Biomedical subjects
Publications and source records attributed to C Eggers.
Primary lymphoedema refers to a swelling of a part or parts of the body due to a congenital defect in the lymphatic system. Recently, the patent blue violet dye test has been described as a means of confirming the diagnosis in dogs. This case report demonstrates that the dye test is a simple and useful diagnostic test for the diagnosis of primary lymphoedema in the cat also.
This paper discusses psychosocial influences of diabetes mellitus type 1 on children and young patients. A group of 21 patients, age 9 to 14 years with Diabetes mellitus type 1 attended a course in "Autogenic Training" for a period of 11 weeks. From the multidimensional questionnaire for children (PFK 9-14, SETZ U. RAUSCHE 1976) 15 dimensions of personality and 5 second rank factors were extracted at the beginning and at the end of training and 5 months later. Additionally HbA1-scores were assessed at the beginning and at the end at a 2 month and a 5 month-follow-up. At the beginning of the course only on one of the 15 scales a significant difference could be observed between experimental group and age related normal population. After training 5 scales and one second rank factor showed significant changes. Significant reduction was observed in: "need for aggressive forms of dominance behaviour" "feeling of submission with respects to other:", "emotional lability" and "tendency for dependence on adults". A significantly increased score was observed in the scale measuring "self confidence regarding one's own meaning, decisions and planning ability". The second rank faktor "neuroticism" was significantly reduced. Against expectations there was no reduction in HbA1 scores. At the end of training HbA1 scores even had increased significantly. But this might have been related to the high frequency of infections during this course. In subjective ratings of training evaluation most of the course members and their parents described fewer problems with attention, less test-anxiety and less aggression and nervousness. The results of this prospective pilot-study are discussed in terms of the psychodynamic influence on diabetes.
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The study compares 5 auditory event-related potential (ERP) components (P1 to P3) after 3 tones differing in pitch and rarity, and contrasts the mismatch negativity (MMN) between them in 12 children with attention-deficit hyperactivity disorder (ADHD; mean 10.2 years of age), 12 healthy controls pairwise matched for age (controls), and 10 with Chronic Tic or Tourette Syndrome (TS). Topographic recordings were derived from 19 scalp electrodes. Four major effects are reported. (a) Shorter latencies in ADHD patients were evident as early as 100 ms. (b) Both ADHD and TS groups showed very large P2 components where the maxima were shifted anteriorly. The differences in the later potentials were of a topographical nature. (c) Frontal MMN was non-significantly larger in the ADHD group but normalized data showed a left rather than a right frontal bias as in control subjects. Maxima for TS were usually posterior. (d) ADHD patients did not show the usual right-biased P3 asymmetry nor the frontal versus parietal P3 latency difference. From these results it is suggested that ADHD patients process perceptual information faster from an early stage (N1). Further, along with the TS group, ADHD patients showed an unusually marked inhibitory phase in processing (P2), interpreted as a reduction of the normal controls on further processing. Later indices of stimulus processing (N2-P3) showed a frontal impairment in TS and a right hemisphere impairment in ADHD patients. These are interpreted in terms of the difficulties in sustaining attention experienced by both ADHD and TS patients.
Prepulse inhibition (PPI) is a measure of the influence of a stimulus (S1) on the response elicited by a second stimulus (S2) occurring shortly afterwards. Most S1/S2 measures of gating have used behavioural startle and the P50 event-related potential (ERP) amplitudes to detect PPI in a simple paired stimulus paradigm. We report on two behavioural (reaction time, RT, and the electromyographically recorded response of the musculus orbicularis oculi, EMG) and 5 ERP measures of PPI where S2 was the target in an auditory two-tone discrimination. Subjects were 21 healthy controls (CON), 11 obsessive-compulsive (OCD) and 9 schizophrenic patients (SCH). The prepulse 100 ms before S2 induced more omission errors and longer RTs compared to 500ms S1-S2 interval in all subjects. PPI was also evident in EMG, P50, N1, P3 but not P2 or N2 amplitudes of CON subjects. SCH patients showed attenuation of PPI on the same measures. OCD patients were characterized only by their slow RT and a marginal attenuation of PPI of the EMG response. A correlational analysis implied separate relationships of ERP indices of PPI to the cognitive and psychomotor consequences of the prepulse on behavioural and discrimination responses. However, SCH patients showed a general rather than a specific impairment of these indices.
The diagnosis of acquired immunodeficiency syndrome-associated toxoplasmic encephalitis (TE), a typically focal disease resulting from reactivation of tissue cysts, relies mainly on indirect diagnostic methods. In a prospective study, we investigated the value of detection of Toxoplasma gondii in cerebrospinal fluid (CSF) by using the polymerase chain reaction and the mouse inoculation test. Twenty-four patients with 26 episodes of TE, 2 HIV-infected patients with primary acute Toxoplasma infection, and 38 HIV-infected control patients with latent Toxoplasma infection were investigated. Detection of T. gondii in CSF by both methods was possible in only 3 of the TE patients (11.5%), the remaining patients being negative with either of the methods. In contrast, T. gondii DNA was detected in both of the acutely infected patients, indicating that in primary acute toxoplasmosis parasites may easily be found in the CSF, whereas in the majority of TE cases in immunocompromised patients, T. gondii parasites do not gain access to the CSF drawn by lumbar puncture.
The first case of disseminated Mycobacterium bovis infection with meningitis in an AIDS patient is reported. A 54-year-old male HIV-positive patient was admitted for evaluation of fever, weight loss, inappetence, fatigue and malaise. Mycobacterium bovis (non-BCG) was isolated from blood, bone marrow, stool, urine, sputum, abdominal lymph nodes and cerebrospinal fluid. Antituberculous therapy using a five-drug regimen plus steroids resulted in complete recovery.
Positive psychotic symptoms are reported to be associated with high, negative symptoms with low dopamine (DA) activity and serotonin (5HT) activity may be altered in obsessive-compulsive disorder (OCD). We analysed 24 h urine samples in these patient groups and in healthy controls for supportive evidence. Young unmedicated OCD subjects excreted more adrenaline (AD) and homovanillic acid (HVA) and showed a higher HVA/MHPG ratio and metabolic rate than healthy controls. Independent of general metabolic rate they showed higher HVA concentrations which suggests that the relative activity of catecholamine systems in OCD (HVA/MHPG) is due more to high DA than to low noradrenergic (NA) activity. Concentrations of 5HT were also high in OCD patients. In psychotic patients low levels of DA, HVA, NA and MHPG probably resulted from neuroleptic medication. Patients diagnosed with paranoid psychosis showed higher DA utilization than controls and those with few paranoid symptoms showed high 5HT utilization. These results support studies suggesting that paranoid psychosis is associated more with increased DA activity (discussed in the context of neuroleptic reactivity), that non-paranoid forms are associated more with increased 5HT activity and that OCD patients are unusually aroused with high levels of Ad, 5HT and HVA.
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Explore the source record for details and available documents.
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We studied Nd in psychotic patients with varying degrees of paranoid symptoms. Nd is an ERP measurement of the difference in the way a nonattended tone is registered and the way the same tone is registered when used later as a discrimination target. In a three-tone oddball paradigm with passive-tone presentation and active discrimination, we recorded from 19 sites in 22 young healthy subjects and 28 schizophrenics. Nd (200-260 ms) was bilaterally symmetrical in healthy subjects. Paranoid patients showed a left frontal/right temporoparietal amplitude reduction which was reversed in nonparanoid subjects (reduced at right frontal/left posterior sites). These asymmetries were clearer when the groups were separated according to active paranoid symptoms rather than by diagnosis. There would therefore seem to be functional asymmetries mediating stimulus relevance in schizophrenics which differ from controls and differ between patients with and without active paranoid symptoms.
UNLABELLED: This study focuses on psychiatric disorders following extreme traumatisation experienced by children born during the Holocaust in World War II. According to numerous epidemiological investigations and case studies on survivors who lived through the Holocaust as children or in adulthood, these traumatic experiences are associated with a higher risk for various psychiatric disturbances during the entire life span. Besides the extreme psychological and physical distress during persecution and following traumatisation (parent-child-separation, discrimination while living in other countries) the coping with the trauma and the development of autonomy and ego-strength is additionally impaired by the specific psychodynamics of families with psychologically altered and disturbed parents. OBJECTIVE: What sort of psychodynamic parent-child relationships developed during traumatisation and after the war in subjects currently suffering from chronic impairment of mental health? METHOD: Retrospective analysis of 22 cases with applications for pensions of invalids evaluated by diagnostic categories. RESULTS: The implicit pressure on the children to be sensitive to the needs of their deprived parents places a sense of guilt on their attempts to develop autonomy. The parents were experienced as restrictive or overprotective on the one hand or liable to be rejected or to be intolerant on the other. The suffering and trauma continues to be perceived in family communication to the extent that coping with loss of relatives and the development of independence are impaired. CONCLUSION: The results are discussed critically in terms of current procedures for expertise on pension applications.
BACKGROUND: In contrast to angloamerican countries there are no national figures for the incidence and prevalence of sexual abuse in Germany. Reports based on criminal statistics are inappropriate and are often misinterpreted. METHODS: In this report we present the main results of a regional study of the prevalence of sexual abuse in childhood and compare them with angloamerican studies. RESULTS: Based on replies from 1009 students and apprentices (age > 18y) the prevalence for criminal sexual abuse was found to be 25.2% for females and 6.2% for males. A breakdown of these figures showed that females reported having to experience anal, oral or sexual intercourse (2.3%), physical contact (11.7%), exhibitionism (4.6%) and other sexual behaviour without physical contact (6.6%). For males the prevalence rates for these categories of sexual abuse were 1.5%, 2.4%, 0.9% and 1.5% respectively. All these figures, especially those for males, should be evaluated critically as actual prevalence rates are probably higher. Girls, particularly those aged 6-10 years, are more often involved than boys. Ninety percent of physical abuse happens with persons known to the victim (60% within the family, only 8% with strangers. In general 95% of abusers are male, however in 25% of cases of hands-on-contact with boys the abusers are female. From the relative frequency of reported abuse we estimate the potential incidence to be 1:30 within the family, 1:23 with other acquaintances and 1:6 with strangers. CONCLUSIONS: The importance of regional differences should not be underestimated. These results cannot be generalized for the whole of Germany. Only prevalence studies appropriately reflect the scale of the problem; they are necessary for a broad, a rational and a sufficient planning of strategies designed for prevention, intervention and rehabilitation. More scientifically based epidemiological studies on the extend of sexual abuse are required in Germany.
The derivatization of valproic acid and undecylenic acid with 4-bromomethyl-7-methoxycoumarin is described. The derivatives were detected by photodiode-array and fluorescence detectors. The optimum monitoring conditions and the stability of the suspension solution and derivatives were investigated. A high-performance liquid chromatographic (HPLC) method with isocratic or gradient elution has been established for the analysis. This method has been used for the determination of total and free valproic acid in serum. There is a satisfactory correlation between the results obtained by this HPLC method and those measured by the enzyme immunoassay. Some other common anti-epileptic drugs did not interfere with the analysis. The method is simple and fast and has better sensitivity and linearity than enzyme immunoassay. It is suited for routine therapeutic drug monitoring.
Conditioned blocking tests for the use of superfluous (irrelevant) information in task-solving. Paranoid psychotic, obsessive-compulsive and healthy subjects usually showed normal blocking, but non-paranoid subjects tended to learn about the superfluous stimulus. Attenuated blocking was usually associated with increased dopamine utilization measured in 24h urine samples. This may reflect poor stabilization of response to neuroleptic medication.
A follow-up study of 16 schizo-affectives (part of a group of 57 children originally diagnosed as schizophrenic) is reported. All 57 patients were under 14 years. They were reinvestigated after an average follow-up period of 16 years (range 6 to 40 years). Of the 57 psychoses 28% had a typical schizo-affective character. In contrast to purely schizophrenic psychoses, we found an overrepresentation in the schizo-affective psychoses of affective psychoses and suicides in the ancestry. Further, in the schizo-affective psychoses there were more premorbidly well adjusted, harmonious personalities. In contrast, maladjusted, dishormonious, introverted characters predominated in purely schizophrenic psychoses. The schizo-affective psychoses had mainly an acute-recurrent character and followed a favorable course. The schizo-affective and affective phases were of significantly shorter duration than the schizophrenic episodes.