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Biomedical subjects

E Steiner

Publications and source records attributed to E Steiner.

At least 37 records · Page 2Linked to original sources
PubMed2001

[The efficacy of an individualized treatment schedule to maintain treatment adherence in an urban community mental health center].

OBJECTIVE: We present an observational study on the efficacy of an individualized treatment schedule, which is meant to support treatment adherence in an urban community mental health center (CMHC). METHODS: The present investigation was carried out in the natural setting of a CMHC in Vienna. During a 3-month period we observed the compliance with the appointments and the actions taken by the team in response to missed appointments as well as the utilization of the CMHC during a follow-up period of 6 months. RESULTS: During the observation period 393 (19,2 %) of 2049 scheduled visits were missed affecting more than half of the patients. Only a minority of patients with low-intensity treatment and a high rate of missed appointments had a high risk for discontinuing treatment. CONCLUSIONS: Missed appointments in outpatient psychiatric care are a common phenomenon but they constitute no major threat to the continuity of care for the majority of the patients due to the graduated efforts of the team. The time required to make up for missed appointments is considerable but the results of the follow-up confirmed the beneficial effects on utilization of psychiatric care.

Adult↗
PubMed2001

[Endometrial carcinoma in patients with diabetes mellitus].

OBJECTIVE: The purposes of this study were to analyze the relationship between clinical and pathological risk factors in endometrial cancer and additional diabetes mellitus and to clarify the correlation between additional diabetes mellitus and survival of patients with this disease. - MATERIAL AND METHODS: This analyze included 181 patients with endometrial carcinoma who were treated between 1985 and 1995 at the University hospital Mainz. Patients with sarcoma were excluded. For statistical analysis a chi(2)-test was performed for univariat analysis. A Kaplan-Meier procedure was performed for over all survival and disease free interval and COX-Regression for multivariate analysis of independence. - RESULTS: The mean follow-up period was 49 months. The mean age was 65 years. 21.8 % of the patients had an additional diabetes mellitus. These patients had a significantly deeper infiltration of the Myometrium (p-value = 0.004) and were more likely to have lymphonode metastasis (p-value = 0.02). - CONCLUSION: Our results show a correlation between Diabetes mellitus and adverse prognostic factors witch affects by the rate of lymphonode spread and overall survival.

Aged↗
PubMed2001

11 beta-hydroxysteroid dehydrogenase (11 beta-HSD-II) activity in human placenta: its relationship to placental weight and birth weight and its possible role in hypertension.

It has been assumed that low birth weight and high placenta weight were key factors for predicting hypertension in human adulthood. A deficiency in placental 11 beta-HSD-II enzyme activity was supposed to be the underlying cause. To possibly establish 11 beta-HSD-II as a leading factor, we determined 11 beta-HSD-II activities in 133 healthy pregnancies, 21 proteinuric pregnancies complicated by pregnancy-induced hypertension (PIH), 26 non proteinuric PIH pregnancies and 15 pregnancies complicated by fetal growth restriction (32nd-41st gestational week). We could not identify differences in 11 beta-HSD-II activity between pregnancies with the rare combination of small babies with big placentas and others (p = 0.59; Kruskal-Wallis test). And although there was no correlation between 11 beta-HSD-II activity and birth weight, in the control gestational age correlated with 11 beta-HSD-II activity (r = 0.22; p < 0.05; Spearman). 11 beta-HSD-II activity in the proteinuric PIH group was significantly higher than in the controls (11.7 pmol/min/mg prot.; range 10-13.2 vs. 7.9; range 7.0-9.1; p < 0.05). The lowest, but not significant, enzyme activities were in the IUGR group (5.8 pmol/min/mg prot.; range 4.0-9.2). In this group, analysis of variance detected a correlation between enzyme activity and placental weight. In conclusion, we could not confirm that placental 11 beta-HSD-II deficiencies act as an indicator for the risk of adult hypertension in small fetuses with large placentas. However, in growth restriction 11 beta-HSD-II activity might play a role. To clarify the influence in this group, further research is needed. Increased 11 beta-HSD-II activities with gestational age in the control may serve to sustain fetal adrenal steroid genesis and to prepare the fetus for autonomic life.

11-beta-Hydroxysteroid Dehydrogenases↗
PubMed2000

Spo0A directly controls the switch from acid to solvent production in solvent-forming clostridia.

The spo0A genes of Clostridium beijerinckii NCIMB 8052 and Clostridium cellulolyticum ATCC 35319 were isolated and characterized. The C-terminal DNA-binding domains of the predicted products of spo0A from these two organisms, as well as 16 other taxonomically diverse species of Bacillus and Clostridium, show extensive amino acid sequence conservation (56% identity, 65% similarity over 104 residues). A 12-amino-acid motif (SRVERAIRHAIE) that forms the putative DNA recognition helix is particularly highly conserved, suggesting a common DNA target. Insertional inactivation of spo0A in C. beijerinckii blocked the formation of solvents (as well as spores and granulose). Sequences resembling Spo0A-binding motifs (TGNCGAA) are found in the promoter regions of several of the genes whose expression is modulated at the onset of solventogenesis in Clostridium acetobutylicum and C. beijerinckii. These include the upregulated adc gene, encoding acetoacetate decarboxylase (EC 4.1.1. 4), and the downregulated ptb gene, encoding phosphotransbutyrylase (EC 2.3.1.c). In vitro gel retardation experiments using C. acetobutylicum adc and C. beijerinckii ptb promoter fragments and recombinant Bacillus subtilis and C. beijerinckii Spo0A suggested that adc and ptb are directly controlled by Spo0A. The binding affinity was reduced when the 0A boxes were destroyed, and enhanced when they were modified to conform precisely to the consensus sequence. In vivo analysis of wild-type and mutagenized promoters transcriptionally fused to the gusA reporter gene in C. beijerinckii validated this hypothesis. Post-exponential phase expression from the mutagenized adc promoter was substantially reduced, whereas expression from the mutagenized ptb promoter was not shut down at the end of exponential growth.

Acids↗
PubMed2000

[Quality of life of the mentally ill].

Object of this research project was to study the subjective quality of life of psychiatric patients. The vulnerability of 424 out- and inpatients was assessed. The Vulnerability Index, composed of: marital status, income, health, life conditions, occupation, and risk factors in childhood was used. According to their vulnerability, two groups of patients were differentiated: patients with high and low vulnerability. We compared these objective criteria of vulnerability with the subjective quality of life (Q-LES-Q). Quality of life was also compared with diagnosis, severity of illness, and treatment (first contact/long-term contacts). Quality of life of 250 patients was analysed after one year follow up. Patients with a low vulnerability score are more satisfied with 'social relations' than patients with a high vulnerability score. In-patients are more satisfied with 'social relations' than out-patients. Out-patients are more satisfied with their 'physical health', 'subjective feelings', 'leisure time activities', and 'overall life satisfaction' than in-patients. Patients with a mild affective disorder have a better 'life satisfaction' than patients with severe affective disorder. Quality of life of schizophrenics and of patients with anxiety and adjustment disorders has improved significantly after one year.

Adaptation, Psychological↗
PubMed2000

The cause of "acid-crash" and "acidogenic fermentations" during the batch acetone-butanol-ethanol (ABE-) fermentation process.

Experiments were performed to determine the cause of "acid crash", a phenomenon which occasionally occurs in pH-uncontrolled batch fermentations resulting in premature cessation of ABE (acetone butanol) production. The results indicate that "acid crash" occurs when the concentration of undissociated acids in the broth exceeds 57 - 60 mmol/l. Prevention can be achieved by introducing some limited pH control to minimize the concentration of undissociated acids or by slowing the metabolic rate, and thus the rate of acid production, by, for example, lowering the fermentation temperature. "Acidogenic fermentations", which occur when batch fermentations are performed at pH values close to neutrality, are due to rapid production of acids followed by inhibition of solventogenesis when the total acid concentration reaches 240 - 250 mmol/l. Solventogenesis can be achieved at these pH values by lowering the glucose uptake rate / acid production rate by use of e.g. elevated glucose or lowered yeast extract concentrations in the growth medium.

Acetone↗
PubMed2000

Reference values of ductus venosus flow velocities and calculated waveform indices.

In recent years, investigations of the venous vascular system have become increasingly important in the assessment of fetal myocardial function. The aim of the present Doppler ultrasound study was to establish both new reference ranges for blood flow velocity during the different phases of the cardiac cycle (S, SD, D, a) and various calculated indices ((S-a)/S, (S-a)/V(mean), (S-a)D, S/D, a/S, S/a) for the ductus venosus. Pulsed-wave colour Doppler was used in this prospective cross-sectional study to examine 696 women with low-risk pregnancies during the period from 14 to 41 weeks' gestation. Reference curves were constructed for the individual measuring parameters based on a growth function from a four-parameter class of monotonic continuous functions according to the smallest square principle. A significant increase in blood flow velocity from 48 cm/s to 65.8 cm/s was observed during ventricular systole (=S) from 14 to 41 week's gestation. Similarly, increases in blood flow velocity were recorded during the endsystolic phase (=SD) (35.5 cm/s to 50.7 cm/s during early ventricular diastole (=D) (41.7 cm/s to 58 cm/s, p=0.0001) and atrial contraction (=a) (11.2 cm/s to 35 cm/s, p=0.0001), as well as for intensity-weighted mean velocity (30 cm/s to 48.3 cm/s). The venous indices were associated with significant decreases in the individual parameters with increasing gestational age: (S-a)/S from 0.77 to 0.47, (S-a)/V(mean) from 1.21 to 0.67, (S-a)/D from 0.89 to 0.54, S/a from 4.5 to 1.99. A significant increase from 0.23 to 0.53 was observed only for the quotient a/S. There were no changes in the S/D quotient (from 1.15 to 1.13). Regarding intra-observer reliability, more favourable results were obtained for calculated indices than for measurements of absolute blood flow velocities. At constant measuring conditions, the reference ranges established by this study for blood flow velocities and calculated indices in the ductus venosus may serve as the basis for Doppler ultrasound follow-up in a normal patient population as well as for the diagnosis of fetal myocardial insufficiency of hypoxic and congestive origin.

Adolescent↗
PubMed2000

[Social vulnerability, social isolation of chronic psychiatric patients].

Social vulnerability and social isolation as to different, light and severe grades of chronically ill psychiatric patients were evaluated. A social vulnerability index, composed out of marital status, income, health, living conditions, occupation, and risk factors in childhood was used. The vulnerability of 64 severely chronically ill patients and of 84 chronically ill patients was assessed. According to their vulnerability, the patients were divided into a group of highly vulnerable and a group of less vulnerable patients. The social isolation of the two groups (severely chronically und chronically ill patients) was compared and assessed. We used objective criteria (such as living alone, no friends, no contact to family members) and subjective criteria (feeling isolated). Social Vulnerability and social isolation are higher in severely chronically ill patients compared to chronically ill patients. The severely sick group is significantly more affected by objective and/or by subjective isolation than the less sick group. In both groups patients have more difficulties in social relationships than non-isolated patients. There is no significant correlation between objective isolation and subjective isolation.

Adolescent↗
PubMed1999

TNFalpha plus IFNgamma induce the production of Alzheimer beta-amyloid peptides and decrease the secretion of APPs.

The appearance of inflammatory markers associated with amyloid plaques indicates a state of chronic inflammation in Alzheimer's disease (AD). Multiple epidemiological studies also suggest that patients taking anti-inflammatory drugs have a decreased risk of developing AD. Here we present evidence that inflammatory cytokines can alter the metabolism of the beta-amyloid precursor protein (betaAPP). We show that the combination of tumor necrosis factor alpha and interferon gamma triggers the production of beta-amyloid peptides and inhibits the secretion of soluble APPs by human neuronal and extraneuronal cells. The results demonstrate a new mechanism by which inflammatory components can exacerbate the fundamental pathology in AD.

Alzheimer Disease↗
PubMed1998

Sex steroids do not prevent amylin-induced apoptosis in human cells.

Formation of amylin-containing islet amyloid deposits may contribute to the progressive deterioration of beta cell function in non-insulin-dependent diabetes mellitus. As diabetes mellitus occurs in male, but rarely in female transgenic mice expressing human amylin in their pancreatic beta cells, it is of interest to study the influence of estradiol (E2) and testosterone (T) on amylin-induced cytotoxicity in human cells. The insulinoma cell line CM, thyroid epithelial cells (TEC) in primary culture, and nontransformed fibroblast lines were used. The occurrence of apoptotic cell death was assessed by nuclear labeling with propidium iodide. Amylin was cytotoxic on all cell types tested, but had the most pronounced effect on TEC and the weakest on the CM cell line. Although both E2 and T decreased the proportion of apoptotic cells in cultures kept in the absence of amylin, neither of the two hormones was able to counteract amylin-induced cytotoxicity. beta cell death and hyperglycemia can thus presumably not be prevented by the neutralization of amylin effects by sex steroids.

Amyloid↗
PubMed1998

Cerebrolysin protects isolated cortical neurons from neurodegeneration after brief histotoxic hypoxia.

A brief period of histotoxic hypoxia exhibits certain metabolic features resembling the in vivo situation of ischemia. In this study the neuroprotective effects of the peptidergic nootropic drug Cerebrolysin (Cere) against iodoacetate induced histotoxic hypoxia were investigated. For that purpose isolated cortical neurons from 9 day chicken embryos were precultured with 0 to 6.4 mg.Cere/ml medium. At the 8th day in vitro histotoxic hypoxia was induced by incubation with 0.01 or 0.1 mM iodoacetate. Cells were allowed to recover from toxic stress for 3, 6, 24 or 48 hours. Cere protected neurons dose dependently from delayed neuronal cell death due to 0.01 mM iodoacetate even after a recovery period of 48h. After induction of histotoxic hypoxia by 0.1 mM iodoacetate high concentrations of Cere again led to neuronal protection after the 3 and 6 h recovery period. Moreover the influence of Cere on the cytoskeletal protein MAP2 in neurons submitted to 0.01 mM iodoacetate was investigated. With Western blotting and immunohistochemical techniques it has been demonstrated that the drug clearly increased MAP2 abundance after histotoxic hypoxia. The present study points out that after severe damage of cortical neurons with iodoacetate Cere is able to protect neurons from delayed neuronal cell death maybe by maintaining neuronal plasticity due to avoidance of the cytoskeletal breakdown.

Amino Acids↗
PubMed1998

Implementing teleradiology in a private radiology practice: lessons learned.

The private practice of radiology deals with the delivery of high quality, timely service to referring physicians. Technology offers the promise of supporting this objective through faster reading of studies through electronic imaging and the delivery of results in a fast, efficient manner. In order to be successful, the practice must clearly define its objectives, understand its fundamental business processes and select a technology solution that is proven to meet those objectives.

Contract Services↗
PubMed1998

[Physiology of the larynx].

The larynx consists of the cartilaginous-osseous framework, elastic membranes and ligaments, joints, muscles, nerves, vessels, and interior cavity. The laryngeal functions are the protection of the airway during swallowing, respiration (i.e. maintainance of the airway) and phonation. During the pharyngeal phase of swallowing the swallow reflex induces a laryngeal closure in three levels and a superior-anterior movement of the larynx and hyoid bone. The laryngeal airway is maintained by the circumference of the cricoid cartilage. Phonation is the phylogenetically recent function of the larynx and was made possible by the laryngeal descent. The sound production is explained according to the myoelastic-aerodynamic theory. The diagnostics of laryngeal diseases is performed in close cooperation between otorhinolaryngology and radiology. For diagnostic purposes, the physiology of the larynx requires to take into account not only morphological, but also functional aspects.

Airway Resistance↗