[Fluorescence angiography of the supraorbital region. A noninvasive method for the diagnosis of carotid artery occlusive processes].
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Biomedical subjects
Publications and source records attributed to M Fischer.
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On the basis of experimental and clinical results evidence accumulates that supportive therapy is still the milestone in the therapy of death cap poisoning. Today the letality is 20%. The main cause of the intoxication are the amatoxines which inhibit DNA dependent RNA Polymerase II or B. Parts of the supportive therapy are: diuresis with 150--200 ml urin/hour, careful corrections of disturbances in electrolyte and acid-base-metabolism, oral administration of charcoal and oral gut sterilization. In spite of a multitude of experimental and clinical reports on the effectivity of Penicillin G, thiocticacid and steroids there are no controlled studies to demonstrate the advantage of one regimen over the other. The time course of resorption and excretion of amatoxines clearly shows that hemoperfusion and/or hemodialysis are only of value if applied within the first 24 hours after poisoning. At this time neither anamnestic nor biochemical data give any clues to the probable course of the disease. Heterologous baboon liver perfusion may be lifesaving in coma hepaticum grade IV, but the small amount of cases so far does not yet allow any comments on its effectivity.
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Neck bruits were noticed 86 times in 60 patients. A hemodynamic obstruction of the carotid artery was diagnosed in 22% by Doppler sonography of the supratrochlear artery. The diagnostic directions in case of neck bruits are suggested: 1. In patients with a history of neurological symptoms a pathological Doppler test will be the indication for cerebral angiography. If obstruction of the carotid artery is suspected by clinical examination cerebral angiography should be done in spite of a normal directional Doppler sonography. 2. Cerebral angiography must be done in patients with asymptomatic neck bruits and a pathological Doppler sonography if the patient will undergo a great operation.
25 female patients with different forms of osteoporosis (progredient form in elderly patients, steroid osteoporosis, involutive osteoporosis) treated during a period varying between 1 to 24 months with a new compound preparation containing 25 mg sodium fluoride and 200 mg L-ascorbic acid per tablet. The daily dose amounts to 2 tablets. Clinical success was observed in 18 patients, X-ray controls showed increase of bone density in 8 patients. In 3 cases it was necessary to discontinue treatment because of side effects (2 patients with pains in the bones and joints, 1 patient with stomach troubles). Late side effects have not been observed. At present the treatment of certain forms of osteoporosis with sodium fluoride is the only effective therapy of this disease.
Abnormalities of oesophago-gastro-intestinal motoricity play an important etiologic role in various affections of stomach, intestine, oesophagus and associated complaints. The new monosubstance bromopride produces a selective action restoring the basal motility of stomach, pylorus, duodenum and of the lower oesophageal sphincter to normal. The effect and tolerance of Viaben (bromopride) were examined in an open field study on 4182 subjects. The drug was given in average doses of one capsule three times a day. The results were assessed as very good in 37.9% of cases, and as good in 47.9%. No change was seen in 12.2%, while only 2.0% were aggravated. 64.7% of all patients benefited within the first fortnight. Nausea, vomiting and intolerance to drugs even disappeared in the first days of treatment. Individuals exhibiting a nervous, irritative stomach also had a rapid response to the drug. Pain, which is a fairly common complaint, passed off quickly. Side effects were seen in 6.8% of cases. However, the question whether they were due to the treatment, is not easily answered in an open study. The most common side effect was tiredness (3.7%), which was reported to be mild in some cases. The dyskinesia observed in subjects treated with other ortho-substituted benzamides was only seen in 0.4% of all patients.
Twenty-four h after permanent occlusion of the middle cerebral artery (MCA) in the cat, the hemispheric swelling due to edema is markedly reduced under treatment with large doses of dexamethasone than is the case with the untreated group. The increase of regional water and sodium content in the MCA territory is less in the dexamethasone treated group, whereas the potassium changes in the ischemic tissue showed only small differences between the two groups. The potassium content of the non-ischemic tissue is slightly increased in the dexamethasone treated animals when comparing with the untreated group. RISA activity in the tissue is increased in the grey and the white matter of both groups. The less marked RISA-131 activity in the cortical grey matter of the treated animals indicates blood-brain barrier damage of a smaller degree due to dexamethasone. These findings indicate a beneficial effect of dexamethasone on local ischemic edema. Regarding our results and the pharmacokinetics of this steroid the dexamethasone loading of a patient has to be in the range of about 100 mg per day for the adult, and has to be started immediately after the onset of a stroke.
A case report is presented of the rare haemoglobinopathy HbS-thalassaemia, type betaS-betathal-O in a Greek family. The special diagnostic features are discussed, with particular reference to the differential diagnosis.
The histochemical localization of five glycosidases was studied in the epididymis of mature dogs. beta-Galactosidase showed a distinct to strong reaction in the epithelium of the ductuli efferentes and throughout the whole length of the ductus epididymidis. beta-N-Acetylglucosaminidase reactivity was weak in the initial segment, but increased significantly in the middle and terminal segment. The maximum beta-glucuronidase activity was found in the ductuli efferentes and in the initial segment. The alpha-mannosidase reaction was weak in all segments except the middle segment where a distinct activity was seen. With the method employed, no alpha-fucosidase activity could be detected. The physiological role of the glycosidases in the epididymis is discussed briefly.
The effect of a gluttony diet in healthy subjects was studied over an observation period of 12 months. Twenty-six agricultural workers, all of them Yemenite Jews, received a high-caloric, high-fat diet, and the changes in serum cholesterol (CH), high-density-lipoprotein-cholesterol, triglycerides, and body weight were assessed. Yemenite Jews as a group are characterized by low serum CH levels and by a low incidence of coronary artery disease. For a period of 7 months the subjects received a diet of 4553 cal/day, more than double their original "Yemenite diet". After this time they resumed their customary low-caloric diet for 3 months, and thereafter for another 2 months they continued with the high-caloric food regimen. The high-caloric, high-fat diet resulted in the expected increase of serum CH. A similar increase of high-density lipoprotein-CH was found. Serum triglyceride levels changed inversely to those of CH. It is suggested that the altered relation of calories derived from carbohydrates to those derived from fats brought about the decrease of triglycerides, and this irrespective of the increased intake of carbohydrates and fats. The rather small gain of body weight over the trial period--despite the doubled caloric intake--is similar to other studies that showed that the ability of normal individuals to gain weight through overeating varies considerably.
An exceptionally high incidence in dizygotic co-twins of schizophrenic index cases, together with normal incidence in siblings, was reported by M. Fischer in 1973. Apart from chance fluctuation, a methodological explanation for the difference is suggested.
The increased incidence of neoplasia in the chronic use of immunosuppressive agents has been linked to a variety of factors including age, dose, agent, and frequency of administration. In this study azathioprine (az) and ifosfamide (ifo) were given both daily and weekly to female (NZB X NZW) mice over a period of 14 or 16 months in various dose regimens. Daily treatment with both agents prolonged survival time significantly but induced an apparently dose-related increase in tumor frequency. Intermittent ifo therapy produced neoplasia and survival results comparable to daily treatment, whereas intermittent az failed to extend longevity or produce malignancies. Varying the age of the mice (180 vs. 120 days) at the outset of treatment did not materially affect results in any respect. Ifo is less toxic than az in doses prolonging survival.
This paper describes the evaluation of a heterologous enzyme immunoassay for the determination of total thyroxine in serum by a group of seven clinical chemical laboratories. The test follows the principles of the enzyme linked immunosorbent assay (ELISA) and uses peroxidase as a marker. The evaluation of analytical reliability yielded the following results within the analytical range from 39 unto 322 nmol/l: 1. Within-batch precision ranged from 3.1 unto 10.4% (coefficient of variation) with single analyses. 2. Between-batch precision ranged from 3.7 unto 20.4% with single analyses. 3. Between-laboratories precision ranged from 5.4 unto 6.8%. 4. Pure thyroxine, added to serum or thyroxine-free serum, gave recoveries between 93 and 120%. 5. Analysis of control sera gave results essentially comparable to the assigned values based upon radioimmunoassays. 6. Analysis of 288 clinical sera gave slightly higher results by the enzyme immunoassay than by the analogous radioimmunoassay from the same manufacturer. 7. Comparison with other methods of analysis (radioimmunoassays, competitive protein ligand assays, hormonal iodine assay) yielded partly comparable, partly higher results. 8. Comparison with the homogenous enzyme immunoassay (EMIT) led to comparable results. 9. Interference due to hyperlipemia or hemolysis was not observed. 10. There might be an interference in hyperbilirubinaemic sera, due to an as yet unknown factor. With respect to practicability the ELISA-test compares favourably with the analogous solid phase radioimmunoassay. The main differences are the absence of radioactive material and a longer shelf-live of reagents. Following the manual procedure the time taken to perform the enzyme immunoassay is slightly longer than for the analogous radioimmunoassay.
Since 1972 electrostimulation anaesthesia (ESA) has been employed in an attempt to reduce the amount of anaesthetic agents needed. In the beginning the Chinese combination of acupuncture points was used; at a later stage Benzer et al. inserted the needles paravertebrally and Abdulla replaced the needles by contact electrodes for ophthalmic operations. At the Department of Anaesthetics, Hamburg, the same course was followed, i.e. the classic acupuncture points were used originally, then the acupuncture points were used originally, then the technique was changed to paravertebral insertion of the needles and now only paravertebrally placed contact electrodes are being employed for inducing ESA for various surgical operations. All three techniques of ESA have proved satisfactory; but ESA with contact electrodes is considered the method of choice on account of both practical considerations and success rate.
In Germany electrostimulation anaesthesia (ESA) has, so far, not been considered suitable for surgical operations on the extremities. An attempt was made to develop a combination of acupuncture points that would allow the use of ESA for this type of surgery. Based on the experience gained with ESA in abdominal surgery the suitability of paravertebral contact electrodes for operations on the limb was studied. Because of its simplicity and efficacy this technique of ESA is highly recommended.
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Testosterone levels in plasma in 50 young males are found on a plateau between 07,00 h and 10,00 h. As this plateau represents the highest level throughout the day, it is necessary to take blood sample only once during this period. Therefore a statement about endocrine testicle function can be given by only one determination of testosterone between 07,00 h and 10,00 h. This faciliates endocrine examination in ambulant patients.
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