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Biomedical subjects

J De Mol

Publications and source records attributed to J De Mol.

32 records · Page 2Linked to original sources
PubMedDate not supplied

[Hydrocephalic and/or degenerative dementia].

The authors report ten cases of progressive dementia. Nine are associated with gait disturbances and seven with urinary incontinence. Despite the severity of dementia and Ct Scan signs of cortical atrophy, magnitude of neuroradiological ventricular dilatation and ventricular reflux at isotopic cisternography lead to shunt therapy. After ventricular shunting of CSF, a follow-up at short and long terms shows different clinical evolutions: two transitory improvements, three cases without change and five worsening. Retrospective clinical study of these cases in which diagnosis leads to a degenerative process of the Alzheimer type shows atypical premorbid neuropsychological characteristics by a normal-pressure hydrocephalus. In fact, in the ten cases preoperative neuropsychological investigation shows, at various levels, aphasic, alexic and agraphic signs. Their occurrence in the clinical picture represents an essential contribution to differential diagnosis.

Adolescent↗
PubMedDate not supplied

[Computer hardware for a surgical service].

While the bulk of all medical information is text, we think that the hardware needed to collect this information and to store it in a databank, must be essentially a first class work processor, working in a multi-user system with terminals where this information is gathered: the nursing stations, operating theatres, outpatient clinics and a working and archiving station centrally placed and capable to link those different terminals and those from other services as well.

Computers↗
PubMedDate not supplied

[Prognostic factors for therapeutic outcome in normal-pressure hydrocephalus. Review of the literature and personal study].

In view of the unpredictable percentage of NPH patients who benefit from surgery and the risk of postoperative complications, the study of predictive parameters appears essential. The literature shows many conflicting results in studies which focus on predictive values. The present study is based on a series of 63 patients, all of whom underwent surgery for NPH. Fifty one historical, clinical, paraclinical and neuropsychological parameters were submitted to statistical analysis on the basis of the postoperative results. Nine of these parameters were correlated with the postoperative evolution: aetiology, chronic alcoholism and seven neuropsychological signs, in particular verbal signs. A statistical analysis by logistical regression allows us to describe an optimum predictive model. The most significant results are discussed.

Adolescent↗
PubMedDate not supplied

Pilonidal sinus. Excision--marsupialization--phenolization?

Too often still this disease is called sacrococcygeal cyst, pointing into the direction of congenital etiology. With this paper (and a review of the literature) we try to proof that the theory of acquired origin of pilonidal sinus is the only one logically to be accepted. We indicate that extensive surgical procedures such as Z-plasty rotated flap or broad excision--are really unnecessary and that a simple and accurate technique--marsupialization--gives excellent results with a minimum of recurrences. The last few years phenolization of the pilonidal sinus has become a popular, and eventually a worthwhile alternative.

Adult↗
PubMedDate not supplied

[Revascularization of the extracranial carotid-, vertebral- and subclavian arteries in a small peripheral hospital (author's transl)].

A total of 21 procedures were performed on a group of 17 patients, 13 of them more than 65 years old, for mixed intra- and extracranial vessel disease. Ten had recovered from a frank stroke. Thirteen of them underwent one procedure, three two procedures and one a total of three revascularizations. Eighteen carotid endarterectomies, without patch angioplasty were performed. The determinant factor whether or not to use an intraluminal shunt was the peroperatory encephalographic monitoring by a neurologist. The shunt was used any time significant EEG changes occurred during a test clamping period of five minutes. The other procedures included a vertebral artery endarterectomy with patch angioplasty, a subclavian- subclavian vein by-pass, as well as a common carotid artery resection for elongation and kinking of the internal carotid artery combined with marked stenosis. The mortality was nihil. Postoperatively all patients did well with an improved mental and neurological status.

Aged↗
PubMedDate not supplied

[Mental troubles in bismuth encephalopathy: a case report (author's transl)].

The authors describe one case of bismuth encephalopathy, insisting particularly on neuropsychological and neurolinguistic troubles. They analyze, the related literature in reference to the clinical picture in its prodromic phase, state phase, differential diagnosis, course and potential neuropsychological complications.

Aged↗
PubMedDate not supplied

[Neuropsychological tests in the diagnosis of dementia].

The author describes the place of the neuropsychological investigation in the clinical evaluation of patients suspected of mental deterioration and criticizes classic psychometry as inadequate in its quantitative and non specific approach to dementia, to examine the operative behavior of demented patients. More specifically, the author points out the careful attention which must be paid in utilizing the usual intelligence scales, the mental deterioration index and organic impairment scoring systems, often unsuitable for the diagnosis. On the other hand, the author preferes the use of a mental investigation more specifically based on fundamental cognitive functions (language, gnosis, praxis) and illustrates this point of view by some mental deterioration batteries currently used in some countries. Finally, the neuropsychological assessment appears indispensable for diagnosis, prognosis and therapy. Problems raised with early diagnosis, differential diagnosis between reversible and non reversible dementia, between dementia and pseudodementia are discussed with the specific contribution of neuropsychology. The necessity of further investigations in this field is emphasized. A proposition is outlined which would lead to improved neuropsychological tests of greater sensibility and accuracy.

Aged↗
PubMedDate not supplied

[Loss of mental images].

The authors report a case of loss of mental imagery in a 35 year old male patient who was operated on for an intraventricular meningioma in the region of the left trigonum collaterale. The symptomatology and its evolution are described. Discussion of the pathophysiologic hypotheses is focused on the possible role of a selective memory disturbance, of a functional disconnection between language- and visual representation-areas of the brain, and of visual agnosia. In the reported case, the underlying pathophysiologic mechanism seems to be very close to the one responsible for visual agnosia, and could be explained as a partial dissolution of visual memories. Analysis of 35 cases of loss of mental imagery reported in the literature shows that the investigation of this peculiar disturbance is in many cases incomplete. It nevertheless reveals that visual agnosia, or a particular form of visual agnosia, is present in all cases of unilateral posterior lesion of the dominant hemisphere.

Adult↗
PubMedDate not supplied

[Pseudo-Hakim-Adams syndrome. Neuropsychological study of 23 cases of misdiagnosed Hakim-Adams syndrome].

The authors study the characteristics of a group of 23 patients for whom an initial tentative diagnosis of Hakim-Adams syndrome (H-A syndrome) was eventually rejected. On account of several factors distinguishing these patients from the true H-A group, the authors propose using the term "pseudo Hakim-Adams syndrome". The distinguishing factors include: the grounds for admission, i.e. mental or mnesic deterioration, associated with radiological images of ventricular dilatation; a clinical picture dominated by mental disorders with only rare disorders of gait and sphincter control (several neurological defects were direct consequences of previous cerebral disease); no antecedents of spontaneous meningeal hemorrhage or meningitis in the case history; neuropsychological examination showing fewer disorders of concentration and less dyscalculia and constructive dyspraxia than in true HA, and far more atypical signs of the aphasic and anxio-depressive type. The authors think that various pathological processes may be responsible for this pseudo H-A syndrome in which a predominant mental picture is associated with ventricular dilatation.

Adult↗
PubMedDate not supplied

[Post-traumatic conversion hysteria. A case report of hysterical paraplegia (author's transl)].

The authors report a case of hysterical paraplegia occurring two days after a craniovertebral trauma. They describe the patient's evolution on psychological, neurological and physical therapy grounds. They also discuss the concept of traumatic neurosis with regard to definition, characteristics, classification and its boundaries in relation to the subjective central post-traumatic syndrome. They also study the definition, frequency, limits and course of conversion hysteria with special emphasis on hysterical paralysis and its characteristics.

Adult↗
PubMedDate not supplied

[Clinical and psychometric study of post-traumatic stress disorders following acts of violence].

Fifty victims of assaults and hold-ups underwent a medical and psychological examination in order to assess the semiological and psychometric features of post-traumatic stress disorder: 27 males and 23 females with a mean age of 41 years were examined 18 months after the traumatic event. The following semiology was observed: excitability, phobic avoidance, distrust, recurrent traumatic nightmares, difficulties in concentration, impaired memory, dysphoric mood, hyperfatigability, recurrent recollection of the traumatic event, headache, middle and terminal sleep disturbances and neurovegetative hyperreactivity. Testing demonstrated anxious and depressive troubles and moderate cognitive disturbances. Statistical study showed no correlation between type of aggression (psychological trauma with or without concomitant physical component) and cognitive and psycho-affective variables. Most of the cognitive disturbances were correlated with the severity of anxiety and depression. Post-traumatic stress disorder also perturbed the work capacity: only 8 patients resumed previous activities after a lapse of time of 1-54 months.

Adult↗
PubMedDate not supplied

Treatment of alkaline reflux gastritis. A report of twenty cases.

The surgical treatment of twenty patients operated for postoperative alkaline reflux gastritis is discussed together with the pathogenesis of this syndrome as a late postoperative surgery syndrome. Diagnostic procedures and results of investigations and treatment were compared with data of the literature. Surgical treatment is of great benefit. The different surgical technics should be used according their own indication.

Adult↗
PubMedDate not supplied

[Neuropsychological study of mental troubles in normal pressure hydrocephaly and their short term evolution after spinal fluid derivation (author's transl)].

Starting with 8 neuropsychological detailed observations, the author has studied mental deterioration resulting from normal pressure hydrocephaly and the short term evolution of mental troubles after apinal fluid derivation. The presurgical mental troubles are characterized essentially by short term memory troubles, by behavioural troubles relating to the two poles of the frontal syndrome and by distrubances in writing and calculus. The modification of the state of consciousness, the visual constructive troubles, attention and concentration troubles, verbal language troubles and psychomotor retardation are also frequent. Aphasia and alexia are rare. Generally, postsurgical evolution is immediate and global; the troubles of consciousness, mental deterioration and behaviour disorders are parallely reduced. Globaly, three out of four troubles disappear. Memory troubles and difficulties in concentrating, although improving, are still maintained six month after ventricular drainage.

Adolescent↗