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Biomedical subjects

E Schulz

Publications and source records attributed to E Schulz.

At least 55 records · Page 3Linked to original sources
PubMed1997

The HSM sentence test as a tool for evaluating the speech understanding in noise of cochlear implant users.

The German HSM Sentence Test, available on compact disc (CD), consists of 30 lists of 20 everyday sentences. It was developed in the desire to have a sufficient number of test sentences for the repeated evaluation of speech understanding of CI users. A noise with speech-shaped spectrum on the CD allows the evaluation of speech understanding in noise. With the HSM Sentence Test we evaluated the speech understanding of participants of the Combi-40 European Multicentric Study. Results are shown for sentences presented without noise and with signal-to-noise ratios of 15, 10, 5 and 0 dB.

Adult↗
PubMed1996

[The medical certificate--contents, form, deficiencies, fees].

The medical certificate ist a written health certificate based on the results of a medical diagnosis or examination. It does not contain scientifically base conclusions. The various forms of the certificate can be, for example, certificates of unfitness for work, certificates for insurance companies, certificates for exemption from school sports, diet certificates for tax returns, confirmation of a stable diabetes condition for driving licence authorities, certificates as proof of unfitness to plead in the process of criminal law. It is an offence (section 278 German Penal Code) to issue false health certificates for use with a public authority or insurance company contrary to one's knowledge. The form of some certificates is free, in some cases forms are used. "Standard form certificates" for insurance company are extended certificates. Certificates, especially free-form certificates, often have deficiencies: the purpose or addressee is not quoted; the date of the examination has not been entered; it is not apparent whether the statement is based on objective results; "catchword" like diagnostic terms are used: the necessary form ist not adhered to. The "Law concerning Compensation for Witnesses and Experts" (ZSEG) and the Scale of Medical Fees (GOA) set the standards for assessing the fee for a certificate.

Confidentiality↗
PubMed1996

Course and outcome in adolescent anorexia nervosa.

OBJECTIVE: To investigate course, outcome, and psychiatric comorbidity in adolescent anorexia nervosa by repeated follow-up assessment. METHOD: Thirty-four subjects (88%) of an original sample of 39 inpatients were followed up personally 3 and 7 years after discharge and classified according to DSM-III-R eating disorder categories. Standardized psychometric instruments were used to assess specific eating disorder symptoms, concomitant general psychopathology, and comorbid psychiatric diagnoses. RESULTS: After 7 years, 1 patient (3%) had anorexia nervosa, 4 patients (12%) bulimia nervosa, and 10 patients (29%) eating disorder not otherwise specified (EDNOS). Anxiety disorders (41%) and affective disorders (18%) were the most prevalent comorbid psychiatric disorders. Concomitant general psychopathology was significantly related to the outcome of the eating disorder. CONCLUSIONS: According to our results, the majority of former adolescent anorexic inpatients had shown substantial improvement in their eating disorders symptomatology after 7 years. Patients with persisting eating disorders mostly suffered from restrictive symptoms. The prevalence and distribution of psychiatric comorbidity were similar to those of adult-onset anorexia nervosa. Subjects with a worse outcome of the eating disorder also displayed higher levels of general psychopathology.

Adolescent↗
PubMed1996

A new type of bradykinin B2 receptor antagonists: bradykinin analogs with N-alkyl amino acids at position 2.

It is commonly assumed that bradykinin B2 receptor antagonists bind to a receptor site partially different from that for agonists. Thus, it is likely that there exists more than one key modification to convert bradykinin receptor agonists into antagonists. In this respect, [L-NMePhe2]-BK represents the basic structure of a new type of bradykinin B2 receptor antagonists without any replacement at position 7. This compound inhibits both in vitro bradykinin-induced contraction of the guinea pig lung strip and in vivo bradykinin-induced bronchoconstriction. Furthermore, this analog shows analgesic activity, blocks in a dose-dependent manner the bradykinin-induced Ca2+ release from macrophages and inhibits at a concentration of 10(-13) M the bradykinin-induced cytokine release from mononuclear cells. Combinations with structural modifications previously performed for other B2 receptor antagonists rather reduce than enhance the potency.

Amino Acid Sequence↗
PubMed1996

Correlated changes in symptoms and neurotransmitter indices during maintenance treatment with clozapine or conventional neuroleptics in adolescents and young adults with schizophrenia.

A study of 40 young patients (age 14-22 years) with DSM-III-R schizophrenia (without substance abuse) was conducted following a mean of 3.4 years of neuroleptic treatment. After failing on conventional agents in clinical trials lasting a mean of 2 years, 20 patients were prospectively maintained on open-label clozapine (mean 324 mg daily), and another 20 patients continued on typical neuroleptics (mean 465 mg chlorpromazine-equivalents daily). Patients were then sampled for biochemical measures and assessed for psychopathology (Brief Psychiatric Rating Scale, Scales for the Assessment of Positive/ Negative Symptoms) on six occasions at consecutive 6-week intervals-during maintenance treatment on clozapine or conventional neuroleptics. There were 22-fold interindividual differences in clozapine levels and also high intraindividual differences over time. Maintenance dosage was linearly related to plasma levels of clozapine and its metabolites. Prolactin levels were elevated with typical neuroleptics but not clozapine. Blood levels of serotonin, methoxyhydroxyphenylglycol (MHPG), norepinephrine, and epinephrine (but not dopamine) were significantly higher in clozapine-treated patients than in conventionally treated patients. Higher serotonin levels were associated with significantly fewer negative symptoms, whereas higher MHPG levels were correlated with less depression. These findings suggest involvement of norepinephrine and serotonin in the pathophysiology of schizophrenia (with depression associated with lower MHPG levels and negative symptoms associated with lower serotonin levels) and in the therapeutic actions of clozapine. Speculatively, a treatment strategy of targeting specific neurotransmitter systems might be based on the presence of specific symptoms in adolescents and young adults with schizophrenia.

Adolescent↗
PubMed1996

Morphometrical investigations on lamina-V-pyramidal-neurons in the frontal cortex of a case with anorexia nervosa.

Pyramidal neurons in the motor cortex of a lethal case of anorexia nervosa were investigated by means of a computer-assisted three-dimensional quantitative neuronographic method. The differentiation level of GOLGI-impregnated lamina-V/VI-pyramidal-neurons was analyzed by comparison of parameters such as the number of basal dendritic fields, ramification degree, length of dendritic segments and spine density with data estimated in another case of corresponding gender and age. In the anorexia case, as well as typical pyramids, a slim neuron type with one extremely long basal dendritic field was found to occur more frequently. In all the neurons investigated, the ramification pattern of single basal dendritic fields was found to be reduced and changes in the spine morphology as well as a reduction in spine density were observed. However, a simultaneous lengthening of the terminal dendrites of higher order give some evidence for the coincidence of regressive process with repair mechanisms and neuronal plasticity.

Adolescent↗
PubMed1996

[Anti-inflammatory and analgesic actions of of long-chain phenyl substituted alpha-aminoketones].

The investigated phenyl substituted alpha-amino ketones have anti-inflammatory and analgesic activities as could be shown in animal models (rats and mice). The effectiveness depends on the length of the alkyl chain. After i.p. application the most active amino ketones are ten times more effective than acetyl salicylic acid, but the activity did not reach that of indomethacin. The effective analgesic dose is ten times lower than that for anti-inflammatory action. Including the results of the toxicity the analgesic efficiency of the amino ketones could be lead to substances with high analgesic activity. After oral administration only in high doses anti-inflammatory and analgesic effectivities were found. The structural analog keto group instead of the ester or amid group leads not to the expected increase in p.o. effectivity.

Analgesics↗
PubMed1995

Effects of endothelin on hemodynamics, prostaglandins, blood coagulation and renal function.

The interaction of the endogenous vasoconstrictors endothelin (ET), angiotensin II (Ang II) and catecholamines with the kallikrein-kinin-, prostaglandin and renin-aldosterone systems in the pathogenesis of acute renal failure (ARF) is still to be defined. In 18 anesthesized pigs the influence of i.v. bolus applications of ET (2 micrograms/kg), Ang II (10 micrograms/kg) and norepinephrine (NE; 20 micrograms/kg) on hemodynamics, plasmatic coagulation and fibrinolysis system, prostaglandins and renal function was studied. ET induced a biphasic change in blood pressure, starting with an initial short-lasting reduction followed by a long-lasting elevation of systolic and diastolic blood pressure. Endothelin bolus resulted in a significant increase of 6-keto-PGF1 alpha, PGE2 and TXB2 plasma levels (P < 0.05 against preinjection values), whereas prostaglandins remained unchanged in the Ang II and NE groups. There was a distinct correlation between the plasma ET and 6-keto-PGF1 alpha levels (r = 0.82). In contrast to Ang II or NE, ET induced a shortening of the activated partial thromboplastin time (aPTT) and increase of antithrombin III levels (ATIII), fibrin monomers (FM), prekallikrein (PKK) and factor VIII activity at the beginning. Finally a pronounced decrease of ATIII, FM and PKK occurred, indicating a consumptive coagulopathy. At the end of the experiment, elevated plasma renin activity and pCO2, significantly decreased creatinine clearance, blood pH, pO2, base excess, HCO3-, oxygen saturation (P < 0.01), a distinct glomerular proteinuria, and a final anuria were observated. These results reveal that ET activates the plasmatic coagulation system and induces an ARF accompanied by impairment of pulmonary function.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiotensin II↗
PubMed1995

Determination of clozapine and its major metabolites in serum samples of adolescent schizophrenic patients by high-performance liquid chromatography. Data from a prospective clinical trial.

This report describes a method for determination of clozapine and its major metabolites N-desmethylclozapine and clozapine N-oxide in serum samples of adolescent schizophrenic patients during maintenance therapy. The method includes deproteinization and subsequent high-performance liquid chromatography with electrochemical detection. The method shows sufficient sensitivity to quantitate clozapine, clozapine N-oxide and N-desmethylclozapine accurately at 0.5, 5, and 0.5 ng/ml, respectively. We were able to demonstrate for 16 patients receiving fixed doses of clozapine that the individual mean values calculated from six consecutive measurements revealed a strong linear dosage and serum level relationship (Pearson's coefficient of correlation): clozapine (r = 0.82, p = 0.0001); N-desmethylclozapine (r = 0.81, p = 0.0001); clozapine N-oxide (r = 0.91; p = 0.0001). Preliminary pharmacokinetic data are presented and dose-response relationship are discussed.

Administration, Oral↗
PubMed1995

Bilateral posterior fracture-dislocation of the shoulders: management by bilateral shoulder hemiarthroplasties.

Bilateral posterior fracture-dislocation of the shoulders is rare, with only 26 reported cases in the literature. We present the case of a patient who sustained bilateral posterior fracture-dislocations after a first time seizure. Due to significant articular surface involvement, bilateral hemiarthroplasties were performed. The literature on this injury and current treatment options is also reviewed.

Adult↗
PubMed1994

The effect of FK506 versus cyclosporine on glucose and lipid metabolism--a randomized trial.

In order to evaluate the effect of cyclosporine (CsA) versus FK506 on glucose and lipid metabolism, an oral glucose tolerance test (OGTT) was performed in 101 patients after orthotopic liver transplantation (OLT) (mean interval after OLT: 511 days). The liver graft recipients had been randomized prospectively to two groups prior to OLT to receive either immunosuppression with CsA, azathioprine, and corticosteroids (CsA group) or FK506 and corticosteroids (FK group). Along with the OGTT, serum insulin, insulin C-peptide and glucagon as well as serum lipids were monitored. There was no statistically significant difference in the occurrence of impaired glucose tolerance (IGT) or manifest diabetes mellitus disease between the two groups. In fact, not a single patient developed new-onset diabetes in any group. In male and female patients, serum levels of cholesterol and triglycerides increased significantly under FK506 and CsA treatment after OLT. Cholesterol was significantly higher in the CsA group in men, in women this was marked, but not significant. While triglycerides were significantly higher in women on CsA treatment, there was no such difference in men. In conclusion, both CsA and FK506 proved to have similar effects on glucose metabolism, while there was a different spectrum of serum lipid alterations.

Adolescent↗
PubMed1994

Childhood-onset schizophrenia: history of the concept and recent studies.

Schizophrenic disorders in childhood are rare: 0.1-1 percent of all schizophrenic disorders manifest themselves before age 10, and 4 percent before age 15. There is, however, a remarkable increase in schizophrenia during adolescence. Age and developmental stage also influence symptoms, course, and outcome. The evidence for a male preponderance in the very early-onset group (< 14) does not apply for adolescents over age 14. The presence of positive and negative precursor symptoms can be demonstrated in child and adolescent schizophrenia before the first clinical manifestation leading to inpatient treatment. With regard to pharmacologic treatment, atypical neuroleptics such as clozapine can be used successfully. As to outcome, schizophrenic psychoses with early manifestation have a poor prognosis. The patients' premorbid personality also seems to be of great importance: A poor prognosis can be found in patients who were cognitively impaired, shy, introverted, and withdrawn before the beginning of their psychotic state.

Adolescent↗
PubMed1994

The correlation of serum hyaluronan of liver donors with posttransplant liver function.

Primary organ non-function occurs in 2-17% of patients after liver transplantation (LTX). Liver function tests focus on hepatocytes, underestimating the importance of non-parenchymal cells such as endothelium. Liver endothelium metabolises hyaluronan (HA). The function of endothelium can be estimated by measuring the concentration of HA in serum. We evaluated two organ donor groups, the first with HA levels below 200 microg/l and the second with HA levels above 200 microg/l. Both groups degraded more than 60% of HA during the first 6 h after reperfusion. Determination of hyaluronic acid in patients after LTX gives valuable information about the functional state of liver endothelium. It does not necessarily parallel the release of transaminases. In this study, there was no correlation between the levels of HA in the donor and posttransplant liver function. High HA in organ donors are most likely a consequence of different degrees of trauma and a higher release of HA into the circulation rather than impaired endothelial function.

Adult↗
PubMed1994

[Early manifestations of schizophrenic psychoses].

Schizophrenic disorders in childhood are rare. Only about 0.5 to 1% of all such disorders have their onset before age 9 and about 4% before age 14. In puberty and early adolescence, however, there is a marked increase in the frequency of such disorders. In childhood more boys seem to be affected, but during adolescence this difference seems to disappear. Possible etiological factors currently under discussion are genetic factors, neurointegrative deficits, attentional deficits, communication deficits and conspicuous premorbid features. With regard to the latter, the authors could show that positive and negative symptoms appear months or even years before the first manifestation of the disorder requiring inpatient treatment. From this perspective schizophrenic disorders in general and those with early onset in particular fit a dimensional model of illness better than a categorical one. In the development of preventive measures more attention to premorbid features is essential.

Adolescent↗
PubMed1994

[Follow-up dynamics of schizophrenic diseases in adolescence].

In the present study the clinical features of the first episode of schizophrenia were investigated retrospectively and the initial symptomatology was compared with follow-up findings. The study group consisted of 40 adolescents with chronic schizophrenia. During a one-year follow-up period positive and negative symptoms of schizophrenia and depressive symptomatology were evaluated every six weeks. When the patients entered the follow-up study the mean duration of their illness was 4.3 years. Our data revealed a close link between positive and negative symptoms during the period studied. Persistent positive symptomatology at the end of the first treatment period was predictive of high scores for positive and negative symptoms during the entire follow-up period. Furthermore, we were able to demonstrate that negative symptoms can be distinguished from depressive symptoms in the context of the schizophrenic symptomatology. Depressive states (Brief Psychiatric Rating Scale, BPRS) were closely related to the positive symptoms (assessed with the Andreasen scale SAPS), and the negative symptoms (SANS) were correlated with the anhedonia score on the BPRS. Our results suggest that productive symptomatology should be treated aggressively both initially and for a prolonged period of time thereafter. Positive and negative symptoms appear to be related to each other longitudinally. Thus we postulate a single disease process rather than two distinct types of adolescent schizophrenia.

Adolescent↗
PubMed1994

[Effect of clozapine on biogenic amines within the scope of drug treatment of schizophrenic psychoses in adolescence].

Longitudinal assessments (every six weeks for one year) were made of plasma norepinephrine, dopamine, epinephrine and 3-methoxy-4-hydroxyphenylglycol (MHPG) in 40 adolescents with schizophrenia, 20 on clozapine therapy and 20 on conventional medication. In addition to the plasma catecholamine determinations, serum levels of 5-HT were determined as a measure of serotoninergic status. All analyses were performed by HPLC-ECD (high-performance liquid chromatography with electrochemical detection). Clinical ratings of symptomatology were obtained with the Brief Psychiatric Rating Scale (BPRS) and the Andreasen scales for negative and positive symptoms (SANS and SAPS). Compared with the typical neuroleptic medication, clozapine administration was accompanied by a significant increase in plasma norepinephrine and MPHG and serum serotonin levels. The fluctuations in the biogenic amines were closely associated with the observed symptomatology. Plasma MHPG was linked to depressive symptoms (BPRS), and negative symptoms (SANS) were related to changes in the serum serotonin levels. The pathophysiological implications and clinical consequences of these findings are discussed.

Adolescent↗
PubMed1994

[Pseudo-esotropia caused by nasal dislocation of the macula in patients with high infantile myopia].

Pseudostrabismus due to dislocation of the macula is a well-known clinical entity mostly reported in the outward, upward and downward directions. This heterotopia is thought to be caused by changes in the growth rate in different areas of the retina or mechanically by retinal traction due to abortive ROP, vascular abnormalities, chorioiditis or other peripheral retinal disorders. In this paper we demonstrate four cases of macular dislocation in the direction of the optic disc associated with high myopia in infants and toddlers without signs of other retinal abnormalities. These children had myopia had myopia ranging from -17 to -20 D and esotropia superimposed by pseudostrabismus. In all four cases, strabismus surgery was performed. Postoperatively, these children showed signs of some binocular interaction. This case report may indicate that in children with strabismus associated with high myopia macular dislocation should be considered as a further characteristic affecting diagnosis and therapy.

Child↗