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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Virchows Archiv 338 (1964), S. 111-129 
    ISSN: 1432-2307
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Of the various complexes of human malformations called forth by chromosomal anomalies, the socalled D-(13–15) and E-(17–18) trisomy syndromes are reviewed, with reference made to the cases reported in the literature. Two cases personally studied are classified with these malformation syndromes. One of the cases, a D-(13–15) trisomy syndrome, showed the appropriate chromosomal anomalies in the somatic cells. The other case, however, had a normal set of chromosomes, although the characteristic clinical and anatomical findings were those of an E-(17–18) trisomy syndrome. Using these cases as the point of departure, the position and the importance of chromosomal aberrations as the cause of disturbances in the development of the body are discussed within the topic of general etiology. Of the chromosomal anomalies now recognized, the D-(13–15) and the E-(17–18) trisomies belong to those which cause a ratter clear cut syndrome of malformations, whereas in many other chromosomal aberrations definite relationships to certain clinical manifestations cannot be recognized. Contrarily, a chromosomal anomaly is not always present with a specified malformation syndrome. In this regard, the necessity of considering the concept of phenotypocopy is emphasized. This concept supplements the definition of malformation syndromes of the type D-(13–15) and E-(17–18) trisomy syndromes, where chromosomal anomalies represent perhaps the most common cause, but not the only.
    Notes: Zusammenfassung Von den durch Chromosomenanomalien hervorgerufenen Fehlbildungskomplexen des Menschen werden das sog. D-(13–15) und E-(17–18)Trisomie-Syndrom in Zusammenhang mit den in der Literatur mitgeteilten Fällen zusammenfassend dargestellt. Zwei eigene Beobachtungen werden diesen Mißbildungs-syndromen zugeordnet, wovon ein Fall eines D-(13–15)Trisomie-Syndroms auch die entsprechende Chromosomenanomalie in den somatischen Zellen aufwies, ein anderer aber bei kennzeichnendem klinischen und anatomischen Befund eines E-(17–18)Trisomie-Syndroms einen normalen Chromosomensatz besaß. Diese Fälle bilden den Ausgangspunkt für eine Diskussion der Stellung und der Bedeutung chromosomaler Aberrationen als Ursache von Störungen der Körperentwicklung innerhalb der allgemeinen Ätiologie. Von den bisher bekannten Chromosomenanomalien gehört die D-(13–15) und E-(17–18)Trisomie zu denjenigen, die ein umschriebenes Mißbildungssyndrom verursachen, während bei manchen anderen Chromosomenaberrationen noch keine sicheren Beziehungen zu bestimmten Erscheinungsbildern zu erkennen sind. Umgekehrt ist bei den genannten Mißbildungssyndromen nicht immer eine Chromosomenanomalie als Ursache zu finden. Es wird im Zusammenhang damit die Notwendigkeit des Phänotypokopie-Begriffes hervorgehoben. Er dient als Ergänzung der Begriffsbestimmung von Mißbildungssyndromen von der Art des D-(13–15) und E-(17–18)Trisomie-Syndroms, bei denen chromosomale Anomalien zwar vielleicht die häufigste, aber nicht die einzige Ursache darstellen.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1203
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Description / Table of Contents: Zusammenfassung Es wird über eine neue Form einer recessiv X-chromosomal vererbten progressiven Muskeldystrophie berichtet. Dieses Krankheitsbild wurde bei 17 Kranken in 3 Generationen einer in Niederbayern ansässigen Sippe beobachtet. Der Erkrankungsbeginn lag bei der Mehrzahl der Patienten in der ersten Lebensdekade. Ein Frühsymptom waren fibrotisch bedingte Kontrakturen insbesondere des M. gastrocnemius, der ischioeruralen und paravertebralen Muskeln sowie des M.biceps brachii. Als Folge dieser Veränderungen kam es zu frühzeitigen Bewegungseinschränkungen in den entsprechenden Gelenken. Pseudohypertrophien wurden in keinem Stadium beobachtet. Bei relativ langsamer Progredienz zeigten die auftretenden Paresen und Atrophien eine scapulo-humero-distale Verteilung mit peripher betonten Extensorschwächen. Gehunfähigkeit trat nicht vor der vierten Lebensdekade ein. Die Fertilität war ungestört. Das Todesalter der 9 bisher verstorbenen Kranken lag zwischen 37 und 59 Jahren; alle 9 Patienten verstarben plötzlich, wahrscheinlich als Folge einer schon vorher bestehenden Herzrhythmusstörung. Bei 5 Kranken wurden im Elektrokardiogramm Rhythmusstörungen in Form eines totalen AV-Blockes mit Reizbildung im AV-Knoten oder in tertiären Zentren nachgewiesen. Die elektromyographischen und histologisch-enzymhistochemischen Untersuchungen zeigten einen myopathischen Krankheitsprozeß an. Die motorische und sensible Nervenleitgeschwindigkeit war normal. Die Aktivität der Serum-CPK war bei allen jungen Patienten leicht bis stark erhöht, bei den älteren Patienten war die Aktivität normal. Sichere und mögliche Konduktorinnen zeigten weder klinische Symptome noch Erhöhungen der Serum-CPK. Die klinische Symptomatik und das Verhalten der Serum-CPK erlauben eine sichere differentialdiagnostische Abgrenzung von anderen Myopathien, insbesondere auch von den recessiv X-chromosomal erblichen Muskeldystrophien Typ Duchenne und Typ Becker-Kiener.
    Notes: Summary A kinship living in lower Bavaria (Germany) is described with a distinct type of a recessive X-linked muscular dystrophy. The disease was observed in 3 generations affecting 17 males. Among the earliest manifestations of the disease — usually before the age of 10 — is the shortening of the musculus gastrocnemius and biceps brachii and the hamstrings as well as an increasing fibrosis in neck and paravertebral musculature. The result of these changes are flexion contractures in the elbow, hip and foot and limitation of the ventral flexion of the spine. Other features of the disease include a slow progression rate, muscle weakness and wasting in a scapulo-humeral-distal distribution, involving mainly the extensor muscles, and absence of pseudohypertrophy. The patients were ambulatory at least up to the fourth decade and showed a normal fertility. Hitherto 9 of them died suddenly aged between 37 and 59 years. The deaths most probably were due to cardiac arrest, since in 5 patients looked for there was a partial or complete atrio ventricular block. Electromyography and standard histology as well as enzymehistochemistry indicated a myopathic process. Motor and sensory nerve conduction velocities were normal. In all of the young patients there was an increase in the serum creatine kinase activity, but in older patients the enzyme activity was normal. Definite and possible carriers revealed neither clinically myopathic signs nor raised serum enzyme levels. The clinical picture in combination with the changes in electrocardiogram and in serum creatine kinase activity differentiate this type of myopathy from others, especially from the recessive X-linked types of muscular dystrophy according to Duchenne and Becker-Kiener.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Human genetics 〈Berlin〉 13 (1971), S. 344-346 
    ISSN: 1432-1203
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Description / Table of Contents: Zusammenfassung In einer Gruppe von arabischen Erwachsenen wurde eine große Häufigkeit der Lactose-Intoleranz (minimal 20/26, maximal 24/26) gefunden. Bei 4 Probanden, bei denen eine Saugbiopsie durchgeführt wurde, war die Aktivität der intestinalen Lactase erniedrigt.
    Notes: Summary A high incidence (minimum 20/26, maximum 24/26) of lactose intolerance was found in a group of adult Arab subjects. A selective reduction of intestinallactase activity was present in 4 subjects in whom a suction biopsy was performed.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Human genetics 〈Berlin〉 13 (1971), S. 118-125 
    ISSN: 1432-1203
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Description / Table of Contents: Zusammenfassung Die Ätiologie der primären Lactose-Intoleranz bei Lactase-Mangel in der Dünndarmschleimhaut ist ungeklärt. Die mangelnde Aktivität der intestinalen Lactase könnte durch eine genetisch gesteuerte Erniedrigung oder durch eine Anpassung an einen Mangel von Lactose in der Nahrung erklärt werden. Die Ergebnisse von Lactose-Toleranztests bei 24 Versuchspersonen (9 Kindern aus Ehen zwischen Asiaten und Europäern, 6 Personen mit Lactose-Toleranz aus Bevölkerungen mit einer großen Häufigkeit der Lactose-Intoleranz und 9 Probanden mit Lactose-Intoleranz, die lange Zeit größere Mengen von Kuhmilch genossen hatten) lassen sich leichter unter der Annahme einer genetischen Bedingtheit der Lactase-Aktivität als unter der Annahme der Adaptation interpretieren. Die Befunde bei diesen 24 Versuchspersonen widersprechen einigen der Argumente, die für eine adaptive Bedingtheit der Lactose-Intoleranz angeführt werden.
    Notes: Summary Controversy exists over the etiology of primary lactose intolerance with intestinal lactase deficiency. The low activity of lactase may be either due to a genetically controled reduction of enzyme activity or to an adaptive response to a lack of dietary lactose. Lactose tolerance tests in 24 subjects (9 persons who are offspring of marriages between Asians and Europeans, 6 lactose tolerant individuals from populations with a high incidence of lactose intolerance, and 9 lactose intolerant subjects with a history of prolonged milk consumption) are more easily interpreted by assuming genetic control of lactase activity as the main determinant of lactose tolerance. The findings in these 24 subjects contradict some of the commonly cited arguments supporting an adaptive origin of lactose intolerance.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 124 (1977), S. 139-153 
    ISSN: 1432-1076
    Keywords: Vitamin B12 ; Selective vitamin B12 malabsorption ; Proteinuria ; Imerslund-Gräsbeck syndrome ; Funicular myelosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei einem zum Zeitpunkt der Untersuchung 10 Jahre alten Mädchen mit selektiver Vitamin B12-Malabsorption und Proteinurie wurden eingehende gastroenterologische und nephrologische Untersuchungen durchgeführt. Die Patientin wies auch nach mehrjähriger, regelmäßiger Vitamin B12-Substitution noch Restzeichen einer funiculären Myelose auf, die durch elektrodiagnostische Untersuchungen objektiviert werden konnten. Die wiederholte Prüfung der Vitamin B12-Resorption mit dem Schilling-Test zeigte eine Vitamin B12-Malabsorption. Antikörper gegen Intrinsic-Faktor und Parietalzellen konnten im Serum nicht nachgewiesen werden. Die Mukosa des terminalen Ileums wies licht- und elektronenmikroskopisch keine pathologischen Veränderungen auf. Die exokrine Pankreasfunktion sowie das pH und die Calcium-Konzentrationen im Duodenalsaft waren im Bereich der Norm. Ein generelles Malabsorptions-Syndrom konnte ausgeschlossen werden. Mit verschiedenen Methoden wurde eine hochselective glomeruläre Proteinurie nachgewiesen. Die Inulin-Clearance war leicht, die PAH-Clearance deutlich erniedrigt. Es bestand sonst kein weiterer Anhalt für eine Störung der Tubulusfunktion. Die Nierenbiopsie ergab lichtmikroskopisch Zeichen einer minimal proliferierenden, intercapillären Glomerulonephritis (minimal changes). Elektronenmikroskopisch wurde eine partielle Verschmelzung der Glomerulumdeckzellen gefunden. Eine Familiarität des Syndroms konnte durch Untersuchung der Eltern und einer Schwester der Patientin ausgeschlossen werden.
    Notes: Abstract In a girl 10 years of age with selective vitamin B12 malabsorption associated with proteinuria and residual symptoms of funicular myelosis an extensive study of the intestinal and nephrologic functions was done. Repeated Schilling tests pointed to a malabsorption pattern of vitamin B12. Gastric acid and intrinsic factor secretion as well as gastric morphology were normal. There were no antibodies against intrinsic factor and parietal cells in serum. Ileal mucosa showed on light- and electron-microscopy no pathologic changes. Pancreatic exocrine function as well as pH and calcium concentrations in the lumen of the gut were within the normal range. A general malabsorption syndrome could be excluded. A high selective glomerular proteinuria was found through different methods. Inulin clearance was slightly reduced, PAH clearance, however, markedley so. There was no further evidence for renal tubular dysfunction. Renal biopsy showed a minimal proliferative intercapillary glomerulonephritis (minimal changes). In electron-microscopic studies a fusion of a part of the foot processes of the podocytes was found. No familial history of the syndrome could be demonstrated in our patient.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-1076
    Keywords: Coeliac disease ; Antireticulin antibodies ; Precipitating antibodies to wheat flour ; Precipitating antibodies to cow's milk
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Antiretikulin-Antikörper im Serum wurden mit der Methode der indirekten Immunfluorescenz an frischen Rattennierenschnitten bei 11/13 Kindern (85%) mit florider Cöliakie, 7/17 Kindern (41%) mit klinisch und biochemisch stummem, bioptisch nachgewiesenem Cöliakie-Rezidiv und 0/16 Kindern mit behandelter Cöliakie nachgewiesen. Präcipitierende Antikörper im Serum gegen Weizenmehl bzw. Kuhmilch wurden mit Hilfe einer Kombination aus Elektrophorese und Immundiffusion bei 3/13 Kindern (23%) bzw. 2/13 Kindern (15%) mit florider Cöliakie und bei 1/16 Kindern (6%) mit behandelter Cöliakie gefunden. Bei den 17 Kindern mit stummem Cöliakie-Rezidiv fiel die Untersuchung auf präcipitierende Antikörper negativ aus. 40 Kontrollkinder wiesen weder Antiretikulin-Antikörper noch präcipitierende Antikörper gegen Weizenmehl oder Kuhmilch auf. Die Bedeutung des Antiretikulin-Antikörper-Nachweises für Screening-Untersuchungen und für die Verlaufskontrolle wird diskutiert.
    Notes: Summary Sera from 41 children suffering with histologically proven coeliac disease and from 40 healthy control children were investigated for the presence of antireticulin antibodies and precipitating antibodies to a watery extract of wheat flour and to cow's milk. Antireticulin antibodies were demonstrated by means of indirect immunofluorescence using sections of fresh rat kidney as substrat. For the detection of precipitating antibodies a combination of electrophoresis and immunodiffusion was used. Serum antireticulin antibodies were found in 11/13 children (85%) with active coeliac disease, in 7/17 children (41%) with clinically and biochemically silent coeliac relapse and in 0/16 children with treated coeliac disease. Serum precipitating antibodies to wheat flour and cow's milk were found respectively in 3/13 children (23%) and 2/13 children (15%) with active coeliac disease and in 1/16 children (6%) with treated coeliac disease. Precipitating antibodies could not be detected in the sera of 17 patients with silent relapse of coeliac disease. In the sera of 40 controls neither antireticulin nor precipitating antibodies were detectable. The presence of antireticulin antibodies in serum did not correspond to the presence of serum precipitins to wheat flour and cow's milk. The significance of serum antireticulin antibodies for sereening investigations and for follow-up studies is discussed.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 135 (1980), S. 169-173 
    ISSN: 1432-1076
    Keywords: Chronic hepatitis ; Chronic persistent hepatitis ; Chronic aggressive hepatitis ; Minimal hepatitis ; Hepatitis B virus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The results of clinical, biochemical and histological studies in 26 children with chronic hepatitis B are reported. Most cases were detected when diagnostic procedures were arranged because of non specific abdominal complaints, by routine tests after acute hepatitis or multiple transfusions, and by examination of family members. Hepatomegaly was found in half of the cases, splenomegaly in a quarter. Other clinical signs were rarely seen. Among the biochemical findings, elevated serum transaminase activities were the most reliable indicators of chronic hepatitis. There was a significant difference of the mean transaminase activities between patients with CPH and CAH. In 15 children CPH was diagnosed histologically. 9 children had CAH, 2 children showed signs of MinH.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 136 (1981), S. 57-62 
    ISSN: 1432-1076
    Keywords: Chronic hepatitis ; Chronic persistent hepatitis ; Chronic aggressive hepatitis ; Minimal hepatitis ; Immunoglobulins ; Autoantibodies ; Hepatitis B virus antigens ; DNA polymerase ; Immunofluorescent studies ; Viral antigen expression patterns ; Nonparenteral HBV infection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The results of immunological studies in serum and liver tissue from 26 patients with chronic HBsAg-positive hepatitis (15 CPH, 9 CAH, 2 MinH) are presented. Determination of serum immunoglobulins showed no significant differences between the three categories of HBsAg-positive CH. AGF, ANA and AMA were not demonstrable in our patients. HBsAg and anti-HBc were demonstrated in all patients, HBeAg in 16, anti-HBe in 6 patients. 2 children had anti-HBs antibodies. Elevated DNA polymerase activity was found in 8 of 12 HBeAg-seropositive and 0 of 9 HBeAg-sero-negative patients. HBcAg was present in liver tissue from 9 of 10 HBeAg-seropositive and 1 of 9 HBeAg-seronegative children. In some cases the classification of viral antigen expression patterns according to the studies of Bianchi and Gudat did not correspond to the histological diagnosis and the presence of serum HBeAg. Studies in 51 family members of 23 children showed a high incidence of HBsAg carriers among the siblings and frequent evidence of anti-HBs in the mothers. Altogether, contact with HBV was demonstrated in 28 of the relatives studied.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 143 (1984), S. 35-40 
    ISSN: 1432-1076
    Keywords: Chronic intrahepatic cholestasis ; Biliary lipid composition ; Bile acids ; Gallstones
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Biliary lipid composition, standard liver function tests, serum lipids and faecal fat excretion were studied in 15 children with chronic intrahepatic cholestasis (severe intrahepatic cholestasis, n=6; paucity of intralobular bile ducts, n=4; benign recurrent cholestasis, n=5) and compared to 15 children without gastrointestinal diseases. Severe and benign intrahepatic cholestasis were associated with normal or moderately elevated serum lipids. Biliary lipid concentrations were extremely reduced, bile acid concentrations were below the critical micellar concentration. This may account for the high incidence of gallstone formation in these patients. Remission periods in patients with benign recurrent cholestasis were not followed by complete normalisation of biliary lipid concentrations, indicating a primary defect in hepatic excretory function. Children with paucity of intralobular bile ducts showed markedly increased serum lipids, but only a two-fold reduction in biliary lipid concentrations. Cholic acid was the predominant bile acid in bile of all cholestatic children even during remission. Neither increased levels of monohydroxy bile acids nor unusual bile acids could be identified in notable amounts.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 148 (1989), S. 605-609 
    ISSN: 1432-1076
    Keywords: 25-Hydroxyvitamin D ; 1,25-Dihydroxyvitamin D ; Vitamin E-Vitamin D binding protein ; Chronic cholestasis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Patients with chronic cholestasis have reduced 25-hydroxyvitamin D (25 OHD) and vitamin E levels. We determined serum concentrations of 25 OHD, 1,25-dihydroxyvitamin D [1,25(OH)2D] and vitamin E before and after oral administration of 10 μg/kg body weight 25-hydroxyvitamin D3 (25 OHD3) and 100 IU/kg body weight vitamin E, respectively, in 4 patients with intrahepatic cholestasis and 6 healthy children. Vitamin E increased in all controls but in only one of the four patients. In contrast, oral 25 OHD3 induced a normal rise in circulating 25 OHD and 1,25(OH)2D. The low serum levels of 25 OHD in the patients before the oral bolus may have been due to inadequate parenteral vitamin D administration and/or to the simultaneous phenobarbital treatment. The latter possibility is supported by the increase of serum 25 OHD into the normal range after withdrawal of phenobarbital in one of the four patients. We conclude that vitamin E has to be supplemented parenterally or in water-soluble oral form. Further studies are necessary to clarify whether high-dose long-term oral 25 OHD3 supplementation is sufficient to prevent vitamin D deficiency in patients with chronic cholestasis.
    Type of Medium: Electronic Resource
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