[Reconstruction of the carotid artery without angiography].
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Biomedical subjects
Publications and source records attributed to P Pohl.
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Single photon emission computed tomography (SPECT) studies were performed in AIDS dementia complex using IMP in 12 patients (and HM-PAO in four of these same patients). In all patients, SPECT revealed either multiple or focal uptake defects, the latter corresponding with focal signs or symptoms in all but one case. Computerized tomography showed a diffuse cerebral atrophy in eight of 12 patients, magnetic resonance imaging exhibited changes like atrophy and/or leukoencephalopathy in two of five cases. Our data indicate that both disturbance of cerebral amine metabolism and alteration of local perfusion share in the pathogenesis of AIDS dementia complex. SPECT is an important aid in the diagnosis of AIDS dementia complex and contributes to the understanding of the pathophysiological mechanisms of this disorder.
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The cerebrospinal fluid (CSF) findings in 21 patients with different manifestations of Lyme disease are presented. 15 patients exhibited CSF changes including a lymphoplasmocytic pleocytosis and a CSF protein profile indicating a barrier leakage combined with an intrathecal immunoglobulin synthesis. Six patients-mainly suffering from cranial neuritis-had a normal CSF.
From January 1984 to August 1985 54 patients presented with cranial nerve lesions at the neurological department of the University hospital Innsbruck. Median age was 42 years, range 5-81 years. Female male ratio was 49/15. In 17 patients cranial neuritis was consistent with meningopolyneuritis Bannwarth (MPN) in 37 cases mere facial palsy was present. Cranial neuritis in MPN-patients affected N. facilis in 10, N. opticus and N. oculo-motorius in one case each. Five patients had polyneuritis cranialis with affection of the cranial nerves II, V, VI, VII, VIII, and IX (Table 1). IgG-antibodies to B. burgdorferi were found in the sera of all MPN patients and in 15 of cases with mere facial palsy. Patients with antibodies to B. burgdorferi were treated with intravenous penicillin and latamoxef dinatrium. The remaining 22 patients were treated with vitamin B compound and corticosteroids. The time for full recovery was 4 weeks on the average in each treatment group.
Modern diagnostic management of diseases of the spinal cord is discussed, illustrated by some exemplary cases and reviewed by the literature. Special attention is directed to high resolution tomography, magnetic resonance imaging, analysis of the cerebrospinal fluid and electrophysiological methods. It seems conceivable that a shift from invasive methods to noninvasive procedures (e.g. magnetic resonance imaging) may occur.
The survival of the street rabies virus in a 10% suspension, prepared from the salivary gland of a naturally infected fox, was studied under various conditions. A bioassay and titration on mice were used for the identification of the virus in different intervals. The heat inactivation of the virus in a suspension kept in a test tube at the temperatures of 20 degrees C and 37 degrees C was performed in two stages. The rapid reduction of the titre within 24 hours was followed by a slower decrease, reaching total inactivation after 96 hours at both temperatures. When the virus was tested by means of the contamination of various substrates (glass, metal sheet, plant leaf) with 0.1 ml of infection suspension in a thin layer, the longest survival of the virus was recorded at the temperature of 5 degrees C--144 hours. At the temperature of 20 to 21 degrees C the virus kept its activity on the glass and plant leaf for 24 hours and on the metal sheet for 48 hours although the applied drops looked like having dried. The temperature of 30 degrees C combined with intensive sunshine devitalized the virus within 1.5 hours, whereas without sunshine the virus still remained active, at the temperature of 30 degrees C, after 20 hours.
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Whatever the product used as a food additive, ("traditional" antibiotic or carbadox) it is likely to increase the proportion of enterobacteria resistant to it. This phenomenon is commonly seen with chloramphenicol, neomycin and ampicillin, whether used as feed additives or therapeutic agents. The use of carbadox also selects strains which are resistant to it, but this increase is much lower than those given by the traditional antibiotics and tends to be reversed when the drug is withdrawn. All the products select coding plasmids for multiple resistances. Resistance to carbadox is most often transferable to the strains of E coli C600 and 14R525; but the Salmonella which were tested proved to be very bad recipients of carbadox resistance.
An attempt was made to measure quantitatively the total cerebral blood flow by means of Duplex sonography. In a group of healthy young subjects a median value for total cerebral blood flow was obtained amounting to 469 ml/min +/- 30%; repeat measurements yielded a maximum deviation of +/- 11%. In three patients the values obtained after severe apoplectic insult due to occlusion of the internal carotid artery were definitely below the value of the group of healthy subjects, whereas the value for the total blood flow was in the upper range of normal values in a patient with occlusion of the a. cerebri media. Comparative measurements of the regional cerebral blood flow with xenon 133 yielded in those patients with occlusion of the internal carotid artery a markedly reduced mean flow and in the patient with occlusion of the a, cerebri media a less markedly reduced mean flow. Regionally reduced perfusion was seen in all the four patients in the range of the clinically and computer tomographically well-known ischaemia zone. Thanks to the simplicity of this sonographic examination method it could be a useful decision parameter in determining the indication for a reconstruction of the carotid artery, especially in asymptomatic patients.
The clinical and serological findings and computer tomographic (CT) appearances of a case of secondary cerebral amebiasis due to Entamoeba histolytica are presented. The effect of therapy on the neurological symptoms as well as on the CT findings are described in detail. The multiple intracerebral lesions resolved almost completely and the patient survived without any neurological sequelae.
The most common complications in breast augmentation surgery with homologous fat grafts obtained from fresh cadavers are presented, showing subsequent surgical procedures to reconstruct the breasts of such patients through use of silicone prostheses and muscle flaps from the latissimus dorsi.
Autologous blood transfusion is indicated and helpful for any patient who is entering surgery in whom the surgeon anticipates a large blood loss because of the multiple or combined plastic operations being planned for one surgical sitting. The advantages of autologous over homologous transfusions include avoidance of incompatibility reactions, better volume expansion, and no risk of acquiring diseases.
This study demonstrates the existence of sex hormone binding globulin (SHBG) in human cerebrospinal fluid (CSF) by means of a highly sensitive radioligand saturation assay that has been recently described by us for measurement of SHBG in human plasma. The molecular similarity of this 5 alpha-dihydrotestosterone binding protein with plasma-SHBG was substantiated by a number of experiments in which the CSF-protein displayed the same properties as plasma-SHBG with respect to thermolability, affinity, specificity and sedimentation rate. SHBG levels in the CSF of normal women were found to be 0.139 +/- 0.04 nmol/l (mean +/- standard deviation), and in normal men to be 0.083 +/- 0.03 nmol/l respectively. CSF-SHBG in patients with a variety of neurological diseases associated with different degrees of a blood-CSF barrier disturbance, showed a good correlation with commonly determined parameters such as CSF-albumin and CSF-IgG that are known to be of plasma origin. The concept of CSF-SHBG originating from plasma by restricted diffusion is strongly supported by the finding that the CSF/plasma ratio of SHBG is independent of the plasma-SHBG concentration in the entire physiological range. Possible diagnostic and pathophysiological implications of this so far undetected CSF-constituent are discussed with regard to neurological and endocrine abnormalities.
Three patients with classical idiopathic polyneuritis cranialis, in whom no other aetiology could be detected, were examined serologically, by means of indirect immunofluorescence test, for antibodies (IgM and IgG) against Borrelia burgdorferi, the aetiologic agent of Lyme disease. In each case polyneuritis cranialis was caused by infection with Borrelia burgdorferi. Therapy with penicillin proved to be effective.
On the assumption that temporal resolution underlies an individual's ear advantage for speech perception, one would predict an ear advantage for a temporal resolution task to correlate precisely with an ear advantage for the discrimination of consonant-vowel syllables that differ in their temporal features. A gap detection task that required the resolution of brief silent intervals in bursts of noise was employed to test this hypothesis in four baboons. The findings offer support for such a hypothesis and thus increase the feasibility of an animal model of functional asymmetry in the auditory system.
A cross-sectional, dichotic listening study of 210 right-handed, middle-class children four to ten years old used thirty pairs of one-syllable words and thirty pairs of four-syllable numbers to assess the developmental course of ear asymmetry. A significant decrease in REA for both word and number pairs was found. Although right-ear and left-ear performance both increased with age, the developmental gain in left-ear performance was greater than the gain in right-ear performance, thus resulting in a decrease in REA with age. The results are discussed with respect to investigations which found no change in REA during development and a structural model based on the development of interhemispheric connectivity is proposed to explain the findings.