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Biomedical subjects

E Körner

Publications and source records attributed to E Körner.

At least 19 recordsLinked to original sources

[EEG mapping in schizophrenia and depression--a multivariate approach].

EEG Brain Mapping offers a promising approach to study complex pattern of brain function. However, traditional usage of this method was focussed mainly on isolated details of the whole specter. The present study was, therefore, aimed at the simultaneous observation of all available parameters. Discriminant analysis was used to distinguish between 4 groups of patients suffering from either schizophrenia (acute/off drugs; improved/on drugs) or depression (acute/off drugs; improved/on drugs) and healthy volunteers, each group with n = 10. The multivariate pattern of 50 topographical spectral variables brought about correct group classification of 49 out of 50 probands. Results suggest that more complex statistical paradigms that take advantage of all available parameters add to an integrative explanation of psychophysiological mechanisms in mental illness.

Acute Disease

Endoscopic surgery versus medical treatment for spontaneous intracerebral hematoma: a randomized study.

A controlled randomized study of endoscopic evacuation versus medical treatment was performed in 100 patients with spontaneous supratentorial intracerebral (subcortical, putaminal, and thalamic) hematomas. Patients with aneurysms, arteriovenous malformations, brain tumors, or head injuries were excluded. Criteria for inclusion were as follows: patients' age between 30 and 80 years; a hematoma volume of more than 10 cu cm; the presence of neurological or consciousness impairment; the appropriateness of surgery from a medical and anesthesiological point of view; and the initiation of treatment within 48 hours after hemorrhage. The criteria of randomization were the location, size, and side of the hematoma as well as the patient's age, state of consciousness, and history of hypertension. Evaluation of outcome was performed 6 months after hemorrhage. Surgical patients with subcortical hematomas showed a significantly lower mortality rate (30%) than their medically treated counterparts (70%, p less than 0.05). Moreover, 40% of these patients had a good outcome with no or only a minimal deficit versus 25% in the medically treated group; the difference was statistically significant for operated patients with no postoperative deficit (p less than 0.01). Surgical patients with hematomas smaller than 50 cu cm made a significantly better functional recovery than did patients of the medically treated group, but had a comparable mortality rate. By contrast, patients with larger hematomas showed significantly lower mortality rates after operation but had no better functional recovery than the medically treated group. This effect from surgery was limited to patients in a preoperatively alert or somnolent state; stuporous or comatose patients had no better outcome after surgery. The outcome of surgical patients with putaminal or thalamic hemorrhage was no better than for those with medical treatment; however, there was a trend toward better quality of survival and chance of survival in the operated group.

Adult

Hemorheologic treatment of cerebral reversible ischemic episodes with pentoxifylline--a prospective study.

One hundred patients (49 males, 51 females) with reversible neurologic deficit due to cerebral ischemia of vascular origin in the carotid artery territory were recruited for a long-term observation to follow up recurrence of ischemic events. Fifty-eight patients (mean age sixty-four years) were treated daily with 1200 mg oral pentoxifylline in addition to basic therapy (antihypertensives, antidiabetic drugs, etc), and 42 matching patients (mean age sixty-two years) of a control group had no pentoxifylline or other hemorheologic medication. The mean observation period was fifty-six months (range thirty-six to sixty). On admission patients presented with increased platelet aggregation and/or impaired red cell filterability and with enhanced red cell aggregation. Five patients in the pentoxifylline group (8.6%) and 16 control patients (38%) suffered a relapse of an ischemic episode. These data support previous reports of a beneficial effect of pentoxifylline in the prevention of cerebral ischemic events.

Aged

[Rolandic spikes as an electroencephalography manifestation of oligodendroglioma].

A 10 5/12 year old boy was presented with seizures of uncertain origin on to the psychosomatic ward of our University Children's Hospital. The question and problem was the distinction of psychogenic versus epileptogenic origin (repeatedly performed EEG's had shown normal findings, the seizures did not response to anticonvulsive therapy). The exploration of a psychodynamic causes of the presenting problem was excluded by family therapeutic and psychoanalytical case history and psychodynamic interview. The first pathological finding was seen with registration of a long term EEG with typical findings of temporal central spikes and waves as seen in the benign rolandic-epilepsia. The following diagnostic considerations were discussed and differentiated. a) benign rolandi epilepsia b) malign rolandi epilepsia c) psychomotoric seizures d) rolandic spikes as symptomatic finding of a brain tumor. The definite diagnosis was finally confirmed by a cerebral computer-tomography which showed a large expensive process in the interferior right regio temporalis, which was identified histologically after operation as a oligodendrogliom grad-I. The tumor was removed successfully as a whole without any neurological defects.

Brain Neoplasms

[Testing the regulation mechanism in inserting an artificial heart by model simulation].

The problems of controlling the cardiac output and the balance of the blood volumes in the circulatory system were discussed for the natural heart as well as for an implanted artificial heart by means of a mathematical function model of the human organism. The control by the Starling mechanism (right atrial pressure) can adapt sufficiently the cardiac output according to the demands of the body, in case the loading steps do not exceed a fixed limit. The false regulation by a strong load of the organism is evidently caused by the limited capacity of the artificial heart and not by the strategy of the control.

Cardiac Output

[Validity of the arteriovenous oxygen difference as guidance for controlling the output of an artificial heart].

The possibility of controlling an artificial heart by the arteriovenous oxygen difference is discussed by means of the model simulation of the human organism. The simulation results are compared with these of the control by the Starling mechanism. No improvement of the results was obtainable because the behaviour of the arteriovenous oxygen difference is very dependent on the kind and the ascent of the load. The control of the artificial heart by the Starling mechanism appeared more favourable also on changed conditions in the atrium.

Blood Volume

[Simulation of a regulation mechanism in inserting an artificial heart, by which the left and right pumps require the same output volume].

The problems of balance of the blood volume in the circulatory system are demonstrated in the application of an artificial heart by means of a mathematical function model of the human organism. The lung is endangered specially in case the right pump brings more than the left pumps away. Therefore a suitable controller was selected: it guarantees the equal output of the right and left pump. A PI-controller was used, because the complete abolition of the control deviation is more important than the dynamics. Variants were discussed about the arrangement of this controller in the total control of the artificial heart.

Blood Volume

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

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

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

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

Mobile long-term EEG monitoring in generalized seizure disorders of different etiology.

Eighteen EEG long-term recordings were carried out in patients with generalized fits of different etiologies using a mobile 4-channel monitoring system in order to observe individual patterns of epileptic activity. In patients with idiopathic tonic-clonic seizures (A) no connection of frequency of spike-wave bursts with the sleep-wakefulness cycle was observed. In patients suffering from fits of organic nature (B) a peak of paroxysms was obtained in the hours before sleep onset, whereas in patients with absence seizures (C) a maximum was found in the morning hours after awakening. In patients with idiopathic fits (tonic-clonic and absence seizures) the minimum of bursts was observed in REM sleep, whereas stage 0 (tonic-clonic) and stage 1 (absence) were most prone to discharges. Patients with secondary generalized epilepsy had most spike-wave bursts in deep sleep. In the absence seizure group the transitional periods within the light non-REM-sleep stages were more susceptible to paroxysms than the retained stages. In patients with idiopathic grand mal seizures, the highest frequency of paroxysmal discharges was found during time spent awake in the night when retained over a longer period of time. The group including cases with attacks of organic nature did not show any preference to shifting times or preservation episodes of sleep stages.

Adolescent

[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

[Clinical findings in multiple sclerosis].

The mean interval between first and last clinical interview in 170 patients with multiple sclerosis was 8.8 years. The main initial symptoms were sensory disturbances and paresis of the cranial nerves. An uncharacteristic symptomatology was found in 6%, psychiatric symptoms in 6%. In the last investigation psychiatric symptoms were found in 2%, uncharacteristic symptoms were seen in 4%. A normal neurological status was found in 9%. Apart from the clinical well defined typical MS patient, also benign forms of the diseases have been found.

Adolescent

[Diseases of nutria and their therapeutic potential].

The article reports important diseases and different farming techniques of nutria. E. coli and salmonella infections are the most important bacterial diseases. Coccidiosis and strongyloidosis are frequently observed in nutria farms. Differentiated prophylactic treatment and hygiene are necessary for optimal breeding conditions.

Animal Husbandry