Plasma exchange alone as therapy for myasthenia gravis.
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Biomedical subjects
Publications and source records attributed to C Herrmann.
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In 47 of 620 pregnant women (7.6%) examined during the first, second and third trimester, it was possible to identify IgM, antibodies against late antigen (LA) of the cytomegalovirus during one or several examinations. 6 of 37 examined children of mothers with positive IgM antibody reaction were found to have intrauterine infection, although there had been no clinical signs of an infection at the time of delivery. All 6 children with intrauterine infection were from 32 mothers (18.8%) with IgM antibodies during the first trimesters. The IgM antibodies of the mothers with children having intrauterine infection did not differ fundamentally from the IgM antibody levels of the mothers with non-infected children with regard to titration value and persistency.
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Twenty patients with myasthenia gravis had chest radiography, conventional tomography, and computed tomography (CT) of the thorax within 1 month of thymectomy. Four of the six macroscopic tumors were detected on routine chest radiography; conventional tomography provided no additional information. CT detected all six macroscopic tumors and provided additional information that was not available by other procedures. However, 18 patients (90%) had anterior mediastinum densities on CT, which could not be distinguished preoperatively from thymic tumors. All six patients with macroscopic tumors had serum antistriational muscle antibody titers; this test was negative in 10 of 11 patients (91%) without thymoma. Chest radiography, CT of the thorax, and antistriational antibodies are the tests recommended for detection of a thymoma in patients with myasthenia gravis.
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All urinary tract infections cannot be safely detected by bacterial urine testing during pregnancy. Therefore, the question was studied whether detection of antibody to the "enterobacterial common antigen" (ECA) might be important to screening of pregnant women for urinary tract infections. Tests were applied to 202 sera obtained from 42 pregnant women with urinary tract infection, with pathological titres having been recorded from 21.8 per cent.--Detection of antibody to ECA, consequently, is not believed to be helpful in improving diagnosis of urinary tract infections during pregnancy.
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Twenty-eight patients with myasthenia gravis (MG), five with and 23 without thymoma, and 47 normal controls were typed for serologically defined HLA-A, B, C, and DRw antigens. Sera from all patients were titered for antibodies to acetylcholine receptors (AChR). The frequency of HLA-B8 and DRw3 in the non-thymoma MG patients was significantly higher than in the normal population. Most of the non-thymoma patients with AChR titers higher than the average level were positive for HLA-B8 and/or DRw3, while the majority of the HLA-B8(-) and/or DRw3(-) non-thymoma patients demonstrated AChR titers below average. These findings support the possibility of the existence of immune response genes in the HLA-B, DRw segment of the major histocompatibility complex which are concerned in the response to or recognition of autoantigens.
Six patients with myasthenia gravis and suspected thymoma underwent radiologic investigation using plain chest radiography, conventional anterior mediastinal tomography, and computed tomography. All underwent exploratory thoractomy within 1 month of the radiologic workup. In three of the five cases that proved to be thymoma, CT yielded significant diagnostic information that bore directly on the management and/or prognosis of the patient. We therefore believe that CT may be a valuable adjunct in the radiologic investigation of the patient with myasthenia gravis.
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The authors describe the use of machine punch cards in the framework of the examination of a great group of subjects and present a processing scheme. They advocate the use of this technique in case of abundance of informations and relatively simple questions.
Brains of three months old male rats were handled by a modified Golgi-Kopsch method. Stellate cells of the gyrus cinguli were drawn, classified into four types and analyzed quantitatively. The values of the four types were compared by means of a varianz analysis. The four types are: isodendritic stellate cells without spines (I/OS), isodendritic stellate cells with spines (AI/OS), anisodendritic stellate cells without spines (AI/OS), anisodendritic stellate cells with spines (AI/MS). Type I/OS and type AI/MS are the most contrary one. Main results are: 1. The lengths of the dendritic branches show maximum values in the 3rd order. The dendritic lengths exhibit great deviations in all the four types. The alteration of the lengths values from one to the next order is similar the basal dendritic tree of primitive pyramidal neurons. The same analogy you can find for the dendritic numbers of corresponding orders: highest numbers are in the 2nd order, in the following orders the numbers decrease permanently. Isodendritic stellate cells without spines have significantly more dendrites of the 1st order compared with the other three types. 2. The branching pattern --- revealed in the number of free dendritic endings --- shows differences between isodendritic stellate cells without spines and anisodendritic stellate cells with spines. 3. The total lengths of the dendritic branches and the lengthes of the single dendritic fields are similar in significant differences: least lengths there are in anisodendritic stellate cells with spines, they are significantly different from isodendritic stellate cells with and without spines. 4. There are differences in the values of spines and varicosities between all types which causes the possibility of classifying stellate cells according to this parameter. This is valid for spines values of the orders, spines values of single dendritic fields and for the total number of spines for one neuron. 5. Localization and extending in the layers: most stellate cells extend through several layers. The isodendritic type is preferentially localizes in layer III, the anisodendritic one in layer V.
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Urinary sediments of 64 pregnant women with significant bacteriuria which has been demonstrated several times before, have been investigated for the presence of antibody coated bacteria. Antibody titers were determined in the corresponding serum samples in addition and the results were compared with the clinical diagnosis. In 50% of pregnant women with pyelonephritis antibody coated bacteria could be demonstrated, while 60% of them had elevated serum titers. Taking into account both results in 80% of the pregnant women the clinical diagnosis of pyelonephritis could be confirmed. Pregnant women with asymptomatically significant bacteriuria never gave positive results, whereas pregnant women with cystitis mainly did have negative results. The demonstration of antibody coated bacteria in the urinary sediments of pregnant women with significant bacteriuria as well as the detection of elevated serum antibody titers with the indirect immunofluorescence technique against the urinary strain were found to be of importance for the valuation of a significant bacteriuria.
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