect to the patient (Kahlbaum/Pauleikhoff), the extent of the incorrect identification (Jaspers), and, lastly, the stage of stability shown by a PV at a particular point in time (Conrad). On this basis it is suggested that it may be best to initially call the PV simply a "delusion" with all further differentiation of types of PV carried out in light of a multidimensional psychopathological model utilizing various combinations of these four aspects of content.

Capgras Syndrome↗