Biomedical subjects

J Obenberger

Publications and source records attributed to J Obenberger.

At least 19 recordsLinked to original sources

PubMed2005

Is it possible to actively and purposely make use of plasticity and adaptability in the neurorehabilitation treatment of multiple sclerosis patients? A pilot project.

OBJECTIVE: To investigate whether neurorehabilitation is able to influence clinical parameters and brain function measured radiologically. DESIGN: A group of healthy probands was compared with two groups of multiple sclerosis (MS) patients, one of which received rehabilitative therapy. SETTING: Outpatient in a university hospital. SUBJECTS: Twenty-eight patients with multiple sclerosis (MS), 17 of whom received rehabilitative therapy, and 13 healthy controls. INTERVENTIONS: Two months of rehabilitative eclectic therapy based on principles of sensorimotor learning and adaptation. MAIN MEASURES: Multiple Sclerosis Functional Composite, Modified Fatigue Impact Scale, Beck Depression Inventory Score, Barthel Index, Environment Status Scale and Multiple Sclerosis Quality of Life--54, and functional magnetic resonance imaging (fMRI). RESULTS: Patients who underwent neurorehabilitation showed a greater drop in fatigue, depression, impairment, disability and handicap and more improvement in quality of life than those who did not receive therapy. Correlation of brain activity between the right and the left hemisphere is greater in healthy individuals than in MS patients. Neurorehabilitation resulted in a trend for increased correlation between the left and the right hemisphere in patients (approaching the standard). In comparison with control groups, signal amplitudes in anatomical areas did not show any significant changes. CONCLUSION: Clinical changes seen with neurorehabilitation were not associated with any detectable changes in fMRI observations.

Case-Control Studies↗

PubMed2003

[Multiple sclerosis and magnetic resonance].

Multiple sclerosis is a demyelinating process presently referred to autoimmune diseases. Its diagnostics is based on clinical examination and paraclinical tests (magnetic resonance, examination of CSF and evoked potentials recording). Magnetic resonance (MR) has the highest significance, both for the diagnostics and for the monitoring of the course of disease and results of treatment. Results of magnetic resonance are not specific for the multiple sclerosis and therefore for the reliable diagnosis the McDonadl's criteria have to be fulfilled. It appears that magnetic resonance is more sensitive to progression of disease than the clinical examination. Monitoring of the course of disease requires new techniques of MR imaging. Automatic, software assisted determination of plaque volumes in T2 and T1 weighted images--so called "lesion load", is checked during the patient's treatment. Assessment of brain volume determines progression of atrophy. The aim of all the new methods of MR imaging is to search for a reliable technique of the disease monitoring and namely for the prediction of disease progression.

Brain↗

PubMed2002

Adipose tissue distribution in obese females. Relationship to androgens, cortisol, growth hormone and leptin.

Adipose tissue distribution predicts development of obesity complications better than total adipose tissue content. The aim of the study was to evaluate the role of the hormonal factors contributing to the adipose tissue distribution in obese females. The cohort examined consisted of 94 women in the range of overweight to obesity, aged 44.2 +/- 11.2 years (21-67), weight 100.1 +/- 17.5 kg (65.8-148), BMI 37.13 +/- 5.72 kg/m2 (26.4-50.7). Adipose tissue (AT) distribution was examined by CT at level L4/5 and intraabdominal adipose tissue and the subcutaneous abdominal adipose tissue area (IAAT and SAAT, respectively) were determined. Growth hormone (GH), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEAS), cortisol, testosterone, androstene-dione, SHBG, total thyroxine, total triiodothyronine (T3), TSH and leptin were assessed by routine methods by RIA and CLIA. GH, DHEA and DHEA-S correlated significantly negatively with IAAT (r = -0.24, p < 0.05, r = -0.30, p < 0.01, r = -0.34, p < 0.005, respectively). A borderline significant negative correlation of T3 with IAAT was shown (r = -0.20, p = 0.054). A significant positive correlation of SAAT with total testosterone and serum leptin was found (r = 0.27, p < 0.01, r = 0.64, p < 0.001, respectively). When comparing the difference of individual hormone levels between the 1st and 5th quintile of IAAT, no significant difference between the groups was found after adjustment for weight and age. In contrast, when comparing the 1st and 5th quintile according to the SAAT a significantly lower total testosterone and leptin in the 1st quintile of SAAT was found. Only in leptin the difference remained significant after adjustment for adipose tissue content. In conclusion, the results suggest that the relationship of individual hormones examined in this study to the central adipose tissue distribution are mostly mediated by age and adipose tissue content; they do not seem to be in a causal connection with the intraabdominal adipose tissue content. The only exception concerns leptin, which is significantly related to the subcutaneous abdominal adipose tissue area.

Adipose Tissue↗

PubMed2001

Magnetic resonance imaging in diplegic form of cerebral palsy.

Eighteen children with diplegic form of cerebral palsy (CP) underwent magnetic resonance imaging (MRI) because of the enlarged occipital horns of both lateral ventricles found on previous computerized tomography (CT). In 16 of them squint was present. MRI in flow attenuated inversion recovery (FLAIR) and turbo spin echo (TSE) modes (T2 weighted images) best showed white matter lesions in occipital areas in all patients with squint, while no white matter changes could be detected in CT (in retrospect), thus proving the superiority of MRI in examining CP children. The authors postulate that the hemispheric occipital lesion causing impairment of visual co-ordination may result in squint.

Adolescent↗

PubMed1999

[Magnetic resonance imaging in the diagnosis of prostatic carcinoma].

The standard diagnostic and staging evaluation of prostate cancer includes digital rectal examination, transrectal ultrasonography (TRUS), serum prostate-specific antigen (PSA) level measurement, abdominal pelvic CT and radionuclide bone scan. Magnetic resonance imaging (MRI) (especially endorectal magnetic resonance) opens new possibilities for diagnostic imaging of the prostate. It seems to be better for detecting seminal vesicle invasion. Unfortunately, sensitivity in evaluation of minor capsular and seminal penetration is low and differentiation between haemorrhage, chronic inflammatory, fibrotic changes and tumours is impossible.

Carcinoma↗

PubMed1999

MRI in an unusually protracted neuronopathic variant of acid sphingomyelinase deficiency.

MRI was performed in two siblings with the neuropathic sphingomyelinase deficiency caused by identical mixed heterozygosity in the structural acid sphingomyelinase gene. The clinical phenotype of the cases is unique in showing a rather protracted course, both having reached the fourth decade. Pronounced cerebellar and mild supratentorial atrophy was seen on MRI in both siblings, in contrast to their strikingly different clinical status. One has no overt neurological deficit, while the second had neocerebellar symptoms and signs, nystagmus and cranial nerve palsies for some years. The MRI findings, together with the cherry-red spot in the ocular fundus, ultrastructurally proved storage in cutaneous nerve Schwann cells and the histopathologically proven brain neuronal storage in a third sibling who died after a relatively rapid course dominated by fatal visceral storage, is evidence that a remarkably restricted neuropathology can be caused by this enzymopathy.

Adult↗

PubMed1999

Osteoblastoma in lumbar vertebral body.

We report a young man with low back pain suspected to have a disc protrusion. Imaging suggested a tumour of the dorsal portion of the fifth lumbar vertebral body. Operation suggested a giant-cell tumour and subsequent histology showed an osteoblastoma. All typical imaging features of osteoblastoma are demonstrated in this rather uncommon location. Contrast-enhancing bone-marrow oedema on MRI, with mild enhancement of the tumour, together with the CT appearances were the clues to the diagnosis.

Adult↗

PubMed1999

[EEG findings in patients with systemic lupus erythematosus].

We have examined electroencephalography (EEG) and Mini-Mental State Examination (MMSE) in 38 patients with verified diagnosis of systemic lupus erythematosus (SLE). In the clinical neurological finding there were epileptic attacks in 9 patients, 10 patients suffered from stroke, 15 patients from lupus headache, 4 patients from psychosis, in 15 patients cranial neuropathy was present, in one person extrapyramidal syndrome. EEG findings were in 12 patients normal (32%), in 26 patients abnormal (66%). In 3 cases there were focal abnormalities (8%), in 19 cases episodic ones (48%), four times abnormalities were diffuse (10%). Diffuse abnormalities correlated in EEG findings with case history of GM attacks.

Adult↗

PubMed1999

[Mutation in the beta3-adrenergic receptor gene (Trp64Arg) does not influence insulin resistence, energy metabolism, fat distribution and lipid spectrum in young people. Pilot study].

UNLABELLED: A missence mutation Trp64Arg in the beta3-adrenergic receptor gene is associated with obesity, insulin resistance, a lower metabolic rate and the earlier onset of NIDDM but the published results are controversial. We investigated the effect of this mutation on insulin resistance (euglycemic hyperinsulinemic clamp), on fat mass and fat distribution (anthropometry, bioimpedance, CT) and resting metabolic rate (indirect calorimetry), lipid spectrum and other metabolic disturbances in Czech juveniles recruited from juvenile hypertensives (H, n = 68) and controls (C, n = 81). The frequency of this mutation (determined by digestion of 210 bp PCR product with MvaI) was double in H than in C (14.7%, vs. 7.4%) and the carriers of Arg64 allele had sig. higher fasting glucose (H: p = 0.002. C: p = 0.025). Four Trp64/Arg64 and six Trp64/Trp64 men (age 23 +/- 4.2, vs. 22.5 +/- 1.9 y, BMI 26 +/- 5.5, vs. 22.9 +/- 5.1 kg/m2) took part in a detailed pilot study. But no signif. differences (Horn's method) in fasting glucose (4.6 +/- 0.6, vs. 4.9 +/- 0.4 mmol/l), in parameters of insulin resistance (M-value150-180 min. 9.1 +/- 1.1, vs. 8.9 +/- 1.5 mg glucose/kg.min(-1)), resting metabolic rate/lean body mass (RMR/kg LBM: 78.6 +/- 4.6, vs. 85.6 +/- 23.2 kJ/kg), lipid spectrum and other screened parameters were found. The lowest resting metabolic rate (RMR/kg LBM 55.4; 62.6 kJ/kg) was found in brothers (both C, Trp64/Trp64) who highly differ in body constitution (BMI 19.0 resp. 32.4 kg/m2). We suppose that in this case the energy metabolism is probably determined by other genetic loci and does not correlate with body fat mass. CONCLUSION: Our pilot study does not confirm the influence of Trp64Arg mutation in heterozygous carriers on insulin resistance, energy metabolism and lipid spectrum.

Adipose Tissue↗

PubMed1998

[Differential diagnosis of expansive lesions in the sellar region using magnetic resonance imaging].

Diagnosis of the type of expansive pathological lesion in the sellar region is of fundamental importance. Magnetic resonance is an imaging method which proved dominant and provides most information from the sellar region. Although no sign in the MR image is quite specific for a certain lesion, the substrate diagnosis can be assessed with a considerable probability. The presented paper gives an account of the authors experience supplemented by literature on the problem.

Brain Neoplasms↗

PubMed1998

[Therapeutic effect of Myolastan on increased muscle tone of various etiologies].

The authors tested in 101 patients the clinical effect of Myolastan (tetrazepam), generic name 1,4, benzodiazepine (BZD), in indications with increased muscular tonus of varying etiology. The drug has a balanced affinity to central and peripheral benzodiazepine receptors, it enhances the presynaptic inhibition of GABAergig neurones at the peripheral and supraspinal level. Clinical experience has shown that a decline of the increased muscular tonus in the affected segment mitigates subjective complaints, in particular pain, if the dosage and time of administration are adjusted for every individual patient. A favourable effect was proved during clinical administration to a heterogeneous group of patients which reflects the spectrum of our ambulatory patients with a locally increase muscle tonus. In addition to vertebrogenic complaints, non-discogenic and discogenic (proved by MR or CT), the group of patients comprised also some with multiple sclerosis. In the latter a favourable effect was recorded in 50%. The effect on spasticity in these patients was comparable with other drugs used by the patients before administration of Myolastan. The heterogeneous group of the remaining patients to whom Myolastan was administered suggests its possible further indications, without the possibility of significant conclusions. Possible side-effects could be eliminated by the administration of low doses in the evening or at night. Myolastan extends the range of drugs which have an impact on an increased muscular tonus.

Anti-Anxiety Agents↗

PubMed1997

[Magnetic resonance imaging of intracerebral hemorrhage].

Computerized tomography (CT) followed with magnetic resonance imaging (MRI) several years later enabled first the direct visualization of extravascular blood and products of it's degradation. Protein component of hemoglobin is from over 90% responsible for the hyperdensity of CT image in case of a hemorrhage, whereas paramagnetic properties of hemoglobin derivates are responsible for signal changes in MRI. CT is capable to diagnose accurately just an acute hemorrhage. It changes towards hypodensity in 3 weeks with posthemorrhagic pseudocyst as a final result that has rather low specificity. Differentiation from contusion, ischemic lesion or even astrocytoma may be difficult. CT has thus "short memory" for hemorrhage. MRI can differentiate 5 stages of hemorrhage according to the time schedule: hyperacute, acute, subacute stage I, subacute stage II and chronic. Sequel of a hemorrhage is detectable even years after the hemorrhagic event. The development of intracranial hemorrhage in daily routine MR imaging is described and documented to serve as a guide of model situation for the use of physician.

Brain↗

PubMed1996

[Imaging methods, particularly magnetic resonance, in multiple sclerosis].

Multiple sclerosis (MS) can only be diagnosed with a certain probability. There are neither any specific moments in the medical history of the patient, nor clinical or paraclinical tests as well as their combinations that would prove the diagnosis. In the daily routine the most common criteria we use are of Schumacher, Poser and Bartel. Until the magnetic resonance imaging (MRI) had been introduced into the clinical practice, imaging methods were used to exclude other treatable lesions (e.g. tumors, arteriovenous malformations etc.), even though computerized tomography (CT) successfully demonstrated some of the plaques. In the MS CT is both insufficiently sensitive as well as specific. On the contrary MRI is in the MS highly sensitive, 92-98% specificity has been achieved among clinical definite cases. MR is nowadays a method of choice for not only the diagnosis but also for the further follow up of our MS patients. Multiple focal hyperintense lesions on T2 weighted images (T2WI) or the flow attenuated inversion recovery imaging mode (FLAIR) are the typical pathological findings.

Brain↗

PubMed1996

[False-negative native CT findings in the development of cerebral ischemia].

BACKGROUND: The "fogging effect" in the native CT picture of the brain masks in case of a cerebrovascular attack the pathological finding of hypodensity by creating a neovascular net necessary for the clearing activity of macrophages. METHODS AND RESULTS: The "fogging effect" was diagnosed on CT and monitored as a transient finding in a patient after a cerebrovascular attack. The submitted paper analyzes in detail and explains the dynamically developing clinical symptomatology of the patient. CONCLUSIONS: The "fogging effect" can be the source of erroneous clinical interpretation of a CT finding. It is important to know about its existence, and in case of diagnostic doubts, consider the i.v. administration of a contrast substance even though the perfusion may temporarily deteriorate. Visualization of an ischaemic focus by contrast provides unequivocal evidence of the extent and site of malacia.

Adult↗

PubMed1996

[Computed tomography of the upper respiratory tract in patients with apnea].

BACKGROUND: When deciding on the therapeutic procedure in sleep apnoea syndrome (SAS) it is important to know the anatomical conditions of the upper airways. METHODS AND RESULTS: We examined on account of SAS, verified by all night monitoring, using the MESAM4 method a total of 60 patients by means of computed tomography (CT). SAS without associated disease was diagnosed in 48 patients. To facilitate comparison of results of (CT) and MESAM4 we defined the MESAM4 score (M4) as the number of desaturations per hour multiplied by their depth (difference between mean minimal and basic saturation). Axial sections, 5mm thick at 5mm intervals were made from the level of the hard palate to the upper trachea in a vertical position to the longitudinal axis of the pharynx in the patient awake at the peak of the inspirium. The air-filled area, sagittal and coronary sections were measured at five levels (nasopharyngeal, velopharyngeal, retrobasilingual, at the level of the hyoid bone and trachea). The results differed significantly from the normal population examined by the same protocol (foreign standards). Macroglossia as a factor promoting SAS was also examined. CONCLUSIONS: The frontal and sagittal reformation reflected, on account of numerous inaccuracies, the actual state only partly. When the borderline between mild and more severe apnoea was set at M4 = 300, the correlation with the retrobasilingual section and coronary and velopharyngeal section was best. The authors suggest a simpler CT examination protocol which improves further the prediction of severity of SAS. The correlation with the body mass index (BMI) and the neck circumference (p < 0.001) confirmed the asset of CT parameters.

Adult↗

PubMed1995

[Selegiline in the treatment of Alzheimer's disease].

Alzheimer's disease accounts for 60-70% of all dementias. Although its etiology has not been elucidated so far, its multiple transmitter effect has been proved reliably. Treatment with selegiline, 10 mg per day, which blocks irreversibly monoaminooxidase type B, when administered on a long-term basis, revealed improvement of cognitive functions and of general functional fitness during objective examinations by means of a battery of psychometric tests. The danger of a hypertensive crisis due to excessive supplies of exogenous monoamines ("cheese effect") can be ruled out when this dose is used. Selegiline has moreover a detoxicating potential and the ability to block the transformation of some protoxins into an effective toxin. The reduced formation of free radicals is of particular importance. The latter participate in a significant way in the destruction of cellular membranes, proteins and nucleic acids. In experiments on rats selegiline improves sexual functions, learning and its use significantly prolongs survival. As a symptomatic drug selegiline is the drug of choice in AD. Only future studies will show the justification of extensive preventive medication in advanced age groups.

Alzheimer Disease↗

PubMed1991

[Fenestration of the anterior cerebral artery. Personal observation].

The authors demonstrate a patient with fenestration of the anterior cerebral artery. The fenestration is in the horizontal portion of the anterior cerebral artery (A1). Its embryonic origin and clinical importance arouse discussion. The paper reviews the literature on the subject.

Aged↗

PubMed1989

Lecithin cholesterol acyltransferase and possible origin of lysolecithin in rabbit aqueous after a damage of blood-aqueous barrier.

Rabbit eye aqueous humor contains lysolecithin (LPC); the LPC concentration markedly increases, if the integrity of the hemato-aqueous barrier is impaired. It is assumed that LPC plays a causal role in the development of cataract because of its detergent action. We have studied the mechanism of LPC cumulation in the aqueous after a mechanical, endotoxic or immunological damage to the hemato-aqueous barrier. We measured in aqueous samples the activity of lecithin cholesterol acyltransferase (LCAT, EC 2.3.1.43), an enzyme which produces LPC and cholesteryl esters in the plasma. The transfer of phospholipids from the plasma into the aqueous was examined in vivo in 32p-prelabeled rabbits. Whereas LCAT was absent in the aqueous humor of intact eyes, an increased transesterification activity could be detected in all cases of impaired hemato-aqueous barrier. The proportion of LPC in aqueous phospholipids was similar to that found in high density lipoproteins, whereas whole plasma and low density lipoproteins contained a much lower proportion of LPC. An increased plasma level of LPC induced by the treatment of rabbits with phospholipase A2 in vivo, did not by itself lead to a preferential passage of plasma LPC through the blood-aqueous barrier. The experimental results rather imply that an impaired blood-aqueous barrier permitted an enhanced transfer from the plasma of intact HDL carrying also LPC and LCAT, and that the enzyme subsequently produced increased amounts of LPC in situ.

Animals↗