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7785475
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The relationship between gender, symptoms of bulimia, and tolerance for stress.
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University students completed a questionnaire that included a measure of bulimia and a measure of tolerance for stress. Women reported significantly more symptoms of bulimia and a lower tolerance for stress than did men. Women in their first year on campus reported significantly more symptoms of bulimia than those not in their first year. For both women and men, a greater number of bulimic symptoms was associated with lower levels of stress tolerance. The present results suggest that women in their first year on campus should be targeted in intervention and prevention activities for eating disorders and that the relationship between disordered eating and stress is the same for both women and men.
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7785472
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Human parathyroid hormone-(1-38) restores cancellous bone to the immobilized, osteopenic proximal tibial metaphysis in rats.
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The purpose of this study was to determine if human parathyroid hormone-(1-38) (hPTH(1-38)) can restore cancellous bone mass to the established osteopenic, immobilized proximal tibial metaphyses of female rats. The right hindlimbs of 6-month-old female Sprague-Dawley rats were immobilized by bandaging the right hindlimbs to the abdomen. After 30 days of right hindlimb immobilization, the rats were subcutaneously injected with 200 micrograms hPTH(1-38)/kg/day for 15 days (short-term treatment) or 75 days (longer-term treatment). Static bone histomorphometry was performed on the primary spongiosa, and both static and dynamic histomorphometry were performed on the secondary spongiosa of the right proximal tibial metaphyses. Immobilization for 30 days without treatment decreased trabecular bone area, number, and thickness in both primary and secondary spongiosa, and induced an increase in eroded perimeter and a decrease in tissue referent-bone formation rate in the secondary spongiosa. These changes reached a new steady state thereafter. Treatment with 200 micrograms hPTH(1-38)/kg/day for 15 days, beginning 30 days after immobilization, significantly increased trabecular bone area, thickness, and number in both primary and secondary spongiosa despite continuous immobilization when compared with controls. The short-term PTH treatment (15 days) significantly increased labeling perimeter, mineral apposition rate, and tissue referent-bone formation rate in the secondary spongiosa and stimulated longitudinal bone growth as compared with the controls. Longer PTH treatment (75 days) further increased trabecular bone area, thickness, and number as compared with controls and groups given short-term PTH treatment (15 days). The bone formation indices in the secondary spongiosa of the longer-term treated rats were lower than those of the short-term treated group, but they were still higher than those of controls. Our findings indicate that PTH treatment stimulates cancellous bone formation, and restores and adds extra cancellous bone to the established, disuse-osteopenic proximal tibial metaphysis of female rats with continuously immobilized right hindlimbs. These results suggest that PTH may be useful in treating disuse-induced osteoporosis in humans.
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7785471
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Morphologic stages in lamellar bone formation stimulated by a potent mechanical stimulus.
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The temporal stages of lamellar bone formation were studied using an animal model subject to up to 16 weeks of a controlled, externally applied load. The left ulnae of 15 adult male turkeys were functionally isolated via transverse metaphyseal osteotomies, while transcutaneous Steinmann pins permitted in vivo loading of the preparation via a servo-hydraulic actuator. For 5 days per week, the ulnae were exposed to 100 cycles per day of an applied load sufficient to cause a peak strain normal to the bone's longitudinal axis of 2000 microstrain (mu E). The contralateral limb was left surgically undisturbed and served as a baseline control. Following a loading period of 4, 8 or 16 weeks, ulnae were harvested and prepared for quantitative bone histomorphometry. Compared with each animal's contralateral ulna, the area of the experimental ulnae increased by 12.5% (+/- 5.6%) at 16 weeks. Periosteal mineral apposition rates in the loaded ulnae were significantly increased compared with control values, with a maximum rate of 6.0 +/- 3.4 microns/day at 5 weeks, slowing to 2.0 +/- 0.3 microns/day by 15 weeks. At 16 weeks, new bone was composed of primary and secondary osteons as well as circumferential lamellae, with osteocyte density and organization indistinguishable from that of the original cortex. Remnants of the initial woven bone response seen at 4 weeks remained clearly visible at both 8 and 16 weeks as diffusely labeled interstitial elements within the newly formed lamellar construct.(ABSTRACT TRUNCATED AT 250 WORDS)
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7785470
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Bone marrow cells are targets for the anabolic actions of prostaglandin E2 on bone: induction of a transition from nonadherent to adherent osteoblast precursors.
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Although prostaglandin E2 (PGE2) is known to stimulate bone formation in vivo, its mechanism of action is not well understood. Circumstantial evidence suggests that bone marrow cells (BMC) may well be involved in this, and in order to investigate this further we have studied the effect of PGE2 on proliferation and matrix synthesis in high-density BMC cultures and on colony-forming unit (CFU-f) formation efficiency by BMC in vitro. High-density cultures of BMC formed a collagenous, calcified matrix, synthesized osteocalcin and expressed alkaline phosphatase activity. The addition of PGE2 caused a concentration-dependent increase in total (but not specific) APase activity, cell number, and collagen accumulation. It was found that PGE2 need only be present during the first 48 hours of the culture period and that longer exposure had no additional effect. PGE2 also caused a concentration-dependent increase in CFU-f formation, and it was found that this was due to the recruitment of new mesenchymal precursor cells from the nonadherent fraction of the BMC. Once again, the presence of PGE2 for only the first 48 hours of the culture period was enough to precipitate a maximal response. We conclude that one mechanism for the anabolic actions of PGE2 may be the recruitment of OB precursors from a population of nonadherent mesenchymal precursor cells present in the bone marrow.
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7785468
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Discriminative value of biochemical markers of bone turnover in assessing the activity of Paget's disease.
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Clinical biochemical markers of bone turnover are usually increased in Paget's disease. However, the analysis of "new" markers, such as serum bone alkaline phosphatase (BAP), carboxy-terminal propeptide of type I procollagen (PICP), tartrate-resistant acid phosphatase (TRAP), telopeptide carboxy-terminal propeptide of type I collagen (ICTP), and urinary pyridinoline (PYR) and deoxipyridinoline (D-PYR), may improve the diagnostic efficacy and the evaluation of Paget's disease compared with conventional markers, such as serum total alkaline phosphatase (TAP) and urinary hydroxyproline (HYP). To evaluate the diagnostic accuracy and the changes of biochemical markers of bone turnover according to Paget's disease activity, we measured the levels of all these markers in three groups of pagetic patients classified according to their serum TAP activity: G-I, patients with serum TAP lower than 250 U/l (upper limit) (n = 15); G-II, patients with serum TAP between 251 and 500 U/l (n = 18); and G-III, patients with serum TAP greater than 501 U/l (n = 26). Serum TAP and BAP showed the highest diagnostic accuracy among the markers of bone formation with a sensitivity of 78% and 84%, respectively, when the specificity was 100%. Urinary PYR was the most sensitive marker of bone resorption. Also, urinary PYR showed the highest proportion of increased values in pagetic patients (73%) compared with urinary HYP (64%), urinary D-PYR (60%), serum ICTP (41%), or serum TRAP (39%). In pagetic patients with normal serum TAP activity (G-I), serum BAP concentration was increased in 60% of patients, and urinary PYR was increased in 40% of patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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7785469
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Relations between histologic indices of bone formation: implications for the pathogenesis of spinal osteoporosis.
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Wall thickness, a major determinant of trabecular thickness, falls with age and falls further in osteoporosis. To estimate the importance of defective osteoblast recruitment in the pathogenesis of this defect, we compared various histologic indices of bone formation in iliac bone biopsies in three groups of subjects--healthy premenopausal women, healthy postmenopausal women, and patients with postmenopausal osteoporosis and at least one non-traumatic vertebral compression fracture. Indices that reflect the frequency of activation of bone remodeling and consequent birth rate of new teams of osteoblasts (osteoid surface, mineralizing surface, osteoblast surface, and bone formation rate, all expressed per unit of bone surface) were each higher in healthy subjects who were postmenopausal than in those who were premenopausal, but lower in osteoporotic than in normal postmenopausal women. In each group, the primary surface measurements were significantly correlated with each other, but the correlation was less close in those with osteoporosis. Indices that reflect the average collective performance of individual teams of osteoblasts (mineralizing surface and osteoblast surface per unit of osteoid surface, mineral apposition rate, adjusted apposition rate, and wall thickness) were all lower in postmenopausal than in premenopausal normal subjects, and even lower in those with postmenopausal osteoporosis. The parameters of the regression lines relating bone formation rate to osteoblast surface were essentially the same in each group, indicating that bone formation rate per unit of osteoblast surface was unaffected by age or menopause, and was the same in osteoporosis as in healthy subjects of similar age.(ABSTRACT TRUNCATED AT 250 WORDS)
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7785466
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Regulation of parathyroid hormone messenger RNA levels by protein kinase A and C in bovine parathyroid cells.
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Secretion of parathyroid hormone (PTH) is regulated by Ca2+ as well as by protein kinases A and C. In this study we report that protein kinases A and C regulate PTH messenger RNA levels in vitro in dispersed bovine parathyroid cells. Incubation of bovine parathyroid cells with cholera toxin (10(-9) M), which activates adenylate cyclase and indirectly stimulates protein kinase A, increased PTH mRNA levels about 2-fold after 3 and 7 h incubation, but not at 24 h. Incubation with pertussis toxin (5 x 10(-9) M), which blocks the high-calcium-mediated inhibition of cyclic adenosine monophosphate accumulation in these cells, also reversed the inhibition of PTH mRNA levels at high Ca2+ (2.0 mM) with a marked increase in PTH mRNA levels. Pertussis toxin also increased PTH mRNA at a low extracellular Ca2+ concentration (0.7 mM) (4-fold increase) and a normal concentration (1.25 mM) (2-fold increase). Inhibition of protein kinase C both by staurosporine (1 x 10(-8) M) and by prolonged incubation with the phorbol ester phorbol 12-myristate 13-acetate (PMA) (1 x 10(-7) M), decreased PTH mRNA levels at 24 h, reaching approximately 40% and 5% of control, respectively. Staurosporine and PMA had no effect on PTH mRNA levels at 3 h. The inactive phorbol ester, phorbol 12-13-dibutyrate (PDBu), had no effect on PTH mRNA levels at 1 and 24 h. There were no changes in a control gene 18S RNA in these studies.(ABSTRACT TRUNCATED AT 250 WORDS)
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7785467
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Zinc is a potent inhibitor of osteoclastic bone resorption in vitro.
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It is well established that zinc, an essential trace element, plays an important role in growth and stimulates bone formation. However, the effects of zinc on bone resorption have received little attention. We studied its effects on isolated rat osteoclasts. Unexpectedly, osteoclasts were exquisitely sensitive to zinc, with a significant decrease in bone resorption occurring at concentrations as low as 10(-14) M. This effect was specific for zinc and was not observed with the other transitional or alkaline metals studied. There was no evidence of toxicity at concentrations up to 10(-4) M. Zinc also completely abolished the stimulatory effect of parathyroid hormone. Zinc is therefore a highly potent and selective inhibitor of osteoclastic bone resorption in vitro. The mode of action remains to be established and may represent a novel inhibitory mechanism in the osteoclast.
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7785465
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Upper extremity bone mass and osteoarthritis of the knees: data from the Baltimore Longitudinal Study of Aging.
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To examine the association of upper extremity bone mass with osteoarthritis (OA) of the knee, bilateral standing knee radiographs, taken between 1985 and 1991, in 430 Caucasian male and 266 Caucasian female subjects aged 40 years and above in the Baltimore Longitudinal Study of Aging, were read by one investigator for grade of OA using Kellgren-Lawrence scales. Several measures of upper extremity bone mass, size, and density, including combined cortical thickness (CCT), total width and percentage of cortical area of the second metacarpal, and bone mineral content (BMC), width, and density of the distal third of the left radius measured with single photon absorptiometry, were assessed at the same visit. In univariate analyses, men and women with definite knee OA were significantly older, men had significantly greater radial width, and women had significantly lower bone mass as measured by both CCT and BMC. After adjustment for age and body weight, however, men with knee OA had significantly higher BMC and radial width while neither of these measures of upper extremity bone mass and size was significantly associated with the presence of definite knee OA in women. Neither measure of upper extremity bone density was significantly associated with definite knee OA in either sex. These data suggest that, although men (but not women) with definite knee OA have significantly higher levels of adjusted radial bone mass and size, subjects with knee OA do not have significantly higher levels of adjusted bone mineral density at either upper extremity site.
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7785463
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Rat tail suspension reduces messenger RNA level for growth factors and osteopontin and decreases the osteoblastic differentiation of bone marrow stromal cells.
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We previously reported that bone marrow stromal cells produce insulin-like growth factors (IGF-I and -II), and that medium conditioned by marrow stromal cells stimulates osteoblast proliferation in vitro. The present study employed the rat tail-suspension model to unload the hindlimbs. It was designed to test the hypothesis that the development of osteopenia or osteoporosis could be due to a deficit in the osteogenic function of marrow stromal cells. Although tail suspension suppressed body weight during the first 3 days of an 11-day pair-fed study, the overall weight gain recorded by these animals was normal. Nevertheless, bone growth was inhibited by suspension. Similarly, the total adherent marrow stromal cell population harvested from the femurs and tibias was decreased by tail suspension, and only half the normal number of fibroblastic stromal cell colonies grew when they were cultured. The proliferation of alkaline-phosphatase-positive cells in the stroma was also inhibited. Northern hybridization revealed that the messenger RNA level for transforming growth factor-beta 2 and IGF-II in stromal cell was reduced by tail suspension. The production of IGF-II by marrow stromal cells was also decreased. The steady-state level of five different transcript sizes of IGF-I mRNA was altered differentially by tail suspension. Osteopontin mRNA was also reduced in marrow stromal cells from tail-suspended rats compared with the normal rats. These data suggest that skeletal unloading not only alters the mRNA level for growth factors and peptide production, but also affects the proliferation and osteogenic differentiation of marrow stromal cells. These changes may be responsible for the reduced bone formation in osteopenia and osteoporosis.
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7785464
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Effect of 1,25-dihydroxyvitamin D3 treatment on bone formation by transplanted cells from normal and X-linked hypophosphatemic mice.
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Bone cells isolated from the Hyp mouse, the murine homologue for hypophosphatemic vitamin D-resistant rickets, produce abnormal bone when transplanted to either normal or phosphate-supplemented Hyp mice. To assess whether correction of the bone formation by mutant cells transplanted into either normal or Hyp mice could be achieved in the presence of supraphysiologic serum concentrations of 1.25-dihydroxyvitamin D3 (1.25-(OH)2D3), recipient mice of both genotypes were infused continuously with 1.25-(OH)2D3 (0.2 micrograms/kg/day). Bone nodules present in transplants recovered after 14 days were characterized by measuring the osteoid thickness and volume. Administration of 1.25-(OH)2D3 to Hyp mice corrected the defective bone formation by normal cells but not by pair-transplanted Hyp cells, despite normalization of serum phosphate levels and 3-fold increases in serum 1.25-(OH)2D3. The osteoid thickness and volume in Hyp transplants into 1.25-(OH)2D3-treated Hyp mice were, however, markedly reduced down to values observed for Hyp transplants into recipient normal mice. Administration of 1.25-(OH)2D3 to normal mice improved further bone formation by mutant cells without affecting that by pair-transplanted normal cells. Administration of 24.25-(OH)2D3 (1 microgram/kg/day) combined with 1.25-(OH)2D3 to recipient mice of both genotypes prevented the sharp fall in serum 24.25-(OH)2D3 but was not more beneficial than 1.25-(OH)2D3 alone for improving bone formation by transplanted Hyp cells. These observations demonstrate an abnormal response of the mutant cells to the extracellular environment and support the concept of an intrinsic osteoblast defect in the Hyp mouse.
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7785462
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Autoregulation of inducible prostaglandin G/H synthase in osteoblastic cells by prostaglandins.
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Prostaglandins (PGs) have been postulated to amplify their own production by stimulating cyclic adenosine monophosphate activity, which in turn stimulates PG production. We examined regulation of messenger RNA levels for the inducible and constitutive prostaglandin G/H synthases, PGHS-2 and PGHS-1, in murine osteoblastic MC3T3-E1 cells, which express both PGHS-1 and PGHS-2, and in rat osteoblastic Py1a cells, which express only PGHS-2. Prostaglandins E2, F2 alpha, and D2 induced PGHS-2 mRNA in both cell lines under serum-free conditions and stimulated small increases in PGHS-1 mRNA levels in MC3T3-E1 cells. PGE2 (1 microM) increased the transcription rate of PGHS-2 mRNA 9-fold at 2 h in serum-free cells and also induced PGHS-2 protein. In the presence of arachidonic acid or serum, PGs also increased medium PGE2. Both forskolin, a protein kinase A activator, and phorbol 12-myristate 13-acetate (PMA), a protein kinase C (PKC) activator, have previously been shown to induce PGHS-2 mRNA in MC3T3-E1 cells, but in the present study only PMA induced PGHS-2 expression in Py1a cells. The induction of PGHS-2 mRNA in Py1a cells by PGs was inhibited by chelerythrine, a PKC inhibitor, and blocked by 24 h of pretreatment with PMA. The 2 h serum stimulation of PGHS-2 mRNA in MC3T3-E1 cells was inhibited 40-50% by three structurally unrelated nonsteroidal anti-inflammatory drugs (NSAIDs), suggesting that endogenous PGs also amplify PG production through induction of PGHS-2.(ABSTRACT TRUNCATED AT 250 WORDS)
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7785461
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Expression of bone morphogenetic protein-6 messenger RNA in bovine growth plate chondrocytes of different size.
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Bone morphogenetic protein-6 (BMP-6) is an osteoinductive factor that may have a regulatory role in the terminal differentiation of chondrocytes. We investigated the expression of BMP-6 messenger RNA in freshly isolated newborn calf rib chondrocytes separated by density gradient centrifugation into five highly enriched subpopulations at different stages of maturation as assessed by cell size and alkaline phosphatase activity. Expression of BMP-6 mRNA was compared with expression of type II collagen mRNA and type X collagen mRNA using Northern analysis. Type X collagen mRNA expression increased with increasing cell size whereas type II collagen mRNA varied little with cell size. BMP-6 mRNA expression was highest in small cells and lowest in the largest cells, which were maximally expressing type X collagen mRNA. This suggests that up-regulation of the BMP-6 gene may precede chondrocyte hypertrophy.
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7785460
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Physicochemical effects of a new slow-release potassium phosphate preparation (UroPhos-K) in absorptive hypercalciuria.
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A new slow-release, neutral potassium phosphate salt (UroPhos-K) has been formulated in order to minimize gastrointestinal side effects and avoid sodium-induced calciuria. It was tested in a prospective randomized, double-blind trial in a group of 21 kidney stone patients with absorptive hypercalciuria type I (AH). Twelve patients allocated to the UroPhos-K group received four tablets twice daily with breakfast and an evening snack providing 1240 mg of phosphorus and 63.5 mEq of potassium daily. Nine patients assigned to the placebo group received placebo tablets of the same appearance containing excipient only. Subjects were studied during a 3-day period in the hospital while consuming a constant metabolic diet containing 400 mg Ca, 100 mEq Na, and 800 mg P per day before and after 3 months of treatment. Treatment with UroPhos-K did not cause any significant gastrointestinal side effects; nor did it raise fasting serum K or phosphorus, or reduce hemoglobin or creatinine clearance. It was associated with a rise in urinary K from 46 +/- 7 to 98 +/- 9 mEq per day and phosphorus from 744 +/- 185 to 1535 +/- 112 mg per day (p < 0.001 each). UroPhos-K treatment reduced urinary Ca from 288 +/- 63 to 171 +/- 49 mg/day (p < 0.001), without altering oxalate excretion. It reduced the urinary saturation of calcium oxalate without altering that of brushite. Moreover, by increasing urinary excretion of inhibitors (citrate and pyrophosphate), it reduced the propensity for spontaneous nucleation of brushite (increased formation product of brushite) and inhibited crystal agglomeration of calcium oxalate.(ABSTRACT TRUNCATED AT 250 WORDS)
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7785459
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Bone density in young women is associated with body weight and muscle strength but not dietary intakes.
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Potential determinants of bone mineral density (BMD) were studied cross-sectionally in 115 healthy, sexually mature Caucasian women aged 18 years. Bone mineral density (Hologic QDR1000W) of the lumbar spine, proximal femur (five sites), and distal tibia and fibula; fasting blood and urine calcium biochemistry; serum sex hormone levels (follicular phase); nutrient intakes; aerobic fitness; trunk muscle strength; and habitual activity levels were measured. The effects of heredity were considered by measuring the BMD of 107 of the subjects' mothers. Simple and stepwise regression analysis were used to identify significant determinants of BMD at each of the regions studied. The analysis indicated that significant bivariate correlations exist between BMD at all sites and body weight (r = 0.23-0.47, p < or = 0.01), lean body weight (r = 0.34-0.46), trunk strength (r = 0.27-0.47), physical activity score (r = 0.20-0.25), and aerobic fitness (r = 0.29-0.45). Dietary calcium intake correlated significantly with BMD at the trochanter site only (r = 0.19), and none of the biochemical or hormonal indices measured correlated consistently with BMD at any site. Significant correlations between the BMD of mothers and daughters ranged from r = 0.43 at lumbar spine to r = 0.34 at the intertrochanteric site. Paired t-tests showed the daughters had significantly (p < 0.03) lower BMD than their mothers at the lumbar spine (98 +/- 12% [mean +/- SD]) and significantly higher (p < 0.002) BMD at the femoral neck, trochanter, and total hip sites (110 +/- 16%, 108 +/- 17%, 103 +/- 14%, respectively). When stepwise regression analysis included weight-corrected strength of the trunk flexor muscles (Corr Flex), weight-corrected aerobic fitness (Corr VO2max), physical activity score, and body weight, body weight was the only significant determinant of BMD at all sites. Corr Flex made significant contributions at all sites except the femoral neck, while Corr VO2max made additional contribution at the femoral neck, trochanter, total hip, and shaft of femur sites. These variables accounted for 13-27% of the variance in BMD. The addition of mother's BMD to these independent variables, in stepwise regression analysis, improved the prediction to 18-31% of the variance.
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7785458
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The relations between physical ability and bone mass in women aged over 65 years.
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In this cross-sectional study of 55 women (mean age 73.54 +/- 5.87), the magnitude of the relation between different indices of physical ability and confounding factors to bone density were determined. Physical fitness was assessed by direct measurement of maximal oxygen consumption (VO2 max), isokinetic muscle strength, and quadriceps and psoas muscle surfaces and densities using computed tomography. Anthropometry, chronological and gynecological ages, and dietary calcium intake were also recorded. The bone mineral density (BMD) was evaluated at the axial level (lumbar spine and proximal femur) and at the peripheral level (radius and tibia, cancellous and cortical compartments). Parameters related to physical ability proved to be the best predictors of BMD in radial and tibial cancellous compartments, spine, femoral neck, and trochanter, accounting for 15-27.5% of the total variance. The VO2 max was a major determinant of the femoral mineral density and one of the predictors of radial and tibial cancellous compartments. Psoas parameters were strongly related to spine mineral density and also constituted a predictor of radius (cancellous) and tibia mineral densities. The arm muscle strength could predict, though weakly, the BMD of axial skeleton, whereas thigh muscle strength only predicted the BMD of inferior limbs. No correlation was observed between current dietary calcium intake and BMD. Age-postmenopause and fertile life remained predictive of BMD at mostly cancellous sites, whereas anthropometry exerted important effects on radial and tibial cortices. The study suggests distinct sets of relations between physical ability and the BMD variables. Subjects with greater and denser psoas muscles had greater spine BMD, and those with higher VO2 max had greater proximal femur BMD.
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7785457
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Sources of interracial variation in bone mineral density.
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Many studies have demonstrated significant differences in bone mineral density between various racial groups. Although it has been suggested that differences in body weight contribute to such interracial variation, the artifactual effect of the skeletal size inherent in projectional absorptiometry methods has been largely ignored. We have measured bone mineral density by dual-energy X-ray absorptiometry in the lumbar spine and at three femoral sites in 200 premenopausal women of Chinese, Indian, European, or Polynesian origin (50 of similar mean age in each group). In the Chinese and Indian women the measured bone mineral density measurements (g/cm2) were similar, but significantly less, at all sites, than those of European women (p < or = 0.005). The European women were, however, significantly taller than both the Chinese and Indian women (p < 0.0001), and when the scale artifact of absorptiometry was removed by dividing the measured bone mineral density either by the height of the subject, or by the square root of the area over which the X-ray beam was projected, then the differences in mean bone mineral density between the Chinese, Indian, and European women were almost completely eliminated. The Polynesian women were significantly more obese (as judged from mean body mass index) than all the other groups (p < 0.0001) and had significantly greater bone mineral density at all sites than all the other groups both before (p < 0.0001) and after (p < 0.0001) correcting for the scale artifact.(ABSTRACT TRUNCATED AT 250 WORDS)
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7785456
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Ethnic differences in bone density in female South African nurses.
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In the United States, the higher prevalence of osteoporosis and the higher incidence of fractures in whites than in blacks may be attributed to the finding of lower bone density (BD) in both white children and adults. In South Africa, osteoporosis and fractures also occur more frequently in whites than in blacks. Appendicular BD has been found to be similar in black and white children in South Africa, but there is little information available on BD of adults in South Africa. This cross-sectional study aimed to assess changes in BD with age in adult females in South Africa and to assess possible differences in peak BD and in the rate of postmenopausal bone loss between blacks and whites. Data for 180 black and 184 white female nurses aged 20-64 years were analyzed. The distal radius bone density (RBD) was measured by single photon absorptiometry. The lumbar spine bone density (SBD) and the femur bone density (FBD) were measured by dual-energy X-ray absorptiometry. Blacks were shorter than whites (p = 0.0001), and blacks' weight, body mass index, and skinfold thickness increased with age. Peak SBD and RBD were similar in blacks and whites, but peak FBD was higher in blacks (p = 0.0001). This ethnic difference in peak FBD became apparent in the fourth decade. Peak FBD was similar in black and white subjects with normal body mass indices (p = 0.09), but in overweight subjects peak FBD was higher in blacks than in whites (p = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
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7785455
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Quantitative ultrasound and vertebral fracture in postmenopausal women. Fracture Intervention Trial Research Group.
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Quantitative ultrasound is a promising technique to evaluate fracture risk. To test the hypothesis that reduction of one ultrasound measurement, broadband ultrasound attenuation (BUA), is associated with an increased risk of vertebral fracture in postmenopausal women, we performed a cross-sectional analysis of 442 women aged 55-80 years enrolling in a clinical trial of alendronate. Prior to randomization, we obtained bone mineral density (BMD) measurements of the hip, spine, and whole body, radiographs of lateral lumbar and thoracic spine, and duplicate measurements of calcaneal BUA with a Walker Sonix UBA575. Vertebral fractures were defined by morphometry and semiquantitative reading by a radiologist. After adjustment for potential confounders, the relative risk of vertebral fracture was 1.8 (95% CI 1.4-2.3) for each standard deviation reduction in BUA; for each standard deviation reduction in BMD, the relative risk was 1.7 (95% CI 1.3-2.1) at the femoral neck, and 2.2 (95% CI 1.7-2.9) at the spine. Adjustment for hip, spine, or whole body BMD did not significantly alter the relation between BUA and vertebral fracture. For example, after adjusting for spine BMD, the relative risk of vertebral fracture was 1.5 (95% CI 1.1-2.0) for each standard deviation reduction in BUA. We conclude that low BUA is associated with the presence of vertebral fractures in postmenopausal women. The relation between BUA and vertebral fracture is similar to that observed for BMD and vertebral fractures. Furthermore, the relation between BUA and vertebral fracture persists after adjustment for BMD.(ABSTRACT TRUNCATED AT 250 WORDS)
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7785454
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Comparison of speed of sound ultrasound with single photon absorptiometry for determining fracture odds ratios.
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The purpose of this study was to compare the ability of ultrasound velocity measurement with that of single photon absorptiometry to determine the odds of history of fracture since age 40, for a population-based study. To do this we computed odds ratios and 95% confidence intervals for 809 women and 502 men, aged 50 years and older, who are participants in the prospective phase of the Saunders County Bone Quality Study. These participants received both the ultrasound and single photon absorptiometry bone measurements at the initiation of the study. In addition, a history of all fractures that had occurred to participants since age 40 was obtained. The two bone assessment methods were compared by examining the magnitude of the odds ratios, to determine which produces the highest estimate of the probability of odds of fracture, and by examining widths of the respective confidence intervals to show which estimate of odds ratio is the most precise. Ultrasound velocity estimates a higher probability of odds of both low-trauma fractures and all fractures than distal radius and ulna bone mineral content, but lower than bone mineral density at the same sites for both women and men. However, the ultrasound measure is more precise than bone mineral density, but less precise than bone mineral content. We conclude that ultrasound velocity is as good as single photon absorptiometry in estimating odds of fracture.
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7785453
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Ultrasound velocity, through bone predicts incident vertebral deformity.
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We followed 130 postmenopausal women without evidence of vertebral deformity by lateral spine radiographs on entry into study for 2 years, and repeat spine radiographs were taken at the end of that time. Incident deformities occurring within this 2 year period were detected by two methods, a level-specific radiogrammetric approach and visual inspection by skilled clinicians. Fourteen incident deformities were detected by the radiogrammetric method, and 19 by the clinicians. Ultrasound transmission velocity was measured at the patella in each subject on entry. Values for ultrasound velocity were significantly correlated with incident fracture occurrence, with individuals having velocity values more than one standard deviation below the mean for the group exhibiting from 3.3 to 4.6 times the probability of incident fracture as individuals with velocity values more than one standard deviation above the mean. Thus, low values for ultrasound transmission velocity at the patella detect yet-unexpressed bony fragility at the spine and predict future fracture.
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7785452
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Changes in the mast cell number and degranulation pattern during periovulatory period and after blocking gonadotrophin surge in mice ovarian compartments.
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Mast cell in the ovary of cyclic mice were observed in the ovarian medulla, hilum and bursa, but not in the cortex. A significant increase in the degranulation of mast cells was observed in the hilum and bursa but not in the medulla following the gonadotrophin (Gn) surge as compared with before the surge at proestrus. The results of pentobarbital treatment at proestrus imply the significant role played by estradiol 17-beta (E2) in inducing mast cells migration and degranulation, specially in the medullary, cortical and bursal region of the ovary. The results indicate differential regulation of mast cells number and degranulation in different ovarian compartments of mice.
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7785451
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Protein level in testes, kidneys and liver after AET or MEA treatment of mice.
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The adult male Swiss mice were treated intraperitoneally with AET (2-aminoethylisothiouronium Br.HBr) or MEA (cysteamine HCl), in a toxic dose of 400 mg/kg body weight. The measurements of the protein content in crude homogenates of testes, kidneys and liver were done every fourth hour throughout a 24-hour period. Treatment of mice with AET and MEA resulted in different patterns of temporal changes in the protein content in testes, kidneys and liver expressed in mg per 1 g of fresh tissue and per the whole organ weight. The extent and timing of the alterations in the protein level appeared to depend on the particular organ chosen and the thiol agent applied.
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7785450
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O2 transport in hypoxic albino rats of first and second generation.
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The generations of rats raised in normobaric hypoxia (10% O2 in N2) were observed for changes in their oxygen-hemoglobin affinity, hemoglobin content (Hb) blood O2 capacity and pO2-O2 content curves: the first generation (H1) and the second generation (H2). H1 rats possessed a lower O2-Hb affinity while H2 rats had a higher O2-Hb affinity than normoxic control rats. Hb was greater in both hypoxic groups, however, H2 rats showed a Hb lower than that of H1 rats. Both hypoxic groups showed a leftward shift of the pO2-O2 content curve. In pO2 range between 25 and 50 mmHg, H2 rats showed a shift greater than H1 rats. So in hypoxic conditions the H1 rat's ability to supply enough O2 to the tissues is smaller than that of H2 rats. In the rat's adaptation to hypoxia the Hb increase plays only a minor role while O2-Hb affinity increase constitutes a physiologically meaningful adaptation.
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7785449
|
Bradykinin-induced shifts in microhemodynamics, lymph production and flow in cat intestine; the effect of gut denervation.
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In experiments on anaesthetized cats increased doses of bradykinin were administered intraarterially into an innervated part of the small intestine perfused in situ with constant inflow. It is concluded that the main factor accelerating transcapillary fluid efflux and lymph flow in this region with bradykinin is the rise in permeability of gut capillaries. This is confirmed by elevation in capillary filtration coefficient which takes place on the background of an increase in capillary hydrostatic pressure (when the intestine is naturally blood supplied), as decrease in the latter (when the preparation is perfused under constant inflow). The gut denervation decreasing regional vascular tone modifies bradykinin-induced lymph flow and shifts of hemodynamics in the small intestine. In denervated small intestine when compared with innervated ones bradykinin causes less expressed increase in lymph production and capillary hydrostatic pressure, but more marked elevation in capillary filtration coefficient.
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7785448
|
Post-implantation fasting does not induce pregnancy failure in newly inseminated mice.
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The effect of food deprivation on the rate of pregnancy failure in newly inseminated mice was evaluated. The pre-implantation fasting for 48 h beginning on day 4 or 5 postcoitum induced a high rate of pregnancy failure in newly inseminated females. However, fasting for 48 h on day 6 had a moderate effect in inducing pregnancy failure. By contrast, females which were deprived of food on day 7 postcoitum exhibited a significant reduction in the rate of pregnancy failure. Pre-implantation fasting was highly effective in inducing pregnancy failure compared to that of post-implantation fasting. The results suggest that fasting (i.e. day 4 or 5 postcoitum)--induced depression in prolactin has resulted in failure of pregnancy and fasting at post-implantation period (i.e. day 6 or after postcoitum) has not been interfered with progesterone production by placenta.
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7785447
|
Three-dimensional (type I) microcrystals of detergent-solubilized membrane-bound gastric (H+, K+)-ATPase enzyme from hog and rabbit stomachs.
|
Multilamellar 3-dimensional (Type I) microcrystals of detergent-solubilized crude microsomes or purified protein preparations of membrane-bound gastric (H+, K+)-ATPase from rabbit or hog stomachs develop in media consisting of 0.1 M KCl, 20 mM imidazole, 5 mM MgCl2, 3 mM NaN3, 5 mM DTT, 25 IU/ml Trasylol, 2 micrograms/ml DTBpC and 20-40% glycerol, using nonionic detergent of C12E8 or BRIJ 36 for solubilization. Crystals developed in a pH-range of 6.0-7.25, during 3-10 days of incubation, at 2 degrees C. For C12E8, the most effective detergent:protein ratio for crystallization varied between (1.8-2.0):1 for the microsomes and between (0.25-0.75):1 for the purified preparations. The results of biochemical and structural analysis of the (H+, K+)-ATPase crystals showed close resemblance to those of the sarcoplasmic reticulum Ca(2+)-ATPase from skeletal muscle and plasmamembrane (Na+, K+)-ATPase from kidney (J. Biol. Chem., 269, 10107-111, 1994). Based on these identities and the high (62%) overall sequential homology to the (Na+, K+)-ATPase, we conclude that the new crystals of the (H+, K+)-ATPase could also contain only the alpha-chain of the alpha beta heterodimers found in the native membrane. High-resolution electron microscopy of frozen-hydrated crystalline (H+, K+)-ATPase samples are in progress to give unit cell dimensions and molecular packing of the new crystals.
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7785446
|
Methodological aspects in the studies on the mechanism of action of synthetic direct thrombin antagonists.
|
Requirements reported for an ideal anticoagulant [12] and for an ideal antithrombotic [18] show the necessity of many-sided methodological approach in order to detect the molecular mechanism of action of a novel synthetic antagonist of thrombin. The lack of a protocol internationally accepted, on the one hand, and with regard to a general proposal accepted [16], on the other hand, authors applied a complex methodological system involving also the study on the possible interactions at molecular level of some novel thrombin antagonists with the main components of their site of action. The surprising contradiction found between in vitro and in vivo efficacy of several antagonists could be attributed and explained by the significant differences in Ki and IC50 values determined in complex clotting assays containing plasma proteins and/or blood cells versus those measured in reaction mixtures consisting of a synthetic chromogenic substrate, the target enzyme, thrombin, and the antagonist compound in buffer solution.
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7785445
|
LB-145 a new radioactive isotope eliminating product with high selectivity.
|
LB-145 is a macrocyclic ligand, which forms, 200 times more stable complex with Stroncium (Sr) ions, than with calcium ones. The product is not toxic, it has no effect on circulation, respiratory system. 85,90Sr and 144Ce were given oral, i.p., s.c. or by inhalation, LB-145 either prophylactic or 30 (60) minutes after the radiointoxication i.v. or i.p. to the animals. The isotope contents of the organism were measured by whole body autoradiography, liquid scintillation, or by NK 350 ratemeter. One injection given prophylactic inhibited the incorporation of isotopes into the organism, within 24 hours after radiointoxication 75-80% of the isotopes were excreted by urine and faeces on the first day, 90-95% excreted on the first week. Also the isotope contents of femur and scissors were mobilised. The suggested human dose-0.5 g/70 kg bw-can be life-saving antihavaric injection.
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7785444
|
Changes in binding of monoclonal antibodies to TSH receptor following thyrotropin (TSH) and gonadotropin (GTH) pretreatments (studies on human thyroid and CHO cell lines).
|
Monoclonal antibody to TSH-receptor binds to the cells of human thyroid gland and to Chinese hamster ovary cell cultures. Pretreatments with TSH can decrease the binding of antibody, which effect is more expressed in CHO than in thyroid cells. Gonadotropin (FSH + LH) cannot influence the binding of antibody to thyroid, but there is an effect on CHO cells. Endotoxin (lipopolysaccharide, LPS) can depress the binding of antibodies on both objects and abolishes the difference between thyrotropin and gonadotropin receptors in their binding capacity, on both cell types. The experiments prove the similarity of thyrotropin and gonadotropin receptors which is responsible for the hormonal overlap.
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7785443
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Administration of benzpyrene and allylestrenol in fetal or neonatal periods of life: does it make difference in the microsomal activity?
|
Administration of allylestrenol or benzpyrene in fetal and neonatal periods of life make the rats susceptible to phenobarbiturate induction. Changes to controls could be observed in three of the enzyme activities tested (p-nitrophenol-hydroxylase, cytochrome P450 and aniline-hydroxylase), with a dominance of the p-nitrophenol-hydroxylase among them. There seemed to be no difference in the action of allylestrenol and benzpyrene, although treatment protocol in the neonatal period proved to be more effective.
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7785442
|
Adaptive control in drug therapy.
|
In medical practice, drugs are administered with the goal of attaining a therapeutic effect without exceeding predetermined safety limits on any adverse action. This paper is intended to provide an introduction to pharmacokinetic-model based adaptive control of drug levels that can be of use in achieving such therapeutic objectives. The principles are illustrated by the problem of providing rapid relief of acute asthmatic symptoms by infusing theophylline.
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7785441
|
Pharmacokinetic study on a new antiischaemic agent (BRLP-42).
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In the present study the pharmacokinetics of BRLP-42--a new antiischaemic agent--was investigated in dogs and rats. Plasma concentrations were measured by HPLC. After intravenous application the curves can be characterized by a two-compartment open pharmacokinetic model. The central volume of distribution (Vcentr.) is large (1.07 +/- 0.14 l/kg in dogs and 2.74 l/kg in rats), the first elimination half-life (t1/2 alpha) is 5.47 +/- 1.67 min in dogs and 13.7 min in rats. These facts indicate rapid and large tissue distribution. The excretion and/or metabolic elimination of BRLP-42 resulted in short second elimination half-life (t1/2 beta = 41.45 +/- 2.34 min in dogs and 43.8 min in rats). After oral application high individual variability can be seen. This fact may be due to the different rate and/or extent of absorption process. The plasma level curves can be characterized by a one-compartment open pharmacokinetic model. The absorption seems to conceal the distribution phase of the kinetic curve. The absorption half-life was short (t1/2a = 17.36 +/- 5.90 min in dogs and 2.7 min in rats). The bioavailability was 40 +/- 8% in dogs and 28% in rats. The elimination half-life (t1/2e = 28.77 +/- 0.88 min in dogs and 30.1 min in rats) is connected dominantly with metabolic elimination and/or excretion of BRLP-42. In the cases of intravenous as well as oral administrations the plasma concentrations decreased under the limit of quantitation by 4-6 hours in dogs and 4 hours in rats after treatments.
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7785440
|
The combined cardiovascular effect of alcohol and noise in rats.
|
Groups of 20 CFY male rats were made to drink water containing 10% alcohol and 5% sugar or 5% sugar. Half of both groups (10-10 animals) were exposed to 95 dBAeq mixed industrial noise for 3 weeks, 6 hours daily. Haemodynamic measurements were carried out using isotope (57Co) labelled microspheres, which were repeated after the i.v. administration of 30 micrograms/kg/3 min noradrenaline, using a second isotope (113Sn). It was found, that alcohol decreased the cardiac fraction of the cardiac output, the nutritive blood flow of the myocardium and increased the vascular resistance of the adrenals. Noise decreased the lung fraction of the cardiac output and the hepatic blood flow. Interaction between noise and alcohol, inhibiting the effect of alcohol, was demonstrated on the intestinal blood flow, adrenal fraction of cardiac output and testicular vascular resistance. The haemodynamic effects of noradrenaline observed in the control were in several organs more or less modified in the animals treated with alcohol or noise or both. It was concluded that the exposures (alcohol, noise or both) modify the alpha-adrenergic effect of noradrenaline.
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7785439
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Demonstration of the potassium channel opening activity of GYKI-12743 by 86Rb+ efflux studies.
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It has been demonstrated that the novel antihypertensive compounds GYKI-12743 showed a potassium channel opening effect as studied in rabbit ear arteries with 86Rb+ as K+ marker. GYKI-12743 produced a concentration dependent 86Rb+ efflux in the same concentration range as the well-known K(+)-channel openers, pinacidil and cromakalim.
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7785438
|
[Effects of berberine on platelet aggregation and plasma levels of TXB2 and 6-keto-PGF1 alpha in rats with reversible middle cerebral artery occlusion].
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Berberine (Ber) 20 mg.kg-1.d-1 for 1, 3, or 5 d inhibited platelet aggregation induced by ADP, arachidonic acid (AA) and collagen (Coll) in rats with 24 h reversible middle cerebral artery occlusion (MCAO), and the platelet adhesiveness was inhibited as well. Using radioimmunoassay method, the thromboxane B2(TXB2) and 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) contents in rat plasma were measured 24 h after MCAO. The results indicate that the TXB2 levels after drug treatment were lower than those in ischemia control rats, but the 6-keto-PGF1 alpha levels showed no obvious difference between the two groups. The same dose of Ber was also shown to inhibit thrombosis formation. This suggests that the decline of platelet aggregation and decrease of TXB2 content may be one of the important factors involved in the anti-cerebral ischemia effect of Ber.
|
7785436
|
[Effects of tetrandrine on cardiac hemodynamics of hypertrophied left ventricle from deoxycorticosterone-salt hypertensive rats].
|
Effects of tetrandrine (Tet) on cardiac mass and hemodynamic parameters were studied in deoxycorticosterone-salt (DOCA-salt) hypertensive rats. Treatment with Tet (50 mg.kg-1, qd x 9 wk) markedly lowered systolic blood pressure and left ventricular (LV) weight. Study on isolated working heart demonstrated that the Tet group compared with the LVH group, AP, LVSP, +/- dp/dtmax, LVDP, coronary blood flow and cardiac output were increased while LVEDP and T were decreased. Studies on LV pressure-volume relation showed that Tet can markedly improve the LV compliance and the LV stiffness constant of LVH rat. These findings suggest that the regression of LVH in DOCA-salt hypertensive rats with Tet is associated with improvement of the contraction, relaxation and pump function, especially relaxation function and hemodynamics.
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7785437
|
[Tyr-D-Ala-Gly-Phe-D-Leu (DADL) solid-phase synthesis and its effects on immune function].
|
DADL, a delta-receptor selective enkephalin analogue, was prepared with the technique of solid-phase peptide synthesis. It was found to stimulate directly the proliferation of mouse splenic lymphocytes dose-dependently. However, synergistic effect of DADL at different concentrations with ConA and LPS were not found. In addition, TNF-alpha production was increased by ip DADL (1.0 mg.kg-1 x 6 d) in mice and the production of LPS-induced TNF-alpha in mouse peritoneal macrophages was enhanced after DADL was added in vitro. These results suggest that DADL, like enkephalins, exerts some immunoregulatory activities.
|
7785435
|
[Inhibition of chemically induced microvascular leakage by ONO-1078, a leukotriene antagonist, in rat skin].
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This study is to determine whether ONO-1078, a potent leukotriene antagonist, influences chemically induced rat skin microvascular leakage which is considered to be, at least in part, due to stimulation of sensory nerve ending and release of sensory neuropeptides. Evans blue dye was used as a tracer for plasma leakage. Intradermal injections of chemical stimuli, histamine (10 micrograms), capsaicin (10 micrograms) and formalin (0.5 mg), evoked Evans blue dye extravasation in rat skin. Intraperitoneal ONO-1078 dose-dependently inhibited the dye extravasation induced by these stimuli, with ID5v values of 1.98 mg.kg-1 for histamine, 1.78 mg.kg-1 for capsaicin, and 2.23 mg.kg-1 for formalin. In contrast to chlorpheniramine, a H1 receptor antagonist, the inhibitory effect of ONO-1078 was weaker on histamine, but more potent on capsaicin and formalin. The inhibitory effect of dexamethasone was more potent than that of ONO-1078 on these stimuli. On the other hand, ONO-1078 inhibited the dye extravasation induced by leukotriene D4 (0.05 micrograms), but showed no effect on those induced by substance P (0.5 micrograms, a sensory neuropeptide), a larger dose of histamine (100 micrograms), and bradykinin (1 microgram). These results suggest that inhibition of chemically induced skin microvascular leakage by ONO-1078 may be mediated by inhibiting the release of sensory neuropeptides from capsaicin-sensitive sensory fibers.
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7785434
|
[Comparison of multiple dosage bioavailability between phenylpropanolamine controlled release suspension and conventional tablet in healthy volunteers].
|
Compared studies between the pharmacokinetics of phenylpropanolamine (PPA) controlled release suspension (CRS) and that of PPA conventional tablet in 10 healthy volunteers showed that the maximal plasma concentration (Cmax), the minimal plasma concentration (Cmin) and the fluctuation index (FI) values were 169.06 +/- 7.76 ng.ml-1, 82.80 +/- 4.29 ng/ml-1 and 0.20 +/- 0.04 respectively for PPA CRS, 180.5 +/- 8.91 ng.ml-1, 76.18 +/- 5.97 ng.ml-1 and 0.81 +/- 0.07 respectively for the conventional tablet. The Cmax and FI of PPA CRS were significantly lower compared with those of the conventional tablet (P < 0.01) during steady state. The Cmin of PPA CRS was higher than that of the conventional tablet (P < 0.05).
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7785433
|
[Synthesis of Achyranthes bidentata polysaccharide sulfate and its antivirus activity].
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Sulfation of Achyranthes bidentata polysaccharide (Abps) with sulfuric acid or sulfur trioxide-pyridine or chlorosulfonic acid-pyridine was studied. A homogeneous sulfation method with good yield of 82.11% was obtained, using chlorosulfonic acid in an excess of pyridine. Sulfated Achyranthes bidentata polysaccharide was obtained as an amorphous sodium salt easily soluble in water. The UV and IR spectrum of Abps sulfate showed absorptions at 208, 268, 286 nm and 1232, 823.6 cm-1 respectively. The sulfur content of the products was found to be 20-22%. The degree of substitution varied from 2.8 to 3.2. It showed that the hydroxy group of Abps was almost completely esterified by chlorosulfonic acid. The Abps sulfate was shown to have high activity as anti-HBsAg and HBeAg. It is also effective on simple herpes virus type-I.
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7785432
|
[Antiulcer effect of polycyclicamine compound HH01 on experimental gastric ulcer in rats].
|
HH01(1-methyl-3,4,5,6,9,10-hexahydro-7H-cyclopenta [j,k]-1,3-dioxolo [4,5-h]-pyrrolo[2,1-b] [3]-benzazepine) A and B in doses 30 mg.kg-1 and 60 mg.kg-1 were shown to protect gastric mucosa of rats from damage induced by absolute ethanol, cold-immersion stress and pylorus ligation. No effect was found in indomethacin model in mice. HH01 was found to decrease secretion of gastric juice and HCl in pylorus ligated rats. The content of DNA in gastric juice of animals treated with HH01 was lower than in control. The results suggest that HH01 is effective as an anti-ulcer agent, but its mechanism of action is yet unknown.
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7785431
|
Autonomic dysfunction in pathologically confirmed multiple system atrophy and idiopathic Parkinson's disease--a retrospective comparison.
|
Autonomic dysfunction (AD) can be a feature of both multiple system atrophy (MSA) and idiopathic Parkinson's disease (IPD), conditions that are frequently misdiagnosed in life. Most studies on AD in MSA and IPD are based on clinical cases without pathological verification. We retrospectively analysed AD in 135 pathologically confirmed cases of IPD and in 33 of MSA from the UK PD Society Brain Bank. MSA started at a younger age than IPD (54.4 +/- 10.7 yrs versus 60.6 +/- 10.8 yrs), and AD began earlier in the course of the illness All MSA patients had some degree of AD in life whereas AD was absent in 24% of IPD patients. Although each of five autonomic domains was affected in variable numbers of IPD patients, AD in MSA generally involved more autonomic domains than in IPD, and to a more severe degree, in particular with regard to inspiratory stridor. These results indicate that the presence of autonomic disturbance alone does not distinguish between MSA and IPD in individual cases. However, the presence of severe AD, of AD preceding parkinsonism, or of inspiratory stridor, are all individually suggestive of MSA.
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7785430
|
Levodopa use in Denmark: high levels in Greenland and the Faroe Islands. Europarkinson Preparatory Activity Research Group.
|
Levodopa (LD) sales from wholesalers to pharmacies during the periods, 1977-1989 in Denmark, 1981-1989 in Greenland, and April 1988-May 1989 in Danish counties and the Faroe Islands, were evaluated using a reported method and a procedure expressly developed for assessment of random variation comparative levodopa use (LDU) measurements. The reference population for comparison of LDU was the Swedish from 1984. LDU diffusion had stabilized by 1989 in Denmark, but considerable annual increments of LD sales were still seen in Greenland in 1989. Crude LDU in Denmark and most Danish counties amounted to a level similar to that of Sweden. Adjustments for age and infant mortality rates, taken as an indicator of socioeconomic development, disclosed statistically significant twofold levels of LDU in the Faroe Islands and Greenland, and lowest LDU in urban regions. The social or biological factors underlying such differences in drug use remain unknown.
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7785429
|
High levodopa use in periodically time-clustered, Icelandic birth cohorts. A vestige of parkinsonism etiology? Europarkinson Preparatory Activity Research Group.
|
We evaluated levodopa use (LDU) by the Icelandic population focusing on: 1) annual gross levodopa (LD) sales from wholesalers to pharmacies for the period 1978-1990, using a reported method; 2) data from a prescription survey conducted from October 1st, 1990 to March 31st, 1991; and 3)raw and reported data on prevalences of Parkinson's disease (PD) in 1963 in this country. The standard for adjustments and reference population for LDU comparisons was the Swedish in 1984. Crude gross sales of LD in Iceland in 1990 and in Sweden in 1984 amounted to 1.67 and 1.35 DDD/1000 person days respectively. After respective adjustments for age, and for age and the infant mortality rates, taken as an indicator of health care quality, LDU in Iceland in 1990 was found to be 1.82 and 1.63 (95% CI 1.47-1.89) times that for Sweden. Prevalences of LD-prescription recipients in 1990-1991 and of PD in 1963 increased with age; however, those of drug users were higher than those of PD among the elderly. Higher-than-expected prevalences of PD and LD-prescription users (there being a partial overlap between these two categories) were found in periodically-clustered, one-year birth cohorts. These results support the notion that Iceland has a high LDU and suggest that this variation is due to a high prevalence of LD responsive disorders. Cohorts born after registered whooping cough outbreaks in Iceland may account for the magnitude and birth-related pattern of PD prevalences and LDU levels.
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7785428
|
Regional cerebral glucose metabolism in autopsy-confirmed Creutzfeldt-Jakob disease.
|
Regional cerebral glucose metabolism was measured in a 72-year-old man, with Creutzfeldt-Jakob disease (CJD), by positron emission tomography using [18F]-2-fluoro-2-deoxy-D-glucose as the tracer. The diagnosis of CJD, a rare neurodegenerative disorder, was confirmed at autopsy 13 months later. Compared with five unaffected elderly men, the patient had reduced metabolism heterogeneously distributed throughout the brain. The hypometabolism was most evident in the right hemisphere, particularly in the posterior frontal, parietal, Sylvian, and temporal regions. This left-right asymmetry is more extensive than that previously reported in Alzheimer's disease, and may provide a useful metabolic marker for early diagnosis of CJD.
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7785427
|
Absence of 4,977-bp deletion of blood cell mitochondrial DNA in patients with young-onset Parkinson's disease.
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Decreased mitochondrial Complex I activities and a 4,977-bp deletion in mitochondrial DNA (mtDNA) have been reported in patients with Parkinson's disease. Based on the assumption of possible links between this 4,977-bp deletion and the etiology of Parkinson's disease, we analyzed mtDNA of blood cells from 15 patients with young-onset Parkinson's disease after the DNA was amplified by polymerase chain reaction. We could not detect the 4,977-bp mtDNA deletion in any of these patients. This result suggests that Parkinson's disease is not a mitochondrial disease due to the 4,977-bp mtDNA deletion. The 4,977-bp deletion in mtDNA appears to be an age-related phenomenon.
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7785426
|
Microsatellite D21S210 (GT-12) allele frequencies in sporadic Alzheimer's disease.
|
Four disease-causing mutations have so far been described in the amyloid precursor protein gene on chromosome 21 in familial early-onset Alzheimer's disease. Linkage analysis with a fourteen-allele microsatellite at D21S210 named GT-12 has proven useful in the elucidation of amyloid precursor protein gene involvement in Alzheimer's disease families, as it is closely linked to the gene. Most cases of Alzheimer's disease are thought to be sporadic and not familial. However, evidence from earlier studies suggests an important genetic contribution also in sporadic cases, where gene-environment interaction may contribute to the disease. We have determined frequencies of the GT-12 alleles in 78 Swedish and 49 British sporadic Alzheimer's disease cases and 104 healthy elderly control subjects, to investigate if the disease associates with a particular genotype in GT-12. However, no differences in allele frequencies were observed between any of the groups.
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7785424
|
Immunocytochemical detection of tumor necrosis factor-alpha in infiltrating tumor cells in the cerebrospinal fluid from five patients with leptomeningeal carcinomatosis.
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We studied the immunoreactivity for tumor necrosis factor-alpha (TNF-alpha) in cerebrospinal fluid (CSF) cell smears from five patients with leptomeningeal carcinomatosis (LC). Immunostained TNF-alpha-positive tumor cells had brownish deposits in the cytoplasm, but no deposits were observed in the nucleus. The intensity of the TNF-alpha staining was greater in these tumor cells than in macrophages from patients with inflammatory diseases. Approximately 27-72% of the tumor cells were found to be TNF-alpha immunoreactive in all five samples from the patient with LC. These results suggest that the large amount of TNF-alpha produced by infiltrating tumor cells may play an important role in the development of the tumor.
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7785425
|
F wave in acute cerebellar damage.
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Studies of occurrence of the F wave can be considered as a method of assessment of excitability of the spinal cord motoneurones. So far it has been analyzed in relation to the damage to the pyramidal and extrapyramidal systems. In the present paper, various parameters of the F response (maximal and mean amplitude-absolute and in relation to the M response, frequency of occurrence of all and identical F waves, minimal latency and chronodyspersion) were given analysis in 15 patients with hypotonia after acute cerebellar damage, and in 35 healthy subjects. In the patients, the F response was found to be decreased in amplitude (mean-absolute and ratio to M) and in frequency. Therefore, a conclusion can be drawn that it confirms the decrease of segmental motoneurone excitability after cerebellar damage.
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7785423
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A syndrome of olivopontocerebellar atrophy and deafness with onset in infancy.
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Olivopontocerebellar atrophy (OPCA) is rare in childhood and onset in infancy is uncommon. We encountered 11 consecutive children with clinical and radiological features of OPCA which started in infancy. In addition to cerebellar ataxia, these children also had sensorineural deafness and speech impairment. Of the present cases, 8 were sporadic and the pedigree patterns in 3 (with a sibling also involved) point to an AR inheritance. The CT scan showed varying degrees of cerebellar and pontine atrophy. The underlying genetic and neurochemical substrates of this syndrome await further study.
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7785422
|
Recurrent hypertensive intracerebral hemorrhage.
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Hypertensive intracerebral hemorrhage has been considered as a one-time event with rare recurrence. This observation is quite different from our experience in Taiwan. We, therefore, conducted a systematic review of our series of consecutive patients with recurrent bleeding. During a 2-year period, we encountered 47 patients with recurrent hypertensive intracerebral hemorrhage from a total of 892 consecutive patients with hypertensive hemorrhage (5.3%). There were 25 men and 22 women with a mean age of 59 +/- 10 (range: 36-78) years at the onset of the first hemorrhage and 62 +/- 9 (range: 39-80) years at the second hemorrhage. The median interval between 2 hemorrhages was 2 years and 4 months (range: 1 month to 8.5 years). All except one recurrent hemorrhages occurred at a site different from the previous one. Of the 38 patients admitted to our hospital for both hemorrhages only 5 were regularly treated with antihypertensive therapy. The outcome for the recurrent bleeding was grave: 26% died and 51% became totally dependent or vegetative. Recurrent hypertensive hemorrhage is not as rare as previously thought; it comprises 5.3% of our patients with hypertensive intracerebral hemorrhage. The recurrent hemorrhage, however, rarely occurs at the same location as the previous one. Uncontrolled hypertension appears to be an important risk factor for the recurrence. Control of blood pressure after the first bleeding should be attempted to prevent recurrent hemorrhage.
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7785420
|
Guillain-Barré syndrome in south-west Stockholm, 1973-1991, 1. Quality of registered hospital diagnoses and incidence.
|
We describe the incidence and explore the quality of registered diagnosis for Guillain-Barré syndrome (GBS) in a population-based retrospective study in South-West Stockholm (SWS), Sweden, during the period 1973-1991. We used data on registered hospital discharges and open-care visits, and from medical records. Medical records were available for 83 (80.6%) of 103 patients with registered GBS diagnosis at discharge from hospitals. For 69 (83.1%) of such patients, the information from the hospital record fulfilled the National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) clinical criteria for GBS. One out-patient presented with suspected GBS. In contrast, none of 40 patients discharged with diagnosis of unspecific polyneuropathy fulfilled the above mentioned criteria. During the period 1973-1991, the mean annual incidence of GBS per 100,000 was 1.74, 95% CI 1.41-2.12, from register data and 1.49, 95% CI 1.19-1.85, after excluding those not fulfilling criteria for GBS. The age-adjusted incidence after validation was higher for men, 1.64, 95% CI 1.19-2.21, than for women, 1.46, 95% CI 1.05-1.99. An increasing incidence with age was found, presenting the age-specific curve a bimodal shape. The results of this study confirm that hospital discharge diagnostic data in Sweden can be used for purposes of epidemiological research and surveillance for GBS, and show that the incidence of GBS in SWS compares to those described in other populations.
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7785421
|
Rasch analysis in the development of a rating scale for assessment of mobility after stroke.
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The study describes the development of a rating scale for assessment of mobility after stroke. It was based on 74 first-stroke patients, 40 men and 34 women, each assessed three times during rehabilitation. Their median age was 69 years, and they represented all degrees of severity of paresis. Content, construct, criterion and convergent validity were examined, as well as the inter-rater reliability. The final rating scale has three special characteristics: 1) it reflects the regularity in the recovery of mobility after stroke; 2) the sum of item scores comprises the information contained in the 10-item subscores; 3) the score sum is independent of age, side of hemiparesis, and gender of the patient. Latent trait analysis (Rasch) was found to be an ideal model for statistical investigation of these properties.
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7785419
|
Inhibitory motor seizures: correlation with centroparietal structural and functional abnormalities.
|
Six adults and 2 children with focal inhibitory motor seizures (ictal paralysis) were evaluated during a 4-year period. Paresthesias at seizure onset occurred during some seizures in all patients, and focal clonic activity followed paralysis in 4. EEG-CCTV recordings of the seizures in 2 patients showed that ictal paralysis coincided with an ictal discharge starting in one centroparietal area. MRI showed centroparietal structural lesions in six patients. One patient with a normal MRI scan had right centroparietal hypometabolism on PET. Inhibitory motor seizures must be differentiated from transient ischemic attacks and migraine. In our patients a centroparietal epileptogenic focus was suggested by neuroimaging studies, and in 2 instances by ictal EEG.
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7785418
|
Morphological studies on the kidney of the spontaneous nephrotic (ICGN) mice in the late stage.
|
Spontaneous nephrotic (ICGN) mice develop proteinuria, hypoproteinemia and hypercholesterolemia. These symptoms steadily progress to chronic renal failure. Details of the changes of the kidney, in the late stage (more than 5 months old) were investigated by both light and electron microscopy. The kidney exhibited a slightly whitish, granular surface and the cortex became thinner and contained fibrous lesions, in which clusters of unaffected and occluded renal tubules were randomly scattered. In the juxtamedullary and outer medullary zone, there were highly dilated renal tubules, which sometimes contained urinary casts. The glomerulus exhibited basement membrane thickening in the capillary loops and the capillary lumen was narrowed in size and sometimes occluded. No detachment of the podocyte from the basement membrane was observed and the podocyte foot-processes were extensively fused, causing their characteristic slits to be lost. The thickened basement membranes were found both in the glomerulus and around the occluded renal tubules, while the basement membrane in the dilated renal tubule appeared normal. Therefore, the basement membranes of the glomerulus and renal tubules appear to react differently in the pathogenesis of the condition. In conclusion, ICGN mice are a good model for not only the nephrotic syndrome but also for chronic renal failure.
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7785417
|
Fine incremental lines observed on the enamel surfaces with a prismless structure in human teeth after phosphoric acid etching.
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In human tooth enamel, the surface prismless layer contains liner laminas homologous to the cross-striations of enamel prisms other than the Retzius lines, while these lines terminate on the perikymata or run in parallel with the enamel surface. In our present scanning electron microscope observations after phosphoric acid etching, many fine incremental lines (FIL) running transversely were found on the inner occlusal enamel with a prismless structure in a young permanent premolar. Almost the same structures were also found on the upper-coronal enamel with scattered prismless and indistinct prism structures in an exfoliated deciduous molar, and the FIL occasionally went across the indistinct prisms or caused the lower half of the prisms to disappear. Their intervals ranged from about 0.5 to 2 microns; less than the diameter of the prisms. Such results suggest that the FIL are not the termination of the laminate striations in the surface prismless layer, but that the previously unnoticed patterns sometimes formed by the sequential completion of the activity of ameloblasts which interact with each other in a transverse row at the final stage of matrix formation.
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7785416
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Agenesis of the celiac trunk: an angiographic case.
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In the angiography performed for a clinical diagnosis, a unique case of "agenesis of the celiac trunk" was encountered in a 42-year-old Turkish male. There was instead an artery which arose from the aorta at the level of the first lumbar vertebra, and supplied blood to the territory of both the celiac and superior mesenteric arteries by giving rise to the splenic, the jejunal, the ileal, the pancreaticoduodenal, the proper hepatic and the left gastric arteries, consecutively.
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7785415
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Lateral plate mesoderm and guidance cues for cutaneous nerve growth in the avian body wall.
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Transplantation of the somatic layer of the lateral plate mesoderm (somatic mesoderm) was performed using the quail-chick chimera system in order to evaluate whether the connective tissue acts as guidance cues for the developing cutaneous nerve in the body wall. When quail somatic mesoderm at the sacro-coccygeal (pudendal) level was transplanted into the chick somatic mesodermal region at the thoracic level, the ventral nerve exhibited the pudendal type of branching pattern in the thoracic region. However, the cutaneous nerve course remained the thoracic type. These results suggest that the connective tissue derived from the somatic mesoderm provides cues for the determination of the nerve branching pattern. In contrast, the pathway selection might require other guidance cues than the somatic mesoderm in the ventral cutaneous nerve growth in the body wall.
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7785414
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Distribution and size of cerebellar and thalamic projection neurons in the trigeminal principal sensory nucleus and adjacent nuclei in the rat.
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Using retrograde axonal transport of wheat germ agglutinin conjugated with horseradish peroxidase (WGA-HRP), the distribution and size of the cerebellar and thalamic projection neurons were demonstrated in the trigeminal principal sensory nucleus (Vpr) and four adjacent nuclei: the trigemino-angular nucleus (Ta), the supratrigeminal nucleus (SupV), the intertrigeminal nucleus (IntV) and the juxtatrigeminal nucleus (JxtV). In the control animal, the size of the constituent neurons of these five nuclei was also analyzed. The mean size of the somata was significantly (p < 0.05) different among these nuclei: it was largest in the Ta, followed by the IntV, SupV and JxtV, and smallest in the Vpr. After cerebellar and thalamic injections of WGA-HRP, labeled neurons were found in all of these nuclei. The cerebellar projection from the SupV and the thalamic projections from the Ta, SupV and IntV were observed for the first time in this study. The proportion of neurons projecting to the cerebellum and the thalamus varied in these nuclei. In the Ta and IntV, the majority of neurons were labeled after cerebellar injections, whereas nearly all neurons in the Vpr were labeled after thalamic injections. In the SupV and JxtV, thalamic projection neurons were greater in number. Thus, each nucleus examined in this study had distinct organizations concerning the soma size and the mode of projection to the cerebellum and the thalamus.
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7785413
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Architecture and function of the extravascular fluid pathway: special reference to the macula cribriformis in the diaphragm.
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Silver staining, transmission electron microscopy (TEM) and scanning electron microscopy (SEM) have been used to delineate the structure and function of the extravascular fluid pathway of the diaphragm of monkeys, rats, mice and rabbits. The submesothelial connective tissue was examined by SEM using the NaOH maceration method. A sieve-like structure, the macula cribriformis, was found in the submesothelial connective tissue on the peritoneal side of both the muscular and tendinous portions. The macula cribriformis, which consisted of densely-packed collagen fibrils, was oval, spindle and polygonal in shape and ranged in diameter from 20 to 300 microns with 5-300 foramina (3-15 microns). The macula cribriformis was located between peritoneal mesothelial cells with stomata and subperitoneal lymphatic capillaries. Intraperitoneally-injected latex particles were carried into the diaphragmatic lymphatic capillaries via the peritoneal stomata and the foramina of the macula cribriformis. These results support the hypothesis proposed by Kihara (Okajimas Fol Anat Jpn 28: 601-621, 1956) that the macula cribriformis is a pre-lymphocapillary pathway, one of the extravascular fluid pathways.
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7785412
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Immunohistochemical studies on supporting cells in the adrenal medulla and pineal gland of adult rat, especially on S-100 protein, glial fibrillary acidic protein and vimentin.
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In the adrenal medulla and pineal gland, the morphological and chemical nature of supporting cells were examined immunohistochemically. In the adrenal medulla, supporting cells in noradrenaline (NA)-cell regions showed similar and intense immunoreactivities to the three glial marker proteins, S-100 protein, glial fibrillary acidic protein (GFAP) and vimentin, forming a network, while those in adrenaline (A)-cell regions were less numerous and their immunoreactivity was positive to S-100 protein but negative to GFAP and, at least in part, negative to vimentin. In the pineal gland, supporting cells in the stalk and the proximal region of the body portion formed a network and showed immunoreactivities to the three antibodies, while those in the distal region of the body portion were less numerous and their immunoreactivity was positive to S-100 protein and vimentin, but negative to GFAP. Thus, the distribution pattern and chemical nature of supporting cells showed regional differences in both glands. There were several similarities in supporting cells between those in NA-cell regions of the adrenal medulla and in the stalk and the proximal region of the body portion of the pineal gland, and also between in A-cell regions of the adrenal medulla and in the distal region of the body portion of the pineal gland, respectively. The biological and functional significances of these results are discussed.
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7785411
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Axonal elongation of grafted, embryonic inferior olivary neurons in the adult rat cerebellum and their synaptic formation on host Purkinje cells.
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Although the brain grafting of adult mammals had failed to show reinnervation of host targets, embryonic neural tissue grafted to adult brains has been reported to establish new neuronal connections. However, the trajectories of growing axons of grafted neurons in the host brain are poorly understood. To study the morphological aspects of the trajectories of growing axons of grafted neurons in detail, ventromedial medulla containing the inferior olivary nucleus of 14-day rat embryos were grafted into the hemicerebella of 8-week-old adult rats whose inferior olivary neurons and climbing fibers were previously destroyed. The cerebellum and the inferior olivary complex of host rats were histologically examined 1-6 weeks after surgery. The heterotopically grafted neurons sent their axons into the white matter and the molecular layer of the host cerebellum. These growing fibers made plexus formation in the molecular layer, ending with axo-somatic and/or axo-dendritic synapses on host Purkinje cells whose afferent climbing fibers had been eliminated. These results show that the growth cones of growing axons arising from the grafted neuron can find and reach host targets along unusual pathways, and that some of the mature host Purkinje cells retain the ability to form synapses with newly developing axons from the grafted immature inferior olivary neuron.
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7785410
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CT measurement of the normal brain ventricular system in 100 adults.
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Examination of 100 voluntary cases with no physical or neurological deficit revealed that the sizes of the cerebral ventricles increase with age in both sexes. According to regression analysis in women, increase in the size of the third ventricle by age was statistically significant. Compared to women, the size of the third ventricle was larger in men. In the measurements of the lateral ventricles, it was observed that bifrontal the cerebroventricular index in men and the bicaudal cerebroventricular index in women increase significantly with age. The indices showed no significant difference between the two sexes.
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7785409
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Anomaly of the ulnar artery arising from the brachial artery.
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A high origin of the ulnar artery was encountered in the body of an 87-year-old Japanese man in the course of normal anatomic dissection at Nara Medical University. The left ulnar artery originated from the brachial artery at the height of the left inferior angle of the left scapula and passed medially to the brachial artery and the median nerve. In the forearm, the ulnar artery passed deep to the flexor carpi ulnaris muscle. Thereafter, the two branches from the ulnar artery contributed to form the superficial and deep palmar arterial arches. The left brachial artery was divided into two terminal branches of the radial and common interosseous arteries.
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7785408
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[A case of mandibular retromolar canal: elements of nerves and arteries in this canal].
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The large bilateral mandibular retromolar canals were found in a 47-year-old Japanese man. This paper presents the nature and distribution of the elements of nerves and arteries in the left retromolar canal which were able to examined. The left mandibular retromolar canal arose from the bifurcation of the mandibular canal at 18 mm anterior to the mandibular foramen and it opened on the surface of the retromolar fossa at 13 mm posterior to the third mandibular molar. The total length of the retromolar canal from the bifurcation to the retromolar foramen was about 16 mm, and 2.5-2.6 mm in diameter. The radiographic image of this retromolar canal was a liner shadow with thin radiopaque anterior and posterior borders cast on a lateral radiography of the left half of the head. Within the retromolar canal, the artery that was branched from the inferior alveolar artery ran through the canal forwards and joined with the branches of the buccal artery and the facial artery, and then gave off the superior and inferior labial arteries. The nerve (R. retromolaris) in the retromolar canal derived from the inferior alveolar nerve trunk and branched off to the following areas: the third mandibular molar, the mucosa of retromolar triangle, the buccal mucosa, and the buccal gingiva of the mandibular premolar and molar region. The retromolar canals and foramina were found in 8 out of 41 Japanese skulls. Clinically, if the arteries in the retromolar canal become injured, complications may arise such as bleeding, and iatrogenic nerve damage may lead to paralysis.(ABSTRACT TRUNCATED AT 250 WORDS)
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7785407
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An unusual coursing of the facial vein.
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During the dissections of 50 adult cadavers for educational purposes, we found a 45-year-old male cadaver with an abnormally coursing facial vein which has joined the retromandibular vein at a higher level--in the parotid gland--on the right side of the face. This anomaly has also been detected radiologically.
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7785406
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[Lymphatics of the thoracic surface of the diaphragm especially located around the inferior surface of the pericardial sac].
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The lymphatics on the thoracic surface of the diaphragm, especially lying around the lateral and posterior sides of the base of the cardiac sac, were examined in 68 adult Japanese cadavers macroscopically (37 males and 24 females, aged 45-92 years, no clinical evidences of neoplasms). In this observation, a vein which drained into the terminal portion of the inferior vena cava was observed. The lymph nodes in this region were located along the vein frequently (80.9%). The vein passed through the esophageal hiatus, or penetrated the diaphragm and finally communicated with veins around the esophagogastric junction. However, lymphatic vessels were not observed passing through the phrenico-esophageal membrane and/or the diaphragm. The collecting vessels, which originated from the lymphatics, drained into the esophageal lymphatics, and it drained into the thoracic duct via the esophageal lymphatics. In pleural effusion cases, lymphatic nets were clearly observed on the thoracic surface of the diaphragm immediately under the parietal pleura. The lymphatic nets did not communicate with the diaphragmatic lymphatics around the base of the cardiac sac. Moreover, large collecting vessel from the lymphatic nets passed through the muscular crus of the diaphragm near the medial arcuate ligament and traveled inferior to merge at the original portion of the thoracic duct at the level of the renal vessels. From these observations, the lymphatics on the posterior part of the thoracic surface of the diaphragm communicated with several regional lymphatics independently. This morphological lymphatic traveling suggests that the route differs in cases of pleural effusion or cancer metastasis.
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7785402
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[Congenital hepatic fibrosis. Study of 26 cases].
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We studied 26 children with congenital hepatic fibrosis during the period 1971-1993. About half of the children were about the 6 years old. Only two had brothers with same disease. The chief clinical manifestation was hematemesis associated or not with liver enlargement, predominantly of left lobe. Only one case showed fever and cholangitis. Liver function tests were usually normal. Twenty-two children had portal hypertension. Liver biopsy was of definitive for diagnosis. Seven children died.
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7785401
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[Viral hepatitis infection and response to the hepatitis B vaccine in hemodialyzed patients].
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Data from 219 hemodyalized patients receiving attention in our Hospital and other private centers in our city are shown. Mean age was 46.9 (range: 14-85), and 132 were male; mean time under dialysis was 20 months, and subjects received an average of 5 transfusions per patient year. Serological reactivity to HBs Ag, Anti HBs and IgG anti HBc by ELISA were investigated in all of them, and anti HCV by second generation enzimo-immunoassay (EIA II) in 73 HBe Ag/anti HBe system were determined in HBs Ag positive patients and those reactive to anti HCV (EIA II) were confirmed by LIA (immunoblotting of synthetic peptides LIA-TEK Organos Teknica). Recombinant anti HBV vaccine 40 mcg at 0-1 and six month were received by 81 cases without HBV markers in their sera and a protective response was considered when anti HBs titration of 10 mU/ml or more were obtained two months later. Prevalence for anti HBc and anti HBs were 38.8% respectively and that for HBs Ag was 21% with 78% of them reactive for HBs Ag. True reactivity for anti HCV (confirmed by LIA) was present in 35.6%, but it was 9.7% in our Hospital and 54.8% in private units (p < 0.0002). Anti HBs titration was done in 69/81 patients who received anti HBV vaccine, and a protective response in 49% were obtained; the other 12 patients underwent acute hepatitis B during the vaccination period.(ABSTRACT TRUNCATED AT 250 WORDS)
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7785400
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[Do the physical characteristics of radiopaque markers modify the results of the measurement of colonic transit time?].
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This study was performed in 15 healthy control subjects (8 males- age 23-70 and 7 females age 20-74) as a way to compare the total and segmental colonic transit time with two different type of radiopaque markers. One type of markers was 3 mm cut sections of a radiopaque polietilene 14 French Levine tube, with a medium weight of 64.3 mg and a specific gravity (SG) of 1.28. The other type were 7 mm lenticular insoluble barium (lentils) with medium weight of 231 mg and a SG of 1.87. Each subject ingested 20 markers of each type with the breakfast and front and profile plain films of the abdomen were taken 24 and 48 hs after. The total colonic transit time for the polietilene markers was 17.7 hs and 27.3 hs for the barium type (BM) (p < 0.001). The segmental transit time for right colon was 2.4 hs (PM) and 9.7 hs (PM) and 9.7 hs (BM) (p < 0.001) in the left colon 9.5 hs (PM) and 11.3 hs (BM) and in rectoanun 5.9 hs (BM) with no statistical significance. the physical characteristics of the radiopaque markers can modify the results of the colonic transit times.
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7785399
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[Predictive factors in the treatment of esophageal achalasia].
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With aim of determining if there are predictive factors in the treatment of achalasia of the esophagus, we analyzed in a group of 119 patients variables such as age, gender, X-Rays, Chagas' disease serology and esophageal manometry before and after treatment. The only significant factor was the LES pressure post-treatment but, since the sampling was heterogeneous, and the differences where the same between bad and good results, we believe it has no predictive value in the treatment of achalasia of the esophagus.
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7785398
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[Biofeedback and surgery in the treatment of fecal incontinence and lesion of the external anal sphincter: long-term follow-up].
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In children, damage in the anal area which affects both the external anal sphincter and the internal anal sphincter is serious problem. Biofeedback is not effective if the external anal sphincter is severely damaged, and surgery by itself cannot effect a cure for incontinence in these cases. a girl aged 6 yrs 8 months who from the age of two suffered from massive recurrent tricolephalosis, causing rectal prolapse, anal abscesses and fistulas, fistulectomy, and finally severe damage in the anal area with total incontinence. The treatment began with recto-anal manometry, and rectal sensitivity studies. Biofeedback was used before and after gracilis muscle transfer and colostomy. After 12 months, total continence was achieved, and has continued through 7 years of follow-up examinations. To treat fecal incontinence combined with severe damage in the external anal sphincter, the following procedure should be followed: manometry and sensitivity studies, reconstruction of the external anal sphincter with gracilis muscle transfer, and biofeedback.
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7785396
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[Mesenteric panniculitis--case report].
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Mesenteric panniculitis is a very rare disease usually involving the mesentery of the small bowel, less frequently the sigmoid colon or other intraabdominal fat tissue. The disease is benign with a favorable prognosis. Diagnosis is, as a rule, established at operation or autopsy and histology. A 58 year old male with this disease is presented. The paticut hod mild abdominal pain and a palpable mass. A tumor of the mesentery was suspected on CT scan. The exact diagnosis was established at operation and confirmed at histology.
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7785395
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[Isolated tuberculosis of the liver--case report].
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Tuberculosis of the liver is rare even in areas where tuberculosis is widespread. Isolated tuberculosis of the liver is extremely rare. It usually presents as a nodular - pseudo-tumorous form. Tuberculosis of the bile ducts is even less frequent. A 37 year old woman with nodular - pseudotumorous form of tuberculosis of the liver is presented. The diagnosis was established after surgical biopsy and histology. It may be caused by the bovine type of the bacillus. The patient had an excellent response to tuberculostatic drugs. Tuberculosis of the liver must be taken into account in the differential diagnosis of the liver masses.
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7785394
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[Treatment of severe craniocerebral injuries].
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During 1992. 19357 patients were examined at the Department for Neurosurgery of the Emergency Centre, Clinical Center of Serbia, out of which 15879 had head injury. In addition to those necessitating hospitalisation, there was also a large number of patients with mild head injury that were not admitted for hospital management and were sent home following initial first aid. The average incidence of these patients was 45 patients per day during 1992. During 1992. a total of 1,978 patients were hospitalised, out of which 1,520 (84%) were injured. A total of 633 patients (25%) were hospitalised due to injuries sustained in traffic accidents. All patients were examined and evaluated according to the standard protocol including GCS as well.
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7785391
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[Teratogenic tumors of the mediastinum].
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Primary teratogen tumors of the mediastinum are rarities in clinical and pathological practice. Their polymorphic histological picture and their enormous size provoke a great diagnostic difficulty. We analyze 85 primary teratogen tumors of the mediastinum (except those that were localized in thymus) which have been diagnosed in Institute for pulmonary diseases and tuberculosis, Clinical center of Serbia, between 1973 and 1991. Material for pathohistological evaluation was obtained by surgical resection of the whole tumor in 58 patients or by percutaneous needle aspiration biopsy in 47 patients. Malignant (immature or teratomas with malignant transformation) were present in 49 (57.65%) patients and benign (mature) teratomas in 36 (42.35%). The majority of benign (mature) teratomas (83.33%) were composed of a variety of tissue elements derived from all three germ layers and 16.67% show only ectodermal and mesodermal derivates. Malignant (immature) teratomas contained both epithelial and mesenchymal incompletely differentiated elements in 67.35% of cases and in 22.45% of cases only epithelial component undergoes malignant transformation. In our series there were two cases of primary seminoma of the mediastinum and one case of primary embryonal carcinoma, primary yolk sac tumor and primary choriocarcinoma of the mediastinum.
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7785393
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[Personal experience in the treatment of injured patients with craniocerebral injuries associated with thoracic injuries].
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In the Emergency Center of the Neurosurgical Intensive Care Unit Belgrade, in the one-year period (from January, 1st 1992 to December, 31st 1992), 54 injured patients with severe head injuries associated with chest trauma were treated. In all injured patients the following parameters were considered: sex, age, mechanism of injury, surgical procedures, and fatal outcome. Thirty-nine patients (72.22%) survived.
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7785392
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[Diagnostic and surgical approaches in the treatment of tracheal diseases].
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The authors present 100 patients operate for diseases of the trachea during a period ranging from 1972-1991. Stricture of the trachea was observed in 75% of pts. and tumours in the remaining 25%. Stricture resulting from tracheostomy was the most frequent. The majority of patients underwent end-to-end anastomosis. A Nevill prosthesis was implanted in 5 patients. The results were good in 93.34% of pts. The mortality was 6.6%. The most frequent operation for malignant tumours was resection of the trachea and end-to-end anastomosis. The length of the respected segment ranged from 3-6 cm. There was no mortality. The authors conclude that adequate preoperative diagnostic procedures unable good assessment of a lesions and a well planed operation with good results and no mortality.
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7785390
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[Modern surgical treatment of pulmonary tuberculosis].
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Correctly performed antituberculous chemotherapy, together with the early diagnostics of tuberculosis, significantly lowered the need for surgery. Surgery is limited to patients with poor or no response to chemotherapy. In the period between 1983-1992 212 tuberculous patients were operated in the Clinic for Thoracic surgery, the Institute for the Pulmonary Disease the operated patients had the following form of the disease: primary tuberculosis in 4 patients (1.87%), 104 patients (49.06%) had the postprimary form of the disease, 67 patients (31.60%) had tuberculoma (causative lesion) cavernous tuberculosis existed in 33 patients (15.57%), while only 4 patients (1.87%) had diffuse pulmonary lesion. Diagnosis of post-tuberculous syndrome was made in 68 patients (32.08%). Secondary aspergylloma existed in 36 patients while the frequency of bronchial stenosis and bronchiectasis was the same -m 31 patients (16.98% and 14.63% respectively). One patient had broncho-oesophageal fistula. Tuberculous empiema, complicating the disease, existed in 36 patients (16.98%). Comparing the two 5-years periods, (1983-87 and 1988 to 1992) the authors conclude that the number of operations for tuberculosis is decreasing. Treatment was successful in all patients except in a patient with a broncho-esophageal fistula, who died postoperatively slow lung reexpansion existed in 5 patients, and in two cases partial upper thoracoplasty had to be done in order to solve the complication of the initial treatment. In all cases postoperative antituberculous chemotherapy was performed taking in consideration the problem of possible drug-resistance. There were no recurrences.
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7785389
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[Surgical treatment of recurrent Crohn's disease].
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According to the literature, the incidence of Crohn's disease is 6.0:100,000, and the prevalence is 50.0-60.0:100,000. The prevalence in this countries 3.2:100,000 and the characteristics of the disease are: a more benign course, better prognosis and infrequent involvement of the colon. The incidence of recurrence is 40.0% during a 5 year period and 65% during a 10 year period. Practically, every patient operated for Crohn's disease will be reoperated once during the first five postoperative years. The experience of the authors indicates that the situation in this country is considerably better. During the period ranging from 1980-1992, a total of 70 patients were operated for Crohn's disease. In this group of operated patients 24 (34.40%) had recurrent symptoms. Seven patients (10.0%) in the series, operated at an earlier date at this Institution, were reoperated for Crohn's disease. Another 8 patients (11.43%) were also reoperated for Crohn's disease in this series, but their initial operation had been done at a different Institution (palliative or inadequate prior surgery). Indications for reoperation did not differ from indications for the initial operation: existence of surgical complications. The most important factors in the surgical management of recurrence are: assessment of disease activity and progression and adequate preoperative and postoperative nutrition in order to improve the immune response, which is often impaired by previous surgery, disease activity and inadequate management. Correct operative strategy is crucial. The authors, in both initial and reoperations, perform limited resection of the small intestine, generous resection of the large intestine and stricturoplasty and divergent stomas on the small intestine.(ABSTRACT TRUNCATED AT 250 WORDS)
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7785387
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[Importance of oximetry parameters in the detection of hypoxia in the early phase of septic shock].
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The routinely monitored variables in shock stages include: arterial pressure, heart rate, central venous pressure, pulmonary artery wedge pressure and cardiac index. With vigorous therapy it is possible to bring these values back into the normal range in both survivors and nonsurvivors. The therapeutic goal in septic shock stages is to maximize the values of cardiac index, O2 delivery (DO2) and O2 consumption (CO2). The aim of this study is to determine the relationship between O2 delivery and O2 consumption as an early sign of hypoxia. Fifteen patients with septic shock were treated in order to maximize the value of CI, DO2 and VO2. We compared the levels of these parameters between the survivors and nonsurvivors and found no significant differences after 24 hours. High levels of DO2 and VO2 do not exclude tissue hypoxia in the early stage of septic shock.
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7785388
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[Results of surgical treatment of primary hyperparathyroidism].
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In the period 1981-1993, 102 patients underwent surgery for primary hyperparathyroidism (HP). Parathyroid adenoma was found in 81, carcinoma in 4 and hyperplasia in 17 patients. HP was usually diagnosed late with marked skeletal or renal damage, psychiatric symptoms and hypertension. Following the first operation in our institution hypercalcemia was successfully reduced in 100 of 102 patients, in two hypercalcemia persisted after the operation and both were reoperated. Postoperative hypocalcemic syndrome (transitory hypoparathyroidism) due to advanced stage of HP and enormous calcium deficit in bones, occurred in 47% of patients (most frequently with skeletal and hypercalcemic form of the disease).
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7785382
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[Percutaneous transluminal angioplasty of the abdominal aorta using the "kissing balloon" technic].
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Percutaneous transluminal angioplasty (PTA) of the distal abdominal aorta is still rarely performed procedure. Sporadic reports come from selected institutions with extensive experience in the field of PTA. Procedure is performed using so called "kissing-balloon" technique, and may be an alternative to the surgical treatment in well selected cases. We present a 45 years old woman with intermittent claudications and infrarenal abdominal aortic stenosis, treated successfully using above mentioned technique.
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7785381
|
[Leiomyosarcoma of the duodenum (case report)].
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Leiomyosarcomas of the duodenum are rare tumors, usually presented with gastrointestinal bleeding and/or symptoms of duodenal obstruction, rarely with obstructive jaundice. If successfully removed, these tumors have better prognosis than carcinomas of duodenum or head of the pancreas. A 62 year old man in whom leiomyosarcoma of the duodenum was successfully removed by cephalic duodenopancreatectomy (Whipple's procedure) is presented.
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7785379
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[Experience of the surgical service and surgeons at the 1st Surgical Clinical Center in Belgrade in the primary care of abdominal war injuries 1991-1992].
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During the recent (1991/92) war on the territory of the former Yugoslavia, 12 of our surgeons participated in the treating of war abdominal injuries, on 8 localities with the various characteristics of combat. Treating all injuries, with adequate evidence and documentation, the general experience of all participants of our team was that abdominal injuries range from 0-12% depending on the the intensity of combat, with the mean percentage of 5.43% while combined injuries approximate 50% with the most common injuries of extremities (24%). The number of laparotomies was 65. The most common cause of abdominal injuries were bullets (75%) except in the localities with heavy combat where the explosive and bullet woundings were equally observed. The blast injuries were recorded in 3%. The most common injured organs were large (29.5%), small intestine (23.46%) liver, stomach and spleen subsequently. The severity of injury and mortality depends mostly of the number of injured organs, and multiorgan lesions were systematically observed (1.89 of injured organs SD 0.96). The total hospital mortality was 6.15% (4 cases: 2 "in tabula" and 2 later) due to multiorgan injuries with severe shock and bleeding. To achieve better results, early transportation to a place where operation could be made is necessary, with the effective first aid and good organisation of the initial management and triage. The diagnosis must be fast and effective, decision quick and the operation must deal with all the injuries primary, by the most safe surgical procedure, with the exposition of external wound.
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7785380
|
[Disorders of respiratory function in rib fractures].
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In the one-year prospective study 71 injured patients were observed (75% male and 25% female). Traffic traumatism was the dominant case (45%). The wounded are divided in the groups with one side fracture of ribs (left/right) and on both sides fracture of ribs considering the side of fracture, and there is consideration about the kind of fracture--there are single fracture of ribs and serial fracture of ribs. The samples of artery blood were followed in PaCO2, %SaO2 and level pH in three points of time: when the patients came, after 24 and after 48 hours. In the group with the both side fracture of the ribs, the fall of worth pH was observed after 48 hours, PaCO2 is increasing to the 6.98 kPa. PaO2 is falling after 48 hours. In %SaO2 there is no considerable difference at any time, but%SaO2 is the highest in the second group. With the serial fracture of ribs wounded are considerate the fall of worth pH which is progressively increasing and is the highest after 48 hours. PaCO2 is increasing in the both groups, but with the serial fracture the worth are considerably higher. PaO2 and %SaO2 are much lower after 48 hours. The authors conclude that the wounded on both sides and wounded with serial fracture along one or several lines of with fracture of all ribs suffer the highest respiratory insufficiency (ARI), so they need artificial ventilation as respiratory support.
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7785378
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[Surgical treatment of peroperative injuries of the duodenum].
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Operative duodenal lesions are rare, but often fatal complications of certain abdominal procedures. This was reported in small series with an incidence of 0.2% of all abdominal operations. The management of these injuries requests the surgeon to be familiar with a number of specific operative approaches, which are to be used according to the operative situation. In the 1985-1992, year period, 21 cases of the operative injury of duodenum were managed without mortality, and with 3 cases of transient postoperative fistula, which healed spontaneously. The most important factors in the management of this complication are the early operative recognition of duodenal injury, or early reoperation, if, in a case of duodenal fistula, distal outflow is considered insufficient. The particularities of the duodenal suture and perioperative treatment are to be well understood. Roux en Y covering of the duodenal defect by open jejunal loop is the best method in management of these injuries.
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7785377
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[Bronchoplasty surgery].
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Bronchoplastic operations are analysed in 114 patients: 76 (66.67%) with bronchial carcinoma, 33 (28.94%) bronchial adenoma, 4 (3.51%) bronchial rupture or stenosis and bronchial hondroma in one case. Sleeve resection was done in 99 (86.84%) and other kind of bronchoplastic operations in 15 (13.16%). Preoperative diagnostic procedures were focused on: clinical course and symptomatology, exact location of bronchial lesion, type of tumor, mediastinal lymph nodes, bronchial three distal from the lesion and respiratory lung tests. Intraoperatively attention was toward to the evidence of peribronchial growth of tumor, mediastinal lymph nodes and lung tissue. Early postoperative course was without complications in 85 (75.89%), with complications in 26 (23.21%) but two patients died. Incomplete reexpansion or athelectasis of the entire lung or lobe but easily treated, were the commonest complications. There was no evidence of bronchial fistula or bronchial sutura at the level of submucosal growth of tumor. In certain indications bronchoplastic operations are good operative choice for surgical treatment of bronchial tumors and traumatic bronchial rupture or its sequelas-stenosis. For malignant tumors, late results, are, after this kind of operations, equivalent to those achieved after classic resections and they do not depend of the kind of surgical procedures but correlate to the nature of the tumor. For benign and slowly growing malignant tumors late results after these operations are excellent.
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7785376
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[Comparative analysis of vascular injuries during times of peace and war].
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The authors present results of reconstructive surgical procedures in 127 non-war and 59 war vascular injures operated on in the last ten and 2 years, respectively. Non-war injures were dominated by blunt trauma, while fire arms and explosives caused most of war injuries. Two thirds of the patients were subjected to primary, and one third to secondary operations. As much as 85% of secondary operations were made in cases of war injuries. The most common reasons for inappropriate primary operations were: incomplete diagnostics, inappropriate surgical procedure and technical errors. About two thirds of the cases were isolated vascular injuries, and one third were combined injuries where in addition to blood vessels, bones and peripheral nerves were also affected. Topographically, the upper and lower extremities were most commonly affected. Most of the operations were complex reconstructive procedures such as graft interpositions or by-passes, and less frequently only suture of a blood vessel or end-to-end anastomosis were made. Fasciotomy was an auxillary method used in all patients with late vascularization syndrome, and exposure in a special "tent" in patients with wound infection. Early success was noted on 88% of operated patients. In 12% of them amputation was performed. Primary amputation (without attempts of reconstruction) was performed in 4% out of the total number of patients. After primary operations they performed (127) the authors had to undertake amputation because of failure of the primary surgery in 4% of patients, while after secondary reconstructions (primary operations performed elsewhere) amputations were necessitated in 23% out of 57 patients. A significant difference was noted which directly correlated with the number of primary and secondary operations after war (28%) and non-war (6%) injuries.
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7785375
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[Causes of dehiscence in the anastomosis between the stomach and small intestine in our clinical data 1970-1990].
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Gastrojejunal anastomotic leakage occurred in our clinical material of 4284 gastric resections Billroth II type with an incidence of 0.93 percent. 62 cases with anastomotic dehiscence were analyzed, with 22 from other clinics. The most critical part of the anastomosis was the upper angle of Billroth II Hoffmeister Finsterer anastomosis. The causes were mostly local; reoperations and resuture with necrotic and devitalized tissue, impaired vascularization of the stomach and small intestine due to rough manipulation, too narrow anastomosis and too tight securing of ligatures, as well as too massive tissue aglomeration in more layers. Stomach obstruction is a significant cause, as it is dista obstruction to anastomosis, duodenal dehiscence, peritonitis or pancreatitis. Some of the local causes are likely to be solved with using of one layer of resorptive suture material or using of a stapling device. General conditions are also important, but only as factors that stress the local conditions of risk. The mortality rate in this serial is high as 70.9%, in spite of the reoperations and complex conservative treatment.
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7785374
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[Limited or extensive surgery in gastric carcinoma?].
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Although the incidence of gastric cancer has dropped it is still the most frequent carcinoma of dhe digestive tract. Surgical management of gastric carcinoma was always dependent on the stage of the disease. Contemporary knowledge of gastric lymph drainage and attempts to remove metastatic glands with the tumor gave rise to more optimism. In the beginning such and approach did not fulfill expectations, but during the past decades, especially in Japan, it became evident that more aggressive and extensive surgical procedures could benefit certain groups of patients. In order to asses this new approach it is necessary to have a unique TNM classification and to perform a rigorous and systematic identification of cancer metastasis in the lymph nodal system of the stomach. Comparison of partial gastric resection with limited standard lymphadenectomy to total gastrectomy with extensive lymphadenectomy is not possible. Nevertheless, patients with gastric cancer stages Ib, II and IIIa profit from more extensive surgery. The author present the modifications in the extent of surgical procedures for the management of gastric cancer. Special emphasis is drawn to the surgical technique and results of systemic extensive lymphadenectomy. The author has demonstrated the benefits of the new extensive surgical approach in he management of gastric cancer in his series. Operative mortality in the group of patients after systemic lymphadenectomy was 6.7% and the 5-year survival rate was 21.0%. In the group of patients where gastric resection with standard lymphadenectomy was performed postoperative mortality was 14.0% and the 5-year survival was only 5.3%.
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7785372
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[The course of immunologic parameters in inpatient psychotherapy exemplified by 2 single case studies].
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Psycho-neuroimmunology depicts a conceptual frame in which possible interactions between psychic and physical processes can be examined. It could be very significant in the field of psychosomatics when the courses of psychic and somatic processes are examined. However, the research results from this field of study are varied and only for a few parameters of immunity is it possible to prove correlations with psychic variables. Many of the studies that have been conducted up to date were construed as cross-section studies and possibly therefore are not very suitable for depicting the probably very complicated forms of interactions between psychic and somatic levels in an adequate manner. In the framework of stationary psychosomatic psychotherapy two single case studies were carried out in order to examine temporal connections between psychic and immunological course parameters. Both single case studies are to be viewed as explorative attempts of examining questions of examination design and organization which are highly resolved regarding time. Furthermore we report several interesting individual results which emphasize in general the correlation between psychic and somatic parameters also in the course of time. However the limits of such studies regarding the significance of the individual immunological parameters, using time serial analytical methods as well as constructing models in the field of psycho-neuroimmunology are discussed.
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7785371
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[Physicians' attitudes of relations with AIDS, cancer and metabolic patients: core conflictual relationship theme and affects].
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With this comes the question: Are there typical relationship patterns and affects, that appear in physicians experience of their relationships to patients with different illnesses? We asked 33 physicians about impressive experiences with one AIDS-, one cancer- and one metabolic disorder patient each. The narratives we received were evaluated with two contentanalytic methods. The relationship patterns were assessed by the Core Conflictual Relationship Theme (CCRT), developed by Luborsky. The affects were assessed by the Gottschalk-Gleser Content Analysis Scales. We found some significant differences between the relationship experience with AIDS- and cancer patients on the one hand, and metabolic disorder patients on the other hand. In relationships with critical ill AIDS- and cancer patients the physicians verbalize more death anxiety and more diffuse or nonspecific anxiety. Furthermore they show more covert hostility against the AIDS- and cancer patient, whereas they verbalize more overt hostility against the metabolic disorder patients. We found also some fine distinction between the relationship experiences with AIDS-patients on the one hand and cancer patients on the other hand. The physicians get more involved with the relationships to AIDS-patients and the closeness-distance-regulation seems to be one central issue in this relationships.
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7785370
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[Social support and social stress in tumor patients and their partners].
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Social support is widely believed to be an important buffer against stress in patients coping with cancer. Support efforts can, however, in turn prove to become a source of distress in themselves, both in patients and support providers. The present study was designed to explore the connections between support and emotional distress. N = 120 lung cancer patients and their relatives (n = 57) are interviewed at three intervals. Social support is assessed by multiple methods: Content analysis, a questionnaire and a confidant rating performed by experts. Cross-sectional and longitudinal analyses are combined. Content-analytical and self-report data show a correlation of support efforts and emotional distress. In the confidant rating, however, the expected differences between supportive and non-supportive spousal relationships emerge. The results are discussed from an interactional point of view.
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7785369
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[Markers of the "fit" between therapist and patient as determinants of treatment outcome of inpatient group psychotherapy].
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Within a study concerning process and outcome of inpatient longterm group treatments the specific question was tested to what extent characteristics of the "fit" between the therapist and the patients were related to treatment outcome. The study shows that a concordance in the formulation of the treatment goals seems to be favorable for a positive outcome. Similarly, congruences between the therapeutic factors of the group treatment, subjectively important for the patients, and those factors classified as typical for the treatment concept by the therapists, were related to treatment success. The results can be discussed within the context of concepts of the therapeutic alliance and might help to operationalize those concepts in a more specific manner.
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7785368
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[Disordered partner relations in neurotic diseases and treatment with psychotherapy].
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Couples with neurotic partner problems are characterized by considerable psychic and/or psycho-somatic complaints. Men usually judge the relationships with their spouses more satisfactory than women do. Women suffer more from conflicts in partner-relationships than men do responding to such conflicts with psychic and/or psycho-somatic complaints. Men are more disturbed by a conflict mobilizing therapy than women are. The strongest decrease of men's psychic symptoms can be found in the year after their therapy. Women's defence against psychic problems is less strong than men's. Decrease of women's symptoms can be found during therapy already. Character neuroses don't make psychic and/or psycho-somatic symptoms in a direct manner. Character neuroses rather give rise to conflicts with other people, and stress by those conflicts cause symptoms.
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7785366
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[The intelligence structure of autistic persons].
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In a research project on the genetics of autistic disorders 115 subjects were examined. An autistic disorder was diagnosed in 102 of the subjects using the standardized Autism Diagnostic Interview (ADI; Le Couteur et al., 1989/ADI-R; Lord et al., 1994). The WAIS-R or WISC-R could be administered to 42 of the subjects. The mean full-scale IQ was 84.4, slightly below the range of normal intelligence. The mean verbal IQ (89.3) was considerably higher than the performance IQ (78.9). Analysis of the subtest patterns showed the highest scores to be in those subtests measuring knowledge of dates and facts and visuospatial abilities. The lowest scores were on subtests requiring an understanding of social relations and the ability to understand concrete social actions. This subtest pattern confirms results of other studies on the intelligence of individuals with autism and was independent of gender and level of intelligence. The subtest pattern appears to be specific for autistic disorder; it has been interpreted with reference to the theory of "weak central coherence" (Frith, 1989; Shah & Frith, 1993), which postulates that in autistic individuals stimulus perception and processing occurs independently of the general context. The results suggest that the differentiation between different types of autistic disorders should be abandoned in favor of a continuum of autistic disorders with differing degrees of severity.
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7785367
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[Psychological versus psychogenic--a necessary clarification of terminology].
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Confusion exists regarding the usage of the two adjectives psychic and psychogenic. Therefore a differentiation of the two words is necessary. We will try to do this with the help of concrete examples. Regarding the pair of terms psychic versus somatic one has to differentiate strictly between (psychic or somatic) causes on the one hand and the forms of manifestation in the psychic or somatic field of observation on the other hand. The discussion about the linguistic ruling of psychic versus psychogenic has important consequences for the responsibilities and care of the different professions: psychiatrist, psychosomatist/psychotherapist, other specialists, general physician.
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7785365
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[Subjective evaluation by parents and objective findings in former perinatal risk children].
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Several studies have shown no correlation between individual perinatal risk factors and outcome. Rather, the children's development depends more on social factors. In our retrospective study we compared the development of 26 at-risk newborns with that of a same-sex healthy sibling 10 to 16 years later. Data were collected by interview, questionnaires and neuropsychological tests. In the parents' view, the children who were at-risk newborns had a special position in the family (close mother-child relationship, overprotectiveness, child cause for concern). They had more educational and behavioral problems and their social network was limited. With one exception (d2 test), the neuropsychological tests showed no significant differences between the two groups of children. However, overall the at-risk children had more attention deficit disorders with hyperactivity (ICD-10, F90.0) and more selected learning disturbances (F81). A division of the children into those with minor and major perinatal risk factors was not of predictive value for outcome. There was only a low correlation between the parent's assessments of the at-risk children and more objective criteria (need for professional help or special schooling). The authors discuss the types of support that should be provided to parents with at-risk newborns.
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