[The importance of diagnostic procedures in cerebrovascular disease].
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Biomedical subjects
Publications and source records attributed to K Grossmann.
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The isolation and purification of DNA-dependent RNA polymerase I (EC 2.7.7.6) from parsley (Petroselinum crispum) callus cells grown in suspension culture is described. The enzyme was solubilized from isolated chromatin. Purification was achieved by using DEAE- and phospho-cellulose in batches, followed by column chromatography on DEAE- and phospho-cellulose (two columns) and density-gradient centrifugation. The highly purified enzyme was stable over several months. The properties of purified parsley RNA polymerase I were investigated. Optimum concentration for Mn2+ was 1 mM, and for Mg2+ 4-6 mM, Mn2+ was slightly more stimulatory than Mg2+. The enzyme was most active at low ionic strengths [10-20 mM-(NH4)SO4]. The influence of various phosphates was tested: pyrophosphate inhibited RNA polymerase at low concentrations, whereas orthophosphate had no effect on the enzyme activity. ADP was slightly inhibitory, and AMP had no effect on the enzyme reaction. Nucleoside triphosphates and bivalent cations in equimolar concentrations in the range 4-11 mM did not influence the RNA synthesis in vitro. Free nucleoside triphosphates in excess of this 1:1 ratio inhibited the enzyme activity, unlike free bivalent cations, which stimulated RNA polymerase I.
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RNA polymerase I was isolated from parsley cells grown in suspension culture and from soybean hypocotyls. Kinetic studies of the enzyme revealed that RNA polymerase I is an allosteric regulated enzyme. The enzyme activity was influenced by nucleoside triphosphates (NTP) and divalent cations. NTP exceeding a 1:1 ratio of these two components acted as allosteric inhibitors, contrary to free divalent cations, which had promotive effects on the RNA polymerase I. Furthermore, isolated nuclei from parsley exhibited a powerful nucleoside triphosphatase (NTPase) activity. Contrary to RNA polymerase I, this enzyme was stimulated by NTP exceeding the 1:1 ratio of NTP and divalent cations. Free divalent cations had an inhibitory effect. Assuming that a causal connection of these two processes does exist, a possible role of this NTPase would be the control of NTP pools in relation to divalent cations and thus regulating RNA synthesis.
It is reported on the pathophysiological peculiarities which may appear in the coincidence of the two vascular diseases. As therapy the fibrinolysis with Awelysin should always be taken into consideration.
The tasks of apparative examination methods in the angiologic diagnostics are explained. Apart from the mechanical oscillography the possibilities of registration and evaluation of the peripheral pulse wave are discussed. As quantitative examination method the plethysmography is broadly used. The most important applications of the ultrasound-Doppler-technique are described.
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In patients with a cerebral vascular process, parameters for the loss in distensibility and the remaining regulation with of sclerotically changed cerebral vessels were obtained by employing a special complex rest and function rheoencephalographic investigation method.
It could be shown that an ECG-screening could be integrated into the routine work of a factory outpatient department. As a result of the automatical analysis of the ECG we got an exact knowledge of the efficiency of Smith's and Pipberger's diagnostic programmes. The suitability of the two programmes for screening examinations resulted from the 91% and 97% certain separation of normal and pathological findings and the small proportion of falsely negative results (Smith, Pipberger). Concerning the exact differentiation of pathological ECG the frequency of recognition of Pipberger's programme still surpassed that one of Smith's programme. However, the two programmes show a diagnostic security which lies above the visual diagnosing. The establishment of findings performed off line per week ascertained a rapid disposal of results. In comparison to former examinations newly detected cases could be established only in a small percentage. The importance for health polities of such examinations results from the necessity of the prophylaxis of cardio-vascular diseases, the numbers of morbidity and mortality of which are permanently increasing.
During the postpartum stay in the hospital 10 randomly selected German mothers and their newborns were video-taped for three feedings on three different days for 1/2 hour each. A written protocol of the behaviours of the mothers from three to five seconds before until three to five seconds after the opening of the eyes of the newborns was kept. The maternal behaviour in these protocols was evaluated. In 92.5% of the cases the behaviour of the mothers changed when their newborns opened their eyes. The following correlations were detected: the social behaviour of the mothers was twice as intense following opening of the eyes of the infant (p less than 0.001). The nurturing behaviour of the mothers remained constant but the interest in other objects decreased (p less than 0.01). Prior to the opening of the eyes of the newborns the mothers moved the body of the infants more (p less than 0.001). Following opening of the eyes of the newborns the mothers showed more lively facial expressions and spoke more to the infants (p less than 0.001). The mothers moved the infants closer following opening of the eyes (p less than 0.001). The results were evaluated in view of maternal infant bonding theory and desirable changes for the obstetric ward were suggested.
By means of a device system consisting of constituents of the SW-production and own developmental works in the factory Kombinat VEB Umformtechnik (combinate nationally owned enterprise transformation technology) for the first time ECG serial examinations were performed with the help of the mechanical ECG-analysis. The corrected orthogonal system of Frank with 3 leads served as deviation system. The ECG-registration was independently performed by function nurses. 1,720 male and female workers of this factory at the age of 21 to 59 years served as test persons. The ECG-registration lasted 20 sec., the whole time of examination including the changing of clothes and the way from the working place to the examination room did not last more than 4 to 8 min. As diagnosis programme served that one developed by Pipberger. The mechanical analysis resulted in 74.4% in a normal course of the electrocardiographic current curve. Among the pathological or abnormal ECGs (25.6%) prevailed the vegetative-functional heart diseases with 92%. Then followed the chronic ischaemic heart diseases with 7.9% and the hypertension with 5.1%. Diseases of the heart and the blood circulation established for the first time referred to 8.9%. Of them 5% needed control and 3.9% needed therapy.
It is reported on the use of an intraarterial infusion therapy by means of indwelling catheter in arterial obstructive disease. The catheters were shoved forward towards the opposite side in Seldinger's techinque under X-ray control antegrade and retrograde through the bifurcation of the aorta. The infusions were performed during several hours with above all metabolically effective substances in combination with various antibiotics. The simultaneous use of aimed surgical measures is to be aspired too. In 6 out of 8 cases a healing of the necroses could be achieved.
After the experiences with the use of the programme of Pipberger concerning the automatised ECG-analysis in clinic, outpatient department and factory public health, which were made at the Medical Academy Erfurt during the last years, at this time comparative examinations with the ECG-analysis programme of Smith were performed. The intake of data (3 orthogonal leads) is done by means of a data establishing unit developed by us. For the analog-digital-changing, the pretreatment of data and the transmission of the ECG-data on the digital magnet tape a process-calculator TPA-i is used. The analysis is performed by the computer Robotron 21. The evaluation of the results shows that, when a great number of patients is examined, normal curves are correctly estimated at 100%. The recognition rate of pathological curves has with 79.5% about the same size as the visual judgment. The deficiencies of the diagnostic programme of Smith must be essentially found in the relatively high proportion of falsely negative findings, the insufficient differentiation of the changes of the chamber variation, in the sometimes incorrect formation, why the classification of the curves in individual groups was performed. On account of the certain centage of falsely negative ones the programme is well recognition of normal findings and the tolerable pernotion of the diagnosis and the sometimes lacking insuited for screening examinations.
In 49 patients with a phlebographically ascertained postthrombotic syndrome, who were above all subdivided into morphologically defined degrees of severity, after May and Nissl, a plethysmographic investigation was carried out with the deep positioning test and the venous drainage test. The results were contrasted with a group of 53 patients with a primary varicosis and the measuring results of 102 test persons with healthy veins. A very good correlation between the morphological changes and the haemodynamic findings establishable by means of the phlebembraxis plethysmography could be proved. A clear evidence was possible by means of the venous drainage test, whereas in the deep positioning test a certain demarcation was possible only in stage III of the postthrombotic syndrome.
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It is reported on 65 patients, out of whom in 48 cases angiographically proved vascular obstructions in the pelvic and femoral regions were present. The comparison of the plethysmographic area calculated and the values of the blood supply established in the same segment of extremities resulted in a good correlation. The area of the peripheral volume pulse gives references to the compensation degree of a vascular obstruction. Slighter sclerotic vascular changes already cause a significant decrease of the area of the volume pulse, so that this method of evaluation seems to be suitable for the early recognition of the arteriosclerosis in the area of extremities.