Biomedical subjects
Publications and source records attributed to H Lange.
A 44-year-old patient with polycystic kidney disease received a renal transplant in December 1984. Nine months after immunosuppressive therapy with cyclosporin A and prednisolone the patient developed Hodgkin's disease of the mediastinum.
Severe rejection crises occurred in 13 out of 20 cadaver kidney recipients; removal of the graft was inevitable in 10 cases. The plasminogen levels were found to be lower (76.5 +/- 2.9%) in the 13 patients with impaired graft acceptance (group B) than in the 7 patients experiencing only moderate rejection (group A, 93.7 +/- 5.2%, p less than 0.01) or the 41 patients with chronic renal disease (group C, 88.2 +/- 2.3%, p less than 0.01). Since alpha 2-antiplasmin was found to be enhanced, the alpha 2-antiplasmin/plasminogen ratio was high (1.56 +/- 0.07) in group B as compared with group A (1.19 +/- 0.05, p less than 0.002) and group C (1.11 +/- 0.04, p less than 0.001). The fibrinolytic capacity, which was assessed by a "reversed fibrin plate" assay, declined significantly after transplantation, and was lower in group B greater than 20 days after grafting. The neoantigen alpha 2-antiplasmin-plasmin complex was not detected in any patient; thus hyperfibrinolysis is unlikely to be responsible for the plasminogen decrease. Protein C rose above preoperative values (group A 117.1 +/- 8.7%; group B 133.7 +/- 9.0%) and reached higher levels in group A (221 +/- 24.1%) than in group B (157.4 +/- 14.8%, p less than 0.05) between days 11 and 20 after transplantation. No constant alterations were found with respect to antithrombin III and fibrinogen. Fibrin deposits, which reduce perfusion, can be found in the vessels of rejected kidney grafts. An impaired fibrinolytic capacity and a subsequent inability to remove these clots may be significant for the outcome of transplantation.
In order to avoid the transition into an irreversible pulmonary fibrosis a diagnosis of the exogenic allergic alveolitis as early as possible is necessary. On the basis of 8 own cases the importance of a correct interpretation of the in detail not specific clinical and radiological symptoms as well as of the with regard to possible inhalative allergen loads directed establishment of the anamnesis is described.
Event-related potentials (ERPs) were studied in patients with Huntington's disease (HD) and their offspring at risk in a simple auditory oddball paradigm requiring the counting of the rarer of two stimulus categories. Group statistical analysis revealed prolongation of latencies of components P2, N2 and especially P3 in HD patients and to a lesser extent in at-risks. In a large population of normals the age-latency relationship for component P3 showed a non-linear shape with increasing slope and scatter in the older age groups. A bipartate linear regression analysis splitting the normal population at age 50 was used for detection of abnormalities of P3 latency in individual cases. Abnormal P3 latencies were present in the majority of HD patients and also in 25% of clinically normal at-risks. Correlation analysis of ERP components with detailed psychometry revealed a particularly high association of P3 latencies with measurements requiring speeded information processing in non-verbal tasks. P3 amplitude did not covary with performance scores but unlike P3 latency showed association with depression and psychosis scores. From the results it appears that analysis of ERPs is a useful electrophysiological tool for an objective assessment of cognition both in clinically definite and subclinical stages.
Serial undiluted passages of infectious bursal disease virus in chick embryo cells were accompanied by a von Magnus type fluctuation of infectivity in viral harvests and a gradual decrease of plaque size. From the 9th undiluted passage on, the whole virus population consisted of small plaque-forming virus. The small plaque size remained constant when subsequent infections were carried out at low multiplicities. Small plaque virus interfered with the replication of large plaque standard virus. The small plaque/low yield mutation favoured the generation of defective particles which could be separated from complete particles by their lower densities in CsCl-gradients, where six fractions became visible and could be analyzed separately. Most of the defective virus particles had lost the larger of their two dsRNA segments and showed an aberrant protein composition. They had a very low residual infectivity and were also able to interfere with the replication of complete virus.
Free and conjugated GABA concentrations were measured in CSF and plasma from 28 patients with manifest Huntington's chorea (HC) and 30 age- and sex-matched controls. GABA was determined by ion-exchange chromatography with fluorimetric detection (IE/F). Free and conjugated CSF GABA was significantly decreased in prolonged HC with advanced disease states and was suggested practicable as an additional diagnostic tool. However, in younger patients (less than 40 yrs) with a short period of HC (less than 2 yrs) an overlap with the age-matched normal range indicated GABA measurement inadequate to early diagnosis nor predictive for offspring at risk. An age-dependent decrease of conjugated CSF GABA was observed in patients and controls. The more pronounced decrease in patients might reflect the neurodegenerative feature of HC.
In 172 patients with various malign tumours the free hydroxyprolin (HP) and N-acetyl-beta-glucosaminidase (beta-NAG) in the serum were determined. The established values were analysed according to the kind of tumour, spread of tumour, behaviour of growth and histological classification and statistically evaluated. In mamma carcinoma progressively metastasing into bones HP is significantly increased in its mean value. 71.4 per cent of the patients have pathological values. The parameter for bone-marrow diagnostics failed in 28.6 per cent. Increases may only occur until 9 weeks before traditional diagnostics of metastases. beta-NAG values lie within the normal range for clinically not metastasing mamma carcinoma. The enzyme level will increase significantly after each tumour progression into an organ. The diagnostic sensitivity for the general diagnostics of metastases amounts to 97.7 per cent. Increases without any evidence of metastases are either due to other diseases with connective tissue changes or to occult micrometastases. An exact control is required for these patients. Likewise, HP and beta-NAG have a prognostic importance for malign testicle tumours from nonseminomes character and malign lymphomas, because with tumour progression they will turn into pathological ones. Cytostatics have no direct impact on the serum level of HP and beta-NAG.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The perivelvic extravasation is a rare X-ray symptom in the intravenous urography. Etiologic, diagnostic and therapeutic aspects are discussed on the basis of an own case and the present literature.
The fibronectin plasma levels of 17 patients undergoing cadaver kidney transplantation were determined serially in the postoperative course using laser nephelometry. While 9 patients retained their grafts (group A), the grafts of 8 patients had to be removed (group B), mainly due to rejection, 3 patients had severe infections. In both groups a significant drop of the plasma fibronectin occurred after surgery. There were no significant differences between the two groups in the mean fibronectin levels. After the initial drop the group A patients exhibited rising values leading to a stable level. Progressively declining fibronectin plasma concentrations were found in 2 of 3 severely infected patients. Fluctuating values were found in 3 group B patients without a clear correlation to the rejection crises or the kidney function. The data suggest that the fibronectin plasma level does not seem to be a prognostic marker for graft rejection. But it might be useful in the important and often difficult differentiation between rejection and infection.
Impaired fibrinolysis is associated with low plasma plasminogen (PLG) and a predominance of its inhibitor alpha 2-antiplasmin (APL). Plasma PLG and APL were determined in 10 recipients who retained their cadaveric graft (A) and 10 patients who lost it immediately after transplantation (B). In group A only five patients had a PLG less than 70 per cent and/or APL/PLG ratios exceeding 1.8, accompanied by severe albeit reversible acute rejection in three of them. In contrast nine of 10 group B patients had low PLG and/or an elevated APL/PLG ratio. Thus impaired fibrinolysis frequently appears to be associated with deterioration of cadaveric graft function.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
On the basis of a case of life-threatening haemorrhage from a postbulbar duodenal ulcer two and a half year after radiotherapy carried out on a non-Hodgkin-lymphoma, cases of the genesis and the diagnostics of this late complication are discussed.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.