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Biomedical subjects

W Lang

Publications and source records attributed to W Lang.

At least 235 records · Page 13Linked to original sources

Investigations on the incorporation of a tritiated ganglioside, GM1, in the injured and intact sciatic nerves of the rat.

Following injury of their left sciatic nerves by means of a standardized procedure, male rats received intravenous injections of a tritiated ganglioside. GM1, on different days during the process of regeneration. The rats were killed at two different times after the injection and the concentrations of the total radioactivity, nonvolatile radioactivity, and labelled GM1 were estimated in six segments of the crushed and intact sciatic nerves. The segments of the damaged nerves showed higher concentrations of radioactivity and a higher content of GM1 than the corresponding segments of the contralateral nerves. Within the immediate area of the lesion the highest levels were found on the 3rd and 6th days after the injury; the segments distal from the lesion showed the highest levels of activity on days 9 and 12. The nerve segments proximal to the site of the injury showed a low rate of radioactivity incorporation. The higher concentrations of [3H]GM1 in damaged nerves as well as the rate of incorporation as a function of time indicate that exogenous gangliosides may be involved in the processes of regeneration and have a bearing on the latter.

Animals↗

Hereditary distal muscular atrophy with vocal cord paralysis and sensorineural hearing loss: a dominant form of spinal muscular atrophy?

In 1980 Young and Harper described a family with an unusual form of distal spinal muscular atrophy associated with vocal cord paralysis. We report a family with three similarly affected subjects. Progressive sensorineural hearing loss was an additional feature in our patients. Electrophysiological and histological investigations did not exclude an involvement of sensory neurones. Whether the classification of this dominant disorder with the spinal muscular atrophies is justified will depend on additional studies in further families.

Acoustic Impedance Tests↗

Quantification of regional cerebral blood flow with IMP-SPECT. Reproducibility and clinical relevance of flow values.

Single-photon emission computed tomography with N-isopropyl[123I]-p-iodoamphetamine (IMP-SPECT) was performed in 14 normal volunteers (seven men and seven women aged 25.1 +/- 5.3 years) and 29 patients with cerebrovascular disease (18 men and 11 women aged 54.1 +/- 13.7 years). The fluid microsphere model was used to estimate cerebral blood flow (CBF). Normal subjects were scanned twice, 1 week apart, to determine the reproducibility of the CBF estimates. Hemispheric blood flow (hCBF) was calculated as the mean of regional cerebral blood flow (rCBF) values in 16 gray matter regions per hemisphere. In normal subjects mean hCBF was 68 ml/100 g/min. The highest rCBF was found in the occipital cortex, followed by the frontal, temporal, and parietal cortexes. CBF values were reproducible (p less than 0.001 except the right thalamic region, where p less than 0.01). Intraindividual variation ranged between 0.3% and 15%. Women exhibited significantly higher (16%, p less than 0.02) CBF than men. Patients were subdivided into groups with reversible (n = 19) and persistent (n = 10) symptoms. Significant hCBF differences between the affected and the contralateral hemispheres were recorded only in the group with reversible symptoms (p less than 0.005), whereas the group with persistent symptoms showed a significant bilateral decrease of hCBF compared with normal subjects and patients with reversible symptoms. Focal CBF was significantly lower in patients with completed stroke than in patients with transient symptoms (p less than 0.001). Our results indicate that IMP-SPECT can be used for the routine estimation of CBF in normal and pathologic states.

Aged↗

The determination of haemoglobin as cyanhaemiglobin or as alkaline haematin D-575. Comparison of method-related errors.

In order to compare the accuracy of haemoglobin (Hb) determination methods, the commonly used cyanhaemiglobin (HiCN) method and the recently developed alkaline haematin D-575 (AHD) method (R. Zander, W. Lang & H. U. Wolf (1984) Clin. Chim. Acta 136, 83-93; H. U. Wolf, W. Lang & R. Zander (1984) Clin. Chim. Acta 136, 95-104) were tested with respect to method-related errors such as plasma, cell, and Hb errors. Both methods yield a series of more or less significant errors which generally lead to an overestimation of the Hb concentration in the order of 1%. However, in all three cases of plasma errors, i.e. normal plasma error, plasma error in lipaemic blood, and plasma error in bilirubinaemic blood, the AHD method shows significantly lower values of errors than the HiCN method. In the case of cell errors such as ghost and leukocyte errors, the overestimation of the Hb concentration by the HiCN method is 60% higher than that by the AHD method. In the case of Hb errors such as fetal Hb and carboxy Hb errors, there is a significant overestimation of the Hb concentration by the HiCN method, which amounts 3 min after mixing of blood and HiCN solution to 0.7% in the case of fetal Hb and to 13.2% in the case of carboxy Hb. The latter value yields an overestimation of 1.3%, when 10% carboxy Hb in a blood sample is present. In contrast, there is no detectable overestimation after 3 min in the case of the AHD method. Thus, the AHD method provides a higher accuracy in Hb determination than the commonly used HiCN method.

Carboxyhemoglobin↗

Coincidence of EGF receptors and somatostatin receptors in meningiomas but inverse, differentiation-dependent relationship in glial tumors.

Somatostatin (SS) receptors as well as EGF receptors have been shown to be present in various brain tumors such as meningiomas or glia-derived tumors. Using receptor autoradiography for both receptors, their localization on adjacent tumor sections was investigated and a correlation was attempted. In glia-derived tumors, there was an inverse relationship for the incidence of the two receptors in individual tumors: in a majority of cases (five of eight) of well-differentiated astrocytomas (I-II), SS receptors were present, but in none of the cases (zero of eight) EGF receptors were detected. In undifferentiated glioblastomas, the reverse situation was observed, no SS receptors were found (0 of 14) but EGF receptors were present in a majority of tumors (8 of 14). In astrocytomas III both types of receptors were normally seen. These data suggest that in glia-derived tumors, SS receptors are markers for the well-differentiated cases as opposed to EGF receptors. In meningiomas, SS receptors are found in all (27 of 27) tumors and EGF receptors in a large percentage (23 of 27) of the same tumors. However, in some cases a coincidence of both receptors on the same cell can be excluded. Furthermore, no effect of the SS analog SMS 201-995 on basal or EGF-stimulated growth of meningiomas in culture could be detected. Nevertheless, the coexistence of the two receptor types in meningiomas may be suggestive for a potential functional interaction between EGF and SS.

Autoradiography↗

Patterns of T lymphocyte changes with human immunodeficiency virus infection: from seroconversion to the development of AIDS.

CD4 and CD8 T lymphocytes of three groups of men infected by the human immunodeficiency virus (HIV) were examined twice yearly for 36 months to elucidate the temporal trends in T lymphocytes during infection. The three groups were 37 HIV seroconverters, 304 prevalent HIV seropositives remaining free of the acquired immunodeficiency syndrome (AIDS), and 69 men who developed AIDS during observation. Six months before seroconversion, CD4 levels were similar among HIV seroconverters and 356 seronegative controls. Within 18 months of seroconversion, mean CD4 levels fell to the level of the prevalent seropositives at study entry. From there, the rate of decline slowed. CD8 lymphocyte counts rose dramatically at seroconversion. Among AIDS-free prevalent seropositives, CD4 levels fell steadily over 36 months of observation. By contrast, CD8 cell levels rose slowly. Among men who developed AIDS, mean CD4 levels fell more rapidly again during the 18 months prior to diagnosis. CD8 cell levels remained elevated until 6-12 months before diagnosis, when they began to fall.

Acquired Immunodeficiency Syndrome↗

Anomalous origin of the circumflex coronary artery in association with the right superior septal artery.

The presence of anomalous coronary arteries is observed infrequently during routine coronary angiography. However, their identification is crucial to the management of the patient with associated coronary artery disease. A case is described in which concomitant anomalous origin of the circumflex coronary artery from the right coronary artery, and a right superior septal coronary artery with a separate ostium occurred in association with severe three-vessel coronary artery disease requiring bypass graft surgery. Clues to the presence of the anomalous vessels were (1) their visualization during left ventriculography and (2) their presence or absence during injection of the normally originating vessels. This particular association of anomalous vessels was previously unreported.

Coronary Angiography↗

Antibody-mediated peripheral neuropathies associated with ARC and AIDS: successful treatment with plasmapheresis.

Peripheral neuropathy is increasingly recognized in patients with AIDS as well as AIDS-related complex (ARC). Thirty homosexual men with polyneuropathy were evaluated in this study. Twenty-one had ARC and nine had AIDS. We observed three distinct clinical syndromes: distal sensorimotor polyneuropathy, chronic inflammatory demyelinating polyrediculoneuropathy (CIDP), and mononeuropathy multiplex. Circulating antibodies to peripheral nerve tissues were found in all patients. In six patients, treatment with plasma exchange was undertaken because of severe, progressive weakness. Four patients with clinical, electrophysiologic, and histologic evidence of CIDP improved with plasma exchange, three regaining normal function. These results suggest that the peripheral neuropathy associated with ARC and AIDS is immunologically mediated and that plasma exchange is an effective treatment in a subgroup of patients with this disorder.

AIDS-Related Complex↗

Cerebral blood flow velocity waveforms in hydrocephalic fetuses.

Pulsed Doppler recordings of intracranial arterial velocity waveforms were made in 9 hydrocephalic fetuses during the second or third trimesters of pregnancy. Normal, increased, and decreased velocity waveform indices could be measured in these cases, and 1 fetus presented retrograde diastolic flow. Cerebral blood flow patterns of hydrocephalic fetuses seem to differ individually from case to case, presenting no uniform waveform type in late pregnancy. There was no obvious correlation between ventricular dilatation and the type of the velocity waveform.

Cerebral Arteries↗

The spectrum of peripheral neuropathy associated with ARC and AIDS.

Peripheral neuropathy is increasingly recognized as a complication of the Acquired Immune Deficiency Syndrome (AIDS) and AIDS-related complex (ARC), but the varied clinical features have been incompletely described. Thirty homosexual men with peripheral neuropathy were evaluated in this study. Twenty-one had ARC and nine had AIDS. Four distinct clinical syndromes were recognized: distal sensorimotor polyneuropathy, chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), mononeuropathy multiplex, and progressive polyradiculopathy. Four patients with clinical, electrophysiologic, and histologic evidence of CIDP and severe progressive weakness improved with plasma exchange, three regaining normal function.

AIDS-Related Complex↗

DC-potential shifts and regional cerebral blood flow reveal frontal cortex involvement in human visuomotor learning.

In the present study, two different physiological parameters were measured to describe brain activity related to visuomotor learning: performance-related DC-potential shifts and regional cerebral blood flow (rCBF) by Tc-99m HMPAO brain SPECT (Single Photon Emission Computerized Tomography). Visuomotor learning was required in a conflicting situation: a visual target moved on a screen and had to be tracked by moving the right hand in an inverted fashion (IT), e.g. movements of the target to the right side required hand movement to the left and vice versa. Compared to a normal, non-inverted control task (T), IT required the development of a novel motor program and the prevention of returning to routine direct pursuit. These additional demands in IT caused a relative hyperperfusion in regions including the middle frontal gyri, frontomedial cortex (including the supplementary motor area, SMA), right basal ganglia (caudate-putamen) and left cerebellum. Correlations of rCBF values between the middle frontal gyrus and basal ganglia may indicate a functional relation between these two brain structures. Visuomotor performance was accompanied by slow negative DC-potential shifts. In frontal and to a lesser degree in central recordings, amplitudes of DC-negativity were larger in IT than they were in T. This additional frontal negativity covaried with the success of learning. Results substantiate, now using a dual approach, previous suggestions that the frontal lobe plays an important role in visuomotor learning.

Adolescent↗

Negative cortical DC shifts preceding and accompanying simultaneous and sequential finger movements.

Cortical DC shifts preceding and accompanying the execution of five different bimanual motor tasks were analysed in 20 subjects. All tasks required repetitive flexions and extensions of the two forefingers for a period of at least six seconds. The temporal and spatial structures organization varied in the different tasks: (1) Simultaneous agonistic performance (forefinger flexion on both sides), (2) simultaneous antagonistic performance (e.g. flexion of the right, extension of the left forefinger), (3) sequential agonistic performance, (4) sequential antagonistic performance, (5) uncoordinated flexions and extensions of the two forefingers. Compared to (1) and (2), conditions (3) and (4) included a temporal delay between the performance of the two forefingers; compared to (1) and (3), conditions (2) and (4) required the subjects to perform movements of opposite directions with their two forefingers. Effects of the temporal factor (T; simultaneous vs. sequential) and the spatial factor (S; agonistic vs. antagonistic) on cortical DC shifts were investigated. The voluntary initiation of each motor task was preceded by a Bereitschaftspotential (BP). The performance of the complex tasks (1-4) was accompanied by a slow negative DC potential shift (N-P). In general, the BP did not differ depending on the temporal or spatial structures of the tasks (1-4). However, amplitudes of N-P (i.e. during tasks) were influenced by the temporal factor with significantly larger amplitudes in sequential than in simultaneous tasks. This difference was not a global phenomenon in all recordings but was selectively found in the recordings over the fronto-central midline.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Left frontal lobe in verbal associative learning: a slow potential study.

In the present experiment pairs of words had to be memorized. The words were either meaningful or meaningless. The experimental design compares conditions of preestablished learning (L-) with active learning (L+). The effects of these two factors, "semantic content (S)" and "learning (L)", on the slow potential shifts accompanying presentation and processing of the verbal material were tested. In the memorizing tasks, the two words were given in a fixed temporal sequence. A slow negative potential shift having a maximum in parietal leads emerged within the inter-stimulus-interval. Its amplitudes were larger in the learning tasks (L+) than in conditions of pre-established learning (L-). This difference of amplitudes may reflect different levels of attention: In L-, the second word could be anticipated, but not in the L+ tasks. After the presentation of the second item, learning tasks (L+) were characterized by a slow negative potential shift in the recordings of the left dorso-lateral frontal lobe. It is assumed that this potential shift may indicate an importance of the left frontal lobe in the elaborative encoding of verbal material.

Adult↗

Single photon emission computerized tomography during and between seizures.

In three patients, patterns of brain activity were measured by 99mTc-hexamethyl-propyleneamineoxime (99mTc-HM-PAO) brain SPECT (single photon emission computerized tomography) in ictal and interictal states. Increased relative blood flow indicated the focus of partial seizures, its spreading to adjacent cortical regions and to distant brain structures via neuronal pathways. Ictal patterns of regional cerebral blood flow (rCBF) were in agreement with clinical symptomatology. Successive SPECT studies were performed after 3-7 days in the absence of electroencephalographic and clinical signs of seizures but still revealed increased relative blood flow in the focus of the seizures. SPECT studies, performed 2-6 weeks after the last clinically observable seizures, demonstrated the transition from increased to decreased relative blood flow in the focus of the seizures. In one patient, the EEG was complementary to and corresponded with the rCBF patterns in the ictal state. However, the dynamics of interictal changes could only be assessed by brain SPECT.

Adult↗

Hexa-methyl-propylene-amine-oxime (HMPAO) single photon emission computed tomography (SPECT) in epilepsy.

Twenty-eight normal volunteers and 74 seizure patients were investigated with hexa-methyl-propylene-amine-oxime (HMPAO) brain single photon emission computed tomography (SPECT). Fifty-four patients suffered from partial seizures and 20 patients had generalized seizures. Indices describing regional tracer distribution (RIs) were calculated in all investigated subjects. Regions whose RI exceeded the mean normal RI +/- 3 SD were defined as abnormally perfused. In normals a significant interhemispheric asymmetry of HMPAO deposition was found, with higher RI values in the right frontal, parietal, temporal and occipital regions. In 59.3% of partial seizure patients abnormal RIs were found. Low RIs were detected predominantly in the frontal and temporal cortex, while elevated RIs were observed predominantly in the anterior basal ganglia. Only in 20% of the cases with generalized seizures, abnormal RIs were found. In one patient an ictal and 3 follow-up SPECT studies were obtained. Here SPECT results indicated transient rCBF changes between the ictal and seizure free state. EEG and SPECT foci were ipsilaterally located in 69.2% of the partial seizure cases. The results indicate that HMPAO brain SPECT is valuable for the detection of rCBF abnormalities in seizure patients and that patients with partial seizures have mostly several abnormally perfused areas in their brains.

Adult↗