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Biomedical subjects

E Flooh

Publications and source records attributed to E Flooh.

17 recordsLinked to original sources
PubMed1996

Pattern of cerebral blood flow and cognition in patients undergoing chronic haemodialysis treatment.

We studied 20 patients aged 46-69 years (mean 57 years) undergoing long-term haemodialysis (HD) and 20 age- and sex-matched controls with single photon emission tomography (SPET) and 99Tcm-hexamethyl-propyleneamine-oxime to look for regional abnormalities in cerebral blood flow (CBF) and their relation to cognitive dysfunction. Global hemispheric tracer uptake relative to the cerebellum was similar in both groups, but regional over cerebellar activity was significantly reduced in the frontal cortex (85.9 +/- 5.1 vs 90.4 +/- 5.3; P = 0.01) and thalamus (99.2 +/- 8.8 vs 104.9 +/- 8.4; P = 0.05) of the HD patients. Normalization to whole-brain activity also showed the frontal cortex to be hypoactive in the HD patients, while tracer uptake was increased occipitally. These regional differences were not explained by the presence of atrophy or cerebrovascular damage seen on brain magnetic resonance imaging. The HD patients scored significantly worse on cognitive tests such as the Mini Mental State Examination (23 +/- 4 vs 28 +/- 1; P < 0.001) and Mattis Dementia Rating Scale (114 +/- 24 vs 143 +/- 1; P < 0.001). Regional activity ratios did not correlate with cognitive test scores, however. Our results indicate a disturbed pattern of CBF in HD patients, although regional SPET abnormalities did not correspond to the severity of cognitive dysfunction.

Aged↗
PubMed1995

Morphology-oriented analysis of cerebral SPET using matched magnetic resonance images.

Complementary morphological information is a prerequisite for the detailed analysis of cerebral SPET studies. We therefore developed a technique which allows the alignment of SPET and magnetic resonance scans by imaging identical slices using external landmarks on an individually fitted mask and subsequent two-dimensional image processing for in-plane matching. Regional analysis of tracer activities can be performed directly on the superimposed SPET and MR outline images or by tracing a region of interest on the original MR scan with a parallel display on the matched SPET image, and vice versa. Tests assessing correct in-plane alignment using MRI, inter- and intra-variability of the matching procedure, and its comparability with an objectively determined best-matching position, confirmed the feasibility, accuracy and usefulness of this procedure.

Brain↗
PubMed1993

Brain stem infarction and diaschisis. A SPECT cerebral perfusion study.

BACKGROUND AND PURPOSE: We studied six patients suffering from pure, unilateral brain stem infarction to explore the association of remote cerebral and cerebellar blood flow changes with damage at different sites of this region of the brain. METHODS: We used single-photon emission computed tomography and [123I]iodoamphetamine to measure regional differences in tracer uptake. Qualitative image analysis and calculated asymmetry indexes were correlated to the location of the infarcted area on magnetic resonance imaging and to the patients' clinical findings. RESULTS: Significant perfusion asymmetries were noted in the two patients with infarction in the upper pons but not in those with lesions below this level. They comprised a contralateral cerebellar and ipsilateral supratentorial hypoactivity that was most marked in the frontoparietal cortex. There was no clear relation between the patterns of cerebral or cerebellar tracer uptake and specific neurological findings. CONCLUSIONS: Remote perfusion changes after pure brain stem infarction may be seen both infratentorially and supratentorially and depend on the lesion site rather than on the neurological deficit. In this context, our study confirmed damage to the corticopontocerebellar pathways as the key event in the genesis of a crossed cerebellar diaschisis. The exact mechanisms causing ipsilateral cerebral hemispheric diaschisis await further clarification.

Aged↗
PubMed1993

Assessment of MRI criteria for a diagnosis of MS.

To test the reliability of four previously proposed MRI criteria for the diagnosis of MS, we reviewed 1,500 consecutive brain scans for the presence, number, size, and location of areas of increased signal (AIS) on proton-density and T2-weighted images, unaware of the patients' clinical presentations and ages. This series included 134 subjects with a clinical diagnosis of MS. Relying exclusively on the presence of at least three or four AIS for a positive diagnosis of MS resulted in high sensitivity (90% for three AIS and 87% for four) but inadequate specificity (71% for three AIS and 74% for four) and positive predictive value (23% for three AIS and 25% for four). If one of these lesions was required to border the lateral ventricles, specificity was 92% and positive predictive value was 50% at a sensitivity of 87%. Using the Fazekas criteria (at least three AIS and two of the following features: abutting body of lateral ventricles, infratentorial lesion location, and size > 5 mm) led to a further highly significant improvement of specificity (96%; p = 0.0000) and increase of the positive predictive value (65%) at the expense of a less significant decrease in sensitivity (81%; p < 0.01).

Adolescent↗
PubMed1987

[EEG studies in bruxism with headache patients].

EEG-investigations before and after long-term-treatment with occlusal-splints were carried out in 36 bruxism patients suffering from unilateral headache. The results of the latter group were compared to those of 41 patients with classical migraine and to those of a healthy control-group. 20 (56%) of our patients showed pathological EEG-pattern in which focal abnormalities (39%) were dominating. After a long-term-treatment, mentioned before, there was a significant decrease of pathological EEG-pattern combined with a distinct improvement of all clinical symptoms. In patients with classical migraine a higher number of pathological EEG-recordings were seen during attack as well as during interval. Comparing the EEG-findings of bruxism after treatment to those of the healthy controls, no significant differences were found anymore.

Adolescent↗
PubMed1986

Computer evaluation of sleep.

Night sleep registrations were carried out using a portable 4-channel tape recorder (Medilog 4-24 recorder). The evaluation of the sleep stages was done by a computer analysis. One channel was used for EMG, 1 for EOG and 2 channels for EEG. For the analysis of the particular sleep stages the criteria of the Florida modification of the classification of Dement and Kleitman were applied. The computer analysis was based on the estimation of the power spectrum of the 2 EEG channels and the number of REM in the EOG. Automatic artifact detections were fit into the computer program and the individual differences of the EEG of the sleep recordings were taken into consideration.

Ambulatory Care↗
PubMed1986

Sleep-inducing effect of L-tryptophane.

Night sleep recordings were performed in 10 patients with sleep disturbance in falling asleep as well as in maintaining sleep using a mobile 4-channel EEG registration system. Three consecutive nights, which were spent under different conditions, were evaluated automatically. The first night without treatment was used as a baseline night to objectify the disturbed sleep, the second night was measured following an infusion of a physiological saline solution and prior to the third recording 5 g l-tryptophane were applied to the patients. Besides a significant decrease of delayed latency times until the appearance of the light sleep stages, an influence was seen on the quantitative sleep parameters such as sleep period time and total sleep time. In parallel, an improvement of the subjective feeling measured by a self-rating scale resulted after l-tryptophane. On the other hand, no definite influence on the other sleep parameters such as an increase of slow wave sleep was observed, so that the use of this treatment might be recommended in disturbances in falling asleep particularly.

Adolescent↗
PubMed1986

Sleep alterations in ischemic stroke.

In 19 patients with cerebral infarctions in the middle cerebral artery territory, investigations of sleep using a mobile EEG recording system were performed. Sleep was found to be markedly altered compared to a normal group. Although an increase of time in bed and sleep period time was observed, total sleep time did not rise in a parallel manner, so that a distinct reduction of the sleep efficiency index was found. This increase of quantitative parameters was particularly caused by a higher amount of NREM time, whereas REM sleep was found to be deeply suppressed. Regarding the different NREM sleep stages, stage 0 (time spent awake during the night) and stage 1 had increased, whereas stage 4 was reduced. Interhemispheric differences were noticed referring to the sleep period time, which was found to be increased particularly in right-sided infarctions (because of an increase of NREM time) and a reduction of REM sleep in lesions of the right hemisphere (worsening of the REM to NREM ratio). Slow-wave sleep (stage 4), on the contrary, was found to be decreased in infarctions of the left hemisphere. These results support the hypothesis of a REM-inducing and regulating function of the right hemisphere and will lead to a new understanding of sleep-controlling mechanisms.

Adult↗
PubMed1986

Distribution of muscle activity during sleep in bruxism.

10 outpatients with bruxism were investigated by polygraphic recordings during night sleep. Electromyogram, electrooculogram and electroencephalogram derivations were used to evaluate the activities of masseter muscle and the different stages of sleep. The results of the bruxist group were compared to those of an age-matched control group. The amount and the length of pressing and grinding jaw movements were correlated with the sleep period time as well as with the different sleep stages. In comparison to the control group, a significant difference of muscle activity longer than 5 s was found, but there was no difference regarding activities of 3-5 s duration. The highest level of activity was found in sleep stage two and during awakening times. No difference was seen with regard to percentages of the sleep stages.

Adult↗
PubMed1986

[Nocturnal sleep studies of bruxism].

Polygraphic recordings during two nights sleep in 7 selected outpatients prior to and following treatment of bruxism were carried out using EMG-, EEG and EOG-recordings to evaluate the activities of the masseter muscle and the different sleep stages. The results thus obtained were compared to those of an age-matched control group. Following treatment with occlusal splints the recordings were repeated eleven weeks later. The length and the amount of grinding and pressing activities were correlated with the total night sleep as well as with the different sleep stages. The highest incidence of muscle activity was found in stage two and during awakening. Furthermore muscle activities were observed immediately before the beginning of REM-sleep and in particular during the change from REM- to NREM-sleep and in sleep stage one. After treatment with occlusal splints there was a decrease of total muscle activity, thus indicating efficiency of the treatment.

Adult↗
PubMed1982

Computertomography and vascular (multiinfarct) dementia: a qualitative and quantitative investigation.

In a qualitative approach it was shown in 204 patients with ischaemic stroke that Computertomography is significantly more often normal and atrophy more seldom in the demented patients. In addition the importance of a bilateral distribution of infarcts in the demented group was shown as well as the more common affection of the thalamus in the demented patients as compared with the non demented group. The quantitative approach was performed with measurements of the width of the 3rd ventricle, the Huckmann, the ventricle, the cella media index as well as the calculation of an index brain/CSF density. Here the importance of total loss of substance - atrophy and infarcts - was evident, explaining why measurements of the ventricle dimensions only - apart from the distribution of infarcts - were not always relevant.

Atrophy↗
PubMed1982

[Changes in pattern evoked visual potentials in multiple sclerosis in respect to development of illness].

In 43 patients (28 female, 15 male) with a definitive diagnosis of disseminated sclerosis visual evoked potentials were tested several times with pattern stimulation. The average duration of the disease was 7 years before the first pattern evoked potential. The latency of the evoked potential, estimated from the first positive peak, was in the pathological range in 30 patients in the first investigation, whereas in 38 patients there was a delayed latency in the last measurement. There was an average period of 1.5 years between the first and last investigation. In 20 cases the evoked potentials showed a continuous delay in the latency. Two patients maintained the original pathological values and in 7 cases the control results were below that of the first investigation. In 9 cases it was not possible to show a definite result because of the marked fluctuation in the values. 5 times in the entire investigation was a pathological result absent. There was a clear correlation between both the duration of the disease and the presence of a delayed latency, and the frequency of episodes and a pathological latency.

Adolescent↗
PubMed1982

[Night sleep studies: mobile recording in comparison to conventional laboratory recording].

Night sleep registrations were made in a group of 11 persons in a laboratory using both traditional polygraphic methods and a portable home recording system. A significantly higher value in the evaluation of the sleep efficiency index (quotient of total sleep time and total time in bed) was found with the mobile recording system. Apart from these findings the latency to the beginning of the particular sleep stages (classification of Dement and Kleitman) were diminished. Furthermore there was found a significant decrease of stage 1 in favour of the REM-sleep. Regarding the relation between the REM and the NREM-time, a distinct difference could also be shown. As to the subjective sensitivity, 10 of the 11 tested persons preferred the mobile recording system.

Adult↗
PubMed1982

[EEG night sleep recording: evaluation with automatic data analysis].

Sleep investigations were made in a laboratory using both traditional polygraphic methods and a portable home recording system (Medilog-Recorder 4-24). The evaluation was done by an automatic analysis. For the division into the particular sleep stages (classification of Dement and Kleitman) at least the diversions of 2 EEG and 1 EOG-channel were found to be necessary. As a further parameter the measurement of the pulse frequency was used. After the determination of the frequency-spectrum by the Fast Fourier Transformation a power spectrum was made in order to register the changes of voltages (in periods of 30 seconds) with a sample rate of 128 and a frequency resolution of 0.5 Hz. To evaluate the EOG, a band pass filter was used and after the determination of a level of 15 microV only activities over this value were regarded. Furthermore an automatic artifact detection was fit into the program. The activities of the EEG, the EOG and the pulse frequency were compared with the normal values of the stages and, after that, the particular sleep phases were determined.

Computers↗