Plasma norepinephrine after a standardized test meal in acute and remitted patients with anorexia nervosa and in healthy controls.
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Biomedical subjects
Publications and source records attributed to E Philipp.
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This article presents the oral situation of 11 anorectic and 41 bulimic patients and compares it with 50 healthy control persons. While patients with an eating disorder showed less signs of gingival inflammation (SBI: anorexia: 14.6%; bulimia: 12.5%; controls: 44.7%), they had clearly more enamel erosions than healthy control persons. In 27 of 41 bulimic patients a bilateral swelling of the parotid gland was found. A significant correlation between the parotid enlargement and enamel erosion exists in bulimic patients with an anorectic prephase. Patients with an eating disorder had higher levels of serum amylase than healthy control persons. A significant correlation between serum amylase activity and dental characteristics was found in bulimic patients.
After any trauma to the fallopian tubes by a sterilizing operation, pregnancy occurs. If the sterilizing procedure was by high frequency current coagulation, large areas of the fallopian tube must be destroyed down into the mesosalpinx in order to avoid the preprogrammed recanalization tendency of the muellerian duct. Fertilization has occurred in recanalized fallopian tubes which only showed a cubic epithelium. Extensive destruction of the fallopian tube is today not justifiable because of the possibility of interference with the ovarian blood supply and subsequent hormonal damage. At present the safest method of female sterilization is by tissue coagulation of segment of the fallopian tube at 100 centigrade and division of the coagulated portion. In 1000 cases there were no pregnancies.
In a prospective double blind clinical study of 70 patients with bony trauma and shock, 35 patients were allocated into each group receiving either a placebo or Aprotinin. In both groups there was a high incidence of pulmonary insufficiency and thrombocytopaenia. In the placebo group there was a higher incidence of pulmonary insufficiency, but not its severity, with greater volumes of blood transufsion and the most severe form occurred only after decompensated shock. Thrombocytopaenia showed a similar pattern in all patients from both groups falling to a mean minimum on the 2nd day and rising thereafter. In the placebo group counts were lower in those with decompensated shock, and the fall was more profound, rapid and earlier in patients developing severe pulmonary insufficiency. Counts of less than 100,000 on the first day were associated with a high probability of severe pulmonary insufficiency subsequently occurring and this finding was not associated with greater volumes of blood transfusion. In those patients receiving Aprotinin, the subsequent incidence of severity of pulmonary insufficiency was less and not associated with increased volumes of blood transfusion. The platelet counts were not lower in decompensated shock and there was a more rapid rise from the minimum level.
The morphology of the pars intramuralis of the fallopian tube has been histological examined in 500 uteri which were exstirpated in the Department of Gynaecology and Obstetrics of the University of Kiel in the years of 1972 to 1973. It was found that the interstitial pars of the endometrium changes regularly during the menstrual cycle. In the same way the endometrium in the interstitial part of the tubal canal suffers from an atrophy if patients were treated with gestagens. The adenomatous hyperplasie or the polypes of the endometrium which are often found near the utero-tubal junction are to be considered as the matrix of the carcinoma of the endometrium; continuous changes between the adenomatous hyperplasie and the carcinoma of the endometrium can be observed. The frequency of precancers near the utero-tubal junction underlines the demand for an accurate curettage in this region of the cavum uteri. The histological examination of the region of the utero-tubal junction after the extirpation of the uterus is absolutely necessary and has to be generally to be asked for.
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Electron microscopical investigations of the cylindrical epithelium of the human cervix uteri demonstrate in the cytoplasm of the secretory cells tubular precoursers of secretory granules which become granular during the differentiation process of the epithelium. In the seventh fetal month mucous granules occasionally show a confluence. In the eights fetal month, typical cuboidal reserve cells are detected near the basis of the epithelium between the secretory cells and the ciliar cells. Under maximal increase of the rough endoplasmatical reticulum the production of secretory granules proceeds. By mitosis a functional adaptation of the epithelium to the growth of the cervical canal is achieved. The differentiation of the endocervical epithelium is nearly finished in the middle of the ninth month. At this time, merocrine extrusion processes become evident.
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During the last two years we have performed diagnostic pelviscopy in 90 patients suffering from a syndrome of chronic repeated pelvic disease. In 44 patients extragenital endometriosis was diagnosed as the causing factor. In 15 cases we found wide-spread adhesions in the region of the lower pelvis after preceeding laparotomies. Only in 12 patients pelvic-alterations caused by chronic inflammatory processes of the adnexa with peritubal adhesions were discovered. As these results show extragenital endometriosis represents in far more cases as generally believed the cause of gynecological pains. We want to give special emphasis to the diagnosis and treatment of this disease.
The granulosa lutein cells of the human corpus luteum have a specialized system of drainage with a particularly formed extracellular space, by which the steroids pass into the capillary vessels. The extracellular space consists of two partial systems: First one finds, similar to the bile capillaries of the liver, lacune-like widnings of the intercellular space, where numerous microvilli of the lining cells are to be found and which are lined by desmosomes and invaginations of the cell membrane. Second there exist relatively wide canals limited by a granular membrane forming a network of their own among the lutein cells. Both systems contact without direct communication. We believe that first the steroids pass into the intracellular lacunes by diffusion or active transport from where they reach the membrane-lined canals by help of the network they pass on to the pericapillar space from where they diffuse into the blood vessels.
There is a report of a case of a bilateral ovarian cancer in a 51-years old woman whose monocygotic twin sister had died of the same carcinoma one year before. In both cases it was partly a solid partly an adenocarcinoma of the ovaries. According to general statistics of carcinoma here it is an accidental event. Developmental aspects allow us to think of a common genetic disposition. The question is whether in case of a carcinoma of the ovaries in a monocygotic twin the adnectomia in the twin sister should be done.
In high active steroid producing cells of the human corpus luteum we can find in the cytoplasm a well developed smooth endoplasmic reticulum in form of smooth tubules and homogenously spread vesicles resulting from an active metabolic process. We also find specific concertinalike folded membrane complexes which too belong to the endoplasmic reticulum. Numerous mainly tubular mitochondria contain dense lipoid inclusions. Their close conection with the endoplasmic vesicles is expression of a direct interaction of both cell organelles in progesterone production. The transport of the intracellular formed steroid hormones to the capillary takes place via locally enlarged intercellular spaces which communicate with the pericapillary space. On the other hand there are pericellular canaliculi which are coated with a membrane. They have no direct connection to the pericapillar space.
By electron microscopical investigations of the cylindrical epithelium of the human cervix uteri we could show that in ciliar cells a regeneration of ciliars is possible. There is a discussion about the question whether the pinching off of ciliars is the beginning of a transformation process into a secretory cell. The functional change of secretory cells to ciliar cells becomes obvious by the existence of so-called granulo-filamentary bodies in the cytoplasm of ciliar cells. These bodies grow by a granulo-filamentary transformation of secretory granules. As these granulo-filamentary bodies do not take place in the extrusion process but stay in the cytoplasm they may thus be used as an indicator which shows the finished transformation process of a secretory cell into a ciliar cell.