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Biomedical subjects

K Wester

Publications and source records attributed to K Wester.

At least 91 records · Page 5Linked to original sources
PubMed1991

Dichotic listening during forced-attention in a patient with left hemispherectomy.

A young left-handed girl with an extensive posttraumatic lesion in the left hemisphere was tested with dichotic listening (DL) under three different attentional instructions. The major aim of the study was to evaluate a structural vs attentional explanation for dichotic listening. As both her expressive and receptive language functions were intact after the lesion, it was assumed that the right hemisphere was the language-dominant one. In the free-report condition, she was free to divert attention to and to report from both ear inputs. In the forced-right condition, she was instructed to attend to and report only from the right ear input. In the forced-left condition, she was instructed to attend to and to report only from the left-ear input. Her performance was compared with data from a previously collected sample of normal left-handed females. Analysis showed that the patient, in contrast to the normal sample, revealed a complete right-ear extinction phenomenon, irrespective of attentional instruction. Furthermore, she showed superior correct reports from the left ear, compared with those of the normal sample, also irrespective of attentional instruction. It is concluded that these results support a structural, rather than attentional explanation for the right-ear advantage (REA) typically observed in dichotic listening. The utility of validating the dichotic listening technique on patients with brain lesions is discussed.

Adolescent↗
PubMed1990

Interaction between human brain tumour biopsies and fetal rat brain tissue in vitro.

The invasiveness of human intracranial tumours was studied in an organ culture system. Biopsies from six glioblastomas, four astrocytomas, two mixed gliomas, one ependymoma, four meningiomas and two carcinoma metastases were cut into fragments of 0.5 mm diameter, and placed in agar overlay tissue culture. The tumour specimens formed spheroids which were co-cultured with cell aggregates or fragments from fetal rat brain for up to 10 days in vitro. The invasiveness of the glioblastoma spheroids was characterised by a gradual destruction of normal brain tissue by tumour cells, followed by replacement of normal tissue by these cells. Co-cultures from two glioblastomas showed lesions in the normal brain tissue in areas removed from the tumour cells. Tumour spheroids from four glioblastomas totally destroyed the normal brain tissue without any change in the original tumour spheroid configuration. The low-grade gliomas were less invasive than the glioblastomas. The meningiomas and the metastases were non-invasive. This organ culture assay appeared to reflect the in situ invasive behaviour of the brain tumours examined. It is suggested that it may be used for evaluating the aggressiveness of individual brain tumours with the specific aim of correlating clinical data with the biological character of the tumour.

Adolescent↗
PubMed1990

Dynamic aspects of expanding cava septi pellucidi et Vergae.

Two paediatric patients with expanding cysts of the cava Vergae et septi pellucidi are presented. In the first patient, consecutive CT scans showed a growing cavum thought to be responsible for his dramatic increase in head circumference. In the other patient, the expanding cavum was discovered because a routine skull X-ray after minor head trauma revealed marked impressiones digitatae. Both patients were successfully treated with stereotactically placed internal shunts from the cysts via the lateral ventricle to the subarachnoid space. During this procedure, contrast medium was instilled, and the cysts were visualized on postoperative CT scans. Some dynamic aspects of such expanding cava are discussed.

Brain Diseases↗
PubMed1990

The role of the left and right thalamus in language asymmetry: dichotic listening in Parkinson patients undergoing stereotactic thalamotomy.

Fourteen patients with Parkinson's disease (rigidity and unilateral tremor as main symptoms) were treated with stereotactic thalamotomy. The operation was performed in either the left or right ventrolateral thalamus, depending on which hand (or foot) was most affected with tremor. Nine patients were operated on the left side and four on the right side. All patients were tested for asymmetry of language functioning with dichotic presentations of consonant-vowel (CV) syllables. The patients had to indicate which of the two syllables he/she heard on each trial. Dichotic listening was performed before and after the operation, as well as during electrical stimulation of the VL nucleus just before the lesion was carried out. The results revealed essentially three things: an overall reduced right ear advantage (REA) in the patient group compared to what is known from studies of healthy individuals; an increase in REA during left-sided stimulations; and a marked reduction in REA after left-sided lesions. It is concluded that the present data support the notion put forward by Ojemann (e.g., 1975) of a lateralized activating gating mechanism in the left VL nucleus that gates access for language information to the appropriate cortical areas. The gating mechanism seems to be activated by stimulation, and deactivated after lesions. Dichotic listening may thus be a heuristic instrument in assessment of language functions in Parkinson patients.

Adult↗
PubMed1990

Stereotaxic thalamotomy--experiences from the levodopa era.

After the introduction of levodopa drugs in the late 1960s, the number of thalamotomies fell dramatically world wide. However, as the Parkinsonian tremor proved rather resistant to levodopa treatment, the interest in this operation has been reviewed. During 1978-86, 51 stereotaxic thalamotomies were performed in 48 patient in our department. Thirty three of these patients had Parkinsonism, nine multiple sclerosis (MS) and the remaining six had various other involuntary movement disorders. The operation was most useful in the Parkinsonian group. Nearly 80% of these patients gained a substantial benefit in their daily lives. Patients with MS were all in advanced stages of the disease, and the operation was tried as a last resort. They had less benefit and more complications from operation than the other patients.

Aged↗
PubMed1990

Dichotic listening in an aphasic male patient after a subcortical hemorrhage in the left fronto-parietal region.

Dichotic listening (DL) performance to consonant-vowel (CV) syllables is reported in an aphasic right-handed male patient. The patient suffered initially from a complete expressive aphasia after an intracerebral hemorrhage caused by the rupture of an arteriovenous malformation (AVM) underlying Broca's area. The patient was tested three times with DL; one week after the hemorrhage, five weeks after, and after at about 6 months. At the first test he could not speak, but understood well. At the second test he uttered one-syllable words, and could answer "yes" and "no" to questions. At the third test he could speak whole sentences, although slow and "stutter-like." Dichotic listening performance showed an almost perfect match with speech recovery. At the first test he showed a left ear advantage which changed to no ear advantage at the second test, and to a right ear advantage at the third test. The overall performance was markedly reduced at the first test, but improved at the following test. It is concluded that dichotic listening may be a valid complement to traditional language assessment procedures after unilateral brain lesions.

Adult↗
PubMed1989

[What do the waiting lists cost? A study of patients with backache].

Waiting for treatment usually contributes to patients' psychological and financial problems. In this study we calculate and discuss the economic implications of these patients being on a waiting list for treatment. Our calculations show that the income lost in economic production is higher than the cost of treating patients with degenerative low back pain. This is mainly because these afflictions strike people of working age and render them invalids, whereas early adequate treatment usually allows the patients to take up their previous work.

Appointments and Schedules↗
PubMed1989

Multicystic syringomyelia treated with a single, non-valved syringoperitoneal shunt: fast and near-complete MRI normalization.

Four patients with multi-cystic syringomyelia were treated by a single, non-valved syringoperitoneal shunt. In all the patients, the cavitations were separated by a segment of apparently normal cord. In two of the patients, the cavitations also contained multiple transverse septa. In three patients the shunt was inserted in the most caudal cavitation, causing the shunted compartment to collapse, usually within a few weeks. The width of the more cranial cavitations normalized on postoperative MRI scans over several months. This was the case also in one patient where the most cranial cavitation was shunted. No complications or side effects were observed that could be attributed to the use of a non-valved shunt.

Adult↗
PubMed1989

Spinal cord damage caused by rotation of a T-drain in a patient with syringoperitoneal shunt.

We report on a severe complication to the use of intramedullary T-drain in syringoperitoneal shunting procedures: rotational forces in the shunt system causing the arms of the T-drain to gradually compress spinal cord tissue and damage it. Further rotation/destruction was prevented by removing the distal part of the drain system, and by separating the two arms of the T-drain, thus changing it into a syringosubarachnoidal shunt. The syrinx remained collapsed throughout all procedures.

Cerebrospinal Fluid Shunts↗
PubMed1989

Flow cytometric analysis of DNA content of deparaffinized nuclei in urinary bladder carcinomas. Comparison of different isolation methods and relation to histological grade and stage.

A consecutive series of 230 patients with transitional cell carcinoma of the urinary bladder was analyzed with respect to the DNA content of the primary tumor, as determined by flow cytometry on material obtained from paraffin blocks. A new method for this analysis was elaborated, based on proteolytic digestion with protease (type VII, Sigma) and density separation of the nuclei by Percoll centrifugation. The method provided DNA flow histograms with less baseline debris and a smaller coefficient of variation in the peaks than published techniques. In eight of 70 cases tested (11%) the method revealed aneuploid peaks that were not distinguished with the original technique and in 197/230 case (86%) interpretable DNA histograms were obtained. The distribution of diploid and aneuploid tumors in different grades and T categories was assessed. None of the grade 1 tumors was aneuploid; 11% of grade 2A, 63% of grade 2B and 83% of grade 3-4, respectively, were aneuploid. The corresponding figures for categories Ta, T1, T2, T3 and T4 were 16, 55, 72, 65 and 100%, respectively.

Aneuploidy↗
PubMed1989

[Surgical treatment of epilepsy. Needs, examination, resource demands and results].

This review gives the current status of epilepsy surgery, the diagnostic procedures involved and the resources needed. Relatively few of the epilepsy patients are possible candidates for surgery. However, only a small fraction of these possible candidates are actually offered this treatment, in Norway as well as world-wide. The need for increased activity within this field is emphasized, as is the necessity of multi-disciplinary, regionalized epilepsy centers.

Epilepsy↗
PubMed1989

Management of acute head injuries in a Norwegian county--effects of introducing CT scanning in a local hospital.

Introducing a new diagnostic tool, a CT scanner, in a county hospital resulted in a marked redistribution of the handling of acute/severe head injuries. Before the introduction of the CT scanner, a substantial number of these patients were referred to the regional neurosurgical unit. After having acquired its own scanner, the county hospital took over most of the diagnostic and therapeutic tasks concerning acute head injuries, surgery inclusive. This change in policy resulted in more patients surviving without sequelae, and reduced the average latency to surgery. The proportion of operated patients increased considerably, from 23% to 64%. In a relatively large proportion of the patients, there were complications with continuous ICP monitoring using the subdural bolt. This procedure was therefore discontinued. In spite of the improved results caused by the observed redistribution, the study indicates a need for additional training of the county hospital staff.

Accidental Falls↗