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Biomedical subjects

F Mundinger

Publications and source records attributed to F Mundinger.

At least 55 records · Page 3Linked to original sources
PubMed1984

[Analysis of movement in extrapyramidal motor diseases using a computer].

Normals are able to move their limbs in a continuous spectrum of speeds. In contrast patients with so called extrapyramidal disorders show typical changes of movement. Short ballistic movements of the upper limb were analysed by a joystick connected with a computer in 57 patients with different extrapyramidal disorders (parkinsonsyndrome, essential tremor, torsion dystonia, chorea and intention tremor) and in 22 normals. Patients with parkinsonsyndrome and with torsion dystonia move the upper limb slower than normals and all other patients. Their movements show breaks. All patients execute aimed movements less precisely than normals. Most unprecise are the movements of patients with essential tremor. Oscillation of movements of all patients deminish, but less than in normals. Patients with parkinsonsyndrome show smallest oscillations at the beginning of each movement. Patients with intention tremor differ not from normals at the beginning, but show still the highest oscillations at the end of movement. Holding the target they correct most frequent. We discuss, that striatum generates timing and strength of ballistic movement and cerebellum apeases oscillation of movement and frequency of correcting while holding a target.

Adult↗
PubMed1981

[Indications and long-term results of stereotactic operations in therapy-resistant epilepsy (author's transl)].

Stereotactic functional surgery was performed on 45 patients with predominantly temporal epilepsy. Results of up to 24 years (= 5.85 +/- 2.25 years) are reported. Depending on the type of seizure and after careful analysis of the EEG focus, the frequency and intensity of the various seizure types, as well as personality and behavior disturbances, can be improved in more than two-thirds of the cases. This improvement is achieved by combining different target points with coagulation of the subcortical motor and senso-motor centers and neuronal structures, thereby cutting off the mostly double-track corticosubcortical connections

Amygdala↗
PubMed1980

Deep brain stimulation in mesencephalic lemniscus medialis for chronic pain.

Stereotactic deep brain stimulation (DBS) with chronically implanted special devices intermittently activated by the patient himself has led to a new concept in the treatment of chronic central pain, such as the thalamic pain syndrome, herpes-zoster neuralgia, anaesthesia dolorosa, radicular and plexus lacerations, stump pain with and without causalgia and cancer pain. Our results in 32 cases (March 31, 1979) with lemniscus medialis stimulation, including the specific and nonspecific somatosensory nuclei or periaqueductal gray matter show in 53% of our cases, a reduction of pain of over 50%. The follow-up period was 47 months. These results are better than those obtained from stimulating only one of the systems. Mesencephalic lemniscus medialis DBS, introduced by one of the authors (Mundinger), leads to a functional blockade of spinothalamic, lemniscus medialis and spino-reticular systems. In cases where a positive morphine test had been done previously, endorphin secretion also plays a role. It is assumed that the effect of endorphin production lasts longer than the stimulation itself, especially in periaqueductal mesencephalic gray matter and medial pulvinar stimulation.

Adult↗
PubMed1980

[Comparative emission tomographic and transmission tomographic studies of cranial and intracranial diseases (author's transl)].

A comparative study was performed in 58 patients with brain lesions using emission computed tomography (ECAT -- single photon, Cleon 710) and transmission computed tomography (TCAT). ECAT better demonstrates vascular functional i.e. physiologic disturbances. A disadvantage of ECAT is that there is no way to produce survey scans of the head. Relatively long scanning times and moderate spatial resolution when compared with TCAT furthermore reduces the value of ECAT. It is expected that the technical development of ECAT will soon alter the situation.

Adult↗
PubMed1980

Stereotactic treatment of brain lesions. Biopsy, interstitial radiotherapy (iridium-192 and iodine-125) and drainage procedures.

Integrating CT imaging techniques into stereotactic procedures makes it easy to puncture cysts, take biopsies from neoplastic and nonneoplastic lesions, and place radioactive material in tumors at exact and reproducible sites. A stereotactic program of interstitial radiotherapy in deep-seated brain tumors has been applied in 326 cases as of December 31, 1979 (270 cases using iridium-192 and 56 cases using iodine-125). The use of iodine-125 is now favored since it requires less radiation protection due to its soft 28-35 keV radiation; at the same time, however, it possesses a comparable half life of 60 days. In 126 cases, stereotactic biopsy was used exclusively for diagnostic purposes followed by open craniotomy or conventional radiation. Cystic brain tumors (i.e., craniopharyngiomas and cystic low grade gliomas) were permanently drained by insertion of Rickham reservoir catheters in 61 cases. Stereotactic ventriculocisternostomies were carried out in cases of hydrocephalus and drainage of suprasellar arachnoid cysts was performed in 15 cases. A simple method of projecting CT images onto stereotactic X-ray pictures provides an exact mapping of lesions within the actual stereotactic brain space. The results of this series of patients strongly suggest that exploratory craniotomies and free-hand punctures can no longer be advocated. No radiation treatment should be considered without histological confirmation. The more clearly the volume of a tumor can be defined, the more favorable the results of interstitial irradiation in otherwise unresectable tumors.

Biopsy↗
PubMed1979

Mesencephalic chronic electrodes in pain patients. An electrophysiological study.

Early components of lemniscal potentials after contralateral median nerve or mechanical stimulus are due to lemniscal pathways, whereas later components, after 70 msec appearing bilaterally and at higher stimulus intensities probably express extralemniscal activity. Evoked potentials in the central gray matter show much smaller amplitudes compared with somatosensory cortical evoked potentials (SSEP). The strongest component is a negative wave after 70--100 msec. Longer conditioning stimulation of the lemniscal system inhibits late components in the median nerve evoked cortical potentials. On the contrary, stimulation of the nonspecific periaqueductal gray matter produces inhibition of early components of cortical SSEP together with facilitation of late components.

Afferent Pathways↗
PubMed1979

[Multiple sclerosis in computer tomography of the brain (author's transl)].

Tissue changes were examined in detail via computerised tomography (matrix 160 X 160) in 28 patients with neurologically established encephalomyelitis disseminata. In the majority of cases, demyelinisation was not characteristic of the predominant pathologico-anatomical substrate, ventricular extension with diffuse atrophy but without demyelinisation being the leading sign. However, if the disseminated disease became manifest with foci of demyelinisation, these presented a preferably periventricular pattern.

Adult↗
PubMed1979

[Objectivation of tremor and motion disorders via computerisation (author's transl)].

The quantitative analysis of motion disorders of the upper extremities can be performed by means of a joystick connected with a minicomputer. Therefore a random squarewave curve is drawn on a computer display and the patient must follow it with the joystick. The deviation of the two curves are recorded, analysed and documented numerically and graphically.

Diagnosis, Computer-Assisted↗
PubMed1979

[The diagnosis of cerebrospinal rhinorrhea with the 131I-hippuran swab test].

The report deals with the 131I-hippuran swab test and its effectiveness as compared with other methods (X-ray techniques, Clinistix) in 123 patients with rhinoliquorrhea. Results in 32 patients with rhinoliquorrhea are correlated with those of various methods of examination and with the surgical reports. In frontal and ethmoidal lesions and in those of the middle part of the face the liquorrheas can be demonstrated with a greater probability and even in cases where other methods are ineffective. An exact diagnosis was made in 88% of the cases. This semi-quantitative method is also suitable for follow-up control since, in contrast to other techniques, even discrete liquorrheas can be identified considering that a subjectively observed cessation of flow may not be equated with an occlusion of the liquor fistula as shown by the 131I-hippuran swab test, which continues to be positive.

Cerebrospinal Fluid Rhinorrhea↗
PubMed1978

Diagnosis of normal-pressure hydrocephalus using CT with CSF enhancement.

Cisternography with the water-soluble contrast medium metrizamide provides substantial advantages for CT demonstration: the discrimination and sharpness of definition of the basal cisterns can be considerably improved by the positive demonstration of the subarachnoid spaces. Studies of CSF dynamics make it possible to differentiate between a communicating hydrocephalus aresorptivus and a hydrocephalus within the scope of a brain atrophy. Brain substance defects and subarachnoid cysts can be clarified with respect to communication with the CSF space. Apart from providing static insights, the cisternographic use of metrizamide through repeated CT examinations also makes it possible to make conclusive statements about CSF dynamics.

Humans↗
PubMed1978

Treatment of small cerebral gliomas with CT-aided stereotaxic curietherapy.

In cases of stereotaxic irradiation of small tumors, CT makes possible a precise determination of tumor volume and dosage and permits exact positioning of the therapy probe. Iridium 192 wires are interstitially implanted in the tumor (mostly gliomas Grades I-III) after biopsy. The results with 98 CT-controlled patients (from a series of 213 implantations in midline tumors) have provided new information about the method of treating small cerebral gliomas.

Brain Neoplasms↗