Biomedical subjects
Publications and source records attributed to E Jarosch.
Beta-endorphins are substances produced by the body to inhibit the perception of pain. Normally they exhibit a steep rise during birth. We have seen an impressive fall which also was statistically highly significant after the application of transcutaneous electric nerve stimulation in 20 parturient women.
UNLABELLED: Patients who are homozygous for an atypical pseudocholinesterase enzyme (PCHE) suffer a prolonged neuromuscular block after succinylcholine application. In order to determine which patients have atypical PCHE preoperatively, an automated method using the Greiner G450 analyzer was developed. PATIENTS AND METHODS: The contribution of blocked and unblocked PCHE by dibucaine hydrochloride (optimal concentration 10(-4) mol/l;) was determined in 113 patients (ASA groups 1-2) and the dibucaine number (DN) was evaluated. RESULTS: According to the DN, the patients were subdivided into three groups: group A (PCHE 5.01 +/- 1.64 kU/l, DN 74.47 +/- 0.87); group B (PCHE 4.28 +/- 3.41 kU/l, DN 64.95 +/- 3.41); group C (PCHE 1.33 +/- 0.54 kU/l, DN 13.08 +/- 2.19;). PCHE and DN of group A corresponded with normal standard values, whereas the patients in groups B and C could be considered to be patients with heterozygous and homozygous atypical PCHE, respectively. CONCLUSIONS: Our data indicate that an automated analysis of blocked and unblocked PCHE with the Greiner G450 can be easily done in a routine laboratory. By interpreting the DN, the possible risks of delayed succinylcholine degradation can probably be prevented.
Parenteral nutrition contributes considerably to the survival of operated newborns. The postoperative period, however, gives rise to special metabolic problems. Commercially available L-amino acid (L-AA) solutions may lead to imbalances in the postoperative period. We used a preparation containing all essential and non essential L-AA, which should take the stress metabolism into account. Twenty newborn infants were treated with a standardized parenteral nutrition regime after major surgery. Two comparable groups were formed; the first (A) receiving up to 2 g L-AA/kg/day and the second (B) 1.5 g L-AA/kg/day at the most. On the seventh postoperative day group B was loaded with 1 g L-AA/kg within 6 h corresponding to the transfer rate in healthy newborn infants calculated by Bürger and Wolf. Plasma L-AA were checked on the seventh day before and after loading. The serum L-AA showed almost normal values in group A, however, several values were found to be too low in group B (proline, alanine, cystine, leucine). After the L-AA load some increased above normal levels (threonine, glycine, lysine, histidine). With reference to these results a daily application of 1.5-2.0 g of L-AA/kg can be recommended for critically ill newborns in the early postoperative period.
In 19 patients receiving a cytostatic therapy with epirubicine and cisplatinum, 31 times in total the renal loss of magnesium was determined using the colorimetric xylidile-blue-method. 16 patients, whose magnesium input postoperatively was equally well known, served as a control. In all these patients a negative magnesium balance could be demonstrated being significantly higher (p less than 0.01) in those receiving cytostatic therapy.
Evidence is presented for defective pyruvate dehydrogenase (EC 4.1.1.1) in leukocytes and muscle tissue from a 10-year old child with persistent lactic acidosis, suffering from myasthenia and growth retardation. The defect is expressed in vitro by a depressed stimulation of pyruvate dehydrogenase catalytic activity by exogenous phosphoprotein phosphatase, and in vivo by a lack of response to muscle work, in comparison with healthy controls. Pyruvate dehydrogenase activity is in the normal range when measured without addition of phosphoprotein phosphatase in cells obtained from the resting patient. The defect reported here represents a new, hitherto undescribed form of a pyruvate dehydrogenase deficiency. The insufficient catalytic activity explains the observed accumulation of pyruvate, lactate, oxaloacetate and alanine and the decrease of citrate concentration in the blood of this patient. Electron microscope studies of the muscle tissue show an enhanced number of enlarged mitochondria with bizarre shapes and high densities of cristae.
We report about the child of a mother with phenylketonuria, which is not suffering from PKU, but is microcephalic and mentally retarded. This retardation is probably a sequel of an intrauterine Hyper-Phenylalanine-status. It is supposed that an intrauterine damage of the offspring even in cases with low Phenylalanine-levels of the mother is possible.
An influence on the production of Angiotensin-I by different ions is demonstrated. Plasma Renin activity was thereby measured by the methods of Boyd et al. (pH 7.5) and of Fyhrquist et al. (pH 6.0) at a concentration of each ion of 50 mmol/L. Ions of different size were used, ranging from Lithium to the Ammonium-ion. A definitive dependency of this effect on the Angiotensin production by the ion size could be shown. With Sodium the concentration in serum was varied at 5 levels (130-170 mmol/L) and Renin measured at Potassium concentrations in low (3.4-3.7 mmol/L) or high (4.8-5.1 mmol/L) so-called normal ranges. A marked increase of the production of Angiotensin-I with increasing sodium concentrations at a low Potassium range was observed and the opposite was true at high Potassium concentrations. These effects have to be taken into account when assaying Plasma Renin activity. In addition, they offer also an explanation of the well-known but unsolved facts of the influence of Sodium and Potassium on the pathogenesis of hypertonia.
9 newborns received a standardized parenteral nutrition following abdominal major surgery. The composition of the amino acid solution used followed the requirements of newborns as well as their postoperative metabolism. The favorable course, the effective control of the catabolism and the lack of significant imbalances of the amino acid patterns indicate that the composition of the amino acid solution was appropriate. Augmentation of the amino acid dosage up to 2 g/kg B.W. at the end of the first postoperative week resulted in a relatively high load of nitrogen and acidosis. Therefore the usually demanded supply of 120-200 non-protein-calories (kcal) for 1 g nitrogen turns out to be too low. Though the relative over-load of amino acids is used for energy utilisation, it stresses, however, the metabolism.
A recent report by Miyagi and co-workers [New Engl. J. Med. 301: 196-198, 1979] suggested that glutamine caused a decrease in cystine excretion in 1 patient. We studied 2 patients with cystinuria on 2-4 g glutamine for 24 and 60 days. In these patients glutamine showed no effect on the excretion of cystine in the urine. This is consistent with the report by the Mayo clinic where 5 patients were treated with glutamine without any response.
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A new method to measure restlessness is described. It consists mainly of recording thoracic electrical impedance and measuring the amount of movement artifacts appearing in the pneumographs. Technical equipment and data evaluation are described; an example of typical data is given together with proposals as to how the method may be automated. Potential applications in different fields of interest are described.
Transthoracic impedance pneumographs from sixty children suffering from acute bronchitis were studied to investigate the effect of Vaporub on the amplitude and frequency of breathing. The experimental technique consisted of an observation period of 70 minutes after a 3-minute treatment with Vaporub or petrolatum as a control. Before the treatment, after an adaptation period of 20 minutes, the pneumogram was recorded for 10 minutes, after the treatment pneumograms were recorded for 70 minutes. The pneumograph data demonstrated an early increase in amplitude up to 33.0%, with subsequent return to slightly above control for the remaining test period. Such an increase was not observed in the Petrolatum-treated group. Breathing frequency demonstrated a progressive decrease to 19.4% of the pre-treatment value at the end of the test period, while the Petrolatum controls were between + 3.6 to - 4.2% difference. It is concluded that Vaporub treatment results in a change in breathing patterns. This, together with the clinical observation of the children suggests a condition of 'easier breathing'.
Fifty-six children, suffering from acute bronchitis were studied. Skin temperature and rectal temperature were simultaneously recorded over a period of 90 minutes after 3-minute rub therapy on chest and back with either Vaporub or its base Petrolatum. A statistically significant increase in skin temperature as compared to the pre-treatment was observed; with Vaporub, however, the increase was 1.1 degrees C on average at the highest point of a large plateau reaching from 30 to 90 minutes after the treatment. Rubbing Petrolatum alone showed 0.2 degrees C on average on the top of the temperature plateau. Rectal temperature did not show significant changes with either therapy. On comparing temperature data of the same type in healthy children, the time course of the temperature elevation (which also was observed in healthy children after Vaporub treatment), was different from that of bronchitic children. In the bronchitic children the temperature rise was still 0.9 degrees C 60 minutes after treatment. In the healthy children after 60 minutes, the temperature elevation was only 0.4 degrees C above the pre-treatment value.
In this study pneumographs of children with acute bronchitis treated with Vicks Vaporub or Petrolatum were used. Movement artifacts were used as a measure of the so-called "restlessness" of the children. The experimental schedule consisted of a 10-minute phase of recording before a 3-minute treatment with Vaporub or Petrolatum, followed by a 70-minute observation period, during which time pneumograms were also recorded. Thirty-four Vaporub-treated children showed an increase in periods without movement artifacts of up to 213.8%, the Petrolatum controls, twenty-six children, up to 62.4% as compared to the corresponding pre-treatment values. It is concluded that Vaporub is effective in decreasing restlessness in children suffering from acute bronchitis. This effect is quite marked and cannot be due solely to psychological effects of the rub therapy, or to effects of petrolatum without aromatics.
Amino acid screening in an institute for children with hearing defects led to the detection of a 14 years male with histidinuria. Further investigations established the diagnosis histidinemia. In this normal intelligent patient audiologic tests showed bilateral internal ear hearing defect. It is accepted that the hearing defect is the reason for speech abnormities in form of diminished articulation. But it is not clear how far the inborn error of histidine metabolism is directly responsible for the hearing loss. This observation suggests that the well known speech defects in histidinemics are partly caused by hearing disability.
We report about experiments to isolate Synaptosome-Membranes of the rat cerebellum in order to produce Antibodies directed toward these membranes in rabbits. The raised Antisera were tested in different Complement-fixation-assays. They reacted only with the Synaptosome-Membranes, not with heart, kidney, liver- and spleen-membranes. Different fractions of the isolation-procedure for synatosomal membranes were also checked for their ability to fix Complement. Only Synaptosomes and the synaptosomal membranes gave sufficient Complement fixation, while Mitochondria, soluble brain proteins, synaptic vesicles and braincell nuclei did not. These biochemical and immunological findings are further supported by electrophysiological data, where the transsynaptic component of the parallel fibre-evoked field potential was strongly suppressed by the administration of the immune sera containing antibodies against membranes of synaptosome fractions.