Biomedical subjects
Publications and source records attributed to R M Schmidt.
The paper describes scanning electron microscopic observations of electric field induced fusions of human lymphocytes. The cells were fused by application of short-time (20 microseconds) field pulses of 5 kV/cm after dielectrophoretic collection at about 1.2 MHz and 750 V/cm. Electron microscopy clearly demonstrates membrane fusion and the stability of initial stages of fusion.
There are neither specific cell investigations nor immunological tests for the diagnosis of MS. Various immunological alterations occur in the course of the disease, but none is unique to MS. Accurate diagnosis remains confined to the clinical field. The diagnosis can be supported by CSF analysis. Laboratory examinations can help to determine the particular stage of the disease and provide clues to the etiology and pathogenesis. The appearance of abnormal CSF levels increases the certainty of the diagnosis.
The available defensive mechanisms are generally sufficient to protect the central nervous system (CNS) against the penetration of infectious particles. The blood-brain-barrier plays a decisive role in this process. The present paper represents the most important circumstances realizing that: 1. The macrophage-lymphocyte-system, 2. the "oligoclonal-CSF-IgG-reaction", and 3. the influence of psychological and physiological burdens on clinical-chemical or immunological parameters. It seems to be important to overcome the instability of the immunosystem and to reestablish the base-line.
The cerebrospinal fluid of 69 patients with tumors of the brain and the spine was examined for total protein content, IgG concentration, IgG total protein quotient, and electrophoretic protein pattern. There is no specific finding in the case of the central nervous system. At best characteristic constellations may be established.
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An epidemiological study of multiple sclerosis (MS) in the district of Halle, Halle-Neustadt and the area near the river Saale was carried out. We found 178 patients with a definite diagnosis in a total population of 396,529, corresponding to a prevalence of 44.9/100,000. The annual incidence rate was 2/100,000. When probable but not definitely diagnosed cases are included in the count, the estimated prevalence rises to 53.7/100,000 population.
This case study describes a spindle cell glioblastoma of the medulla oblongata (foramen magnum region) in a decreased patient aged 35 years. At the beginning of the illness which lasted about 7 months, the symptoms were quite uncharacteristic, and major neurological failure accompanied by tetraparesis and bulbar symptoms appeared only during the terminal phase, which was of several weeks duration. The specific clinical and diagnostic features of tumours at the magnum foramen, which account for only about 1% of all tumours of the CNS, and the difficulties they entail are described.
In accordance with Hallen we classified 20 patients with cryptogenic psychomotoric epilepsy into an oral, adversive, dysphasic type and into clear psychomotoric epilepsies. Psychomotoric attacks are a complex process, whereby feed back control systems like the limbic system, the formatio reticularis or the hypothalamus play an essential part. Ammon's horn and gyrus cinguli are considered as fundamental organic background for the forming of character and predominantly take part in the modulation of the situation-dependent modes of behavior.
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The cells of the cerebrospinal fluid consist of three systems: the lymphatic immune-competent system, the "mononuclear phagocyte system (MPS)" and the reticulo-histiocytic system (RHS). Within the lymphatic cells the lymphocytic line and the plasmocytic line must be considered separately, although the two cell-lines are from their origin functionally inter-connected; they constitute the immune-system. To the "mononuclear phagocyte system" belong the monocytes and the macrophages. The reticulo-histiocytic system includes the cell-forms which are definitely excluded from the "mononuclear phagocyte system". The investigations show that most of the cells in the CSF originate from the blood.
A case of reticulo-histiocytic meningoencephalitis is reported. Changes in the fluid cell pictures, especially giant cells and mitoses are described. Obviously, reticulo-histiocytic encephalitis and neoplastic reticulosis are different stages of development and malignity of a uniform process, the etiology of which has not been understood until now but in which an immunological reaction in the sense of a delayed type of hypersensitivity plays a considerable part.
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This report deals with the results of tumour cells in the cerebrospinal fluid in secondary brain tumours. In 32 cases in which we could make autopsy tumour cells were found in 8 cases, the number constituting 25 per cent. Tumour cells of patients with metastasis of carcinoma, metastasis of melanocytoblastoma, meningosis carcinomatosa et sarcomatosa and meningosis leucaemica, have been demonstrated. The importance of the identification of tumour cells in cerebrospinal fluid has been emphasized in the report.
The report deals with values of cell number and total protein in intermittent and chronic-progressive multiple sclerosis taking into account age and sex. Moreover, the average values of monocytic, lymphocytic and lymphoid cells are correlated with age and sex. Finally, monocytic, lymphocytic and lymphoid cell forms are compared with agarelectrophoretic gamma 3- and gamma 4-globulin augmentation. For these investigations we summarized the parameters of 213 patients with multiple sclerosis according to the criteria of BAuer et al. (1973) and Poser et al. (1973). In intermittent multiple sclerosis there was a preponderance of lymphocytic and lymphoid cell forms, while in chronic-progressive syndromes and late polysclerosis monocytic cell reactions dominated. Although in chronic-progressive multiple sclerosis nearly the same changes in the gamma-globulin spectrum are demonstrable there seems to exist a disturbed condition of immunity which is expressed in a progressing demyelinization process.
After a short discussion of the incidence rate and the distribution of multiple sclerosis in the world, some epidemiological problems are dealt with. Multiple sclerosis is a relatively frequent disease occurring mainly in zones of temperate climate, in highly civilised and technically advanced countries, and it is mainly found among the white (European) race. Clinically important appraisal criteria are pointed out. Retaining or regaining of efficiency and working capacity are regarded as simple assessment criteria of long-term therapeutic efforts.
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In the 1976 hemoglobinopathy proficiency testing survey of the Center for Disease Control (CDC), whole-blood samples from hematologically normal adults and from individuals heterozygous for beta-thalassemia were shipped to survey participants. The object of this survey was to determine the state of the art for technics used to quantitate hemoglobin A2 (Hb A2) and to test the ability of laboratories to differentiate between blood samples having normal Hb A2 levels and those having elevated levels (i.e., those from individuals with beta-thalassemia trait). The results of Hb A2 quantitation obtained from 183 volunteer participant laboratories were compared with those obtained from 24 reference laboratories. Individual values varied greatly among laboratories and among methods for both normal and elevated Hb A2 samples. The results returned by many laboratories were not within 2 SD of the reference laboratory mean and also were not sufficiently accurate to differentiate between the normal blood samples and those with beta-thalassemia trait. The results suggest that methods for quantitating Hb A2 need to be standardized and a suitable method for determining laboratory performance found.
Samples of whole blood from four hematologically normal adults and from two individuals with increased fetal hemoglobin levels were shipped to laboratories participating in the 1976 and 1977 Center for Disease Control (CDC) hemoglobinopathy proficiency testing surveys. The data from these surveys were used to evaluate the interlaboratory variability of current methods used to quantitate hemoglobin F (Hb F). Results of Hb F quantitation obtained from more than 100 laboratories than voluntarily participated in the survey were compared with those obtained from 21 reference laboratories. Individual values for all samples varied greatly among laboratories and among methods. Results returned by most of the laboratories were outside two standard deviations of the reference laboratory mean and were not accurate enough to differentiate between a normal level and an increased, abnormal level.