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Biomedical subjects

B Steinmann

Publications and source records attributed to B Steinmann.

At least 199 records · Page 11Linked to original sources
PubMed1978

[The heart of the old hemiplegic patient (author's transl)].

The heart of the old hemiplegic patient is examined as follows: 1. The preapoplectic situation of the heart which often induces in a conclusive manner the beginning of a stroke, 2. the occurrence of heart troubles with the stroke itself and 3. the influence of rehabilitation measures and the heart function. Preexistent heart troubles are very frequent (in ca. 80%). Thereby the hypertension with a left ventricular hypertrophy and later with heart failure play an important role. The stroke itself especially in subarachnoidal bleedings can cause severe electrocardiographic anomalies. The telemetric controlled heart shows specially while rehabilitation more extrasystoles and alterations of repolarisation but usually do not impair the rehabilitation. With a systematic rehabilitation (training) the heart is most favourably influenced.

Aged↗
PubMed1978

Nonketotic hyperglycinemia treated with strychnine, a glycine receptor antagonist.

A 6 1/2-month-old boy suffering from nonketotic hyperglycinemia has been treated for at least 12 months with oral strychnine. The drug caused improvement of muscle tone, motoricity, vigilance and social behavior. Glycine is one of the putative neurotransmitters of postsynaptic inhibition, particularly at the spinal and reticular levels, strychnine its antagonist at the postsynaptic membrane. Strychnine improved the patient's motoricity presumably by blocking the excessive glycine-mediated inhibition of motoneurons. The beneficial effect of strychnine on vigilance and social behavior is more difficult to explain but may have been related to its antagonism of glycine inhibition of brainstem reticular neurons.

Amino Acid Metabolism, Inborn Errors↗
PubMed1978

Hereditary fructose intolerance in early childhood: a major diagnostic challenge. Survey of 20 symptomatic cases.

Twenty infants and young children with hereditary fructose intolerance (HFI) were admitted to hospital. None was diagnosed at admission. Referals were for vomiting of unknown aetiology (16X), pyloric stenosis or hiatus hernia (5X), toxic condition (3X), and hepatomegaly of unknown origin (5X). Feeding difficulties (20X), vomiting (18X), and failure to thrive (16X) were leading symptoms. The most frequent clinical findings were hepatomegaly (18X), pallor (14X), haemorrhages (13X). Ascites, oliguria, tachypnoea, fever, splenomegaly and rickets were less frequent. Laboratory findings were indicative of disturbed hepatic and renal tubular function and also of disturbed intermediary metabolism (hypokaliaemia, hypophosphataemia). However, hypoglycaemia was found in only 4 out of 15 patients tested. Differential diagnosis after hospital admission centered on metabolic disorders such as glycogenoses, galactosaemia, tyrosinosis, or Wilson's disease. Hepatitis, toxic hepatosis, liver tumour, intrauterine infection and sepsis were also considered. Eleven children had first ingested fructose within the first 6 weeks of life. The diagnosis was usually established only many weeks or months after first fructose intake and appearance of symptoms. This documents how difficult the diagnosis of this disease can be both in practice and in hospital. The course was severe in 11 children and lethal in 4. In only 5 patients was the course mild. The 16 survivors are doing well under fructose-exclusion diet. Irreversible visual impairment after intraocular haemorrhage occurred once. In each case HFI could have been suspected immediately, had a detailed nutritional history been taken. Practising paediatricians should know the composition of commonly used infant formulae. They should never prescribe sugared condensed milk for intractable vomiting prior to excluding HFI. Solution for intravenous infusion containing fructose and sorbitol are life-threatening for undiagnosed HFI patients.

Age Factors↗
PubMed1977

[Analysis of gait in hemiplegics (author's transl)].

The gait of 31 hemiplegics is analyzed with a multiplecomponents force-plate. The healthy and paretic side differ in 5 of 7 parameters. The difference betwen the left and right side is bigger in the right hemiplegic, because in the left hemiplegic, the healthy side is more disturbed as in the right hemiplegic. That makes less differences between healthy and paretic side. The variability of the single steps is bigger in subjects with a bad gait. The method is suitable to screen the change of the gait and its progress.

Contingent Negative Variation↗
PubMed1977

Uridine diphosphate galactose 4'-epimerase deficiency. IV. Report of eight cases in three families.

Eight persons who had no activity of uridine diphosphate galactose 4'-epimerase in their circulating blood cells are known today. They were healthy members of three different families. Propositi were newborns discovered in a mass screening test for blood galactose which registered high levels of erythrocyte galactose-1-phosphate. Epimerase deficiency was restricted to circulating blood cells, but in liver biopsy specimens, in cultured skin fibroblasts and in activated lymphocytes epimerase was found to be normally active. Heterozygotes had intermediate red cell epimerase activity. There were no symptoms of galactose intolerance and no pathology related to the enzyme defect. All 8 epimerase deficient persons had a ccdee Rhesus genotype. Attempts at demonstrating genetic linkage between the epimerase and Rhesus loci were unsuccessful because of the difficulty encountered in ascertaining epimerase heterozygosity. Individuals with hereditary UDP-galactose 4'-epimerase deficiency appear to produce an unstable mutant enzyme requiring higher NAD concentration for maximum activity.

Aged↗
PubMed1976

Hydantoin-5-propionic aciduria in folic acid nondependent formiminoglutamic aciduria observed in two siblings.

Hydantion-5-propionic acid was detected in massive amounts in the urine of two previously described sisters with folic acid nondependent formiminoglutamic aciduria. HPA was identified rigorously, e.g. by gas chromatography-mass spectrometry, and was measured quantitatively by selected ion monitoring (mass fragmentography) using deuterated HPA as internal standard. Before histidine loading, both girls with the postulated formiminotransferase deficiency excreted an amount of HPA more than 50 times greater than the control subjects. After histidine ingestion, HPA excretion was still doubled or tripled. With the exception of the father, the values for the other members of the family also markedly exceeded the normal range and were of the same order of magnitude as in folate deficiency. Measurement of HPA excretion in urine seems to be a valuable supplement or alternative to the enzymatic FIGu test for the detection of general or functional folate deficiency or impaired folate utilization and it will be indispensable for the detection of (as yet unknown) 4-imidazolone-5-propionic acid hydrolase deficiency.

Adolescent↗
PubMed1976

[Problemss of tending to chronicity of diseases in geriatrics (author's transl)].

The most important alterations of the old age are mentioned. They have a great influence on the behaviour of the elderly in a hospital. Charactersitic behaviour patterns at admission, during hospitalization and at dismission are pointed out. Multimorbidity should not cause a thoughtless and highly technical work-up. Rehabilitation measures in order to keep the patient in bed as short as possible are important. For this reason the nursing staff should have a good knowledge of activating care. Pharmacogherapy, intensive care, preoperative and postoperative care are mentioned.

Aged↗
PubMed1975

[Telemetric ECG control of the heart during the rehabilitation of hemiplegics].

In hemiplegic patients of advanced age the incidence of cardiac disorders, frequently combined with heart failure, is 80%. To assess the effect of rehabilitation on cardiac status 25 patients underwent period telemetric ECG monitoring during the rehabilitation period. The rest forced upon the patient in the initial period following the stroke economizes cardiac effort. The increasing load in rehabilitation thus has a favourable effect on the heart and affords appropriate cardiac training in addition to its immediate purpose.

Aged↗
PubMed1975

[Risk factors and age].

The known risk factors for atherosclerosis do not possess the same significance in young people as in the elderly. Hypercholesterolemia, diabetes and cigarette smoking appear to have a greater bearing below the age of 50 than later, particularly in myocardial infarction but also in apoplexy. On the other hand, hypertension is an important factor in the young and, especially in the case of apoplexy, even more so in advanced age. There is marked difference with regard to preexisting heart disease, which scarcely plays a role in myocardial infarction of the younger patient but is a factor in some 50% of hemiplegia cases. Only one fifth of elderly patients with this disease have no preexisting carcdiopathy. The similarity of the risk factors in elderly patients either with or without apoplexy is due to the fact that arteriosclerosis is already established in both groups and the risk factors which give rise to ischemia, thrombosis or embolism assume prominence. The therapeutic implications are briefly discussed.

Adult↗
PubMed1975

Reversal of UDP-galactose 4-epimerase deficiency of human leukocytes in culture.

Stimulation with phytohemagglutinin of the leukocytes from six of the seven known individuals with UDP-galactose 4-epimerase (= UDP-glucose 4-epimerase; EC 5.1.3.2) deficiency consistently resulted in the appearance of epimerase activity in the cultured cells. A long-term lymphoblast culture derived from one proband also contained an active epimerase enzyme. A comparison of the properties of this enzyme with those of epimerase produced by control lymphoblast lines revealed comparable Km values for UDP-galactose and NAD and identical behavior on polyacrylamide electrophoresis. However, a difference in the NAD requirement for heat stability at 40 degree provided some evidence for a structural defect in this enzyme. Possible explanations for the appearance of UDP-galactose 4-epimerase activity in stimulated lymphocytes include an increased rate of synthesis of a mutant enzyme and a derepression of an epimerase locus during lymphocyte transformation.

Carbohydrate Epimerases↗
PubMed1975

Persistent and transient distal renal tubular acidosis with bicarbonate wasting.

Bicarbonate titration studies were performed on two patients with bicarbonate wasting distal renal tubular acidosis (RTA; patients 1 and 2) and on three patients (3,4, and 5) with classic distal RTA. Daily requirements of alkali were 4.5 mEq/kg body wt in patient 1, a 3-year-old boy, and 16 mEq/kg in patient 2, a 5-month-old male infant. In contrast, only 1.5-2 mEq/kg/24 hr alkali were required in the three patients with classic distal RTA (age 8 1/2- 22 years). Patient 1 had glucose-6-phosphate dehydrogenase deficiency and patient 3 had inner ear deafness as an associated anomaly. In patient 2, the acidification defect was transient. Mean fractional excretion of bicarbonate (ChCO3-/Cin) times 100 at a plasma concentration of HCO3 below 20 mmol/liter was 5.1% in patient 1, 11.6% in patient 2, and 1.7% in patients 3-5. Minimal urine pH during the study was 7.38 in patient 1, 7.66 in patient 2, and 6.78-6.97 in the other patients. Values of net acid excretion at plasma HCO3 = 16 mmol/liter were strongly negative in patients 1 and 2 (-75 and -195 mumol/100 ml glomerular filtrate (GF), respectively) but slightly positive in the three patients with classic RTA (+3 to +20 mumol/100 ml GF). The two patients with bicarbonate wasting distal RTA were thus clearly separated from the group of patients with classic distal RTA.

Acidosis, Renal Tubular↗
PubMed1975

Catalytically inactive sucrase antigen of rabbit small intestine: the enzyme precursor.

By immunofluorescence microscopy using a specific antibody to the active rabbit sucrase-isomaltase complex, a catalytically inactive sucrase antigen was discovered on the small intestinal mucosa of young rabbits still lacking sucrase activity. In adult rabbits, the same antigen was demonstrated on enterocytes of mucosal crypts devoid of sucrase. Catalytically inactive antigen was isolated by means of immobilized antibody to active sucrase, and it was compared with the active sucrase-isomaltase complex. From structural similarities between the 2 proteins and from the fact that active sucrase succeeds the inactive antigen in both the maturing and the mature rabbit, it is concluded that the inactive antigen is the enzyme precursor. In some patients with hereditary sucrase-isomaltase deficiency, abnormal persistence of sucrase precurosr due to a faulty activation mechanism may be the underlying defect.

Age Factors↗