[Cerebrospinal fluid cytologic diagnosis--possibilities and limits]. / Liquorzytodiagnostik--Möglichkeiten und Grenzen.

Findings of functionally active and proliferating cells in CSF, such as granulocytes, macrophages, lymphoid cells and blastoma cells are of diagnostic importance in pathological reactions of meninges. Such findings have a special significance in different phases in the course of meningoencephalitis, subarachnoid haemorrhage and infiltrations of neoplasms with subependymal localization which can not be obtained even by modern methods in neuroradiology. A correct diagnostic assessment is only given by knowledge and in consideration of all clinical and laboratory findings. The diagnostic value is limited in cases of deeply intracerebral localized diseases, of chronic recurrent processes, of cases with previous lesions or of concommitant symptoms because the results are atypical.

[Cytodiagnosis in the cerebrospinal fluid with special reference to illness course phases in diseases of the central nervous system]. / Zur Zytodiagnostik im Liquor cerebrospinalis unter besonderer Berücksichtigung der Verlaufsphasen bei Erkrankungen des Zentralnervensystems.

The cytological diagnostic of CSF is indicated in inflammations, vascular and tumorous diseases. A change of normal ratio of 4:1 of CSF-lymphocytes and -monocytes and/or the appearance of functionally active forms of these cell-lines are typical for immunoreactive inflammation (lymphoid cells) or cleaning up (macrophages). Cellular reactions with differing pleocytosis are caused by different irritations within the space of CSF: during the acute phase of meningitis with granulocytosis, in the following cleaning up with monocytosis and macrophages and in inflammatory and immunological reactions with lymphocytosis, lymphoid cells and plasmocytes. Necessary to CSF-diagnostic is the correlation of the stages of the course of disease additional with regard to the quantitative and qualitative results of CSF-protein. Findings of the examination of CSF-cells in diseases of CNS are represented in tabular form.

[Cerebrospinal fluid, especially cell findings, in subarachnoid hemorrhage]. / Der Liquor cerebrospinalis, insbesondere die Zellbefunde im Verlauf subarachnoidaler Blutungen.

Liquor samples (n = 303 each from the Neurological Department of the Wilhelm Pieck University Rostock, GDR and the Neurological Hospital of the Pommeranian Medical Academy, Szczecin, Poland) collected from patients following subarachnoid hemorrhage are used as a basis to present various findings for the, on the whole, characteristic hemorrhagic liquor syndrome. The differential liquor cell picture (sedimentation after Sayk) is important for determining the time of the hemorrhage and the post-hemorrhage phase and for identifying recidivating hemorrhage and complications, including hemorrhagic meningoencephalitis (lympho-plasmocytic cells), post-traumatic states (activated macrophage and storage function) and blastomatous infiltration (malignoma cells). Artificial blood contamination (easily recognisable immediately after puncture) leads to differences, with less granulocytosis and a few sparsely charged macrophages, a few days later; the same also applies to diseases stemming from the vessels and hematomas that are not in contact with the liquor space. Despite the introduction of diagnostic hardware, examination of the liquor a few days after subarachnoid hemorrhage is still important as a means of identifying recidivating hemorrhage and complications and, in particular, for differentiation from inlammatory diseases of the CNS.

[Value of MS associated factors for test procedures in multiple sclerosis: 1. Carp's MS associated agent in the serum]. / Wertigkeit von MS-assoziierten Faktoren für Testverfahren bei der Multiplen Sklerose: 1. MS-assoziiertes Agenz im Serum nach Carp.

The determination of multiple sclerosis-associated factors in serum is grounded on the conception that there exist virus-like particles with a special predicative value for diagnosis. A test system, elaborated by Carp, is basing on the reduction of neutrophilic granulocytes in peripheral blood of mice by a MS-associated agent (MSAA) of serum, cerebrospinal fluid, brain and other organs of MS-patients. Several groups and the present investigators did not always receive constantly positive findings in applying this method. The cause may be the variation of results characteristic for such biological test systems. As well as for some other methods discussed (e.g. the rosette test with measles-infected epithelial cells or the determination of anomalous cells in bone marrow of MS-patients) the procedure shows an only confined valence, not absolutely specific for the disease in the diagnostical relevant case.

[Current status of cerebrospinal fluid diagnosis]. / Zum derzeitigen Stand der Liquordiagnostik.

The possibilities of the analysis of cerebrospinal fluid (CSF) are explained from the aspect of a clearly arranged representation, partly in tabular form, concerning the following details: --the relation of the findings of CSF, in particular the cytological results, to the course of disease, --the special cytological methods for determination of cells in CSF, --cytomorphological characteristics of malignancy in regard of activated cells inflammatory reactions, --the assessment of the results of qualitative analyses of proteins and the differentiation of an intrathecal production of immunoglobulins opposite to the impairment of the barriers, --the damage of parameters of CSF by artificial factors. In case of the determination of distinct CSF syndromes results a special diagnostical consequence before all for exsudative, immunoreactive and inflammatory disorders, vascular disease and tumors of the nervous system.

[IgG determination in the cerebrospinal fluid--correlation of these results with other cerebrospinal fluid values]. / Zur quantitativen IgG-Bestimmung im Liquor cerebrospinalis--Korrelation der Ergebnisse zu anderen Liquorwerten.

IgG determined by means of quantitative radial immunodiffusion in the cerebrospinal fluid of 225 neurological patients correlates in a statistically significant manner (p less than 0.001) with the gamma-globulin determined by the acetate foil electrophoresis. The indication of the IgG as a percentage of the total protein (limiting value of 10 per cent) is suitable for an orientating assessment in the diagnosis of inflammatory-immunoreactive diseases of the central nervous system. The IgG-values exceeding 10 per cent of the total protein correlate in 260 fluids examined in the respect with the percental value of the lymphocyte content which also lies above the reference range (p less than 0.001). For the assessment of the presence of a barrier disturbance, a comparison with the serum values should be carried out, either in the form of the frequently used fluid/serum quotients of the immunglobulin or the electrophoretically separated protein fraction.

[Cell reactions in the cerebrospinal fluid with inflammatory and neuroallergie diseases of the central nervous system (author's transl)]. / Zellreaktionen im Liquor cerebrospinalis bei entzündlichen und neuroallergischen Erkrankungen des Zentralnervensystems.

In the course of bacterial and abacterial meningoencephalitis the cell reaction of the cerebrospinal fluid can well be surveyed, permitting important conclusions to the reactions occurring in the leptomeningeal vascular connective tissue. The application of additional cytological methods in completion of the panoptic routine staining proved to be favourable. The respective results may be additionnally availed of for the diagnostic confirmation of the activities found in the panoptic routine cell-picture. In addition to the general evaluation of the nitro-blue tetrazolium test, pyroninophilia, peroxidase and PAS-reaction, above all, the observation somehow the despositing of the reaction products in the celles has proved to be important for the activity detection of the nonspecific esterase. For judging the immunreactive processes in the central nervous system, the role of the lymphocytes and their forms of transformation, as well as their behaviour with the different cytological reactions has to be duly considered.

[Diagnostic value of quantitative and qualitative variations in cerebrospinal fluid proteins]. / Zur diagnostischen Bewertung quantitativer und qualitativer Eiweissveränderungen im Liquor cerebrospinalis.

Values of the liquor pherogram, which were obtained by means of electrophoresis on acetate folie and classified by disease groups and by the proportions of beta-globulin and first fraction, are compared, with respect to the absolute contents, by reference to tables and figures. The diagnostic importance of low total protein contents in the lumbar liquors of adults is considered in connection with a discussion of the usefulness of indicating the liquor pherogram in terms of percentage or absolute values.

[Changes in cerebrospinal fluid findings with glucocorticoid therapy]. / Veränderungen der Liquorbefunde unter Therapie mit Glukokortikoiden.

The quality and quantity of the cell and albumin findings in the cerebrospinal fluid taken from 50 patients suffering from an acute onset of an encephalomyelitis disseminata and from 30 patients with vertebrogenic diseases were compared between the two groups before and after glucocorticoid therapy. In the vertebrogenic cases the symptoms did not show any fundamental changes in the composition of the fluid. In the encephalomyelitis disseminata cases a tendency to levelling was observed after this treatment together with decreasing cell numbers and a recession of the relative lymphocytosis which was very marked beforehand. This was interpreted as the result of the unspecific and immunosuppressive effect of the glucocorticoid. Although under the given dosage the intensity of the immune reaction in the fluid remains uninfluenced with regard to plasma cells and an increase in gammaglobulin--a causal therapeutic effect cannot be shown--however, because of the results with regard to the condition of the fluid after the glucocorticoid it is useful for the control of therapy.