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L Lachenmayer

Publications and source records attributed to L Lachenmayer.

At least 37 records · Page 2Linked to original sources
PubMed1992

[Parkinson therapy yesterday, today, tomorrow. Neuroprotection gains in importance].

Owing to a lack of knowledge of the pathophysiology and pathochemistry of Parkinson's disease, conservative treatment was long restricted to the treatment of symptoms. In recent decades, as the role of dopamine became better known, progressive improvements in therapy were achieved, which initially meant the administration of the precursor, L-Dopa, of the primarily non-replaceable neurotransmitter, and later augmentation of the activity of dopamine in addition. Amantadine, a highly effective drug with a wide spectrum of action and a high level of tolerability, was successfully introduced in 1969. The recently discovered NMDA antagonism, also in conjunction with a description of the mechanism of action of amantadine, which makes it possible to inhibit the effect of excitatory amino acids--in particular glutamate--in the CNS, led to the principle of neuro-protection, which is now considered the key to the treatment of Parkinson's disease.

Aged↗
PubMed1991

Dissection of the extracranial vertebral artery: report of four cases and review of the literature.

Four cases of cervical vertebral artery (VA) dissection are reported. In three patients VA dissection was associated with neck trauma. All patients were young or middle-aged (range 27 to 49 years). In two there was a history of migraine. Pain preceded neurological symptoms from hours to six weeks. Three patients had neurological deficits including elements of the lateral medullary syndrome, and one experienced recurrent transient ischaemic attacks in the vertebrobasilar territory. Angiographic findings included irregular stenosis, occlusion and pseudoaneurysm; in two patients VA abnormalities were bilateral. All patients were treated with anticoagulants and improved. In a review of 28 cases with traumatic dissection and 29 cases with spontaneous dissection of the VA reported in the literature, distinct clinical and angiographic features emerge. Aetiology remains obscure in most cases of spontaneous dissection and management is still controversial.

Adult↗
PubMed1989

[The problems of L-dopa therapy in the course of Parkinson syndrome].

UNLABELLED: 101 patients with Parkinson's disease were analyzed in a retrospective study to evaluate the influence of L-Dopa monotherapy, duration of the disease and age at onset on the clinical course of the syndrome. The effects of L-Dopa dosage adjustments after hospitalization were particularly considered. RESULTS: patients with late onset of symptoms showed a more accelerated deterioration as compared to those with early manifestation of the disease who also were less severely affected. Patients treated with L-Dopa for more than five years had a greater neurological deficit score than patients who had not received L-Dopa. Besides a more severe course, these patients also exhibited significantly more dyskinesias and on-off-phenomena. It should be emphasized that in our study, 73% of the 101 patients had been treated inadequately prior to admission to our clinic. The extent of neurological deficit could be improved by L-Dopa dose adjustments in those cases. Only in 11% of cases, an augmentation of the dopa medication was found to be effective in improving the clinical syndrome, whereas in 43%, a substantial reduction of dosage was necessary and resulted in a marked improvement of the clinical syndrome.

Adult↗
PubMed1988

[Magnetic resonance imaging in myasthenia gravis. An alternative to mediastinal computerized tomography?].

Twenty patients with myasthenia gravis underwent magnetic resonance imaging (MRI) of the anterior mediastinum, 17 of them additionally computed tomography (CT). In 14 of the patients the imaging results were checked against the histological findings of a subsequent thymectomy, which revealed four thymomas and (with the exception of one normal thymus) hyperplastic changes in all the others. Overall, MRI was not better than CT for demonstrating blastomatous changes in the thymus. It was also no more sensitive in differentiating between thymoma and hyperplasia.

Adult↗
PubMed1988

'Head and heart'--neurological and psychological reactions to open heart surgery.

Neurological and psychological reactions to open-heart surgery are widely underestimated phenomena and occur in a much higher incidence than one might expect. When analyzed retrospectively, up to 3.8% of patients who underwent cardiac surgery at the Hamburg University Hospital exhibited these reactions, whereas 35%-50% presented with symptoms and signs of perioperative CNS dysfunctions in prospective studies at our department. About the same percentages are detected in prospective studies of the patients' perioperative psychopathology, stating that a great number of cardiac patients exceed the normal range of anxious, tense, and depressive moods in this setting. The consequences of these findings for the patients' quality of life and the impact for the perioperative management of patients undergoing open-heart surgery are discussed. The current prospective studies, preliminary results of which are presented here, are part of an international interdisciplinary study, initiated to bring more light into the complicated relations between ECC-assisted cardiac surgery, anaesthesiology, neurology and psychology.

Adaptation, Psychological↗
PubMed1987

Cerebral cysticercosis in a European patient: problems of disease activity and therapeutic implications.

The case of a German patient who was treated with two courses of praziquantel for parenchymal cerebral cysticerosis (CC) is reported. Efficacy of the treatment could not reliably be distinguished from the natural course of the disease. After a brief review of the literature concerning problems with assessment of the activity of CC, the criteria recommending praziquantel therapy are discussed.

Adult↗
PubMed1985

Anatomical features and physiological properties of central serotonin neurons.

The authors describe the anatomical features and physiological properties of central serotonergic neurons. The central serotonin neurons (part of which store peptides [substance P, TRF, enkephalins] in addition to 5HT) are highly collateralized reticular-type brain stem neurons receiving multi-modal afferent information from ascending sensory and descending motor pathways. They are under control by noradrenergic, peptidergic and and gaba-ergic projection neurons and interneurons. Furthermore, they establish variable synaptoid and synaptic contacts to neuronal, glial and secretory targets throughout the entire neuraxis and send terminal branches into the ventricular CSF space. Firing rate and transmission activity appear to be controlled in a complex and rather rigid manner by 5HT release-dependent dendrodendritic and dendrosomatic inhibition via autoreceptors (which also regulate release at the axon terminals) and via transsynaptic inhibitory feedback circuits which may involve gabaergic projection and interneurons. 3H-imipramine appears to bind to an "imipramine recognition site" in the vicinity of the 5HT carrier, and to a variety of other transport and (postsynaptic) receptor sites (NA uptake, H1, 5HT2- and alpha 1-binding sites). Circumstantial evidence points to an as yet undetermined role of the postsynaptic 5HT-1-binding sites in neurotransmission. 5HT-2-binding sites fulfil the criteria for receptors: binding affinity of antagonists to these sites correlates significantly with their potency to inhibit behavioral excitation in rats elicited by 5-hydroxytryptophan or 5HT agonists.(ABSTRACT TRUNCATED AT 250 WORDS)

Afferent Pathways↗
PubMed1982

Thymolipoma in association with myasthenia gravis.

Among 72 thymic tumors that were examined we have found five (7.5%) thymolipomas. Two of these patients have had clinical symptoms. One, a five-year-old boy, has had an erythrocyte hypoplasia as well as a hypogammaglobulinemia. The other patient, a 56-year-old man, has had myasthenia gravis. This case is the second in the world literature in which a thymolipoma is associated with symptoms of myasthenia gravis. The clinical, radiologic, and histopathologic findings and the pathogenesis of thymolipoma are discussed.

Adult↗
PubMed1979

[Demonstration of acetylcholine receptor antibodies in the serum of myasthenia gravis patients applying affinity chromatographically purified human acetylcholine receptor preparations (author's transl)].

Sera from 75 patients with Myasthenia gravis were tested for acetylcholine receptor antibodies using acetylcholine receptors from human skeletal muscle. From the crude Triton x-100 extract, which has so far been used for antibody tracing, a pure acetylcholine receptor preparation was obtained by affinity chromatography using alpha-Najatoxin-Sepharose 4B. When the purified 125J-alpha-Bungarotoxin-acetylcholine receptor complex was applied in a radioimmunoassay 80% of the Myasthenia gravis patients had acetylcholine receptor antibodies in contrast to none of the tested control persons. Inspite of using a pure acetylcholine receptor preparation, no clear-cut correlation was found between the amount of serum acetylcholine receptor antibodies and the clinical stage of the disease. When individual antibody titration curves were established, different reaction patterns were observed indicating either different antibody specificities in regard to antigenic determinants on the receptor molecule or differences in the antibody affinity.

Acetylcholine↗
PubMed1977

[Problems of postthymectomy-syndromes, e.g. myasthenia gravis (author's transl)].

6 years after resection and postirradiation of an "asymptomatic" thymoma, myasthenia gravis developed in a 46 year old man which improved within 6 months following initiation of immunosuppressive therapy with azathioprine. In a 28 year old man with incomplete operative removal of a metastasizing malignant thymoma, a myasthenia gravis appeared 8 weeks after surgery, i.e. before irradiation of the tumor relics. Myasthenia improved upon irradiation of the tumor relics and was no longer demonstrable one year after onset of its clinical signs. During the whole period of manifestation of the myasthenia, antibodies to skeletal muscle were deomonstrated in the first case, while, in the second case, in which antinuclear factors were present in the serum throughout the course of the myasthenia, muscular antibodies were detected only prefinally, i.e. in a stage without clinical symptoms of myasthenia. A review of the literature indicates that myasthenia gravis is a particularly frequent event in postthymectomy-syndromes (e.g. polymyositis, thyreoiditis, lupus erythematosus, hematological and dermatological syndromes). In postthymectomy-myasthenia, latency of manifestation, clinical distribution and its course may be rather variable. The problems of diagnosis, immunology and therapy of postthymectomy-myasthenia are discussed and general conclusions concerning postthymectomy-syndromes are drawn.

Adult↗
PubMed1977

[Occlusion of the basilar artery (author's transl)].

Occlusion of the basilar artery was demonstrated arteriographically in two cases. The symptomatology is described. Due to effective collateral circulation the patients survived and recovered from severe neurological deficits. One of the patients, clincally in a state resembling akinetic mutism for several weeks, not only survived but regained speech. To our knowledge this has not been reported in the literature previously. Our cases as well as similar ones of others showed, that for development of effective intrcranial collaterals the time, during which occlusion occurs, is clearly of importance. Development of collateral circulation also depends on the anatomy of the circle of Willis and a sufficient extracranial circulation.

Adult↗