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Biomedical subjects

D Richter

Publications and source records attributed to D Richter.

At least 145 records · Page 8Linked to original sources

[Contents of a "basic psychosomatic management" curriculum. Results of a 4-year concomitant evaluation].

The results of evaluations proceeding the educational seminar "Psychosomatic Primary Care" in South Baden are presented and analyzed. From 1991 to 1995, approximately 450 physicians took part in these courses. From critical feedback and suggestions for improvement obtained from participants following each course, recommendations for future seminars pertaining to content, structure, process, didactic and evaluation are presented.

Adult↗

[Distal tibial fracture--an indication for osteosynthesis with the unreamed intramedullary nail?].

In a prospective study, 50 fractures of the distal fifth of the tibia with additional involvement of the ankle joint in 18 patients were stabilized by unreamed nailing. In all, 90% of all fractures healed uneventfully without further surgical intervention after unreamed nailing, the highest ratio of complications (22%) being seen in all patients with distal fractures of the fibula without additional plating (of the fibula). Tibial fractures close to the ankle joint can be managed by unreamed nailing; distal fractures of the fibula should be additionally stabilized by fibular plating.

Adult↗

Mutational analysis and molecular modeling of the nonapeptide hormone binding domains of the [Arg8]vasotocin receptor.

To identify determinants that form nonapeptide hormone binding domains of the white sucker Catostomus commersoni [Arg8]vasotocin receptor, chimeric constructs encoding parts of the vasotocin receptor and parts of the isotocin receptor have been analyzed by [(3,5-3H)Tyr2, Arg8]vasotocin binding to membranes of human embryonic kidney cells previously transfected with the different cDNA constructs and by functional expression studies in Xenopus laevis oocytes injected with mutant cRNAs. The results indicate that the N terminus and a region spanning the second extracellular loop and its flanking transmembrane segments, which contains a number of amino acid residues that are conserved throughout the nonapeptide receptor family, contribute to the affinity of the receptor for its ligand. Nonapeptide selectivity, however, is mainly defined by transmembrane region VI and the third extracellular loop. These results are complemented by a molecular model of the vasotocin receptor obtained by aligning its sequence with those of other G-protein coupled receptors as well as that of bacteriorhodopsin. The model indicates that amino acid residues of transmembrane regions II-VII that are located close to the extracellular surface also contribute to the binding of vasotocin.

Amino Acid Sequence↗

Co-evolution of ligand-receptor pairs in the vasopressin/oxytocin superfamily of bioactive peptides.

In order to understand the molecular mechanisms that underlie the co-evolution of related yet functionally distinct peptide-receptor pairs, we study receptors for the vasopressin-related peptide Lys-conopressin in the mollusc Lymnaea stagnalis. In addition to a previously cloned Lys-conopressin receptor (LSCPR1), we have now identified a novel Lys-conopressin receptor subtype, named LSCPR2. The two receptors have a differential distribution in the reproductive organs and the brain, which suggests that they are involved in the control of distinct aspects of reproduction and mediate transmitter-like and/or modulatory effects of Lys-conopressin on different types of central neurons. In contrast to LSCPR1, LSCPR2 is maximally activated by both Lys-conopressin and Ile-conopressin, an oxytocin-like synthetic analog of Lys-conopressin. Together with a study of the phylogenetic relationships of Lys-conopressin receptors and their vertebrate counterparts, these data suggest that LSCPR2 represents an ancestral receptor to the vasopressin/oxytocin receptor family in the vertebrates. Based on our findings, we provide a theory of the molecular co-evolution of the functionally distinct ligand-receptor pairs of the vasopressin/oxytocin superfamily of bioactive peptides.

Amino Acid Sequence↗

[Ultrasound follow-up of callus distraction of the tibia. Technique, possibilities and limits].

In a prospective study 20 patients were monitored with serial sonograms and radiographs during distraction osteogenesis at the lower limb. All sonograms were obtained in four planes using a 7.5 MHz transducer. The distraction gap was seen as a sonolucent area in all patients after corticotomy. At an average of 20.7 (14-28) days after the beginning of the distraction, echogenic foci occurred and showed increasing longitudinal alignment with further distraction. Radiographical signs of beginning mineralization were seen an average of 48.3 days after the start of the distraction. Exact measurement of the distraction gap was possible in all patients during lengthening. Bone healing complications and hematoma could be detected by ultrasound. A rapid increase of bone mineralization was seen after the distraction was stopped. With increasing cortication of the regenerate bone, sonograms showed a hyper-reflecting solid line so that further mineralization and the time of removal of the fixator could not be assessed by ultrasound. Ultrasound is more sensitive than radiography in identifying new bone formation during distraction, measuring the length of the distraction gap, and detecting early bone-healing complications and can therefore reduce the need for radiographs.

Adult↗

[Pseudarthroses in childhood].

Nonunion of fractures in children is rare. It occurs after pathological fractures, post-infection and after incorrect osteosynthesis. Sometimes, delayed union of one bone in the forearm or the lower leg can be observed. Typical cases of nonunion are those of the radial condyle of the humerus and the femoral neck. A different problem is presented by congenital pseudoarthroses. The treatments of choice for nonunion are autogenous bone grafting and external or internal skeletal stabilization. In the radial part of the elbow joint the only indication for operative correction is an irritation of the ulnar nerve (ventralization of the nerve and supracondylar osteotomy). Nonunion of the femoral neck can be avoided by internal screw fixation.

Adolescent↗

Are coping strategies related to disease outcome in early breast cancer?

A consecutive series of 107 women with early breast cancer were investigated for coping strategies and disease outcome 5 to 6 years after primary surgical treatment (mastectomy or lumpectomy). Coping was assessed several times during a 3-year investigation period by the Zurich and Freiburg Questionnaires of Coping with Illness (ZQCI, FQCI). Data analysis revealed no significant correlations between coping strategies and the target variable "death from breast cancer". However, significant relations were found between postsurgical tumour size (p < or = 0.01), positive histological node status (p < or = 0.01) and death from breast cancer. The results of a discriminant analysis also indicated that somatic parameters are more important for the course of breast cancer disease than psychological aspects of coping. The role of psychosocial variables for the outcome of cancer disease remains unclear and further studies in this field are necessary.

Adaptation, Psychological↗

Vertical deceleration injuries: a comparative study of the injury patterns of 101 patients after accidental and intentional high falls.

We analysed the pattern of injury of 101 adult patients who were treated in our Trauma Center after a fall from an average height of 7.2 m between 1987 and 1990. In 62 patients the fall was accidental, and 39 jumped with suicidal intent. The most common injuries were fractures of the thoracic and lumbar spine (83.0 per cent) especially of the thoracolumbar junction. The pattern of limb injuries is towards a significant preference of the metaphyseal and epiphyseal parts of the bones of the distal joints (wrist, elbow, ankle, subtalar). Fractures of the diaphyseal areas and the proximal joints (shoulder, humerus, hip, femur) were rare. The incidence of thoracic (20.8 per cent) and pelvic injuries (30.0 per cent) was relatively lower. Blunt abdominal injury (5.9 per cent) was rare after a fall from a great height. Head injuries occurred in only 27 per cent of our patients who all survived their transport to hospital. There is no significant difference in injury patterns between deliberate and accidental falls, but there is a higher number of isolated injuries in all patients after unsuccessful suicidal jumps.

Accidental Falls↗

Heterologous expression of human vasopressin-neurophysin precursors in a pituitary cell line: defective transport of a mutant protein from patients with familial diabetes insipidus.

Familial hypothalamic diabetes insipidus is an autosomal dominant disorder characterized by deficient vasopressin synthesis. Different point mutations in the vasopressin-neurophysin (VP-NP) precursor gene have been found in affected families. In a Dutch kindred, a single G to T transversion in the NP-encoding exon B of one allele converts the highly conserved glycine 17 to a valine residue. In order to examine whether this point mutation affects the processing and transport of the VP-NP precursor, the normal (HV2) and mutant (MT6) vasopressin cDNAs were stably expressed in the mouse pituitary cell line AtT20. The normal precursor was correctly glycosylated and processed, and NP was detected in the culture medium. Secretion of NP was stimulated by 8-bromo-cAMP, indicating that the normal precursor was targeted to the regulated secretory pathway. In contrast, the mutant precursor was synthesized, but processing and secretion were dramatically reduced. The mutant precursor was core-glycosylated but remained endoglycosidase H-sensitive, suggesting that the protein did not reach the trans-Golgi network. These results were supported by immunocytochemical studies. In HV2 cells, NP derived from the precursor was concentrated in the tips of the cell processes where secretory granules accumulate. In MT6 cells, NP staining was restricted to the endoplasmic reticulum (ER) as determined by colocalization with an ER-resident protein, BiP. These results suggest that the mutation within the conserved part of NP alters the conformation of the precursor and thus triggers its retention in the ER.

Amino Acid Sequence↗

Etiology of the acrodermatitis chronica atrophicans lesion in Lyme disease.

Spirochete diversity in acrodermatitis chronica atrophicans lesions in a closely defined central European site was compared to that in the local vector population, in human erythema migrans lesions, and in cerebrospinal fluid by amplifying and sequencing a segment of the gene of outer surface protein A directly from sampled tissues. Borrelia garinii, Borrelia afzelii, and Borrelia burgdorferi acutely infect human skin and invade internal tissues. Only B. afzelii, however, is associated with acrodermatitis chronica atrophicans lesions, persisting chronically where the skin has atrophied.

Acrodermatitis↗

Characteristics of Lyme disease spirochetes in archived European ticks.

To determine whether the characteristics of the Lyme disease spirochete (Borrelia burgdorferi) in Europe may have changed during the past century, DNA was amplified from archived Ixodes ricinus ticks. Tick DNA could be amplified, even when ticks had been stored under museum conditions for nearly a century. Spirochetal DNA was detected by polymerase chain reaction in 6 ticks preserved for as long as a century; the oldest was collected in 1884. Borrelia garinii, which predominates in modern ticks in the region, infected 3 of these older ticks, and the presently infrequent B. burgdorferi sensu stricto infected 2. These data indicate that residents of Europe have been exposed to diverse Lyme disease spirochetes at least since 1884, concurrent with the oldest record of apparent human infection.

Animals↗

Risk of urban Lyme disease enhanced by the presence of rats.

To determine whether Norway rats contribute to the risk of human Lyme disease in a central European city park, densities of endemic rodents were compared as were feeding densities of vector ticks and prevalence of infection by the Lyme disease spirochete. Only Norway rats and yellow-necked mice were abundant, and three times as many mice as rats were present. More larval ticks fed on rats than on mice, and far more nymphs engorged on the rats. All rats but only about half of the mice infected ticks. Each rat was more infectious than each infectious mouse. Infected rats were distributed throughout the city. Spirochetes infected about a quarter of the questing nymphal ticks. The capacity of rats to serve as reservoir hosts for the Lyme disease spirochete, therefore, increases risk of infection among visitors to this and other urban parks.

Animals↗

Case study: acute basal ganglia enlargement and obsessive-compulsive symptoms in an adolescent boy.

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAs) may arise when antibodies directed against invading bacteria cross-react with basal ganglia structures, resulting in exacerbations of obsessive-compulsive disorder (OCD) or tic disorders. This is a report of severe worsening of obsessive-compulsive symptoms in an adolescent boy following infection with group A beta-hemolytic streptococci for whom serial magnetic resonance imaging scans of the brain were acquired to assess the relationship between basal ganglia size, symptom severity, and treatment with plasmapheresis. These data provide further support for basal ganglia-mediated dysfunction in OCD and the potential for immunological treatments in PANDAs patients.

Autoantibodies↗