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Biomedical subjects

R Zimmer

Publications and source records attributed to R Zimmer.

97 records · Page 6Linked to original sources
PubMedDate not supplied

[A comparative study of the cardiovascular effect of dobutamine. Preliminary results obtained in a surgical resuscitation unit].

Dobutamine (dobutamin hydrochloride, Lilly) is a new inotropic catecholamine; it is presented in lyophilized ampoules for I.V. use, each containing 250 mg of dobutamine to be reconstituted with 5 per cent glucose or sterile water for injection. In the first part of this study, animal pharmacology is reported as described in medical literature: inotropic activity with minimal chronotropic effects, direct action, no vasconstriction, minimal arrhythmogenic activity and minimal diversion of blood flow to skeletal muscles are the main experimental features. The authors report afterwards their own experience with dobutamine in 8 patients (cranial traumas) without cardiac failure, and in 9 patients presenting with a cardio-circulatory failure in a toxi-infectious condition. In all patients tested, hemodynamics parameters (heart rate, mean A.P., central venous pressure) and cardiac output measurement (dye dilution method) were performed. Cardiac index and systolic index, total systemic resistances, left ventricular performance were also calculated. Dobutamine dosage ranged from 2.5 to 10 mcg/kg/mn except in patients with low output syndrom (2.5 and 5 mcg/kg/mn). Dobutamine offers new possibilities by its constant and indisputable inotropic activity contrasting with its minimal chronotropic effect.

Animals↗
PubMedDate not supplied

Mini-infarct encephalopathy associated with uncommon microvessel convolute formation presenting with presenile dementia.

A female patient started to suffer from transient ischemic attacks when she was 47 years of age, followed by increasing predominantly left-side spastic tetraparesis, generalized seizures and progressive dementia over a period of 11 years. She died when she was 58 years of age. On gross examination the brain showed enlarged ventricles and arteriosclerotic changes of large extracerebral vessels of the circulus arteriosus. Microscopic examination of the atrophic brain showed innumerable incomplete microinfarcts in the white and gray matter throughout all parts of the brain. In the white matter these lesions were characterized by small foci of demyelination and loss of oligodendrocytes while occasionally some scavenger cells were seen. Axons seemed to be unaffected or displayed irregular axonal regeneratory growth. Any inflammatory reaction failed. In the cerebral cortex and subcortical nuclei the lesions showed loss of neurons and decrease in synaptophysin expression. Intracerebral arteries showed fibrosis or fibrohyalinosis of the entire intracerebral small-vessel network. In addition, numerous uncommon clusters of angioma-like telangiectatic vessels were observed. Medium-sized ischemic infarcts were found in the right putamen and adjacent internal capsule region, left-side dorsolateral brain stem and cerebellar hemisphere as well as a left-side pyramidal tract degeneration. Contralateral pseudohypertrophy of the inferior olivary nucleus was seen. The clinical and the neuropathologic observations made in this patient are compatible with small vessel disease characterized by a multicentric special and not yet described type of incomplete mini-infarcts in cerebral cortex and white matter accompanied by some larger ischemic infarcts of the common type in brain stem and cerebellum.

Alzheimer Disease↗
PubMedDate not supplied

[On the problem of depressive pseudodementia].

The term "depressive pseudodementia" introduced 20 to 30 years ago by Madden and coworkers and by Kiloh is critically evaluated. This originally descriptive term is not unequivocal due to its diagnostic and therapeutic connotations. Even by omitting the negative prefix "pseudo" it cannot be distinguished whether a psychopathological description of symptoms or a clinical diagnosis is meant. Therefore, on the present state of knowledge of dementia research and in view of the necessary distinction between syndromal and nosological classification level, the authors favour the abandoning of the term "depressive dementia". At the syndromal level it is suggested to use the term "dementia syndrome" according to Folstein and McHugh or to use the term "cognitive impairment" according to Caine. At the diagnostic-nosological level this procedure should include the information as to whether the "cognitive impairment" of an elderly patient coincides with a depression, a certain type of dementia or a combination of both. Such a positive terminology may promote the qualitative differentiation and quantification of the "cognitive impairment" which are scientifically necessary.

Aged↗
PubMedDate not supplied

[A systematic genetic-epidemiologic family study of patients with Alzheimer disease--experience with the MIRAGE study in Germany].

A register of the families of 60 patients with Alzheimer's disease was established with two questionnaires (the Family History Questionnaire and the Patient History Questionnaire). These questionnaires, instruments of the MIRAGE study, were translated into German. 35% of the families had more than one family member affected with dementia. The frequencies of the risk factors that were studied were surprisingly high. The responses of the family members to the study were very positive and encourage further investigation in the field of genetic epidemiology in Alzheimer's disease.

Aged↗