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Biomedical subjects

I Sulla

Publications and source records attributed to I Sulla.

At least 19 recordsLinked to original sources
PubMed1996

[The time factor in cauda equina syndrome].

Cauda equina syndrome is a rare but potentially catastrophic complication of lumbar disc disease. In spite of properly performed surgical decompression, the outcome is mostly unsatisfactory. One of the important factors influencing the recovery of motor function of the lower extremities, sensation, bladder and rectum control, sexual function, as well as working ability is thought to be the duration of cauda equina compression. The evaluation of data obtained in a group of 58 persons (21 women and 37 men) operated upon for discogenic cauda equina syndrome in the period of time from January 1, 1982 to December 31, 1991 did not confirm this opinion. (Tab. 7, Ref. 23.).

Adult↗
PubMed1995

Multiple protracted cauda equina constrictions cause deep derangement in the lumbosacral spinal cord circuitry in the dog.

Neuropathological changes of the neuronal pools and spinal cord circuitry in the lumbosacral segments were studied in a canine model of multiple protracted cauda equina constrictions. Anterograde degeneration of all sacrococcygeal and L7 dorsal root fibers was detected in S1-S3 and lower lumbar segments. A narrow degenerated gracile fascicle was found in all thoracic and cervical segments terminating in the gracile nucleus. Transneuronal degeneration of middle-sized and large neurons, located in S1-S3 and sporadically in L7 segments, was noted. Identical transneuronal degeneration was seen in a group of small neurons located in the ventralmost part of lamina VII in S1-S3 segments. Simultaneously, a terminal degeneration was detected in the lateral cervical nucleus and in the ventral posterior lateral nucleus of the ventrobasal thalamic complex. Concomitantly, a fully developed retrograde degeneration affecting motoneurons in the ventrolateral portion of the anterior horn in S1-S3 segments appeared.

Animals↗
PubMed1994

Ischemia-induced delayed-onset paraplegia is accompanied by an unusual form of synaptic degeneration in the lumbosacral segments: an experimental light and electron microscopic study in dogs.

We studied the effect of high thoracic aorta cross-clamping, complete transverse section of the spinal cord at Th6 level, and combined hemisection at Th6 level followed later by high thoracic aorta cross-clamping upon the morphology and number of identified presynaptic knobs in lumbosacral segments in dogs. In animals surviving 48-72 hours after high thoracic aorta cross-clamping the occurrence of an unusual form of boutons accompanied by periboutonal halo in L3-S1 segments was found. According to the bouton size and light as well as electron microscopic appearance, four types, i.e., light giant (T1), dark enlarged (T2), light giant with periboutonal halo (T3), and giant disintegrating (T4) boutons were detected after 48 and 72 hour reperfusion. The appearance of four boutonal types in the lumbosacral segments is caused by spinal cord ischemia secondary to high thoracic aorta cross-clamping followed by 48 or 72 hour reperfusion. At the end of the sixth reperfusion day no signs of enlarged and giant boutons were detected in L3-S1 segments. A statistically significant increase of enlarged and giant boutons was noted at the end of the third reperfusion day in comparison with 48 hour survival. After spinal cord transection at midthoracic (Th6) level, followed by 72 hour survival, no such unusual synaptic knobs could be found in L3-S1 segments. The laminar distribution pattern of T1-T4 types based on light microscopic analysis and confirmed electron microscopically is characteristic and strictly bound to those spinal cord gray matter layers which serve as main termination sites of the descending cortical, brain stem, as well as long propriospinal projections in the lumbosacral segments (laminae V-VII). A statistically significant increase of enlarged and giant boutons was found in the intermediate zone (lamina VII). Hemisection at midthoracic level (Th6) followed later by 30 minute high thoracic aorta cross-clamping and 48 hour reperfusion caused a marked decrease of enlarged and giant boutons in L3-S1 segments on the hemisectioned side in comparison with the contralateral one. Large amounts of irregularly arranged round vesicles and tubular profiles were disclosed in the boutonal matrix of T1, T3, and T4 types in L3-S1 segments of animals subjected to 30 minute high thoracic aorta cross-clamping followed by 72 hour reperfusion. Accumulation of tubular and membranous materials was invariably seen in the bulbous enlargement of the terminal axonal branch.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1994

Patients age and results of treatment in discogenic cauda equina syndrome.

Cauda equina syndrome is a feared complication of lumbar disc disease. Despite of early surgery it frequently leaves persistent effects. Localisation, type, and duration of spinal nerve roots compression are quoted as the most important factors influencing the results of treatment. Statistical evaluation of data acquired by examinations of 58 persons operated on for this disease et the Department of Neurosurgery in Kosice within the period from January 1st, 1982 to December 31st, 1991 has shown that the further important facts are ageing of tissues and impairment of microcirculation. In patients over the age of 45 the recovery of motor and sexual functions, as well as the voluntary control of rectal sphincters, and the working ability were significantly worse. It is suggested thereby that in elderly persons with a proven intervertebral disc disease an early surgical intervention is indicated. (Tab. 7, Ref. 23.)

Adult↗
PubMed1994

Central hypothyroidism--various types of TSH responses to TRH stimulation.

Thyrotropin (TSH) levels in serum before and 20 and 60 min after the administration of 0.2 mg TRH i.v. as well as thyroid hormone (T3, T4) levels were studied in 39 patients with organic diencephalo-pituitary lesions and 27 healthy subjects. All participants gave their informed consent with the study. By the type of TSH response to TRH stimulation all patients were divided into 4 groups: 1. Normal response (n = 10): basal TSH 2.31 +/- 1.51, peak TSH 20 min after TRH 12.17 +/- 6.53, TSH 60 min after TRH 8.43 +/- 4.65 microU/ml; T3 2.02 +/- 0.48 and T4 95.9 +/- 27.73 nmol/l; 2. Blunted or absent TSH response (n = 8): basal TSH 0.82 +/- 0.42, peak TSH 20 min after TRH 1.51 +/- 0.66, TSH 60 min after TRH 1.35 +/- 0.51 microU/ml; T3 1.6 +/- 0.49 and T4 86.63 +/- 16.49 nmol/l; 3. Delayed ("diencephalic") TSH response (n = 16): basal TSH 2.69 +/- 1.27, peak TSH 20 min after TRH 7.96 +/- 3.35, TSH 60 min after TRH 10.0 +/- 3.97 microU/ml; T3 1.30 +/- 0.63 and T4 65.85 +/- 21.13 nmol/l; 4. Higher basal or stimulated TSH (n = 10): basal TSH > 10 mU/ml or stimulated values above 25 mU/ml. Mean T3 and T4 values in patients with normal or blunted TSH response did not differ significantly from the controls. Mean T3 and T4 in the group with delayed TSH response were significantly lower (P < 0.01). High TSH and low T3 and T4 levels were found in the patient with large meningioma sellae.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

[Results of surgery for hypertensive cerebral hemorrhage].

The authors subdued 82 patients to an analysis, the aim of which was to determine the most optimum indication criterias for operations due to hypertonic brain hemorrhage. The survival rate, its qualities and other parameters in the group under observation did not significantly differ from characteristics of groups of patients given by literature. Therefore, they recommend the following factors to be taken into consideration of surgical indication: age, general status of the patient, localization of the hematoma, associated internal diseases. (Tab. 3, Fig. 5, Ref. 16.)

Adult↗
PubMed1991

Mapping of the canine lumbosacral spinal cord neurons by Nauta method at the end of the early phase of paraplegia induced by ischemia and reperfusion.

The Nauta impregnation method was used to map the neuronal changes in the canine lumbosacral segments following ischemia and reperfusion. The early perikaryal changes ensuing during the first phase after 30 min of thoracic aorta cross-clamping alone or followed by 30 min of reperfusion were mapped. During the second phase (one to six postischemic reperfusion days) the dendritic, preterminal and synaptic degeneration developed. The influence of 30 min cross-clamping immediately followed by perfusion fixation is characterized by the occurrence of flocculent argyrophilic clusters in the cytoplasm of middle-sized and large neurons of L3-S1 segments. Declamping of the thoracic aorta followed by 30 min of reperfusion basically modifies the susceptibility of lumbosacral neurons to Nauta impregnation promoting somatic and dendritic argyrophilia mainly of small (less than 15 microns) neurons, localized mostly in the fifth, sixth and seventh layers, respectively. This early appearing somatic and dendritic argyrophilia is not abolished by a pretreatment of sections with acetone in which cholesterol and its esters are highly soluble, or chloroform-methanol which extracts total lipid. After 24 h of reperfusion the somatic and dendritic argyrophilia is lost but the first signs of drop-like degeneration are detected in all but three superficial dorsal horn layers. At the end of the third reperfusion day, an atypical form of bouton degeneration was found, consisting of massive occurrence of enlarged (greater than 4 microns) boutons encircled by a clear halo. Laminar distribution of enlarged degenerating boutons coincides with laminar quantitative distribution of small argyrophilic neurons detected 30 min after reperfusion. The basic orientation of the many terminal fibres attached to enlarged boutons suggests that they belong to the axons localized mainly in the lateral and anterior columns. Despite a dense argyrophilic network pervading the gray matter of lumbosacral segments only pale shadows of middle-sized and large neurons were found at the end of the sixth reperfusion day and neither somatic nor vessel wall argyrophilia could be detected. All animals surviving one, three and six days postoperatively suffered from fully developed paraplegia.

Animals↗
PubMed1991

[Problems of recurrence and reoperations in discogenic lumboischiadic syndromes. 1].

During the period between Feb. 1 1982 and Dec. 31 1989 at the Neurosurgical Clinic in Kosice 2346 patients were operated (813 women and 1533 men) on account of discogenic lumboischiadic syndrome. Because of true relapses 79 patients were reoperated (29 women, 50 men), i.e., 3.37% of 2346 patients. These formed the investigated group. The youngest patient was 18 years old, the oldest 60 years, the mean age was 38.5 years. Check-up examinations, X-ray material and mathematical evaluation revealed that even marked deviations from the ideal weight according to Broca, balneotherapy, regular physical training and localization of the damaged disc did not influence the development of a true relapse which called for re-operation. The latter were significantly more frequent in subjects engaged in excessively hard physical work and those who developed a complication during the first operation.

Adolescent↗
PubMed1991

[Problems of recurrence and reoperation in discogenic lumboischiadic syndromes. 2].

In a group of 79 patients (29 women and 50 men) reoperated at the Neurosurgical Clinic of the Faculty Hospital with Policlinic in Kosice between Feb. 1 1982 and Dec. 31, 1989 for substantiated suspicion of a true relapse of discogenic lumboischiadic syndrome it was revealed that neither perimyelography nor CT examination of the spine disclosed reliably the conditions in the spinal canal. The assumed disc compression of spinal roots was confirmed by the surgeon on reoperation only in 58.2% of the patients. Complications were encountered on reoperation in 26.6% patients of the group whereby in the majority an injury of the dura mater fixed by an epidural scar was involved. The results of reoperations were worse than the results of primary operations. Improvement can be expected from a better differential diagnosis of complaints after disc operations and from improvement of the surgical technique which will reduce the risk of preoperative complications, e.g. by using the microsurgical technique.

Adolescent↗
PubMed1991

[Prolonged epidural hemorrhage].

The authors give an account of four male patients aged 4, 26, 34 and 51 years where they removed on the 4th to 20th day following head injury an epidural haematoma. In the youngest patient the haematoma was in the area of the posterior cranial fossa on the left in another patient on the left in the occipital area, in the third patient concurrent epidural and subdural haemorrhage in the left temporal region was involved as well as contusion of the brain on the same side, in the last patient a large epidural parieto-occipital haematoma on the right side was involved. In the four-year-old boy the haemorrhage developed without fracture of the skull, in the remainder there was fracture of the skull, its course was, however, so inconspicuous that with the exception of one it was found only on operation. Although the clinical symptoms in all patients suggested that a posttraumatic intracranial complication is involved, CT helped to establish the correct diagnosis. All four patients are alive, three without an obvious neurological deficit, one suffers from mild hemiparesis.

Adult↗
PubMed1990

[Results of treatment of infantile hydrocephalus (a group of 64 children)].

The authors present a report on 64 children operated between January 1, 1982 and December 31, 1986 on account of infantile hydrocephalus. As the primary operation in the great majority of children ventriculo-atrial drainage with a valve according to Spitz- Holter (60 times) was indicated, in exceptional cases ventriculo-mastoidostomy according to Nosik without a valve (four times). Thirty-eight patients (59%) had to be re-operated, some repeatedly on account of different disorders of the system. Most frequently the valve failed (22 times). Forty-four children (62.6%) of the group survive. Twenty-four (37.6%) thrive, sixteen are retarded as regards psychomotor development (25%), thirteen died (20.3%), eleven did not attend examination (17.1%).

Cerebrospinal Fluid Shunts↗
PubMed1990

[The technique of experimental procedures on the floor of the fourth cerebral ventricle of rabbits].

The technique of experimental operative procedures in the distal area of the brain stem in the reach of the fourth brain ventricle is described in rabbits. The experiments were carried out in 25 rabbits (breed great-chinchilla, body-weight 4.5 to 5.25 kg) of both sexes. All manipulations were performed in general anesthesia. The best methods for endotracheal intubation of the rabbit and for the surgical technique in the floor of the fourth ventricle were searched.

Anesthesia, General↗
PubMed1990

Spontaneous spinal epidural hematoma.

The authors presented a 61-year-old patient after the spontaneous epidural hemorrhage in the spinal canal. Her state has improved after the surgical intervention. The authors attach call attention to the atypic clinical course of this disorders. Because paraclinical diagnostic is not complicated, the effective surgical aid immediately after the origin of the motility disorders may mean the significant rescue of the patient's health.

Female↗
PubMed1990

Two-dimensional ultrasonographic examination through postoperative defects in skull.

The authors describe the advantages of two-dimensional ultrasound examination in patient with skull defects of various origin. It is better to use ultrasound transducer with high frequencies, which have higher discerning capability to distinguish fine anatomic details. In comparison to CT the two-dimensional echoencephalography is harmless for the patient, it enables the monitoring of intracranial situation through an "acoustic window" and examination in several planes.

Brain Diseases↗