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Biomedical subjects

R Kluge

Publications and source records attributed to R Kluge.

At least 19 recordsLinked to original sources

[Long-term course of dyslexia beyond the school years: catamnesis from pediatric psychiatric ambulatory care].

In our follow-up study 12 years after index admission we were able to examine 59 out of 115 male patients who had been diagnosed in our department as dyslexic (mean age: 10.1 years). Spelling skills at follow-up were more than one standard deviation below the norm for the subjects' age (T-value on the RT of only 24). About half of our patients had participated in a specific spelling remediation program lasting more than 6 months, but at follow-up no effect of therapy could be demonstrated. The patients with the higher IQs regressed in spelling less than those with the lower IQs. We assume that the effects of remediation programs do not survive therapy and school for long because later on good spelling is no longer either required or encouraged. Our patients were severely impaired in their school career: Although their average IQ was 112 only 6 out of 59 had completed a college-preparatory program (Abitur), all of them from middle-class families with well-educated parents. Our patients chose occupations corresponding to the type of high school diploma they had, often those requiring practical skills rather than reading or spelling skills. Patients who had completed no more than the nine obligatory years at school were less content with their work than expected. Emotional disorders during the past 6 months were no more frequent than expected. In a self-report about delinquency there was no difference compared to a random sample.

Adolescent

[Electrocardiography in pediatrics. 2: Recommendations for a newly introduced recording and evaluation procedure].

ECG recordings were made by means of a modified NELSON-lead system in a total of 100 children aged between 2 weeks and 59 months. Software developed by ourselves served for on-line calculations of the dipole moment D which is graphically represented by vector loops in three projection planes, horizontal, frontal and sagittal. In addition, the maximum spatial vector Dmax and the mean vector A are calculated by the program. The examination of one child including positioning of 20 electrodes and production of a hard-copy of the results takes no longer than 15 minutes. The children were unsedated and awake when the ECGs were recorded. The results show the continuously growing dipole moment and its gradually changing direction from the right posterior or left anterior to the left posterior quadrant in parallel with the growth of the body and the heart, respectively. The smallest vector magnitudes and smallest vector loops of the dipole moment are measured in the youngest infants (0-2 months) while very high voltages in conventional ECGs of infants are regularly seen, predominantly in the precordial region. Two examples of pathological NELSON-ECGs are reported. One case is a boy aged 4 years 10 months with aortic supravalvular stenosis, the other one is a girl aged 4 years 3 months with pulmonic valve stenosis. These cases demonstrate the excellent suitability of this noninvasive method as a diagnostic tool for pediatric cardiology.

Child

X-linked nephrogenic diabetes insipidus: from the ship Hopewell to RFLP studies.

Nephrogenic diabetes insipidus (NDI; designated 304800 in Mendelian Inheritance in Man) is an X-linked disorder with abnormal renal and extrarenal V2 vasopressin receptor responses. The mutant gene has been mapped to Xq28 by analysis of RFLPs, and tight linkage between DXS52 and NDI has been reported. In 1969, Bode and Crawford proposed, under the term "the Hopewell hypothesis," that most cases in North America could be traced to descendants of Ulster Scots who arrived in Nova Scotia in 1761 on the ship Hopewell. They also suggested a link between this family and a large Mormon pedigree. DNA samples obtained from 13 independent affected families, including 42 members of the Hopewell and Mormon pedigrees, were analyzed with probes in the Xq28 region. Genealogical reconstructions were performed. Linkage between NDI and DXS304 (probe U6:2.spl), DXS305 (St35-691), DXS52 (St14-1), DXS15 (DX13), and F8C (F814) showed no recombination in 12 families, with a maximum lod score of 13.5 for DXS52. A recombinant between NDI and DXS304, DXS305, was identified in one family. The haplotype segregating with the disease in the Hopewell pedigree was not shared by other North American families. PCR analysis of the St14 VNTR allowed the distinction of two alleles that were not distinguishable by Southern analysis. Carrier status was predicted in 24 of 26 at-risk females. The Hopewell hypothesis cannot explain the origin of NDI in many of the North American families, since they have no apparent relationship with the Hopewell early settlers, either by haplotype or by genealogical analysis. We confirm the locus homogeneity of the disease by linkage analysis in ethnically diverse families. PCR analysis of the DXS52 VNTR in NDI families is very useful for carrier testing and presymptomatic diagnosis, which can prevent the first manifestations of dehydration.

Blotting, Southern

Interrater agreement for CT scans of patients with lacunar infarcts and leuko-araiosis.

A total of 74 CT scans from patients with lacunar syndromes were presented to 10 raters, most of them experienced in neuroradiology. The attributes to be judged were: lacunar infarcts (yes/no), leuko-araiosis (decreased density of the cerebral white matter) (yes/no), cortical atrophy (yes/no), and normal (yes/no). The chance corrected kappa coefficients were 0.641 for decreased density, 0.445 for lacunar infarcts and 0.206 for cortical atrophy. Taking into consideration the attribute cortical atrophy, the kappa coefficient for the attribute normal was 0.330, and without taking cortical atrophy into consideration, it was 0.523. Studies of lacunar infarcts and of leuko-araiosis should be based on clear definitions in order to guarantee a minimum level of interrater agreement.

Atrophy

Genetic variation and biochemical properties of esterase-18 (ES-18) in the laboratory rat (Rattus norvegicus): a new locus of esterase cluster 2 in linkage group V.

A new liver-specific rat carboxylesterase isozyme (EC 3.1.1.1) designated esterase-18 (ES-18) is described. Genetic variation of ES-18 was examined in 93 inbred strains and substrains and a structural locus Es-18 was suggested, coding for either the presence (Es-18a) or the absence (Es-18b) of the isozyme. Linkage studies involving two backcross series revealed that Es-18 resides in cluster 2 of LGV. No recombination between Es-18 and other cluster 2 loci was found in 19 lines of two RI strain sets or in the backcross series.

Animals

[Pathophysiology of cardiovascular disorders in artificial ventilation].

Increase in intrapulmonary and intrathoracic pressures caused by mechanical ventilation decreases cardiac output and redistributes perfusion mainly to lower regions of the lung. The amount of the disturbances depends on the mean ventilatory pressure. If disturbed lung mechanics require the application of high ventilatory pressures an individual ventilation method with optimal matching between ventilation and perfusion must be created.

Cardiac Output

Dietary protein restriction in renal insufficiency in private practice.

About 50% of patients in an ambulatory setting with different stages of renal insufficiency are suitable candidates for protein-restricted diets. This is due to contraindications and, more important, noncompliance of patients. The German health insurance system does not reimburse for dietitians' consultations. Institution and execution of any diet as well as controls of patients' adherence are issues of physicians' work. Protein restriction prescribed varies between 60 and 30 g protein/day. As soon as 40 g/day has been reached, supplementation by essential amino acids is started. Metabolic control is confined to evaluations of BUN/creatinine serum concentration and the reciprocal serum creatinine concentration. Patients' general state of well-being and weight are also followed. For more detailed investigations there is also no reimbursement.

Dietary Proteins

[NMR tomographic studies in experimental renal vein ligation].

Experimental ligation of the renal veins in rats indicate highly significant and characteristic changes within two hours, consisting of significant prolongation of T2 relaxation time in the cortex and T2 shortening in the medulla. In addition, there is a considerable increase in the size of the kidney, due to swelling of the cortex. T2 prolongation of the cortex is most marked between 30 hours and two to four days after ligation of the vein. In the following weeks there is a return to normal. T2 of the medulla at two to three weeks after ligation shows highly significant reduction compared with the normal side and, at this time, the size of the experimental kidney is significantly less than the opposite kidney. These results indicate that magnetic resonance tomography is a highly sensitive method for the early demonstration of renal vein thrombosis.

Animals

Rocky Mountain spotted fever and jaundice. Two consecutive cases acquired in Florida and a review of the literature on this complication.

Rocky mountain spotted fever is increasing in Florida, a state that has had few cases in the past. The typical clinical illness has been well described, but jaundice has been rarely reported. In two patients with illnesses resembling leptospirosis, jaundice appeared on the sixth and ninth day of illness, and peak bilirubin levels were between 7 and 9 mg/100 ml. Liver biopsy specimen from one patient showed a nonspecific hepatitis. Hemolysis and renal dysfunction may have contributed to the production of jaundice in these patients. Fourteen instances of jaundice were reported in 43 autopsied cases as of 1941, but since that time only rare mention of jaundice has been made.

Child

[Therapeutic possibilities in ulcus simplex vesicae].

On the basis of own clinical experiences in the treatment of the ulcus simplex vesicae in connection with the special literature is described that frequent failures in therapy may be traced back to the up to now still uncleared genesis of the disease. According to the modern stage of knowledge the disease in question seems to be determined by trophoneurotic disturbances. Success in therapy may be achieved by interruption of pathological reflexes of the autonomous nervous system by means of infiltration of procoffin.

Adult

[Secondary vesico-ureteral reflux in the adult age].

The transurethral dehiscence of the ostium is a therapeutic method which causes the spontaneous passage of incarcerated intramural ureteroliths. However, it may be performed only in the centre of the roof of the ureter to a maximum length of 0.5 cm. With lateral indentation the antireflux principle of the ostia of the ureters is abolished by damaging the reins of the intravesical musculature of the ureters. An asymptomatic reflux necessarily becomes a reflex disease, when it is complicated by an infection of the urinary tract. In secondary vesico-ureteral reflux by dehiscence of the ostium at adult age the indication to the operative treatment shall be made narrowly, since with the sanation of the infection of the urinary tract the reflux often disappears.

Humans