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PubMed1989

[A neurologic model of early infantile autism].

Based on the abnormalities in sleep-wakefulness cycle of early infantile autism, the author discussed its pathophysiology focusing on its main lesion in the raphe nuclei. These neurons, located in the midline portion of the brainstem send their axons to various neurons of the upper and lower nervous systems, including the locus coeruleus and the dopamine neurons of the tegmentum, the former having a broad innervation and the latter a restricted area in the central nervous system. These monoaminergic neurons modulate the functions of the involved neurons and regulate their functional and structural maturation in the early developmental course. The early lesion of the raphe nuclei causes poor adaptation to environment which develops as abnormal circadian oscillation and pervasive lack of responsiveness. Combined hypofunction of the locus ceruleus, particularly of its dorsal bundle, results in the failure of extinction of acquired memory in mice which relates clinically to the excellent memory and resistance to change peculiar interests and attachments in humans. From early childhood, the disturbance of dopaminergic neurons becomes apparent clinically, and causes hyperkinesia and stereotyped activities. With the other two monoaminergic neurons, dopaminergic neurons cause occasional aggressiveness or self-mutilation. The latter behaviors are like those of pampered children and are simulated to "muricide" and "friendliness" observed in rats with these monoaminergic lesions. The particular language disturbance with echolalia is due to the right hemispheric dominance, which might have been caused by a delayed functional lateralization of the hemisphere resulting also from the delayed development of the circadian oscillation in infancy. The motor disturbances consisting of hypotonia and impaired locomotion might be due to decreased tonic innervations of the locus ceruleus and the raphe nuclei to the spinal locomotion center. CT examination of symptomatic autism showed the amygdala as one of the causative nuclei for the autistic behavior.

Animals↗
PubMed1989

[Fractures of the distal end of the radius].

Attitudes to the treatment of distal radial fracture are now more critical than previously, especially where intraarticular fracture is concerned. Inadequate primary reduction and such complications as redislocation or dystrophic problems lead to poor results. Quantification of fracture instability is becoming increasingly important in fracture classification, determination of the indications for the different treatment modalities and management. Accurate anatomical reduction also improves later function. The quality of alignment attained during the treatment depends on the quality of reduction. Closed reduction by means of traction should be achieved by pulling on fingers I, II and IV. The radial dislocation should be corrected first and then the dorsal dislocation; a cast applied to the lower arm is sufficient for immobilization. Primary surgery is indicated more urgently and the type of surgery in more detail, for example, when there are steps in the articular surface or when there is more than one factor in instability. Pin fixation should be applied sooner and more frequently with either primary or early secondary indications. Plate fixation is mostly achieved from the volar surface; it is indicated in flexion fractures and sometimes in extension fractures, but only in combination with rigid screw fixation with or without bone grafting. We are finding increasingly more indications for external fixation, not only in the case of open fractures with soft tissue damage but also with multiple fragments or comminuted fractures, sometimes in combination with bone grafting.

Bone Nails↗
PubMed1987

[Surgical therapy of dislocation fractures of the head of the humerus in adults. Personal procedure and results].

Surgical intervention is indicated in the vast majority of humerus head fracture dislocations. In the present paper, we report on the results of 24 such interventions performed between 1975 and 1984. Implantation of a T-plate is considered the standard procedure to obtain osteosynthetic stability during exercise. However, in elderly patients or in cases of multiple fragment fracture, this procedure is inadequate to achieve the required stability. In such cases, development of a humerus head necrosis would rather be promoted. If a sufficiently stable osteosynthesis without the risk of necrosis cannot be achieved, we prefer replacement of the humerus head by a shoulder prosthesis to humerus head resection, resection-interposition-arthroplasty or shoulder arthrodesis. However, not only optimal surgical management of humerus head fracture dislocations has a decisive influence on the later function of the most flexible human joint with the important rotator cuff, but also properly performed active and systematic postoperative physiotherapy.

Adult↗
PubMed1986

Immunosuppression in viral oncogenesis. III. Effects of virus infection on interleukin 1 and interleukin 2 generation and responsiveness.

Malignant rabbit fibroma virus (MV) is an oncogenic immunosuppressive leporipoxvirus. We studied the effects of MV infection and MV-associated tumor-induced suppressor factor (TISF) on the production of and responsiveness to interleukins 1 and 2. Adherent cells from MV tumor-bearing rabbits elaborate adequate amounts of IL 1 in response to E. coli endotoxin. Neither live virus nor TISF alters the production or the responsiveness to IL 1. However, when we examined spleen cells from rabbits 7 days after MV inoculation, we noted that their ability to produce and respond to IL 2 is deficient. Despite their relatively poor capacity to produce IL 2, these spleen cells express receptor for IL 2 in normal amounts, as measured by the monoclonal antibody 7D4. TISF derived from T lymphocytes from MV tumor-bearing rabbits is by itself capable of inhibiting partially normal secretion of IL 2 and also the response of the cloned murine T cell line HT-2 to added IL 2. Full expression of the immunosuppressive capacity of spleen cells from MV tumor-bearing rabbits requires cell-cell contact, however, and cannot be replaced by either live virus or spleen cell supernatants. Such spleen cells inhibit normal mitogen responsiveness, a defect not remedied by adding exogenous IL 2. Immunologic dysfunction induced by MV infection is transient, and by 11 days after virus inoculation, actively mediated recovery from immunosuppression is observed. We found that spleen cells from rabbits studied 11 days postinoculation secreted IL 2 normally. Thus, immunologic dysfunction secondary to infection with malignant rabbit fibroma virus reflects deficiencies in both elaboration of and response to IL 2, and return of immune function later in the course of the infection is associated with return of the ability of lymphocytes to secrete IL 2.

Animals↗
PubMed1988

[The infected elbow joint fracture].

Post-traumatic infection of the elbow joint is a serious complication, because the bone structure and the thin soft tissue cover make all actions directed at reconstruction and at calming the infection difficult. A good overall prognosis for later function depends decisively on early diagnosis, stability of the fragments and the earliest possible initiation of functional therapy. If this cannot be achieved, the infection must first be treated by transfixation techniques and the joint function restored subsequently. In late cases with chronic inflammation and destruction, nothing but resection arthroplasty or arthrodesis is still possible.

Fracture Fixation, Internal↗
PubMedDate not supplied

[Current problems in aviation physiology].

Soviet aviation has developed an efficient system of medical support based on physiological knowledge and aimed at the solution of various problems associated with pilot selection and training, his professional activity, arrangement of his working place, etc. It is understood that the following lines of research hold great promise in protecting the human body against adverse flight effects: methods of protection against high altitude effects which also help maintain high operational efficiency; conditioning of transport, regulation and energy mechanisms of oxygen supply; methods of predicting man's tolerance to motion sickness; study of mechanisms of photoreception of blinding brightnesses; development of photoprotectors, etc. With respect to professional selection, it is important to use EEG data for prognostic purposes, to investigate lateral functions of paired organs, and to explore their relationship with body tolerance to flight factors and efficiency of training. The results of physiological investigations of the functional state of the pilot form the basis to standardize his workload, to develop rational work-rest cycles, and to prevent performance deterioration. Physiological recommendations can be used to formulate requirements for the configuration of the pilot working place.

Aerospace Medicine↗
PubMed1979

[Recurrence of inguinal, undescended, testicle (author's transl)].

An analysis of 94 patients from 1970 to 1977 demonstrates the problems of recurrence of the inguinal undescended testis. In more than 2/3 of the patients operative deficiencies were considered as the cause. The technique of secondary corrective surgery is described. The special difficulties with short internal spermatic vessels are outlined. In 90% of the patients a good anatomical result was obtained but no data are available concerning later functional results.

Cryptorchidism↗
PubMedDate not supplied

Chronomorphology--today.

The present review deals with a subdiscipline of chronomorphology, viz. morphocyclicity, and outlines what progress has been made in the past and points to areas of research that appear most promising. The early years of chronomorphology were characterized by the attempt to demonstrate that a phenomenon such as morphocyclicity exists at all and how waxing and waning of morphological parameters is related to function. Later the rhythms were manipulated to study the underlying mechanisms. More recently, morphocyclic research has revealed its effectiveness as a potent research tool by demonstrating that even the circuitry and the topographical relationships in the central nervous system change in a cyclic manner. Within the biological clock system the pineal gland plays an important role. Here, ultradian, circadian and infradian rhythms interact to perhaps ensure the correct temporal integration of a variety of neuroendocrine processes.

Animals↗
PubMed1985

[Detection of occult fractures of the pelvic bones by roentgen computed tomography].

The informational value of C.T. concerning pelvic fractures is presented. Not all injuries to the hip joint and to the os sacrum can be seen on standard a.p.-projections, oblique views, special projections or conventional tomography. 17 typical examples have been selected from young patients with multiple injuries. C.T.-findings concerning fractures of the hip joint, of the os sacrum and of hidden pelvic fractures are described. Emphasis is placed on careful radiological analysis of fractures with special regard to the planning of conservative or operative treatment and also on the later functional results following fractures of the hip joint.

Acetabulum↗
PubMed1983

From infant affect expression to symbolic play: the coherence of development in Down syndrome children.

To examine further the coherence of development of a sample of Down syndrome children, assessments were made of the quality and level of play at age 3-5 years. It was found that, with corrections for mental age, the play of these children was similar to that of nonhandicapped children. Moreover, individual differences in the level and quality of play were strongly predicted from Bayley DQ scores obtained at age 2 and by several indexes of affective expressiveness including 1 obtained in the first year of life. This was despite limitations on the performance range represented in the subsample included in this follow-up study. Finally, the various aspects of play, as indexed by 5 separate scales, intercorrelated strongly, suggesting consistent individual differences in the play session itself. All of these findings point to the coherence of development of these children. In addition, it is suggested that early affective assessments are strong predictors of the later functioning of Down syndrome.

Affect↗
PubMed1983

[Current concepts of the biology of the development of the human head. Observations and hypotheses].

Morphological dynamics controlling vertebrate embryo development, which takes place in flotation in a liquid medium, leads to the hypothesis that the pentameric symmetry of echinodermes, ancestors of the vertebrates, is conserved during evolution. This embryogenesis consists of morphological repetitions: synchronous growth of five expansions specialized in exploration and spatial deplacements (head and four limbs); each of these five expansions consists of five buds or five radii (facial buds, fingers and toes). Homomorphism of the mouth, of the hands, and of the feet--which are capture catastrophes over the environment, installed early during development--allows later functional and sensory connections. These morphological repetitions are also demonstrated by the association of facial, hand, and foot buds, malformations for which a topological correspondance can be shown. During vertebrate morphogenesis by flotation in a liquid medium, other phenomena take place. For instance, the palate is formed anteriorly by a triple junction resulting from the fusion of its three constitutive buds.

Congenital Abnormalities↗
PubMed1983

[Lateralization factors in the vertebrate brain].

Conditioning in white rats and suppression of a hemisphere's cortex with spreading depression revealed that the right hemisphere prevailed in perception of space, in the simultaneous information processing, in perception of concrete signs and in deductive processing whereas the left hemisphere was predominant in perception of time, in successive information processing, in perception of abstract signs and in inductive processing. Induction and deduction are hypothetically assumed to be the main factors determining the lateralization of functions in the brain hemispheres.

Animals↗
PubMed1978

[Synovectomy of the cubital joint in rheumatoid arthritis (author's transl)].

46 patients underwent synovectomy of the cubital joint for rheumatoid arthritis during the last seven years (1970 to 1977). 38 patients were followed up. The articular function improved in 71%, pain had been eliminated in 55%, no effusion was any longer present in 71%. In advanced stages of the disease resection of the head of the radius generally is performed because it facilitates surgery and improves the articular function later on. Synovectomy is recommended at an early stage.

Adult↗
PubMed1983

Degradation of extracellular matrix by larvae of Schistosoma mansoni. II. Degradation by newly transformed and developing schistosomula.

We have studied the ability of schistosomula of Schistosoma mansoni to degrade an extracellular connective tissue matrix synthesized by rat vascular smooth muscle cells in culture. Six to 12% of the total matrix was degraded by schistosomula from the time of transformation from cercariae to adult development in vitro. Most matrix degradation occurred during the first 24 hours of incubation and was dependent on the number of schistosomula and the type of medium in which they were incubated. The use of proteinase inhibitors indicated that schistosomula activity was distinctly different from that of cercariae. Newly transformed schistosomula expressed one activity that was similar in inhibition characteristics to that of cercarial preacetabular gland secretions and another activity that was unique to schistosomula. From 1 day after transformation to adulthood, the schistosomula-derived activity was the predominant activity detected. Schistosomula degraded a smaller percentage of the total matrix than did cercariae and showed a different substrate profile. Schistosomula degraded glycoprotein components of extracellular matrix but showed little or no activity against elastin or collagen. Matrix-degrading activity was also detected in schistosomula-conditioned medium. Sedimentation of the activity and lack of permeability through filter barriers suggest that the enzyme may be initially associated with membrane and then sloughed with membrane fragments. Since the schistosomula-derived activity initially overlaps with cercarial preacetabular gland proteolytic activity, the two activities may act in concert to facilitate skin penetration by newly transformed schistosomula. However, schistosomula activity probably serves some, as yet undetermined, function later in development.

Animals↗
PubMed1982

[New concepts of the biology of human cephalic development. Observations and hypotheses].

Morphological dynamics controlling vertebrate embryo development, which takes place in flotation in a liquid medium, leads to the hypothesis that the pentameric symmetry of echinodermes, ancestors of the vertebrates, is conserved during evolution. This embryogenesis consists of morphological repetitions: synchronous growth of five expansions specialized in exploration and spatial deplacements (head and four limbs); each of these five expansions consists of five buds or five radii (facial buds, fingers and toes). Homomorphism of the mouth, of the hands, and of the feet--which are capture catastrophes over the environment, installed early during development--allows later functional and sensory connections. These morphological repetitions are also demonstrated by the association of facial, hand, and foot buds, malformations for which a topological correspondence can be shown. During vertebrate morphogenesis by flotation in a liquid medium, other phenomena take place. For instance, the palate is formed anteriorly by a triple junction resulting from the fusion of its three constitutive buds.

Animals↗
PubMed1995

Transient hypothyroidism after iodine-131 therapy for Grave's disease.

UNLABELLED: We studied 355 patients with Grave's disease to characterize transient hypothyroidism and its prognostic value following 131I therapy. METHODS: The patients received therapeutic 131I treatment as follows: 333 received a dose < 10 mCi (6.6 +/- 1.9 mCi) and 22 received a dose > 10 mCi (12.8 +/- 2.9 mCi). Diagnosis of transient hypothyroidism was based on low T4, regardless of TSH within the first year after 131I followed by recovery of T4 and normal TSH. RESULTS: After administration of < 10 mCi 131I, 40 patients developed transient hypothyroidism during the first year; transient hypothyroidism was symptomatic in 15. There was no transient hypothyroidism after high doses (> 10 mCi) of 131I. Iodine-131 uptake > 70% at 2 hr before treatment was a risk factor for developing transient hypothyroidism (Odds ratio 2.8, 95% confidence interval 0.9-9.4). At diagnosis of transient hypothyroidism, basal TSH levels were high (51%), normal (35%) or low (14%); therefore, the transient hypothyroidism was not centralized. If hypothyroidism developed during the first 6 mo after basal TSH > 45 mU/liter ruled out transient hypothyroidism. CONCLUSION: The development of transient hypothyroidism and its hormonal pattern did not influence long-term thyroid function. Since no prognostic factors reliably predicted transient hypothyroidism before 131I or at the time of diagnosis, if hypothyroidism appears within the first months after 131I, the reevaluation of thyroid function later is warranted to avoid unnecessary chronic replacement therapy.

Female↗
PubMed1994

[Apraxia and autotopoagnosia without aphasia or agraphia with compulsive language activity in right hemispheric lesion].

A 75 year-old woman was admitted with a left hemiplegia resulting from an infarct in the right middle artery's territory. Her manual preference was ambiguous from early childhood. She presented with severe bilateral apraxia, autotopoagnosia, finger agnosia, and left spatial neglect. There was, however, no aphasia nor agraphia. When the patient attempted to perform gestures on order, she compulsively produced oral or written language. In this very unusual case, dominance for gesture and dominance for language were strictly independent, each ensured by one hemisphere. The patient's performances in gestual activities, especially dissociation between automatic and voluntary movements, and compulsive linguistic productions, are discussed in relation to this functional lateralization. We suggest that the propositional nature of the responses required in test conditions could activate either voluntary language in the left cerebral hemisphere, or voluntary gestures in the right. A competition between the two hemispheres could explain the patient's linguistic apraxic or behavior in response to orders. Autotopoagnosia, an uncommon symptom, could interfere with apraxia, but is not directly responsible.

Aged↗