PubMed Health⌕ Search

Biomedical subjects

W Bernhardt

Publications and source records attributed to W Bernhardt.

At least 37 records · Page 2Linked to original sources

[Relationship between immunoglobulin levels in cerebrospinal fluid and serum].

By means of radial immunodiffusion, immunoglobulins A, G, M and albumin were determined in serum and unconcentrated cerebrospinal fluid from 182 controls and 141 patients. Concentrations in cerebrospinal fluid and serum of patients did not correlate, not even in those groups whose elevated immunoglobulin and albumin concentrations in cerebrospinal fluid resulted from damage to the blood-cerebrospinal fluid barrier, as in inflammatory diseases and neoplastic processes of the central nervous system or of the meninges.--Concentrations of immunoglobulins in cerebrospinal fluid should therefore be evaluated independently of the serum concentrations. Cerebrospinal fluid and serum constitute samples from two separate compartments which are capable of independent immune reactions.

Albumins↗

[Glucose tolerance and neurogenic muscular atrophies (author's transl)].

Glucose tolerance is reduced in patients suffering from neurogenic muscular atrophies. In a group of 20 patients with myatrophic lateral sclerosis the extent of atrophy correlated significantly with the decrease in glucose tolerance. Creatinine excretion was used as a measure of functioning muscle mass. Insulin secretion was not reduced, on the contrary, it was strongly pronounced in these cases. The observations are not explained by a decrease in distribution volume of glucose. By testing glucose tolerance, functions of sceletal muscles are examined at the same time. In evaluating the results, the functioning muscle mass has to be taken into account.

Adolescent↗

Protein fractions of lumbar, cisternal, and ventricular cerebrospinal fluid. Separate areas of reference.

Ventricular (n=27), cisternal (n=33) and lumbar (n=127) cerebrospinal fluid of "non-diseased" reference persons was investigated. The following measurements were taken: (1) Total protein, albumin, immunoglobulin A,G, M (IgA,G,M) in unconcentrated cerebrospinal fluid (CSF). (2) Protein fractions in the microzone electrophoresis of concentrated CSF. Albumin and IgG concentrations were highly correlated in all the samples, regardless of their origin. Therefore, bivariate areas of reference as well as interdependent regression coefficients were computed for the paired data. The regression lines of the 3 different areas of reference (ventricular, cisternal, lumbar) ran parallel to each other, displaced along the axis of the IgG concentration: approximately 10% of the lumbar IgG does not originate directly from serum. Although the albumin concentration increased 2.2 times, and the IgG 2.6 times, from ventricular to lumbar region, the concentration of pre-albumin decreased by a factor of 0.7. The concentration of IgA never surpassed the limits of detection set by this method (8 mg/I), in spite of its similarity to IgG regarding molecular weight and size. The observations strengthen the assumption that selective functions are present at the blood-CSF barrier. In 4 illustrative cases with a chronic inflammatory process, the discriminating power of the different reference areas was demonstrated. The findings should be evaluated in a multivariate manner, considering the location from which the sample was obtained.

Cerebral Ventricles↗

[Laboratory findings in cerebrospinal fluid in relation to age: trivariate evaluation of albumin and immunoglobulin G concentrations (author's transl)].

In cerebrospinal fluid from controls ("non-diseased probands", n = 326) the following variables were determined: albumin and immunoglobulin G (by immunodiffusion) and total protein. Total protein rose parallel with the age of the subjects (r = 0.319); the albumin fractions (r = 0.126) and immunoglobulin G (r = 0.144) also correlated with age. The concentrations of albumin and immunoglobulin G were correlated even more closely (r = 0.589), leading to a particularly slender form of the elliptic bivariate normal range. The correlation of the variables albumin and immunoglobulin G with each other and with age was drawn upon as additional information, in order to discriminate between laboratory findings from diseased and from non-diseased subjects: a trivariate area of reference ("trivariate normal range") was calculated, which avoided errors of the second kind (diseased values not recognized) more powerfully than the usual one-dimensional ranges (x +/- 2s or percentile).

Adult↗

[Unexplained tetraspasticity in adults (author's transl)].

1. Between 1965 and 1974 146 patients with unexplained tetraspasticity were admitted and examined. In 123 cases extended neuroradiologic examination with myelography of the cervical spinal canal was carried out. A space occupying lesion was found in 59 cases: narrow spinal canal, protruding discs. In 64 cases no pathologic processes were seen radiologically. Comparison of both groups: no differences in clinical signs, history or findings. 2. Tetraspasticity alone was the leading sign in 30 cases. The legs were always more severely involved than the upper limbs. In 70% spasticity was more severe on the right. Further clinical analysis depends on additional signs, particularly paresthesiae, pain, disturbed joint-sense. Among the patients with protruding discs heart-and circulatory insufficiency is a little more common, but in the group without protrusion exogenous/endogenous metabolic conditions(intoxication, malabsorption) and neoplasms. -Protein content of CSF is raised equally in both groups, particularly albumin. This is probably due to reduced circulation of CSF. In 6 patients an internal hydrocephalus was found. 3. No single active causative factor could be found nor any familial relationship. In spite of increasingly extended diagnostic techniques no underlying condition could be discovered. Tetraspastic is a "polygenetic" reaction of the central nervous system without a final common path. The cases show that mechanical factors (cervical myelopathy) predispose locally to non-mechanical injuries.

Adolescent↗

[Bivariate evaluation of laboratory findings: immunoglobulin G and albumin in cerebrospinal fluid (author's transl)].

Using radial immunodiffusion, albumin and immunoglobulin G were determined in non-preconcentrated cerebrospinal fluid from 127 controls and from 239 patients. In controls the concentrations of albumin and immunoglobulin G followed normal distribution. The two variables were correlated linearly (r = 0.60). The elliptic bivariate normal range was calculated, and was found to contain 95% of the paired values. As a clinical limit, this range discriminated more effectively between normal and altered pairs than the two one-dimensional normal ranges X+/-2 s, thus improving the evaluation of laboratory findings in the single case. Likewise in clinically defined groups of patients, bivariate evaluation of results provided additional evidence. In many distinct clinical syndromes, e.g. bacterial encephalomeningitis, polyneuropathy, amyotrophic lateral sclerosis, albumin and immunoglobulin G concentrations exhibited an especially close correlation, probably resulting from damage to the blood-cerebrospinal fluid barrier. However, no correlation of these two variables was detected in acute encephalomeningitis due to virus infection, and in multiple sclerosis: in these groups, immunoglobulin G concentrations were elevated independently of albumin. Since evidence is lacking as to the pathogenesis of multiple sclerosis, it seems noteworthy that the same phenomenon was observed in a well-defined group of viral infections.

Albumins↗

[Metabolic myelosis (author's transl)].

102 patients suffering from metabolic myelosis were studied clinically. Among the early signs and symptoms, pins and needles, freezing or burning feet, and impaired kinaesthesia were the most frequent ones. With the syndrome progressing, motor disturbances of supramotoneuronal character developed. Every third patient had neurogenic ischuria. Examinations of the cerebrospinal fluid did not reveal any deviation characteristic or "typical" of myelosis. Different pathogenic factors were detected by analysis according to the rules of internal medicine. However, no single factor defining myelosis aetiologically could be discovered. The majority of cases suggested that the metabolic steady state decompensated by the coincidence of more than one factor, thus initiating myelosis. The following pathogenic factors were observed frequently: Malabsorption, abuse or intoxication, liver cell damage, neoplasm. The great variety of pathogenic factors emphasizes that metabolic myelosis must be counted among the polygenetic identical reactions of the central nervous system. These are the organism alarming signals and they require comprehensive general examinations.

Adult↗