Immune reactivity towards insulin, its amyloid and protein S100B in blood sera of Parkinson's disease patients

Peripheral immune responses can be sensitive indicators of disease pathology. We evaluated the autoimmune reactions to endocrine (insulin) and astrocytical (S100B) biomarkers in the blood sera of 26 Parkinson's disease (PD) patients compared with controls by using ELISA. We found a statistically significant increase of the autoimmune responses to both antigens in PD patients compared with controls with a mean increase of 70% and 50% in the autoimmune reactions towards insulin and S100B, respectively. Heterogeneity of the immune responses observed in patients may reflect the modulating effect of multiple variables associated with neurodegeneration and also changes in the basic mechanisms of individual autoimmune reactivity. We did not detect any pronounced immune reactions towards insulin amyloid fibrils and oligomers in PD patients, indicating that an amyloid-specific conformational epitope is not involved in immune recognition of this amyloid type, while sequential epitope of native insulin is hidden within the amyloid structures. Immune reactions towards S100B and insulin may reflect the neurodegenerative brain damaging processes and impaired insulin homeostasis occurring in PD.

Regional cerebral blood flow in endogenous psychoses, measured by 99mTc HMPAO-SPECT

The aim of this pilot study was to determine the sensitivity of HMPAO-Single Photon Emission Computed Tomography (SPECT), a new technique for determining cerebral blood flow. 7 RDC-schizophrenics, 5 schizoaffectives and 6 depressives were investigated after remission of the psychosis. It appeared that in the schizophrenics the blood flow was significantly reduced in the left anterior region in the infraventricular and ventricular section when compared with the depressives. This finding is discussed here. Apparently, HMPAO-SPECT is another valuable technique for investigating cerebral blood flow.

[Esthesioneuroblastoma--treatment of recurrences using the remote-control afterloading technic. A case report]

At the Radiological Hospital of the Heidelberg University, one patient with a local recurrence of an esthesioneuroblastoma situated on the left-hand side of the skull base was treated between February 11 and March 18, 1986, by an afterloading contact therapy with curative intent. After preceding surgery and percutaneous radiotherapy, repeated local recurrences and locoregional lymph node metastases had occurred. The contact therapy was performed after adjusting an individual face mask in which the afterloading probe was placed and brought into its position in the tumor region. The irradiation scheme was based on the transformation of the source coordinates form the stereoscopic X-ray localization system into the coordinate system of the computed tomogram by means of X-ray tight reference points. The irradiation planning by computed tomography allows to optimize the arrangement of sources within the tumor region. The principles of the method as well as the treatment result are presented.

[Preliminary results of 99mTc-HMPAO-SPECT studies in endogenous psychoses]

18 psychopharmacologically treated patients (7 schizophrenics, 5 schizoaffectives, 6 depressives) were studied using 99mTc-HMPAO-SPECT of the brain. The regional cerebral blood flow was measured in three transversal sections (infra-/supraventricular, ventricular) within 6 regions of interest (ROI) respectively (one frontal, one parietal and one occipital in each hemisphere). Corresponding ROIs of the same section in each hemisphere were compared. In the schizophrenics there was a significantly reduced perfusion in the left frontal region of the infraventricular and ventricular section (p less than 0.02) compared with the data of the depressives. The schizoaffectives took an intermediate place. Since the patients were treated with psychopharmaca, the result must be interpreted cautiously. However, our findings seem to be in accordance with post-mortem-, CT- and PET-studies presented in the literature. Our results suggest that 99mTc-HMPAO-SPECT may be helpful in finding cerebral abnormalities in endogenous psychoses.

[Effect of irradiation of oral, pharyngeal and laryngeal tumors on thyroid function]

The irradiation of cervical lymphatics in case of oral and pharyngeal carcinomas as well as the irradiation of the operated area in case of laryngeal carcinomas leads to an exposition of the thyroid gland which may result in a dysfunction of this organ. An evaluation of our patients suffering from these tumors and treated during 1984 and 1985 showed a latent hypothyreosis in 46.7% of the patients treated only by cervical irradiation and in 20.7% of the cases treated by radiotherapy of the tumoral focus and additional irradiation of the cervical lymphatics (p less than 0.1). Clinical symptoms were scarcely evident in both groups. For struma prophylaxis, thyreosubstitution with L-thyroxine is recommended.

[Role of 131I-metaiodobenzylguanidine scintigraphy in the diagnosis of intestinal carcinoids]

Iodine-131 metaiodobenzylguanidine (131I-MIBG) is concentrated in a variety of neuroendocrine tumors, such as pheochromocytoma and neuroblastoma. Other neuroendocrine tumors from the APUD-cell system such as carcinoid tumors, may possess this uptake capability as well. We investigated 11 patients suffering from intestinal carcinoid with 131I-MIBG in order to determine the value of MIBG scintigraphy in these tumors. MIBG scans were positive in 5 out of 11 patients (45%). False-positive MIBG-scans did not occur. No correlation between MIBG uptake, clinical symptoms and urinary 5-HIAA level could be found.

[Value of various radiological study results in the follow-up of Camurati-Engelmann disease]

Camurati-Engelmann disease is a rare progressive bone dysplasia; involvement of the skull base can lead to deafness, vestibular disturbances, facial paralysis and damage to the optic nerves. Treatment with corticosteroids, calcitonin and diphosphonates promises only very limited success. Conservative treatment of compression of the cranial nerves is almost ineffective, but the aim of surgical treatment is decompression of involved nerves. The differential diagnosis depends on radiological findings and clinical symptoms. Follow-up depends on radiographic examination and skeletal scintigraphy for showing the extent of the disease. CT may help in demonstrating compression of cranial nerves and define the indications for surgical decompression.

Die Rolle der131J-Metajod-benzylguanidin-(MIBG-) Szintigraphie in der Diagnostik der intestinalen Karzinoide

lodine-131 metaiodobenzylguanidine (131I-MIBG) is concentrated in a variety of neuroendocrine tumors, such as pheochromocytoma and neuroblastoma. Other neuroendocrine tumors from the APUD-cell system such as carcinoid tumors, may posses this uptake capability as well. We investigated 11 patients suffering from intestinal carcinoid with 131I-MIBG in order to determine the value of MIBG scintigraphy in these tumors. MIBG scans were positive in 5 out of 11 patients (45%). False-positive MIBG-scans did not occur. No correlation between MIBG uptake, clinical symptoms and urinary 5-HIAA level could be found.

Angiotensin II control of the renal microcirculation: effect of blockade by saralasin

The hydronephrotic rat kidney with intact circulation and innervation was split and spread out as a thin sheet in a tissue bath. The microvasculature was observed in vivo via television microscopy. We quantitated the effects of increasing concentrations (10(-9) to 10(-5) M) of saralasin (angiotensin II antagonist) applied locally in the tissue bath on microvascular diameters and on relative glomerular blood flow (measured using fluorescent labeled RBCs). Saralasin produced an increase in preglomerular diameters which was largest (37 +/- 11%) in the interlobular artery (there was no dilation in the afferent arteriole near the glomerulus), an increase in postglomerular diameters which was largest (17 +/- 4%) in the efferent arteriole near the glomerulus, and an increase in blood flow (19 +/- 4%). If these types of findings would hold for the normal kidney, it would suggest a role for angiotensin II in the control of total renal blood flow, in the regional distribution of flow, and in the control of filtration fraction. We also made control micropressure measurements using the servo-nulling approach. Pressures measured were: afferent arteriole, 65 +/- 5 mm Hg; intraglomerulus, 50 +/- 5 mm Hg; and efferent arteriole, 19 +/- 3 mm Hg. These data indicate that there is major vascular resistance near the glomerulus, especially in the efferent arteriole.

Absorbable fixation of first ray osteotomies

A study was undertaken to evaluate the use of ORTHOSORB absorbable pin fixation for distal first ray osteotomies, in the management of hallux valgus. Data presented include 20 osteotomies fixated with ORTHOSORB absorbable pins in a crossing fashion, performed in 14 patients with an average follow-up period of 11 months. The patient population presented with an average age of 30, all were female. The patient pool was evaluated for hallux abductus, metatarsus primus varus, tibial sesamoid position, quality and quantity of range of motion at the first metatarsophalangeal joint, metatarsalgia, and osteolysis, both before and after surgery. No osteotomy displacement, delayed healing, or osteonecrosis was noted in this study. No adverse clinical reactions were observed in response to the ORTHOSORB pins.