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Biomedical subjects

K Felgenhauer

Publications and source records attributed to K Felgenhauer.

At least 91 records · Page 5Linked to original sources
PubMed1987

Beta trace-protein as marker for cerebrospinal fluid fistula.

The detection of beta trace-protein with the help of an easy-to-perform Ouchterlony test is strongly indicative of liquorrhea. The protein has been purified from pooled cerebrospinal fluid and an antiserum has been produced in rabbits. An open CSF fistula was diagnosed in 24 cases and there was no false positive result.

Beta-Globulins↗
PubMed1987

Protein transfer at the blood cerebrospinal fluid barrier and the quantitation of the humoral immune response within the central nervous system.

The cerebrospinal fluid (CSF)/serum concentration quotients of albumin and the immunoglobulins G, A and M have been determined for 396 patients with a normal blood CSF barrier function or a pure barrier impairment without a humoral immune response within the central nervous system. The ratios between the concentration quotients of the three immunoglobulins and that of albumin increase in a nonlinear fashion with progressive impairments of the blood CSF barrier, i.e. the molecular size dependent discrimination of the protein transfer ('selectivity') decreases. The upper reference values of the concentration quotients for the whole range of passive transfer comply with the hyperbolic function: Q(IgX) = a/b square root Q(Alb)2 + b2 - c with different constants a/b, b2, c for IgG (0.8, 15 X 10(-6), 1.8 X 10(-3), IgA (0.72, 80 X 10(-6), 5.1 X 10(-3) and IgM (0.65, 150 X 10(-6), 7.5 X 10(-3). With these discriminatory functions the locally synthesized fractions IgX(loc) of IgG, IgA and IgM in CSF can be calculated by the general formula: IgX(loc) = [Q(IgX) - a/b square root Q(Alb)2 + b2 + c] X IgX(Ser).

Albumins↗
PubMed1987

Evidence for different immune responses to HIV in CSF and serum?

A case of acquired immune deficiency syndrome (AIDS) and a case of AIDS-related complex (ARC) are described. In both instances comparative Western blot analysis of cerebrospinal fluid (CSF) and serum samples show evidence of qualitative differences in antibody-binding patterns to viral polypeptides.

AIDS-Related Complex↗
PubMed1987

Myo-, neuro-, gastrointestinal encephalopathy (MNGIE syndrome) due to partial deficiency of cytochrome-c-oxidase. A new mitochondrial multisystem disorder.

A 42-year-old woman had a 10-year history of external ophthalmoplegia, malabsorption resulting in chronic malnutrition, muscle atrophy and polyneuropathy. Computer tomography revealed hypodensity of her cerebral white matter. A metabolic disturbance consisted of lactic acidosis after moderate glucose loads with increased excretion of hydroxybutyric and fumaric acids. Post-mortem studies revealed gastrointestinal scleroderma as the morphological manifestation of her malabsorption syndrome, ocular and skeletal myopathy with ragged red fibers, peripheral neuropathy, vascular abnormalities of meningeal and peripheral nerve vessels. Biochemical examination of the liver and muscle tissues revealed a partial defect of cytochrome-c-oxidase (complex IV of the respiratory chain). This mitochondrial multisystem disorder may represent a separate entity to be classified between the spectrum of myoencephalopathies and oculo-gastrointestinal muscular dystrophy.

Adult↗
PubMed1987

The compartmental IgM and IgA response within the central nervous system.

The diagnostic value of the locally synthesized IgA and IgM fractions in cerebrospinal fluid is described. The differentiation of the CSF immunoglobulins was performed with the help of a diagram that had been established on empirical grounds. Immunoglobulin G generally dominates the humoral immune response within the central nervous system, but in some diseases a comparatively strong participation of the other immunoglobulins was found: IgA in purulent meningitis and neurotuberculosis, IgM in tick-borne early summer meningoencephalitis. In meningopolyneuritis Bannwarth and mumps meningoencephalitis a broad three class response was found. The diagnostic significance of these findings is independent of the disease stage, since the compartmental immune response lacks the Nossal-Switch from IgM- to IgG- antibodies.

Central Nervous System↗
PubMed1987

The prevalence of locally-synthesized virus antibodies in various forms of multiple sclerosis.

In 125 patients with multiple sclerosis, intrathecally synthesized antibodies against measles, rubella and zoster viruses were determined with an ELISA. 70% of patients with chronic progressive disease synthesized measles antibodies in comparison to 50% with a relapsing course. Women suffering from chronic progressive multiple sclerosis exhibited zoster antibodies 3 times as frequent as the other patients. These data indicate that relapsing and chronic progressive forms of multiple sclerosis exhibit different antiviral responses within the central nervous system which remain stable during the course of the disease.

Adolescent↗
PubMed1987

[The amnestic episode as a symptom of vertebrobasilar insufficiency].

People who experience an episode of transient amnesia are often not inclined to inform their doctors. Sometimes they behave normally and respond adequately, so that other people do not notice their abnormal condition. Sometimes, however, they behave abnormally or repeat the same question over and over again. The amnestic episode begins suddenly and the short-term memory is limited to several minutes. There is a retrograde amnesia for up to several years, that disappears slowly, and apparently no confabulations. Three professors of medicine and other patients have reported their transitory amnesias. Their experiences have revealed much about the dynamics of this disease.

Aged↗
PubMed1987

[Differentiation of cerebrospinal immunoglobulins in mumps meningoencephalitis].

In 24 children with mumps-meningitis or -meningoencephalitis the process dynamics of the locally produced CSF immunoglobulins were quantified by end-point laser-nephelometry. In 8 cases there was a local production of all the immunoglobulins IgG, A and M. In 6 cases the humoral immune response was still detectable after six weeks, in one child after one year. In all cases of meningoencephalitis locally produced immunoglobulins became detectable and their levels were higher than in meningitis. The locally produced CSF immunoglobulins reached the maximum in the first disease stage. There was no shift from IgM to IgG production in the CSF compartment. At present time there is no explanation for the wide variation of the humoral immune response within the central nervous system.

Adolescent↗
PubMed1986

Sensitive quantitation of carcinoembryonic antigen in cerebrospinal fluid and its barrier-dependent differentiation.

Modification of an enzyme immunoassay using beads as solid phase allows the detection of 3 pg/ml carcinoembryonic antigen (CEA). The beads are shown to be advantageous for the extraction of proteins in highly diluted antigen solutions thus replacing a need for concentration of the sample. The mean concentration of CEA in pooled cerebrospinal fluid (CSF) from 120 control persons was shown to be 2.7 pg/ml. The mean of the CSF/serum concentration quotients of CEA was 0.0015 for normal blood CSF barrier function with a corresponding mean albumin CSF/serum quotient of 0.0048. From the ratio of these two quotients (QCEA/QA = 0.31) and the corresponding biological variation we constructed the normal range of an evaluation graph. In the range of a blood CSF barrier dysfunction, the discrimination line between values with or without a local CEA synthesis in brain was determined to be QCEA = 0.7 QA. Twenty-five out of 383 control persons and 29 out of 45 patients with a tumor metastasis had evaluable quotients. The evaluation graph had a high significance with respect to the identification of tumor metastasis: from a group of patients with a confirmed leptomeningeal metastasis 13 out of 13 and from a group of patients with intraparenchymatous tumor metastasis 10 out of 16 could be identified by CSF analysis. The CEA CSF/serum concentration quotient fits well in the concept of a molecular size-dependent filter function of the blood CSF barrier.

Blood-Brain Barrier↗
PubMed1986

The clinical relevance of locally produced carcinoembryonic antigen in cerebrospinal fluid.

Sixteen out of eighteen meningeal carcinomas (89%) secreted carcinoembryonic antigen (CEA) into the cerebrospinal fluid, where it could be quantified separately from the portion originating from the circulating blood. The discrimination of both fractions was performed according to an empirical approach analogous to the immunoglobulins. Only 47% of the intraparenchymal carcinomas released CEA into the CSF compartment and it is possible that the extra-cellular space of these tumour sites does not communicate with the free CSF space. Extradural metastases may cause an impairment of the blood-CSF barrier via restrictions of the CSF fluid turnover, but the dura remains impermeable for the tumour marker. Seven out of 54 primary brain tumours (13%) released carcinoembryonic antigen into the cerebrospinal fluid.

Blood-Brain Barrier↗
PubMed1985

Diagnostic significance of IgG-synthesizing activated B cells in acute inflammatory diseases of the central nervous system.

An immunohistological technique was used to identify activated, i.e. IgG-synthesizing, B cells in cerebrospinal fluid. A total of 177 patients suffering from inflammatory diseases of the central nervous system were investigated. Activated B cells were found in 61% of patients with bacterial meningitis, especially in lethal or prolonged cases. The number of activated B lymphocytes was low in most cases of viral meningitis, whereas in tick-borne meningopolyneuritis Bannwarth, a very strong B cell activation was detectable. In all inflammatory diseases investigated, the B cell response was restricted to the mononuclear phase. Comparing the number of activated B cells and the amount of locally synthesized IgG, there was a loose correlation between these inflammation parameters in meningopolyneuritis Bannwarth. In acute viral and bacterial meningitis more than 50% of the patients exhibited activated B cells without any detectable intrathecal IgG synthesis.

Antibody Formation↗
PubMed1985

[Physiological proteinuria in the newborn].

The levels of the individual proteins albumin, caeruloplasmin, immunoglobulin G, and alpha 2-macroglobulin were determined by Laurell's electroimmunoassay in the serum and urine of 127 children. Their age ranged from 29 gestational weeks to 13 years. Highest levels of the proteins in the urine were found during the first days of life. The values did not depend on gestational age. The urine concentrations are influenced by glomerular filtration and the reabsorption of proteins and water. The steady state of these functions can be characterized by the serum/urine concentration ratios and the clearance of the proteins. In the first days after birth the permeability of the renal barrier is maximal, the concentration ratios are low and increase markedly up to the end of the first three months; after that, they continue to rise only slightly. The clearances of all the examined individual proteins decrease between term and the third month of life, thereafter increasing until late childhood. The selectivity of the glomerular filtration also shows its highest rate of development during the first days after term.

Adolescent↗
PubMed1985

Apurulent bacterial meningitis (compartmental leucopenia in purulent meningitis).

Meningococci and Haemophilus influenzae may invade the subarachnoid space during the bacteriaemic phase without impairment of the blood-CSF barrier and in the absence of any leucocyte reaction. In pneumococcal meningitis the CSF may also contain less than 100 cells/microliter despite the presence of "pure bacterial cultures", but the barrier is completely broken when the serum/CSF concentration ratio is below 10. A clinical analysis of eight patients with fewer than 100 cells/microliter revealed that the first symptoms of meningitis appeared at least 3 days prior to the diagnostic lumbar puncture. There was a strong neutrophilic reaction in the blood with a prevalence of juvenile forms in most cases, indicating intact antibacterial defence mechanisms. Within 24 h after the start of antibiotic therapy the cell number rose above 2000/microliter accompanied by disappearance of pneumococci. Six of the eight patients died. In three cases autopsy revealed thick layers of pus over the convexities, indicating a compartmental separation of the ventricles and the spinal subarachnoid space. In one case of late diagnosed bacterial meningitis with a pleocytosis of 430/microliter the CSF lysozyme level was seven times higher than compatible with this cell number. Hyperphagocytosis and cellular disintegration is thought to cause the leucopenia within the spinal CSF compartment. "Apurulent bacterial meningitis" can be seen as a disease entity that is a diagnostic pitfall and also a prognostic sign.

Adult↗