Thoracic outlet syndrome: a therapeutic approach based on 115 consecutive cases.
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Biomedical subjects
Publications and source records attributed to W Messerschmidt.
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29 human albumin solutions commercially available in Germany were analyzed. Results for total protein vary between 86,25% and 102.40% of the declared value. Values for monomer albumin are between 74.19% and 91.81% of the declared value for total protein (test method: discontinuous polyacrylamide gel electrophoresis). With an sodium content, there are also various differences in quality in missing or wrong declarations of the electrolytes.
The biological values of 11 heparin-Na formulations and 3 heparin-Ca formulations were determined in vitro according to the regulations of the Compendium Medicamentorum (RGW 1975) and versus USP Reference Standard and 3rd International WHO standard. With respect to the Na formulations there was not total agreement between the determinations and the declared values. All the Ca formulations showed that the Ca values ranged between 61.3 and 82.0% of the declarations. These values correlate with those quite frequently published for in vivo findings. Due to the absence of a delayed-release effect and insufficient bioavailability further therapeutic use seems to be questionable.
We measured the concentrations of serum calcium and 25-hydroxy-vitamin D in a patient with hypervitaminosis D during 3 months of therapy directed toward correcting the hypercalcemia. Serum calcium could not be maintained at normal concentration without specific therapy until 9 weeks after vitamin D was discontinued. Concentration of 25-hydroxy-vitamin D at the time was 285 ng/ml, approximately half of the value measured three weeks after withdrawal of vitamin D. Serial measurements of the concentration of 25-hydroxy-vitamin D seem to be a useful means of assessing the degree of intoxication in patients with hypervitaminosis D.
The possible complications in two women who had injected themselves intravenously with thermometer mercury with suicidal intent are discussed with reference to the few comparable cases. A manifest pulmonary hypertension due to multiple mercury emboli in the lesser circulation in one patient who developed a dyspnoea on exertion could be excluded by cardiac catheterization. Signs of acute and chronic mercury poisoning could not be demonstrated in our patients, in contrast to some cases reported in the literature. So far, specific therapy has therefore been dispensed with.
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