Biomedical subjects
G Stoppe
Publications and source records attributed to G Stoppe.
Life-threatening allergic reaction to clozapine.
Clozapine, an 'atypical' antipsychotic drug, rarely induces allergic complications, which usually present as cutaneous reactions. We report the case of a 69-year-old woman, suffering from chronic schizophrenia, who developed an allergic asthmatic reaction following clozapine therapy. Intensive-care treatment was necessary. The reaction could be repeated by further exposure to the drug. Skin tests for hypersensitivity were negative.
[Somnambulism and pavor nocturnus--review and case report].
A case of night terror with sleepwalking in an adult patient is described. Sleep polygraphic data are presented. The literature related to sleepwalking, night terror and its treatment is reviewed. The psychopathologic patterns of sleepwalking and night terror are illustrated and the differentiations of parasomnias and epileptic seizures discussed. The clinical applications of these findings are described and practical recommendations made for the management of NON-REM parasomnia.
[Central nervous system side effects of different antibacterial substances].
This review concerns central nervous system side effects of different antibacterial agents. Special attention is focussed on the new quinolone derivatives, penicillins and cephalosporins. As far as possible, mechanisms of action are discussed as well as therapeutic regimens.
[Central nervous system involvement in systemic lupus erythematosus].
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Positron emission tomography in neuropsychiatric lupus erythematosus.
We performed positron emission tomography (PET) using 18F-labeled 2-F-2-deoxyglucose in 13 patients with systemic lupus erythematosus (SLE). Ten of them had clinical signs of central nervous system involvement (NP-SLE). All patients with neurologic symptoms showed pathologic changes on PET, always in accordance with the clinical state. Three patients without neuropsychiatric manifestations had normal PETs. Computed tomography of the brain and magnetic resonance imaging proved to be less sensitive to both presence and localization of CNS lesions. We conclude that the combination of PET and MRI constitutes the most useful diagnostic procedure for NP-SLE.
PET and MR imaging in a neuro-Behçet syndrome.
Positron emission tomography (PET) and magnetic resonance imaging (MRI) studies were performed on a case of neuro-Behçet's syndrome. In accordance with the clinical signs, FDG PET (using 18F-labeled 2-F-2'-desoxyglucose) revealed disseminated storage defects in the cerebrum and cerebellum. Focal regions of enhanced signal intensity were demonstrated in the parietal white matter of the cerebrum in T2-weighted images and in the brain stem by MRI.
Cerebral involvement in systemic lupus erythematosus (SLE): comparison of positron emission tomography (PET) with other imaging methods.
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[Use of fluorodeoxyglucose PET in the diagnosis of central nervous system lupus erythematosus and a comparison with CT and MRI].
Central nervous system involvement has been found in 30-75% of all cases of systemic lupus erythematosus (SLE). Up to now, clinical diagnosis is difficult and there are no markers for disease activity. We have compared cranial computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) using fluorodesoxyglucose (FDG) in two cases. FDG-PET is shown to be the most sensitive method demonstrating even reversible deficits and a better correlation with other neurological findings. MRI seems to be more sensitive than CT. A survey of the literature concerning imaging methods in neuropsychiatric SLE is given. The special problem of neuronal desactivation by antineuronal activity is discussed.
Mollaret's meningitis: CSF-immunocytological examinations.
Mollaret's meningitis is a rare clinical entity consisting of recurrent attacks of meningeal irritation, which, after a sudden onset, last for a few days. The prognosis appears to be excellent, although the aetiology has not been established. In the CSF so-called endothelial cells are a typical finding, but their classification is not yet clear. In the present case immunocytological examination of CSF cells revealed that the so-called Mollaret cells are monocytes. The time course of changes in helper/suppressor ratio is similar to that in other infectious diseases of the central nervous system.
[Percutaneous resorption of testosterone, androstenedione and estradiol and their effect on serum steroid levels].
2.5 mg/m2 body surface of testosterone, 0.5 mg/m2 estradiol and 1.25 mg/m2 androstenedione were applied to the skin of healthy young men. The steroids were dissolved in a mixture of ethanol, water, and propylenglycol and applied to 10% of the body surface. Thus the amount given was equivalent to about one fifth of the amount in mg/m2. Serum levels of testosterone, androstenedione, and estradiol were measured by means of radioimmunology, both before the application as well as 2, 4, 8, and 24 h afterwards. Pregneolone and androstenedione did not alter the serum levels of the hormones determined. Testosterone and estradiol lead to a short peak of their serum concentration. Our results indicate that precursor steroids, pregnenolone and androstenedione, are rapidly metabolized to other compounds before they reach the blood in measurable amounts.
[Experience with the inhalation of a 33% xenon-(stable-)oxygen mixture in relation to a new method of measuring local cerebral circulation].
We describe a new non-invasive method for measuring local blood flow in the brain. Xenon (stable)-nl CBF-CT-method has been used in our clinic for the first time in Europe. It is superior to all other methods, such as 133Xenon, SPECT and PET in terms of anatomical accuracy and its resolution. We describe the method and its side effects. Inhalation of Xenon in sub-narcotic doses (33% for five minutes) produced no significant complications. Of 95 examinations, 74 were free of any incidents. The most common side effect was euphoria. The method appears to be suitable for general clinical use.
Alzheimer disease: absolute quantification of cerebral metabolites in vivo using localized proton magnetic resonance spectroscopy.
In vivo magnetic resonance spectroscopy of brain metabolites such as N-acetylaspartate and myo-inositol has been proposed for the diagnosis of Alzheimer disease. Thirty patients with probable Alzheimer disease as well as 22 elderly controls underwent quantitative proton magnetic resonance spectroscopy of parietal gray and white matter with use of a short-echo time localization technique (echo time, 20 ms; repetition times, 6,000 and 3,000 ms, 2.0 Tesla) providing access to the regional concentrations of N-acetylaspartate, creatine, choline-containing compounds, myoinositol, glutamate, glutamine, and lactate. No statistically significant alterations of the metabolites were found in patients relative to controls. There were also no differences between patients with early and late onset of the disease and with respect to the presence of APOE-epsilon4 phenotype. A general trend for slightly decreased levels of N-acetylaspartate and creatine was not observed for their respective concentration ratios. In summary, the spectroscopic findings were in accord with known Alzheimer disease neuropathology, i.e., mild gliosis in white matter as well as mildly enhanced cortical atrophy in comparison to elderly controls. However, cortical atrophy with little or no N-acetylaspartate changes provided no evidence for a major decrease of neuronal density or loss of viable neurons. The data do not support the utility of proton magnetic resonance spectroscopy as an early diagnostic tool for Alzheimer disease.
Cerebrovascular reactivity to acetazolamide in (senile) dementia of Alzheimer's type: relationship to disease severity.
Neuropathological reports about denervation and amyloid angiopathy in dementia of Alzheimer's type (DAT) as well as signs of selective incomplete white matter infarctions point to a vascular involvement within the degenerative process. In order to investigate potential alterations of cerebrovascular function we performed cerebral blood flow measurements before and after intravenous injection of 1 g acetazolamide using technetium-99m hexamethylpropyleneamine oxime and single photon emission tomography in 12 patients (6 female, 6 male; mean age 70.8 +/- 9.6 years) with probable (senile) dementia of Alzheimer's type (SDAT) and 9 controls (7 female, 2 male; mean age 71.2 +/- 8.6 years). SDAT patients revealed significantly reduced cerebrovascular reactivity with lower values with increasing cognitive impairment. We discuss possible underlying mechanisms.
[Imaging diagnosis of central nervous system involvement in panarteritis nodosa].
Central nervous system involvement of periarteritis nodosa is a rare complication of this disease. The diagnosis of CNS manifestation in vasculitis has been improved by using imaging techniques (i.e., magnetic resonance tomography, computed tomography, positron emission tomography). A case of polyarteritis nodosa with CNS involvement is presented; the diagnostic value of magnetic resonance imaging and positron emission tomography is discussed.