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Biomedical subjects

H Reisner

Publications and source records attributed to H Reisner.

At least 37 records · Page 2Linked to original sources

[Progress of technical medicine within the field of gerontoneurology (author's transl)].

1938 respectively 1978 are dates for progress of technical medicine concerning gerontoneurology. Following the discussion of the development in technical (apparatus), chemical and immunological diagnostic activities in neurology the applicability in elderly people should be described. On principle there are no methods of investigations which cannot be used in geriatric causes. Main point of interest is the correct indication. Non invasive methods can be used without somatic risk; one has to observe only the fact of psychological stress for the patient; indications of invasive methods (merely angiography of vessels within the brain) must be focused on special diagnosis of the illness. Suspicious facts of space occupying intracranial process almost everytime ask for angiography following EEG and cranial computertomography. In cases of arteriosclerosis in aged people with typical changes within the vessel system of the brain one should only use angiographical investigations if clinical findings (based on noninvasive methods) show indications for surgical treatment in extracranial regions of the brain vessels. It might be the same procedure if shunt-operation between carotis externa and interna circulation system can be expected as curative or prophylactic influence within the neurological condition. In these cases risk of selective angiography of the vessels within the brain (outgoing from arteria femoralis) are much less dangerous than in direct charges. First of all neurological status, general condition and age will be decive for medical indication. One should not use the full range of diagnostic features in gerontoneurology only to satisfy diagnostic appeasement.

Aged↗

[Scope and limitations of cranial computerized tomography (author's transl)].

Cranial computerized tomography (CT) has revolutionized the scope of diagnostic procedures in intracranial diseases. The method is based on the quantitative registration of x-ray absorption and enables many different pathological features within the skull to be directly visualized for the first time on the tomogram. Cerebral haemorrhage and encephalomalacia can be immediatley differentiated on the basis of the totally different appearance on CT. In the case of tumours, the additional administration of the contrast medium intravenously provides enhancement of the diagnostic evidence. Atrophic processes can be diagnosed by means of CT without recourse to additional neuroradiological methods and this facilitation is of particular value in neuropaediatrics. Orbital processes can be easily spotted due to the high definiation matrix of image. The limitations of CT are based on physical conditions.

Atrophy↗

[Acute cerebrovascular disorders caused by ovulation inhibitors].

Cerebral circulatory disturbances occurred in 42 women between the ages of 17 and 52 who were taking oral contraceptives. The disturbances were primarily in the form of cerebral haemorrhages. The symptoms ranged from ephemeral neurological deficiencies to massive hemi-syndromes. Complete remission occurred in 16 patients, partial remission in 24 patients, two patients died. The patients were subdivided into two age groups, one comprising 31 persons between 17 and 39, and the other 11 persons between 41 and 52 years of age. The aim was to ascertain facts which were related to the possibility of haemorrhage in women taking ovulation inhibitors. The first finding, statistically significant, was that the possibility of a cerebro-vascular disturbance increases with the period during which the pill is taken and that this possibility is especially great in the presence of migraine which may also be existent in the family, and in the case of hypertension. The second finding, not significant however, was that the risk was higher in the presence of several factors in one person. These factors include familial factors with a predisposition to migraine and thrombosis, past illnesses of the peripheral vascular system, a predisposition to allergic reactions, obesity and kidney damage. Should one of these situations or both prevail, the patient will be advised to stop taking the pill, and the contraceptive will be discontinued if certain prodromes are observed in a general form, or if focal symptoms occur.

Acute Disease↗

[Traumatic cerebral thrombosis (author's transl)].

The observation of 6 patients with traumatic cerebral thrombosis following closed injury to the skull stimulated this compilation and review of the relevant literature on this subject. Thrombosis of the internal carotid artery and the vertebral artery head the list and do not only come about after blunt trauma to the neck, in which case traumatic aetiology is always thought of in conjunction with the appearance of appropriate neurological symptoms, but also arise from injuries to the skull. In the latter circumstances, the cerebral symptoms will usually be attributed to an epidural or subdural haematoma, particularly if there is a symptom-free period. This happens especially after minor injuries to the skull. In fact, traumatic thrombosis is seen less frequently than extracerebral haematomas, but is nevertheless repeatedly encountered owing to the great number of traffic accidents. Definitive diagnosis can be made only by angiography of the cerebral vessels, above all of the internal carotid artery. Similar to the prognosis of any disease caused by vascular occlusion, the prognosis as to the extent of recovery from the cerebral focal symptoms depends on the sufficiency of the collateral circulation, whereby surgical removal of the thrombus at the earliest possible moment appears to absolutely indicated.

Carotid Artery Thrombosis↗

[Thrombosis of the cerebral vessels following closed cranial trauma (author's transl)].

The case histories are presented of 6 patients, 5 of whom developed carotid artery thrombosis (the left vessel being affected in 4 cases and the right only in 1 case) following closed cranio-cerebral trauma; the 6th patient developed thrombosis of the posterior cerebral artery, as confirmed at autopsy. The factors involved in the aetiology of these events are discussed on the basis of the case reports.

Accidents, Traffic↗

[Effect of Ouabain on cerebral blood flow (author's transl)].

The effect of 0.25 mg ouabain on cerebral blood flow (CBF) was investigated in patients with and without cerebrovascular disease using the xenon clearance method. The 36 patients included in this study did not show any signs of heart failure. Ouabain increased the CBF and this effect was demonstrable 15, as well as 90 min. after administration. This effect was proven statistically using the t-test for a comparison of the values with spontaneous changes in a control group without medication. The perfusion of pathologically-supplied brain regions was altered in the same way as the hemispheric flow; changes in the distribution of blood in the way of a steal effect were not observed. The haemodynamic parameters do not indicate a primary cardiac effect. Hence, an influence of ouabain on cerebral vessels might be responsible. The present results support reported clinical experience with ouabain for the treatment of patients with cerebrosvascular disease.

Blood Pressure↗

Characterization of human anti-factor VIII antibodies purified by immune complex formation.

Anti-factor VIII antibodies from three hemophilia A patients were selectively isolated by immune complex formation and secondary precipitation with polyethylene glycol. These antibodies were characterized as IgG, with only one type of light chains (kappa) and a mixture of IgG3 and IgG4 heavy chains. This finding indicated that stable complexes of factor VIII and homologous anti-factor VIII antibodies could be obtained, and that the immunologic response to the infusion of homologous factor VIII was oligoclonal rather than monoclonal in these patients.

Antibodies↗

[The place of echoencephalography in neurolgy].

A short survey is given of the use of ultrasound examinations in neurology. Special attention is paid to the original immersion technique of Dussik, the A-scan echoencephalographic technique and the non-directional and directional Doppler technique, which are described with particular reference to their applications in the field of neurological diagnosis.

Brain Diseases↗