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Biomedical subjects

C Müller

Publications and source records attributed to C Müller.

At least 595 records · Page 33Linked to original sources
PubMed1988

Single photon emission computerized tomography during and between seizures.

In three patients, patterns of brain activity were measured by 99mTc-hexamethyl-propyleneamineoxime (99mTc-HM-PAO) brain SPECT (single photon emission computerized tomography) in ictal and interictal states. Increased relative blood flow indicated the focus of partial seizures, its spreading to adjacent cortical regions and to distant brain structures via neuronal pathways. Ictal patterns of regional cerebral blood flow (rCBF) were in agreement with clinical symptomatology. Successive SPECT studies were performed after 3-7 days in the absence of electroencephalographic and clinical signs of seizures but still revealed increased relative blood flow in the focus of the seizures. SPECT studies, performed 2-6 weeks after the last clinically observable seizures, demonstrated the transition from increased to decreased relative blood flow in the focus of the seizures. In one patient, the EEG was complementary to and corresponded with the rCBF patterns in the ictal state. However, the dynamics of interictal changes could only be assessed by brain SPECT.

Adult↗
PubMed1988

Increased serum concentrations of cholesterol and triglycerides in the progression of breast cancer.

The course of serum concentrations of cholesterol and triglycerides was investigated in patients with advanced breast cancer. The patients studied were divided into two groups according to their clinical status: group-I consisted of 51 patients who already had metastases at the start of the investigation, but progressed further during the time of observation; group-II consisted of 14 patients in remission who experienced recurrence of disease while under observation. In group-I, 28 patients (54.9%) were found to have normal serum triglyceride levels at the beginning of the observation period; 22 patients (78.6%) from this group experienced a significant (P less than 0.0001) increase above the normal range upon further disease progression. Similarly, serum cholesterol levels were normal in 32 patients (62.8%) at the start of the investigation, but increased significantly (P less than 0.0001) above the normal range upon disease progression. In group-II, 8 patients (57.2%) had normal serum triglyceride levels at the beginning of the observation period, but the levels increased in 4 patients (50%) significantly (P less than 0.005) upon the occurrence of metastases. Within the same group, a significant increase (P less than 0.001) of initially normal serum cholesterol levels was found in 4 (44.9%) out of 9 patients. In summary, a rise in serum levels of triglycerides and/or cholesterol should receive increased attention and could indicate progression or recurrence of breast cancer.

Aged↗
PubMed1988

Evaluation of prostaglandin-receptors in human and rat liver: interspecies differences at the prostaglandin receptor-level.

The properties of PGE1-, PGE2- and iloprost (stable PGI2-analogue)-binding sites on normal human and rat liver surface cell membranes were investigated. The specific binding of [3H]PGE1 to human (rat) liver surface cell membranes could be displaced most effectively by unlabeled PGE1 (IC-50:2.5 +/- 1.7, (6.1 +/- 2.1) microM) and the specific binding of [3H]PGE2 by unlabeled PGE2 (IC-50: 1.9 +/- 0.9 (2.0 +/- 0.8) microM. The Scatchard analysis on [3H]PGE1- as well as on [3H]iloprost-binding was curvilinear whereas it was clearly linear on [3H]PGE2-binding in both the species. The high-affinity [3H]PGE1-sites showed a Bmax of 36.3 +/- 5.2 (21.3 +/- 4.3) fmol/mg protein and a Kd of 2.1 +/- 1.8 (1.9 +/- 0.7) nM, the low-affinity [3H]PGE1-sites a Bmax of 93.4 +/- 18.2 (86.1 +/- 13.2) fmol/mg protein and a Kd of 10.5 +/- 2.9 (15.1 +/- 3.2) nM. The high-affinity [3H]iloprost-sites exhibited a Bmax of 71.4 +/- 13.9 (35.9 +/- 8.2) fmol/mg protein and a Kd of 4.1 +/- 1.2 (1.7 +/- 1.8) nM, the low-affinity [3H]iloprost-sites a Bmax of 217.3 +/- 42.1 (142.9 +/- 17.8) fmol/mg protein and a Kd of 16.3 +/- 4.9 (9.2 +/- 7.2) nM. The [3H]PGE2-sites showed a Bmax of 135.4 +/- 51.9 (38.8 +/- 7.4) fmol/mg protein and a Kd of 16.2 +/- 3.2 (2.5 +/- 1.2) nM. It is assumed that prostaglandins of the E-series are promising substances in the regulation of human and rat liver function since liver cells are able to bind reasonable amounts of these substances in a high affinity manner. However, interspecies differences in the affinity of the prostaglandins to their receptor-sites make it strange to assume that the same biological findings claimed several times for the rat liver are relevant for human too.

Animals↗
PubMed1988

Lytic effector cell function in schizophrenia and depression.

Natural killer (NK) cell activity and antibody-dependent cellular cytotoxicity (ADCC) were tested in patients with schizophrenia or depression. It was found that NK activity as well as ADCC were significantly lower in both groups, as compared to healthy control individuals (P less than 0.001). Psychopharmacologic treatment with neuroleptics and antidepressives resulted in a significant increase in NK activity and ADCC (P less than 0.005) in patients with schizophrenia but not in treated patients with depression. In patients with schizophrenia, no correlation could be established between the dose of neuroleptic given and the increase in NK activity. Lithium also did not produce an increase in NK activity and ADCC. The addition of serum, derived from untreated patients with schizophrenia, to cell cultures in concentrations of 10 and 20% had an inhibitory effect upon the ADCC and, to a lesser degree, upon NK activity (20% serum concentration only); sera from treatment schizophrenics produced no inhibition of NK activity, but did affect ADCC. No serum-derived inhibitory effect upon either NK activity or ADCC was found to be present in sera from patients with depression. We conclude that lytic effector mechanisms are impaired in patients with schizophrenia or depression and that this defect is reversed in schizophrenic patients on treatment, but not in depressives on therapy. Patients with schizophrenia also tend to have a reversible serum-mediated inhibition of NK activity which is absent in patients with depression.

Adult↗
PubMed1988

Plasma atrial natriuretic factor in cirrhotic patients with ascites. Effect of peritoneovenous shunt implantation.

Human atrial natriuretic factor (ANF) levels were measured before and after peritoneovenous shunt implantation in 10 cirrhotic patients with ascites, in whom sodium retention is a major clinical problem. The mean preoperative plasma level of ANF was 82 ng/L (normal range, 5-80 ng/L). Peritoneovenous shunting resulted in a significant rise in plasma ANF to 308 ng/L (p less than 0.0025) immediately after operation. This was followed by a constant fall until the seventh postoperative day, when mean plasma ANF was still significantly elevated (149 ng/L) compared with the preoperative value (p less than 0.01). Three months after shunt implantation mean plasma ANF had returned to the preoperative level (75 ng/L). Mean sodium excretion increased from 2.6 mEq/h preoperatively to 10.2 mEq/h at the second postoperative day (p less than 0.025). No direct relationship was noted between changes in plasma ANF level and changes in urinary sodium excretion after shunt implantation. These data demonstrate an intact ANF release response to intravascular volume expansion in cirrhotic patients with ascites, but exclude ANF as the diminished natriuretic factor as proposed by the overflow theory of ascites formation. Sodium excretion and fluid retention seem to be the result of vascular underfill and fluid maldistribution, and hormonal changes are likely to be secondary to them.

Aged↗
PubMed1988

Results after implantation of gelatine-impregnated bifurcated grafts.

In two randomized prospective trials grafts impregnated with gelatine were compared to those not impregnated. In the first trial a double-velours graft (n = 50) was compared with a graft without velours trimming (n = 50) implanted in the aorto-iliac bifurcation. One half of the grafts in both groups were gelatine-impregnated. In the second trial 24 grafts without velours trimming (Cooley II, Meadox), 24 grafts manufactured by a new warp-knitting procedure without velours trimming (Protegraft 2000, B. Braun AG) and 24 identical grafts of B. Braun AG but with gelatine impregnation were evaluated. Gelatine-impregnated or not the grafts without velours showed no satisfying results. An elevated intraoperative bleeding incidence and a low two-years-patency rate of 64% were noted. On the other hand all double-velours grafts, gelatine-impregnated or not, showed a 100% patency rate two years after implantation. In the second trial a slight reduction in intraoperative blood loss was noted when using the gelatine-impregnated grafts.

Aorta, Abdominal↗
PubMed1988

[Bullous dermatosis with conjunctival and corneal involvement: differential diagnostic scope and explanation of the "overlap syndrome" concept].

Chronic blister-forming dermatosis can lead to conjunctival and corneal involvement. Taking one such case as an example, the authors show that while disorders of this kind can be classified as a form of bullous dermatosis, the differential diagnostic classification is not unequivocal, regardless of the examination method adopted. The term "overlay syndrome" has been introduced into the dermatologic literature to cover clinical pictures of this kind.

Adolescent↗
PubMed1988

[Immune reactions of the conjunctiva and cornea following severe chemical burns of the outer eye].

Conjunctival and corneal tissue samples from nine patients with severe changes after acid and alkali burns were examined immunohistochemically. Epithelial HLA Class II antigen expression was present in three of five conjunctival samples, and all of the antigen markers examined in the conjunctival stroma could be stained. HLA Class II expression was demonstrated in four out of five corneal tissue samples. The results show that in Grade III or IV chemical burns, with the diverse changes of the external eye that they produce, immunological and possibly also autoimmune mechanisms can influence the clinical course.

Autoimmune Diseases↗
PubMed1988

Survival rate and causes of death in patients with pacemakers: dependence on symptoms leading to pacemaker implantation.

The survival rate of 2256 patients with pacemakers was analyzed. Patients paced for Adams-Stokes equivalents (e.g. dizziness) showed a significantly better survival rate than did patients with pacemakers implanted for Adam-Stokes attacks or heart failure (P less than 0.0001). The estimated survival of the latter two groups did not differ significantly. Of the deceased patients who had received a pacemaker for the treatment of heart failure, 54% died due to this condition despite pacemaker implantation. The relative percentage of cases of sudden death after pacemaker implantation was high in the groups with Adams-Stokes attacks (12%) and Adams-Stokes equivalents (13%). In patients paced for Adams-Stokes attacks, sudden death occurred more frequently in the first year after pacemaker implantation (P less than 0.015) than during the following years. Therefore, increased efforts should be made to monitor patients carefully after pacemaker implantation to enable prompt detection of malignant tachyarrhythmias, probably the cause of sudden death in a substantial number of patients with pacemakers.

Adams-Stokes Syndrome↗
PubMed1988

HLA-DP in rheumatoid arthritis.

Frequencies of HLA-DR, Dw and DPw specificities were compared between rheumatoid arthritis (RA) patients, Felty's syndrome (FS) patients and normal controls. It was confirmed that the frequency of DR4 was increased in RA patients (54% (n = 111) vs 23% (n = 272), relative risk (RR) = 3.98, P less than 0.001). Cellular typing showed a highly significant increase in HLA-Dw14 in the entire RA population (17% (n = 32) vs 2% (n = 242), RR = 11.90, P less than 0.001), and a tendency towards an increase of HLA-Dw14 in DR4+ RA patients compared to DR4+ controls (28% (n = 32) vs 11% (n = 47), RR = 3.29, P less than 0.05). Regarding DPw specificities, the only significance was for a negative association with DPw3 (13% vs 22% (n = 254), RR = 0.51, P less than 0.05), with an additional tendential decrease of DPw1 (11% vs 19%, RR = 0.53, not significant (NS]. The decrease of DPw3 was more marked in DR4- RA patients (RR = 0.33, P less than 0.05) than in DR4+ RA patients (RR = 0.69, NS). In FS patients, 96% of whom were DR4+, decreased DPw1 was very marked, whereas the frequency of DPw3 was unaltered compared to DR4+ normals. These alterations in frequencies were not caused by linkage disequilibria between HLA-DR and -DP alleles. Thus, taken together, these data suggest that, in the presence of the major DR4-associated "susceptibility" gene(s) for RA, DPw1 may have "protective" effects, whereas in the absence of DR4, the presence of DPw3 has significant "protective" activity.

Arthritis, Rheumatoid↗
PubMed1988

Spontaneous and interferon-induced natural cytotoxicity in Crohn's disease.

Natural killer cell (NK) activity and antibody-dependent cellular cytotoxicity (ADCC) exerted by peripheral blood mononuclear cells (PMNC) were investigated in 53 patients with Crohn's disease (CD). NK activity and ADCC were found to be significantly reduced in patients with CD (p less than 0.0005) as compared to healthy controls. Both effector cell functions increased after in vitro treatment of PMNC with gamma-interferon, but did not reach the levels found in controls (p less than 0.0005). Neither NK activity nor ADCC was significantly influenced by therapy with corticosteroids. Moreover, the reduced serum zinc levels in patients with CD, which have been shown to be associated with impaired immune function, did not influence the lytic effector cell mechanism assayed either. Finally, no association could be found between NK cell activity or ADCC and CD activity index, the extent of the disease and several laboratory parameters of inflammation. We conclude that patients with CD have a reduced lytic effector cell function which remains uninfluenced by corticosteroid treatment and seems to be present independently of disease activity.

Adolescent↗
PubMed1988

Phenotypic and functional analysis of cellular cytotoxicity after splenectomy.

Phenotypic and functional aspects of cellular cytotoxicity were investigated in patients after splenectomy. While assays testing for natural killer cell (NK) activity and antibody-dependent cellular cytotoxicity showed a significantly reduced (p less than 0.005 and p less than 0.025, respectively) activity of the relevant cell populations, lectin-dependent cellular cytotoxicity was either normal or, in one dilution of phytohemagglutinin, even significantly increased (p less than 0.025), as compared to healthy control persons. In a search for a possible explanation for this phenomenon, it was found that the total lymphocyte count was significantly increased (p less than 0.01) in patients after splenectomy, when compared with healthy control individuals. However, neither the absolute cell count nor the percentage of Leu7+ lymphocytes showed significant differences between splenectomized patients and controls. In contrast, the percentages of (Leu7+Leu2)+, OKT11+, OKT4+ and Leu2a+ lymphocytes were significantly decreased (p less than 0.0025, p less than 0.01 and p less than 0.005, respectively) in splenectomized patients with not only the percentage, but also the absolute number of DR+ lymphocytes being significantly increased (p less than 0.005 and p less than 0.05, respectively). We thus conclude that in patients after splenectomy NK activity is decreased which may possibly be due to the lack of a NK subset. In contrast, the overall percentages of T cells (OKT11+), T helper/inducer (OKT4+) and T suppressor cells (Leu2a+) were significantly decreased in patients after splenectomy, although this defect could be compensated by a significant increase in the absolute lymphocyte number.

Adult↗
PubMed1988

Demonstration of glycosylation variants of human fibrinogen, using the new technique of glycoprotein lectin immunosorbent assay (GLIA).

A new highly sensitive method, incorporation the ELISA technique (enzyme-linked immunosorbent assay), is described for the quantitation of the glycan residues of glycoproteins. With the aid of this "glycoprotein-lectin immunosorbent assay (GLIA)", it is possible to determine the nature of the glycan residues of a single protein in a glycoprotein mixture, without prior purification. The GLIA can be used for the accurate determination of the inhibitor constant for the interaction of any monosaccharide with any lectin. Using the described technique, glycosylation of human fibrinogen from plasma and amniotic fluid were compared. In fibrinogen from amniotic fluid a "fetal" glycosylation type could be demonstrated. In addition, evidence is presented for the first time that plasma fibrinogen possesses (GlcNAc beta 1----4Man beta) residues (bisecting GlcNAc) and O-glycosidically bound carbohydrate units. Preliminary results were published as abstract (E. Köttgen et al. (1988) Fresenius Z. Anal. Chem. 330, 448).

Enzyme-Linked Immunosorbent Assay↗
PubMed1988

[Apropos of the new mental health law in Italy].

In this article psychiatric assistance in Italy is examined 8 years after the Law 180 that enacted the closing down of psychiatric hospitals has come into force. Starting with an outline of the political and social history of the country, the authors considered the characteristics of the law, the difficulties and results of its application, and the criticisms that have been expressed, basing themselves on the available statistical and epidemiological data. Even if a conclusive evaluation of the validity of this reform seems to be premature, these two elements were estimated as definite: 1. Discussion and debate remain necessary. 2. Thanks to Basaglia, psychiatry in Italy is gradually making up its historical delay.

Community Mental Health Services↗
PubMed1988

[Chemotherapy of advanced pancreatic cancer with 5-fluorouracil, doxorubicin and high-dose methotrexate].

The aim of the present phase II clinical trial was to investigate the therapeutic efficacy and tolerance of a combination chemotherapeutic protocol consisting of 4-weekly intervals of 5-fluorouracil, doxorubicin and high-dose methotrexate (FAMeth-regimen) in patients with advanced measurable pancreatic cancer. After a median treatment duration of 4 (2-12) months, one complete and one partial response were achieved in the 13 evaluable patients. Two additional patients had evidence of objective tumour regression, although response was less than 50% of pretreatment tumor measurements. Stable disease was noted in 3 patients, and the tumour progressed in 6. The median survival of all evaluable patients from start of therapy is 7 (2-17) months. Side-effects associated with FAMeth-chemotherapy were generally mild and reversible and primarily included gastrointestinal symptoms (38%) and leukopenia (62%). There was 1 treatment related death due to pancytopenia and sepsis. Our preliminary data suggest some antitumour activity of the regimen against pancreatic cancer, although final assessment of therapeutic results must await accrural of additional patients.

Adult↗
PubMed1988

[The readmission of schizophrenics: a retrospective study over 5 years].

Since the introduction of neuroleptics, the number of beds in psychiatric hospitals has decreased progressively, but, in the same time, the number of readmissions has increased. For schizophrenic outpatients, we can estimate that 68% will be readmitted during the 5 years following their departure from the hospital. In our retrospective survey, we have studied the different factors which influence the readmissions. We have shown, with a statistical significancy, that an agricultural background, a fulltime job and brief hospitalizations prevent the readmissions. However patients aged less than 30 years, with long hospitalizations and living alone have a high risk of readmission. The most frequent causes are patient's omission to take prescribed drugs, environmental conflicts and alteration in the familial situation.

Adult↗
PubMed1988

[Use of plasmapheresis in therapy of systemic lupus erythematosus: a controlled study].

The effectivity of a combination of various plasma exchange regimens in combination with immunosuppressive medication consisting of corticosteroids and cyclophosphamide was tested in patients with severe systemic lupus erythematosus (SLE) the symptoms of which were found to be refractory to conventional immunosuppressive treatment administered orally. The patients were then submitted in a controlled manner to the following treatment modalities: 1. consecutive plasmapheresis (plasma exchanges every 2 to 3 days during a period of 2 to 3 weeks) with a continuation of immunosuppressive therapy administered orally; 2. chronic intermittent treatment (once per week) with parallel immunosuppression; 3. 2 plasmaphereses followed by an i.v. cyclophosphamide bolus. Only the third approach resulted in a stable and persistent clinical and serological improvement of disease activity.

Adrenal Cortex Hormones↗