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Biomedical subjects

K Schimrigk

Publications and source records attributed to K Schimrigk.

At least 145 records · Page 8Linked to original sources
PubMed1989

[Evoked potentials with intrathecal and systemic corticosteroid therapy in multiple sclerosis].

46 MS-patients were treated by systemic or intrathecal administration of steroids. Before and three weeks after the beginning of the treatment, we measured the latencies of visual and somatosensory evoked potentials and examined clinically according to the Expanded Disability Status Scale (EDSS). Only one patient showed significant changes in VEP latencies, SEP showed equivalent results before and after therapy. In contrast, in 24 out of 46 patients the clinical examination revealed a change in EDSS. As a consequence visual and somatosensory evoked potentials can not be regarded as adequate tools for short-term assessment in therapeutic trials.

Administration, Oral↗
PubMed1988

Changes in nocturnal sleep in Huntington's and Parkinson's disease.

There have been no reports of studies on nocturnal sleep or quantitative studies of sleep spindle density in Huntington's disease, whereas sleep in Parkinson's disease has been extensively reported. We therefore examined nocturnal sleep changes in patients with Parkinson's and Huntington's disease and compared them with a control group. The previously reported decrease in sleep spindle density was observed in patients with Parkinson's disease. The patients with Huntington's disease, however, had a significant increase in sleep spindle density, the nocturnal sleep pattern being normal in other respects when compared with the control group. This observation may provide a further diagnostic criterion in Huntington's disease.

Adult↗
PubMed1988

Cardiac arrhythmias in subarachnoid haemorrhage.

In this prospective study 52 patients with spontaneous subarachnoid haemorrhage were examined with respect to cardiac arrhythmias and their relationship to cerebral lesions. A continuous ECG was registered over an average of five days. Sinus tachycardia was the most frequently recorded arrhythmia, followed by multifocal ventricular extrasystoles, couplets, frequent supraventricular extrasystoles, non-sustained ventricular tachycardia, asystolia and sinus arrhythmia. A significant correlation was found between the clinical manifestation of a midbrain syndrome and sinus arrhythmia, and multifocal ventricular extrasystoles. This correlation points to the autonomic cardiovascular centres as the structures involved.

Adult↗
PubMed1988

High-dose steroid therapy in Guillain-Barré syndrome.

In a pilot study, high-dose steroid therapy in acute Guillain-Barré syndrome (GBS) proved to be successful. The pharmacodynamic aspects of this approach appear interesting and worthy of further investigation. An initial dose of 1000 or 500 mg methylprednisolone is recommended which should be given in four divided doses per day. A very slow reduction in the dose is necessary to avoid a relapse. Lack of response correlated with late onset of therapy and high age of the patients.

Adolescent↗
PubMed1988

Progressive myopathy in trisomy 21.

A 23-year-old female patient with clinical manifestations typical of Down's syndrome progressively developed intensifying weakness of the proximal muscles from the age of 16 years. CK levels were distinctly elevated. Electromyography showed myogenic lesions and muscle biopsy a myopathic image with extensive fibre hypertrophy. Progressive sporadic myopathy in association with Down's syndrome has not been reported previously.

Adult↗
PubMed1988

[Intravenous and oral treatment with amantadine sulfate in Parkinson disease].

The rapid efficacy of amantadine on akinesia and rigidity in Parkinson's disease is generally known. The duration of this therapeutic result is however controversial. Some authors have reported a loss of efficacy after only a few weeks of therapy. The success of a short-term parenteral and subsequently oral long-term treatment with amantadine sulphate in 8 Parkinsonian patients was tested by means of clinical and neuropsychological examinations and by monitoring the serum concentration over the course of half a year. A ten-day intravenous treatment with amantadine sulphate (200 mg daily) led to a significant improvement in the clinical and psychological test results. This attained improvement could be maintained for 6 months with oral therapy consisting of 600 mg amantadine sulphate. There were strong interindividual variations in serum concentration.

Administration, Oral↗
PubMed1988

[Disorders of microcirculation in subarachnoid hemorrhage and intracerebral hemorrhage].

The pathophysiological notions of hemodilution treatment of ischemic seizures with plasma expanders indicates the significance of microcirculation. Microcirculation disorders arise from the interrelations of hemodynamic, vascular, and hemorrheologic factors. It seems that hemodilution with hydroxyethyl starch reduces peripheral microcirculation disorders, thus inhibiting the development of cerebral edema. In the case of subarachnoid hemorrhage, the hemorrheologic factors deteriorate less severely when given antifibrinolytic treatment with Aprotinin. Simultaneous hemodilution with hydroxyethyl starch can counterbalance the already existing changes.

Blood Coagulation Tests↗
PubMed1987

[Mistaken diagnosis in subarachnoid bleeding. A study of 154 cases].

In 154 patients with spontaneous subarachnoid hemorrhage owing to a ruptured aneurysm, the way by which the diagnosis was arrived at was checked. The correct diagnosis was missed initially in 52 patients (33.8%) and the subarachnoid hemorrhage was misinterpreted most frequently as systemic infection, brain tumor, disorder of cerebral blood flow or cervical spinal syndrome. The proportion of false diagnosis was especially high in younger patients with an initially less severe illness. Freely practicing physicians without specialist neurological training missed the diagnosis in 33.3%, free practicing specialists for nervous diseases and neurologists in 17.4%, doctors at smaller hospitals in 16.3% and doctors at the Neurologic Division, University Hospital for Nervous Diseases in Homburg/Saar in 6.5%. The time up to correction of a wrong initial diagnosis was up to seven days in 34 patients (65.4%), up to 14 days in 13 patients (25.0%) and between 15 and 27 days in five patients (9.6%).

Adolescent↗
PubMed1987

[Visual evoked potentials following double-pattern stimulation with pseudo-color perception].

We examined in which form an additional structural stimulus in the white checks influenced the visual evoked potential of a checkerboard reversal induced response. A pattern of vertical bars was introduced with a short delay to the checkerboard reversal. The purpose of these experiments was to find out about the discrimination threshold of the occipital cortex for timely spaced stimuli. The double stimulus was separated from the next change minimally for 800 ms. With this arrangement we avoided "steady states", which are shown by repetitive interstimulus intervals of less than 200 ms. Nine normal volunteers between 22 to 28 years of age were measured. We found a typical waveform after the P 100 potential consisting of a positive peak followed by a negative long-lasting baseline elevation. Only separations of more than 60 ms yielded this configuration. Interstimulus times of less than 60 ms resulted in refractory effects on the visual evoked response. All the subjects reported colour or brightness changes of the additional bars. These pseudo colours were very probably due to the Prevost-Fechner-Benham-Effect which is common with repetitive white and black pattern changes. Our pseudo colours showed remarkable differences to the classical designs which has led us to the conclusion that colour perception on TV monitors is influenced so far by unpredictable flicker factors.

Adult↗
PubMed1987

Levodopa and monoamine oxidase inhibitor combination therapy. A controlled clinical trial.

During a long-term double-blind study, which began February 1985, we have treated 16 patients with Morbus Parkinson or Parkinson's syndrome with deprenyl or identically appearing placebo tablets. The aim of the study is to ascertain whether a reduction of other antiparkinsonian medication, especially Madopar, can be achieved with deprenyl, in order to minimize the known late undesirable collateral effects ("on-off"-phenomena, dyskinesias). The criteria used in evaluation of the course of disease are the clinical-neurological findings as well as a series of motor performance tests. The results to date indicate that the dose of Madopar could be reduced in 7 of the 16 patients. Two of these patients were receiving Madopar alone, while 5 had been given anti-cholinergics in addition. In one female patient the dose of Madopar had to be reduced due to the development of dyskinesias. It is noteworthy that the psychological condition of the patients remained constant. There was no increase in side-effects, e.g. headaches, dizziness, nausea, etc. with administration of the study substance. In 3 patients with longstanding Parkinson's disease treated with Madopar or Nacom, who were not included in the study, the doses of the above drugs could be maintained or reduced by addition of deprenyl.

Aged↗
PubMed1987

[Intracranial pressure-controlled treatment of brain edema with glycerin and sorbitol in intracerebral hemorrhage].

The continuous epidural registration of intracerebral pressure showed that the pronounced brain edema which develops during the 4th to 14th day of an intracerebral hemorrhage could lead to an increase in intracerebral pressure (ICP greater than 25 mmHg) requiring treatment. During the therapy extensive ICP crises (ICP greater than 35 mmHg), lasting for 1 to 3 days and only controllable through high doses of glycerol and sorbitol, developed. Glycerol (50 g orally) and sorbitol (50 g i.v.) lowered the pressure during this phase for approximately 3 h and 1.5 h respectively. These time intervals were in accordance with the changes in plasma osmolality through the administration of both substances. Due to its longer efficacy, glycerol provides an important supplement or alternative to sorbitol therapy, especially as the permitted maximum dosage would have to have been exceeded in a treatment consisting exclusively of sorbitol. The duration of the decrease in intracerebral pressure lasted longer during the remainder of the treatment in the case of both substances, being decisively dependent on the intracerebral pressure intensity. The relatively harmless epidural measurement of intracerebral pressure allowed an optimal control of the brain edema therapy as the dosage of the hyperosmolar substances could be given exactly in accordance with the intracerebral pressure intensity and subsequently varying efficacy.

Administration, Oral↗
PubMed1986

[Dextran 40 or HES 200/0.5? Hemorheology of the long-term treatment of ischemic cerebral attacks].

Haemorheological parameters on long-term treatment of ischaemic stroke were measured in two groups of 12 patients receiving dextran 40 or hydroxyethyl starch (HES 200). Both substances similarly lowered haematocrit and whole-blood viscosity. Dextran produced a clear-cut increase in plasma viscosity and red-cell aggregation. The effects were due to a marked increase in the plasma concentration of dextran caused by an accumulation of large molecules. HES 200 improved plasma viscosity and red-cell aggregation. Since these haemorheological parameters are of special importance for improving a disordered microcirculation as would occur at the margins of the ischaemic lesion, HES 200 would seem to be the appropriate plasma expander in long-term treatment with haemodilution. The differences between dextran 40 and HES 200 become the more marked the higher the volume infused.

Blood Viscosity↗
PubMed1986

Type 2B muscle fibre deficiency in myotonia and paramyotonia congenita. A genetically determined histochemical fibre type pattern?

The histochemical ATPase fibre type pattern was examined in muscle biopsy samples obtained from patients with recessive myotonia, paramyotonia and from one patient with dominant myotonia. Absence (less than or equal to 5%) of 2B fibres was a genuine finding in the minority of the cases. In additional cases of recessive myotonia, a deficiency (less than or equal to 15%) of 2B fibres was observed. Absence or deficiency of 2B fibres was not related to the minor myopathic alterations or to (para-)myotonic activity. It is hypothesised that absence of 2B fibres is a dominant or a recessive autosomal trait, and deficiency of 2B fibres is a recessive trait. Reported findings and our own observations suggest the possibility of a genetic combination of myotonia and absence/deficiency of 2B fibres. Implications of these hypotheses are proposed.

Adenosine Triphosphatases↗
PubMed1985

Direct evidence of hypertension and the possible role of post-menopause oestrogen deficiency in the pathogenesis of berry aneurysms.

To determine the significance of hypertension in the pathogenesis of berry aneurysms, 113 patients with subarachnoid haemorrhage (SAH) and verified aneurysm and 63 patients with SAH without aneurysm were compared. Of those patients with angiographically verified aneurysms, 61.9% were found to have elevated blood pressure (greater than 160/95 mmHg) and 19.5% showed electrocardiographic signs of left ventricular hypertrophy (SV1 + RV5 (6) greater than 3.5 mV). The percentages for patients without aneurysm were 36.5% and 6.4% respectively. A significant correlation was found between anterior aneurysms and left ventricular hypertrophy (P less than 0.01). The mean Sokolow index values were also significantly elevated in cases of aneurysm (P less than 0.01). There was a complementary relationship between the extent of left ventricular hypertrophy and the percentage of females with regard to localization of an aneurysm and age group. The predominance of females in the total aneurysm population, in the 50- to 59-year-old age group, and among patients with internal carotid aneurysms indicates that a sex-specific hormonal factor may also play a role in the pathogenesis of aneurysms in addition to hypertension. The collagen wasting commonly observed in bone and skin in the post-menopausal period due to decreased oestrogen levels could possibly be responsible for the formation of aneurysms in the proximal segments of the cerebral arteries, as occurs in various connective tissue diseases.

Adult↗
PubMed1985

Intrathecal thyrotropin-releasing hormone therapy of amyotrophic lateral sclerosis.

Six patients with amyotrophic lateral sclerosis were given from 800 to 4000 micrograms of thyrotropin-releasing hormone (TRH) intrathecally for a period of 2-6 months. The progressive course of this disease, manifested by increasing atrophy, paralysis and disability score, was not altered. This supports the hypothesis that the decrease in TRH content in the anterior horn region is secondary to the cellular destruction. TRH appears to play no significant role in the pathogenesis of amyotrophic lateral sclerosis.

Amyotrophic Lateral Sclerosis↗