[The initial acute renal failure and late manifestation of extrarenal symptoms in Wegener's disease].
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Biomedical subjects
Publications and source records attributed to J Schirmeister.
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A 24-year-old patient with isolated IgA deficiency and a 3-year history of minimal change glomerulonephritis with nephrotic syndrome developed acute hemorrhagic diathesis. A spontaneous inhibitor of factor VIII was diagnosed. Therapy with substitution and plasmapheresis was without prolonged effect. Only consistent immunosuppressive therapy normalized coagulation. The patient died from septic complications during immunosuppressive therapy.
The history, clinical picture, and laboratory values are clues in the diagnosis of biliary obstruction. The next diagnostic procedure for the differentiation between intra- and extrahepatic obstruction is an ultrasound study. Bile duct dilatation, cholelithiasis, hydrops, and empyema can be detected quickly and reliably. Surgical and endoscopic procedures are used for the treatment of extrahepatic biliary obstruction. In special cases the lysis of the gallstones is possible with drugs given systemically or through a nasobiliary tube.
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Long survival in Hodgkin's disease after diagnosis of the stage IVb is very rare. A 45-years old woman is reported on, who survived for 12 years after detection of Hodgkin's disease involving lymph node regions on both sides of the diaphragm, bone, and lung parenchyma, including night sweats and weight loss (stage IVb according to the Ann Arbor classification 1971). This unexpectedly favorable course is possibly due to a so-called host resistance.
Record on a case of collagen disease with pure red cell anemia and perimembraneous glomerulonephritis. The direct antiglobulin tests with anti-IgG and anti-kappaserum were positive as were the tests on antinuclear serum-antibodies. During therapy with fluocortolon and azathioprin the anemia remitted completely even when therapy was stopped. The antiglobulin tests became negative, the glomerulitis remained active, there was no deterioration of renal function.
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The patients seen at the medical clinic of a community hospital over 6 years included 291 with diseases of the pancreas, 52 of whom had carcinoma of the pancreas. Their signs and symptoms are listed. The triad of weight loss, icterus, and abdominal pain was the commonest symptom cluster. In one third of the cases the serum lipase was raised though the blood level of amylase was normal. Laparoscopy led to exploratory laparotomy in 94 percent of cases, which was performed an average of 14 days later. The future will show whether ERCP (+cytology) and CEA will improve the possibility of early diagnosis.
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The Autoturb System, a semiautomated system for photometric bioassay, was used to determine cefazolin content. Suitable conditions for the assay using Streptococcus faecalis ATCC 10541 as the indicator organism included a medium pH of 6.0 to 7.0 and an incubation time of 3 to 3.5 h at 36 C. Multiple independent assays of samples from a common batch showed the test to be highly reproducible. Accuracy of the turbidimetric assay was evaluated by comparing data obtained from a chemical (hydroxylamine) and a biological (disk diffusion) assay. The available data show the turbidimetric assay to be a rapid, accurate, and reproducible method for determining the biological activity of cefazolin samples.
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