[Evoked potentials and intracranial pressure--experiences from the neurosurgical viewpoint].
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Biomedical subjects
Publications and source records attributed to K Schwerdtfeger.
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During lumbar disc operation in the flexed prone position, a decrease in conjunctival pO2 can be observed although there is an increase in systemic blood flow after infusion of colloidal volume expanders. The regions of the body situated below the heart do not profit from the increase in systemic blood flow due to compression. The pO2 decreases more significantly after the infusion of a medium-molecular-weight solution with a more marked hemodynamic effect than after the infusion of low-molecular-weight hydroxyethyl starch. As the decrease in conjunctival pO2 is considerably less after low-molecular-weight hydroxyethyl starch, improved blood fluidity may be responsible for the increased tissue perfusion in the compressed area.
In 1680 cases of alveolitis ("dry socket") the national economic-loss is more than 339,693.-marks. Nearly 3 million teeth will be extracted in one year in the DDR. By a valuation of nearly 3% of the alveolitis 90,000 patients have this complication. That will be a economic-loss of 18.1 million marks in one year. The prophylaxis of this complication is therefore a most important problem.
The authors present the case of a 60-year old man with a spontaneous spinal intradural hematoma in the thoracic and lumbar region, which was caused by anticoagulant therapy and led to a severe progressive transverse lesion. After substitution of coagulation factors, a small catheter was inserted into the subarachnoid space via a lumbar puncture. By alternating irrigation and suction removal of the blood clot, restoration of the cerebrospinal fluid passage was possible along with a marked improvement in the neurological deficits. At 8 months' follow-up, the patient had completely recovered from the severe paraparesis and bladder dysfunction.
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Stainless steel staples commonly used for skin suture were tested for their suitability as electrodes for recording electrophysiological data. Investigations were performed in vivo and as well as in vitro, and showed the typical behaviour of electrodes made from a polarizable metal, i.e., an increase of electrode impedance with low frequencies. In spite of this fact most electrophysiological data can be recorded if the input impedance of the amplifier is in the common range of 100 MOhms. Advantage of these electrodes is their quick and easy application, their resistance to mechanical stress and the possibility of leaving them in place for a long time.
In fifteen cases of brain stem lesions caused by basal tumours, operations, injuries, arteriosclerosis or multiple sclerosis, a paradoxical activity of jaw closing muscles during jaw opening was observed. This inverse activity was the cause of severe trismus in 8 cases. It is the manifestation of a faulty programming of jaw movements in the trigeminal motor area in brain stem. This distinct new brain stem syndrome can only be detected by EMG investigation. EMG findings, pathological background, outcome and treatment possibilities are discussed in this paper.
pH-titrations with NADH show two ionizable groups in mitochondrial and cytoplasmic malate dehydrogenase, the first with a pKa in the range 6.8-8.3 for the mitochondrial and 6.4-7.8 for the cytoplasmic enzyme, the second with a lower limit at 10.2 resp. 11. Comparison with bis-(dihydronicotinamide)-dinucleotide and dihydronicotinamide-ribosyl-P2-ribose-pyrophosphate instead of NADH indicates that the second alkaline ionization is caused by a residue placed near the adenine binding site of the active centre of the two isoenzymes. Binding studies with NADH and NAD+ give evidence for the participation of a group in the mitochondrial enzyme with pKa 6.8, deprotonation of which is necessary for detectable association of NAD+. In contrast the fixation of NAD+ to the cytoplasmic enzyme is independent of pH.