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W Entzian

Publications and source records attributed to W Entzian.

10 recordsLinked to original sources

Immunoelectrophoresis in the diagnosis of neuroectodermal and mesodermal intracranial tumours, especially those of the posterior fossa.

Immunoelectrophoresis of extracts of 200 intracranial tumours against rabbit anti-glioblastoma serum gave positive results (= precipitation) in all cases of tumours of neuroectodermal origin such as glioblastoma, astrocytoma, oligodendroglioma, ependymoma, neurinoma, and spongioblastoma. No immunoelectrophoretic precipitation was seen for any of the tumours of mesenchymal origin, for instance meningioma and metastases of cancer. On the basis of these findings, immunoelectrophoresis is considered to be a reliable method for differentiation between tumour tissue of neuroectodermal and non-neuroectodermal origin. Among the 41 posterior fossa tumours some unusual observations were made. Cerebellar angioblastoma (Lindau tumour) showed an atypically located precipitation line, which for the present is interpreted as an immunological reaction to vascular wall tissue. Furthermore, among the group of so-called medulloblastomas, two subgroups were distinguished on the basis of three parameters. The first of these subgroups comprises tumours whose immunoelectrophoretic pattern resembles that of gliomas, which are histologically characterized by neuroectodermal structures and which occur in younger children (5--10 years). The tumours of the second subgroup, which do not show this neuroectodermal immunoelectrophoretic pattern, have a sarcomatous character histologically, and occur in patients aged between 10 and 50 years. The view that medulloblastoma comprises a number of different types of tumour seems to be confirmed by this finding.

Animals

[The influence of some inhalation anaesthetics on the intracranial pressure with special reference to nitrous oxide (author's transl)].

The influence of inhalation anaesthetics on intracranial pressure (ICP), arterial blood pressure and cerebral perfusion pressure (CPP) was investigated on 12 unconscious patients with head injury having an initial ICP of about 20 mm Hg. Halothane, enflurane and nitrous oxide induced a considerable rise of ICP during a 15 to 25 minute period of observation. The moderate fall in blood pressure caused by halothane and enflurane enhanced the reduction of the calculated CPP. Besides, a regular fall in blood pressure of about 16% was observed under the influence of nitrous oxide, subsequently reducing the CPP in some cases under 40 mm Hg. Inhalation anaesthetics, including nitrous oxide, should therefore not be used in patients with decreased intracranial compliance before the increased ICP is treated.

Anesthesia, Inhalation

[Hyperhidrosis].

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Humans

The influence of intravenous anaesthetic agents on primarily increased intracranial pressure.

In the choice of anaesthetics and techniques the danger of a possible progressive increase of intracranial pressure (ICP) should be considered. Therefore the influence of intravenous anaesthetic agents on mean arterial pressure, ICP, and cerebral perfusion pressure (CPP) in patients with primarily increased ICP was observed under standard conditions for 20-40 minutes. Etomidate, thiopentone, propanidid, and ketamine showed remarkable effects on ICP, even in patients with disturbed cerebro-vascular reactivity. Etomidate and thiopentone cause a fall of ICP by 26%. Because of its stabilizing effects on circulation etomidate does not induce a reduction of CPP, whereas thiopentone will do so because of its depressing effect on blood pressure. Propanidid appears to be a less suitable agent when there is raised ICP, because it induces fluctuations of ICP and blood pressure up to the third minute after injection. According to our results, monoanaesthesia with ketamine cannot be recommended when there is increased ICP because it causes a prolonged increase in ICP, and reduction of blood pressure and CPP.

Adolescent

New aspects of cerebrospinal fluid dynamics in humans investigated by sequential gamma camera cisternography, with data evaluation by the digital multichannel analyzer. Part 4: A unifying criterion of the development of hydrocephalic syndrome. Its dynamic basis.

In the final part of this series we present all of the clinical material, and the patients are classified by different cisternographic syndromes on the dynamic basis offered for our method: dynamic disconnection between ventricular system and basal cisterns, brain atrophy, initial dynamic decompensation or prehydrocephalus, communicating hydrocephalus with and without epicortical fluid circulation. A nomogram method for clinical estimation of CSF production based on the mathematical properties of our analysis of the ventricular reflux is proposed. The different normal and pathological characteristics of fluid movements in the spinal canal are given, and their importance as signs of turbulence in the posterior fossa are emphasized. Different aspects of the dynamics of CSF production are shown and discussed, and an evolving conception of hydrocephalus development is presented.

Adolescent

New aspects of cerebrospinal fluid dynamics in humans investigated by sequential gammacamera cisternography, with data evaluation by the digital multichannel analyzer. Part 3: Physiopathology of the ventricular reflux.

Although well described and intensively used for diagnostic purposes, the ventricular reflux as a gammacisternographic phenomen has not yet been satisfactorily explained, and its physiopathology is a subject of controversy. Based on our method of quantitative gammacisternography and gammaventriculography we study the evolution of the tracer concentrations in two main chambers:--the basal cisterns together with the upper cervical canal, considered as a functional unity (the distribution area) and--the ventricular system. We propose the mathematical analysis of a theoretical model which represents the normal and pathological situations of these two chambers, as a method for measuring ventricular volume and ventricular tracer clearance. From the correlation in results with patients and models, we suggest turbulence as the main factor in generating backmixing or total mixing, the appearance of which is called ventricular reflux. We deny the existence of a real inversion of CSF flow. The spinal canal velocity of isotope flow is proposed as additional evidence of turbulence. The normal general dynamics of CSF are delineated, and we propose the following factors that lead to ventricular reflux:--partial obstruction to epicortical CSF flow;--total obstruction to epicortical CSF flow. Their principal characteristics are given, and the importance of using their quantitative parameters in descriptions of patients is stressed. Different aspects in the evolution of hydrocephalus, transependymal resorption, and factors involved in hydrodynamic changes etc. are discussed.

Cerebral Ventriculography

[Clinical and morphological considerations concerning "medulloepithelioma" (author's transl)].

The clinical course and autopsy findings in a 20 months old child with a so-called medulloepithelioma of the brain stem are reported. The histological features of this tumour are described. Ten previous cases in the literature are reviewed and the controversial problems of this entity are discussed. It seems reasonable to place this malignant tumour in the group of ependymomas; in detail, the definition "embryonic ependymoma"; proposed by Fowler, appears to be the most suitable, because it comprises all morphological and biological features of this rare malignant tumour.

Brain Neoplasms

[Long-Term Results of Surgical Treatment of Spinal Tumours in Children and Adolescents].

Catamneses of children up to the age of 16, operated on spinal tumours, are reported. Spinal tumours of this age account for about 15% of the total (all ages). There are about 50% intradural and 50% extradural tumours. The most frequent extradural tumours are sarcomas, followed by lipomas and dysontogenetic tumours like teratomas. Intradural tumours consist of intramedullary and extramedullary ones, about 50% each. Intramedullary tumours are gliomas, extramedullary ones may be neurinomas, meningeomas and vascular tumours. Time from onset of first diffuse symptoms up to clinical diagnosis depends on growth tendency of the tumour as well as on its localization. Hence, case history in cases of intramedullary gliomas usually covers two years, of sarcomas only a couple of months. In half of the cases, pain was the first symptom, followed by disturbed motor function. In more than 50% of the cases, complete restoration or significant improvement could be achieved by surgery. In the remaining half, there was either no change or even deterioration of the disturbed function. It seems justified to replace the former pessimistic attitude towards therapy of spinal tumours in childhood by a discret optimism. If in addition other spinal diseases like disk herniation are taken into account, prognosis is even more favourable.

Adolescent