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Biomedical subjects

M Graf

Publications and source records attributed to M Graf.

At least 109 records · Page 6Linked to original sources
PubMed1988

[Malignant hyperthermia in Austria. II. A comparison of the results of diagnostic test procedures].

During the last 4 years different diagnostic procedures for the detection of malignant hyperthermia (MH) susceptibility have been used at the authors' clinical unit; this study was designed to compare the results of these tests. PATIENTS AND METHODS. Since March 1983, 158 patients have been referred for the following reasons: group A: probands (n = 17) who had had symptoms of MH during anesthesia; group B: patients of probands (n = 48) if the latter were not tested because of age (n = 24) or death (n = 2); group C: relatives from MH families (n = 86); group D: patients (n = 5) who developed fever during stress and/or physical activity (n = 3), had myotonia (n = 1), or developed rhabdomyolysis during intensive care (n = 1); group E: controls (n = 2). Two static halothane and two static caffeine tests according to the European protocol were performed in all patients (n = 158). Histological examinations of skeletal muscle (fixed in glutaraldehyde, stained with hematoxylin-eosin, Gieson, and toluidine blue) were done in the first 100 patients; all specimens were scored by the same investigator (E.S.). Score 0: normal; 1: increased number of sarcolemma cores; 2: 1+cores forming groups; 3: 1+2+fiber degeneration; 4: specific changes-myopathies. Plasma levels of creatine kinase (CK) were determined in the first 50 patients. Complete neurological examinations, including electromyography (EMG), were done in ten patients who had increased CK levels as well as histological scores of 3 or 4 (Table 1).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Stress mediated changes in hypothalamic corticotropin releasing factor-like immunoreactivity.

Hypothalamic corticotropin releasing factor-like immunoreactivity (CRF-LI), plasma ACTH and corticosterone levels were measured by radioimmunoassay over a two hour period of restraint stress. The results of this study demonstrate a significant decrease in hypothalamic CRF-LI levels 15 and 30 minutes after the start of restraint stress which is followed by a significant increase at 60 minutes that is abolished by cycloheximide pretreatment. Plasma ACTH and corticosterone levels were significantly elevated after 15, 30, 60, 90, and 120 minutes of restraint stress. These results are consistent with a release of CRF from the hypothalamus during stress. The cycloheximide-sensitive increase in hypothalamic CRF-LI indicates that synthesis of CRF-41 occurs during prolonged stress. These results suggest that the response of an organism to exposure to a long-term, high intensity stress involves both the release and synthesis of CRF-41.

Adrenocorticotropic Hormone↗
PubMed1987

Electrophysiologic findings in meningopolyneuritis of Garin-Bujadoux-Bannwarth.

Previous reports on neuropathy in Lyme disease and related disorders suggest predominant demyelination in most of the few cases investigated. We analysed retrospectively electrophysiologic data in 29 patients with MPN-GBB. In peripheral nerve involvement slowed NCV and/or prolonged DL was the prominent finding, concordant with primary demyelination. Distribution of pathology resembles mononeuritis. Facial nerve palsy was common and often bilateral.

Adolescent↗
PubMed1987

Characterization of groups of hyperandrogenic women with acanthosis nigricans, impaired glucose tolerance, and/or hyperinsulinemia.

This study examined the prevalence of both basal and glucose-stimulated hyperinsulinemia and acanthosis nigricans (AN) as well as the relationship between insulin and androgen levels in hyperandrogenic women. Sixty-two women who had an elevation of 1 or more plasma androgen levels were studied. The results in these women, grouped for analysis on the basis of obesity and ovulatory status, were compared to those in 36 control women of similar ages and weights. The anovulatory hyperandrogenic women had the clinical and biochemical features of the polycystic ovary syndrome (PCO). Oral glucose tolerance tests were performed with measurement of glucose, insulin, sex hormone-binding globulin (SHBG), and total and non-SHBG-bound sex steroid levels. AN was present in 29% of the hyperandrogenic women, the majority of them obese. Fifty percent of obese PCO women had AN, but they did not otherwise differ from PCO women lacking this dermatological change. Only women with PCO had significant hyperinsulinemia independent of obesity, and obese PCO women with AN had the highest serum insulin levels. Plasma glucose values during the oral glucose tolerance test were significantly increased in obese PCO women independent of the presence of AN, and 20% of these women had frank impairment of glucose tolerance. Ovulatory hyperandrogenic women had normal insulin levels and glucose tolerance. Obese and nonobese women had different relationships between sex steroid and insulin levels; obese women had significant correlations between insulin and non-SHBG testosterone levels (r = 0.30; P less than 0.05), whereas nonobese women had significant correlations between insulin and FSH (r = 0.40; P less than 0.01), dehydroepiandrosterone sulfate (r = 0.33; P less than 0.05), and SHBG (r = 0.37; P less than 0.05) levels, suggesting that the mechanisms underlying the association between sex steroid and insulin levels are complex. These findings suggest that 1) only women with PCO have hyperinsulinemia independent of obesity; hyperinsulinemia is not a feature of hyperandrogenic states in general; 2) AN is a common finding in obese hyperandrogenic women, particularly those with PCO; 3) only obese PCO women are at risk for impairment of glucose tolerance, independent of the presence of AN, suggesting that the negative impact of PCO and obesity on insulin action is additive; and 4) PCO women with AN can be considered as a subgroup of PCO and do not appear to have a distinct endocrine disorder.

Acanthosis Nigricans↗
PubMed1986

[Treatment of hypothalamically-induced primary amenorrhea with epimestrol].

Eleven patients with hypothalamic primary amenorrhoea, aged between 17 and 23 years, were examined. Each patient was given 10 mg epimestrol (E) orally over a period of 10 days followed by a 20-day pause. This regimen was repeated 6 times. Gonadotropin secretory patterns were investigated between 9 a.m. and 2 p.m. before, during (on the 5th day of treatment in the 4th cycle) and 3 weeks after termination of treatment. In addition LHRH double stimulation tests were carried out before and after treatment to evaluate the acute releasable pool of gonadotropins as well as the pituitary synthesis capacity. In 3 patients with low baseline gonadotropin levels no effect of E on the release of gonadotropins could be found. These patients also showed non-pulsatile secretion with low baseline gonadotropin levels and no response in the LHRH stimulation tests. Similar results could be observed in one patient with low baseline LH levels but FSH levels within the normal range. Variable results were found in 7 patients with both LH and FSH in the normal range: 3 women experienced menstrual bleeding during and/or after E treatment; 1 woman stated that spotting had occurred twice. These 4 patients all showed regular pulsatile LH secretion after cessation of E treatment; the duration of the LH pulses was 60 to 120 minutes. Some hypothalamic activity seems to be essential for a positive response to E in patients with primary amenorrhoea. This activity is characterized by a positive gestagen test as well as baseline gonadotropin levels in the normal range.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

[Puberty and ovarian function following cytostatic therapy in childhood].

Chemotherapy for malignant disease can cause gonadal dysfunction. However, little is known about the reversibility and severity of these effects in girls treated during childhood or puberty. For this reason we investigated clinical data and endocrine parameters (FSH, LH, PRL, E2, progesterone) of 51 adolescent females. Our clinical data showed that intermittent pulse chemotherapy as administered to most patients with solid tumours leads to a more pronounced growth retardation than continuous low dose chemotherapy as given to patients with leukemia and lymphomas. Girls treated prior to menarche failed to start menstruation while on chemotherapy, but all had their menarche shortly after cessation of the treatment. Most of the girls treated post menarche developed amenorrhoea, whereas some had irregular cycles unless they were on a very mild drug regimen. From the endocrinous data we concluded that primary ovarian failure was rare and occurred in adolescent girls only after a combination of chemotherapy and radiotherapy. In girls with regular menstrual cycles after treatment a high incidence of anovulation or an inadequate luteal phase could be observed. The latter symptoms may be signs of hypothalamic ovarian failure as caused by stress, anxiety and emotions associated with a malignant disease.

Adolescent↗
PubMed1986

[Ovarian insufficiency in blepharophimosis, ptosis, epicanthus inversus].

Combined blepharophimosis, ptosis, and epicanthus inversus (BPEI) represent a rare syndrome with autosomal dominant transmission. In affected females it can be associated with infertility. In this case report we could follow the development of primary ovarian failure in a 28-year old woman with BPEI by repeated hormone determinations. Endocrinological and morphological results give good evidence of increasing gonadotropin resistance on the ovarian level.

Adult↗
PubMed1986

[Neurophysiologic studies in Pickwickian syndrome].

In 11 patients clinically diagnosed as Pickwickian syndrome the results of daytime and night polysomnogramm were compared. The daytime recording was very efficient in identifying apnoea and correlating various types of apnoea to different sleep stages. In polysomnogramms of night sleep we found, as did Lugaresi, a reduction of sleep stages III and IV, and a slight increase of sleep stages I and II. Patients without apnea in daytime sleep also showed a normal apnea index in night sleep. The BAEP's especially the pontomesencephalic components were pathological in six patients (55%). This might be due to a primary lesion or to hypoxic damage of the brainstem.

Adult↗
PubMed1985

Divicine induces calcium release from rat liver mitochondria.

Divicine, a pyrimidine aglycone strongly implicated in the pathogenesis of favism, induces calcium release from intact rat liver mitochondria. Divicine-dependent calcium release is accompanied by oxidation and hydrolysis of intramitochondrial pyridine nucleotides. Inhibition of both mitochondrial glutathione peroxidase and glutathione reductase slows down divicine-induced calcium release. Cyanide-insensitive respiration indicates redox cycling of divicine in mitochondria. The results suggest that attention should be paid to the action of divicine in cells other than red blood cells.

Animals↗
PubMed1985

Rapid psychotherapeutic effects of anesthesia with isoflurane (ES narcotherapy) in treatment-refractory depressed patients.

Treatment-refractory depressed patients who objected to electroconvulsive therapy (ECT) were given a series of anesthesias with isoflurane (Forane), a modern and established inhalation anesthetic. According to our hypothesis to be tested, the brief period of electrocerebral silence (ES), which can be observed shortly after the grand mal seizure in ECT, may be in itself a crucial biological determinant for the therapeutic effects of ECT. Isoflurane is the only drug known to effect an ES in the EEG in nontoxic concentrations, which does not result in adverse effects on any body organ including the brain; no seizure activity can be observed. Eleven depressed patients received a total of 36 anesthesias with isoflurane (ES narcotherapy). Rapid antidepressant effects were observed in 9 patients (p less than 0.0001). Effects were reproducible and lasted up to several weeks. No adverse effects of anesthesia were noticed.

Adult↗
PubMed1984

Polysomnography of torsion dystonia.

Nocturnal EEG, electro-oculograms, and electromyograms were studied in nine patients with dystonia musculorum deformans and in nine healthy controls. Electrodes were placed over frontal, central, and occipital regions in accordance with the international 10-20 system of electrode placement. A standard bipolar montage was used for the recordings, and records were scored independently in accordance with the manual of Rechtschaffen and Kales. All patients were found to sleep poorly. Patients in advanced stages of dystonia all displayed an EEG pattern characterized by pronounced, high-amplitude (greater than 150 microV) spindles that were continuous for all stage 2 and portions of stage 3 sleep. Other sleep parameters were also disturbed. Sleep spindles become less frequent and diminish in amplitude with advancing age. The spindle activity of patients with advanced dystonia presents a stark contrast to this pattern and may underscore their clinical significance.

Adolescent↗
PubMed1984

Electrocorticography: information derived from intraoperative recordings during seizure surgery.

The findings of 100 consecutive electrocorticographies in 94 epileptic patients were reviewed. Most of these patients underwent temporal lobectomies. A well defined and circumscript cortical spike focus was found in only 28 tracings whereas multiple sub-foci of spike activity or dissipated areas of spiking were demonstrated in 46 recordings. Cortical spike activity was minimal in 14 and absent in 12 tracings. Additional one-lead depth electrodes (inserted mainly into amygdala and hippocampus) yielded rather little information in contrast to the wealth of information derived from chronic multiple-leads depth implants prior to surgery. The frequent occurrence of dissipated spike foci suggests that, in partial epilepsies (and especially in temporal lobe epilepsy), epileptogenic zones are more widespread than one would expect from the scalp EEG recordings. These findings lend support to the use of en-bloc removal of large portions of an affected lobe.

Adolescent↗
PubMed1984

The center of the umbilicus as the Veress needle's entry site for laparoscopy.

Transumbilical laparoscopy was performed on 217 patients for diagnostic purposes. The center of the umbilicus was chosen as the entry site for both the Veress needle and the trocar. Two years of follow-up on 92 patients, including 29 who carried full-term pregnancies, did not reveal any damage to the umbilicus or any hernia formation. Beyond cosmetic advantages, the procedure proved to be easier for creating a pneumoperitoneum. No false passage or obstructive bleeding occurred during the procedures.

Evaluation Studies as Topic↗
PubMed1984

Case report: polysomnographic effects of thalamotomy for torsion dystonia.

We report a patient with torsion dystonia whose polysomnographic recordings revealed poor sleep and a pronounced and almost continuous type of spindle activity during non-rapid eye movement sleep. Rapid eye movement sleep was also reduced. These changes proved to be independent of medications. After a clinically successful unilateral thalamic operation, a normalization of sleep parameters and a reduction of the high amplitude sleep spindles was observed, implying that the regulation of sleep spindles and the advancement of dystonic symptoms are affected by a common mechanism.

Adult↗
PubMed1983

[Idiopathic thrombocytopenic purpura: diagnosis and therapy in 46 patients].

The hematological and immunological data of 46 patients with idiopathic thrombozytopenic purpura (ITP) and their response to treatment are reported. The findings are as follows: (1) Antiplatelet antibodies (serum assays) cannot be recommended as a useful diagnostic approach in ITP. (2) Circulating immune complexes are demonstrable in 77% of our patients. (3) The bone marrow contains increased numbers of eosinophils and erythrocytes in about the half of the patients. (4) A "remission" is obtained in 50% of patients with corticosteroids and in 60-80% with splenectomy. Among the immunosuppressants, cyclophosphamide appears to be the most useful. (5) Fatal hemorrhages are very rarely seen in adults with ITP.

Adolescent↗
PubMed1983

[Polygraphic registration of spontaneous syncope].

A 29 year-old female patient suffered from a syncopal attack in the early morning hours. During polygraphic registration (ECG, EEG, pulse, breathing, blood pressure) on a tilt table she developed another spontaneous orthostatic syncopal attack, which was triggered off by a lengthy period of standing and was preceded by a drop in the recorded blood pressure. She was asystolic over 21 sec., the EEG did not show any bioelectric activity (with standard attenuation) over 22 sec. Within a short time she recovered fully from the clinical, as well as from the polygraphic point of view. The syncopal attack in this patient is discussed as being of the vagocardial type in connection with vagotonia. The original polygraphic data of the relevant period are presented.

Adult↗