Search PubMed⌕ Search

Biomedical subjects

K Schimrigk

Publications and source records attributed to K Schimrigk.

At least 109 records · Page 6Linked to original sources
PubMed1994

Big endothelin in spontaneous intracerebral hemorrhage.

Plasma big endothelin (BE) levels were studied in 17 patients during the first 2 weeks following spontaneous intracerebral hemorrhage (ICH). Three patients had experienced an infratentorial hemorrhage of the pons and cerebellum. The group of 14 patients with supratentorial hemorrhage presented with 8 hematomas of the putamen, 4 of the capsula interna and 2 in the thalamus. Significant elevations of BE during the first 2 weeks after the initial ICH, significant differences between the different localisations and between patients with different prognoses were not apparent (mean BE level: 2.95 +/- 1.39, control group: 2.68 +/- 1.29 fmol/ml). These results support the theory that endothelins do not play a significant pathophysiological role in acute severe ICH.

Adult↗
PubMed1994

Colonic transit time in nonidiopathic Parkinson's syndrome.

Constipation is well known to be a frequent symptom in idiopathic Parkinson's disease. In this study, colonic transit time was measured in 16 patients with nonidiopathic Parkinson's syndrome (non-IPS). These patients all had lacunar infarcts in the caudate, putamen, or globus pallidus, as a cause of the disease, as demonstrated by MRI. In comparison with the control group there was only a slightly longer transit time with, on the whole, a normal transit time (about 59 h). In only five cases was the transit time significantly decreased. Our results suggest that colonic transit is only prolonged in patients with idiopathic PD, whereas it is normal in non-IPS. This seems to be cause by a multi-degenerative process in the idiopathic disease.

Aged↗
PubMed1994

The effect of cisapride on delayed colonic transit time in patients with idiopathic Parkinson's disease.

Disorders of autonomic regulation are common in patients with Parkinson's disease (PD). Patients most frequently complain of dysphagia and therapy resistant constipation, as far as the gastrointestinal tract is concerned. These symptoms have to be attributed to a neuronal degeneration. In a pilot study we therefore investigated the effect of stimulation of the myenteric plexus by cisapride. 11 women and 13 men were examined, the average age was 67.3 years, the Webster rating 17 points. In 2 out of 24 patients, colonic transit was prolonged up to the limit, both with and without therapy. The other 22 patients showed an acceleration in transit on response to cisapride. On average the colonic transit of 130 hours was reduced to 79 hours. This objective improvement was associated with a subjective improvement. Central side effects or a worsening of Parkinsonian symptoms were not found. We conclude that cisapride is effective in the treatment of constipation in idiopathic PD.

Aged↗
PubMed1994

[Ergotamine-induced rectal lesions in asymptomatic patients].

Suppositories containing ergotamine can cause anorectal lesions and even fistulae. We therefore carried out prospective investigations on 20 patients (17 female, 3 male) who had been prescribed ergotamine suppositories for migraine therapy. No serious ulceration was found. There was one case of reduced local blood circulation and three patients showed signs of increased blood circulation in the anterior rectal wall. In two further cases we found local hyperemia with minor bleeding. In our opinion anorectal ergotism is a possible, although rare consequence of ergotamine suppository abuse. For longterm treatment alternative routes of ergotamine administration or other groups of substances should therefore be used.

Adult↗
PubMed1993

[Lumbar puncture--the post-puncture syndrome. Prevention with an "atraumatic" puncture needle, clinical observations].

Postlumbar puncture syndrome (PPS) is caused by continuous leakage of CSF through the dural puncture defect. While it has long been known that the symptoms are dependent on the diameter of the puncture needle, the influence of the needle point on the frequency of PPS has now also been examined. Following diagnostic and/or therapeutic lumbar puncture (LP) with Sprotte's "atraumatic" needle, the symptoms in 600 patients during a period of 8 days were recorded. In 92% of the patients LP involved no problems. In 7% the puncture was successful only at the second or third attempt. In 4 cases it was necessary to carry out the procedure under X-ray control. While the literature shows that PPS following lumbar puncture with a 21 G needle occurs in 30-40% of cases, only 3.6% of the patients complained about position-dependent headaches where the Sprotte needle was used. Nausea, dizziness and tinnitus were extremely rare (< 1%).--The "atraumatic" puncture needle reduces the frequency and the degree of PPS to the minimum and makes the lumbar puncture procedure possible on an outpatient basis.

Adolescent↗
PubMed1993

[Routine diagnosis of disorders of autonomic regulation. References for implementation and evaluation].

In the routine diagnosis evaluation of regulatory disorders of the autonomous nervous system, 5 non-invasive procedures have proved both easy to perform and valid: orthostatic and static blood pressure reactions, the ratio of the 30th to the 15th RR interval on changing to an erect posture, variations in the heart rate in response to the Valsalva maneuver and deep respiration. These measures need no special equipment and can be carried out at any hospital or outpatient department. They provide not only qualitative but, in part, also quantitative information about possible disorders of the autonomic nervous system, as well as permitting a certain differentiation to be made between parasympathetic and sympathetic regulation. More complex tests should be employed only for specific problems.

Arousal↗
PubMed1993

Cisapride treatment of constipation in Parkinson's disease.

Constipation, a frequent symptom in Parkinson's disease (PD), is probably caused by degeneration of the autonomic nervous system, particularly the myenteric plexus. Cisapride is a drug that causes increased release of acetylcholine in the myenteric plexus. In a pilot study, cisapride therapy was investigated in 20 PD patients, 10 women and 10 men, who suffered from delayed intestinal transit. In all cases, cisapride therapy was associated with a significant acceleration of colonic transit, as measured by radioopaque pellets viewed on radiographs. Pellet count fell from a mean of 53.8 pretreatment to 30.4 after cisapride treatment. No adverse reaction and no "overshoot affects," such as diarrhea, were seen. Our findings suggest that cisapride may alleviate the constipation associated with Parkinson's disease.

Acetylcholine↗
PubMed1993

Beta-blockade in acute aneurysmal subarachnoid haemorrhage.

The effects of beta-blockade to prevent autonomic disorders after acute aneurysmal subarachnoid haemorrhage were prospectively investigated. 11 patients were treated with the beta-1-selective beta-blocker metoprolol (up to 200 mg/die intravenously). 14 patients received standard therapy as controls. Pulse rate, blood pressure and dosage of the additional antihypertensive medication as signs of sympathetic disturbance were registered. The main result was the normalizing of the pulse rate especially during the first two weeks in contrast to the control group. The patients in the beta-blocker group did not need further antihypertensive medication. This was mainly a result of the reduction in sympathetic activation. No severe side-effects were documented and the survival was better in the treated group. Thus, beta-blockade is able to prevent and reduce autonomic disorders, especially activation of the sympathetic tone, in subarachnoid haemorrhage. Metoprolol as a so called cardioselective beta-blocker seems to be one of the suitable agents and is considered superior to the non-selective agents.

Adult↗
PubMed1993

[Neurologic complications of malaria infection].

Infections with malaria are increasing in Europe and Northern America and are also spreading in tropical endemic areas. A falciparum variety of malaria known as cerebral malaria is the most well-known neurological complication, caused by Plasmodium falciparum and characterised by a fulminant course with disturbances of consciousness and facultative seizures or focal neurological deficits. 50% of deaths caused by malaria are due to cerebral involvement. Pathologically a disseminated vasculomyelinopathic disorder is seen. Immunological changes, vascular-hypoxic disturbances and metabolic-toxic factors contribute to these pathological findings. Facts on diagnostic, differential diagnostic and therapeutic procedures are presented. Beside the severe and life-threatening cerebral malaria some unspecific cerebral symptoms are seen, such as cerebellar ataxia and chorea. Spinal disease and peripheral nerve involvement, polyradiculitis and especially psychiatric disorders have also been described. Every neurological and psychiatric disorder presented first in tropical areas or malaria-endemic regions requires malaria diagnostic tests. In our geographical region, any previous history of a journey to the tropics is an important pointer; in particular, neurological or psychiatric symptoms can be important pointers to malaria.

Adult↗
PubMed1993

Renin activation correlates with blood amount and distribution in subarachnoid haemorrhage.

Blood extent and localization visible in CCT predicts complications and prognosis in patients suffering from subarachnoid haemorrhage (SAH). Plasma renin activity (PRA) elevation is one of the hormonal parameters of autonomic disorders after SAH and its prognostic relevance could be confirmed by this study, too. But the correlation of PRA with blood amount and distribution was the main target of this study. Large amounts of blood are connected with higher PRA-levels and more PRA-rises. Even a linear correlation between the amount of blood defined by a CCT-score and PRA in ng ml h-2 could be established. A significant correlation was found between intraventricular, suprasellar blood, ventricular enlargement of the third/lateral ventricles and PRA-elevations. Disorders of hypothalamic and/or medullary centres of sympathetic control are thought to be the underlying cause and to depend on blood extent and distribution.

Adult↗
PubMed1993

Absence of elevation of big endothelin in subarachnoid hemorrhage.

BACKGROUND AND PURPOSE: Endothelin peptides are potent vasoconstrictors and thus are seen as potential cause of cerebral vasospasm after subarachnoid hemorrhage (SAH). Earlier reports showed elevated or normal endothelin levels in plasma and cerebrospinal fluid in patients suffering from SAH. The present study was designed to determine whether endothelin is a causal factor in SAH. METHODS: We studied 11 patients with acute SAH. Seven of these 11 patients had a proven aneurysm and six had experienced vasospasm. Big endothelin levels were determined by a radioimmunoassay recognizing the C-terminal peptide (normal range, 1-11 fmol/ml). RESULTS: There were no elevations of big endothelin in the 59 plasma samples and the 17 simultaneously estimated cerebrospinal fluid samples. Differences between plasma and cerebrospinal fluid did not reach significant levels. Big endothelin values between patients with and without vasospasm showed no significant differences. CONCLUSIONS: Our findings suggest that plasma elevation of the endothelins is not reproducible in SAH and that big endothelin is unlikely to be a causal plasma factor in the complex multifactorial development of vasospasm after SAH.

Adult↗
PubMed1993

[Functional studies of the autonomic nervous system].

There are many methods to choose from in the investigation of the autonomic nervous system. The value of the individual tests to the clinician varies according to the method of investigation used. No one test can elucidate all the information needed for all functional disturbances. As a routine, measurement of blood pressure and heart rate reaction to active orthostasis and heart rate variation with deep breathing and the Valsalva manoeuvre can be useful. Spectral analysis of the heart rate is an easily performed test, only minimally disturbing for the patient, and is a valid means of investigation which may find a way into routine clinical use in the future.

Arousal↗
PubMed1993

[Psychosomatic aspects of essential blepharospasm].

Relative to nosological classification and therapeutic strategies essential Blepharospasm is discussed controversially in Neurology, Psychiatry, Psychoanalysis, and other related branches. From an integrative point of view the clinical symptomatic is a result of psycho-social factors as well as organic factors. Two own cases are reported. The diagnostic, therapeutic, and prognostic core problems are discussed.

Adult↗
PubMed1993

[Schizophreniform psychosis in paraneoplastic limbic encephalitis].

Paraneoplastic limbic encephalitis is seldom mentioned in the psychiatric literature and premortem diagnosis is rare. Affective symptoms, agitation, and memory impairment are the core features, which can predate the diagnosis of carcinoma. We report the case of a patient with bronchial carcinoma, whose clinical picture could hardly be distinguished from that of endogenous schizophrenia.

Adult↗
PubMed1993

[Brain metastases as an initial manifestation of tumor disease].

A retrospective study compared a group of 122 patients with brain metastases from unknown primaries with a second group of 121 patients, who developed brain metastases in the course of a known malignant disease. Special attention was paid to the kind of primary cancer, therapeutic influences and prognostic differences. The results pointed to a late occurrence of brain metastases in breast cancer, no patient with this type of cancer being found in group 1. Melanoma and colorectal cancer were also found predominantly in group 2, whereas lung cancer was the most common cause of metastasis in group 1 and the most frequent cancer in both groups. Clinical course, therapy and outcome showed no significant differences between the two groups. Mean survival time was 4.6 (+/- 6) months for the patient series as a whole. Patients with breast cancer had a significantly higher survival rate than those with other forms of cancer. Localisation and degree of malignancy mainly determine the life-prognosis, the type and intensity of therapy being of secondary importance.

Adult↗