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Biomedical subjects

K Pape

Publications and source records attributed to K Pape.

At least 19 recordsLinked to original sources
PubMed2000

Developmental apraxia arising from neonatal brachial plexus palsy.

OBJECTIVE: To determine whether motor unit activation is impaired in patients with persisting disability arising from neonatal brachial plexus palsy (NBPP). BACKGROUND: In NBPP patients, the authors previously found more extensive muscle reinnervation than might have been anticipated from the clinical examination. METHODS: Motor skills were tested in a group of nine boys and seven girls with prior NBPP, who then underwent physiologic investigation of proximal and distal muscles in their affected and unaffected arms. The latter tests comprised measurements of maximal evoked muscle compound action potential (M-wave) amplitude, maximal voluntary torque, twitch torque, and twitch interpolation. A group of 17 children of similar ages served as control subjects. RESULTS: In the NBPP group, motor skills were diminished and voluntary torque was reduced relative to M-wave amplitude and twitch torque. Moreover, interpolated twitches could be demonstrated in some NBPP patients but not in control subjects. CONCLUSION: Persisting disability in NBPP patients is due, at least in part, to impaired motor unit activation. The authors suggest that the impairment is a form of developmental apraxia caused by defective motor programming in early infancy.

Action Potentials↗
PubMed2000

B cell receptor expression level determines the fate of developing B lymphocytes: receptor editing versus selection.

During B lymphocyte development, antibody genes are assembled by DNA recombination. Successful cell surface expression of IgM promotes developmental progression. However, when antigen receptors bind autoantigen, development is blocked and ongoing antibody gene recombination occurs, which often alters antibody specificity in a process called receptor editing. We demonstrate here a significant role of developmental block and receptor editing in B cell receptor quality control. During development a functional, non-self-reactive receptor undergoes receptor editing if its expression is below a certain threshold. Doubling the receptor gene dose promotes development in the absence of autoantigen, but allows editing when autoantigen is present. Thus, both underexpressed and harmful B cell receptors can undergo correction by receptor editing.

Animals↗
PubMed2000

B-cell-receptor-dependent positive and negative selection in immature B cells.

This review touches on only a small part of the complex biology of B cells, but serves to illustrate the point that the antigen receptor is the most important of many cell-surface receptors affecting cell-fate decisions. Receptor expression is necessary, but not sufficient, for cell survival. It is also essential that a B cell's antigen-receptor specificity be appropriate for its environment. The need to balance reactivity with self tolerance has resulted in an intricate feedback control (affected by both the recombinase and cell survival) that regulates independent selection events at the level of the receptor and the cell.

Animals↗
PubMed1999

Denervation and reinnervation in congenital brachial palsy.

Motor unit number estimation (MUNE) was shown to be useful in assessing the neurophysiological status of 18 subjects with congenital brachial palsy. This was especially so since conventional M-wave measurements may give misleading impressions as to the extent of motor axon regeneration. In most subjects the involvement of sensory nerve fibers indicated that the traumatic lesions included postganglionic segments of the fibers, with or without preganglionic damage. In a minority the lesions were purely preganglionic. Digital sensory nerve involvement was more in a mediolateral direction, consistent with greater damage to the uppermost elements in the brachial plexus. In 5 individuals, MUNE and sensory testing showed that there had been trauma to the supposedly unaffected arm. Discrepancies between sensory and motor results suggested that reinnervation of the biceps brachii muscle was greater than that of the intrinsic muscles of the hand. In one subject examined serially, reinnervation of the hand muscles was detected by 10 months and continued in the hypothenar muscles for the next 6 years.

Action Potentials↗
PubMed1998

[Who were the healers in medieval Trondheim?].

When Trondheim celebrated its millenium in 1997, this also marked a 1000 year-old medical tradition. In medieval times, sick and disabled people made their pilgrimage to the Nidaros cathedral and the grave of Saint Olav (995-1030). Working from the assumption that every organized society develops rituals and rules to deal with disease and death, we have looked for evidence of what kind of healers one would expect there were in medieval Trondheim up to the reformation in 1537. Sources include reports from archaeological excavations, written material of both medieval and more recent origin, buildings and objects, and living traditions. Three kinds of healer traditions can be identified: The popular and "wise" folk healers were based on traditional pre-Christian mythology and belief in natural forces. The charitable clerics emerged with Christianity. The "professional" wound healers evolved from the needs of the military, later to merge with the early barber surgeons. Traces of scientific traditions, the Salerno school and early European university medicine can be found in local texts, but there is no evidence of any university educated doctor practising in Trondheim before the 17th century.

Barber Surgeons↗
PubMed1997

Negative and positive dimensions of schizotypal personality disorder.

The positive (perceptual-cognitive) and negative (social-interpersonal) dimensions of schizotypal personality traits were examined in biological relatives of individuals with Axis I disorder. The subjects were young adult offspring from three contrasting parental groups, including schizophrenic disorder, affective disorder, and normal controls. Cognitive correlates, including digit span (presumed to assess working memory) and P3 amplitudes, were also examined. Preliminary results showed that positive and negative dimensions were distinguished by different prevalence patterns in the offspring subjects, and by a different pattern of correlations with cognitive measures. Negative dimensions were more frequent in offspring from the schizophrenic parental group than in the offspring from affective disorder and normal control parental groups. Digits forward and backward, and P3 amplitude decrements, characterized a subset of offspring with negative features from the schizophrenic parental group. Positive dimensions did not differ between the psychiatric parental groups, and did not covary with digit span or P3 amplitude assessments. These results support the view that positive and negative dimensions may reflect separable pathophysiologic processes.

Adult↗
PubMed1991

[Minimizing of local anesthetic dose in dental surgical treatments].

It is possible to operate painless in outpatients with for smaller local anesthetic doses as till now usually. Clinical examinations showed that 1-1.5 ml of the 2% Xylocitin Solution with 0.001% epinephrine are enough. The increase of the local anesthetic dose causes no anesthetic intensification but a prolongation of the anesthesia. Further is the avoidance of the stress situations for the patient by a accentuated psychical management necessary.

Anesthesia, Dental↗
PubMed1991

[Tumors of the peripheral nervous system in the region of jaw and face].

Benign and malign forms of tumors of the peripheral nervous system also occur in the region of jaw and face. They demonstrate a quite different dignity and different courses. Very well known is the neurofibromatosis (Recklinghausen) which can be observed in several variants in face. The possibility is pointed out that primarily benign tumours of the peripheral nervous system may be degenerated to malign ones and the course as well as the therapy with benign and malign tumours are being described.

Adult↗
PubMed1986

Predicting survival of infants of birth weight less than 801 grams.

The likelihood of survival to 28 days of life was determined retrospectively for 106 infants weighing less than 801 g at birth. Multiple logistic regression analysis revealed that birth weight and inspired oxygen fraction made an independent contribution to the prediction of survival at 8 h of age (predictive accuracy 76%). At 16 and 24 h of age, body temperature, pH, and the presence of spontaneous breaths were the independent variables predicting survival (predictive accuracy 79%). Of 37 infants with calculated chances of survival of less than 50% at 16 h, 29 died (predictive accuracy 78%). Seven of the remaining eight infants who survived "against the odds" either died later of chronic lung disease or had severe handicapping complications by 3 months of age. These predictions are first approximations and are not intended for use in making decisions about patient management.

Body Temperature↗
PubMed1986

Intravenous paraldehyde for seizure control in newborn infants.

We studied 14 newborn infants with seizures after birth asphyxia or other causes. Paraldehyde was given as a 200 mg/kg IV bolus followed by an infusion of 16 mg/kg/h (10 cases), or as a 400 mg/kg bolus (4 cases). Serum concentrations of paraldehyde were higher in periods of adequate seizure control than in periods of little or no response. Paraldehyde serum concentrations above 10 mg/dl were associated with anticonvulsant effects and were achieved in most neonates with a 2-hour infusion of 200 mg/kg/h. If there is no effect, serum concentrations are probably below 10 mg/dl and an additional 200 mg/kg can be given safely over 1 hour.

Female↗
PubMed1985

Hemorrhage and cyst development in the cavum septi pellucidi and cavum Vergae. Report of three cases.

Three newborn preterm infants are reported in whom sonography and CT showed abnormalities of the cavum septi pellucidi and cavum Vergae. Hemorrhage into the cavum was noted in two and an acquired cyst developed in the third. These lesions are rare and appear to be of little clinical significance in the three reported infants. All three had associated intraventricular hemorrhage.

Brain Diseases↗
PubMed1985

Postoperative morphine infusion in newborn infants: assessment of disposition characteristics and safety.

Twelve newborn infants were given morphine intravenously for postoperative analgesia. They received a continuous infusion of 6.2 to 40 micrograms/kg/hr for 9 to 105 hours (mean +/- SEM 59.5 +/- 10.2 hours); in four the infusion was preceded by a loading dose of 50 to 100 micrograms/kg. Morphine plasma concentrations correlated with the rate of infusion, but with large variability. There was a tendency for plasma morphine concentrations to decrease in some patients receiving a constant infusion rate, suggesting improvement in morphine clearance rate. Elimination half-life of morphine (13.9 +/- 6.4 hours) was significantly longer than in older children and adults (about 2 hours). Similarly, morphine concentrations in neonates receiving 20 micrograms/kg/hr for 24 hours were three times higher (52 +/- 31 ng/ml) than in older children receiving the same schedule. Two infants who received 32 and 40 micrograms/kg/hr, respectively, developed generalized seizures. Because of the apparently greater sensitivity to morphine and the lower elimination rate in newborn infants, the infused dose should not exceed 15 micrograms/kg/hr.

Half-Life↗
PubMed1985

Long-term follow up of children with the Wilson-Mikity syndrome.

Nine children who survived the development of Wilson-Mikity (W-M) syndrome were studied at a mean age of 7.6 +/- 0.3 years. Persistent respiratory symptoms during the year preceding the study were present in one child. Pulmonary function studies demonstrated a significant degree of airway obstruction in 3 children. Positive methacholine challenge was observed in 6 children indicating bronchial hyperreactivity. Abnormal chest radiographs were present in 3 children. One showed the characteristic appearances of asthma with air trapping, bronchial wall thickening and redistribution of pulmonary vessels. The other child showed minimal residual peribronchial thickening and the third child had normal lungs, but a rather prominent pulmonary artery segment. Echocardiographic studies revealed enlarged right ventricular cavity in 2 children. However, the pre-ejection period and the systolic time intervals were all within normal limits. It appears that unlike patients with bronchopulmonary dysplasia survivors of W-M syndrome have a good prognosis.

Adult↗
PubMed1985

Morphine-induced seizures in newborn infants.

Two neonates suffered from generalized seizures during the course of intravenous morphine sulfate for post-operative analgesia. They received morphine in doses of 32 micrograms/kg/hr and 40 micrograms/kg/hr larger than a group of 10 neonates who received 6-24 micrograms/kg/hr and had no seizures. Plasma concentrations of morphine in these neonates was excessive (60 and 90 mg/ml). Other known reasons for seizures were ruled out and the convulsions stopped a few hours after cessation of morphine and did not reoccur in the subsequent 8 months. It is suggested that post-operative intravenous morphine should not exceed 20 micrograms/kg/ml in neonates.

Humans↗