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Biomedical subjects

F Regli

Publications and source records attributed to F Regli.

At least 19 recordsLinked to original sources

The response of focal ischemic cerebral edema to dexamethasone.

Twenty-four h after permanent occlusion of the middle cerebral artery (MCA) in the cat, the hemispheric swelling due to edema is markedly reduced under treatment with large doses of dexamethasone than is the case with the untreated group. The increase of regional water and sodium content in the MCA territory is less in the dexamethasone treated group, whereas the potassium changes in the ischemic tissue showed only small differences between the two groups. The potassium content of the non-ischemic tissue is slightly increased in the dexamethasone treated animals when comparing with the untreated group. RISA activity in the tissue is increased in the grey and the white matter of both groups. The less marked RISA-131 activity in the cortical grey matter of the treated animals indicates blood-brain barrier damage of a smaller degree due to dexamethasone. These findings indicate a beneficial effect of dexamethasone on local ischemic edema. Regarding our results and the pharmacokinetics of this steroid the dexamethasone loading of a patient has to be in the range of about 100 mg per day for the adult, and has to be started immediately after the onset of a stroke.

Animals

Recurrent familial neuropathy with liability to pressure palsies: reports of two cases and ultrastructural nerve study.

Electrophysiological, histological and ultrastructural studies on two patients (one family) with familial neuropathy and a liability to pressure palsies are reported. There was slowing of nerve conduction velocities and increase of distal latencies of clinically affected and clinically non-affected nerves. These alterations were confirmed by biopsy of the sural nerive which had the characterized signs of the disease. Pathogenetically there seems to be an endogeneous metabolic defect of the Schwann cell to synthetize a normal myelin sheath, which is responsible for the particular susceptibility to mechanical damage.

Adolescent

[Lead poisoning. Apropos of a case of acute encephalopathy in an adult].

Although acute lead encephalopathy is rare in adults, the authors had the opportunity to observe a case in a patient who had been exposed to lead occupationally for 25 years. This patient was also seen to be suffering from anemia and polyneuropathy. The blood lead level was 591 micrograms/100 ml (28,52 mumol/l). A review of the literature concerning the principal sources of lead poisoning, routes of absorption, metabolism and consequences of poisoning is conducted. Treatment by chelating agents is discussed. CaNa2-EDTA was administered by i.v. infusion over 24 hours and a favorable evolution was rapidly observable in the encephalopathy and anemia. On the other hand, the polyneuropathy was intensified, a fact which may have been caused by redistribution of lead in the soft tissues.

Acute Disease

Neuropathy, amyloidosis, and monoclonal gammopathy.

Three cases of neuropathy with monoclonal gammopathy and amyloid deposits in peripheral nerves are described. They appeared to present a benign gammopathy because of the duration of the neuropathy in the absence of any clinical or biological sign of myeloma or macroglobulinaemia. The pathological abnormality found in the sural nerves of the three patients was characterised by a marked loss of myelinated and unmyelinated nerve fibres because of active axonal degeneration with Wallerian degeneration. The most striking feature in all three cases was the finding of deposits identified as an accumulation of microfibrils.

Aged

[The short periodicity of paroxysmal complex waves in electroencephalographic and clinical course of Creutzfeldt-Jakob disease (author's transl)].

The Creutzfeldt-Jakob disease reveals striking bioelectrical and clinical features which provide indirect confirmation of actions in cortical, subcortical and brainstem neuronal systems determining the type, the stage and the fatal limits of the course. The periodic paroxysmal complex waves in EEG, the signs of motor, vigilance and respiratory impairment and the site of lesions are delineated in a case of cortico-striato-cerebellar type and compared with other cases in literature. Other forms of electroencephalographic periodicity in different clinical and experimental conditions are discussed. The period dynamics are referred to the course of disease and investigated under the influence of anticonvulsive drugs.

Brain

[Interest of auditory brainstem responses in clinical diagnosis (author's transl)].

The auditory brainstem response yields information on both the neurological and the audiological status of infants and adults. These early waves have particular properties as: non-habituation, absence of modification between sleep, awake state or under high doses of barbiturates. We have developed a procedure for extracting each type of information by measuring the latencies of wave I (auditory nerve) and wave V (inferior colliculus), then the speed of conduction between these two waves.

Adult

[Usefulness of the immunoglobulin-albumin ratio compared to electrophoresis in the diagnosis of multiple sclerosis].

The results obtained with gel electrophoresis on CSF samples of multiple sclerosis patients are compared with measurements of CSF IgG indexes (IgG/alb and IgG/total protein). The correlation between these parameters is good, provided the upper normal limit of the IgG/alb index is over 35% and an "overlapping" zone between 21 and 35% is introduced where the IgG/alb index has not the same diagnostic value.

Adult

The effect of arterial hypertension of focal ischemic edema. An experimental study.

The middle cerebral artery (MCA) of cats was occluded permanently for 24h to study the influence of arterial hypertension during the early phase of focal ischemia upon the development of endema and changes of the blood-brain barrier (BBB). In normotensive animals MCA occlusion results in a hemispheric weight increase of about 8% and marked water and electrolyte alterations in both the grey and white matter of the MCA territory. The RISA space increases mainly in the grey matter. Hypertension aggravates these changes significantly, whereby water and electrolyte changes in the grey matter are predominantly concerned, while there is a preferential increase of the RISA space in the white matter. It is suggested that arterial hypertension aggravates the ischemic edema and enhances a vasogenic type of edema in the white matter.

Animals

Cochleovestibular involvement as the first sign of syphilis.

Three cases of syphilis with cochleovestibular symptoms are reported. There was either cochlear or vestibular involvement in two cases and, in the trird, cochlear and vestibular involvement together. The disorder was unilateral in all three. In one case there was a concurrent lesion of the oculomotor nerve which was the motive for consultation. There was no other symptom suggesting the diagnosis of syphilis in any case. The important features of diagnosis are discussed.

Adult

[Determination of antibodies against nicotinic acetylcholine receptor: clinico-immunological correlations in 30 patients with myasthenia gravis].

In 30 patients with myasthenia gravis, serum assays were performed for antibodies to human nicotinic acetylcholine receptor. 19 of 20 generalized forms which were symptomatic and 6 of 9 patients in remission at the time of blood sample had detectable amounts of antibodies. The six highest levels were found in benign courses. 2 patients had a five- and twofold drop in antibody level during rapid deterioration. Patients in remission after thymectomy may still have low to moderate levels, while symptomatic patients occasionally have no detectable antibody.

Adolescent

Cerebral coenurosis. Report of a case with arteritis.

A case of the unusual clinical condition of cerebral coenurosis, the unique parasitic disease that is localized only in the CNS, is reported. The patient had repeated attacks of transient hemiparesis due to intracranial arteritis which was demonstrated by several angiographic studies. The CSF showed a discreet lymphocytosis and increased immunoglobulins. This inflammatory reaction which preceeded the manifestations of the intracranial mass can be explained by the parasitic foreign bodies, the liberation of somatic and metabolic parasitic toxins and the immunological reaction of the organism. The arteritis of the basal intracranial vessels was probably secondary to the inflammatory reaction of the leptomeninges. In presence of the rare association of meningovascular disease and an expanding intracranial lesion a parasitic condition due to a larval stage of Cestodes (Hydatidosis, Cysticercosis, Coenurosis) should be always considered.

Adult