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Biomedical subjects

R Koch

Publications and source records attributed to R Koch.

At least 289 records · Page 16Linked to original sources

[Comparison of different charts for determining the percentage of hearing loss].

Different methods are being employed at present to determine the percentage of hearing loss, on the basis of speech-and-tone audiometry. We scrutinized 1000 expertises on noise, and we were able to show the comparative mutual relationships between the methods employed, on the basis of regression analysis. The methods according to Trautmann/Oeken were relatively better than the other methods, but none of these methods yielded optimal relations.

Audiometry↗

Tyrosine supplementation during pregnancy in a woman with classical phenylketonuria. A case report.

A woman with classical phenylketonuria (PKU) adhered poorly to a phenylalanine-restricted diet but did receive tyrosine supplementation from the 14th week of gestation until delivery. At birth the infant demonstrated a head circumference more than two standard deviations below the mean but at 2 years of age had a development quotient (DQ) of 94. This case illustrates the fact that while single case reports may be of value in disproving a theory, they are not sufficient to prove an association because biologic variation may explain one's results. Thus, while tyrosine supplementation may explain the relatively normal DQ, the results are also compatible with the moderate degree of phenylalanine restriction obtained. Current evidence favors the elevated maternal phenylalanine level as the cause of defects in offspring of women with PKU, but tyrosine supplementation should be considered if the level is subnormal.

Female↗

A clinical trial of amygdalin (Laetrile) in the treatment of human cancer.

One hundred seventy-eight patients with cancer were treated with amygdalin (Laetrile) plus a "metabolic therapy" program consisting of diet, enzymes, and vitamins. The great majority of these patients were in good general condition before treatment. None was totally disabled or in preterminal condition. One third had not received any previous chemotherapy. The pharmaceutical preparations of amygdalin, the dosage, and the schedule were representative of past and present Laetrile practice. No substantive benefit was observed in terms of cure, improvement or stabilization of cancer, improvement of symptoms related to cancer, or extension of life span. The hazards of amygdalin therapy were evidenced in several patients by symptoms of cyanide toxicity or by blood cyanide levels approaching the lethal range. Patients exposed to this agent should be instructed about the danger of cyanide poisoning, and their blood cyanide levels should be carefully monitored. Amygdalin (Laetrile) is a toxic drug that is not effective as a cancer treatment.

Adolescent↗

Four cases of hyperphenylalaninaemia: studies during pregnancy and of the offspring produced.

Four cases of variant hyperphenylalaninaemia during pregnancy are presented. Babies born to mothers with blood phenylalanine concentrations of 4-8 mg/dl were normal and did not exhibit significant microcephaly, although one did have a major congenital anomaly (exstrophy of the bladder). The mother with blood phenylalanine concentrations of 6-12 mg/dl during pregnancy delivered three of four infants with mild microcephaly but normal intellectual function. The data suggest that phenylalanine concentrations of 4-8 mg/dl are reasonable and desirable during pregnancy in hyperphenylalaninaemic women. Furthermore, the data do not support or refute the justification hypothesis of Bessman et al.

Adult↗

Preliminary report on the effects of diet discontinuation in PKU.

A collaborative study of diet discontinuation in children with PKU was initiated in 1973. Children treated with the phenylalanine-restricted diet since early infancy were randomly assigned to continue or discontinue dietary therapy at age 6 years after parental consent was obtained. The 115 children participating in this study range in age from 8 to 13 years. At 6 years of age, the IQ of continuers and discontinuers was 101 and 97, respectively. At 8 years, WISC Full-Scale IQ scores adjusted for mean differences on the 6-year Stanford-Binet IQ were 101 for continuers and 98 for discontinuers (P = 0.075). School performance measured by the Wide Range Achievement Test showed significant differences on reading (3.9 vs 3.2) and spelling (3.3 vs 2.9) grade placement, although scores were above actual grade placement (2.7 vs 2.6) for both groups. Continuers and discontinuers were not different in arithmetic scores, with performance at grade placement of 2.7 and 2.6 respectively. Although these data are preliminary in nature, they suggest that subtle changes in cerebral function may occur in children with PKU in whom the phenylalanine diet has been discontinued.

Age Factors↗

[Relations between the discriminatory curve in the speech audiogram and tone audiometric measurement data (author's transl)].

The authors used the multiple linear regression model to describe the relationship between tone and speech hearing in noise induced hearing loss. The authors believe that these mathematic relations are significant for the expert opinion of noise induced hearing loss. Considerable discrepancy between the measured and calculated value might be simulation, aggravation or central disturbances. In these cases ERA should be applied.

Audiometry↗

[Initial results of computer analysis of behavioral systems in patients with epilepsy].

A catalogue of features for the qualitative and quantitative determination of behaviour peculiarities in epilepsy is presented (in extracts). The results of a factor analysis with Varimax rotation are discussed. Six factors were found which explain more than 45 per cent of the total variance and which could be brought in good agreement with "behaviour types" in epilepsy that have been described in the respective literature.

Adolescent↗

[Hydrochlorothiazide in the metaphylaxis of recurrent calcium oxalate lithiasis].

The main indication for the application of Disalunil in the convalescent care of recidive calcium-lithiasis patients is renal hypercalciuria. Treatment with 50 mg Disalunil/d reduced the rate of recidivation by two thirds. Even during long-term application of this therapy over 3-7 years, side effects were slight and did not require any cessation of therapy.

Adult↗

[How dependable is the end systolic pressure/volume relationship for the determination of left ventricular contractility in aortic valve diseases?].

The validity of the end-systolic pressure/volume ratio (ESP/ESVI) was evaluated in 88 patients with aortic valve disease (31 with aortic stenosis, 28 with aortic insufficiency and 29 with combined valve disease) by comparing the ESP/ESVI ratio with left ventricular systolic function parameters. The results demonstrate that in practice a normal EST/ESVI ratio excludes depression of myocardial contractility. A reduced ESP/ESVI ratio found in 57 patients did, however, correspond to other systolic function parameters indicating depressed or possibly depressed contractility in only 38 patients (66%), whereas biplane left ventricular ejection fraction and the isovolumic velocity indices were normal in 19 patients (33%) - 10 of whom had aortic insufficiency, 8 combined valve disease and only 1 aortic stenosis. It is therefore concluded that the ESP/ESVI ratio is of possible value for the diagnosis of depressed contractility only in patients with aortic stenosis.

Adult↗

Hypergonadotropic hypogonadism in female patients with galactosemia.

We evaluated gonadal function in 18 female and eight male patients with galactosemia due to transferase deficiency; it was normal in the males, but 12 females had signs of hypergonadotropic hypogonadism. All female patients had a 46,XX karyotype, normal levels of thyroid hormone and prolactin, and no anti-ovarian antibodies. The biologic activity of urinary gonadotropins was normal. Ultrasonography of the pelvis revealed that ovarian tissue was diminished or absent. Total estrogens increased in one of two patients after administration of human menopausal gonadotropin. The frequency of hypergonadotropic hypogonadism was higher in females in whom dietary treatment for galactosemia was delayed. Clinical course and mean erythrocyte galactose-1-phosphate and urinary galactitol levels did not correlate with ovarian function. We conclude that female patients with galactosemia have a high incidence of ovarian failure due to acquired ovarian atrophy. Galactose or its metabolites may be toxic to the ovarian parenchyma, particularly during the immediate neonatal period.

Adolescent↗