[The epidemiology of neurosyphilis (author's transl)].
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Biomedical subjects
Publications and source records attributed to G Ritter.
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Myelin basic protein (MBP) was demonstrated in the CSF of 15 out of 41 patients with assumed or ascertained neurosyphilis using a radio-immunoassay. In parenchymatous syphilis (progressive paralysis, tabes dorsalis) more than 50% of patients had MBP-positive CSF independent of immunological findings and previous treatment. CSF of patients with meningovascular neurosyphilis was mostly negative, only in 2 cases with acute symptoms was MBP demonstrable. In one of these patients MBP was no longer demonstrable in the CSF 6 months after treatment. The frequent occurrence of MBP in CSF in parenchymatous neurosyphilis can be taken as evidence of persistence of demyelinising activity even in cases where immunological finding point to "syphilis satis curata" (sufficiently treated syphilis).
The present study is based on a multicenter documentation system which includes standardized information on a total of 1271 patients with multiple sclerosis (MS). In 441 (34.7%) cases the optic nerve was involved at the first appearance of the disease, and in 212 (16.6%) subjects optic neuritis (ON) was the sole initial sign. For all MS patients with ON at the onset of the disease the female to male ratio was 1.3, whereas it was 1.5 for the whole series. The mean age at onset was 2 years lower for patients with initial ON as compared with the whole series (29.0 and 31.1 years, respectively). Correlation of the disability of the patients to the duration of the disease revealed the best prognosis for patients with ON as the sole inital sign of MS. The frequency of brainstem/cerebellar and pyramidal signs was lowest among these patients at the time of the present examination. The difference was more pronounced during the first years of the disease and disappeared after longer duration. The correlation curves of disability to the present age of the patients confirmed this pattern. Our findings do not support the idea of initial ON as being a favorable sign of the later course. As an initial bout of MS, it reflect more precisely the mean age of onset of the disease than other signs.
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3374 accidents occurring on the field of sport during the years 1975--1977 accounted for 19% of all accidents dealt with at the Institute of Kinderchirurgie in Graz. 51% of the accidents were caused by the typical winter sports: skiing, tobogganing, ice-skating and ski-jumping with skiing accounting for 75% of the accidents. The fracture localization typical of the different kinds of winter sport is dealt with in detail. The correct size and safety of the equipment were found to be particularly important in the prevention of such accidents in childhood.
Scintigraphy and the stimultaneously effected osteoscintimetry of the pelvis and of both hip joints offers the possibility of a safe early diagnosis of Perthes' disease directly after manifestation of the clinical symptoms, two months before the roentgenologically identifiable, discrete changes of stage I have occurred, or four months before the clear roentgenological visualisation of the disease (stage II). Moreover, scintigraphy enables detection of the time at which restitution or revascularisation of the necrotic bone of the epiphysis of the head of the femur sets in, and to draw further conclusions from the scintigraphic and scintimetric pattern of results, on the prognosis and further course (with time) of Perthes' disease.
A variety of 99m-Tc-phosphate compounds are sensitive and reliable for scintigraphic diagnosis of bone diseases. Therefore bone scan has become a safe method for evaluating patients with suspected acute hematogenous osteomyelitis. So we were able to perform early and adequate treatment without evidence of bony changes in the radiograph. Quantitative regional measurements with a relative uptake ratio was found to be a clinically useful parameter in the follow-up of osteomyelitis.
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In a prematurely born infant of a diabetic mother a purulent arthritis with osteomyelitis of the elbow occurred 18 days after an enterobacter aerogenes-septicemia was proved. Enterobacter (aerobacter) aerogenes is a nosocomial gramnegative germ, that is more and more regarded responsible for infection of the newborn in intensive care units. In accordance with the literature recording a high rate functional loss after septic arthritis also our patient suffered from a mobility deficiency in his right elbow a year after the onset of the disease.
Attempts at total hip replacement in the presence of unstable acetabula--which may be caused by a recent fracture or pseudarthrosis--are doomed to failure if conventional implantation technics are used. Such attempts lead inevitably to a rapid loosening of the cup. This article describes a newly developed implant which simultaneously re-establishes acetabular stability while solidly anchoring the cup. Use of this implant contributes to early patient mobilization and undisturbed healing of fractures and pseudarthroses.
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Cervical myelography by means of lumbar application of metrizamide was performed on 110 patients. The exploration technique, the results, the quality of the myelograms, and the side effects observed are discussed. The most frequent complaint was headache. There were also cases of vertigo, vomitus, pain in the back and legs, and one case of tachycardia. Complications of a more serious nature, in particular epileptic seizures, did not occur.