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Biomedical subjects

J Gschwend

Publications and source records attributed to J Gschwend.

30 records · Page 2Linked to original sources
PubMed1989

[Isolated spontaneous coronary dissection].

Spontaneous coronary artery dissection is a rare cause of myocardial infarction. It occurs most commonly in young, otherwise healthy women, especially in the peripartum period. Dissections are most often located in the proximal part of the left coronary artery. Histologically a hematoma is found in the media with compression of the true lumen and usually a localized periadventitial inflammation. The etiology of the disease is unknown; hormonal influences and defective collagen metabolism are discussed. Prognosis is poor; only one third of patients survive the first 24 hours after acute onset of symptoms, and mortality is high in the following days and weeks. Surgery may prevent extension of infarction, and for this reason early diagnosis by coronary angiography is essential in patients at risk for this disease. Two cases of coronary dissection are described, followed by a review of the literature and discussion of etiology, prognosis and management.

Adult↗
PubMed1987

Retroperitoneal teratoma presenting as an abdominal-pelvic mass.

Nonovarian teratomas are relatively common neoplasms in children, but are rarely seen in adults. A case of a large retroperitoneal teratoma in a 42-year-old woman is presented. The 21.5-kg tumor originated in the retroperitoneal space inferior to the origin of the superior mesenteric artery, and displaced the contents of the entire abdominal cavity. The duodenum, pancreas, and transverse colon mesentery were incorporated into the tumor's pseudocapsule. Evaluation and operative management are described. Diagnosis and pathogenesis of nonovarian teratomas are reviewed.

Abdominal Neoplasms↗
PubMed1984

Excretion of ibuprofen into breast milk.

Concentrations of ibuprofen in breast milk and serum were compared in 12 patients who had ingested one 400 mg tablet of ibuprofen every 6 hours over a 24-hour period for relief of post-cesarean section pain. Samples of breast milk and blood were obtained simultaneously over a 34-hour period beginning just prior to the first dose of ibuprofen. Gas-liquid chromatography assay methodology capable of detecting 1 microgram/ml was used to determine concentrations of ibuprofen in serum and breast milk. Ibuprofen was present in the serum with a half-life of approximately 1.5 hours. No measurable amounts of ibuprofen were found in the samples of breast milk. The conclusion drawn is that, in lactating women who take up to 400 mg of ibuprofen every 6 hours, less than 1 mg of ibuprofen per day is excreted in breast milk.

Adult↗
PubMed1978

[The dissociated laughing and weeping in apoplectic insult (author's transl)].

A patient with the volitional type of facial palsy showed in the arteriography an obstruction of the middle cerebral artery without affecting the thalamostriatal arteries. As laughing and weeping are motivated in the cerebral trunc they must have been projected through the mesopallium (which includes the thalamus) to the facial nuclei. These two behaviour elements did not show any modification on the paretic side, indicating so, that they are phylogenetic old elements, normally modified by the volitional influence. The original weeping expresses an appeal to the companion, the original laughing the readiness of affilation.

Adult↗
PubMed1977

[Yawning in a case with transsecting glioma of the pons (author's transl)].

A patient with ponsglioma got completely tetraplegic and plegic in all muscles innervated by the caudal brainstem nerves (locked-in syndrome). He could not open or close the mouth, but he was able to yawn. It is concluded that the motivation of yawning stems from the sleep inducing system in the region of the raphe-nuclei and is projected directly to the nuclei of the caudal brainstem nerves.

Adult↗
PubMed1977

[The comparison of human reflex and instinct behaviour (author's transl)].

On the basis of characteristics of the exteroceptive reflexes and of the instincts it was shown that instinct behaviour developed from reflex characteristics (local characteristic of the stimuli, pos. and neg. taxis, habituation, conditioning). Most similarities are found between reflex and avoidance instinct behaviour (instincts for excretion, thermoregulation, body care, pain avoidance and safety). Except the safety instinct, all others react on stimuli, characterised by the localisation of the receptors. In the safety instinct the structure of the stimulus becomes important, together with the growing importance of the third dimension. This instinct shows also for the first time a variability of the threshold with spontaneous remaining low for some time after stimulation of the system. Inverse the gain instincts (nutrition, sex and social instinct). Here the threshold falls spontaneously, when stimuli are lacking and raises, when stimuli are found. The spontaneous motor expression of the lowering of the threshold is the appetite behaviour. It means seeking stimuli, which will be gained by elements of the initial and terminal success behaviour. The successfull nutritional and sexual behaviour is stopped by success inhibition, whereas the social instinct remains in the terminal success behaviour with group dynamic hierarchy, with imitating and helping behaviour. Overchanging of the gain instincts provokes avoidance behaviour with constant threshold. The neural systems of most reflexes lie distributed in the spinal cord and brainstem, the ones of the instincts in the limbic part of the brain, the nutrition and sex instinct with a hypothalamic pacemaker. Simultaneous activation of two or many instinct motivation systems result, not comparable with the direct reflex interaction, in interactions on the level of the global interaction, in interactions on the level of the global integration (summation, mixture, synthesis, rest, oscillation, intention) which projects the activity patterns via the motor cortex to the peripheral neurons. There it is completed by the reflexes. The hormonal and vegetative projection instead go directly to the end organs. The motivation is responsible for the subjective experience, the dominating integration with its motor projection for the instinct behaviour.

Behavior↗
PubMed1977

[Disturbances of the human instinct behaviour in hypothalamic lesions (author's transl)].

Since the findings of W.R. Hess, who systematically stimulated the hypothalamus of the cat, motivational systems for instinct behaviour have been postulated in the hypothalamus and the surrounding limbic brain. It has been asked, if hypothalamic lesions in man would cause alterations in instinct behaviour, which could be attributed to the instinct motivational systems. Therefore 19 patients with hypothalamic lesions have been examined in respect of their instinct behaviour. They showed no qualitative alteration in their instinct behaviour, but quantitative diminution and rarefication of their gain instincts (nutritional, sexual and social instinct). Mainly reduced was the sex instinct together with hormonal deficiency. Inversely the safety instinct (the only avoidance instinct with variable threshold) was more often activated. The other avoidance instincts (for excretion, thermo-regulation, bodycare and painavoidance) remained intact. It is concluded that the pacemaker for the threshold of the gain instincts and of the safety instinct is disturbed and not the motivation system in its qualitative functioning. As this pacemaker is so characteristically different in each instinct, the theory of different specific motivational systems is more probable than the theory of one unspecific system with different functions.

Brain Diseases↗
PubMed1976

[Ovulation inhibitors from a neurological viewpoint].

It is increasingly accepted that oral contraceptives foster thromboembolic diseases (chiefly cerebral ictus) by affecting hemostatic mechanisms causing intimal proliferation. Since 1968 the antithrombotic activity of Aspirin has been under study, and Aspirin has proven effective in preventing arterial thrombosis. Therefore, if oral contraceptives foster arterial thrombosis, Aspirin may prevent cerebral thrombosis in women on oral contraceptives. Six women with cerebral ictus (the incidence is 10 times higher than in men of the same age and in women not on oral contraceptives) have undergone chest X-ray and ECG. Two underwent pulmonary scintigraphy and 1 pulmonary arteriography. They did not exhibit signs of thrombosis in pulmonary veins or in the heart, a fact which suggested primary cerebral thrombosis. This was verified by cerebral arteriography. Accordingly, Aspirin in a dose not exceeding 1 g per day may be effective in the prevention of ictus. In vizw of the well known side effects of Aspirin, this hypothesis would need to be tested in a prospective study.

Adult↗