Biomedical subjects
Publications and source records attributed to M Heim.
Four elderly patients with longstanding unrecognized dislocation of the shoulder were treated by physiotherapy only. Good functional results, associated with a greatly increased range of pain-free motion, demonstrate the usefulness of conservative treatment in cases of persistent dislocation of the shoulder in the elderly.
After an introductory survey of the literature, a report is given on three own observations of chronic tactile hallucinosis which occurred in 0.09 per cent of a non-selected group of patients. Nosological problems are discussed. In two cases the results of the neuroradiological examinations suggested an atrophy of the brain stem including the thalamus. The authors suppose that these findings are of importance in the pathogenesis of chronic tactile hallucinosis and that the syndrome can be classified among the cerebro-organic reaction forms.
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During the years 1973-5 we performed 190 meniscectomies. We report 4 cases of tears of the anterior cruciate ligament after meniscectomy. Although this complication is mentioned in the literature, very few orthopaedic surgeons are familiar with it.
Orally 5 HTP has significantly decreased serum TSH level in eight patients with primary non treated hypothyroidism, but not in five normal subjects. Serum T4 et T3 levels did not change and serum PRL did not increase in the two groups. These results indicate a possible inhibitory action of 5 HT on TSH regulation. Action of 5 HT on PRL has not been defined here.
Serum vasopressin level has been measured by radioimmunoassay in 5 healthy subjects during water loading, before and during treatment by carbamazepine. Serum vasopressin drops significantly during carbamazepine in spite of antidiuresis. This drop may be explained by an effect of carbamazepine on renal tubular cell.
The antidepressants trimipramine and imipramine were compared within the framework of a multiclinical study performed under the conditions of a controlled clinical experiment. There has been found a time-different remission of affective und psychomotoric symptoms. The panthymoleptic action of trimipramine and other antidepressants is discussed with reference to these results. Trimipramine influences psychotic states, especially if in depression anxiety is combined with agitation, also in hypochondriac forms of depression.
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The authors report two cases with roentgenomophologically established cerebellar atrophy caused by chronic diphenylhydantoin overdosing. Exact neuropsychiatric testing of epileptics treated with diphenylhydantoin for a long period of time is demanded, and it is recommended that in the case of long-time therapy a maximum daily dose of 0.3 g of diphenylhydantoin be not exceeded.
3 cases of inappropriate vasopressin secretion during one case of anaplastic carcinoma of the lung, one case of carcinoma of the prostate with bony metastases and one case of acute intermittent porphyria are presented. The plasma levels of vasopressin, measured by radioimmunoassay were high. Treatment with demeclocycline was attempted in one case. The clearance of free water was positive but the treatment was poorly tolerated by the digestive tract.
Twenty four cases of differentiated thyroid carcinoma with distant metastases are analysed. Prolonged survival periods are possible. The best prognosis in papillary forms is stressed. Metastases fixing I131 progress more slowly, as a result of treatment with radioactive iodine but apparently also by virtue of the higher degree of differentiation of such metastases. One case of apparent cure of pulmonary metastasis after treatment with radioactive iodine is described. Surgery and external radiotherapy retain a place of choice in the treatment of metastases. In our experience, chemotherapy has been disappointing.
Gastric juice was neutralized (nGJ) in vivo by 80 ml of a phosphate buffer containing radiolabelled vitamin B12 as dilution indicator. Unprocessed nGJ was analyzed in the double gel diffusion technique for the presence of serum proteins using monospecific antisera. Alpha1-Acid glycoprotein (AGP) was found in a high incidence (36 out of 38 subjects) in nGJ of gastric cancer patients. AGP was also observed less frequently in nGJ of patients with Billroth II resections (6/15), metaplasia (11/52), gastric ulcer (3/24), chronic atrophic gastritis (2/26) and chronic gastritis (3/63). AGP was absent in the control group (0/21), in patients with surface gastritis (0/38) and in subjects with normal acid secretion (0/45). Immunochemical studies demonstrated no identity of AGP with human "gastrointestinal tumor associated antigens." In 7 out of 17 AGP positive samples immunochemical differences between gastric and serum AGP were observed.
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An insulin-dependent 26-year-old woman was complaining of nocturnal attacks of transient right hemiplegia. Hypoglycemia was found to be present at the time of each attack, and further investigations showed that these neurological disorders were related to an overdose of insulin. The authors discuss the effects of hypoglycemia on the brain and the pathogenetic theory of "hypoglycemic hemiplegia", involving selective neuronal vulnerability, regional blood flow disturbances or underlying ischaemic disease.
Estrogen receptors, members of the nuclear hormone receptor family, are not only able to bind their endogenous hormone, 17beta-estradiol, but can also accommodate other naturally-occuring, non-steroidal molecules. Here, we describe a spin-column procedure to determine accurately equilibrium dissociation constants (Kds) and IC50 concentrations for estrogenic compounds. The human wild-type ERalpha was used to validate the protocol. We expressed the full-length ERalpha protein in an eukaryotic system to ensure all possible post-transcriptional modifications. The gel filtration-based assay revealed a temperature-dependent Kd shift for ERalpha. At physiological conditions (150 mM salt, 37 degrees C) we determined the 17beta-estradiol Kd for ERalpha to be 281 +/- 13 pmol/L. Positive cooperativity was only apparent at low temperatures and diminished to zero at 37 degrees C. In homologous competition binding experiments using 17beta-estradiol, we observed fifty fold higher IC50 values than the respective Kd. This paper presents a reliable and sensitive protocol to generate saturation binding curves and heterologous competition curves to test estrogenic compounds.
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