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Biomedical subjects

C Meier

Publications and source records attributed to C Meier.

At least 127 records · Page 7Linked to original sources
PubMed1988

Specific antibody activity against neuroendocrine tissue in a case of POEMS syndrome with IgG gammopathy.

Specific antibody binding activity directed against pituitary tissue was demonstrated in a typical case of POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes) syndrome with paraproteinemia of IgG lambda type. IgG binding against various other tissues could not be detected by immunoelectroblotting and immunocytochemistry. We propose that POEMS syndrome is an antibody-mediated immune disorder, in which the hypophysis is the primary target of the pathologic myeloma antibodies. The immunopathogenetic lesion of the hypophysis could induce secondary disturbances of other organs, thus explaining the multisystemic disorder.

Adult↗
PubMed1987

[Lipid myopathy: a heterogenic familial case].

A case is reported of lipid storage myopathy in a 24-year-old patient and her family. In the patient and an aunt, muscle biopsy disclosed intrafibrillar lipid depositions, and electron microscopy revealed lipid vesicles in the sarcolemma border. In the father, no lipid depositions were observed but electron microscopy showed alterations to mitochondria compatible with a mitochondrial myopathy. In the patient muscular biochemistry revealed a major reduction in NADH oxydase activity and in the aunt a diminished level of carnitin compatible with carnitin deficiency. The heterogeneity of these lipidic myopathies is discussed.

Adult↗
PubMed1987

[Hereditary neuropathy with liability to pressure palsies. A contribution to the differential diagnosis of multiplex mononeuropathy].

Hereditary neuropathy with liability to pressure palsies could be diagnosed in two families. This little-known, dominantly inherited disorder is clinically characterised by recurring, spontaneously regressive palsies of peripheral nerves, mostly after minimal mechanical compression of the nerve concerned. It can be clearly differentiated from mononeuropathies of different pathogenesis even in clinically not involved nerves, by means of pathological neurographic findings and by the detection of pathognomonic myelinic thickenings in nerve biopsies. Prognosis is favourable if recurrences are avoided. This means that counselling of the patients and their families is of prophylactic significance.

Adult↗
PubMed1987

[Complications of anesthesia in elderly patients].

Progress in surgery and anesthesia has contributed to lowering operative risk and expanding the indications for operations in higher age groups. The goal of treatment in the elderly is to achieve the best possible degree of reducing discomfort and increasing personal independence. Methods. A brochure with a clinical study on 1,021 patients chosen at random shows the frequency of complications arising during the peri- and post-operative course in patients around 60 years of age and older. Operative areas were general and emergency surgery, vascular surgery, neurosurgery, and urology. Operations were carried out in regional or general anesthesia. Patients were divided into groups below and above age 60. Evaluation of the data was carried out according to an integrated data processing concept. This program enables quantitative and qualitative data to be combined at will, taking into consideration that evaluating criteria can be varied considerably. Results. The results demonstrate that patients over 60 have significantly more complications than patients under 60. Analysis of the influence of the factors associated with surgical risk reveals that factors related to the operation such as type, length, and extent do not increase the risk as much as the numerous accompanying illnesses in both age groups. As far more elderly patients are affected by multimorbidity, the conclusion may be drawn that the increased risk observed is not due mainly to age, but rather to the patient's condition prior to surgery. The results indicate clearly that an exact analysis of the initial condition as well as avoiding failure or malfunction of certain organs must have priority in both age groups.

Aged↗
PubMed1986

[Polyneuropathy, organomegaly, endocrinopathy and skin changes in a case of solitary myeloma].

The case is reported of a 32-year-old woman with polyneuropathy, organomegaly, edema, endocrinopathy, dark skin and solitary myeloma with monoclonal gammopathy of IgG/lambda type. More than 100 cases of this rare disorder have been observed up to now, mainly in Japan. In recent reviews the terms POEMS-syndrome or Crow-Fukase-syndrome have been used. Local radiotherapy of the myeloma led to lasting regression of symptoms. Studies with immunocytochemistry and immunoelectroblotting revealed specific antibody activity against hypophysis, suggesting that the pathologic monoclonal myeloma antibodies may damage the neuroendocrinic centers in hypothalamus and hypophysis as the primary target. Most of the multisystemic symptoms would thus be explained as secondary alterations.

Adult↗
PubMed1986

Neuropathy of vasculitic origin in a case of Garin-Boujadoux-Bannwarth syndrome with positive borrelia antibody response.

A 42-year-old man suffered from erythema chronicum migrans on different parts of the body after repeated tick bites. A few months after the last tick bite he developed a painful neuropathy in both legs with patchy disturbance of sensibility, mild weakness of the feet and loss of the right ankle jerk. Repeated determinations of antibodies against borrelia spirochetes revealed increasing IgG titres. Biopsy of the left sural nerve, which was clinically and electrophysiologically affected, showed a vasculitis of epineurial vasa nervorum and severe angiopathic lesions of the perineurium and the neural parenchyma. Parenteral high-dose penicillin treatment resolved the clinical symptoms.

Adult↗
PubMed1986

Perhexiline-induced lipidosis in the dark Agouti (DA) rat. An animal model of genetically determined neurotoxicity.

Perhexiline maleate, an antianginal compound, may cause severe adverse effects such as weight loss, hepatic dysfunction and peripheral neuropathy in a small proportion of patients. Since present evidence suggests that poor debrisoquine hydroxylators are at risk, we designed an experimental study comparing its neurotoxic effects in dark Agouti (DA) rats, with poor hydroxylation of debrisoquine with that in Sprague Dawley (SD) rats, which are vigorous hydroxylators. Light and electron microscopic investigations revealed neurotoxic changes in DA rats after cumulative doses which did not cause any changes in SD rats. Although there was no evidence of hepatic disturbance, morphological examination disclosed a heavy lipid deposition in neurons of dorsal root and sympathetic ganglia in DA rats. This was correlated with increased plasma and tissue concentrations of the drug. The lipid accumulation was similar to that observed in man with perhexilene-induced neuropathy. Our results suggest that perhexilene neurotoxicity in the DA rat is related to a genetically determined impairment of hydroxylation. The DA rat may serve as an animal model for investigating the potential neurotoxicity of drugs which are metabolized by hydroxylation of the debrisoquine type.

Animals↗
PubMed1985

[Polyneuropathy after cisplatin treatment].

Polyneuropathy developed in 7 of 87 women who had been treated with cis-platinum for ovarian carcinoma. Distal disturbances of sensitivity were clinically prominent, the emphasis being on disturbed vibratory perception and acrognosis. No relevant signs of motor dysfunction were noticed, neither clinically nor neurophysiologically. Sural biopsies taken from two women revealed a primary axonal degeneration, mostly affecting the myelinic fibres of large diameter. In 3 cases mild reversion was seen, and in 4 cases no definite reversion, of the disturbed functions - uncertain gait and clumsiness of the hands - during the follow-up period of 6 to 30 months.

Aged↗
PubMed1985

Polyneuropathy in paraproteinaemia.

Paraproteinaemias are frequently associated with peripheral neuropathies. "Benign" paraproteinaemia, myeloma and Waldenströms macroglobulinaemia may present clinically as polyneuropathy. Therefore immunoelectrophoresis is strongly recommended in the routine diagnosis of polyneuropathies of unknown origin. Peripheral neuropathies associated with paraproteinaemia are clinically, electrophysiologically, pathologically and probably also pathogenetically heterogeneous. There are subgroups such as demyelinating neuropathy associated with IgM paraproteinaemia, which show quite distinctive features. This survey describes the different types of paraproteinaemia and their associated peripheral neuropathies. The incidence, pathogenesis and therapy of peripheral neuropathy associated with monoclonal gammopathies are discussed.

Aged↗
PubMed1985

A monoclonal antibody that binds to both astrocytes and myelin sheaths.

A monoclonal antibody designated III 5H8 was shown to bind both to astrocytes and to myelin sheaths as studied with immunocytochemical techniques on brain sections and cell cultures. Binding to astrocytes was confirmed by double immunofluorescent labelling of frozen sections and cell cultures with anti-GFAP, and appeared to be sensitive to formalin treatment. Binding to myelin sheaths was confirmed by comparing sections labelled with III 5H8 with sections labelled with antibodies against axons and myelin basic protein as well as by staining of sections of hypomyelinated spinal cord with III 5H8. On immunoblots of separated white matter III 5H8 revealed two bands, while on immunoblots of purified myelin only one band was seen. The findings are discussed with respect to the function of astrocytes in white matter and shared antigenic determinants between astrocytes and oligodendrocytes.

Animals↗
PubMed1985

Heterogeneity of congenital motor and sensory neuropathies.

Six children suffering from a congenital motor and sensory neuropathy (CMSN) are described. Severe muscle hypotonia, areflexia and a delay of motor development are detectable in all of them. Sural nerve biopsies exhibited an almost complete absence of myelinated fibres and a correspondingly slow nerve conduction velocity (NCV) of less than 10 m/s was detectable in four patients. A few segments with hypermyelination adjacent to gross hypomyelination were seen in the fifth patient, and the NCV was 15 m/s. The sural nerve of the sixth patient showed a loss of thick myelinated nerve fibres, and his NCV was 25 m/s. These results demonstrate the histological heterogeneity of CMSN which was already detected by the NCV. The relation of our findings to the classification of HMSN by Dyck and Lambert (1968) is discussed.

Child↗
PubMed1985

Passive transfer studies in demyelinating neuropathy with IgM monoclonal antibodies to myelin-associated glycoprotein.

Serum or IgM fraction from two patients with a demyelinating neuropathy and IgM monoclonal antibodies to myelin-associated glycoprotein were injected in three different animal species. There were no clinical, electrophysiological or morphological signs of demyelination in either chronic or acute passive transfer experiments. These results suggest that the pathogenesis of this human demyelinating neuropathy may be more complex than has been assumed.

Animals↗
PubMed1985

Refsum's disease: management by diet and plasmapheresis.

A case of Refsum's disease treated by serial plasma exchanges together with a moderate low phytanate diet is reported. Serial plasma exchanges determined a rapid significant clinical improvement (neuropathy and cerebellar ataxia) that allowed immediate return to full-time employment. The initial improvement could be maintained by intermittent serial plasmapheresis despite partial failure of the initially introduced low phytanate diet bringing 20 mg phytanic acid daily. A new dietary regimen bringing 10 mg phytanic acid was later introduced that was well tolerated. No liquid formula was used. The clinical improvement was clearly correlated to a fall in serum phytanic acid from 45.3 to 16.2 mg/100 ml.

Adult↗
PubMed1985

Coronary artery bypass grafts. Influence of preoperative risk factors on the late postoperative course.

In order to assess the influence of preoperative risk factors on the late postoperative course, 186 consecutive patients in whom coronary artery bypass graft (CABG) was performed for chronic stable angina (169 men, 17 women, mean age +/- SD 54 +/- 8 years) were followed for an average of 54 (6 to 113) months. The overall five-year survival rate by life-table analysis was 90 +/- 2 percent. The postoperative course was considered favorable in 112 patients (60 percent) in whom angina was absent or improved by at least 2 NYHA classes throughout the entire follow-up, and was unsatisfactory in 74 patients. It was concluded that the late postoperative course of patients with CABG was unfavorably influenced by the presence of two or three risk factors, and a high preoperative cholesterol level was the only single risk factor associated with unsatisfactory outcome.

Adult↗
PubMed1984

[Immunopathogenesis of polyneuropathies in paraproteinemia].

Polyneuropathies are the most common neurological complications of paraproteinemias . In many cases pathogenesis remains unclear. In two patients with chronic demyelinating neuropathy in IgM-paraproteinaemia subtle methods were applied ( immunoelectroblot and immunocytochemistry). It could be demonstrated that the pathologic antibodies in the patients' serum reacted specifically with an antigen in the sheath, the myelin-associated glycoprotein. These observations suggest an antibody-mediated immunopathogenesis of the patients' polyneuropathy and invite prospects for a rational treatment with immunosuppressive approaches.

Aged↗