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Biomedical subjects

P Mindus

Publications and source records attributed to P Mindus.

At least 37 records · Page 2Linked to original sources
PubMed1987

Magnetic resonance images related to clinical outcome after psychosurgical intervention in severe anxiety disorder.

Postoperative verification of radiosurgical lesions in white matter has been difficult to obtain with CT. With magnetic resonance (MR) imaging, however, lesions could be demonstrated in patients undergoing a psychosurgical procedure, gamma capsulotomy, for anxiety disorder. The appearance and location of the lesions were related to the irradiation dose and to the long-term clinical outcome studied prospectively by two independent evaluators who had not been involved in the selection or the treatment of the patients. Seven consecutive cases were examined. CT was also included for comparison reasons. Lesions were clearly visible with MR in patients who improved after surgery. Conversely, lesions were inadequate in cases who did not benefit. MR proved to be more accurate than CT both in detecting the lesions and in defining their configuration. The observations argue for the use of MR for post-operative verification of radiosurgical lesions. MR may facilitate the determination of a clinically effective radiation threshold estimate for radiosurgical lesions, which should be of value for the planning of studies of this type of limbic system surgery.

Adult↗
PubMed1986

Regional cerebral glucose metabolism in anxiety disorders studied with positron emission tomography before and after psychosurgical intervention. A preliminary report.

Regional cerebral metabolic rate of glucose (rCMRGl) was studied with positron emission tomography in patients suffering from severe anxiety disorders undergoing capsulotomy, an anti-anxiety psychosurgical intervention in which fronto-limbic connections are interrupted. Preliminary observations on five patients show a statistically significant reduction in rCMRGl postoperatively in the orbitomedial frontal cortex, a region knonw to be of relevance for the capsulotomy effects. Clinically, 4 of 5 patients improved after surgery. The study may provide new information on the pathophysiology of anxiety.

Adult↗
PubMed1986

Magnetic resonance imaging of stereotactic radiosurgical lesions in the internal capsule.

Confirmation of radiosurgical lesions in white matter has earlier been difficult to obtain, which has hampered the evaluation of clinical outcome in relation to the site and the size of the lesions. In this investigation 7 consecutive patients subjected to bilateral stereotactic gamma capsulotomy for intractable anxiety disorders were re-examined several years after treatment. The protocol included both magnetic resonance imaging (MRI) and computed tomography (CT) interpreted under blind conditions and prospective psychiatric evaluations performed by two independent evaluators who had not been involved in the selection and the treatment of the patients. The lesions were clearly visible with MRI in all patients who improved after treatment. MRI proved to be more accurate than CT both in detecting and in defining the size and the configuration of the lesions. The extent of the tissue reaction following the irradiation seemed to be best defined in T2 weighted images. A high correlation (p less than 0.01) was obtained between ratings of clinical outcome and radiosurgical precision as reflected by MRI. It is concluded that MRI may provide the clinician with more information than CT does. In the future MRI may also facilitate the determination of a radiation threshold value for white and grey matter lesions and provide a more detailed knowledge of the time course of the development of such lesions.

Adult↗
PubMed1985

Imaging of [11C]-labelled Ro 15-1788 binding to benzodiazepine receptors in the human brain by positron emission tomography.

The benzodiazepine antagonist Ro 15-1788 was labelled with [11C] and examined for possible use as ligand for PET scan studies on benzodiazepine receptors in the brain of cynomolgus monkeys and human subjects. [11C] Ro 15-1788 allowed the in vivo visualization of benzodiazepine receptor binding in cerebral and cerebellar cortical areas as well as in basal brain nuclei in PET scan images. [11C] Ro 15-1788 exhibited a high ratio of specific benzodiazepine receptor binding (cerebral cortex) to non-specific binding (pons) and the kinetics of binding should be satisfactory for quantitative clinical PET scan studies using [11C]. The in vivo binding of [11C] Ro 15-1788 in the cerebral cortex of cynomolgus monkeys and healthy human subjects was reduced by approximately 90% within 10 min after the intravenous injection of a high dose of unlabelled Ro 15-1788 (0.5 mg/kg i.v.). Different areas of the healthy human brain showed an approximately 10-fold variation in maximal [11C] Ro 15-1788 binding that corresponded to the previously known distribution of benzodiazepine receptors in these regions. The highest degree of binding was obtained in the medial occipital cerebral cortex followed by frontal cortex, cerebellum, thalamus, striatum and pons. Two psychiatric patients with anxiety syndromes who had been treated for a long time with high doses of benzodiazepines had roughly the same degree of maximal [11C] Ro 15-1788 binding in brain regions as the healthy subjects but the rate of decline of [11C] Ro 15-1788 in the brain was higher. This indicates that there is measurable competition between [11C] Ro 15-1788 binding and clinical benzodiazepine concentrations in the body fluids of psychiatric patients. The results demonstrate that [11C] Ro 15-1788 should be a valuable tool for quantitative analyses of benzodiazepine receptor characteristics and receptor occupancy in the brain of patients with neuropsychiatric disorders.

Adult↗
PubMed1984

Penile implants in erectile impotence: outcome and prognostic indicators.

In a prospective, multi-disciplinary study thirteen men with protracted, organic erectile impotence were examined before and after penile implantation. Outcome after one year was judged as favourable in nine, doubtful in two, and unfavourable in two cases. Neurotic functioning was unexpectedly common in the group and the more neurotic subjects fared less well after surgery and reported less benefit from it. Findings in the preoperative psychiatric examination that correlated significantly with unsuccessful outcome were immature and neurotic, particularly hysterical traits, low sexual drive, low sexual activity, disavowal of ambivalence towards penile implantation and high "femininity" scores on a sex role inventory, the Gough Femininity Scale.

Adult↗
PubMed1983

Neuropsychiatric symptoms in workers occupationally exposed to jet fuel--a combined epidemiological and casuistic study.

Some aircraft personel and airline industry workers are exposed to jet fuel, a mixture of aliphatic hydrocarbons (petroleum 80%) and some organic solvents (petroleum 80%) and some organic solvents (aromatic hydrocarbons 20%). In order to evaluate the possible neuropsychiatric sequeale of such long-term occupational exposure, we examined 30 workers exposed at about 250 mg/m3 for 4-32 years at a jet motor factory. They were compared with two control groups (2 x 30) of matched non-exposed workers. The medical history was first assessed by standardized interviews and examination of medical records kept by the factory physician. The exposed subjects had, after their employment, much more often sought medical advice because of emotional dysfunctions, such as depression and anxiety, than had the control groups (P less than 0.005). When the prevalent mental symptoms, indicative of brain lesion, later were rated by psychiatrists, the exposed workers scored higher than did the controls (P less than 0.001). 14 subjects showing most symptoms were then selected for a thorough neuropsychiatric clinical investigation comprising psychosocial inquiries, psychological testing, personality assessment and neurological/neurophysiological examination. Seven were judged to suffer from mild organic brain syndrome (i.e. "organic neurasthenia") of which one subject was a severe case. The subjects had all undergone a slow but steady personality change over the years--starting from an ordinary strength without neurotic traits and moving towards an asthenic state with fatigue, anxiety and vegetative hyperreactivity. No other cause for this change could be identified as an alternative to the occupational exposure to jet fuel. It is concluded that personality changes and emotional dysfunctions are the foremost effects of such long-term exposure to petroleum products.

Adult↗
PubMed1980

Psychiatric ratings in occupational health research: a study of mental symptoms in lacquerers.

Most previous occupational health studies have employed various questionnaires for the quantitative assessment of mental symptoms. However, reporters' errors may reduce the value of the information so obtained. Semistructured psychiatric interviews and rating scales offer another method to collect data on the prevalence of mental symptoms. This paper describes the application of rating techniques in an epidemiological study of the effect on the nervous system of occupational exposure to organic solvents. The results suggest that ratings by trained interviewers are as useful as many neurophysiological and psychometrical methods to detect early neurotoxicity. The contention agrees with a general opinion that slight changes in mental comfort and personality often are the first signs of progressive brain damage.

Adolescent↗
PubMed1980

Exposure to organic solvents. A cross-sectional epidemiologic investigation on occupationally exposed care and industrial spray painters with special reference to the nervous system.

In the present epidemiologic study 80 car or industrial spray painters with long-term low level exposure to organic solvents were examined and compared with two matched reference groups of nonexposed industrial workers (80 persons in each group). The aim of the study was to investigate the possible effects of the solvent exposure on health. The investigation included psychiatric interviews, psychometric tests, neurological, neurophysiological and ophthalmologic examinations, and computed tomography of the brain. The painters' previous and present exposure was carefully assessed by interviews and on-the-job measurements both at modern places of work and in a reconstructed model of a workshop from 1955. On the basis of the psychiatric interviews the psychiatric symptoms were rated according to a specially designed scale of 46 different items, graded in seven steps of increasing severity. The psychological performance was assessed by a battery of 18 tests. The neurological and neurophysiological examinations comprised visual evoked responses (VER), electroencephalography (EEG), and computerized EEG analysis (SPA) for the central nervous system and electroneurography (ENeG), the estimation of vibration sense thresholds, and a quantified neurological examination for the peripheral nervous system. The ophthamologic examination concentrated on the condition of the lens. Statistically significant differences between the exposed individuals and referents were found for psychiatric items indicative of a slight cerebral lesion (ie, a neurasthenic syndrome). The psychometric tests revealed statistically significant differences between the groups with respect to reaction time, manual dexterity, perceptual speed, and short-term memory. No differences were found with respect to performance on verbal, spatial, and reasoning tests. Significant differences between the groups were also found for the majority of the neurophysiological parameters measuring peripheral nerve functions, the most pronounced occurring in the long, sensory fibers. Moreover EEG and VER showed some differences between the groups, as did the results of the ophthalmologic examination and the computed tomography. Finally, it should be emphasized that the exposure levels, as measured at modern places of work and in the reconstructed workshop from 1955, were found to be considerably lower than the valid threshold limit values in Sweden.

Brain↗
PubMed1979

Neurasthenic symptoms in workers occupationally exposed to jet fuel.

Long-term exposure to petroleum distillation products (e.g. jet fuel) has been suggested to cause chronic mental and neurological symptoms. In the present "cross-sectional epidemiological study" the extent of neuropsychiatric ill-health in 30 workers exposed to jet fuel was compared with that in 60 non-exposed matched controls. Standardized medical interviews showed a higher occurrence of neurasthenic symptoms in exposed subjects (P less than 0.001). The result was confirmed by examination of the medical records kept by the factory physician (P less than 0.01). The prevalence of psychiatric symptoms was assessed with a rating scale of 37 items (a modified CPRS). Again, the exposed workers scored higher than the controls (P less than 0.001), particularly regarding the neurasthenic symptoms, i.e. fatigue, anxiety, mood changes, memory difficulties, and various psychosomatic symptoms (P less than 0.01). The results could neither be explained by observer's bias, nor by a greater susceptibility for mental disorders in the exposed subjects. We therefore conclude that occupational exposure to jet fuel vapours around the present threshold limit values may induce a neurasthenic syndrome.

Adult↗
PubMed1978

A CPRS subscale to assess mental symptoms in workers exposed to jet fuel--some methodological considerations.

A CPRS subscale was constructed for the assessment of mental symptoms in 30 workers exposed to jet fuel and in 30 matched non-exposed controls. All subjects were interviewed in random order by the same psychiatrist. Interviews were recorded on tapes later used for evaluation of rating-rerating and inter-rater reliability, which were in the range of rs 0.75--0.85. The average score of the exposed group exceeded significantly that of the control group. Items concerned with symptoms referred to as neurasthenic and as neurotic differentiated best between the groups. It appears that the subscale is sensitive enough differentiate between two groups of non-patient individuals and has helped establishing that occupational exposure to jet fuel may induce a psycho-organic reaction.

Environmental Exposure↗