[Theoretical overview and interdisciplinary approach to Munchausen's syndrome (syndrome of factitious disorders)].
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Biomedical subjects
Publications and source records attributed to S Frisch.
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Autopsy tissues of white and grey matter from brains of MS patients and controls were homogenized in PBS and centrifuged at 100,000 x g for 1 h. The residues were thoroughly washed with PBS and further extracted at acidic and alkaline pH. The eluates contained a low but significant amount of IgG, indicating that bound IgG was present in MS brains. A greater yield of IgG was obtained with alkaline pH buffer than with acidic pH buffer. In contrast, sections from 2 of 3 neurologic controls and 3 of 4 non-neurologic control failed to show detectable level of bound IgG extractable at acidic pH. These results might suggest the presence of antigen-antibody complexes in MS brains. Isoelectric focusing analysis demonstrated oligoclonal IgG bands in low pH eluates from MS brains and these bands were partly similar to those seen in neutral (unbound) pH brain extracts.
Few studies evaluate the effect of topical corticosteroids on thermal sensation and in alleviation of itch produced by intradermal injection of histamine. We evaluated the antipruritic effect of hydrocortisone (1% and 2.5%) on histamine-induced itch and sensory effects by measuring itch magnitude, itch duration and thermal thresholds using a computerized thermal sensory analyzer (TSA). This was a double-blind, random, comparative, controlled, single-dose and single-center study. Itch was experimentally induced in both forearms by intracutaneous injection of histamine in 18 subjects. Hydrocortisone 1%, 2.5% and placebo were applied to test sites on both forearms. The thermal threshold for warmth sensation, cold sensation, cold and heat pain was measured with the TSA. Itch magnitude was measured each minute after histamine injection for 10 min with a visual analogue scale (VAS). Itch duration was also recorded. In comparison to placebo, 2.5% hydrocortisone significantly (p = 0.03) reduced itch duration from 12.6 +/- 11.0 min (mean +/- SD) to 8.6 +/- 8.2 min (the reducing rate was 32%) as well as itch magnitude (at minutes 3, 6, 7 and overall). Placebo, 1% and 2.5% hydrocortisone significantly altered (p <0.05) the cold sensation threshold. No treatment altered cold or heat pain thresholds. These data suggest that topical application of 2.5% hydrocortisone may be significantly beneficial for the treatment of histamine-induced itch. The correlation between thermal measurements and antipruritic effects warrants further study.
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An objective examination of olfactory function is needed for evaluation and clinical progression of patients with olfactory deficits. Two hundred sixty-eight healthy subjects were studied in order to establish olfactory thresholds for three test odorants. Subjects were required to simply detect the presence of an odor when comparing various log dilutions of test odorant against two "blank flasks. These data have provided a means of quantitating existing olfactory deficits in affected patients. Olfactory function was found to be diminished in elderly subjects and should be considered a factor when evaluating older patients.
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