A case of mania induced by high-dose fluoxetine treatment.
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Biomedical subjects
Publications and source records attributed to W Steiner.
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In view of the increase of malignant tumors of the upper aerodigestive tract-caused mainly by the increasing tobacco and alcohol consumption-as well as the frequent delay in attaining a correct diagnosis with the often unavoidable result of mutilation of the patient, early invalidism and premature death, the search for new ways of early cancer detection and preventive measures becomes understandable. The analysis of the results of two pilot studies in Erlangen should clarify the question as to whether or not the preventive mouth, throat, and larynx examination of persons endangered by the consumption of tobacco and/or alcohol is practical and reasonable as well as medically efficient and economically justifiable.
Hyalinosis cutis et mucosae is a rare autosomal recessive disorder of unknown aetiology. Clinical features are hoarseness from early infancy and yellowish papules and plaques in mucous membranes and skin. Light and electron microscopy demonstrates accumulation of PAS-positive material around blood vessels and in the dermis. This substance probably derives from glycoproteins of basement membranes. Carbon dioxide laser surgery of thickened vocal cords proved to be effective for the treatment of hoarseness.
17 unilateral and 6 bilateral choanal atresias in children were observed in the ENT-Dept. of the University Hospital Erlangen during 1975-1982. Bilateral choanal atresia requires immediate trepanation by using the CO2 or Argon laser technique. The surgical procedure in unilateral choanal atresia is postponed until the age of 4 years. Transnasal microsurgical approach is preferred in these cases because it involves minimal damage to the developing structures. The satisfying results are reported.
In the treatment of congenital and acquired diseases in the newborn, infant and older children, increasing use is being made of endoscopic surgery in the nose, paranasal sinuses and nasopharynx, and endolaryngeal microsurgery in the larynx and pharynx. In recent years new technical developments in the field of endoscopy, together with the use of various types of laser, have either made endoscopic surgery possible in the first place, or have facilitated and improved it.
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A high performance liquid chromatography (HPLC) method was developed for the quantitation of strychnine in urine of children with nonketotic hyperglycinaemia and other developmental disorders treated with the alkaloid. Mobile and stationary phases were polar, i.e. methanol-water-330 g/kg ammonia (volumes, 85 ml + 14.2 ml + 0.8 ml) and LiChrosorb Si-60, 7 microns. Brucine was the internal standard. Extraction was performed by the Extrelut technique. At strychnine nitrate concentrations in urine of 21, 126, and 70 micrograms/l, recovery was 92.1 +/- 8.7, 98.1 +/- 2.7, and 102.5 +/- 2.7%. A child with nonketotic hyperglycinaemia under continued strychnine treatment excreted 1 to 13.6% of the daily dose unmetabolized in urine. The method was also suitable for the estimation of unreacted strychnine in tissue extracts. The fast disappearance in vitro of strychnine from a guinea pig liver preparation was confirmed.
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A method for the qualitative analysis of oligopeptides in human urine in cases of peptiduria is described. After sample precleaning on a strongly acidic ion exchanger, the trifluoroacetyl/methyl esters were formed and the peptide derivatives were transformed into trifluoroethyl oligoamino alcohols according to Nau and Biemann. It was found that oligoamino alcohols could be isolated selectively on a weakly acidic ion exchanger. The O-trimethylsilylated trifluoroethyl oligoamino alcohols were separated on a SE-30 glass capillary column and analyzed by computer-assisted gas chromatography-mass spectrometry. In order to increase specificity and to facilitate mass spectrometric interpretation, aliquots of the sample were reduced separately with lithium-aluminium deuteride and hydride. Each peptide gave a pair of derivatives with characteristic mass differences of the ions, namely 2 mass units per reduced oxo group (deuterium-hydrogen-labelling of oxo groups by reduction). Correct identification is assumed only if both mass spectral patterns fit the theory. Sample volumes of 5--100 ml of urine are needed. About six samples can be derivatized per week. Three cases with suspected peptiduria were investigated and the following peptides were found: Gly-Pro-4Hyp-Gly; Gly-Pro-4Hyp; Gly-Hyp-Hyp (postulated isomer Gly-3Hyp-4Hyp); Pro-4Hyp and Gly-Pro. With exception of the tetrapeptide, these compounds could be detected also in the urine of a healthy child.
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