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Biomedical subjects

G Schliep

Publications and source records attributed to G Schliep.

15 recordsLinked to original sources
PubMed1984

[Posttraumatic syringomyelia].

Communications on posttraumatic syringomyelia, a late sequel of complete or incomplete paraplegia or even tetraplegia, are rather infrequently in German literature. The problems of this well known complication occurring several months, years or even decades after a severe spinal cord trauma are discussed by two own cases. Both patients suffering from paraplegia developed signs and symptoms of posttraumatic syringomyelia 6 months and 3 years respectively after the accident. Case history and clinical findings correspond with reports in literature. Cystic degeneration in the cervical spinal cord could only be demonstrated in one patient by metrizamid -T-myelography combined with computerized tomography. The value of radiological and other technical investigations, pathogenesis, morphological findings and treatment are discussed.

Adult↗
PubMed1984

[Diagnostic value of clinical study methods in syringomyelia].

Between 1968 and 1981 52 patients with syringomyelia were investigated clinically and with several additional procedures. The introduction of computerized axial tomography (CAT) has led to a change in diagnostic measurements in this disease. Therefore it has become necessary to evaluate the usefulness of additional investigations made in recent past. From own experiences the following measurements are indicated in patients with presumed syringomyelia: X-rays of the cervical and thoracal spinal column and the skull have to be complemented by automatic computerized transverse axial tomography (ACTA) of the spinal canal. CSF should be investigated before metrizamide myelography combined with computerized tomography--the so called computed assisted myelography--is done. These methods both the automatic computerized transverse axial tomography of the spinal canal and the computed assisted myelography allow a differentiation between communicating and non communicating syringomyelia. Computerized axial tomography of the skull is indicated to detect interval hydrocephalus that may be associated with communicating syringomyelia. The other methods evaluated in this study cannot be used to ascertain diagnosis. These measurements combined with clinical and radiological findings may only support diagnosis. Their significance lies in the critical examination of lost functions in the individual case. Especially electrodiagnostic test--as electromyelography and measurement of nerve conduction velocity--show the extension and distribution of the involved peripheral nervous system. These methods are necessary for the critical evaluation of both the spontaneous clinical course and the results of therapeutic procedures. The electromyography findings show the process of denervation already occurred and the degree of motor activity yet available. The measurement of nerve conduction velocity indicates the localization of involved peripheral nerves. The determination of evoked potentials yields informative findings. But at present the value of this method cannot yet be estimated finally. The indication of the discussed investigations depends on the clinical findings in the individual case with the exception of the radiological procedures.

Adult↗
PubMed1980

The process dynamics of viral and bacterial diseases of the central nervous system.

Several patients with herpes simplex encephalitis developed a prolonged humoral immune reaction within the central nervous system, which was evaluated by the measurement of locally synthesized immunoglobulin fractions in cerebrospinal fluid. Such phasic immune responses seem to occur predominantly in CNS infections with herpes and myxo/paramyxo viruses. In many cases the B-cell response follows a primary neutrophilic and a secondary mononuclear phase. Most benign viral encephalomeningitis cases lack this type of strong local B-cell activity. This is also true in most cases of bacterial meningitis, that recover after a strong neutrophilic attack and a minor mononuclear reaction. The initial phase of a purulent meningitis is characterized by a complete breakdown of the blood-CSF barrier. This occurs also in some cases of "apurulent bacterial meningitis", that are characterized by very low CSF-cell counts in spite of a totally broken barrier. The "compartmental leucopenia" is interpreted as an imbalance between the supply from the blood and an intense phagocytic consumption within the CSF space. The influence of the hydrodynamic size of viruses on the mode of entry into the central nervous system and on the dynamics of the inflammatory reactions is discussed.

Adult↗
PubMed1978

Serum-CSF protein gradients, the blood-CSF barrier and the local immune response

For the majority of proteins there is a steady state equilbrium between the serum and the CSF compartment which depends upon the hydrodynamic radii of the passively transferred molecules. For clinical purposes the serum-CSF concentration ratios of albumin (Aalb) and alpha2-macroglobulin (Qalpha2 M) have proven to be a reliable barrier parameter, which is more sensitive than the total protein level in certain diseases, e.g. disk protrusions, degenerative processes and metabolic disorders. The immunoglobulins G and A cope with the passive transfer mechanism in both normal conditions and all degrees of pure barrier impairments but deviate in cases with local immunoglobulin production. The method described produces a quantitative differentiation between the locally synthesized and the serum-derived immunoglobulin fractions. A humoral immune response within the central nervous system was found in certain stages of acute infectious diseases and with chronic inflammatory processes such as subacute sclerosing panencephalitis, neurolues and multiple sclerosis.

Blood-Brain Barrier↗
PubMed1978

Rapid determination of proteins in serum and cerebrospinal fluid by laser-nephelometry.

The Laser-nephelometric technique is characterized by its easy handling, accuracy, good reproducibility and especially by the short time in which reliable results are available. A very good correlation was found between the results obtained by the electroimmunoassay and those obtained by Laser-nephelometry. In both techniques alpha2-macroglobulin is the largest serum protein that can be determined in normal unconcentrated cerebrospinal fluid (CSF). This is of diagnostic significance, since the serum/CSF ratios of both albumin and alpha2-macroglobulin are used as a parameter for the blood-CSF barrier condition.

Albumins↗
PubMed1976

Evaluation of the blood-CSF barrier by protein gradients and the humoral immune response within the central nervous system.

A linear correlation was found between the serum/cerebrospinal fluid (CSF) concentration ratios of albumin, caeruloplasmin and alpha2-macroglobulin and their hydrodynamic radii in a semilogarithmic plot. This protein gradient is used as a parameter to evaluate the blood-CSF barrier under normal and pathological conditions. Irrespective of vastly different transfer rates, the ratio/size permeation curves of proteins at the blood-CSF barrier and the blood-lymph barrier have comparable characteristics. Therefore the protein gradients found in various disease states are interpreted by means of Renkin's general law of lymph formation. Declined gradients are caused either by an increased permeability of the barrier sites or by a decreased turnover rate of the CSF within the compartment punctured. The concentration ratios of immunoglobulins are related to the gradient that is constructed with the ratios of the barrier-indicative marker proteins. As judged by comparative disc electrophoresis of serum and CSF, those disease states that are dominated by barrier impairment are used to establish the range of concentration ratios, compatible with a passive immunoglobulin transfer in any condition in which the barrier is disordered. A mathematical approach is described, which allows the quantitative evaluation of the minimal immunoglobulin portion that is synthesized within the central nervous system.

Adult↗