Biomedical subjects
Publications and source records attributed to L J Endtz.
This article is an overview of the literature on integrated, multidisciplinar examination of aphasic patients, its consequences for treatment and the evaluation of the results thereof; the need of virtually standardized methods of investigation for each language is stressed.
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On the basis of six cases of a tumour at the spinocranial junction, the clinical symptomatology is discussed with special reference to the occurrence of astereognosis and amyotrophy of the hand muscles. Possible mechanisms underlying these symptoms are discussed. In the authors' opinion, the frequent association of these symptoms is explained by the association of two pathogenic mechanisms, i.e., compression of the posterior column or interference with the arterial blood flow to the medial lemniscus, leading to astereognosis, and interference with the venous blood flow, leading to amyotrophy of the hand muscles.
The cerebrospinal fluid glutamine level was determined and an electro-encephalogram was made at roughly the same time in 41 patients on 55 occasions. A modified electro-encephalographic grading for practical use was introduced, because the classical electroencephalographic grading described by PARSONS-SMITH et al. (1957) does not apply to patients in deep coma. A significant correlation was found between the natural logarithms of cerebrospinal fluid glutamine levels and the electro-encephalic grade. In combination, these parameters provide valuable diagnostic and prognostic information in hepatic encephalopathy, and each can serve separately for follow-up purposes.
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In a patient with histologically confirmed multiple sclerosis, cranial computerized tomography revealed contrast-enhanced lesions showing a mass effect.
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In a double-blind controlled clinical trial on 51 patients with subarachnoid hemorrhage, tranexamic acid, 4 gm per day for ten consecutive days, did not favorably affect the outcome. Neither mortality nor rebleeding rates were improved after a follow-up of three months.
Three sisters died of astrocytoma, and the microscopic appearance of the tumor was the same in all three. This finding supports either genetic or environmental influences in the occurrence of brain tumors.
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Two cases of voluntary postural dyskinesia with hypertrophic neuropathy are reported. Electron-microscope studies revealed in one case a hypertrophic neuropathy with onion bulb formation, in the other axonal degeneration. The findings are compared with those of Pierre Marie-Boveri disease, of Roussy-Lévy disease and with the case of Salisachs and Lapresle (1973).
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The determination of transketolase activity and of pyruvic acid after glucose loading in 20 patients with the Wernicke-Korsakow syndrome and in 14 other patients is described. Glucose loading took place after the first injection of thiamine. Normal values for transketolase were found in 10 patients with the Wernicke-Korsakow syndrome, for pyruvic acid after glucose loading in three, for both of these determinations in only one patient. The normal values found for transketolase were probably due in most cases to the administration of thiamine before admission. For practical purposes it is suggested that both determinations be done in all patients with the clinical diagnosis Wernicke-Korsakow's syndrome.
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