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Biomedical subjects

H J Gaertner

Publications and source records attributed to H J Gaertner.

At least 37 records · Page 2Linked to original sources
PubMed1991

Urinary dolichol--a doubtful marker of alcoholism.

The purpose of this study was to replicate the results of Pullarkat and Raguthu and Roine et al. who found elevated levels of urinary dolichol (long-chain 2,3-dihydropolyprenols) in chronic alcoholic patients. We investigated a sample of 21 alcohol-dependent inpatients voluntarily entering detoxification treatment. Urinary dolichol was only slightly increased as compared to 21 healthy controls. When dolichol was related to urinary creatinine no differences between alcoholic patients and controls could be found. Under conditions of confirmed abstinence the slightly elevated levels of dolichol returned to normal within 2 weeks. Compared with the sensitivity of gamma-glutamyltransferase which ranges from 72-85%, the value of urinary dolichol (sensitivity 9-19%) as a biochemical marker of alcoholism must be doubted.

Adult↗
PubMed1990

Amisulpride versus haloperidol in treatment of schizophrenic patients--results of a double-blind study.

In a double-blind study, 41 schizophrenic patients (ICD, 9th rev.) were divided into two groups. With a flexible dose, twenty patients were treated with haloperidol, twenty-one with amisulpride. With respect to relevant criteria such as age, sex, length and degree of illness, the two groups were comparable. The study was conducted over 42 days. As early as within the first 14 days, both groups showed significant improvement with respect to their psychotic symptoms. When the two groups were compared on the basis of the BPRS subscore for the anxiety-depression syndrome, and the AMDP system subscores for the somatic-depressive syndrome and the hypochondriac syndrome, the amisulpride group showed significantly better results than the haloperidol group. The ratings on the EPS scales of Webster and Simpson revealed significantly fewer extrapyramidal side-effects in the amisulpride group. Psychotic symptoms were improved after both types of treatment. Amisulpride treatment showed better results with regard to depressive symptoms, and less tendency to generate extrapyramidal side-effects.

Adult↗
PubMed1990

[Endophlebitis hepatica obliterans. Unusual cause of liver insufficiency in early childhood in a dizygotic twin].

Findings recorded from obliterative hepatic endophlebitis are described in this paper and are compared with international literature. They had been obtained from a male twin who had died with clinical symptoms of hepatic failure. Differential diagnosis of liver insufficiency in early childhood is discussed in some detail. Also recorded was obliterative angiitis of intramural blood vessels in the ileum. Systemic vasculitis is postulated, possibly developed on the basis of an immunological reaction. Intra-uterine infection had probably been the most likely cause.

Budd-Chiari Syndrome↗
PubMed1989

Side effects of clozapine.

In addition to the low risk of agranulocytosis, several more frequent side effects are associated with clozapine therapy. We tried to estimate the incidence of these side effects. We analysed 391 treatments in 315 inpatients, who received clozapine alone or combined with other neuroleptic and antidepressant drugs. Two thirds were combined treatments, one third were treatments with clozapine alone (i.e., no other neuroleptic, antidepressant or anticonvulsive drugs were allowed). The numbers in brackets show the incidence based on the analysis of the treatments with clozapine alone. In 49% (61%) of the treatments a rise in the liver enzyme values was observed. However, counting only the cases in which a two-fold increase over the normal values was observed, the incidence was reduced to 20% (31%). Increase in temperature was observed in 4% (6%) and leukopenia (leukocyte count under 3500/microliters) was recorded in 2% (2%). Hypotensive dysregulation (systolic blood pressure under 90 mm Hg) was observed in 25% of all treatments and pharmacogenic delirium in 8%. No cases of agranulocytosis were observed. Mean treatment duration was 56 days, mean daily dosage 257 mg. The mean age of the patients was 34 years. In the overall evaluation 71% of the treatments were classified as successful; clozapine therapy was continued after discharge in 68% of the treatments. Adverse reactions (delirium, rise in temperature, hypotension, fatigue, rise in liver enzymes) necessitated a change of medication in 17% of the treatments. Changeover to another neuroleptic drug due to ineffectiveness of clozapine was necessary in 7% of the treatments.(ABSTRACT TRUNCATED AT 250 WORDS)

Clozapine↗
PubMed1989

Validation of a therapeutic plasma level range in amitriptyline treatment of depression.

In the course of a double-blind study, 29 depressed patients received amitriptyline 150 mg/day for 4 weeks. Scores on the Hamilton Depression Rating Scale were assessed before treatment and after 2 and 4 weeks, and plasma levels of amitriptyline, nortriptyline, and (E)-10-hydroxynortriptyline were monitored weekly. Response reflected by percent reduction of Hamilton Depression Rating Scale score and by final score was better at steady-state amitriptyline + nortriptyline concentrations of 125-210 ng/ml than at lower and higher plasma levels. This applied to the total group and to the subgroup of 22 female patients. The data confirm the results of a previous study performed in the same hospital. An influence of the (E)-10-hydroxynortriptyline concentration in plasma on therapeutic outcome was not discernible. The results suggest that plasma level monitoring may be helpful when patients do not respond to conventional amitriptyline doses.

Adolescent↗
PubMed1988

Single-dose kinetics of the neuroleptic drug perazine in psychotic patients.

Eight male and two female unmedicated psychotic patients received 100 mg perazine orally and seven blood samples were taken within 25 h. Plasma levels of perazine and its demethylated metabolite were analyzed by HPLC with electrochemical detection. They exhibited large interindividual variations, with maximal concentrations as well as AUC values of perazine differing more than 10-fold. From the decay of plasma levels during the last 12-18 h half-lives were estimated to be between 7.5 and 10 h; they did not correlate with AUC. There was a significant positive correlation between AUC and age. Desmethylperazine was consistently present at lower concentrations than the parent drug during the first 12 h.

Adult↗
PubMed1987

[The anxiolytic action of phenoxypropanolamine derivatives in comparison with propranolol, diazepam and placebo].

The hypothesis that the phenoxypropanolamine derivative CGP 361 A possesses anxiolytic activity was examined in 80 female healthy volunteers. Each volunteer received the treatment under double-blind conditions as part of a 1-way analysis of variance design. The medication factor had 4 levels (CGP 361 A, propranolol, diazepam and placebo). Stress was induced by asking subjects to deliver a free speech in front of a video camera. The anxiety was measured using adjectives list, state-trait-anxiety inventory and visual analogue scales. The physiological equivalents observed were pulse rate and skin resistance. The results support the hypothesis that a single dose of 10 mg CGP 361 A has a higher anxiolytic effect than 10 mg propranolol, 5 mg diazepam and placebo, with the peripheral beta-blocking effects (established by pulse rate) being no stronger than with propranolol. No subjective or objective sedation has been determined under the different drug conditions.

Adult↗
PubMed1985

[Serum levels of pyridostigmine in myasthenia gravis: methods and clinical significance].

Correlation studies on patients with myasthenia gravis are reported in which clinical assessment of fatigue and neurophysiological findings are compared to blood levels of pyridostigmine. Measurements using a high-pressure liquid chromatography method (HPLC), give reproducible results. The levels of pyridostigmine in the serum or plasma of healthy controls and of patients show no essential differences. Components of coffee, tea, chocolate and cigarettes can markedly disturb the chromatography by adding additional peaks, so that interpretation becomes difficult or impossible. Blood levels can be measured approximately one hour after oral intake of 60 mg pyridostigmine. Concentrations rise for two to four hours and then decline exponentially. The half-life of pyridostigmine was between 156 and 210 minutes. Despite identical oral dosages, the concentration differed intraindividually and interindividually among patients. While the blood level does not reach its maximum value for 1-1 1/2 to 3 hours, the maximum clinical and neurophysiological effect of pyridostigmine appears 30-60 minutes after ingestion. Variable distribution of cholinesterase inhibitors over the different compartments (blood, synaptic region) is assumed to cause this temporal lag. If the total amount of pyridostigmine is divided into 4-5 doses, the concentration profiles over the course of a day are relatively stable. There is no significant correlation between the variations in blood level throughout one day, and changes in myasthenic symptomatology. Effects of pyridostigmine can be measured at levels as low as 5 ng/ml; at levels above 40 ng/ml further improvement can be detected only rarely. Blood levels were lower if corticosteroids were administered simultaneously; azathioprine had no influence on blood levels. Blood levels assays allow better differentiation of cholinergic and myasthenic crises and the identification of disturbed absorption and interactions with other medications.

Adolescent↗
PubMed1985

[Perazine-induced agranulocytosis--case report and discussion].

A 22-year-old female patient developed agranulocytosis 26 days after starting single agent treatment with perazine. In accordance with the clinical and hematological picture this agranulocytosis is classified as antibody mediated with destruction of peripheral neutrophils. After cessation of perazine treatment and proper therapy of infection the patient recovered within two weeks. The diagnosis of agranulocytosis should be suspected in anyone on neuroleptic treatment who develops fever, malaise or objective evidence of an infection and in neutropenic patients the adequate treatment should be started immediately.

Adult↗
PubMed1984

Amisulpride--an open clinical study of a new benzamide in schizophrenic patients.

In pharmacological screening amisulpride produces no catalepsy, no inhibition of stereotypic movements, yet a blockade of drug-induced vomiting. During an open clinical trial lasting 4 weeks, 14 patients (13 schizophrenics) were treated with the compound. The (BPRS-) syndromes anxiety/depression, thought disorder, activity, hostility and the global score showed significant improvement. With the AMDP system significant changes were seen in the paranoid-hallucinatory, manic, depressive and hostility syndromes as well as in the global score. No changes were revealed in anergia (BPRS) and apathia (AMDP). In the EEG a significant decrease in the frequency of alpha-rhythms was found. The scores of the Simpson-scale for extrapyramidal side effects were low, but there was an acute dystonic reaction in one patient. In three cases akathisia occurred; biperiden administration was necessary three times. In conclusion, amisulpride showed good antipsychotic efficacy without sedation. Contrary to expectations based on the pharmacological screening, we did find extrapyramidal side effects.

Adult↗
PubMed1984

[Procoagulatory activity of macrophages and monocytes of the guinea pig].

Guinea pig peritoneal macrophages and blood monocytes possess a membrane-bound tissue factor-like procoagulant activity. This activity can be induced to grow by mitogenic lectins and by lymphocyte products released specifically upon contact with immunizing antigens in vitro. The procoagulant activity can be easily measured by a plasma recalcification test. Guinea pig peritoneal cells and mononuclear blood cells from animals immunized with ovalbumin, bovine gamma-globulin or tetanus vaccine reacted to the corresponding antigen in a specific manner by expression of increased amounts of procoagulant activity (ovalbumin: + 16.9%; bovine gamma-globulin: + 26.8%, tetanus vaccine: + 23.5%). Supernatants from peritoneal cells were active in transferring the stimulus to neutral peritoneal cells which expressed thereafter higher amounts of procoagulant activity.

Animals↗
PubMed1983

[Effects of neuroleptics on liver function, the hematopoietic system, blood pressure and temperature regulation. Comparison of clozapine, perazine and haloperidol by evaluating medical records].

The frequency of disturbances of the liver function, of leucopoiesis, blood pressure and temperature regulation under clozapine in comparison with perazine and haloperidol in 478 patients (partly being treated repeatedly) was investigated by means of case histories of the Psychiatric Clinic of Tübingen from October 1974 up to June 1978. Within the time of the investigation no case of jaundice arose, however non-symptomatic increases of the liver values could be observed. The three drugs did not differ in this respect. Within the time of the investigation no case of agranulocytosis was observed. Only one leucopenia under clozapine, one under perazine, and six under haloperidol occurred. Concerning cardio-vascular effects of the neuroleptic medication, in 4.1% of the patients under clozapine therapy, 4.3% under haloperidol therapy and 10.3% under perazine therapy hypotension could be observed. Under clozapine 15.2% of the patients showed a rise of temperature, under perazine 3.2% and under haloperidol 2.8% of the patients. 83.3% of cases with elevated temperature under clozapine occurred during the first two weeks of treatment.

Adult↗
PubMed1983

[Experimental study on the activity of the triazolo-benzodiazepine GP 55 129 compared with diazepam and placebo in healthy volunteers].

Animal studies have led to the hypothesis that GP 55 129 sedates less than diazepam while possessing the same anxiolytic qualities. This hypothesis was tested on 60 healthy, emotionally labile volunteers. The drugs were administered once in a double-blind test at a dosage of 10 mg diazepam and 4 mg GP 55 129. A video camera and very difficult tests were used to induce anxiety in the subjects. Multivariate analysis of the 15 factors in the adjective check list showed a global drug effect (P less than 0.025). Comparison of the profiles of mean values indicated that the subjects under diazepam felt more tired and groggy than those with GP 55 129 and placebo medication at the dosage level used. However, the individual comparisons were not statistically significant. There was a significant reduction for both drugs in relation to the placebo in the "excitation" factor of the polarity profile. Free description showed a typical tranquilizer profile for both drugs. Significant achievement decrements (concentration-performance test by Düker, Viennese determination instrument, pursuit rotor, critical flicker fusion frequency) were not evident for either drug after a single dose of the strength we were examining. Subjective verbal tests yielded some significant sex differences without showing any interaction between sex and drug. To summarize the results, it can be said that the new substance possesses tranquilizing effects marked by a general suppression of excitation. The profile differences on the adjective check list showed a trend toward confirmation of the hypothesis, but must be replicated in further tests.

Anti-Anxiety Agents↗
PubMed1982

Do urinary MHPG and plasma drug levels correlate with response to amitriptyline therapy?

Twenty-nine inpatients with primary affective disorder were treated with 150 mg amitriptyline (AT) daily for 28 days. Pretreatment urinary excretion of 3-methoxy-4-hydroxyphenylglycol (MHPG) was measured in two or three 24-h urine samples. Plasma levels of AT and nortriptyline (NT) were determined after 14, 21, and 28 days of treatment. MHPG excretion was significantly correlated with clinical response to treatment. Responders defined by two different methods showed higher pretreatment MHPG excretion than nonresponders. Correspondingly, high MHPG excretors (median split) showed significantly more improvement than low excretors. These relationships were even more apparent when possibly incomplete urine samples (creatinine excretion below 1000 mg/24h) were excluded. The high and low MHPG subgroups did not significantly differ from each other in their plasma levels of AT, NT, or AT plus NT. A significant rank correlation between clinical response and plasma levels of AT and/or NT did not exist, but there was a trend towards lower levels in responders.

Adult↗
PubMed1982

Antidepressive effect and pharmacokinetics of amitriptyline with consideration of unbound drug and 10-hydroxynortriptyline plasma levels.

In 27 inpatients with primary affective disorder the urinary excretion of 3-methoxy-4-hydroxyphenylglycol (MHPG) was measured prior to a 4-week treatment with 150 mg amitriptyline (AT)/day. Ratings according to the Hamilton depression scale were performed before therapy and repeated after 2 and 4 weeks. Plasma levels of AT, nortriptyline (NT), and E-10-hydroxynortriptyline (OHNT) were assayed weekly, and binding of AT to plasma proteins was determined in one sample. Better therapeutic results were obtained at intermediate, as compared to low and high concentrations of AT or AT plus NT. Independent evaluation of AT and metabolite levels revealed that patients with AT of 50--125 ng/ml responded particularly well when NT did not exceed 95 ng/ml or when NT plus OHNT was below 150 ng/ml. Outside this "therapeutic window' the outcome was markedly poorer. Interindividual variation of AT binding was much smaller than variation of total concentrations. Evaluation of free, instead of total levels did not help to clarify the relationship between clinical and pharmacokinetic variables. Plasma levels within the optimal ranges were found in more patients with high than with low MHPG excretion. The free fraction of OHNT in plasma of healthy subjects was about 35%.

Adult↗