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Biomedical subjects

U Runge

Publications and source records attributed to U Runge.

17 recordsLinked to original sources
PubMed2001

Oxcarbazepine in focal epilepsy and hepatic porphyria: a case report.

PURPOSE: Despite the development of new antiepileptic agents (AEDs), the therapy of epilepsies along with hepatic porphyrias remains difficult. Most AEDs such as carbamazepine (CBZ), phenytoin (PHT), valproate (VPA), and lamotrigine (LTG) may precipitate clinically latent porphyria by inducing hepatic metabolism and increasing hepatic heme synthesis. Actually, only gabapentin (GBP), an AED without any hepatic metabolism, is known as a potential therapy for partial seizures in patients having hepatic forms of porphyria. METHODS: We present the case of a 28-year-old man with porphyria cutanea tarda (PCT) who has had pharmacoresistant epilepsy with complex partial and secondarily generalized seizures since early childhood. Despite having undergone several AED therapies over the years, no seizure-free interval had been observed. Only CBZ could cause a seizure reduction, but this treatment had to be discontinued as an elevation of the transaminases as well as pruritus and erythema were noted. The patient was then started on oxcarbazepine (OCBZ), a ketoanalogue of CBZ similar in its pharmacologic mechanism as well as its clinical use, but which, in contrast to CBZ, has only a low hepatic induction of microsomal enzymes. A final maintenance dose four times higher than that of CBZ was prescribed. RESULTS: In the follow-up, the patient stopped having seizures, and his liver functions became normal. CONCLUSIONS: It can be concluded that OCBZ can successfully be administered to patients with hepatic porphyria and focal epilepsy who did not respond to treatment with GBP.

Acetates↗
PubMed1999

Influence of valproate monotherapy on platelet activation and hematologic values.

PURPOSE: Valproate (VPA) has been linked to coagulation disturbances, with both impaired and exaggerated clotting, which has been attributed to an effect of VPA on platelets or hemostatic proteins. Additional thrombocytic function testing may help to identify patients at risk of increased bleeding caused by platelet dysfunction. METHODS: We evaluated the influence of VPA on hematologic routine values and platelet activation by using immunostaining and flow cytometry in 30 patients receiving long-term VPA therapy and in 30 controls. RESULTS: The fraction of activated platelets was similar in both groups; however, the general extent of platelet activation was significantly lower in the patient group, with considerable interindividual variability. In addition, patients had a significantly lower platelet count, prolonged thrombin time, and higher mean corpuscular hemoglobin. CONCLUSIONS: Our data confirm the previously reported hematologic changes caused by VPA and additionally suggest that VPA impairs procoagulatory thrombocytic function, which is reflected by reduced platelet activation and increased thrombin time. Possible mechanisms of VPA-platelet interaction are discussed.

Adult↗
PubMed1998

[Dissociative stupor--differential diagnosis of coma following injury].

Two cases are described in which a dissociative stupor originating from conversion neurosis simulated a coma following a sustained trauma. At first both patients showed no response to being addressed or to pain stimuli. They presented an upward eye gaze deviation, cardiorespiratory functions were stable. Following extensive diagnostic procedures revealing no organic cause for the clinical symptoms, the diagnosis of a hysterical consciousness disorder was stated. Symptoms of conversion neuroses include lacking call response, gait disorder, seizure-like conditions and strength diminution in one or more extremities. In these cases suspicious facts are the absence of injuries (for example by falling down or tongue bite during a dissociative attack), eye gaze deviation and the phenomenon that, when the patient's arm is raised above the head and let fall, it never hits the face but glides down beside the body.

Adult↗
PubMed1997

Ictal and interictal ECD-SPECT for focus localization in epilepsy.

Forty-one ECD (Technetium-99m-ethyl cysteinate dimer) SPECT investigations were undertaken in the course of a presurgical diagnostic work-up in 23 patients with pharmacoresistant focal epilepsy. In 21 patients, both an ictal and interictal SPECT were conducted. In the patients receiving ictal SPECT the tracer was injected between 7 and 30 s after the seizure onset. Of the interictal SPECTs 17 of 23 showed focal hypoperfusion which was consistent in 17 cases (74%) with the area of the electrophysiological focus (EF) and 6 patients had a normal interictal SPECT. Of the ictal SPECTs 18 of 21 (86%) showed regional hyperperfusion, 18 of them in the same location as the EF. Ictal SPECT showed a hypoperfusion similar to that in interictal SPECT in another 3 patients. In these cases seizure duration was short (28-54 s), so that the tracer reached the brain postictally. Our results show that ictal ECD-SPECT is an effective method for demonstrating an epileptogenic focus. Possible reasons for false-negative ictal SPECT results are discussed.

Adolescent↗
PubMed1996

[Prognostic factors and clinical outcome in symptomatic focal epilepsies].

Successful drug therapy for symptomatic focal epilepsy is often difficult to achieve. The aim of our study was to determine predictors of seizure-free versus therapy-resistant courses of epilepsy. To accomplish this, we evaluated clinical data obtained early in the course of focal symptomatic epilepsy to determine which factors best determine the probability of therapeutic success. This retrospective study included 70 patients who were treated at the Neurology Clinic, University of Greifswald, between 1984 and 1992. Inclusion criteria were: Clear clinical diagnosis, a minimum of 3 years follow up in our epilepsy outpatient clinic, therapy with standard anticonvulsant drugs, and good compliance. We distinguished between patients who were seizure-free for at least two years and those who were not. 22 patients (31.4%) were seizure-free, whereas 48 patients (68.6%) remained resistant to pharmacotherapy. Prognostic factors for seizure-free outcome were: Focal grand mal seizures as the only seizure type ever experienced by the patient, the occurrence of only one type of seizures during the course of the illness, the occurrence of only nocturnal seizures, few grand mal seizures before starting an effective anticonvulsant therapy, no previous status epilepticus, and the remission of focal epileptic EEG patterns during effective drug therapy.

Adolescent↗
PubMed1990

Heart rate variability in diabetic patients during orthostatic load--a spectral analytic approach.

Spectral analysis of heart rate variability (HRV) was used to assess the autonomic nervous control of cardiac function during orthostatic load in insulin-dependent diabetic patients and healthy subjects. The diabetic patients were divided into three groups: diabetics without neuropathy (group 1), diabetics with peripheral neuropathy (group 2), and diabetics with peripheral and autonomic neuropathy (group 3). Resting mid-frequency (MF, 0.05-0.15 Hz) and respiration-related (RF, power around respiration rate) HRV were significantly lower in group 2 and 3 diabetics than in controls, indicating a reduced parasympathetic nervous system influence on the heart. Standing MF and RF spectral power data were significantly lower in all diabetic groups than in controls, suggesting marked alterations in the autonomic cardiovascular control during a mild physical load not only in symptomatic diabetics but also in patients with no signs and symptoms of neuropathy. The difference between supine and standing MF power, an estimate of beta-adrenergic influence on the heart, was significantly lower in all diabetic subject groups studied than in controls. This suggests a reduced sympathetic nervous system influence on the heart in diabetic patients. Our data suggest that computerized spectral analysis of HRV during orthostatic load seems to be a very sensitive method of evaluating of the autonomic nervous systems influence on the heart in patients suffering from diabetes mellitus.

Adult↗
PubMed1988

ERCG: endoscopic retrograde catheterization of the gallbladder.

This report describes a newly developed catheter system with the aid of which the cystic duct and gallbladder can be reliably catheterized, retrograde, via an endoscope. In 8 out of 10 autopsy preparations, transpapillary gallbladder catheterization was successfully achieved, with an average fluoroscopic duration of 12 minutes (range: 4-20 minutes). Neither macroscopic nor microscopic traumatization of the gallbladder was observed. The procedure described in this paper opens up a diagnostic and therapeutic approach to the gallbladder.

Adult↗
PubMed1988

Miniscopes in gastroenterological endoscopy--inspection of the gallbladder and the biliary and pancreatic duct systems in autopsy specimens.

This report describes a newly available endoscopic system, the purpose of which is to inspect the common bile duct, gallbladder, cystic duct and the pancreatic duct with the aid of retrograde endoscopy. A miniscope examination of the gallbladder was carried out in eight out of ten autopsy specimens, and the entire pancreatic duct was inspected in nine out of ten specimens after successful transpapillary catheterisation. The procedure described in this paper opens up a new diagnostic and therapeutic approach to the gallbladder, biliary tree and the pancreatic duct.

Autopsy↗
PubMed1987

Contributions of sympathetic and vagal mechanisms to the genesis of heart rate fluctuations during orthostatic load: a spectral analysis.

Spectral analysis was utilized in order to determine the influence of postural change on heart rate fluctuations and respiratory frequencies and to evaluate the frequency-specific contributions of both vagal and beta-adrenergic mechanisms to the genesis of the heart rate fluctuations during change in posture. In unmedicated subjects the total power (0.01-0.5 Hz) of heart rate fluctuations and the relative power at the mid-frequency band (0.05-0.15 Hz) were significantly increased in response to postural change, while the relative power of high-frequency fluctuations (0.15-0.5 Hz) was significantly depressed. Low-frequency fluctuations (0.01-0.05 Hz) were unchanged. The respiratory frequency was non-significantly slowed. The coherence between heart rate and respiration showed a significant reduction during orthostatic load. The heart rate fluctuations above 0.05 Hz were abolished by vagal blockade, during supine rest, while beta-adrenergic blockade reduced fluctuations at the mid-frequency band. Combined blockade caused a depression of heart rate fluctuations over the entire frequency range. On standing, vagal blockade or autonomic double blockade caused a decrease in heart rate fluctuations at each frequency band. After beta-adrenergic blockade alone, mid-frequency and high-frequency fluctuations were significantly reduced. The coherence between heart rate and respiration was nearly abolished under vagal blockade in each body posture. We conclude that the increased sympathetic outflow during orthostatic load is reflected by a marked increase in heart rate spectral power densities in the mid-frequency range.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

[Not Available].

Explore the source record for details and available documents.

Anatomy↗
PubMed1983

[A test for the evaluation of the amplitude distribution of the EEG].

After a critical analysis of the available publications, a new test for the examination of the EEG amplitudes with respect to a normal distribution is presented. By means of autoregressive models, a linear transformation of the EEG to noise signals of a low-degree correlation is carried out, the normal distribution which is studied with respect to obliquenes and excess. In this way, the compromise between the demands for a low scanning frequency, a large extent of random tests and short EEG intervals, which is necessary for the correct application of the adaptation test, is avoided. A total of 82 percent of the tested 40 EEG intervals showed a normal distribution, EEG's with slight general changes being more frequent than alpha-EEG's.

Alpha Rhythm↗
PubMedDate not supplied

Heart rate fluctuations in diabetic patients with cardiac vagal dysfunction: a spectral analysis.

The autonomic nervous control of cardiac function during active orthostatic load has been studied by measuring the power spectrum of heart rate fluctuations in 16 insulin-dependent diabetic patients and 14 age-matched control subjects. The patients were subdivided into two groups: 8 with normal respiratory sinus dysrhythmia (RSA+) and 8 with reduced respiratory sinus dysrhythmia (RSA-). In RSA- patients the total power (0.01-0.50 Hz) was significantly reduced compared with control subjects (4.7 versus 15.5 min-2, 2p less than 0.05) and the pattern of heart rate fluctuations was characterized by a relative increase in the low-frequency component (0.01-0.05 Hz) as compared with RSA+ patients and control subjects (45% versus 24% and 27%, both 2p less than 0.01). There was also a significant reduction in the high-frequency component (0.15-0.50 Hz) as compared with RSA+ patients and control subjects (17% versus 36% and 33%, both 2p less than 0.05). During standing, a significant increase in total power was found only in control subjects (2p less than 0.01) and the difference between control subjects, and RSA+ and RSA- patients reached significance (32.2 versus 15.1 and 12.7 min-2, 2p less than 0.02 and 2p less than 0.01). The pattern of heart rate fluctuations in RSA- patients showed no significant change on standing. These results suggest that the reduced overall heart rate variability in diabetic patients with cardiac autonomic neuropathy is associated with a typical heart rate fluctuation pattern.

Adult↗