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H J Oosterhuis

Publications and source records attributed to H J Oosterhuis.

At least 19 recordsLinked to original sources
PubMed1992

[Quantification of the gnostic sensitivity via measurement of the vibration threshold and of finger tip sensation].

OBJECTIVE: Quantification of vibration perception and fingertip sensation in routine neurological examination. SETTING: Neurological Clinic, University Hospital, Groningen, the Netherlands. DESIGN: Prospective, controlled investigation. METHODS: Vibration perception and fingertip sensation were quantified in a large group of normal control persons of various ages and in neurological patients and compared with the usual sensory tests at routine neurological examination. The vibration perception limit was measured with a biothesiometer without accelerometer, the fingertip sensation with a device for two-point discrimination slightly modified according to Renfrew ('Renfrew meter'). Concordance of the tests was studied by calculating kappa values. RESULTS: The normal values of both sensory qualities had a log-normal distribution and increased with age. The values obtained with the Renfrew meter correlated well with those of the two-point discrimination and stereognosis but were systematically higher than those indicated by Renfrew. CONCLUSION: Both methods appear useful at routine neurological examination if certain measuring precautions are taken.

Adolescent↗
PubMed1992

HLA type is not indicative for the effect of thymectomy in myasthenia gravis.

The frequency of HLA types in a selected group of 40 patients with myasthenia gravis in relation to the effect of thymectomy and also to gender, and thymus histology was studied. As generally described we found a significant increase in the frequency of HLA-A1, HLA-B8, HLA-DR3 and HLA-DQ2 in the total group. There were no further differences between subgroups of patients, which demonstrates that HLA type is not indicative for the effect of thymectomy in myasthenia gravis.

Adult↗
PubMed1992

Antibodies to acetylcholine receptors in myasthenia gravis. In vitro synthesis by peripheral blood lymphocytes before and after thymectomy.

Pokeweed mitogen (PWM)-driven in vitro synthesis of antibodies to the acetylcholine receptor (PSA) was studied in non-thymoma patients with myasthenia gravis. In a group of 46 patients, the occurrence of PSA was related to the presence of the thymus or, in operated patients, the absence of a clinical effect of thymectomy. Sixteen patients were followed before and soon after thymectomy. PSA disappeared in all patients, at least temporarily, between 6 weeks and 1 year afterwards, independent of the clinical course and eventual clinical effect of the operation. A recurrence was found only in one of the five patients who derived no benefit from the operation. These findings support the hypothesis that the therapeutic effect of thymectomy can be explained by removal of a source of autoreactive lymphocytes. There was no correlation between the changes in serum levels of a-AChR and clinical improvement, suggesting a minor role of circulating peripheral blood lymphocytes (PBL) and the thymus in the total production of a-AChR.

Adult↗
PubMed1991

[The effect of thymectomy in patients with myasthenia gravis without thymoma; a statistical analysis].

In order to determine the effect of thymectomy on the prognosis of patients with myasthenia gravis, an analytical-descriptive study was carried out in the Neurological Clinic of the Groningen University Hospital and the Mathematical Institute of Groningen University. In 183 patients with generalized myasthenia gravis without thymoma, with onset between 9 and 46 years of age, the severity of the disease was scored by one neurologist at fixed times (0.5, 1, 2, 3, etcetera up to 15 years) after onset. Thymectomy was performed in 144 patients at different times (0.5, 1, 2, 3, etcetera up to 7 years) after onset. Logistic regression analysis was carried out with, as the criterion for marked improvement, a decrease of the disease score by 50%. Using this criterion, age, sex, duration of the disease and severity of the disease prior to operation played no distinct parts as prognostic factors. At different periods after the onset of the disease, groups of patients operated or not (yet) operated were compared. Patients subjected to thymectomy within 5 years after onset of myasthenia gravis had a better probability of halving of the severity score than patients not subjected to operation. These data render it possible in the individual patient to make an adequate estimate of the probability of marked improvement if thymectomy is performed or postponed.

Adolescent↗
PubMed1991

Anti-acetylcholine receptor antibodies decrease after thymectomy in patients with myasthenia gravis. Clinical correlations.

Clinical course and changes in serum levels of antibodies to the acetylcholine receptor (a-AChR) were followed in 82 patients with myasthenia gravis during a period of 1-8 years after thymectomy. Decrease in a-AChR immediately after thymectomy was influenced by changes in a total IgG. Immunosuppressive medication affected serum a-AChR at all points of time. In a subgroup of 41 patients without thymoma who had no immunosuppressive drugs, there was a steady decrease in a-AChR concomitant with clinical improvement from 6 weeks after thymectomy.

Adolescent↗
PubMed1991

Azathioprine in myasthenia gravis: observations in 41 patients and a review of literature.

We report azathioprine treatment of 41 patients with myasthenia gravis, with a follow-up of more than 3 yr. The data show that azathioprine is effective in controlling the disease, both as a single drug as well as in combination with prednisone. In addition it may be steroid sparing. Older patients derived more benefit from the medicament. Side-effects could be managed fairly well, except for one patient who developed a non-Hodgkin lymphoma. Data from this study do not support the supposition that the therapeutic effect of azathioprine is dependent on macrocytosis. Fluctuations of serum levels of antibodies to the acetylcholine receptor were simultaneous with clinical changes and thus were not of predictive volume for the clinical course.

Adult↗
PubMed1991

Vibration perception threshold, complaints and sensory examination in diabetic patients.

The vibration perception threshold (VPT) was investigated by means of a biothesiometer among 40 patients with insulin dependent diabetes mellitus. The age as well as the duration of the disease affected the VPT. However, a correlation between the VPT and the rate of metabolic control measured through the glycolysed Hb (HbAlc) could not be demonstrated. In early stages abnormalities were already detectable in the feet. The VPT was elevated in 13 of 20 patients with sensory complaints and in 4 of 20 patients without complaints. Routine neurological examinations such as light touch and pinprick sensation were less sensitive to diagnose neuropathy. In detecting early signs of diabetic neuropathy in an outpatient population the determination of the VPT is a sensitive tool.

Adolescent↗
PubMed1991

Hand-held myometry: reference values.

In thirteen major muscle groups of 50 healthy females and 50 males, aged 20-60 years, maximum voluntary contraction was measured with a hand-held dynamometer. The intrasession variation, the left-right variation, and the fifth and fiftieth centile values were calculated. The ratio of two observations within one session ranged from 0.85 to 1.18 and the ratio of left to right ranged from 0.82 to 1.22 (95% reference limits). In 20 volunteers the repeatability was tested after one week. The ratio of averages of three measurements in two successive weeks ranged from 0.82 to 1.23 (95% reference limits). There were only small differences between muscle groups concerning these ratios. A significant relation with age and weight/Quetelet Index could be demonstrated in some muscle groups. The mean strength of females is approximately two thirds of the strength of males. The data may be useful as reference values in the application of hand-held myometry.

Adult↗
PubMed1991

The "make/break test" as a diagnostic tool in functional weakness.

Strength was measured in four major muscle groups with a hand-held dynamometer. The "make" and "break" technique was used with and without encouragement, and fatiguability was tested in patients with organic weakness and patients with functional weakness. Patients with functional weakness could be distinguished from the other two groups by an increase in strength greater than 20% with the break compared with the make technique. Additionally they tend to show larger increases in strength with encouragement and their "fatiguability" was less.

Adult↗
PubMed1990

Measurement of the handcoordination.

The validity and reproducibility of two simple coordination-tests, the spiraltest and nailtest were examined in 113 healthy subjects, 33 patients with Parkinson's disease and 24 patients suffering from cerebellar disorders. The performances of the healthy subjects decreased significantly with age but gender had no influence. The performances of the dominant hands were significantly better. At a specificity of 90% the sensitivity was about 70% for the nailtest and about 75% for the spiraltest. For the patients with Parkinson's disease the spiraltest was more accurate than the nailtest. Since reference values are available these tests can be useful in the diagnostic process if a patient is suspected of a coordination disorder of the hands. Furthermore they are likely to give a better impression of the course of a disease affecting the coordination than if only clinical judgment is used.

Adolescent↗
PubMed1990

Permanent muscle weakness in familial hypokalaemic periodic paralysis. Clinical, radiological and pathological aspects.

Myopathy accompanying familial hypokalaemic periodic paralysis (HPP) is much less well documented than the paralytic attacks from which the disease derives its name. Eleven affected members of a large kinship with HPP were studied clinically and radiologically for the presence of myopathy. In 4 patients muscle biopsies were also performed and in 1 of them the histological findings obtained at autopsy were compared with the CT scans of various muscles. In another patient not previously biopsied, the specimens of both amputated legs were examined histologically. The age of the studied individuals ranged from 33 to 74 yrs. The 4 youngest patients showed no clinical signs of myopathy. However, in 2 of them CT scans demonstrated discrete hypodense lesions in the leg muscles, whereas in the other 2, muscle biopsies showed a vacuolar myopathy. The other 7 patients, all older than 50 yrs, presented both clinical and CT evidence of myopathy of proximal and distal muscles ranging from very mild to very severe, males being slightly more affected than females. In all 11 patients a mean CT grading was made that was based on the abnormalities found in the different muscle groups. The myopathy appeared to be unrelated to the history of paralytic attacks, but a strong correlation was found between age and mean CT grading. It was concluded that HPP is a myopathy with permanent muscle weakness of late onset in all the patients. The expression of the paralytic attacks is variable.

Adult↗
PubMed1989

The natural course of myasthenia gravis: a long term follow up study.

A long term follow up study is presented of 73 patients with myasthenia gravis, living in Amsterdam between 1926 and 1965. In the period 1961-65 the annual incidence was 3.1, the prevalence 53 per million. Maximum severity of the disease occurred during the first seven years after onset in 87%. Eighteen (29%) patients died, of whom eight had a thymoma (TH). Spontaneous improvement or remission occurred at any time during the follow up. At the end of the study (1985) 16 (22%) patients were in a complete clinical remission, 13 (18%) had improved considerably (3 with prednisone), 12 (16%) had improved moderately, 12 (16%) had remained unchanged and two had deteriorated. If the early deaths are excluded the outcome is similar in the early and the late onset group without TH. Patients with TH had a less favourable course. Associated autoimmune diseases were diagnosed in 25% (n = 58). Because most of these patients were treated with anticholinesterases only, the evolution of their clinical state represents the natural course of MG.

Adolescent↗
PubMed1988

The muscle fiber conduction velocity and power spectra in familial hypokalemic periodic paralysis.

Surface EMG has been used to determine the average muscle fiber conduction velocity (MFCV) and power spectra of the m. biceps of 10 patients and 15 asymptomatic offspring of a large kinship with familial hypokalemic periodic paralysis (HOPP). The MFCV of the patients was 3.37 +/- 0.35 m/sec (mean +/- SD, n = 9), the median frequency (Fmed) of the power spectra was 55.0 +/- 5.8 Hz (mean +/- SD, n = 9), both values are significantly (P0.001, Student's t-test) lower than the control values: MFCV = 4.55 +/- 0.33 m/sec; Fmed = 88.6 +/- 15.5 Hz (mean +/- SD). In 6 of the 15 asymptomatic relatives, the surface EMG results were also abnormal. It is concluded that the MFCV is reduced in familial HOPP. This results in a predominantly low-frequency content of the power spectra, thereby providing a new model for studying the relationship between the MFCV and the frequency spectrum of surface EMG. Asymptomatic relatives that have inherited the disease probably can be detected with this method.

Adult↗
PubMed1988

Improvement of muscle strength in familial hypokalaemic periodic paralysis with acetazolamide.

A double blind cross-over study of eight patients with familial hypokalaemic periodic paralysis was made to assess the influence of acetazolamide on muscle strength. All patients had a reduced interictal muscle fibre conduction velocity. Five patients had no attacks at the time of the study. One patient withdrew from the study because of an adverse reaction. The muscle strength of 11 muscle groups was measured with a hand-held dynamometer. The sum of force improved significantly in the seven patients (mean increase: 17%, p less than 0.05; 95% confidence interval: 7.2-26.8%). Endurance tests showed an improvement in the performance of 30 full kneebends. Surface EMG measurement showed no change in the muscle fibre conduction velocity or power spectra during treatment. The integrated EMG showed a (non significant) mean increase of 21%.

Acetazolamide↗