[The ECG in patients with sleep-related disorders of respiratory control--its status in diagnosis and therapy].
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Biomedical subjects
Publications and source records attributed to U Köhler.
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This paper presents 4 cases in which the punctum had been temporarily occluded with tissue adhesive, still showing toxic tissue reaction years later. Abscess, dacryocystitis, dacryocystitis with dacryolithiasis, dacryocellulitis and polyposis were found. In the light of these findings and the relevant literature-especially with regard to late injuries-it is not advisable to use tissue adhesive, at least not for the purpose of punctal occlusion.
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A day vs. night comparison of type and frequency of cardiac arrhythmias documented by long-term ECG was done in 30 patients with nocturnal respiratory disorders in the form of the sleep apnoea syndrome. The commonest nocturnal arrhythmia was pronounced sinus arrhythmia during the apnoeic phases with variations of cardiac frequency between 40 and 120/min. Supraventricular and ventricular extrasystoles occurred significantly more frequently during the night than during the day. In three patients bradycardiac arrhythmias presenting as sinoauricular and atrioventricular blockades of the 3rd degree with node or ventricular substitute rhythm were seen during the sleep apnoea which could not be demonstrated during the day. Predominantly nightly occurrence of cardiac arrhythmias should lead to differential diagnostic consideration of the sleep apnoea syndrome.
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Report on a patient suffering from keratosis follicularis spinulosa decalvans (Siemens I syndrome). This ia a very rare clinical picture, at least in its complete form. The patient's father and brother are suffering from an abortive Siemens I syndrome. The condition is a form of hereditary parakeratosis, a spinulose keratosis with typical localization in the eyes and on the skin. Causal therapy is not possible; attempts at conservative and surgical treatment are described. Prognostically, the condition will probably come to a standstill at puberty. The description of this case is intended to illustrate the necessity of close cooperation between dermatologist and ophthalmologist.
The visual fields of nine eyes (nine patients, aged 51--60 years) with fundus sclerosis and relatively low systemic blood pressure, as well as the visual fields from 25 eyes (25 patients, aged 51--60 years) with increased blood pressure, but no ophthalmologic evidence of arteriosclerosis or fundus sclerosis were investigated with the Goldmann Perimeter before and after the application of pressure to the eye. In the first group pressure application resulted in a narrowing of the I/4-isopters and a marked narrowing of the I/2-isopters of the visual field. The blind spot scotomes become larger and are excluded from the I/2-isopters by their marked narrowing. In contrast, the I/4-isopters on the second group of eyes are little influenced by pressure application and I/2-isopters are never narrowed to an extent which excludes the blind spot from the I/2 scale.
The authors describe results of surgery employing the Steinbach-Novers procedure. Intraocular pressure was lowered in all cases. Of 14 patients, 12 were subsequently free of pain. The authors conclude that direct ciliary body coagulation may be recommended as an alternative procedure, especially in diabetic patients suffering from hemorrhagic glaucoma.
The authors studied the visual fields in 100 healthy persons of different ages before and 10 min after oculopression. They found a depression of the I/2 isopter mostly in the nasal lower quarter of the visual field in persons over 60 years old, due to a disturbed or diminished vascular compensation of bulbus compression. They consider that oculopression might have clinical importance as an indirect provocation test of the cellular blood circulatory system.
In the years 1966-1969 100 haemangiomata which had developed in early childhood were prospectively investigated in a randomised study. Half of them were treated by soft X-ray radiation, the other half underwent mock-radiation as a control. 54% of the original group could be examined after 6 years. The results showed that the ratio of cure was similar in the both groups. The skin pattern of the incompletely cured haemangiomata was also comparable. The biological rule of regression of haemangiomata in early childhood seems not to be influenced by X-ray treatment. It is striking that X-ray treatment in dark-skinned children leads to a better therapy-result than in fair-skinned ones.
The spectrophotometric methods of Kind et al. and Kleihauer et al. were checked by more than 900 experiments on 85 blood stains on different material (cotton, nyltest and paper) from native and citrate blood, aged at room temperature up to 5 years. As a result, the variation of values within one age-group exceeded the differences between the values of samples of different age. Therefore, both methods are thought to be unsuitable for the estimation of blood stain age in practical forensic medicine, although the general trend described by the above authors could be confirmed.
The influence of oculopression on the EOG in 6 persons with healthy eyes and in 7 patients with advanced glaucoma was investigated. The reaction of the potential produced by oculopression may be an objective feature of the ability of compensation.
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The authors analysed the findings in 280 patients suspected of glaucoma. These patients were controlled over a long period in the course of which 30 developed a glaucoma. The authors recommend the measurement of IOP in all patients in the office so far as there is no contraindication and a 1/2 yearly control of all suspected cases to begin with. They recommend further that after 4 year control the provocative tests should be repeated in case there is yet no manifestation of the disease. Finally they recommend that the pilocarpine-test should be done if the pressure level reaches 26 mm Hg in order to fish out cases of manifest glaucoma early enough.