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Biomedical subjects

J D Herrlinger

Publications and source records attributed to J D Herrlinger.

At least 19 recordsLinked to original sources
PubMed2001

[Lysis of an extensive thrombus in the internal carotid artery using a glycoprotein IIb/IIIa receptor antagonist].

HISTORY: A 55-year-old man was admitted with acute right-sided arm and leg paralysis and motor aphasia, which were regressing at time of admission. He was known to have had several episodes of abnormal motor function in the right arm resulting from transitory cerebral ischaemic attacks. He was a heavy smoker. INVESTIGATIONS: Cranial computed tomography (CCT) excluded acute bleeding and there was no evidence of a stroke. Duplex sonography showed a filiform stenosis at the origin of the left internal carotid artery (ICA) with an echo-poor structure in the distal lumen. Subsequent angiography demonstrated an inoperable thrombus adherent to the filiform left ICA stenosis and extending to the base of the skull. DIAGNOSIS, TREATMENT AND COURSE: The neurological symptoms regressed over 24 hours, confirming the diagnosis of prolonged ischaemic neurological deficit. CCT having excluded bleeding, but significant left ICA stenosis by a thrombus having been demonstrated, treatment with acetyl salicylic acid (aspirin) and heparin was initiated. After the described angiographic confirmation of a thrombus adherent to the filiform stenosis, treatment with Tirofiban, a glycoprotein (GP) IIb/IIIa receptor antagonist, was begun and the thrombus completely dissolved. The filiform ICA stenosis was then treated surgically. CONCLUSION: This case demonstrates complete lysis of a long thrombus in the ICA by Tirofiban, making a primarily inoperable stenosis amenable to surgical intervention. It is not yet clear whether administration of GP IIa/IIIb receptor antagonists provides a therapeutic option in the treatment of intracranial arterial thromboses.

Aphasia, Broca↗
PubMed1992

Long term prognosis in yersinia arthritis: clinical and serological findings.

Twenty two patients were followed up for a mean of 10.7 years after acute yersinia arthritis. Their clinical course, agglutination antibodies, antibodies against plasmid coded yersinia proteins, and laboratory parameters of inflammation were analysed. The clinical findings were unremarkable. Serum agglutinating antibodies against Yersinia enterocolitica were not found in any patient. Ten patients had no antibodies against plasmid coded bacterial proteins. Five patients showed IgG antibodies, one patient had an IgA and IgG result of questionable significance, and six patients had IgA and IgG antibodies in the immunoblot reaction. No evidence of systemic inflammation was found. The persistence of IgA or IgG antibodies, or both, did not have a discernible influence on the clinical course. The development of erosive changes in the sacroiliac joints occurred independently of yersinia infection.

Adult↗
PubMed1989

[Atrial lipoma as a cause of tachycardiac arrhythmia].

A 41-year-old man had paroxysmal tachycardic arrhythmias. Computed tomography revealed a right atrial lipoma, 7 cm in diameter. After the tumour had been removed (with histological confirmation of the diagnosis) the arrhythmia ceased. Such tumour must be considered in the differential diagnosis of tachycardic arrhythmias of undetermined origin.

Adult↗
PubMed1984

[Intracellular gold content of circulating blood cells using various gold compounds].

Evidence on the action mechanisms of gold salts in the treatment of rheumatoid arthritis is still inconclusive. The intracellular localization of the place of action is likely. Therefore not only the serum gold levels but also the intracellular concentration of gold are of special interest. We measured the gold concentration in the serum and in the blood cells after in vitro application of aurothiomalate (Tauredon), gold keratinate (Auro-Detoxin) and triethylphosphine-gold (Ridaura) and in blood samples of patients undergoing these gold salts treatments. Cell-bound concentrations were found to vary extensively as a function of the gold compound used. While no or very little gold was present intracellularly after administration of the 2 parenteral drugs, up to 40% of the circulating gold was found to bind to the cells after administration of the triethylphosphine compound for gastro-intestinal absorption. The red cell concentration was more or less the same as that in the extracellular compartment. Gold apparently accumulated in the white cells, because the cell-bound concentration relative to unit volume was up to 20 times higher than the plasma level. The method used did not offer any information on the actual binding site of gold in white cells, i.e. cytoplasm versus nucleus versus cell membrane.

Anti-Inflammatory Agents↗
PubMed1983

[Successful conservative treatment of bronchial carcinoid with Cushing's syndrome due to ectopic ACTH production].

In a 53-year-old female patient with typical clinical Cushing's syndrome increased blood sugar levels, hypokalaemia, increased non-dexamethasone suppressable plasma cortisol levels and increased ACTH values in serum were observed. CAT scanning revealed bilateral adrenocortical hyperplasia. The endocrine anterior pituitary function was normal. Radiographically and bronchoscopically a rightsided parahilar tumour was found. Histology showed an atypical metastatic bronchial carcinoid with ectopic ACTH production. Conservative treatment with metyrapone suppressed the Cushing syndrome. The ACTH producing tumour responded to combined chemo- and radiotherapy. The patient is symptom free two years after onset of treatment.

ACTH Syndrome, Ectopic↗
PubMed1980

[Clinical trial in couples of effectiveness and side-effects of gold and D-penicillamine in long term treatment of rheumatoid arthritis (author's transl)].

A prospective clinical trial in couples was done to compare effectiveness and toxicity of gold and D-penicillamine (D-Pen.) in treatment of rheumatoid arthritis (r.A.). Respecting defined criteria 70 patients were put to couples according to a random list and were treated with gold or D-Pen. alternatively. Physical and laboratory indices of inflammatory activity were checked every 3 months, X-rays every 12 months. Dropouts (side effects, missing compliance, uneffectiveness) were replaced by the nextcoming fitting patient. Thirty-two of 147 totally recruited patients stopped treatment because of side effects, three because of unsatisfying efficiency. Forty-two patients shuned the necessary controls. The clinical course was better in 16 couples with gold, only in sex couples with D-Pen. Thirteen pairs showed no difference in this respect (p = 0.05). Looking to the laboratory parameters separately D-Pen. tends to be superior (p < 0.05), radiografic deterioration seems to be more seldom with gold (< 0.05). Side effects occur with both drugs in comparable frequency (15/44 with D-Pen., 17/52 with gold), but the complications with D-Pen. are more serious. Altogether this trial shows gold superior to D-Pen. in the long-term treatment of r.A.

Adult↗
PubMed1980

[Pharmacokinetics of gold after administration of aurokeratinate (author's transl)].

Aurokeratinate (Auro-Detoxin) was administered intramuscularly to patients with chronic rheumatoid arthritis, using two different dosage schedules and measuring serum gold concentration. (1) Using slowly rising doses (as generally practised) the gold level gradually rose to 3.2 microgram/ml after four weeks (before the ninth injection), without reaching cumulation equilibrium. Elimination from serum occurred during this phase, with a half-life of 3-5 days. When treatment was continued at about 25 mg gold twice weekly, the cumulation equilibrium was reached with a minimal value at 3.5 microgram/ml and a maximal one of 6 microgram/ml, elimination half-life then being increased to nine days. During the subsequent maintenance treatment with 65 mg gold once a month the serum-gold concentration fell to about 1 microgram/ml, maximal values being about 6 microgram/ml, with an elimination half-life of 11 days. (2) With a constant dose of about 25 mg gold twice weekly, cumulation equilibrium was reached after two weeks (3.4 microgram/ml before the fifth injection), while on 50 mg gold every 14 days as maintenance dose the serum concentration was between 2 microgram/ml minimally and 6 microgram/ml maximally. At the modified dosage the drug was well tolerated.

Arthritis, Rheumatoid↗
PubMed1979

[Yersinia arthritis (author's transl)].

Clinical picture and differential diagnosis of Yersinia arthritis are shown by means of three own observations. It is an acute oligoarthritis affecting especially knee- and ankle-joints. The involved joints are very painful, swollen and warm. There may be a history of enteritis or suspicion of acute appendicitis because of lower abdominal pain, but this is not obligatory. The laboratory parameters of inflammation (ESR, C-reactive protein, white blood count, serumproteinelectrophoresis) are changed significantly. Diagnosis is made by serum agglutination reaction (Widal-reaction) against ceesurface antigens (O-antigens) of Yersinia enterocolitica. Almost only people with the HL-A antigen B27 tend to get arthritis during Yersinia infection. The differential diagnosis has to consider reactive arthritis during Salmonella or Shigella infections, acute sarcoidosis, Reiter's disease and rheumatoid arthritis.

Adult↗
PubMed1979

B cell activity in rat bone marrow and spleen during primary and secondary response: dependence on strength of antigen.

B cell activity was studied in the spleen and the bone marrow of inbred rats after applying xenogeneic erythrocytes of different antigenic strength (mouse or sheep). The hemolytic plaque technique of Cunningham was used. In contrast to the studies of other authors with other species, these experiments showed that in the rat the kinetics of IgM and IgG responses in bone marrow and spleen are principally similar during a primary as well as during a secondary reaction, varying only with the strength of the antigen.

Animals↗
PubMed1978

Different suppressive effects of combined cyclophosphamide-antigen treatment compared with exclusive cyclophosphamide treatment on primary and secondary humoral immune reactivity.

The immunosuppressive effect of a combined treatment with antigen (C3H erythrocytes - ME) and cyclophosphamide (CY - dosage 65% LD50) has been studied in inbred CAP rats showing different degrees of immunological reactivity. When primary reactivity existed before treatment, this reactivity was not abolished but diminished. When weak secondary reactivity (after one antigen injection) existed before treatment this reactivity was abolished and again diminished primary reactivity was found. When strong secondary reactivity (after 4 antigen injections) existed before treatment selective unresponsiveness was found during the 4 weeks following treatment. 12 weeks after treatment diminished primary reactivity was found again. When the same dose of CY was given without antigen no immunosuppressive effect could be seen - irrespective of whether primary, weak or strong secondary reactivity existed. The results indicate that in this model it is easier to induce selective unresponsiveness in sensitized than in nonsensitized rats and suggest that primed lymphocytes are more susceptible to a combined antigen-CY treatment than unprimed cells.

Animals↗
PubMed1975

[Effect of D-penicillamine on the humoral primary response (author's transl)].

The influence of D-penicillamine (Pen) on the humoral primary response was studied systematically. Inbred rats are sensitized with erythrocytes of mice of one strain. Pen given at various schedules (dosage: 3 X 100 resp. 3 X 1000 mg/kg at 24 h intervals) showed no effect on antibody titer 7 days after sensitization. When Pen is given before the antigen the slope of the titer after day 7 is accelerated. Compared to experiments with alkylating drugs and antimetabolites in the same model Pen does not show immunosuppressive potency.

Animals↗