Hydranencephaly--clinical and neuropathological aspects.
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Biomedical subjects
Publications and source records attributed to V Reinhardt.
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This is a report of clinical, morphological, diagnostic, endocrinological and therapeutical experiences with 18 patients with tumours in the pineal region. The histological diagnosis was verified in four cases by autopsy, in seven cases by biopsy, and in one case by microscopical verification of tumour cells in the CSF. In all biopsy cases we are dealing with typical germinomas. In the other clinical cases diagnosis was made by neuroradiological and endocrinological methods. The localization was possible by encephalotomography or CT scan, according to Kageyama, Particular attention was given to the endocrinological dysfunctions which originate in the hypothalamus. Also the hypothalamic dysfunctions after irradiation were discussed. Since the results of primary surgical approach and biopsy have been unsatisfactory, we preferred a non-operative schedule for treatment of pineal tumours.
Hypothalamic lesions occasionally lead to excessive hypernatraemia and hyperosmolarity which cannot be explained by defective ADH secretion alone. As osmoregulation is a complex system the clinical features differ widely from one patient to another. In general central dysregulation of osmolarity is due to diffuse hypothalamic lesions, e.g. inflammatory inflammatory infiltration by histiocytosis X or by large suprasellar tumours. We report on a ten-year-old girl suffering from a suprasellar spongioblastoma and a twelve-year-old-girl, who had been operated for a large craniopharyngioma. Polyuria and polydipsia were not present. Whereas one patient presented hypernatraemic crises and showed normal osmolarity at the intervals, the other patient suffered from sustained hypernatraemia and hyperosmolarity. In the first patient water loading led promptly to clinical and laboratory normalisation. In the other case water loading failed to decrease hyperosmolarity but led to oedema. In the first patient hypernatraemic crises were combined with decreased serum potassium levels and elevated urinary aldosterone excretion. Therefore acute and long-term trials of spironolactone treatment were successful. Exogenous ADH-derivatives failed to normalize hyperosmolarity. In the other patient, however, DDAVP decreased the serum sodium level seen with small doses.
"Wernicke's encephalopathy", as one of the sequelae of chronic alcoholism, is discussed with regard to its effects on driving ability. The neurological symptoms are presented with reference to 33 cases and the possible personality defects with thalamic lesions and abortive types of disease are emphasized.
In 2 prepubertal bulls 10-min blood samples collected during a 24-h period showed that gonadotrophin and testosterone peaks occurred regularly at intervals of 6h in one animal and 8h in the other. There was a clear relationship between the LH, FSH and testosterone peaks. The increase of gonadotrophin levels was followed 20 +/- 6 (s.d.) min later by an increase of testosterone; the interval between the peak values was 61 +/- 9 (s.d.) min. The pattern of prolactin concentration differed; there were two prolonged elevations rather than regular peaks.
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Factors which lead to social rank tension and dynamics of social hierarchy were analysed in a herd of dairy cattle. Socioethological characteristics were evaluated by means of the Dominance Value (DV) and the Index of Aggression (IA) which were computed for each animal of the herd. The analysis of interrelationships between DV--IA--seniority--body weight--individual pecularities elucidated some impulses of social rank dynamics.
Experiments have shown that the prolactin response specific to sustained teat stimulation is strictly dependent upon the duration of stimulation. There is some evidence for assuming two principally different patterns of prolactin response, namely high sensitivity to the stimulus with an initial maximal response, and poor sensitivity to the stimulus with a gradually intensifying response. Hyperstimulation of teats results in relative refractoriness of neural receptors for specific prolactin impulses. Refractoriness of one teat leads to a reduction in the release of prolactin which can be overcome by the stimulation of another as yet unstimulated teat.
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We report a case of a 37-year-old female who suffered from seizures and underwent external beam radiotherapy due to a suspected low-grade astrocytoma in the left hemisphere. After 7 years free of seizures under antiepileptic treatment and no signs of change in the yearly performed control MRI, she developed a progressive right-sided hemiparesis. MRI now showed an enhancing lesion with space occupying perifocal edema in the entire left hemisphere. Stereotactic biopsy revealed only inflammation. Due to further progress of the neurological deficit an open biopsy was performed. Histological examination revealed a middle-graded astrocytoma and a radiation necrosis. This case demonstrates that radiation necrosis and tumor recurrence may develop concurrently and that it may be difficult to distinguish them by clinical or radiological methods.