Reduction of insulin-like growth factor-I expression in the skeletal muscle of noncachectic patients with chronic heart failure.

Objectives: We sought to assess the role of insulin-like growth factor-I (IGF-I) in muscle wasting in chronic heart failure (CHF), serum concentrations and local muscular IGF-I expression were determined in patients with severe CHF.

Background: Chronic heart failure is associated with progressive muscle atrophy, leading to cardiac cachexia. Skeletal muscle disuse and inflammatory activation with elevated cytokine levels have been implicated; however, the pathomechanism involved remains largely unknown.

[Mediastinal space-occupying lesion as a rare cause of atrial arrhythmia].

History And Clinical Findings: A 61 year old man presented with newly developed tachyarrhythmia. Echocardiographically a tumour of unclear origin in the left atrium was diagnosed.

Investigations: The heart rate in the ECG was arrhythmic at 146/min; intermittently sinus rhythm was established.

[Percutaneous reconstruction of a pelvic vascular occlusion using the "kissing-balloon" technique].

Unlabelled: A 43-year-old patient was admitted for severe claudication in his right leg, doppler ultrasound and angiography revealed an occluded right common iliac artery. Using the cross-over-approach from the contralateral side, it was possible to navigate a guide wire through the occlusion, and after passage with an excimer laser an ipsilateral retrograde puncture with placement of a sheath was performed. In order to protect the the aortoiliac bifurcation, a primary stent implantation of the occluded side was carried out using the kissing balloon technique.

Coexisting hyperparathyroidism, renal osteodystrophy and psoriatic arthritis.

We report the case of a 60-year-old woman with hyperparathyroidism, renal osteodystrophy and psoriatic arthritis. The coexistence of findings of hyperparathyroidism and renal osteodystrophy has been described and there are also reports of patients suffering from renal arthropathy mimicking hyperparathyroidism. To our knowledge, there is no description to date of a case displaying findings of the co-occurrence of these conditions in a patient.

Sternocostoclavicular hyperostosis: its progression and radiological features. A study of 12 cases.

Twelve cases of sternocostoclavicular hyperostosis were followed up over four to 16 years. The patients underwent repeated radiological examinations of the sternocostoclavicular joints and the sternum, and the extrasternal osseous manifestations of the disease were studied to show changes in the radiological features during long term follow up. Five of 12 (41%) patients had extrasternal manifestations.

Localization of occult persisting medullary thyroid carcinoma before microsurgical reoperation: high sensitivity of selective venous catheterization.

In 14 patients with occult persisting medullary thyroid carcinoma, tumor tissue was removed by microsurgical reoperation in 13 of 14 patients. This resulted in biochemical improvement in all but 1 patient and biochemical cure in 3 patients (21%). The lateral compartment of the neck or the upper mediastinum was involved in all but 1 patient.

Hypertension in rats induced by renal grafts from renovascular hypertensive donors.

Renal transplantations were performed, using microsurgical techniques, with adult male two-kidney, one clip hypertensive rats (n = 9) and sham-operated normotensive Wistar-Kyoto rats (n = 8) as kidney donors and with F1 hybrids, bred from Wistar-Kyoto and stroke-prone spontaneously hypertensive rat parents, as recipients. Systolic blood pressure before surgery was 200 +/- 2.7 mm Hg in hypertensive and 115 +/- 1.

[Dilatation treatment of esophageal stenoses in young patients with recessive epidermolysis bullosa dystrophica].

Recessive dystrophic epidermolysis bullosa is a hereditary disorder affecting both skin and esophageal mucosa. The esophagus is frequently affected resulting in almost complete obstruction. We report here the use of inflatable dilatator balloons as a new treatment of esophageal stenosis in three young patients.

[Cardiomyopathy in hypocalcemia].

A 48-year-old woman developed a hypocalcaemic cardiomyopathy, the hypocalcaemia being due to hypoparathyroidism after three previous thyroid operations for goitre with tracheal compression. She had signs of severe cardiac failure, but no tetany. She was put on calcium and vitamin D3 medication which raised calcium concentration.

[Extraosseous calcification in juvenile dermatomyositis. The ineffectiveness of EHDP].

A now 20-year-old man was first diagnosed as having dermatomyositis when aged 12 years. At that time he had muscular weakness and heart failure followed a year later by heterotopic calcifications. For over seven years he was treated with corticoids, at times also with azathioprine or methotrexate.

A newly developed spine deformity index (SDI) to quantitate vertebral crush fractures in patients with osteoporosis.

The available methods to quantitate vertebral deformity in osteoporotics are not satisfactory in comparing follow-up measurements in patients. This paper describes a newly developed 'spine deformity index' (SDI) which allows the quantitation of the extent of vertebral fractures. It is based on the observation that, in 110 normal persons, the heights of all vertebral bodies were related to each other in a predictable and constant manner.

Prediction of breakthrough patterns of organics from laboratory tests.

The investigations have shown that it is possible to predict the breakthrough behavior of complex mixtures in a pilot-plant filter. The aim of future studies will be to predict the breakthrough behavior of waterworks filters in the same way as discussed here. This seems to be fairly simple if the filters are working with adsorption only.

[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.

[Pulmonary candida manifestation with cavitation in immunosuppressed patients].

The roentgenologic pattern of the pulmonary manifestation of candida species, resulting in a rapid development of pulmonary cavitations with mycetoma-like structures, was described in three patients. All patients, undergoing antineoplastic chemotherapy because of acute leukemia, presented with fever and expectoration, which were resistant to various antibiotic regimes. Cultures of blood and urine were sterile; but Torulopsis glabrata, a candida species, was found in multiple cultures of the sputum of all patients and also in a bronchoscopic lavage obtained from one patient after reconstitution of the granulopoesis.

[Therapy of esophageal stenoses in recessive epidermolysis bullosa dystrophica].

Stenosis or complete occlusion of the oesophagus are potentially life-threatening complications of recessive dystrophic epidermolysis bullosa. Consequences are malnutrition, growth retardation, aspiration, or cachexia. Total replacement of the oesophagus by colon interposition has been recommended in such patients.

Management of esophageal stenosis in recessive dystrophic epidermolysis bullosa.

Total replacement of the esophagus by colonic interposition has been recommended as the treatment of esophageal obstruction in recessive dystrophic epidermolysis bullosa. We report our experience in the conservative management of esophageal blisters, strictures, and complete occlusion in 5 patients (aged 2-61 yr). Our therapy consists of a combination of the following principles: (a) inhibition of collagenase formation by oral phenytoin to reduce epithelial detachment; (b) pureed or semiliquid food because minor trauma by hard food particles may induce blistering and result in scarring of the upper esophagus, and larger food particles may obstruct an esophageal stricture; (c) avoidance of tangential shearing forces induced by bougienage and endoscopy and instead use of inflatable dilatator balloons which produce vertical pressure that seems to be less harmful; and (d) long-term nasogastric tube feeding, which may relieve even tight strictures.

[Paget's osteitis deformans. Significance and control].

Follow-up observation of patients with Paget's disease by conventional radiology is useful to evaluate the spontaneous course of the disease in untreated cases and to determine the regeneration of the affected bone after therapy. This also includes complications of the otitis deformans Paget--mainly complete or incomplete fractures, severe deformations as well as rare malignant changes.

[Paget disease of the skeleton. Internal medicine aspects].

Paget's disease of bone seems to be a slow virus infection of a single or several areas of the skeleton. Pagetic lesions are rather common among elderly people, but the disease does not manifest itself very often. Compared to the incidence of Paget's disease in England it seems to be rarer in this country.

[Notes on the differential diagnosis of nodules in the lung: Rendu-Osler-Weber disease (author's transl)].

The hereditary hemorrhagic teleangiectasia, commonly known as "Rendu-Osler-Weber" disease, is a relatively seldom found affection manifesting itself by the formations of localized arteriovenous capillary connections which are tiny arteriovenous fistulas. They are found in the skin, the mucous membranes and in nearly all organs of the body. The diseases is transmitted by a dominant character.

[The distribution of destructive polyarthritic changes in the hand skeleton].

The distribution of common and erosive changes in advanced polyarthrosis is radiologically demonstrated in the hands of 32 patients. 23 of them showed erosive destructions in at least one joint. In general the alterations were symmetrical.