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Biomedical subjects

E Deutsch

Publications and source records attributed to E Deutsch.

At least 127 records · Page 7Linked to original sources

The persistence of somatosensory and auditory pathway evoked potentials in severe hypoglycemia in the cat.

In a previous study it was shown that during severe insulin-induced hypoglycemia in rats and cats (0.38 mmol/l, i.e., 6.8 mg% and 0.8 mmol/l, i.e., 14 mg% respectively) with isoelectric EEG, the latency and amplitude of the auditory nerve-brain-stem evoked responses were not affected. In the present study on cats, the above evoked responses were complemented by recording in addition the cortical auditory evoked potential and the peripheral, brain-stem and cortical components of the somatosensory evoked potentials. Each of these evoked potentials remained in the presence of 0.75 mmol/l glucose in plasma. The persistence of the somatosensory cortical evoked potential was unexpected since two other groups have reported the disappearance of this potential during hypoglycemia. The types of neuronal activity which can still be recorded in severe hypoglycemia are probably generated by neuronal structures with lower metabolic demands such as axons and oligosynaptic pathways, surviving on the consumption of endogenous substrates with compensatory elevation of local cerebral blood flow.

Animals↗

Deficiency of fibrinogen and factor VII following treatment of severe aplastic anaemia with anti-thymocyte globulin and high-dose methylprednisolone.

In 4 patients with SAA treated with ATG and high-dose MP, an as yet unrecognized acquired deficiency of fibrinogen and factor VII was observed. The plasma level of fibrinogen fell to 39% (34-51%) and of factor VII:C to 50% (31-55%) of the pretreatment value. The nadirs were between days 10 and 35 (fibrinogen) and d 3 and 11 (factor VII) after the 1st dose of ATG/MP. From additional clotting studies it is concluded that disseminated intravascular coagulation, fibrinolysis, liver cell damage and synthesis of abnormal clotting factors are unlikely causes of these clotting abnormalities. The most probable explanation seems to be a selective inhibition of the synthesis of fibrinogen and factor VII by an as yet unknown mechanism. These clotting abnormalities might, to some extent, increase the bleeding tendency in these patients, which up to now had been solely attributed to thrombocytopenia.

Adult↗

Treatment of severe chronic idiopathic thrombocytopenic purpura in adults with high-dose intravenous gammaglobulin.

12 patients with severe chronic idiopathic thrombocytopenic purpura (ITP) were treated with i.v. polyvalent intact immunoglobulin (0.14-0.4 g/kg body weight for 5 d) because of various bleeding episodes or prior to surgery. In 9 patients a significant rise in platelet counts was noted, starting on d 2 and reaching its maximum between d 4 and 11. Thereafter, platelet counts decreased slowly, approaching pre-treatment values after 20 d in most cases. Response to immunoglobulin was reproducible, when infusions were repeated. Response to high-dose immunoglobulin was independent of age of patients and duration of disease. Platelet-associated IgG decreased in all patients tested. A pepsin-treated immunoglobulin preparation was ineffective in 3 patients.

Adult↗

Enhancement of renal function with ornipressin in a patient with decompensated cirrhosis.

An infusion with Ornipressin (8-ornithin vasopressin) in a patient with decompensated alcoholic liver cirrhosis increased urinary volume from 30 ml/h to 500 ml/h, creatinine clearance from 24 to 65 ml/min, and fractional sodium excretion from 0.86% to 11.1%. Free water clearance decreased from -10.2 ml/h to -26.2 ml/h and noradrenaline plasma concentrations dropped from 2.04 to 1.37 ng/ml. After stopping Ornipressin infusion all values returned to initial concentrations. Possible effects are an increase of renal blood flow secondary to an increase in arterial blood pressure, possibly potentiated by the vasodilatory effect of the fall in noradrenaline and/or angiotensin concentration.

Adult↗

Combined dys-form of homozygous factor XI deficiency and heterozygous factor XII deficiency.

A 12-year-old girl with lifelong hemorrhagic episodes was found to have both a dys-form of homozygous factor XI deficiency and heterozygous factor XII deficiency. The heredity of the coagulation defects was confirmed by family studies. Severe bleeding after dental surgery occurred in spite of replacement therapy and local measures including fibrin glue. Our findings suggest that the risk of bleeding in patients with homozygous factor XI deficiency must not be underestimated and that the most effective measure is the transfusion of sufficient amounts of fresh frozen plasma until at least the 5th postoperative day.

Blood Transfusion↗

Phospholipids accelerate factor IX activation by surface bound factor XIa.

Activation of bovine factor IX by surface bound factor XIa which was generated either by activation of human citrated factor IX deficient plasma or a mixture of purified human factors XII, high molecular weight kininogen (HMWK) and XI in glass tubes, is accelerated by cephalin. Human brain cephalin in dilutions ranging from 1:5 to 1:500 was studied for its effect on the activation of factor IX in concentrations of 1.0 u/ml and 16 u/ml. Cephalin dilutions from 1:5 to 1:30 accelerated the activation of the concentrated factor IX sample two- to threefold. Protein cleavage of this factor IX sample in the presence of 1:30 cephalin occurred twice as fast as in the absence of cephalin. Activation of the dilute factor IX sample (1.0 u/ml) was most effectively accelerated by cephalin in dilutions from 1:30 to 1:250. In all experiments the presence of phospholipid led to an increased factor IX cleavage concomitantly with faster generation of factor IXa activity. The results demonstrate that phospholipids actively participate in blood coagulation at an earlier stage than previously described.

Animals↗

CRM+ severe Fletcher factor deficiency associated with Graves' disease.

A 59-year-old male patient with Graves' disease and severe hereditary Fletcher factor deficiency is described. PKK clotting activity as well as the activity by a chromogenic substrate method (Chromozym PK) was less then 0.01 U/ml. In contrast to functional tests, the immunological assay (Laurell method) showed a PKK antigen concentration of 0.25 U/ml, indicating the presence of an abnormal nonfunctional PKK molecule (CRM+ variant). An inhibitor was excluded since the patient plasma did not inactivate partially purified PKK. Investigation of 11 family members revealed a reduction of the PKK clotting activity in 9 relatives of the patient. Since Graves' disease is considered an autoimmune disease, our case represents an example of an association of a severe hereditary deficiency of a contact factor and an autoimmune disease.

Cross Reactions↗

Waardenburg syndrome with associated multiple anomalies.

A 4 1/2-year-old girl presenting characteristics of Waardenburg's syndrome with associated multiple defects is described. The patient presents all the obvious signs of the syndrome with the exception of the white forelock (poliosis), but with additional anomalies like: syndactyly, absence of the fourth left toe, bilateral preauricular sinus and dacrocystitis. It is the second case of Waardenburg's syndrome reported by us during the last 20 years.

Abnormalities, Multiple↗

Synchronous bilateral oncocytoma of the parotid glands. A case report.

A case of synchronous bilateral oncocytoma arising in the parotid salivary gland is presented and the literature is reviewed. The oncocytoma forms a small group of neoplastic diseases in the parotid gland and synchronous bilateral tumors are relatively rare. According to the available literature this is the fourth case reported.

Adenoma↗

[Complications of the use of microcatheters using Grandjean's technic in ergometry].

The method of microcatheterism was described in the now usual form first by Grandjean in 1967. It offers an appropriate information about pressures in the pulmonary circulation at rest and during stress. This report gives a comprehensive survey about the complications with this method in a time range of seven years, from 1976 until 1982, in 4901 patients. The total rate of complications was very low (0.67%). Compared with a study about complications with Swan-Ganz-catheters in similar patients from Roskamm and co-workers, we found in our investigation a lower rate of dangerous arrhythmias. We conclude that microcatheterism is a simple, and cheap method, which is poor of risks. It is suitable ideally either for screening and control investigations or for the quantification of a cardiopulmonary disease.

Arrhythmias, Cardiac↗