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Biomedical subjects

S L Notermans

Publications and source records attributed to S L Notermans.

At least 19 recordsLinked to original sources
PubMed1992

Motor evoked potentials from the bladder on magnetic stimulation of the cauda equina: a new technique for investigation of autonomic bladder innervation.

Although neurophysiological techniques have become widely accepted in the diagnostic evaluation of urogenital tract dysfunction, arguments have been forwarded to question their validity. Current techniques merely deal with somatosensory nerves, whereas micturition and sexual functions depend on autonomic motor nerve function as well. This study presents a new technique of motor evoked potentials obtained after magnetic stimulation of the cauda equina. Bladder and pelvic floor motor evoked potentials could be measured with concentric needle electrodes. Mean latency was 35.6 msec. for bladder motor evoked potentials and 10.6 msec. for pelvic floor motor evoked potentials. The technique was easy to perform, and provided consistent and objective data. No harmful side effects were noted.

Adult↗
PubMed1992

Beriberi cardiomyopathy.

In Indonesia beriberi is still endemic, but subclinical cases are not uncommon. Three patients suffering from beriberi presented with different clinical manifestations. One had the classical features of Shoshin beriberi and the other two had the non-alcoholic cardiac beriberi (chronic type). The cardiac symptoms of all three patients responded dramatically to thiamine tetrahydrofurfuryl disulfide; there was also some improvement of their polyneuropathy, consistent with the neurophysiologic findings and somatosensory evoked potentials (SSEPs). We conclude that SSEPs provide additional clinical information on beriberi polyneuropathy. The mortality of untreated cardiovascular beriberi is high. In view of the harmless nature of the treatment, a good case could be made for routine administration of thiamine to all patients in whom heart failure is present without clear evidence of the cause.

Adult↗
PubMed1992

Spinal monitoring during vertebral column surgery under continuous alfentanil infusion.

An anaesthetic technique for surgical procedures on the vertebral column is described consisting of a continuous infusion of a short acting opioid, alfentanil, and a muscle relaxant, vecuronium, in combination with positive pressure ventilation using a nitrous oxide/oxygen mixture. It is shown that the two standard forms of spinal monitoring, wake-up testing and somatosensory cortical evoked potentials, can be employed effectively using this anaesthetic technique. Wake-up testing was performed in 23 patients. Average wake-up time was 10 min (SD 3.7 min). Evoked responses suitable for spinal monitoring could be obtained in 60 of 61 patients.

Adolescent↗
PubMed1991

Fatigue in type I fiber predominance: a muscle force and surface EMG study on the relative role of type I and type II muscle fibers.

The relative proportions of fiber types within muscle and the characteristics of these fiber types are important determinants of the surface electromyogram (SEMG) during fatigue. In this study, patients suffering from congenital myopathy characterized by a strong type I fiber predominance were studied. Six patients with 95-100% type I fibers, 2 patients with 80% type I fibers, and 12 healthy volunteers participated in an ischemic, isomeric, intermittent exercise test of m. quadriceps femoris at 80% MVC. Considering the results of the morphometric analysis of muscle biopsy specimen and of the anthropometric estimated muscle-bone volume, it was found that type I muscle fibers had a lower force generating capacity than type II fibers. The initial conduction velocity along the muscle fiber membrane (MFCV) was low in patients with 95-100% type I fibers. During the ischemic exercise test, the 95-100% type I fibers showed less fatigability than type II fibers, which was reflected by a nearby absent decrease of the muscle membrane excitability as measured by the MFCV, and only a slight increase of the SEMG amplitude compared with patients having 80% type I fibers and controls. The absence of a definite MFCV decrease was related to the nearby lacking lactate formation in 95-100% type I fibers.

Adolescent↗
PubMed1991

Force and fatigue in human type I muscle fibres. A surface EMG study in patients with congenital myopathy and type I fibre predominance.

An isometric ischaemic intermittent m.biceps brachii exercise test is performed by 4 patients suffering from congenital myopathies which are characterized by a 100% type I fibre predominance, and by 26 healthy volunteers. Thirty contractions per minute are made at an 80% of maximal voluntary contraction level. It is found that type I muscle fibres have a fourfold lower force-generating capacity than type II muscle fibres. The EMG amplitude shows that more EMG voltage is needed per unit force in the patients with 100% type I fibres compared with controls. Under standardized fatiguing circumstances the power density frequency spectrum shows a weaker shift to lower frequencies in patients with 100% type I muscle fibres compared with controls. The muscle fibre conduction velocity (MFCV) of type I muscle fibres shows no decline during ischaemic exercise indicating an unimpaired muscle membrane excitability.

Adult↗
PubMed1990

Thiamine tetraphydrofurfuryl disulfide in nutritional polyneuropathy.

An open trial with thiamine tetrahydrofurfuryl disulphide (TTFD) was carried out on 44 patients with nutritional polyneuropathy who were admitted to the Neurological Department, Dr. Soetomo Hospital, Surabaya, Indonesia, Thirty-four patients showed improvement of their motor functions (P less than 0.01) with slight restoration of sensory function and reflexes (P less than 0.1). Of the 18 patients who were re-examined electrophysiologically 3 months later, 6 showed remarkable improvements. No side-effects were observed during TTFD treatment. It seemed that nutritional polyneuropathy in our low socio-economic patients was mostly caused by thiamine deficiency.

Adolescent↗
PubMed1988

Dermatomal somatosensory evoked potentials of the lumbar and cervical roots. Method and normal values.

We describe a method for obtaining cortical evoked potentials after stimulation of the lumbosacral and cervical dermatomes in healthy volunteers. Such dermatomal evoked potentials are expected to contribute to the diagnosis of lumbar and cervical root entrapment. Normative data are presented for each dermatome including left-right differences. A significant correlation was found between absolute latencies and body length for the lumbosacral segments. This correlation was virtually absent in the cervical segments. The latency difference between the same cervical or lumbosacral dermatome left and right was also independent of body length for all segments.

Adolescent↗
PubMed1986

Some comments on the clinical use of evoked potentials.

In this survey we describe the uses of somatosensory, visual, and auditory evoked potentials (EPs), adding some critical comments on the values and pitfalls of these methods. It must be stressed that the application of EPs is most valuable when combined with a thorough neurological examination. There is general agreement that EP measurement is one of the best techniques for objective, noninvasive study of brain function in humans.

Brain↗
PubMed1986

The central auditory conduction at term date and three months after birth. II. Auditory brainstem response.

This communication describes the results of auditory brainstem responses (ABRs) obtained in 25 healthy mature newborns with a follow-up at 3 months of age. The combination of ipsi- and contralateral recordings, the intensity series and the comparison with the composite group averages are useful for the identification of the separate ABR components. Differences between the records after right or left ear stimulation were not observed. Comparing our data with those obtained by others, we conclude that the interpeak latency differences (IPLDs) offer a more consistent measure of ABR latency values than the peak latencies measured from stimulus onset. The simultaneously recorded ABRs ipsi- and contralateral to stimulation show both at term, and at 3 months, an equal central conduction time. The ABR II-V complex shows contralaterally a significant shift compared with the ipsilateral II-V complex. The significant latency changes observed between term and at 3 months are due mainly to the latency decrease in the II-III IPLD.

Age Factors↗
PubMed1986

The central auditory conduction at term date and three months after birth. III. Middle latency responses (MLRs).

Middle latency responses (MLRs) were obtained in 25 healthy newborns with a follow-up recording at 3 months in all but three. A four-channel recording provided topographic information. Linkage of the ear references reduced the myogenic contamination of the recordings. P0 and Na proved to be the most consistent components in the sinusoidal MLR wave sequence. Topographic differences suggest a generation of P0 and Na contralateral to stimulation. A significant latency decrease was found for P0 and na between term and 3 months. The most important latency and amplitude changes may occur before term date and immediately thereafter. The MLRs are the link between the auditory brainstem responses (ABRs) and the auditory cortical responses (ACRs), and it may be possible to use them for recordings in newborn infants. They provide information about the generation of specific components as well as regarding the auditory afference in the stimulus propagation between the brainstem and the cortical auditory areas.

Auditory Cortex↗
PubMed1986

The central auditory conduction at term date and three months after birth. IV. Auditory cortical responses.

Auditory cortical responses (ACRs) were recorded in 25 healthy mature newborns with a follow-up at 3 months. The waveform, latencies and amplitudes for the ACRs for this time period are studied. Topographic differences between the central and central-temporal derivations and changes between term and 3 months are found with respect to latencies and amplitudes for different peaks and troughs. The ACRs, obtained as a part of a protocol covering the entire auditory afference, offer consistent parameters, which can be used to study developmental neurophysiological properties of audition and which are potential diagnostic tools for the detection of deviant sensory or mental development.

Auditory Cortex↗
PubMed1985

The central auditory conduction at term date and three months after birth. I. Composite group averages of brainstem (ABR), middle latency (MLR) and auditory cortical responses (ACR).

We are investigating the maturation of auditory evoked responses, as a potential diagnostic tool for the neurological examination of premature infants at the Intensive Care Unit for Prematures. In this communication we report the group composite averages of the BMC-ARs in a group of 25 mature and healthy newborns with a follow-up at 3 months of age. The ABRs showed a remarkable variability in wave I latency, with a relatively stable I-V central conduction time (CCT) of the brainstem. The ipsilateral II-V CCT does not differ appreciably from the contralateral II-V CCT. The MLR components NoPoNa and Nb, Nc, Nd are easy to identify in the group averages. Voltage asymmetry between stimulated versus non-stimulated side is slight but persistent in the newborn period as well as at 3 months of age. The group averaged ACRs, show an early complex within the latency reach of 100 ms and a slow W-shaped late complex, most distinct at 3 months. The results indicate that the protocol as applied constitutes a tool for the testing of conduction function of the auditory afference in newborns, even beyond the level of the brainstem. Group averaging offers a method to determine the intragroup stability of evoked potentials under investigation.

Acoustic Stimulation↗
PubMed1984

Postoperative ulnar neuropathy after kidney transplantation.

Postoperative ulnar neuropathy as a result of mechanical trauma at the elbow was observed in eight patients undergoing renal transplantation. In five cases this occurred on arms that were adducted during the operation and in which an arteriovenous shunt was present. In four cases (one patient had the lesion bilaterally) the other, abducted arm was affected. Analysis of possible causes revealed no single factor responsible for the condition. Factors that most likely contributed were: pressure on the adducted arm by the combined weights of patient and surgeon, blood pressure monitoring with a cuff compressing the cubital fossa, venous congestion by the arteriovenous shunt, and subclinical uraemic polyneuropathy. Although no single factor could be identified protection of the adducted arms with a hard plastic cover and placement of the blood pressure cuff as proximally as possible on the abducted arms provided a successful solution to the problem.

Adult↗