Biomedical subjects
Publications and source records attributed to F Fischer.
A series of 15 cases of replantation in children is reviewed with special attention to the frequency and the implications of epiphyseal lesions. Definite conclusions, however, will only be possible after these patients reach maturity.
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Several types of extremely thermophilic archaebacteria have recently been isolated from solfataric water holes, hot springs and hot sea floors. It has been shown that some of them can live using sulphur respiration of reduced carbon substrates as a source of energy, a type of metabolism previously described for the eubacterium Desulfuromonas. We report here that several extremely thermophilic archaebacteria can live with carbon dioxide as their sole carbon source, obtaining energy from the oxidation of hydrogen by sulphur, producing hydrogen sulphide. They are thus capable of a new type of anaerobic, purely chemolithoautotrophic metabolism, a possible primaeval mode of life.
Twelve months after onset of streptozotocin-induced diabetes in rats, the basal lamina width of peripheral retinal capillaries, as measured with two different morphometric methods, is increased only in the basal lamina regions adjacent to perivascular glial cells. In the region between endothelial cells and pericytes no increase of thickness was observed. These facts support the suggestion of a predominantly glial (neuroectodermal) contribution to basal lamina thickening of retinal capillaries in diabetes mellitus. No correlation exists between the degree of basal lamina thickening at the different anatomic sites. Furthermore, no clear-cut correlation was found between basal lamina thickening and severity of the metabolic disease.
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UNLABELLED: Clinical and autoptic investigations of thirty patients suffering from diabetes mellitus and retinopathia proliferans result in these findings: Of the various manifestations of angiopathy only retinopathy (leading symptom), nephropathy, and arterial hypertension are present in all cases, all other forms receeding into the background numerically, though not in potency. 20 cases of nephropathy ended in uremia (cause of death), 10 cases in azotemia. In 14 out of 20 cases of uremia specific glomerulosclerosis (M. Kimmelstiel-Wilson) was stated autoptically, in the remaining 6 cases a different form of nephropathy was found (pyelonephritis, arteriosclerosis renum, chronic glomerulonephritis). In the 10 patients suffering from azotemia, direct causes of death were various general diseases, such as coronary sclerosis, encephalomalacia, pyogenic infections, and acute tuberculosis. CONCLUSION: Diabetes mellitus in connection with retinopathia proliferans turns out to be the most serious form of the general diabetic disease.
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Friend erythroleukemia cells, a widely used in vitro model of murine erythropoiesis, express prior to induction, a state of erythroid differentiation similar to that of the early erythroblast in vivo. To investigate whether this uniform and stable epigenetic state was the result of a selection in long-term culture for the corresponding cell type, 29 new cell lines were isolated from the hemopoietic organs of DBA/2 mice infected with Friend virus and were analyzed without delay for the expression of several erythroid traits. All the lines examined displayed levels of expression of the markers indistinguishable from those displayed by established Friend cell clones. Thus, newly isolated Friend cell lines appear to be blocked at essentially the same stage of erythroid differentiation as established clones. This indicates that the expression of several characteristic erythroid markers is remarkably stable in vitro and does not result from long-term selection. In contrast, the capacity of these cells to respond to chemical inducers varies considerably from clone to clone and with time in culture.
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General experience shows that proliferative diabetic retinopathy leads to blindness within only a short time, in spite of short-term improvements in the clinical picture. Long-lasting remission can occur, but seldom for more than a few years. We have observed 3 patients with proliferative retinopathy in whom remission continued for more than 15 years, in one case even lasting over 20 years. Good, useful vision was maintained during all this time. This was only true of one eye, however, while the other eye rapidly became blind. Of the other forms of angiopathy, little coronary heart disease and no peripheral vascular disease was observed in these patients. There were also no signs of nephropathy, i.e. diabetes-specific glomerular sclerosis. Thus, the total picture of angiopathy seems to be benign. The remission of the retinopathy seems to be in accord with this general trend, although it can perhaps be partly explained by unknown local factors in the eye itself.
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In ten patients (six female, four male) proliferative retinopathy manifests itself soon after the onset of diabetes. The events accompanying retinopathy (initial stage, start of proliferations etc.) occur in rapid succession. Compared with other forms of angiopathy, retinopathy shows a certain degree of independence. Quite apart from questions of diabetes duration and management, a new conception of the causes of diabetic retinopathy and angiopathy is taking shape, emphasizing the constitutional hereditary background.
Interrelations between the process of growing old and diabetic proliferative retinopathy are investigated with 45 patients, arranged in two groups, group I (21 cases) comprising patients of 20 to 30 years of age, group II (24 cases) patients 50 to 60 years. Inner structures and certain conditions of retinopathy prove to remain untouched, only the appearance is diminishing during the process of growing old. All this is reflected by the attendant nephropathy and the other forms of angiopathy. Behind it there are the multifarious symptoms of aging, contingent chiefly on the changing endocrine and the early developing of vascular "old-age sclerosis".
There are two groups of diabetics under report, group I comprising 70 cases of retinopathia simplex, group II 100 cases of retinopathia proliferans in the centre. Retinopathy, showing as first sign of angiopathy, offers a comparatively good prognosis for the overall case of diabetes since, normally, neither retinopathia proliferans nor glomerulosclerosis are apt to develop. The same, in a higher degree, applies to cases of simple retinopathy fully devoloped and verified through ten years, at least: Retinopathy then shows stationary, in fact regressive development, the attending nephropathy generally expressing itself by the benign form of pyelonephritis and arteriolosclerosis renum rather than by glomerulosclerosis. All this in sharp contrast to proliferating retinopathy. Coronary sclerosis, peripheral and cerebral sclerosis and, to a limited extent, arterial hypertension stand independent of that; they attract attention by noteworthy independence.
Proliferative retinopathy and glomerulosclerosis (Kimmelstiel-Wilson disease), crucial prognostic features in determining morbidity and mortality of diabetics nowadays, appear to be closely related: joint inadence, parallel progression and similar histological findings. A report is given on four cases suffering from proliferative retinopathy for 20 to 26 years, yet without any signs of glomerulosclerosis. The patient are all advanced in age (68 and more) and in relatively good general condition, but have, tragically, been blind for many years. Hence proliferative retinopathy, though part of diabetic angiography, is proved to originate independently from glomerulosclerosis although apparently so closely related to this syndrome. Nothing can be said in explanation of this fact, neither on a metabolic nor an organic basis.
Changes of individual non-esterified fatty acids in serum were studied in 7 metabolically healthy patients, suffering from idiopathic trigeminal neuralgia, who underwent electrocoagulation of gasserian ganglion under neurolepthypalgesia. The mean concentration of fatty acids increased by about 40% during the strong surgical pain stimulus. The increased lipolysis affected all individual fatty acids in proportion to the ratio of their presence in adipose tissue. The mechanism of pain-induced activation of lipase and possible consequences of alterations in individual non-esterified fatty acids are discussed.
In the period 1967 to 1976 the Adverse Drug Reaction Committee of the Medical Association of the Federal Republic of Germany (AMK) received 323 reports of transfusion emergencies following the administration of colloid plasma expanders (dextran, gelatin, starch). The reports ranged from medium to severe cases. Nine percent of the reported cases had a fatal outcome. The data contained in these case reports could only be statistically analyzed within certain limitations as the reports were incomplete and other parameters necessary for a definite statistical evaluating were missing. Furthermore the results do not cover the following points: 1. What percentage of reactions to plasma expanders in W. Germany was reported? --2. What percentage can be attributed to the individual colloids within the entirety of these undesirable side effects? --3. What percentage of the individual colloids can be allocated to the varying degrees of severity of these reactions? -- Further limitations which complicated the analysis of the case reports are discussed individually. Despite these difficulties an attempt was made to analyse the parameters necessary in the diagnosis of acute transfusion emergencies and to compile a guide for the clinical symptomatology. Grading of reactions into four degrees of severity has proved useful both in terms of diagnosis and immediate therapy. The medical statistical evaluation presented in this paper gives an indication as to the significance of the observed side-effects and confirms the statement and recommendations made elsewhere in the literature. In these emergency cases life-threatening incidents appear to be more common than is generally assumed and the user is aware of. The incidence of product-specific emergencies can only be determined to some degree of accuracy by randomized prospective studies. These would have to be conducted with numerous strict guidelines. On the basis of the results presented here, these studies should be attended to with a sense of urgency. Regardless of the difficulties encountered in the evaluation of the case reports, guidelines as to the recognition of reactions, prophylaxis and immediate remedial therapy could be established. These would appear to suffice as urgently required comprehensive information for the nursing staff as well as all doctors. Recognizing side-effects and instituting immediate remedial therapy along the principles laid down in these guidelines can in most cases of severe reactions remove the acute threat to life.