PubMed Health⌕ Search

Biomedical subjects

J P Reulen

Publications and source records attributed to J P Reulen.

14 recordsLinked to original sources
PubMed1989

Method for the measurement of susceptibility to decubitus ulcer formation.

A method for measuring the susceptibility of a patient to develop decubitus ulcers is described and initially evaluated. It is based on an indirect, noninvasive measurement of the transient regional blood flow response after a test pressure load which simulates the external stimulus for pressure-sore formation. This method was developed to determine the individual risk of a patient and to study the subfactors which contribute to the susceptibility. This would also offer the possibility of evaluating the effect of preventive treatment aimed at reducing the susceptibility. The method was found to discriminate between preselected elderly patients at risk on the one hand, and non-risk patients and healthy young adults on the other hand. No differences in blood flow responses were found between the non-risk elderly patients and the healthy young adults. This suggests that age per se is not a factor in the formation of pressure sores. In the risk group the recovery time after pressure relief was found to be three times as long as the duration of the pressure exercise. This indicates that the recovery time after pressure exercise may be as important as the period of pressure exercise in deducing the risk of developing decubitus ulcers.

Adult↗
PubMed1989

The pupillary light reflex in diabetes mellitus: evaluation of a newly developed infrared light reflection method.

Pupillary light reflexes were measured in 18 diabetic patients without clinical signs of neuropathy and in 18 control subjects, using a newly developed infrared light reflection technique called IRIS. This method has some important advantages. Apart from being non traumatic, it enables the recording of dynamic pupillary light reflexes simultaneously in both eyes. Furthermore, it has a large amplitude and time resolution (1 ms), permitting accurate determination of latency values. It was found that 78% of the diabetic patients show a significantly prolonged latency of the constriction reaction, while 39% of the diabetic patients show an abnormally prolonged dilatation latency. All patients with an abnormally prolonged dilatation latency also show a prolonged constriction latency. This finding suggests that in diabetes mellitus the parasympathetic system is affected before abnormalities of the sympathetic nervous system can be demonstrated. Assessment of the pupillary light reflex, using the sensitive IRIS method, is an easily applicable and reliable method for detection of subclinical autonomic nervous system dysfunction associated with diabetes mellitus. The method may also provide an objective tool for the assessment of therapy results in diabetic neuropathy.

Adult↗
PubMed1988

Autonomic nervous function in Huntington's disease.

Autonomic nervous system function was studied by means of a series of standardized tests in 11 patients with Huntington's disease (HD) and in 11 age- and sex-matched controls. Two statistically significant differences were found. The blood pressure response to sustained handgrip was diminished and the pupillary light reflex latency was increased in the HD group. The former probably reflects diminished input from higher centers on an otherwise intact sympathetic nervous system. The latter may indicate involvement of the pretectal or Edinger-Westphal nuclei in HD. No further signs of autonomic nervous system dysfunction were found.

Adult↗
PubMed1988

Pupillary light reflex and quantitative sensory and motor neural function tests in diabetic patients.

In 29 diabetic subjects with or without symptoms of diabetic peripheral and autonomic neuropathy, the association between the pupillary light reflex (the latency of the constriction of the pupil) and various sensory and motor neural measurements, duration of diabetes and quality of glycaemic control was evaluated. Compared with normal subjects the latency of the constriction reaction of the pupil was significantly prolonged in the group of diabetics (mean +/- SEM: 236.3 +/- 5.8 ms versus 210.5 +/- 3.7; P less than 0.001). Thermal discrimination thresholds were positively correlated with the latency of the constriction reaction of the pupil (r = 0.43, P less than 0.025). Vibratory perception threshold, motor nerve conduction velocity of the peroneal nerve, H-M interval of the Hoffmann reflex and duration of diabetes were not correlated with the constriction latency, whereas glycaemic control showed a weak correlation. It is concluded that there may be a relationship between autonomic (parasympathetic) pupillary dysfunction and peripheral small nerve fibre dysfunction.

Adult↗
PubMed1988

Oculomotor control in Gilles de la Tourette syndrome.

Saccadic eye movements, fixation and smooth pursuit were studied in 28 children with Gilles de la Tourette syndrome and found to be normal. A link has been postulated between Gilles de la Tourette syndrome and other movement disorders. The results obtained in the present series do not support this hypothesis.

Adolescent↗
PubMed1986

The diagnosis of multiple sclerosis. Contribution of non-clinical tests.

A group of 89 patients in whom multiple sclerosis (MS) has been clinically diagnosed with varying degrees of certainty, and 25 patients with optic neuritis (ON), were subjected to the following electrophysiological tests: visual evoked response (VER), auditory brainstem-evoked response (ABER), somatosensory-evoked response (SSER), blink reflex and electronystagmography (ENG). All these patients also underwent computerized tomography (CT scan) and analysis of cerebrospinal fluid (CSF). A new diagnostic procedure is proposed, combining optimum detection of definite MS with optimally economical use of the above-mentioned non-clinical tests. The results for the MS patients show that definite MS can be diagnosed much more frequently (72%) if abnormal results in the above-mentioned tests are accepted as evidence of a (subclinical) CNS lesion. Application of the clinical diagnostic criteria of McAlpine yielded "definite MS" only in 27% of our patient material. Our diagnostic criteria showed evidence for MS in 36% of the patients clinically diagnosed as having ON. The test results were inconclusive as regards the possibility of the remaining ON patients developing MS in the future.

Adult↗
PubMed1986

Horizontal and vertical saccadic eye movement abnormalities in Huntington's chorea.

With a newly developed infrared reflection technique, voluntary saccadic eye movements (VOLS), visually evoked saccades (VES) and unsuppressed visually evoked reflex saccades (USVERS) were measured in 11 patients with Huntington's chorea. Abnormalities, including latency increase, peak velocity decrease and undershoot dysmetria with multiple step saccades were found in all types of saccadic eye movements. Peak velocity decrease and undershoot dysmetria can be explained by dysfunction of the brainstem reticular formation in Huntington's chorea. USVERS and square wave jerks occurred abnormally frequently and showed direction-dependent differences. Both were more frequent in horizontal than in vertical direction. Frequency of USVERS and square-wave jerks tended to be correlated. These findings point to disinhibited superior colliculi as a possible common supranuclear origin of USVERS and square-wave jerks in Huntington's chorea.

Adult↗
PubMed1985

Electrophysiological disorders in multiple sclerosis and optic neuritis.

Visual evoked response (VER), auditory brainstem evoked response (ABER), somatosensory evoked response (SSER), blink reflex and electronystagmographic (ENG) investigative methods were applied to a group of 89 patients with Multiple Sclerosis (MS) and Optic Neuritis (ON). The MS patients were classified as definite (n = 31), probable (n = 31) and possible (n = 27). The aim of this study was to determine the diagnostic value of the five electrophysiological tests in MS. VER and ABER recordings were found to reveal the highest number of asymptomatic abnormalities (33 and 31 percent respectively). The combination of VER, ABER and ENG revealed all possible electrophysiological disorders. As these tests are completely non-invasive it is proposed, that a combination of two of these three tests is useful for the detection of a second silent lesion in patients with suspected MS showing purely spinal signs (VER, ENG, ABER) and/or a history of uncomplicated ON (ABER, ENG).

Adult↗
PubMed1985

Brainstem involvement in multiple sclerosis: a clinical and electrophysiological study.

A major aim of this study was to determine the diagnostic value of 4 electrophysiological tests in MS, and particularly their effectiveness in detecting signs of brainstem involvement. Therefore, auditory brainstem evoked response (ABER), somatosensory evoked response (SSER), blink reflex and electronystagmographic (ENG) investigative methods were applied to a group of 89 patients with definite, probable or possible multiple sclerosis (MS). The 4 methods yielded interdependent data, especially where the brainstem function was concerned, thus it can be concluded that a single demyelinating lesion may cause a combination of electrophysiological disorders within a small structure such as the brainstem. ENG recordings were found to reveal the highest number of asymptomatic abnormalities. The combination of ABER and ENG tests revealed electrophysiological disorders in 81% of all patients. The blink reflex and the SSER tests gave hardly supplementary information.

Adult↗