Psychopathologic and zoological aspects of acarophobia.

Acarophobia represents a nosologically inconsistent psychiatric clinical picture which is exceptional in that it is noticed among the clientele of those in charge of pest control, hygienists, health department medical officers and dermatologists rather than in psychiatric practice or mental hospitals. Apart from acarophobia in the course of schizophrenic, affective and organic psychoses as well as cases in which the phobia was induced by another individual, roughly half of the cases were 'pure' forms, i.e.

Nosocomial myiasis.

When the larvae of flies invade man the clinical picture is referred to as 'myiasis'. When myiasis occurs in a patient after hospitalization the disease is termed nosocomial myiasis, a very infrequent phenomenon. The present investigation was conducted to record the cases of nosocomial myiasis documented worldwide.

[Subarachnoid hemorrhage from the anterior communication artery in a sex offender. Considerations regarding liability].

A 32-year-old man was accused of attempted rape. While urinating at the side of the road he felt an erection. He approached a 9-year-old girl who happened to be coming along and pressed his penis between her legs until ejaculation.

[Proprioceptive deficit following cruciate lesions--afferent disorder or compensatory mechanism?].

It was suggested that the ACL has not only mechanical functions but also acts as proprioceptive organ. In cruciate deficient knees pathological patterns of muscle control were found. These findings could be caused by a disturbed afferent signal from the disrupted ACL or by secondary changes in muscle innervation, which shall protect the instable knee against subluxation.

Changes in muscular activity after knee arthrotomy and arthroscopy.

The object of this study was to find out whether an arthrotomy of the knee would damage joint proprioception. Twenty patients who underwent arthrotomy, and 20 patients after arthroscopy, were tested on a modified ergometer and the electromyographic action of their quadriceps and hamstrings recorded. The quadriceps action started later and had a shorter duration (20 ms) after arthrotomy.

[Pesticides as chemical indoor pollution and persistence in the hospital as an example in long term and short term studies].

It is because of combined hygienic, ecological, commercial and psychological aspects that controlling public health pests in the hospital becomes a complex problem area in which dubious practices and philosophies have had a tradition for decades. These include harmlessness assumptions considered as a carte blanche, ignoring the biological peculiarities of the species controlled, payment for consumption of chemicals or area controlled rather than for efficiency of control, and a contract policy between the pest control contractor and the hospital governed by a profit-oriented control frequency rather than by the actual infestation. Thus, the hospital environment has often experienced an unnecessarily high exposure to toxic and, in part, persistent substances which can adversely affect the chemical indoor situation in acute terms or on a long-term basis, and may give rise to sustained problems.

[Social conditions of stuttering].

Sixty-seven stuttering and 50 non-stuttering children, all of them aged between three and five years, were investigated regarding their social conditions in an interdisciplinary study. Numerous studies so far conducted into family circumstances of stuttering children and adolescents have supported diverse conclusions regarding the parent-child relationship, personality traits of parents as well as their style of child raising and social status. Most of the resulting publications have concentrated on children from whom stuttering symptoms had been recordable for several years, so that it was not safely verifiable whether the parental behaviour described had been one of the causal factors for stuttering of children or a belated response to that stuttering.

[Conditions in stuttering. Results of an interdisciplinary study of 3- to 5-year-old children. Child psychiatric aspects].

An interdisciplinary study was conducted with 67 children aged three to five years at the onset of speech fluency impairment as well as with 50 controls identical to the above group by age and sex. Findings reported are on psychic conditions which were obtained by interviews with and examinations of parents and children as well as by watching children at play and by means of questionnaires. Children with disruption of speech (DS) significantly differed from children in the control group (CG) with regard to prevailing mood, affect, psychic stability, capability of concentration, sociability and timidity.

[Conditions in stuttering. Results of an interdisciplinary study of 3- to 5-year-old children. Neurologic aspects].

Results recorded from neurological surveys are reported in the context of an interdisciplinary study conducted on 67 children aged three to five years at the onset of speech fluency disorders as well as investigations on 50 children of identical age and sex. The two groups (DS: disruption of speech; CG: control group) significantly differed from each other regarding family predisposition for stuttering. Sub-coordination and whole-body coordination were investigated.

[Rational neurologic diagnosis in fecal incontinence].

The effective therapy of a disturbance of anal continence requires an adequate preoperative diagnostics. In most cases this includes some kind of neurophysiological investigation. Close cooperation between the internist, the surgeon and the neurologist is advantageous.

[Long-term treatment of Lambert-Eaton syndrome by 3, 4 diaminopyridine].

A patient with a 5 year history of slow-progressive Lambert-Eaton Myasthenic Syndrome (LEMS) was treated for a period of 12 months with 3,4-diaminopyridine (3,4-DAP). The therapy led to an objective increase in muscle power. During the treatment period, there was no increase in muscle weakness, but attempts at withdrawal of the drug confirmed a progression.

Therapeutic approaches to Lambert-Eaton myasthenic syndrome in the intra-individual comparison.

A patient with Lambert-Eaton myasthenic syndrome was clinically treated several times over a period of 9 months. During at least 3 weeks each time, the patient received prednisone, then underwent 9 plasmaphereses, and was given guanidine-hydrochloride (HCl) and 3,4-diaminopyridine (3,4-DAP). The muscle-power scoring, muscle function tests and the electrophysiological parameters showed a superiority of 3,4-DAP over the other pharmacological therapies.

[Analysis of the public health status and assessment of vaccination status in maternal health services and child and adolescent preventive health care of a district city].

A total of 23 maternity centres and 8 youth welfare centres in the county town of Magdeburg were inspected in 1987 and 1988 to review the condition of buildings and layout of rooms. Checks were also made on anti-infectious routines and compliance with the vaccination regulations. In all of these areas a number of deficiencies were found, and the results of follow-up inspections clearly show that the attention being given to public health regulations for sterilization and disinfection and to the storage of vaccines, is still inadequate.

[Isolated vitamin E deficiency].

Since the detection of vitamin E in 1922, nearly 50 years passed until the recognition that there is a pathogenic vitamin E deficiency in humans. Such a deficiency can be found mostly in a disturbed resorption or transport of the vitamin (mucoviscidosis, chronic cholestasis, abetalipoproteinaemia) and leads typically to a progredient spinocerebellar ataxia in combination with a polyneuropathy. Substitution of the vitamin may hinder a further progression or even lead to an amelioration of the symptoms.

[Acute multifocal placoid pigment epitheliopathy with inflammatory CSF findings. A special form of borreliosis?].

A 24-year-old woman with acute multifocal placoid pigment epitheliopathy in both eyes had no signs or symptoms other than the impaired vision. Visual evoked potentials demonstrated prolonged latency. Lumbar CSF showed inflammatory changes.

Progressive myopathy in trisomy 21.

A 23-year-old female patient with clinical manifestations typical of Down's syndrome progressively developed intensifying weakness of the proximal muscles from the age of 16 years. CK levels were distinctly elevated. Electromyography showed myogenic lesions and muscle biopsy a myopathic image with extensive fibre hypertrophy.

[Blood group antigens and ABH secretor status in dystrophia myotonica (Curschmann-Steinert)].

The linkage between the dominantly inherited Dystrophia myotonica and ABH-Secretor locus is well known. It has been used as a genetic marker for the early detection of heterozygous patients. Genetic counselling, however, requires exact knowledge of the gene combination.

Rheographic indications for reduced cerebral vasoconstriction after oral magnesium medication in tetanic patients, a double-blind, placebo-controlled trial.

Volume and tonus oscillations of cerebral blood vessels are measurable with rheoencephalography. A lowered amplitude under resting conditions and an increased reactivity after hyperventilation (with pronounced and prolonged vasoconstriction) was found in tetanic patients, 360 mg Mg/day (as magnesium citrate tablets) was administered in 17 tetanic patients (A) and a placebo in 18 patients (B) in a double-blind, placebo-controlled trial. After 4 weeks the hyperventilation-induced vasoconstriction was reduced significantly within group A compared to group B.

Antimyotonic therapy with tocainide under ECG control in the myotonic dystrophy of Curschmann-Steinert.

Ten patients suffering from advanced myotonic dystrophy with severe myotonic symptoms were treated with 800-1200 mg/day of the anti-arrhythmic drug tocainide (Xylotocan). All patients reported a marked subjective improvement of myotonia, which was confirmed by objective tests. Except for a slight QT-prolongation in one patient, the ECG was not significantly altered by the treatment.

Centronuclear myopathy with special consideration of the adult form.

We report clinical, electrophysiological, enzyme histochemical and ultrastructural findings in 4 patients afflicted with centronuclear myopathy of adulthood whose disorder emphasizes the broad spectrum of this congenital myopathy including clear ocular ptosis in only one and facio-scapulo-peroneal syndrome in another patient. The morphological criteria for classification are central nuclei and the enzyme histochemical findings in muscle biopsies which did not show any significant progression over many years, more severe involvement of distal muscles in 2 patients and conspicuous presence of intrafascicular fat cells. 1 patient had associated minicores in a familial setting.