Seven month old child with fever, lethargy and bulging fontanel.
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Biomedical subjects
Publications and source records attributed to T Huber.
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Optokinetic nystagmus (OKN) continues after the cessation of visual stimulation in complete darkness as primary optokinetic after-nystagmus (OKAN I). After variable periods of time, it is followed by secondary OKAN (OKAN II). Short periods of visual fixation during OKAN I in monkey and in man inhibit OKAN I, but enhance OKAN II. The enhanced OKAN II starts earlier, lasts longer, and often reaches higher slow-phase velocities than in control experiments. Therefore, OKAN II depends not on the ocurrence or strength of OKAN I, but mainly on parameters of the preceding optokinetic stimulus. Results suggest that OKAN I duration is partially determined by the development of OKAN II.
The importance of cooperation between physicians and all other services in vocational rehabilitation is shown by demonstration of three follow-up studies. Vocational rehabilitation is understood as a new dimension in the therapy of disabled people.
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Plasma renin activity (PRA) was determined in both renal veins of 37 patients with angiographically proven renal artery stenosis. Renal venous PRA was determined in 17 patients without furosemide stimulation and in 20 patients before and 15 and 30 min after intravenous injection of 40 mg furosemide. 21 of 37 patients showed abnormally high peripheral PRA. In the 17 patients in whom renal venous PRA was measured without stimulation, 11 showed a PRA ratio (PRA stenotic side/PRA unaffected side) greater than or equal to 1.5. The 20 patients in whom stimulation with furosemide was performed were divided into 2 groups each containing 10 patients: The first group was characterized by an increase in PRA ratio after furosemide stimulation, while in the second group this PRA ratio decreased. In the first group mean duration of hypertension was 4.5 years compared to 7.5 years in the second group. In 17 of 37 patients renal artery stenosis was corrected by surgery. After operation 12 patients became normotensive and in 2 patients hypertension improved. There was no effect of renovascular surgery on blood pressure in only 3 patients. None of these patients showed an increasing ratio in response to furosemide. Our results suggest that the validity of renal venous PRA measurements is enhanced when the procedure is performed before and after administration of furosemide.
As in other parts of the rehabilitation of disabled, e.g. paraplegics the teamwork of all staff-members together with the integrated patient is indispensable. The occupational therapists combine the experience of a many year's training with their creative phantasy. The amputee learns by the assistance of occupational therapists to become independent. The physician has a coordinative and leading function in the team of nurses, occupational therapists, physiotherapists and the orthopaedical technical workshop.
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The course of renal osteodystrophy possibly includes changes, which can mistakenly considered malignant. Especially dialysis-associated tumoral calcinosis may mislead to an inadequate aggressive surgical procedure. Spontaneous involution of these lesions takes place after subtotal parathyroidectomy. Brown tumors subsequent secondary hyperparathyroidism are extremely rare. During maintenance hemodialysis frequently appearing intraosseous cysts develop secondary to beta-2-microglobulin-amyloidosis. Surgery only should be performed in case of occurring pathologic fractures. Other cases are treated conservatively under continuous nephrologic supervision.