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Biomedical subjects

V Neumann

Publications and source records attributed to V Neumann.

At least 37 records · Page 2Linked to original sources

[Progress of research in the diagnosis of multiple sclerosis by study of the cerebrospinal fluid].

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.

Blood-Brain Barrier

[Clinical and pathophysiologic aspects of viral infections of the CNS].

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.

Encephalitis

Electrically induced fusion of different human cell types.

The fusion of human cells of the cerebrospinal fluid and of the peripheral blood is reported, as well as the fusion of these cells with tomato protoplasts. The cells were fused by applying short-time electric pulses after dielectrophoretic collection. The importance of this method for diagnosis and therapy is discussed and possible applications are mentioned.

Cell Fusion

Growth failure and decreased bone mineral of newborn rats with chronic furosemide therapy.

To test the hypothesis that chronic furosemide treatment in otherwise healthy newborn animals may lead to lowered bone mineral [calcium (Ca) and magnesium (Mg)] content, healthy littermates within each litter of Sprague-Dawley rat pups were randomly assigned to three groups: control, low dose furosemide (5 mg/kg/day), and high dose furosemide (15 mg/kg/day). The pups were treated between days 4 and 28 postnatally. The wet and dry weights of kidneys and tibiae significantly correlated with body weights at sacrifice. Furosemide-treated pups demonstrated a dose-dependent growth delay, decreased total bone (tibiae) Ca and Mg, increased urine Ca and Mg concentration, and a significant inverse correlation between bone Ca and urine Ca concentration. There was no significant difference among the groups when bone Ca and Mg were normalized to per gram of bone dry weight. There were no significant differences among the groups with respect to bone phosphorus or urinary phosphorus concentration; kidney and serum Ca and Mg; or serum sodium, potassium, alkaline phosphatase and immunoreactive parathyroid hormone concentration. We conclude that chronic furosemide therapy leads to growth failure and to increased urinary losses of Ca and Mg. Total bone Ca and Mg in the furosemide-treated pups were diminished in proportion to growth retardation but the bone mineral content per unit of dry weight remained similar to control pups.

Animals

[Incidence and distribution of multiple sclerosis in Halle District].

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.

Cross-Sectional Studies

Combination therapy with pulsed methylprednisolone in rheumatoid arthritis.

Pulsed methylprednisolone (PMP) has been shown to produce clinical improvement and reduction in the ESR and acute phase protein concentrations in patients with active rheumatoid arthritis and has been advocated for use either as an alternative to slow-acting antirheumatoid drugs (SAARDs) or in conjunction with SAARDs to accelerate the response to treatment. To test these potential roles for PMP 45 patients with active RA were randomly allocated to treatment with PMP alone, PMP + sulphasalazine (SAS - at a maintenance dose of 2.0 g/day), or PMP + D-penicillamine (DPA - at a maintenance dose of 500 mg/day). In each case three 1 g intravenous infusions were given on alternate days during the first week of the trial. Patients were monitored for 24 weeks by standard clinical and laboratory measurements. All three treatment groups showed significant clinical and laboratory improvements at two weeks. With PMP + DPA and PMP + SAS these improvements were sustained and were not significantly different in these two treatment groups. However, in the 'PMP only' group ESR and CRP rose to pretreatment values by eight weeks. Twelve patients withdrew from the study owing to a relapse of the RA. No serious adverse effects were seen in the 'PMP only' group. Both combination regimens were well tolerated; adverse effects seen were attributable to either DPA or SAS. We conclude that PMP alone is insufficient for treatment of RA but can be used successfully in combination with either DPA or SAS. A comparison between these results obtained from two previous groups of 15 patients treated with DPA alone and SAS alone (using the same study design) shows that PMP accelerated the response to therapy by at least six weeks.

Arthritis, Rheumatoid

Attempt to modify klebsiella carriage in ankylosing spondylitic patients by diet: correlation of klebsiella carriage with disease activity.

Patients with ankylosing spondylitis were asked to follow a 'klebsiella exclusion diet' for 5 months of a 10-month study. The same percentage of faecal samples were positive for klebsiella whether the patients were on or off the experimental diet. The diet also failed to influence variability of klebsiella serotypes. We found no correlation between acquisition of klebsiella and deterioration of disease symptoms, as recorded by the patients. Furthermore, carriage of klebsiella did not correlate with any of the following parameters of disease activity measured in the outpatient clinic: morning stiffness, pain measured on a visual analogue scale, analgesic consumption, ESR, total serum IgA. We found no evidence, therefore, that faecal klebsiella is involved in disease exacerbations of ankylosing spondylitis.

Adult

Pathogenesis of seronegative arthritis.

The concept of seronegative spondarthritis, linking several diseases around ankylosing spondylitis, has received considerable clinical and genetic support, especially through the discovery of a high frequency of HLA-B27 in these disorders. Exogenous factors would appear to be responsible for some manifestations of the disease, but the role of Klebsiella micro-organisms is equivocal, and dietary control does not affect clinical manifestations. Increased serum and salivary IgA antibodies in active ankylosing spondylitis patients tend to suggest that IgA may act as an acute-phase reactant.

HLA Antigens

Clinical trials of an antiplatelet agent, ticlopidine, in diabetes mellitus.

At present there is no simple, reliable and non-invasive method for monitoring progression and improvement in diabetic microangiopathy. However, some diabetic patients with severe microvascular complications show a fairly specific pattern of impaired left ventricular function (abnormal relaxation, cavity filling and wall thinning) and abnormalities of haemorheology (increased viscosity, erythrocyte rigidity and beta-thromboglobulin and decreased threshold for platelet ADP aggregation). A single-blind, 6-months' crossover study of an antiplatelet agent, ticlopidine, was conducted in 20 diabetics with clinical evidence of microvascular disease. Response to therapy was monitored by digitised M-mode echocardiographic analysis of left ventricular diastolic function and haemorheology. All patients had abnormal basal values with no significant change during the 3-month placebo run-in period but, although significant alterations in viscosity, erythrocyte deformability, beta-thromboglobulins and ADP threshold were observed, no change in left ventricular function was detected. It is concluded that, while it may be possible to alter abnormal haemorheology in diabetes, there was no change in one parameter of microvascular end-organ damage.

Adult

High-dose intravenous methylprednisolone in rheumatoid arthritis.

Fourteen patients with severe rheumatoid arthritis (RA) were given 27 courses of methylprednisolone intravenously, each of 3 infusions of 1 g on alternate days. After 7 days there was marked improvement in clinical state and most laboratory tests; levels of ESR and 4 serum acute-phase proteins, C3, C, IgG, and IgA, fell significantly. Serum IgM and rheumatoid factor titre were unchanged. 125I C1q binding fell in all instances where it was initially raised. Clinical remission lasted a mean of 10 weeks. Serum C-reactive protein (CRP) fell to less than 30 mg/l after all courses except one within 7 days and rose above this figure after a mean of 7 weeks. The ESR fell below 30 mm/h within seven days in 17 courses and remained below this value for a mean of 7 weeks. Three patients had clinical remissions, with serum CRP less than 30 mg/l and ESR less than 30 mm/h, lasting more than 42 weeks.

Adult

Liquor-cytological investigations in multiple sclerosis.

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.

Adult

[Epidemiological and clinical problems in multiple sclerosis].

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.

Adult

[Surgical therapy of odontogenic maxillary sinusitis. Report on 397 cases].

Operative procedures were carried out on 410 maxillary sinuses in 397 patients. The most frequent indications for surgery were communication between the mouth and the atrium (55.4%) and cysts (24.2%). A Caldwell-Luc operation was carried out in 76.6% of the cases (radical operation). Vestibulum-cheek flaps were used to close the fistula in 97% of the cases. A follow-up examination of 220 patients showed that 10.2% complained of pain. The indications for surgery were limited to avoid this lasting damage.

Adolescent

CSF -- oligoclonal bands in multiple sclerosis.

The present paper is concerned with a correlation between clinical parameters of multiple sclerosis and different agar gel electrophoretical patterns in CSF. The agar gel electrophoresis represents clearly the most sensitive method for the demonstration of oligoclonal bands in CSF.

Adult