Biomedical subjects

H Strenge

Publications and source records attributed to H Strenge.

At least 19 recordsLinked to original sources

PubMed1992

Psychosocial, neuropsychological and neurological status in a sample of heart transplant recipients.

The sample for this psychosocial follow-up study was formed using the 71 surviving patients from a total of 100 who underwent heart transplantation up until March 1990 at Kiel University Hospital. Forty of these could be investigated comprehensively. The neurological investigation comprised EEG and auditory and visually evoked potentials. The psychological investigation started with several neuropsychological tests; additionally all patients were interviewed and they completed questionnaires concerning anxiety, depression, ways of coping, personality characteristics and life satisfaction. Within the entire sample, there were few indications for specific psychological impairment. The psychosocial status of the patients was not significantly related to the time which had elapsed since they underwent transplantation. There were few associations between neuropsychological and psychosocial data, and several indicators of early postoperative complications which are described in the literature (e.g., length of stay in the intensive care unit). Clinically relevant subgroups (formed on the basis of neuropsychological test results, anxiety and depression) did not differ in terms of these indicators. Nevertheless, a considerable proportion of the patients (25%) were characterized by having a higher level of affective and neuropsychological impairment. Although based upon retrospective investigations, the results of this follow-up generally correlate with those gained from Anglo-American countries. In interpreting the results one needs to consider the possible influence of premorbid personality characteristics as well as denial which may be typical for patients undergoing heart transplantation.

Adaptation, Psychological↗

PubMed1992

Preoperative and late postoperative psychosocial state following coronary artery bypass surgery.

In a prospective study of psychological and neurological reactions to coronary artery bypass surgery, 45 patients were examined preoperatively, postoperatively, and 21 to 27 months after, using a variety of neurological, psychiatric, and psychological investigations. Within the follow-up sample, three subgroups of patients could be identified by cluster analysis who differed with respect to their emotional status and life satisfaction. One group (24% of the total sample) was characterized by high levels of anxiety, depression and life dissatisfaction and appears as a risk population. The other groups could be described as either average (42%) or stable (33%). At the follow up, the risk group further indicated a preference for depressive coping styles, a slightly higher degree of cognitive impairment, more neurological and psychopathological symptoms (specifically giving-up and hostility), a considerably lower return-to-work rate, more subjective physical complaints and a poorer attitude toward the outcome. While postoperative measurements (obtained 2-3 and 6-8 days after surgery) as well as intraoperative parameters did not reveal significant group differences, the analysis yielded an increased impairment within the risk group already prior to surgery, especially emotional problems, specific health-related cognitions and a more fatalistic attitude. The results are in line with those of other studies investigating the late postoperative psychological status with regard to the proportion of patients showing psychological impairments as well as to their specific psychological characteristics.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗

PubMed1991

[Polyneuropathy and central nervous system diseases before and after heart transplantation. Is cyclosporin neurotoxic?].

In a cross-sectional study, 52 patients (44 men, 8 women, mean age 50.6 [19-68] years) were investigated clinically and electrophysiologically for evidence of peripheral and central nervous system damage before and after heart transplantation. 20 patients were investigated before heart transplantation (group 1), 16 at 7 days to 5 months after transplantation (early post-operative group; group 2) and 16 at 6 to 32 months after transplantation (late post-operative group; group 3). Nerve conduction studies (median, peroneal and sural nerves) revealed polyneuropathy in 14 out of 16 patients in group 2, significantly more than in group 1 (11 out of 19) and group 3 (9 out of 16). The mean blood cyclosporin concentration was 656 ng/ml in group 2 and 409 ng/ml in group 3 (P less than 0.001). Patients in group 3 with polyneuropathy had significantly higher cyclosporin concentrations than patients without polyneuropathy (505 vs 284 ng/ml; P less than 0.01). Among patients who had undergone operations, there were no noteworthy differences between the mean cyclosporin concentrations and clinical data in those with or without central nervous system lesions. There is preliminary evidence of a neurotoxic effect of cyclosporin on the peripheral but not the central nervous system.

Adult↗

PubMed1991

[Somatosensory evoked potentials in moderate hyperthermia].

The effects of moderate whole-body hyperthermia on the cervical and cortical somatosensory evoked potentials (SEP) were studied in healthy male subjects, aged 22-32 years. They were immersed in hot water and heated to a median rectal temperature of 39.0 degrees C. Serial SEPs to median nerve stimulation were recorded during cooling at intervals of 0.1 degrees C. The general wave form and the amplitudes did not systematically change. For a 1 degrees C drop there was a median latency increase of 2.6-3.7% in cervical and 1.5-7.4% in cortical SEP components. In individual cases significant latency delays of cervical N13 and cortical N20 could already be observed at differences of 0.2 degrees and 0.5 degrees respectively. All other components showed significant latency changes at temperature intervals of 0.6 to 0.8 degrees C.

Adult↗

PubMed1990

Early neurological abnormalities following coronary artery bypass surgery. A prospective study.

A prospective analysis of 78 patients undergoing coronary artery bypass surgery (CABS) was carried out to assess clinically the frequency and course of cerebral complications during the 1st postoperative week. Detailed evaluation of the patients showed that neurological abnormalities after CABS were common, occurring in 40 of the 78 patients (51%). However, there were no serious cerebral complications. Changes in reflexes and new focal signs were found in 26 and 25 cases respectively; in 7 patients (9%) they were confined to the first postoperative days. There was no statistically significant correlation between postoperative outcome and age, preoperative neurological state or bypass time. However, some strong associations could be calculated between a history of cerebrovascular signs or symptoms and the appearance of persisting focal signs or development reflexes during the 1st week after CABS.

Adult↗

PubMed1990

[The cervical somatosensory evoked potential in lesions of the cortical efferents].

Cervical and cortical somatosensory evoked potentials to median nerve stimulation were analysed in 20 patients with unilateral central paresis of the arm. Neither the configuration nor the latency and amplitude measures of the neck potential did reveal any association with pathological alterations of cortical efferents or with abnormal cortically evoked responses. Thus, also in this population the evaluation of cervical potentials can be done according to the known criteria.

Adult↗

PubMed1989

[The cervical somatosensory evoked potential and its relation to F-wave activity].

In 6 healthy volunteers aged 18-25 years cervical somatosensory evoked potentials (CEPs) were recorded following stimulation of the right median nerve at the wrist. At the same time the antidromically elicited individual F-waves evoked by any single impulse were recorded from the abductor pollicis brevis muscle. By means of selective averaging of the neck responses it could be shown that there was a close relationship between an F-wave-activity of 120-150 microV/stimulus or more during the trial and the appearance or the enhancement of a negative peak occurring 0.5-1.4 ms after the main CEP component N13. An F-wave-activity of more than 224 microV/stimulus regularly resulted in a total change of the CEP configuration.

Adolescent↗

PubMed1989

[Variations in the configuration of somatosensory evoked potentials following stimulation of the median nerve].

The variants of waveform patterns of cervical and cortical somatosensory evoked potentials to median nerve stimulation at the wrist were analysed in 86 normal subjects aged 15 to 71 years. In cervical SEP recordings the components N13, N14 and the trough-shaped variant of P17 showed the highest short-term stability. Immediate changes of the amplitude proportions of subcomponents within the potential, i.e. a lack of uniformity in waveforms, have to be considered normal. Significant associations were found between the occurrence of components N14 and an arm length of more than 68 cm and between the appearance of a plateau configuration of P17 and an age of at least 40 years. Considering definite criteria the latency of P17 can be used as an additional reliable parameter. In cortical SEP recordings the combination of an initial V-shaped pattern and a following bifid W-configuration appeared as the most frequent waveform profile. All parts of the potential but the positive waves of the primary complex revealed a high intraindividual stability.

Adolescent↗

PubMed1989

[The repeat reliability of somatosensory evoked potentials].

The test-immediate-retest reliability of latency and amplitude values of cervical and cortical somatosensory evoked potentials (SEP) to median nerve stimulation was assessed in 86 normal subjects aged 15 to 71 years. In addition to the stability of data between repeat trials within one test session the standard errors of measurement and the interpretable differences for SEP measures were calculated according to measurement theory. The study revealed retest correlations rtt greater than 0.80 for all latency measures of the cervical and cortical SEPs and all cortical amplitude parameters. The highest stability was found for the latency measures of the cervical components P10, N11, N13, the cortical components P16 and N20 and for the amplitude N20/P25.

Adolescent↗

PubMed1988

Cerebellar ataxia with recovery related to central pontine myelinolysis.

Development of severe ataxia and mild pyramidal signs without mental deterioration, tetraparesis or pseudobulbar palsy during recovery from withdrawal delirium and initial hyponatraemia are unusual clinical features consistent with central pontine myelinolysis. This diagnosis was confirmed by magnetic resonance imaging (MRI) in an alcoholic man. Clinical and electrodiagnostic improvement occurred, whereas the MRI findings remained unchanged in a follow-up study.

Alcoholism↗

PubMed1986

[Age changes in early somatosensory evoked potentials].

There are characteristic age-related changes in the cervical and early cortical somatosensory potentials evoked by electrical stimulation of the median nerve. At an age of 40 to 50 years the latencies of the potential components and the transit times start increasing progressively. Moreover, there is an attenuation of the cervical and an enhancement of the cortical components with age. Considering the presumed neuronal basis of the bioelectric phenomena the changes are discussed in connection with aging processes of the spinal ganglion cells, cortical pyramidal cells and the locus coeruleus.

Adolescent↗

PubMed1982

Visual and somatosensory evoked potentials and F-wave latency measurements in hereditary neuropathy with liability to pressure palsies.

Pattern shift visual evoked potentials (VEPs), cervical and cortical somatosensory evoked responses (SEPs) and motor conduction velocities studied by F-wave latency measurements were investigated in two family members with hereditary neuropathy with liability to pressure palsies (HN-PP). In both cases in VEPs and SEP conduction times N13-N20 were normal. A bilateral pathological increase of latencies of early SEP components, N9-N13 transit times and F-wave latencies revealed a lesion in the proximal parts of the median nerves close to the spinal cord in the older patient. These abnormalities emphasize the close relationship of HN-PP with hereditary polyradiculopathy (Mayer 1975).

Adult↗

PubMed1982

Multimodality evoked potentials and electrically elicited blink reflex in optic neuritis.

Pattern shift visual evoked potentials, brain stem auditory evoked potentials, spinal and scalp recorded somatosensory evoked potentials, and electrically elicited blink reflexes were investigated in 32 patients with isolated optic neuritis. Eleven patients were shown to have one additional lesion in the central nervous system outside the optic nerve. Therefore, cases with optic neuritis of unknown origin should be considered as possible cases of multiple sclerosis.

Adolescent↗

PubMed1982

Age-dependent changes in central somatosensory conduction time.

Cervical and cortical somatosensory evoked potentials(SEPs) were recorded in 45 normal subjects. Absolute peak latencies and latency differences between the components P7, N9, N11, N13, P17 and N20 were measured. Subjects aged 40-60 years had significantly longer latencies of N13 and N20 than subjects aged 15-39 years. Moreover, statistical analysis revealed a significant prolongation of N9-N13, N11-N13 and N13-N20 transit times in older subjects. Possible connections with known morphological age-related findings are discussed.

Adolescent↗

PubMed1981

On the nucleus endymalis of the human thalamus.

In the present article the shape and extent of the nucleus endymalis in the human thalamus is described. By means of a newly developed method of selective staining of intracellular lipofuscin granules with aldehydefuchsin it is possible to examine the three-dimensional shape of the griseum in complete series of 800 micrometer thick slices. The nucleus endymalis can be divided into an invariably occurring strongly pigmented caudal pars pigmentosa with clear-cut boundaries and an oral pars commissuralis. The weakly pigmented oral part is only found in brains with developed massa intermedia and varies considerably from individual to individual. The pars pigmentosa is characterized by its periventricular position medial to the nucleus parafascicularis. Differences in nomenclature and outlines of topographically corresponding thalamic nuclei of other authors are discussed. It is assumed that the pars pigmentosa a least partly corresponds to the catecholaminergic cell group A11 in the rat brain (Dahlström and Fuxe 1964). Finally, its possible functional connections to the dorsal periventricular bundle and its significance for stimulation-produced analgesia (SPA) in man are discussed.

Aged↗

PubMed1980

The blink reflex in chronic renal failure.

The components of the electrically elicited blink reflex were investigated in 15 patients who were admitted to a chronic dialysis program because of chronic renal insufficiency with serum creatinine concentrations from 6.0 to 14.2 mg/dl. In addition, the conduction time in the facial nerve, the motor conduction velocities, and the distal motor latencies of the median and peroneal nerves were measured. In 13 of 15 patients (87%) there was at least one component of the blink reflex pathologically delayed. Bilateral prolongation of the latency of the component R1 was seen most frequently. In all pathological cases the distribution pattern of the responses revealed dysfunction in the brainstem. Correlating the values of blink reflex latencies, the period of dialysis, the values of serum creatinine and urea nitrogen, and the results of peripheral neurography, there was a significant relationship between the motor conduction velocity of the peroneal nerve and the latency of the early component R1. The value of these findings in reference to the known neurological symptomatology in chronic renal failure is discussed.

Adult↗

PubMed1980

Evaluation of various brain structures in multiple sclerosis with multimodality evoked potentials, blink reflex and nystagmography.

Pattern reversal visual evoked potentials (VEP), blink reflexes, auditory brainstem evoked potentials (ABEP), spinal and scalp recorded somatosensory evoked potentials (SSEP), and nystagmographic records were investigated in 55 patients with multiple sclerosis (MS), who were separated in different categories of probability according to the clinical history, symptoms, and signs. The combined use of different electrophysiological methods forms a sensitive battery for investigating clinically uncertain cases of MS. It was stressed that care should be taken in the interpretation of the electrophysiological findings, since a single lesion in the central nervous system, particularly in the brainstem, may affect different functional systems simultaneously and therefore mimic a disseminated disease.

Adolescent↗

PubMed1979

Diagnostic validity for different components of pattern shift visual evoked potentials in multiple sclerosis.

Visual evoked potentials, elicited by checkerboard-pattern reversal were recorded from multiple sclerosis patients with different probabilities of diagnosis. Latencies and amplitudes of the different components were analyzed for diagnostic validity. It was demonstrated that the latency of the main positive peak (P2) was the most sensitive parameter. But in a few cases determination of P2 latency and interocular difference of this peak alone failed to detect involvement of the visual system. Additional evaluation of absolute latencies, asymmetries in latency and amplitudes of other components would give evidence in predicting abnormalities of the visual pathways.

Adolescent↗