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Biomedical subjects

E Rumpl

Publications and source records attributed to E Rumpl.

At least 55 records · Page 3Linked to original sources
PubMed1980

Prostaglandin F2 alpha levels in human cerebrospinal fluid in normal and pathological conditions.

Prostaglandin F2 alpha concentrations in cerebrospinal fluid (CSF) from normal human subjects and patients with various pathological disorders of the central nervous system (CNS) were measured by radioimmunoassay. The mean PGF2 alpha level in 54 controls with no evidence of organic CNS disease was 67 pg/ml (range: 25-150 pg/ml). A significant increase of PGF2 alpha levels was demonstrated in most samples from patients with CNS diseases. Extremely high values were found in patients with stroke and subarachnoid hemorrhage when samples were collected shortly after the cerebral attack. With the regression of clinical symptoms and radiological findings a decrease of PGF2 alpha levels was demonstrated in this group of patients. In 32 patients with cerebral transient ischemic attacks a mean PGF2 alpha concentration of 170 pg/ml (range: 35-355 pg/ml) was found. Increased PGF2 alpha levels were found in patients with epilepsy when samples were collected within a few days after a convulsion. PGF2 alpha levels of four patients with slow progredient forms of multiple sclerosis without clinical symptoms at the time of sample collection were not different from normal controls while the mean PGF2 alpha level of all other patients with multiple sclerosis was 152 pg/ml (range: 55-325 pg/ml). Moreover, increased values could be demonstrated in patients with cerebral tumors and inflammatory processes.

Brain Diseases↗
PubMed1980

The activity of the sympathetic nervous system following severe head injury.

The activity of the sympathetic nervous system during the course of severe closed head injury has been evaluated in 15 patients by measuring plasma levels of epinephrine and norepinephrine. With the onset of the transition stage from midbrain syndrome to the apallic syndrome the plasma levels mainly of norepinephrine started to increase and remained high during the further course of the disease. During the remission from the apallic syndrome the elevated norepinephrine levels started to decline. The data indicate that a longlasting overactivity of the sympathetic nervous system is a characteristic feature in the course of severe head injury. As a rational therapy to protect the peripheral tissues against the consequences of a longlasting sympathetic overactivity we suggest the use of beta-adrenergic blocking agents and adrenergic neuron blocking drugs.

Adolescent↗
PubMed1980

[Electro-neurological correlations in early stages of post-traumatic comatose states. II. The EEG at the transition stage to, and at the full stage of the traumatic apallic syndrome (author's transl)].

The EEG patterns of 36 patients (out of 140 patients with severe brain injury) in the transition stage from midbrain to the traumatic apallic syndrome and/or in the full stage of apallic syndrome are compared with the EEGs in the acute stages of traumatic secondary midbrain syndrome. There is a clear decrease in the variety of EEG-patterns, especially of sleep or sleep-like potentials and alternating patterns, and a loss of rectivity in patients in the alternating patterns, and a loss of reactivity in patients in the transition stage. Therefore these changes not only indicate the increasing rostro-caudal deterioration, but also indicate the increasing rostro-caudl deterioration, but also the transition to the traumatic apallic syndrome. in these cases the EEG-changes mentioned above don't carry a worse prognosis. The reduction of different EEG patterns is less marked in patients in the full stage of the apallic syndrome. The variety of EEg patterns increases by the onset of sleep and waking activity, the appearance of spindles and of long runs of delta.

Adolescent↗
PubMed1979

Varieties of the locked-in syndrome.

The locked-in syndrome (LiS) was broken down on the basis of neurological symptoms in 12 patients. The criteria of classical LiS are total immobility except for vertical eye movements and blinking. If any other movements are present one should consider the condition as incomplete LiS. Total immobility, including all eye movements, combined with signs of undisturbed cortical function in the EEG led to the concept of total LiS. The anatomical basis for this condition consists of lesions in both cerebral peduncles which interrupt the pyramidal and corticobulbar tracts, the supranuclear fibers for horizontal gaze and the postnuclear oculomotor fibers. As to the course, chronic and transient LiS have been described.

Adult↗
PubMed1979

Recurrent transient global amnesia in a case with cerebrovascular lesions and livedo reticularis (Sneddon Syndrome).

Eight attacks of transient global amnesia were observed in a female patient who suffered from livedo reticularis and a series of other neurological symptoms, which were transient in most stances. The neurological deficits include focal epileptic attacks, unilateral loss of vision, paresis of left arm and/or leg and dysarthria. The first amnestic attack was seen at the age of 19. The episodes lasted from a few to 3 days. The intervals between the amnestic episodes varied between a few days and 11 years. The livedo reticularis became more obvious during each neurological episode and was less pronounced during the time of remission. A benign type of essential hypertension and parproteinemia (gamma-M) was found. The investigations failed to show any evidence of essential thrombocythemia, polyarteriitis nodosa, lupus erythematodes and other immune complex diseases. The underlaying disease remained unclear.

Amnesia↗
PubMed1979

The EEG at different stages of acute secondary traumatic midbrain and bulbar brain syndromes.

One hundred and thirty EEGs were analysed from 113 patients with acute secondary traumatic midbrain and bulbar brain syndromes. The EEG pattern was related to the stage of the midbrain syndrome caused by supratentorial brain shift. A decrease in the number of different EEG patterns was associated with increasing intracranial pressure. Unfavourable prognosis was indicated by the disappearance of sleep or sleep-like activities alternating pattern and loss of reactivity. Lateralization by the EEG proved to be superior to clinical findings in full stages of the midbrain syndrome. EEG abnormalities due to the herniation itself interfered with EEG changes due to secondary circulatory, respiratory and metabolic encephalopathies. In such cases, the above mentioned regularities were blurred.

Adolescent↗
PubMed1979

[Electroencephalographic changes in coma due to hepatic insufficiency with porto-caval shunt (author's transl)].

EEG studies were done in 19 patients comatose due to severe hepatic insufficiency associated with porto-caval shunting. The neurological deficits were graded in 5 stages and related to the abnormal EEG-pattern observed in 38 records. With deepening of coma, alpha-frequencies were gradually replaced by theta- and delta-activities. The frequency of theta- and delta-runs decreased with neurological deterioration. Triphasic waves (typical and/or atypical) were seen in 26% of the records. Typical triphasic waves were found to be limited to stage 3 of coma, whereas atypical forms appeared in earlier and later stages. After infusions of L-Valin, a transient improvement and disappearance of triphasic waves was observed, but no significant effect could be established on the final course of the disease. Sleep-like potentials and the reactivity to external stimuli decreased in deep stages of coma. Severe EEG abnormalities were correlated to low cholinesterase and high lactid acid blood level, but no correlation was found to the level of ammonia.

Alpha Rhythm↗
PubMed1979

[Electro-neurological correlations in early stages of posttraumatic comatose states. I. The EEG at different stages of acute traumatic secondary midbrain and bulbar brain syndrome (author's transl)].

165 EEG were analysed from 140 patients in posttraumatic coma with secondary traumatic midbrain and bulbar brain syndrome. The EEG-pattern was related to the stage of midbrain or bulbar brain syndrome caused by supratentorial brain shift. There was a close relation between EEG-pattern and the grade of rostro-caudal deterioration. A decrease in the number of different EEG-patterns was associated with increasing intracranial pressure. An unfavourable state of coma was indicated by the disappearance of sleep or sleep-like activities, alternating pattern and loss of reactivity. In deep stages of midbrain syndrome the neurological examination reveals no lateralizing signs at all. The EEG gives the only hint to a local cerebral lesion. EEG abnormalities due to the herniation itself interferred with the EEG-changes due to secondary circulatory, respiratory and metabolic encephalopathies. In such cases the above mentioned regularities were slurred.

Adolescent↗
PubMed1978

Myotonic myopathy with painful muscle contractions and decrease of symptoms by cold.

Myotonic reaction and paresis accompanied by painful muscle contractions limited to the upper limbs, which decrease remarkably in the cold, were observed in a 29 year old man. The histological investigation revealed minimal non-specific signs of myopathy. The biochemical studies of muscular tissue contained a normal amount of myophosphorylase, acid maltase and glycogen. Ischemic work induced normal elevation of venous lactate. The activities of CPK, LDH and SGOT in the blood serum were occasionally increased. The EMG showed typical myotonic bursts and electrical silence during painful muscle contractions. Repetitive high frequency stimulation demonstrated a clear initial increase of the amplitude of action potentials followed by a decrease in the contracted muscle. The father of the patient suffered from dystrophia myotonica. This coincidnece suggests that this myotonic myopathy is a variant of dystrophia myotonica.

Cold Temperature↗
PubMed1978

Plasma lipids, coagulation factors, and fibrin formation after severe multiple trauma, and in adult respiratory distress syndrome.

Following severe multiple trauma, decreases were observed in a) Free cholesterol, b) Cholesteryl esters, c) Total phospholipids, and d) Lysolecithin. Comparatively slight changes in coagulation parameters did not differ regardless of whether pulmonary complications developed. In contrast, increased fibrin lipid complexing was more closely correlated with clinical data, because: a) Plasmatic lipids, particularly triglycerides complexed with fibrins, were elevated severalfold in patients with adult respiratory distress and fat embolism syndromes when compared with multiple trauma patients without pulmonary complications. This was independent of plasma lipid levels. b) Plasmatic triglycerides complexed with fibrins were significantly higher in patients who died than in those who survived. The considerable changes in the plasma lipid pattern following severe trauma suggest the presence of an abnormal lipoprotein with increased affinity to fibrin, thereby inhibiting fibrinolysis. This might well be one pathogenic mechanism in the development of post-traumatic respiratory distress syndrome.

Adult↗
PubMed1978

[Transitory burst-suppression pattern in endogenous-exogenous encephalopathy (author's transl)].

A status epilepticus was observed in a 22 year old female patient during endotoxinshock. The status epilepticus was treated with a high dosage of diazepame. The EEG showed a burst suppression pattern, in our case mixed by anoxia and diazepame. The burst-suppression pattern and the clinical suspicion of delayed degradation of diazepame caused by toxic hepatic failure suggested the therapy of forced diuresis. This therapy was followed by decreasing suppression periods, indicating the dominante influence of the hypnotic drug. This result shows the diagnostic as well as the therapeutic value of forced diuresis in this case.

Adult↗
PubMed1977

[Electrophysiogical and neuropharmacological studies in a patient with progressive myoclonus-epilepsy (author's transl)].

A progressive form of myoclonus-epilepsy was described in an 21 year old girl. Electrophysiological and neuropharmacological studies were carried out. The typical EEG-pattern, the close association of cortical discharges and myoclonic jerks, the form of myoclonus indicated a "pyramidal" myoclonus. Pharmacological data suggested that two possible mechanisms--a partial deafferentation of cortical neurones and a failure of thalamic, extrapyramidal and brain stem reticular formations--might be responsible for the EEG-abnormalities and concomitant myoclonus. Results from neuropharmacological studies demonstrated a suppressive effect (on EEG-discharges and myoclonic jerks) of clonazepam, diazepam, phenobarbital, taurine, levodopa and budipin. Taurine, levodopa and budipin might induce a new aspect in therapy of progressive myoclonus epilepsy and of myoclonus caused by other etiologic factors.

Adult↗
PubMed1977

[Hyperammonemia during parenteral nutrition of intensive-care patients].

Metabolic features of parenteral feeding with conventional amino acid solutions were examined in 47 patients over a long period. 30 patients were kept alive by artificial respiration. The metabolic parameters ammonium, blood urea nitrogen, GOT, alkaline phosphatase were carried out, in 6 patients the pattern of amino acids was analysed. All patients showed a significant increase of ammonium during the course of parenteral feeding. The amino acids demonstrated pattern of imbalance. The other other parameters were not changed significantly. Traumatic, hypoxic or toxic liver damage might influence the reduction of liver function.

Adult↗
PubMed1977

[The relation of electroencephalographic foci to vasospasms in patients with subarachnoid haemorrhage (author's transl)].

During a period of five years 74 patients with acute subarachnoid haemorrhage were controlled by angiography and EEG. 19 patients demonstrated angiographically proved intracranial aneurysms, seven intracerebral haematomas, three arteriovenous abnormalities. 25 patients had vasospasms. 34 patients showed foci in the EEG. Focal neurological abnormalities were in 43 patients. A correlation was established between EEG focus and vasospasm, focus and intracerebral haematoma. Further a relationship between focus and focal neurological abnormalities was detected. There was no correlation between EEG focus and aneurysm. It was claimed, that some foci in the EEG could be the result of persistent vasospasms.

Blood Vessels↗
PubMed1977

[The value of EEG after sleep deprivation (author's transl)].

Seventy seven adult epileptics and 30 patients with clinically non epileptic seizures were subject to a 24 hours sleep deprivation. The waking records of these patients were normal or unspecific abnormal. After sleep deprivation 29 (37%) of epileptics had abnormal EEG with epileptiform or focal activity, more often in cases with frequent (26 (60%) patients out of 43) epileptic seizures. Patients with sporadic attacks only exceptionally showed specific EEG changes (3 patients (8,8%) out of 34). Drug induced sleep emerged to be diagnostically less helpful. Twenty nine out of 30 patients with clinical nonepileptic seizures had no additional abnormalities in the EEG after sleep deprivation.

Adolescent↗
PubMed1977

[Poisoning and forced diuresis].

The effect of two different methods of forced diuresis was investigated in two groups consisting of twelve patients. These groups were statistically selected from 86 cases with severe poisoning caused by hypnotic drugs, exhibiting a comparable metabolic and neurological symptomatology. Group 1 underwent the usual diuretic therapy group 2 was treated with standardised forced duiresis (SFD). In group 2 a significant higher hourly urinary output, a lower incidence of acidosis and more stability of the electrolyte balance were found. Therefore SFD was judged to be a useful help in elimination of hypnotic drugs.

Acidosis↗
PubMed1975

[The pattern of phospholipids during the course of delirium tremens (author's transl)].

Plasma phospholipids were examined in patients with delirium tremens in the acute phase of the disease and after recovery. The levels of lysolecithin, phosphatidylinositol, phosphatidylethanolamine, sphingomyelin and the total of phospholipids were decreased in comparison to normals. Phosphatidylethanolamine, phosphatidylinositol and the total phospholipids were diminished in comparison to patients with liver cirrhoses. Only in the plasma of patients with liver cirrhoses with bad prognosis (hepatic coma) similar low levels of total phospholipids were found. It is concluded from these results, that the synthesis of phospholipids is reduced during delirium tremens.

Alcohol Withdrawal Delirium↗