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Biomedical subjects

G Rudolf

Publications and source records attributed to G Rudolf.

At least 37 records · Page 2Linked to original sources

[Structure and structural disorder].

One of the central tasks of psychodynamic diagnosis, next to determining intrapsychic conflicts, central relational patterns, and subjective forms of experiencing is assessing the psychic structure or the structural disorder. This article develops the structure term from object relationship theoretical, ego-psychological, and self-psychological concepts of psychoanalysis. This "Structure of the self in the relationship to others" thus obtained is described with six structural criteria (self-perception, self-control, defence, object perception, communication, attachment). In order to be able to distinguish the extent and the quality of structural disorders four structure levels of integration based on psychoanalytic experience in the out-patient and the in-patient setting are differentiated. A basis for an operationalization is then made; it is made in the system OPD (Operationalized Psychodynamic Diagnostics). First studies regarding practicalibility and reliability are promising.

Communication↗

[The course of immunologic parameters in inpatient psychotherapy exemplified by 2 single case studies].

Psycho-neuroimmunology depicts a conceptual frame in which possible interactions between psychic and physical processes can be examined. It could be very significant in the field of psychosomatics when the courses of psychic and somatic processes are examined. However, the research results from this field of study are varied and only for a few parameters of immunity is it possible to prove correlations with psychic variables. Many of the studies that have been conducted up to date were construed as cross-section studies and possibly therefore are not very suitable for depicting the probably very complicated forms of interactions between psychic and somatic levels in an adequate manner. In the framework of stationary psychosomatic psychotherapy two single case studies were carried out in order to examine temporal connections between psychic and immunological course parameters. Both single case studies are to be viewed as explorative attempts of examining questions of examination design and organization which are highly resolved regarding time. Furthermore we report several interesting individual results which emphasize in general the correlation between psychic and somatic parameters also in the course of time. However the limits of such studies regarding the significance of the individual immunological parameters, using time serial analytical methods as well as constructing models in the field of psycho-neuroimmunology are discussed.

Adult↗

[Methodological and statistical aspects of therapy evaluation exemplified by the Berlin psychotherapy study].

The answer to the question concerning the efficacy of psychotherapy is increasingly sought metaanalytically. For this purpose almost exclusively investigations are taken into consideration which have at least one control group. Using realistic data, the present paper refers to some basic considerations for the investigation and evaluation of therapeutic changes, which are however not always satisfyingly solved in metaanalytical studies. Investigations, therefore, especially of naturalistic samples, such as may be found in the context of outpatient or inpatient routine care, have a high clinical relevance for the evaluation of therapeutic changes even if they do not satisfy experimental requirements/standards. However, they do supplement experimental studies where the important aspect of external validity is concerned.

Germany↗

[Results of psychoanalytic therapy].

Within a naturalistic design 44 psychoanalytic treated patients are examined with regard to qualitative and quantitative outcome. The results are compared to 56 dynamic and 164 inpatient therapies. A comparison of symptoms, diagnoses and motivation before therapy leads to the conclusion that there are very different patient groups treated within this different settings. Therefore randomization seems to be an inadequate strategy to compare groups in different therapeutic settings. Using different criteria of outcome it can be demonstrated that psychoanalytic treated patients improve very well and to a larger extent than psychodynamically treated patients or inpatients. Different criteria of outcome and different observing perspectives (patient/therapist) lead to interesting results. Patients report primarily improvements in somatic, anxiety and depressive complaints. Therapists moreover report substantial improvements in interactional symptoms and behaviour. The different results in using several criteria are presented and discussed with regard to the methodology of outcome measurement. Finally recommendations for further studies in the psychoanalytic context are presented.

Ambulatory Care↗

Type-I interferons are potent inhibitors of interleukin-8 production in hematopoietic and bone marrow stromal cells.

Interleukin-8 (IL-8) is produced by many cell types upon stimulation with bacterial products or inflammation-associated cytokines such as tumor necrosis factor-alpha and IL-1. Interferons (IFNs) represent another group of cytokines that are induced by similar stimuli in inflammatory reactions. We show now that type-I IFNs are potent inhibitors of IL-8 expression in vitro and in vivo. A significant reduction of both secretion of IL-8 protein and accumulation of IL-8 mRNA in vitro was observed in several cell types comprising peripheral blood mononuclear cells (PBMNC) from healthy donors and from patients with chronic myelogenous leukemia (CML), the myelomonocytic cell line THP-1, and bone marrow (BM) stromal cells as a representative model for BM microenvironment. By contrast, in lipopolysaccharide-stimulated polymorphonuclear phagocytes IFN failed to suppress IL-8 expression. In untreated patients with CML, a constitutive expression of IL-8 mRNA was detected in freshly isolated PBMNC that was markedly reduced 5 hours after therapeutic application of IFN-alpha. The mechanism of IL-8 downregulation was studied more in detail in the THP-1 cell line. The experiments showed that de novo protein synthesis was not required for the inhibitory effect. RNA decay analysis and nuclear run-on assays suggest that in THP-1 cell line the inhibition of IL-8 expression is predominantly regulated at the posttranscriptional level.

Bone Marrow↗

Acute blockade of dopamine receptors with haloperidol: a retinal model to study impairments of dopaminergic transmission.

A pulse of dopamine produces a transient dose-correlated increase in the transepithelial potential (TEP) of the chicken eye, mimicking the light-induced response, the light peak (LP). Acute blockade of retinal dopaminergic transmission with haloperidol, a mixed antagonist, produced a dose-correlated TEP voltage decrease which was rapidly reversed by intravitreal injection of dopamine. The LP recorded thereafter was strongly reduced. These data confirm the hypothesis that dopamine released by light from amacrine cells triggers light-induced changes in the TEP of the intact chicken eye, and that these potentials could well provide an electrophysiological tool to evaluate retinal dopaminergic deficiency.

Animals↗

Divergent in vivo and in vitro antileukemic activity of recombinant interferon beta in patients with chronic-phase chronic myelogenous leukemia.

It was the aim of this study to investigate the antileukemic activities of recombinant interferon beta (rIFN beta) in chronic-phase CML in vitro and in vivo. Nine patients in the early chronic-phase of CML were treated in a phase-II trial with escalating doses of rIFN beta. In parallel, antiproliferative and immunomodulatory activities of rIFN beta and rIFN alpha 2b were studied in vitro. rIFN beta exhibited a significantly higher antiproliferative activity on hematopoietic progenitor cells of CML patients in vitro than rIFN alpha 2b. In contrast, only very limited clinical antileukemic efficacy of rIFN beta was observed. None of the patients achieved a complete or partial hematologic response (0% response rate, 0-36% 95 C.I.). Primary resistance of CML patients to rIFN beta treatment was caused neither by antibody formation against the recombinant material nor by deficient IFN receptor targeting and/or signaling; Induction of serum levels of beta-2-microglobulin (beta-2-m) and neopterin after administration of rIFN beta was comparable to that seen after administration of rIFN alpha. However, rIFN beta treatment less effectively induced biosynthesis of interleukin-1 receptor antagonist protein (IL-1-Ra) than rIFN alpha 2b. Thus, we conclude that rIFN beta at doses up to 12 MU/day s.c. is ineffective for treatment of chronic-phase CML. Further investigations into divergent biologic responses to various type-I interferons might help to elucidate mechanisms crucial for IFN action in patients with CML.

Adult↗

[The prognostic significance of the therapeutic working alliance from the perspective of the patient and therapist].

In general, the prognostic relevance of a working alliance for both the course and the outcome of psychotherapy is no longer a matter of dispute. Since a working alliance is conceived as an interactional variable, the results must be interpreted on the basis of several important dimensions: the perspective of the investigator and the time structure during the course of therapy. Using the data available from the Berlin Psychotherapy Study (Rudolf 1991), we investigated for the 238 patients (inpatients and outpatients who received psychoanalytically oriented therapy in the study) the prognostic relevance of diagnostic and therapy-related working alliance variables for the various outcomes investigated. A complex correlation-statistical method (latent-trait-model) was used to consider the investigator perspective with regard to the working alliance and the outcome as well as the time structure and the diagnostic variables. Our results emphasize the relevance of the therapist's perspective beginning with the diagnostic indication, the working alliance and finally the outcome. The patient's perspective, however, seems to be less relevant. The results are presented and discussed in relation to the relevant literature. One result we have found as a further important dimension is that the kind of therapy carried out must be taken into consideration. This implies that as in our study for all phases of the investigation therapy specific instruments must be applied. In this regard our results also contribute to the validation of the instrument used to measure the working alliance TAB.

Adult↗

Dopamine and melatonin interactions in the intact chicken eye. Electrooculographic and biochemical study.

Electrophysiological and biochemical techniques were used to investigate the interactions between dopamine (DA) and melatonin (MEL) in the intact chicken eye. Endogenous DA depletion induced by intraocular administration of alpha-methyl-para-tyrosine (alpha-MPT), a selective tyrosine hydroxylase inhibitor, decreases the transepithelial potential (TEP) of the retinal pigment epithelium and reduces the light peak (LP) recorded by an indirect electro-oculographic (EOG) method. An intraocular injection of MEL also reduces the TEP but does not reduce the LP. Retinal MEL is increased after endogenous DA depletion and a tight inverse correlation between DA and MEL contents was found. The present data, together with other findings support the hypothesis (1) that in the intact chicken eye, DA and MEL play respectively a role of light and dark signals on the TEP, and (2) that a balance between these two neurohormones may be responsible for the regulation of RPE events which are dependent on light-dark conditions.

Animals↗

[Psychopathologic findings and results of treatment of pension applicants].

As part of a broader follow-up study (n = 1088) in a psychosomatic hospital, 35 patients who had applied for early retirement on health grounds were examined by means of a psychosomatic personality inventory (PSKB-Rudolf). In addition to confirming previous findings in relation to the character-profile and defence-mechanisms of such patients, the present study describes a cluster of characteristics that would lead to unfavourable therapeutic results. The fact that these persons had applied for early retirement had in itself no appreciable therapeutic consequences.

Adaptation, Psychological↗

[Elderly patients in psychosomatic psychotherapeutic institutions].

With the aid of a comparative study of the data collected in the Berlin Psychotherapy Study and the outpatient clinic of the Psychosomatic Clinic (University of Heidelberg), the allocation and utilization modalities of elderly patients with regard to psychosomatic-psychotherapeutic institutions is investigated. One important result seems to be the high rate of psychodynamically understandable triggering situations (as a measurement of psychological comprehension of the symptoms) and the consequent therapy recommendations (as a measurement of treatability) even for elderly patients. A case study will demonstrate that the danger may arise to subsume new somatic symptoms in the elderly under the aspect "multimorbidity" and thus withhold recommended psychotherapeutic treatment.

Adaptation, Psychological↗

Light and dark induced variations of the c-wave voltage of the chicken eye after treatment with sodium aspartate.

Light and dark-induced variations of the ERG c-wave voltage were recorded in control chickens and after intravitreal injection of Na aspartate, a treatment whose main effect is to functionally disconnect the pigment epithelium-photoreceptor complex from second order neurons. After aspartate, the fast light rise which characterizes this preparation is no longer observed; it is substituted for by a potential variation of much slower time course and of lower magnitude. The data totally confirm previous findings obtained through an indirect EOG technique and suggest the participation of inner retinal layers in the generation of the light peak in the chicken eye.

Animals↗

Is dopamine involved in the generation of the light peak in the intact chicken eye?

The implication for dopamine (DA) in the modulation of the standing potential (SP) and the light peak (LP) was tested in intact chickens using an indirect EOG method. After an intravenous or intravitreal injection of DA, a transient, dose-dependent increase in the SP was observed. The LP, recorded after an intravenous injection, was preserved. But after an intravitreal injection, the LP was strongly reduced or even abolished depending on the dose of DA, whereas the photoreceptor response was unchanged. The data supports the hypothesis that the light peak, which is generated by a neural retina-pigment epithelium interaction, could be triggered by dopamine released at light onset from the inner retinal layers.

Animals↗