Overcoming the coupled climate and biodiversity crises and their societal impacts.

Earth's biodiversity and human societies face pollution, overconsumption of natural resources, urbanization, demographic shifts, social and economic inequalities, and habitat loss, many of which are exacerbated by climate change. Here, we review links among climate, biodiversity, and society and develop a roadmap toward sustainability. These include limiting warming to 1.5°C and effectively conserving and restoring functional ecosystems on 30 to 50% of land, freshwater, and ocean "scapes." We envision a mosaic of interconnected protected and shared spaces, including intensively used spaces, to strengthen self-sustaining biodiversity, the capacity of people and nature to adapt to and mitigate climate change, and nature's contributions to people. Fostering interlinked human, ecosystem, and planetary health for a livable future urgently requires bold implementation of transformative policy interventions through interconnected institutions, governance, and social systems from local to global levels.

Thyroid function in 44 patients with amyotrophic lateral sclerosis.

In an endemic goiter area of West Germany (incidence of goiter, 19% to 32%), thyroid function was evaluated in 44 patients with amyotrophic lateral sclerosis (ALS) with radioimmunoassay of triiodothyronine, thyroxine, thyroxine-binding globulin, and thyroid-stimulating hormone, including the protirelin stimulation test. The presence of circulating anti-thyroid antibodies was sought by hemagglutination techniques. All patients were found to be euthyroid and thyroid antibody-negative. Clinical examination disclosed concomitant goiter in 36% (16/44). The data suggest that thyroid status is not relevant to the pathogenesis of ALS.

Thyroid function and circulating antithyroid antibodies in myasthenia gravis.

Evaluation of thyroid function in 104 patients with myasthenia gravis by T3, T4, TBG, and TSH radioimmunoassays and the TRH-stimulation test in 47 patients disclosed thyrotoxicosis in 5.7%, preclinical hyperthyroidism probably due to autonomously functioning thyroid tissue in about 10% of patients stimulated with TRH, hypothyroidism in 1.9%, and preclinical hypothyroidism in 3.4%. Eighty-four percent were euthyroid. Antithyroid antibody activity was detected by hemagglutination tests. Twelve patients had antithyroglobulin antibodies (Tab), and 28 had antimicrosomal antibodies (Mab). Among the euthyroid myasthenic patients, 7 were Tab-positive and 20 were Mab-positive. Euthyroid antibody-positive patients had a significantly higher TSH response in the TRH stimulation test and may be at high risk for hypothyroidism.

Complement dependen cytotoxic antibody activity against measles virus in multiple sclerosis.

The presence of measles cytotoxic (CT) and hemagglutination inhibition (HI) antibodies in 195 multiples sclerosis (MS) patients and 251 controls was tested. The measles virus Lu carrier cells labeled with 51Cr were exposed to serum specimens in the presence of complement in order to test the presence of CT antibody. The analysis of complement dependent CT antibodies against measles virus revealed significantly (P less than 0.01) higher titers in MS patients than in the control group. However, the measles HI test failed to show this difference. Measles CT titers greater than or equal to 1: 32 among MS patients occured in 54.9% and in 35.5% among the controls. In comparison with this the HI method revealed measles titers greater than or equal to 1:128 more often in the control group than in MS cases (27.9 and 17.9%, respectively). The presence of CT antibodies against measles virus in MS proves that these patients have a function defence mechanism to eliminate virus infected cells. The high measles antibody titer among MS patients could be due to recurrent antigenic stimulation caused measles virus persistency. Whether this virus persistency plays a role in MS can not be decided on the available data.

Serum myoglobin in primary and secondary skeletal muscle disorders.

Serum myoglobin was measured by a sensitive radioimmunoassay in healthy controls and patients with primary and secondary skeletal muscle disorders. The results indicate that serum myoglobin is a useful parameter in the assessment of muscle damage.

Agarose gel electrophoretic detection of six beta-lactam antibiotic residues in milk.

An electrophoretic method coupled with bioautography was developed for detection and identification of penicillin G, ampicillin, amoxicillin, cloxacillin, cephapirin, and ceftiofur residues in milk. The method uses a 2% agarose gel for electrophoresis, an overlay of PM indicator agar seeded with Bacillus stearothermophilus var. calidolactis, and incubation at 55 degrees C for 16-18 h. The new method separated and detected residues in milk at the levels of concern for the Food and Drug Administration (FDA) for penicillin G (5 ppb), cephapirin (20 ppb), and ceftiofur (50 ppb). The method also detected ampicillin, amoxicillin, and cloxacillin at 20, 30, and 30 ppb, respectively, but these levels are above those of concern for FDA (10 ppb).

Correlation between serum myoglobin and thyroid status in myasthenia gravis.

In 52 patients with myasthenia gravis serum myoglobin showed a significant inverse correlation to circulating thyroxine and triiodothyronine levels. The highest myoglobin concentration (240 ng/ml) was found in a myasthenia gravis patient with hypothyroidism. Slightly elevated myoglobin (54-60 ng/ml) was measured in four euthyroid myasthenic patients. The data suggest that a concomitant hypothyroid state must be excluded whenever high myoglobin levels are found in myasthenia gravis.

[Anaphylactic reaction in enzyme therapy of multiple sclerosis]. / Anaphylaktische Reaktion unter Enzymtherapie bei multipler Sklerose.

CASE REPORT: During enzyme therapy with intramuscular injections of Wobe-Mugos over 3 weeks a female MS-patient developed a severe anaphylactic reaction. The problems of enzyme therapy are discussed.

[Group music therapy in multiple sclerosis: initial report of experience]. / Gruppenmusiktherapie bei multipler Sklerose: Ein erster Erfahrungsbericht.

Group music therapy is a special kind of psychotherapeutic treatment. Within two years 225 patients with multiple sclerosis (MS) had the opportunity to participate a music therapy group over 4-6 weeks after admission to a MS-clinic. The major topics which were chosen in group sessions were MS associated problems such as disability, uncertainty, anxiety, depression, loss of self esteem etc. The data suggests that group music therapy is a useful adjunct not only in actual psychological support but also in the individual coping strategies.

[The problem of femoral neck fracture in multiple sclerosis]. / Zur Problematik der Schenkelhalsfraktur bei multipler Sklerose.

CASE REPORT: In a female MS-patient with severe osteoporosis a fracture of the femoral neck occurred while doing neurophysiological exercises. A lawsuit for damages followed and ended in settlement. The risk of femoral fracture in MS and an expert report are discussed.

Serum levels of myoglobin and creatine kinase in Duchenne muscular dystrophy.

Using a sensitive myoglobin-radioimmunoassay (Mb-RIA) serum Mb was measured in 50 patients with Duchenne muscular dystrophy (DMD) and compared with the serum creatine kinase (CK) activities. The Mb concentrations (normal range 4-60 ng/ml) measured ranged between 160-6,000 ng/ml and did not only show a significant correlation to the CK but also an inverse relationship to the age of the patients. It is suggested that Mb is an essential adjunct in the diagnosis of DMD.

[Myoglobin radioimmunoassay: experience of the diagnosis of skeletal muscle disorders (author's transl)]. / Myoglobin-Radioimmunoassay: Erfahrungen bei der Diagnostik von Skeletmuskelerkrankungen.

Serum myoglobin was measured by a sensitive radioimmunoassay in healthy controls and in patients with skeletal muscle disorders such as polymyositis and Duchenne type muscular dystrophy. The serum myoglobin levels were closely related to the serum creatine kinase (CK) activity, thus indicating that myoglobin is a useful adjunct in the assessment of muscle cell damage.

[The state of professional psychological guidance for patients with multiple sclerosis]. / Zum Stand der professionellen psychischen Betreuung Multiple-Sklerose-Kranker.

Over a period of two years, a total of 847 patients with multiple sclerosis (283 male and 564 female aged 18 to 79 years) were interviewed relative to the psychological care provided. Two patients currently participated in regular client-centered group therapy, 11 patients had regularly attended individual or group psychotherapy in previous years, and one patient had undergone family therapy several years ago. Another 26 patients reported occasional supportive counselling by their neurologist or family doctor in the framework of outpatient care. Ten patients used relaxation techniques such as autogenic training, and 42 patients reported emotional benefit from contacts within an MS self-help group. The findings of our study show that professional psychological care of persons with MS is extremely sparse, substantiating the call for better psychological services in coping with MS.

Circulating TSH-binding inhibiting immunoglobulins in myasthenia gravis.

Using a radioligand receptor assay the sera of 46 patients with myasthenia gravis (MG) were tested for the presence of circulating TSH-binding inhibiting immunoglobulins (TBII). In addition thyroid function was evaluated on the basis of T3, T4, TBG and TSH radioimmunoassays including the TRH stimulation test. Circulating antimicrosomal and antithyroglobulin thyroid antibodies were measured by haemagglutination techniques. Two patients had concomitant Graves' disease (GD), 5 were euthyroid with autonomously functioning thyroid tissue due to non-immunogenic multinodular goitre and 39 myasthenic patients were euthyroid with normal pituitary thyroid axis. Only 1 patient with GD had strongly positive TBII-activity and 3 euthyroid MG patients were TBII borderline-positive.

Search for canine-distemper-virus antibodies in multiple sclerosis. A detailed virological evaluation.

Sera and cerebrospinal fluid samples from multiple-sclerosis (MS) patients, matched controls, and subacute sclerosing panencephalitis (SSPE) patients were analysed for the presence of antibodies specific for measles and canine distemper virus (CDV). Virus-specific antibodies were identified by haemagglutination inhibition, neutralisation, and immune precipitation in combination with polyacrylamide-gel electrophoresis. SSPE and MS patients had a higher antibody activity towards measles virus than controls. Moreover, human sera partly neutralised CDV; this was attributed to antibody activity against CDV proteins, antigenically related to those of measles virus. However, CDV-specific antibodies were not found in the samples tested. These findings indicate that MS can develop without a preceding CDV infection.

Measles-virus-specific immunoglobulin-M response in subacute sclerosing panencephalitis.

Measles-virus specific IgM and IgG responses in sera and cerebrospinal fluid (C.S.F.) of 20 patients with subacute sclerosing panencephalitis (S.S.P.E.) and of two control groups were examined by indirect radioimmunoassay. All S.S.P.E. patients, regardless of the stage of the disease, had high titres of anti-measles antibodies in sera and C.S.F. The antibody activity was associated with both the IgM and the IgG classes of immunoglobulins. In 7 (35%) of the S.S.P.E. cases the specific IgM response was more pronounced in the C.S.F. than in the serum, suggesting IgM production within the central nervous system. The two control groups did not have a specific IgM response in C.S.F. or serum. It is assumed that the continuing release of measles antigen in S.S.P.E., as the result of the persistence of virus virus in the central nervous system, pevents the shut-off of IgM synthesis and is responsible for the specific IgM activity. It is proposed that the detection of virus-specific IgM antibodies in the C.S.F. of patients with chronic diseases of the central nervous system can be taken as an indication of persistence of virus.

Phenotypic consequences of low arylsulfatase A genotypes (ASAp/ASAp and ASA-/ASAp): does there exist an association with multiple sclerosis?

Arylsulfatase A (ASA) pseudodeficiency does per definitionem not lead to metachromatic leukodystrophy. It is conceivable, however, that it may contribute to the susceptibility for more common, multifactorial disorders of the nervous system. In order to examine whether there is an association with multiple sclerosis (MS), the most common demyelinating disease, we screened 160 MS patients for ASA activity and looked for pseudodeficiency genotypes using polymerase chain reaction. Four homozygotes for the ASA pseudodeficiency allele were found among the MS patients, but only one in the control sample. Further studies are necessary to validate whether ASA pseudodeficiency is associated with MS.

[T3, T4, TSH and circulating antithyroglobulin antibodies in myasthenia gravis]. / T3, T4, TSH und zirkulierende Schilddrüsenantikörper bei Myasthenia gravis.

Myasthenia gravis (MG) is a rare neuromuscular disease which is known to be associated with hyperthyroidism at high frequency (3-10%). These investigations, however, are basing on studies of the basal metabolic rate, protein bound iodine (PBI) and the thyroidal radioiodine uptake. In our study (104 MG patients, 104 control subjects) we wanted to evaluate thyroid function on the basis of T3, T4, TBG and TSH radioimmunoassays and in addition we looked for the presence of circulating antithyroglobulin antibodies (Tab) and antimicrosomal antibodies (Mab). The following thyroidal states were disclosed: Thyrotoxicosis (5.8%), hypothyroidism (1.9%), preclinical hypothyroidism (3.8%) and euthyroidism (88.5%). Twenty-eight myasthenic patients were Mab-positive and twelve in addition Tab-positive. Comparing the twenty euthyroid antibody-positive MG-patients with euthyroid antibody-negatives no statistically significant differences were found in thyroid function parameters. It is discussed that part of the thyroid antibody-positive patients may have a symptomless autoimmune thyroiditis which is finally resulting in hypothyroidism via a preclinical hypothyroid status.