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Biomedical subjects

J Glaser

Publications and source records attributed to J Glaser.

At least 91 records · Page 5Linked to original sources

Multifocal fibrosclerosis with hypertrophic intracranial pachymeningitis.

We describe a 34-year-old man with a 17-year history of multifocal fibrosclerosis resulting in unique neurologic complications. Episcleritis, orbital pseudotumor, and sclerosing cholangitis accompanied a florid intracranial inflammatory pachymeningitis. The latter was associated with blindness, multiple cranial neuropathies, pseudotumor cerebri, and seizures. Extensive investigation failed to reveal an etiology. Corticosteroids were ineffective in preventing progression of the disorder, and the value of antineoplastic therapy was uncertain. Multifocal fibrosclerosis, a rare disorder, may result in a confusing array of neurologic manifestations.

Adult↗

Significance of a sonographic secretin test in the diagnosis of pancreatic disease. Results of a prospective study.

In a prospective study the pancreatic duct diameter was measured sonographically before and after secretin stimulation in 20 healthy controls and 59 patients with upper abdominal pain, weight loss, and/or diarrhea. Whereas healthy controls and patients without pancreatic disease after secretin stimulation showed a distinct pancreatic duct dilatation of more than 90% of basal duct diameter, no distinct secretin-induced duct enlargement was observed in most patients with chronic pancreatitis. Patients with circumscript pancreatic duct stenosis even had a marked and longer-lasting duct dilatation after stimulation. In patients with anomalies of the pancreatic duct system, no uniform response was found after secretin injection. In this study the sonographic secretin test showed a sensitivity of 92% and a specificity of 95% for diagnosis of chronic pancreatitis. The results confirm that this diagnostic method can be recommended as a reliable screening test for pancreatic disease.

Adult↗

[Plasma perfusion in life-threatening exogenous poisoning].

Since 1984 30 patients with severe exogenous intoxications have been treated by plasma perfusion. This method has advantages compared to other instrumental detoxification techniques, especially hemoperfusion; i.e. no loss of blood cells, no necessity for systemic anticoagulation and no blockage of the adsorber by thrombus. The plasma, which was obtained by plasma separation, perfused the respective adsorber (activated charcoal, resin). After "purification" the plasma was returned to the patient. The mean perfused plasma volume amounted to 3800 ml per patient and per treatment cycle. 27 of the 30 patients were treated successfully. The observed toxokinetic data confirmed the effectiveness of plasma perfusion in the elimination of toxic substances.

Adolescent↗

Sonographic imaging of the pancreatic duct. New diagnostic possibilities using secretin stimulation.

The pancreatic duct or at least parts of this structure can be demonstrated today by sonography in 75-85% of all persons examined. In 84 persons we have now measured the caliber of the sonographically visualized pancreatic duct in the region of the proximal body of the pancreas with special attention to dependence on age. The diameter of Wirsung's duct ranged from 1 to 3 mm (mean 1.9 mm) and increased significantly from the fifth decade of life onwards. After intravenous injection of the hormone secretin, healthy persons usually show a distinct duct enlargement, which also depends on age. Nine persons aged 19 through 35 (median 28) years showed a dilatation of the main pancreatic duct by about 110% following secretion injection. Nine further probands, 50-74 (median 58) years old, had a dilatation of about 70%. Eighteen patients with confirmed chronic pancreatitis and a pancreatic duct diameter not exceeding 4 mm generally showed no duct enlargement after secretin stimulation. We believe that periductal fibrosis, which is common in chronic pancreatitis, is the most important reason for these results. The use of the sonographic secretin test in the diagnosis of chronic pancreatitis should be considered.

Adult↗

[Primary sonographic diagnosis of pancreatic duct calculi: the non-uniform aspect].

Four cases of sonographically visualised intraductal pancreatic calculi are reported. In three of these cases the calculi had been caused by chronic pancreatitis, and in one case by carcinoma of the head of the pancreas. The calculi did not present a uniform sonographic pattern, especially as regards echogenicity. A dorsal echo extinction was observed in three cases only. The non-uniform sonographic aspect of intraductal pancreatic calculi can probably be ascribed to differences in the lime content.

Adult↗

Systemic to pulmonary shunting masquerading as patent ductus arteriosus: a pitfall in clinical diagnosis.

Patent ductus arteriosus (PDA) frequently complicates the course of respiratory distress syndrome in premature infants. A 920-g, 28 weeks' gestation infant with clinical and radiographic evidence of left to right shunting, was presumed to have a patent ductus arteriosus. Following ductal ligation the signs persisted. Aortic angiogram demonstrated multiple collateral vessels arising from the systemic circulation and communicating with pulmonary vessels. Accurate diagnosis of left to right shunting is imperative if such collateral shunting is not to go undiagnosed.

Arteriovenous Malformations↗

Terminal CNV in the absence of motor response.

We addressed the question of whether the terminal CNV, or E-wave, can be obtained in the absence of a motor response. In our design, the stimuli served only to reduce uncertainty with respect to a prior prediction, so that no response to S2 was required. In one experiment, the location of uncertainty reducing information was manipulated: in S1 alone or in S2 alone. When S2 reduced uncertainty, the pre-S2 E-wave was larger than when S2 did not reduce uncertainty. Similarly, when S1 reduced uncertainty, a pre-S1 negativity (whose topography did not differ from that of the pre-S2 E-wave) was larger than when S1 did not reduce uncertainty. The pre-S1 results also indicated that a prior experimenter-generated warning signal is not necessary for a non-motoric negativity to be obtained. In another experiment, the S1-S2 interval was manipulated (1 sec versus 3 sec). For the pre-S2 E-wave, onset was later and duration was longer for the longer S1-S2 interval. Peak amplitude and time of termination after S2 did not differ for short and long duration E-waves. Apparently, the timing of the E-wave is related to when in time the process it reflects is 'needed.' The dependence of the amplitude and timing of the pre-stimulus negativity on the temporal location of information, in conjunction with its independence of motor response requirement, suggests that the pre-stimulus negativity reflects some operation in the domain of expectancy, anticipation or 'mental preparation' for the informational stimulus.

Adolescent↗