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Biomedical subjects

T Kuurne

Publications and source records attributed to T Kuurne.

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

Reduction of stress/catecholamine-induced cardiac necrosis by beta 1-selective blockade.

114 haemodynamically stable patients with acute head injury were randomised, double-blind, to either placebo or atenolol given intravenously (10 mg every 6 h) for 3 days then orally (100 mg daily) for a further 4 days. Both groups were equally stressed as shown by raised arterial noradrenaline levels. In patients receiving placebo, but not in those receiving atenolol, there was a significant (p less than 0.01) positive correlation between arterial noradrenaline and levels of the myocardial isoenzyme of creatine kinase (CKMB). 30% of the placebo group compared with 7.4% of the atenolol group (p less than 0.05) showed CKMB levels greater than 3% of total creatine kinase (compatible with myocardial damage). CKMB levels greater than 6% of total creatine kinase (compatible with acute myocardial infarction) were present in 16.7% of patients receiving placebo but in no patients receiving atenolol (p = 0.053). Atenolol appeared to reduce significantly the likelihood of supraventricular tachycardia and ST-segment and T-wave changes and prevented cardiac necrosis seen at necropsy.

Adolescent↗
PubMed1987

Estrogen and progestin receptors in intracranial tumors.

Tissue samples from 17 intracranial tumors were analysed for the cytosolic estrogen and progestin receptor concentration. Three of the four meningiomas were progestin receptor-positive, but all were estrogen receptor-negative. All the four meningioma patients were postmenopausal women. The intracranial metastasis of a mammary carcinoma contained both estrogen and progestin receptors. Low progestin receptor concentration was found in an astrocytoma of a postmenopausal women. In addition, the presence of estrogen and progestin receptors was studied in four prolactinomas, two glioblastomas, two oligodendrogliomas, two mixed-cell carcinomas and one astrocytoma. All these tumors were estrogen and progestin receptor-negative.

Brain Neoplasms↗
PubMed1986

Bleeding of a venous hemangioma inside the filum terminale.

Spinal vascular malformations can present with acute symptoms suggesting spinal cord or nerve root compression. We describe a case of bleeding from a venous hemangioma within the filum terminale. This malformation caused acute compression of the lumbar spinal roots. Thus, vascular malformations may exist behind the symptoms of acute radiating pain and lower extremity weakness. They can be treated by total extirpation, when possible, by resection or by decompressive laminectomy alone.

Cauda Equina↗
PubMed1985

Indole levels in human lumbar and ventricular cerebrospinal fluid and the effect of L-tryptophan administration.

Levels of tryptophan (TRP), 5-hydroxytryptophan (5-HTP), 5-hydroxytryptamine (5-HT), and 5-hydroxyindoleacetic acid (5-HIAA) in human lumbar and ventricular cerebrospinal fluid (CSF) were measured by reversed phase liquid chromatography (HPLC) with electrochemical detection. The levels of TRP ranged from 1593 to 4865 nmol/l in ventricular (VF) and from 1257 to 2557 nmol/l in lumbar CSF. The level of 5-HTP varied from 1.1 to 68.9 nmol/l in VF and from 5.3 to 10.8 nmol/l in lumbar CSF; no previous reports of 5-HTP levels in CSF exist. The serotonin level was 1.9-27.3 nmol/l in VF and 5.7-12.0 nmol/l in lumbar CSF. The levels of 5-HIAA were considerably higher in VF than in lumbar fluid with respective means of 498 +/- 52.4 nmol/l and 112 +/- 15.6 nmol/l (P less than 0.001). An oral dose of 2 g L-tryptophan significantly increased all indole levels except that of 5-HT, both in patients with progressive myoclonus epilepsy and in controls.

5-Hydroxytryptophan↗
PubMed1983

Subdural effusions re-appearing after shunts in patients with non-tumoural stenosis of the aqueduct.

Three patients shunted for non-tumoural stenosis of the aqueduct suffered from progressive clinical symptoms about four months after the shunting. Computed tomography (CT) showed bilateral subdural effusions. The effusions were evacuated, and the shunts revised. One month later all patients suffered from symptoms of increased intracranial pressure, and CT showed enlargement of the supratentorial cerebral ventricles. The effusions had disappeared. After shunt revision the symptoms decreased again. The fluctuation in the ventricular size, the thickness of the subdural effusions, and the clinical deterioration were related to the change in the opening pressure of the shunt valve in all patients. Patients with large supratentorial cerebral ventricles (Evans index over 0.40) should be monitored by intraventricular pressure recording in order to select the exact opening pressure of the shunt valve before inserting a relieving shunt; a clinical check-up and a CT examination should be carried out about three months after the operation in order to investigate any changes in the function of the shunt.

Adult↗
PubMed1982

Is chronic brain damage in boxing a hazard of the past?

Of fourteen boxers with a mean age of 31 years who had been Finnish, Scandinavian, or European champions, only one showed deficits in neurological status and he and one other had had episodes of inappropriate behaviour which were attributed to boxing. However, computed tomography revealed pathological findings attributable to brain injury in four of six professional and one of eight amateur boxers. Two of the professionals and four of the amateurs had electroencephalographic abnormalities which may have been caused by brain injury. Twelve of the boxers had psychological test results which suggested brain injury, although only two professionals had definite deviation from normal. The results indicate that modern medical control of boxing cannot prevent chronic brain injuries but may create a dangerous illusion of safety. The only way to prevent brain injuries is to disqualify blows to the head.

Adolescent↗
PubMed1982

Ventricular fluid pressure in neurosurgical patients receiving intravenous lorazepam for premedication.

The effect of 0.05 and 0.03 mg/kg of intravenously administered lorazepam on the ventricular fluid pressure (VFP) was recorded continuously for 45-90 minutes in 13 wakeful spontaneously breathing unanaesthetized patients with hydrocephalus. The initial VFP was low in 11 patients with low-pressure hydrocephalus, and at the upper level of normal in 2 who had stenosis of the aqueduct. Lorazepam caused minute changes in VFP. The largest transient increased (7 and 16 torr) occurred in the two patients with the highest initial VFP. Blood acid-base balance, blood pressure, and heart rate remained unaltered. However, lorazepam caused such drowsiness that it was difficult to check the patients' level of consciousness. For this reason, intravenously administered lorazepam in a dosage of 0.03 mg/kg or more seems unsuitable for premedication in neurosurgical patients with brain disease.

Adult↗
PubMed1982

Unpredictable central nervous system effects after lorazepam premedication for neurosurgery.

Administration of lorazepam for preanaesthetic medication is generally expected to produce amnesic action. We conducted two studies to evaluate the relationship of plasma levels of lorazepam with its clinical effects. Forty patients, receiving 0.03 or 0.05 mg/kg lorazepam i.m. as preanaesthetic medication for various neurosurgical procedures, were asked 24 h after anaesthesia whether they could recall the insertion of the i.v. needle and a picture shown to them before induction of anaesthesia. Another 11 patients were given 0.03 mg/kg lorazepam i.v. and their degree of drowsiness was rated immediately before induction of anaesthesia. Plasma levels of lorazepam were measured by gas chromatography from samples drawn before induction of anaesthesia. No relationship between either the dose of lorazepam used or the plasma levels of lorazepam and the incidence of amnesia or the degree of drowsiness was observed. Three patients receiving 0.05 mg/kg of lorazepam i.m. had prolonged drowsiness, which made it difficult to check the patients' neurological condition after the operation. It is postulated that the unpredictable and variable central nervous system effects of lorazepam in neurosurgical patients may be due to differences in the capacity of lorazepam to penetrate the blood brain barrier.

Adult↗
PubMed1975

Acute paraplegia caused by a spontaneous extradural heamatoma of the conus medullaris area.

Four patients with a typical clinical picture of spinal extradural heamatoma of the conus area are presented. Initial symptoms were acute low back pains. The development of symmetrical paraparesis took place in a matter of hours, and spread to total paraplegia. The sensory level was as high as the groins and bladder and rectum paralysis developed early. All patients were over 63, mean age 67 years. Two patients had coagulation defects, one was on anticoagulants, and the other had a severe thrombocytosis. Two patients had used salicylates for rheumatic pains; in one of those patients there was a hemangioma on PAD . In 2 patients, the neuroradiological diagnosis was confirmed with rhizography (Figs. 1 and 2); in the third patient the rhizography was misleading but in her and in a fourth patient the oxygen-myelography was diagnostic, showing an extradural compression in the conus area. Haematomas were removed in all patients through an extensive decompressive laminectomy within 24 hours from the onset of the symptoms. Recovery was good in 2 cases, and fair in one patient who had a poor recovery of the bladder function. In on patient, both paraplegia and bladder paralysis were permanent after 3 years. The differential diagnosis by myelography between the cauda equina syndrome caused by typical disc compression from the one side and from vascular medullary syndromes and myelitis from the other side should be clear. For good functional recovery, early myelography and operative decompression are imperative.

Aged↗