Biomedical subjects
M Kütemeyer
Publications and source records attributed to M Kütemeyer.
[Comment on the contribution by Carl Eduard Scheidt--"Clinical and psychometric findings in spasmodic torticollis"].
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[Comments on Gubler Gh. Lüthy R. M.: "Fever of unknown origin in general practice: what to do?"].
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[Comments on the review by Wilfrid A. Nix. Chronic fatigue syndrome--a new disease picture?].
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[Psychoanalytic treatment of a lustful murderess 1930].
In the course of collecting historical material about the first psychoanalytic in-patient clinic ("Sanatorium Schloss Tegel") in the years 1927-1931, the authors discovered an unpublished typescript by Ernst Simmel entitled "Neurotic criminality and lust murder". On the basis of clinic records, excerpts from letters, and personal information, the authors supplement Simmel's treatment report of a lust murderess with a historical, documentary text, which is followed by Simmel's paper.
[Early psychoanalytic concepts of pain].
It is amazing how small a proportion of the very extensive psychoanalytic literature is devoted to the psychoanalytic understanding of pain and how much less to a pain-theory. Reviewing the history of psychoanalytically orientated pain-concepts up to 1933--mostly concerning "psychogenic" pain--Sigmund Freuds remarks are reaching from autobiographical notices up to his case histories ("Studien über Hysterie"), in which pain is one of the dominating conversionsymptoms. Psychoanalytic observations on pain are also made by Sandor Ferenczi, Wilhelm Stekel, Edoardo Weiss, Anna Freud and Ernst Simmel--one of the pioneers in psychosomatic research--who developed an unknown theory of an earliest postnatal intestinal libido for a better understanding of somatogenic pain.
[The spontaneous course of disk prolapse in lumbar root compression syndrome. A CT-controlled prospective study].
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[Course of conservatively treated acute lumbar root compression syndrome. A computer tomography controlled study].
Of 129 patients with an acute lumbar root compression syndrome due to disc herniation 21, who were symptom-free, were examined by computed tomography (CT) on average 276 days after a three-step regimen of conservative treatment. In no instance had there been a deterioration of the original findings. In 14 patients the CT picture continued to demonstrate disc herniation, although the patients were without symptoms. In two patients a moderate, in five a marked regression of herniation was demonstrated by CT. Clinical improvement without change in the CT picture points to the compression syndrome not being explainable solely in mechanical terms. As a matter of fact, a possible cause may be a disturbance of radicular blood supply resulting in oedematous root swelling which is usually masked in the CT by prolapsed disc tissue. There is as yet no easy explanation for regression in case of prolapsed, perhaps even sequestered, disc tissue. It is possible that there have been reparative processes, such as have been described histopathologically in form of ingrown vessels. More plausibly would be a separation of the herniated and/or sequestered disc tissue in form of an asymptomatic sliding into the terminal caudal region.
Traumatic occlusion of both internal carotid arteries.
Two cases of bilateral occlusion of the extracranial internal carotid artery after blunt trauma to the head and neck are presented. Sixteen similar cases have been reported in the literature, and at least 150 case reports exist on unilateral blunt trauma of carotid arteries. The 25-day post-traumatic latent interval in one of our cases is the longest to date. The diagnosis of both of our cases was established by directional cw-Dopplersonography, whereas previously the only diagnostic method available in cases with negative CT scan and latent interval was angiography. In the differential diagnosis of craniocerebral or craniocervical trauma, particularly following delay between injury and onset of neurological symptoms, Dopplersonography is a necessary test additional.
Extrarenal clearance, distribution volume, and elimination rate of digoxin and metildigoxin in anuric patients.
The pharmacokinetics of 3H-labeled digoxin and metildigoxin were compared in six anuric patients. The following means +/- s.e.m. were obtained: extrarenal clearance of digoxin, 43.3 +/- 5.4 ml/min, of metildigoxin, 30.3 +/- 2.9 ml/min; distribution volume of digoxin, 315 +/- 29 1, of metildigoxin, 258 +/- 22 1; rate constant for elimination of digoxin, 0.0086 +/- 0.0013 h-1, of metildogixon, 0.0071 +/- 0.0007 h-1. The elimination rates correspond to half-lives of 80 h for digoxin and of 97 h for metildigoxin. From our investigations and published data a weighed mean of 47 ml/min was calculated for the extrarenal clearance of metildigoxin. This is not significantly different from the mean extrarenal clearance of 40 ml/min reported for digoxin. A total body clearance of 40 ml/min and a daily intravenous dose of 0.1 mg correspond to an average steady-state glycoside concentration of 1.74 ng/ml.
Symptom changes during the psychotherapy of patients with myasthenia gravis.
Four patients with myasthenia gravis were treated psychotherapeutically: two who suffered from generalized myasthenia gravis were treated without additional medical treatment. During the course of the therapy a clear correspondence of the patients' behavior and the severity of symptoms could be observed. The symptoms would improve, or even disappear, depending on the developed 'ego-strength' and the possibility of being aggressive and creative during therapy and also depending on the degree to which the 'meaning' of the symptoms could be understood. There seems to be a possibility of influencing decisively the course of myasthenia gravis by psychotherapy.