PubMed Health⌕ Search

Biomedical subjects

J Mewes

Publications and source records attributed to J Mewes.

6 recordsLinked to original sources
PubMed1997

[Coma-associated neuropathy].

To evaluate signs of peripheral nerve dysfunction, over a period of 31 months all patients treated for more than 14 days in our intensive care unit (ICU) had clinical and electrophysiological examination. The results of 78 patients were analysed: 53 had diseases of the central nervous system, 25 suffered from general cerebral hypoxia, mainly after cardiopulmonary reanimation. 54 showed bilateral signs of denervation activity, additionally 10 patients had fibrillation potentials unilateral to their spastic hemiparesis. 19 patients had denervation potentials only in proximal muscles of the upper limbs. Generalized denervation activity developed mainly after septic organ failure. On the other hand 35 patients showed denervation potentials already between day 14 and 21, suggesting an affection of peripheral nerve function in the first week of ICU treatment. Time course, pattern of distribution and frequency of electrophysiological abnormalities are not generally consistent with alterations of nutrition, metabolism or hypoxia in the course of ICU treatment. Clinical signs of peripheral nerve dysfunction were present in 40% of the patients showing denervation in the EMG.

Adolescent↗
PubMed1997

[Megadolicho basilar artery as indication of intensive care relevant vertebrobasilar ischemia].

An ectasia and enlargement of the basilar artery by a fusiform aneurysm is called megadolicho basilaris. We report five cases with this condition identified at our clinic since 1989, reflecting an incidence of 0.05 percent (5/9300 scans). All patients presented with an acute brainstem syndrome (medullary in 2, pontine in 1 and pontomedullary in 2 patient). With one exception, all cases required intensive care due to respiratory insufficiency. Two patients died, one required total care, and two patients made a good recovery, one of these under therapeutic anticoagulation. All but one patient experienced additional episodes of cerebrovascular ischemia before or after presentation. Vascular risk factors were found in four patients. The detection of a megadolicho basilaris identifies a patient subgroup that is highly prone to vertebrobasilar ischemia and therefore of high significance for neurological intensive care medicine. Recurrence rate for ischemia is high. While even a severe brainstem syndrome may be reversed under anticoagulation in the individual case, presence of multiple vascular risk factors often prevents the employment of this treatment modality.

Aged↗
PubMed1995

An unusual case of central nervous system cryptococcosis.

Opportunistic infections of the central nervous system (CNS) in immunocompromised patients often represent a diagnostic and therapeutic challenge due to the variety of possible infectious agents causing CNS disease. We report the case of a severely immunocompromised 43-year-old woman presenting with headache, confusion, abnormal CSF findings (cell count 237/mm3 with 50% eosinophils and elevated protein), multiple contrast enhancing lesions on CT and MRI in the basal ganglia, and serologic findings compatible with latent or reactivated toxoplasmosis with high IgA and IgG antibody titers against Toxoplasma gondii in whom a final diagnosis of CNS cryptococcosis was made. This case illustrates the considerable difficulties in the differential diagnosis of opportunistic CNS infection in the immunocompromised host. We conclude from our report that (1) the diagnosis of toxoplasma encephalitis should not be based on serological findings but rather be proven by either PCR, mouse inoculation or brain biopsy, (2) CNS cryptococcosis can be associated with marked CSF eosinophilia and multiple cryptococcomas, and (3) cryptococcomas can persist on CT and MRI despite successful antifungal treatment.

Adult↗
PubMed1994

[Sex differences in the structure of the normal porcine myocardial wall].

The myocardium of 20 young sows, 20 young boars, 10 old boars and 10 old sows was studied histometrically. Significant sex-depending differences in the structure of the normal cardiac wall could be observed. In first line--exactly as in man--the diffusely distributed intramyocardial connective tissue is significantly higher in adult female subjects than in male ones. Later on, it changes and the amount of intramyocardial connective tissue is reduced in older sows. An interaction is suggested between the content of intramyocardial connective tissue and the estrogen level.

Animals↗
PubMed1988

Prognosis of acute polyneuritis requiring artificial ventilation.

We compared two selected groups of patients with acute Guillain-Barré syndrome requiring artificial ventilation. Both groups were treated with conventional therapy, group A (n = 35) between 1970 and 1978, group B (n = 21) between 1979 and 1983. Neither plasmapheresis nor any other immunosuppressive treatment was applied. Significant differences were found favouring group B: There was a decline of mortality from about 60% to less than 10% (p less than 0.001) and a smaller number of severe complications due to improvement of supportive care.

Acute Disease↗