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Biomedical subjects

E Beuls

Publications and source records attributed to E Beuls.

12 recordsLinked to original sources
PubMed2004

Deep brain stimulation in movement disorders. The applications reconsidered.

In this study the role of DBS in advanced Parkinson disease (PD) is re-evaluated and new indications in the field of movement disorders are explored. The authors performed unilateral pallidal stimulation in 26 patients with advanced PD. At long-term follow-up review, the motor effect is unsatisfying. The authors conclude that unilateral pallidal stimulation is not a favourable treatment option for patients with advanced PD. Bilateral subthalamic nucleus stimulation was performed in twenty patients with advanced PD. After a minimum follow-up of 4 years, there was still a significant improvement in motor function and functional performance in all patients. One side-effect of the stimulation was however rather concerning: four patients presented with stimulation-induced hypomanic to manic characteristics. Bilateral subthalamic stimulation was performed in four patients with multiple system atrophy-parkinsonism. At long-term follow-up, the patients fared better with than without stimulation. The authors finally present a completely new indication for DBS: Tourette syndrome (TS). They review the literature on surgical procedures performed in TS, all of which consisted of making lesions. Three TS patients are presented on which bilateral thalamic stimulation was performed. At long-term follow-up, all major tics had disappeared, as well as associated behavioral disturbances.

Adult↗
PubMed2003

The Arnold-Chiari type II malformation at midgestation.

The Arnold-Chiari malformation type II (ACMII) is reported to be reversible after closure of a myelomeningocele at midgestation. To elucidate the developmental state of the ACMII malformation at the approximate time fetal surgery is performed, the ACMII of a 20-week human fetus was investigated in vitro using high-field magnetic resonance microscopy at 9.4 T and compared with the hindbrain of a neurologically intact fetus of the same gestational age. Up to 20 weeks of gestation, the developmental failures caused by the early embryonic herniation of the posterior fossa contents are the dominant feature of fetal ACMII, but after 20 weeks, the accelerated and disproportionate growth of the cerebellum dominates. As midgestational surgery stops the leakage of cerebrospinal fluid, the posterior fossa will expand in time to allow further normal growth of both the cerebellum and brain stem. Some early developmental anomalies already present in the primitive rhombencephalon due to early embryonic hindbrain herniation as well as some intra-axial anomalies are probably not reversible.

Abortion, Legal↗
PubMed2002

Intracranial pressure and cerebral blood flow velocity in preterm infants with posthaemorrhagic ventricular dilatation.

AIM: To determine the volume of cerebrospinal fluid (CSF) that should be tapped in preterm infants with posthaemorrhagic ventricular dilatation as guided by intracranial pressure (ICP) and cerebral blood flow velocity (CBFV). METHODS: The total number of measurements was 106 in 22 infants. Birth weights ranged from 630 to 2050 g, gestational age from 24.5 to 30.3 weeks, and age at insertion from 12 to 67 days. A subcutaneous ventricular catheter reservoir for repetitive CSF drainage was placed when the diameter of a ventricle was > 4 mm above the 97th centile. A volume of 5 ml/kg body weight was removed twice daily. ICP and CBFV were determined before and after CSF tapping. RESULTS: If the ICP after tapping exceeded 7 cm H(2)O, tapping did not result in a significant improvement in CBFV. If the ICP before tapping was less than 6 cm H(2)O, tapping also had no effect on CBFV. Longitudinal studies in individual infants showed a slight correlation between ICP and CBFV. CONCLUSION: Volume of repetitive CSF drainage in preterm infants with posthaemorrhagic ventricular dilatation guided by ICP and CBFV may be a useful technique. An ICP of about 6 cm H(2)O is the cut off point for CSF drainage.

Blood Flow Velocity↗
PubMed2000

[Systemic capillary leak syndrome].

A man aged 61 had recurrent attacks of severe shock. The episodes were preceded by symptoms such as a runny nose, epigastric discomfort with nausea, vertigo, orthostatism and sometimes light fever. During the attacks there were marked hypotension, a strong rise of the haematocrit, a decrease of the protein and albumin concentrations in the blood and prerenal kidney failure. In addition, there was a paraprotein, type IgG-kappa. The shock every time responded rapidly to intravenous administration of fluid and was followed by a period of substantial polyuria. The pattern was characteristic of systemic capillary leak syndrome, a rare but frequently fatal disease characterized by episodes of unexplained extravasation of plasma. The aetiology and pathogenesis are unknown. Attacks are suppressed by supportive therapy (administration of fluids, inotropics) and future attacks may be prevented by the intake of terbutaline and theophylline. The systemic capillary leak syndrome should be considered in the differential diagnosis of idiopathic and anaphylactic shock.

Capillary Leak Syndrome↗
PubMed2000

Helmet versus nonhelmet treatment in nonsynostotic positional posterior plagiocephaly.

A total of 105 infants with nonsynostotic posterior plagiocephaly were treated using a helmet or by head positioning. Effect of treatment was scored using a cosmetic outcome score (0-10 points) assigned by the parents. The onset of the observed skull deformity correction was not different for the helmet vs. nonhelmet treatment. Improvement was significantly better and faster in the helmet group compared with nonhelmet treatment (p < 0.01 and p < 0.001, respectively).

Craniosynostoses↗
PubMed1997

Radiofrequency lesions of the dorsal root ganglion in the treatment of hip flexor spasm: a report of two cases.

The current popular model of spasticity is that the abnormalities are primarily due to increased sensitivity of the reflex are at the segmental level of the spinal cord. Neurosurgical procedures, such as open selective dorsal rhizotomy for the reduction of spasticity, have been based on this assumption. We describe two patients with hip flexor spasm of different origin treated with radiofrequency lesions of the dorsal root ganglion.

Adolescent↗
PubMed1994

High field magnetic resonance imaging of normal and pathologic human medulla oblongata.

High field proton magnetic resonance (MR) imaging has been applied to depict the MR appearance of the normal excised human cervicomedullary junction, based on which neuropathologic specimens can be described. More specifically, two normal cases and one case of Chiari deformity were imaged in the transverse, sagittal, and coronal dimensions using a 9.4 Tesla vertical bore magnet. The MR images of the normal specimens reveal most of the neuroanatomical microstructures described in literature. An accurate description of the Chiari deformity could be made by comparing the MR reference images with those of the pathologic specimen. All MR detected abnormalities were confirmed by histopathology, by which no additional lesions could be found.

Aged↗
PubMed1992

Intrathecal chemotherapy with ACNU for meningeal gliomatosis.

ACNU [1-(4-amino-2-methyl-5-pyrimidinyl) methyl-3-(2-chloroethyl)-3-nitrosourea hydrochloride], one of the chloroethylnitrosoureas (CENUs), is believed to be effective against malignant glioma when intravenously or intrathecally administered. A rat model with meningeal gliomatosis (MG) induced by an intracisternal inoculation of rat C6 or 9L glioma cells was intrathecally and intravenously treated with ACNU in order to test the feasibility of intrathecal chemotherapy with ACNU in the treatment of meningeal gliomatosis. The median survival time (MST) of the animals was significantly prolonged when ACNU was intrathecally administered at dosages of 0.5 to 1.5 mg kg-1 in the early stages of MG, i.e. within 3 days after the tumour inoculation, whereas intravenous therapy with ACNU at a dose of 15 mg kg-1 did not exhibit any efficacy in the rats inoculated with C6 glioma cells (C6-MG). Intrathecal ACNU, however, at dosages of up to 1.5 mg kg-1 failed to demonstrate any therapeutic effect in the late stage of MG, i.e. 5 days after the tumour inoculation, except in the rats inoculated with 9L brain tumour cells (9L-MG). Intravenous chemotherapy with ACNU at a dose of 15 mg kg-1 extended the MST of the 9L-MG rats more significantly in the late stage of MG than in its early stage. This points to the feasibility of intrathecal ACNU in the treatment of meningeal gliomatosis in its early stages, but not in its late stages in which intravenous ACNU might be more effective than intrathecal treatment against MG of which the parenchyma has already been deeply invaded by the tumour.

Animals↗
PubMed1992

Isolation and preliminary characterization of ACNU-resistant sublines of rat brain tumors in vivo.

Two variant cells lines resistant to the nitrosourea derivative ACNU ((1-4-amino-2-methyl-5-pyrimidinyl)-methyl-3-(2-chloroethyl)-3-nitrosourea hydrochloride), namely C6/ACNU and 9L/ACNU, were selected in vivo from rat brain tumors. Stable resistance to ACNU proved to be a characteristic of these cell lines, whether they were grown in vivo or in vitro. These cell lines exhibited a different pattern of cross-resistance to a wide range of chemotherapeutic agents with dissimilar chemical structures and mechanisms of action as compared with that of other ACNU-resistant cell lines established in vitro. Distinct cross-resistance was observed in both the C6/ACNU and 9L/ACNU cell lines to chloroethyl-nitrosoureas such as BCNU (carmustine), CCNU (lomustine), and methyl CCNU and, additionally, to vincristine, vinblastine, Adriamycin (doxorubicin), and arabinosylcytosine, but not to bleomycin, methotrexate, cis-platinum, and 5-fluorouracil. This might point to a multifactorial mechanism of drug resistance in ACNU-resistant cell lines derived from rat C6 and 9L brain tumor cells.

Animals↗
PubMed1989

Hypertrophic retromedullary venous drainage in spinal cord tumours: MR visualisation.

Pseudoangiomatous dilatation of retromedullary veins at myelography was noted in three cases of intramedullary spinal cord tumours. This concerned two haemangioblastomas at levels Th8 and L1, respectively, and an ependymoma of the conus terminalis. MRI accurately demonstrated the tumoural mass, together with the enlarged and tortuous draining perimedullary veins. In patients with dilated vascular shadows on myelography, MRI should be performed before medullary angiography to differentiate between spinal vascular malformations and intramedullary tumours with enlarged draining veins.

Adult↗
PubMedDate not supplied

Microanatomy of the excised human spinal cord and the cervicomedullary junction examined with high-resolution MR imaging at 9.4 Tesla.

PURPOSE: To study in detail the MR anatomy of the spinal cord and the cervicomedullary junction that could serve as a reference for clinical MR studies. METHODS: Specimens of fresh human spinal cord and formalin-fixed cervicomedullary transition zones were imaged with a 9.4-T vertical bore magnet. Using a multisection spin-warp pulse sequence the parameters were selected to produce essentially proton density images. RESULTS: The images obtained depict the microanatomical organization of the spinal cord and cervicomedullary junction. In the spinal cord, the central gray has the expected higher signal intensity compared with the white matter, which is, apart from its darker general appearance, characterized by the presence of a dense radially structured neuroglial framework of high signal intensity. Anatomically more complex regions such as the dorsal root entry zone, the adjacent posterior horn complex, and the crossing fibers of the cervicomedullary junction are seen as well as parts of the microvascular system. CONCLUSION: Although cellular details are still beyond the limits of this investigation, the images at 9.4 T show the spinal cord and cervicomedullary junction with detail comparable to low-power microscopic images of fixed sections, especially with respect to distinguishing gray and white matter, nuclei, tracts, and angioarchitecture.

Adult↗