Regression of conjunctival Kaposi's sarcoma under chemotherapy with bleomycin.
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Acquired Immunodeficiency Syndrome↗
Biomedical subjects
H Heimann
Publications and source records attributed to H Heimann.
Cellular and humoral immunity to the 60-kD heat shock protein in inflammatory bowel disease.
BACKGROUND: Mycobacteria have been considered a possible etiological agent in Crohn's disease. Since cross-reactivity between epitopes of mycobacterial and self-heat shock protein might represent a potential disease mechanism, we determined the cellular and humoral immune responses to the mycobacterial and the human 60-kD heat shock protein, as well as various control antigens. METHODS: We studied samples from 19 patients with Crohn's disease, 12 patients with ulcerative colitis, and from 19 healthy individuals. T cell responses were studied using a standard proliferation assays to purified recombinant mycobacterial and human 60-kD heat shock protein. Antibody levels were measured by establishing an enzyme-linked immunosorbent assays to recombinant purified 60-kD heat shock protein. RESULTS: The proliferative responses to the mycobacterial and the human 60-kD heat shock protein were closely correlated, but the cellular immune response to both antigens was not significantly different between the two patient groups and healthy controls. In addition, antibody levels to heat shock protein were also not significantly different between the three groups. CONCLUSIONS: These results argue strongly against a role for mycobacterial heat shock protein in the pathogenesis of Crohn's disease. However, in view of previous data demonstrating overexpression of 60-kD heat shock protein in inflammatory Crohn's disease tissue, this considerable cellular and humoral autoreactivity suggests an important immunoregulatory role for the 60-kD heat shock protein.
Adult↗
Increased activation of indirect semantic associations under psilocybin.
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Adult↗
Primary vitrectomy without scleral buckling for rhegmatogenous retinal detachment.
BACKGROUND: Pars planta vitrectomy has evolved as an alternative method in the treatment of more complicated rhegmatogenous retinal detachments. We report a series of patients who underwent primary vitrectomy with gas tamponade without the use of additional scleral buckling. METHODS: A retrospective study of 53 patients with a follow-up of 6-45 months (mean 17.8 months) was carried out. Preoperative findings included unusual, multiple or large breaks, vitreous haemorrhage, proliferative vitreoretinopathy and bullous retinal detachment. Preoperative visual acuity was between light perception and 1.0, with 30% (16/53) of patients with 0.4 or better. RESULTS: Retinal reattachment was achieved in 64% of cases (34/53) with one and in 92% (49/53) with one or more operations. Final visual acuity was between light perception and 1.0, with 41% (22/53) of patients with 0.4 or better. Cataract formation occurred in 86% (37/43) of all patients with a clear lens preoperatively. Macular pucker was noted in 11% (6/53) and postoperative proliferative vitreoretinopathy causing redetachment in 6% (3/53). CONCLUSION: With primary vitrectomy, a high final anatomical success rate with few intraoperative complications can be achieved in more complicated forms of rhegmatogenous retinal detachment. The major drawback of the procedure is the high incidence of post-operative cataract formation.
Adult↗
Keratokyphosis in rabbits: a functional and morphologic study.
Keratokyphosis, a "nonfreeze keratomileusis" procedure, was applied in rabbits. The refractive changes were -6.5 +/- 0.7 (SD), -9.5 +/- 2.6, and -13.0 +/- 3.2 D for convex applanation surfaces with a vertex of +100 microns, +125 microns, and +150 microns in the microkeratome and +1.5 +/- 2.0 and +2.5 +/- 2.6 D for concave applanation surfaces with a vertex of -100 microns and -125 microns. The pachymetric corneal changes were +43 +/- 24 microns, +39 +/- 32 microns, and +71 +/- 24 microns for the convex applanation surfaces and -21 +/- 40 microns and -17 +/- 24 microns for the concave. Wound healing was uncomplicated. The scar at the interface was 0-5 microns wide. The mean central density of nerve endings was 1,255 +/- 532/mm2. The endothelial cell size was 25.1% (p < 0.01) greater as measured by specular microscopy than by vital preparation technique; this difference was greater with higher (33.4%) than with lower (18.02%) corneal refraction (p = 0.02). In addition, there was a method-independent correlation (correlation coefficient, -0.63) between endothelial cell count and corneal thickness. This may indicate an increased demand on corneal endothelium in thickened corneas.
Animals↗
Reduced emotional response of schizophrenic patients in remission during social interaction.
Inappropriate emotional response during social interaction is a prominent feature of schizophrenia during the acute stage of illness. This study evaluates the course of reduced facial activity in schizophrenic patients in remission and compares it with healthy controls. The experimental conditions included watching two films, one inducing happy and the other sad emotional states. Each is followed by an interview eliciting happy and sad feelings. The facial actions were recorded (1) by a computer-based analysis of recordings of the skin movement and (2) by electromyography of the corrugator and zygomaticus muscles. Twenty schizophrenic patients in remission and 20 normal controls participated in the study. In contrast to previously studied acute patients, there was no overall reduction of facial expression in the upper face of schizophrenic patients in remission. Patients showed fewer movements (automatic analysis) of the lower face during the happy interview and more movements during the sad interview compared with controls. Furthermore, schizophrenic patients showed reduced zygomaticus activity (EMG) during both the happy film and the interview, suggesting a reduced ability of schizophrenic patients to express happy facial expressions, such as smiling, in the lower face. This may indicate a reduced variability in emotional response in schizophrenia.
Adult↗
Brofaromine in non-endogenous major depressed inpatients--results of a preliminary dose-finding trial versus tranylcypromine.
In a controlled, double-blind, comparative four-week trial on reactive or neurotic major depressed inpatients, the efficacy and safety of the new selective and reversible inhibitor of monoamine oxidase type A, brofaromine, was evaluated in three dose steps (50 mg/day [N = 13], 100 mg/day [N = 12], and 150 mg/day [N = 11]) versus 20 mg tranylcypromine/day (N = 11). In the four groups a pronounced reduction of the depressive symptomatology (measured by the Hamilton Depression Scale, the Zung Self-Rating Scale of Depression, and by a global evaluation of efficacy) was found, but it was not possible to show any differential effect. The safety parameters in all groups were comparable. The results of the trial are compared with other trials of monoamine oxidase inhibitors in this patient group and the possible reasons for the lack of a clear dose-response relationship are discussed.
Adolescent↗
Interleukin-2 receptor--targeted therapy by monoclonal antibodies in the rat corneal graft.
A possible selective therapeutic approach to corneal graft rejection will aim at IL-2 receptor-bearing antigen-activated T-lymphocytes with monoclonal anti IL-2R antibodies. In a rat penetrating keratoplasty model (Lewis x Lewis-BN) comparing to controls (median, 8 days), a significant delay of the allograft reaction was achieved by applying a therapeutic dose (15 mg/kg bw) of cyclosporin A (median, 18 days; p < 0.01), an intraperitoneal (1.0 mg/kg bw) (median, 13.5 days; p < 0.05) or a subconjunctival injection of IL-2R mab (0.5 mg/kg bw ART-18) (median, 16 days; p < 0.01) with low-dose Cyclosporin A (1.5 mg/kg bw). In pharmacokinetic experiments, the corneal radioactivity 24 h after intraperitoneal injection of 125I-labeled ART-18 was < 1% (p < 0.01) of the values obtained by subconjunctival injection, whereas the serum radioactivity values (p > 0.05) were in the same range. The above results suggest that the onset of an allograft reaction in perforating keratoplasty seems to depend on the locally achievable antibody concentration and can be delayed with a high level of IL-2 R mab present in the immediate surrounding of the foreign antigen-expressing cells.
Animals↗
Self-regulation of slow cortical potentials in psychiatric patients: alcohol dependency.
Ten unmediated alcohol-dependent male inpatients participated in a Slow Cortical Potential (SCP) self-regulation task utilizing biofeedback and instrumental conditioning. These patients were hospitalized for treatment of alcohol dependency after chronic abuse of alcoholic beverages. Somatic withdrawal symptomatology had occurred recently and the patients were free of any withdrawal symptoms of the autonomic nervous system. Immediately after hospitalization patients were unable to control their SCPs without the reinforcement of immediate feedback across 4 sessions. Seven patients participated in a fifth session an average of 4 months later. Six out of these 7 patients had not had a relapse at the follow-up. In the fifth session these patients were immediately able to differentiate between the required negativity and negativity suppression, whereas the seventh patient, who had relapsed, was unable to control his brain potentials successfully. Results are further evidence that some of the frontocortical dysfunctions in alcohol-dependent patients are reversible. This could covary with a morphological restitution of the cortex.
Adult↗
Comparison of schizophrenic delusions between Japan and Germany.
The content of schizophrenic delusions of 150 German patients in the Psychiatrische Universitätsklinik Tübingen and those of 324 Japanese patients (ICD-9:295) were compared according to the classification of Huber and Gross. The comparison revealed significantly higher frequencies of delusions of poisoning (18 vs. 8%; p < 0.01) and jealousy (6 vs. 1.9%; p < 0.05) in the German cases, but there was no significant difference in the incidence of comprehensive injury delusions. There was also no significant difference in the incidence of comprehensive grandeur delusions. However, comprehensive belittlement delusions were more frequent in the German group (24 vs. 13.3%; p < 0.01). Among the delusions of this type, the themes of guilt/sin (15.3 vs. 4.9%; p < 0.001), particularly those related to religion, were more frequent in the German group. Although religious delusions were more frequent in the German group (21.3 vs. 6.8%; p < 0.001), the difference regarding the incidence of 'delusions of world destruction' was not statistically significant. Among the persecution/injury delusions, themes of direct persecution from others (Verfolgungswahn) were conspicuous in the German group, whereas delusions of reference (Beziehungswahn) related to harassment, such as 'being slandered by others' or 'being known', were common in the Japanese group. Namely, the difference in the content of these persecution/injury delusions may derive from the different types of self in the two countries: the individually oriented self in Germany and the group-oriented self in Japan. Delusions of guilt/sin in the German group may reflect the characteristics of sin in Christianity.
Adult↗
Increased hydrolase activities in the human trabecular meshwork of glaucomatous eyes.
Alterations in the metabolic functions of trabecular meshwork (TM) cells are thought to be involved in the pathogenesis of primary open-angle glaucoma (POAG). In an investigation of this possibility, 30 trabeculectomy specimens from patients with POAG were examined histochemically for 11 lysosomal and membrane-bound enzymes. The patients ranged from 48 to 87 years in age. The degree of enzyme staining was compared with that of 15 age-matched controls obtained from an eye bank at less than 24 h after death. There was no history of eye disease in the controls. The enzymes examined were: dipeptidylpeptidases II and IV (DPPII and IV); beta-glucuronidase (beta-GLUC); acid-beta-galactosidase (s beta-GAL); N-acetyl-beta-D-glucosaminidase (NAG); nonspecific esterase (UE); acid phosphatase (SP); alkaline phosphatase (ALP); gamma-glutamyltransferase (GGT); and aminopeptidase A and M (APA and APM). Evaluation of the specimens was performed by two observers and by computer-aided optic densitometry. Results showed increased staining of SP, UE, GGT and APM in the pathological specimens as compared with the controls. SP and UE indicate phagocytic activity, APM is involved in collagen turnover and GGT participates in both drug detoxification and the breakdown of glutathione in the gamma-glutamyl cycle. Our observations show different hydrolase activities in the TM cells of human glaucomatous eyes as compared with normal values, suggesting that such metabolic differences may be related to the pathogenesis of POAG.
Aged↗
Self-regulation of slow cortical potentials in psychiatric patients: schizophrenia.
Slow cortical potentials (SCPs) are considered to reflect the regulation of attention resources and cortical excitability in cortical neuronal networks. Impaired attentional functioning, as found in patients with schizophrenic disorders, may covary with impaired SCP regulation. This hypothesis was tested using a self-regulation paradigm. Twelve medicated male schizophrenic inpatients and 12 healthy male controls received continuous feedback of their SCPs, during intervals of 8 s each, by means of a visual stimulus (a stylized rocket) moving horizontally across a TV screen. The position of the feedback stimulus was a linear function of the integrated SCP at each point in time during the feedback interval. Subjects were required to increase or reduce negative SCPs (referred to pretrial baseline) depending on the presentation of a discriminative stimulus. The correct response was indicated by the amount of forward movement of the feedback stimulus and by monetary rewards. Schizophrenics participated in 20 sessions (each comprising 110 trials), while controls participated in 5 sessions. Compared with the healthy controls, schizophrenics showed no significant differentiation between negativity increase and negativity suppression during the first sessions. However, in the last 3 sessions, patients achieved differentiation similar to controls, demonstrating the acquisition of SCP control after extensive training.
Adult↗
Self-regulation of slow cortical potentials in psychiatric patients: depression.
Findings on depressive patients indicate that depressives have electrophysiological characteristics similar to those of schizophrenics, in that they exhibit reduced Contingent Negative Variation (CNV) amplitudes and more distinct Postimperative Negative Variations (PINVs) than normal controls. In a biofeedback experiment, 8 medicated male inpatients with the DSM III-R diagnosis of "Bipolar Disorder, Depressive," and "Major Depression" demonstrated no impairment in the self-regulation of Slow Cortical Potentials (SCP) in comparison to schizophrenics in terms of increasing and suppressing negativity. Continuous visual SCP feedback is presented to the patient as a horizontally moving rocket in a video game format. The direction changes of the rocket represented SCP changes at each point in time, recorded by the central EEG (based on the pretrial baseline). Depressives demonstrated SCP self-regulation across 20 sessions, although with many between-and-within variations. The 8 male controls were unable to regulate their SCPs across 5 sessions. This result contradicts other findings of our laboratory on normal controls. Motivational factors and insufficient operant reinforcement (financial reward) may have facilitated this effect.
Adult↗
The effects of neuroleptics on facial action in schizophrenic patients.
This paper describes the influence of neuroleptic therapy on facial action in drug-naive schizophrenics. In a comparative study of medicated and unmedicated schizophrenic patients, the coordinates of 12 small light-reflecting points, attached to subjects' faces, were computer-recorded and analyzed automatically during a semi-standardized clinical interview. In addition, facial activity in videotaped interviews was coded using the Facial Action Coding System (FACS). Each sample group comprised of eight patients with the DSM-III-R diagnostic criteria "schizophrenia" or "schizophreniform disorder". Subjects were studied on two occasions, one shortly after admission to the hospital, the other three weeks later. Group 1 was unmedicated during the first session, whereas group 2 was medicated throughout the study. Three weeks after the start of medication, at the second interview, both recording methods showed a reduction in facial activity and facial expression across all subjects in group 1. The facial action of patients in group 2, however, remained unchanged.
Adult↗
[Effect of diagnostic habits on the incidence of psychiatric diagnoses].
In this study, we analyzed the frequency of ICD-9-diagnoses in 2,868 inpatients (spanning 3 consecutive years) who had been admitted to the Psychiatric Hospital at the University of Tübingen. "Paranoid schizophrenia" (15.8%), "endogenous monopolar depression" (11.2%), "alcohol dependency" (9.9%), "neurotic depression" (6.5%) and "schizoaffective psychosis" (5.3%) turned out to be the most frequently diagnosed illnesses. The diagnosis of 6 mental illnesses described more than 50% of our patient population. In a concurrent study physicians employed at the hospital filled out a questionnaire about their diagnostic style. According to the data physicians were not aware of their narrow diagnostic style. A comparison of physicians within each ward resulted in moderate diagnostic agreement insofar as their diagnoses was based on 4-digit-ICD-categories. When using 3-digit-diagnostic main categories, diagnostic agreement appeared to be higher.
Affective Disorders, Psychotic↗
[Recognition of emotions in facial expression of visual half-field images by schizophrenic and depressed patients].
Twenty schizophrenics, 20 depressives, and 20 normal controls were asked to identify positive and negative emotional expressions of faces tachistoscopically presented to the left and/or right visual hemifields. Results replicated the frequently cited recognition advantage for emotional stimuli presented in the left visual hemifield (right hemispheric processing). A significant reduction in decoding advantage was observed in both patient groups, which could be explained in terms of an interhemispheric disconnection syndrome in schizophrenics and depressives. Bilateral findings in particular tend to support this hypothesis, since they revealed that both cerebral hemispheres processed contrary information simultaneously.
Adult↗
[Modification of autoregulation of intrinsic physical processes in field-dependent subjects: a study of performance in heart rate biofeedback].
Witkin, the founder of the concept of "field dependence", assumed that there is a relationship between field dependence and body perception. However, this hypothesis was never investigated experimentally in a well-controlled study. Twenty healthy subjects learned to increase and decrease their heart rate dependent upon two discriminative stimuli. In order to increase and decrease their heart rate they received exteroceptive feedback (movements of a rocket-ship on a video screen). Each trial lasted 6 s. The distance of the rocket-ship from a certain point indicated the amount of the achieved increase or decrease. Field dependent subjects scoring higher in field dependency as measured by the Embedded Figures Test were poorer at heart rate control on feedback and transfer trials (test trials with feedback removed) than were subjects scoring low in field dependency. This result may be of therapeutic interest in the application of behavioral medicine to psychosomatic and psychiatric disorders.
Adult↗
[Results of electroconvulsive therapy in restrictive indications. A retrospective study of 15 years].
In Tübingen ECT is restricted to severely ill patients who do not respond to other somatic therapies; especially to patients with endogenous depression and pernicious catatonia. Between 1976 and 1990, 45 patients were treated with ECT, of whom 22 suffered from endogenous depression and 10 from pernicious catatonia. Thirteen patients with other diagnoses (schizophrenic and schizoaffective psychoses, borderline schizophrenia and obsessive-compulsive disorder) were treated with ECT for severe depressive states after failure of psychopharmacological therapy. A positive therapeutic response to ECT was observed in 46% of patients with endogenous depression and in all 10 with pernicious catatonia. In the patients with schizophrenia and schizoaffective psychosis, borderline schizophrenia and obsessive-compulsive disorder, an amelioration of the depressive or anxiety syndrome was observed only in individual cases. Side effects of ECT were transit syndromes (20%), reversible amnestic syndromes (20%) and cardiac arrhythmias (6%). According to our results, ECT is highly effective in therapy-resistant endogenous depression and pernicious catatonia, and therefore remains a necessary part of psychiatric therapy.
Adolescent↗