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Biomedical subjects

A Heinz

Publications and source records attributed to A Heinz.

At least 109 records · Page 6Linked to original sources

Palinopsia as sensory epileptic phenomenon.

Visual perseveration (VP) is defined as persistence or recurrence of visual images, when the stimulus is no longer present. We report three patients with occipital cortical lesions in the right hemisphere and VP. Electroencephalography showed epileptic abnormalities in all cases. In one patient synchronous electroencephalic recordings during the onset of palinopsia-a subtype of VP-revealed, that VP was associated with a clear cut right occipital seizure with a secondary diffusion of the discharge over both hemispheres, which has not been reported in combination with the onset of palinopsia heretofore. In all three patients sensory seizures have to be considered as probable cause of VP.

Adult↗

Dopaminergic responsivity in alcoholism: trait, state, or residual marker?

OBJECTIVE: In order to classify neuroendocrine abnormalities in alcohol-dependent patients as trait, state, or residual markers, growth hormone (GH) secretion was assessed longitudinally. METHOD: GH secretion, stimulated by the dopaminergic agonist apomorphine, was evaluated in 21 alcohol-dependent patients (16 men, five women) and 10 healthy comparison subjects (eight men, two women). The patients were tested during early withdrawal, after 8 days of abstinence, and after 3 months. RESULTS: Patients who relapsed within 3 months (N = 8) showed significantly less GH secretion in all neuroendocrine tests than did either the patients who abstained from ethanol consumption for 6 months (N = 13) or the healthy comparison subjects. The relapsers and abstainers did not differ significantly in any of their clinical or pathophysiological data, in the severity of their withdrawal symptoms, or in antecedent or concomitant illnesses associated with alcoholism. CONCLUSIONS: GH blunting appears to be a residual marker of clinical relevance in alcoholism.

Adult↗

Metamemory, distinctiveness, and event-related potentials in recognition memory for faces.

A neglected topic in metamemory research is the ability of subjects to predict their own recognition performance for faces. We investigated whether subjects can make such judgments of learning (JOL) for unfamiliar faces and whether JOLs relate to facial distinctiveness, a powerful determinant of face recognition. One group of subjects made JOLs, and a second group rated the same faces for distinctiveness; subsequently, both groups tried to recognize these faces among new faces. There was significant prospective metamemory for faces that appeared to be based on facial distinctiveness. Both prospective metamemory and distinctiveness ratings related to long-lasting effects in event-related brain potentials (ERPs), closely resembling an ERP component that predicted face recognition. Therefore, the brain processes underlying JOLs, distinctiveness, and recognition memory for faces appear to be intimately related.

Adult↗

[Clinical aspects and follow-up of dopamine-induced psychoses in continuous dopaminergic therapy and their implications for the dopamine hypothesis of schizophrenic symptoms].

We present the case reports of 11 Parkinsonian patients who developed acute psychosis under continuous dopaminergic stimulation. Psychopathologically, two of the patients mainly suffered from organic hallucinosis, while nine patients showed the clinical symptoms of delirium. The clinical course and psychopathological findings in these patients did not differ from other acute organic psychoses. However, the symptoms of these dopaminergically induced psychoses varied significantly from the psychopathological findings of paranoid schizophrenic patients who were regularly treated and evaluated in our clinic. These differences in symptoms and clinical course of dopamine-induced and schizophrenic psychosis do not support the hypothesis that the pathogenesis of schizophrenic symptoms can be explained only by a hyperfunction of dopaminergic transmission. Instead, the involvement of other neurotransmitter system must be considered in order to explain the pathogenesis of schizophrenic symptoms on a neurobiological level.

Aged↗

[Optical and tactile hallucinosis as clinical onset of Creutzfeld-Jakob disease].

A patient suffering from Creutzfeld-Jakob disease (CJD) complained of optical hallucinations, followed by feelings of persecution. Clinical, encephalographic and neuropathological findings pointed towards a focalized beginning of the disease process in the right frontal and temporal lobe. The hypothesized further spread of the infectious agent, as indicated by electroencephalographic and neuropathological findings, was accompanied by periacute manifestation of dementia and an irreversible disturbance of vigilance. The diagnosis of CJE can be especially difficult in the early stages of the disease, with dementia, myocloni and typical electroencephalographic findings still absent.

Aged↗

Blunted growth hormone response is associated with early relapse in alcohol-dependent patients.

Growth hormone (GH) secretion, stimulated by the dopamine D1 and D2 receptor agonist apomorphine, was assessed in 55 alcohol-dependent patients before detoxification (on the day of admittance to hospital) and after 7 days of treatment on the ward (day 8). Patients who relapsed early (i.e., within 3 months after detoxification) showed significantly blunted GH secretion before detoxification, compared with both healthy controls and patients who abstained for 6 months. Among early relapsing patients, GH secretion was blunted whether or not patients were acutely intoxicated on the day of admittance to hospital. However, for patients who abstained during observation, a blunting effect of acute ethanol consumption on GH secretion was demonstrated. On day 8, a trend toward blunted GH secretion was found in early relapsing patients only when GH response over infusion time was assessed. Therefore, GH blunting, and no other variable indicating the clinical course of the disease, was associated with early relapse in alcohol-dependent patients. These findings are evidence of reduced dopamine receptor function in a subgroup of early relapsing alcohol-dependent patients during chronic intoxication.

Adult↗

Anhedonia in schizophrenic, depressed, or alcohol-dependent patients--neurobiological correlates.

Anhedonia, dysphoria, and avolition are common symptoms of schizophrenic, depressive, and alcohol-dependent patients during withdrawal. These symptoms may be caused by a functional deficit of dopaminergic transmission in the dopaminergic reward system, ascending from the mesencephalon to the ventral striatum (nucleus accumbens). The dopaminergic reward system is functionally and anatomically closely connected with the ascending extrapyramidal pathways from the substantia nigra to the dorsal striatum. A dysfunction of both ascending dopaminergic pathways is therefore expected to cause both psychomotor slowing and dysphoria and anhedonia. This hypothesis is supported by PET and SPECT findings, which show that a reduced striatal density of unoccupied dopamine D2-receptors is correlated with extrapyramidal side-effects in neuroleptic-treated schizophrenics and with craving and dysphoria in drug-dependent patients. In order to further investigate the correlation of anhedonia, psychomotor slowing, and the status of the dopaminergic reward system, the density of striatal dopamine D2-receptors can be measured by IBZM-SPECT and related to psychomotor slowing and anhedonia in different states of schizophrenic, depressive, and alcohol-dependent patients.

Alcoholism↗

[Topodiagnosis of Creutzfeldt-Jakob disease using HMPAO-SPECT].

An 80-year old female presented with early stage Creutzfeldt-Jakob disease with clinical, neurophysiological and neuropathological findings suggesting a focal involvement of the brain. HMPAO SPECT disclosed asymmetries of regional cerebral perfusion, thus suggesting that it may be a further diagnostic instrument in this disease.

Aged↗

Continuous subcutaneous lisuride infusion in OPCA.

Four patients with sporadic olivopontocerebellar atrophy (OPCA) and severe signs of Parkinsonism received continuous subcutaneous lisuride infusion via a small external pump. All 4 patients benefitted from this treatment: 3 showed an overall improvement in motor performance, in 1 patient mainly dysphagia and dysarthria improved. Therapeutic benefit lasted for at least 6 months of follow up. With a daily dose of 1.0 mg subcutaneous lisuride, treatment limitations were reached in the form of dysphagia, probably due to oropharyngeal dystonia. Subcutaneous lisuride infusion should be taken into consideration in OPCA patients with signs of Parkinsonism if oral dopaminergic treatment has failed earlier on.

Aged↗

Long-term observation of chronic subcutaneous administration of lisuride in the treatment of motor fluctuations in Parkinson's disease.

Twenty-nine patients with advanced Parkinson's disease were treated with subcutaneous lisuride infusion in addition to a basic therapy consisting of levodopa + PDI in all, and deprenyl in some patients. At the time of the report, 13 patients are still receiving lisuride infusion after 5-36 months, while 16 have dropped out after 0.5-30 months: one because of psychosis, three because of insufficient efficacy, three due to death unrelated to treatment, three because of difficulties in handling the pump as outpatients, and six for other reasons. "Off"-periods and Parkinsonian disability in "off" and in "on" were reduced significantly. These improvements remained constant throughout the observation period. Once the optimal dose regimen is established, only minor adjustments of the doses of lisuride and levodopa are required in the individual case.

Aged↗

Apomorphine--test in dystonia.

In a doubleblind, placebocontrolled design subcutaneous apomorphine was given to 7 patients with dystonic movement disorders to assess dopamine sensitivity of their symptoms. Five patients who displayed a marked clinical improvement after the apomorphine test injections subsequently responded to oral or continuous dopaminergic therapy. The effective apomorphine doses correlated with the doses of dopaminergic drugs. Two non-responders to apomorphine did not benefit from dopaminergic therapy. Apomorphine application thus seems to be a valuable test predicting dopamine sensitivity in dystonia.

Apomorphine↗

Membrane sidedness and the interaction of H+ and K+ on Ca2(+)-activated K+ transport in human red blood cells.

The sided effects of H+ on Ca2(+)-stimulated K+ transport (the Gardos channel) were studied in human red blood cells. Cells were loaded with Ca2+ during energy depletion with the internal pH adjusted to desired levels prior to treatment with the anion-exchange inhibitor 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (DIDS), which inhibits pH equilibration across the membrane. This treatment provides a "pH clamp" whereby the internal and external H+ (H+i and H+o) concentrations can be varied separately. Channel activity was evaluated by measuring either net K+ loss or unidirectional 42K+ efflux from cells where SO2(-4) replaced Cl- on both sides of the membrane. When pHi was set at 7.4, decreasing pHo from values of 8.0 to 5.0 inhibited K+ efflux. This effect of H+o could be overcome by increasing K+o at all values of pHo. In addition, this effect of K+o could be separated from its effects on altering the membrane potential, indicating an interaction between K+o and H+o on the channel. A similar interaction was shown to occur between H+i and K+i. K+o is known to be required for activation of Ca2(+)-stimulated K+ transport, since the channel in cells preincubated in the absence of K+o (prior to exposure to Ca+i) becomes refractory to subsequent activation by Ca2+i and K+o. We found that H+o would not substitute for K+o in this regard nor would H+o inhibit the protective effect of K+o; in addition, H+ was not transported inward in exchange for K+i. Thus it would appear that there are two external sites where K+o interacts with the channel. One site is antagonized by H+o, whereas the second site is required for channel activation independent of H+ in the range studied. The inside of the channel would have, by an analogous argument, at least one site where K+i and H+i interact.

Calcium↗

[In vivo testing of cell-mediated immunity in urology].

The new disposable plastic device, called Multitest, presents 7 standardized microbial antigens. In this way 558 urological patients and healthy subjects were skin-tested. We obtained a statistically decrease in generalization of tumor disease and in perioperative complications. So the test battery may be of interest for monitoring cancer patients and to define high-risk patients.

Antigens, Bacterial↗

[Clinical value of thrombocyte aggregation inhibitors during massive-dose estrogen therapy].

Due to an advanced prostatic carcinoma 166 patients were given a massive dose of oestrogen over a period of 10 days (6 g Honvan i.v.). A retrospective comparison of a control group of 94 patients without prophylaxis against thrombosis and a control group of 36 patients having received Heparin-Dihydergot did not show a significant difference of cardiovascular complications. Therefore, further 36 patients received a thrombocyte aggregation inhibitor (Godamed) as prophylaxis against embolic thrombosis. At the same time lung perfusion scintigraphy (99m Tc-Microspheres) was made directly before and after oestrogen therapy. Clinically and lung scintigraphically there was no different thromboembolic incidence compared to the patients given a Heparin-Dihydergot prophylaxis.

Aged↗