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Biomedical subjects

J C Krieg

Publications and source records attributed to J C Krieg.

At least 55 records · Page 3Linked to original sources
PubMed1994

[Neuropsychiatric symptoms in primary hyperparathyroidism].

Over a period of 3 months a 51-year-old woman developed a depressive syndrome with loss of memory, inability to find words, impaired fine movements and phases of spacial disorientation. Biochemical tests demonstrated occasional slight rises in serum calcium (2.8-2.9 mmol/l) and parathormone (4.6-5.2 pmol/l). She had a grade II nodular goitre with normal thyroid function. Ultrasonography of the thyroid suggested a right cranial parathyroid adenoma, confirmed at a right thyroidectomy with resection of the right upper parathyroid, while the other parathyroid glands were grossly normal. Calcium and parathormone levels returned to normal after the operation, as did the neuropsychiatric symptoms (within two months). This typical case illustrates that even in seemingly isolated neuropsychiatric changes an organic disease, like primary hyperparathyroidism, needs to be thought of.

Adenoma↗
PubMed1994

Satiety and cholecystokinin.

The effect of a fat and protein rich test meal of 800 kcal on subjective satiety ratings and on plasma cholecystokinin (CCK) 8-S was studied in 18 acutely ill patients with anorexia nervosa, 11 former anorectic patients, who were weight recovered for at least 4 years, and in 25 healthy young women. Eleven normal weight patients with bulimia nervosa were studied in the same experiment. Satiety ratings were significantly elevated in acutely ill anorectic and bulimic patients. CCK 8-S values were significantly stimulated by the test meal in all groups except from the bulimic group. Anorectic patients and weight recovered anorectics had normal values before and after the test meal. Bulimic patients had significantly lower values. These data suggest that CCK 8-S is not involved in the regulation of short-term satiety in anorexia and bulimia nervosa.

Adult↗
PubMed1994

Somatostatin in eating disorders.

Somatostatin concentrations in plasma were measured before and after a standardized fat and protein-rich fluid test meal in patients with anorexia nervosa, weight-recovered anorectic patients, obese women, and healthy controls. Somatostatin was significantly elevated in all four groups after the test meals. Hormone levels remained elevated for up to 100 min after the test meal. The area under the response curve was significantly higher (p < .01) in the anorectic patients as compared with healthy controls and weight-recovered anorectics. Obese women had blunted somatostatin responses. The findings may explain alterations in insulin secretion and in gastric emptying described earlier in patients with eating disorders.

Adult↗
PubMed1994

Resting metabolic rate and total energy expenditure in acute and weight recovered patients with anorexia nervosa and in healthy young women.

Because little is known about energy requirements in anorectic patients before and after weight gain we measured resting metabolic rate (RMR) by indirect calorimetry and total energy expenditure (TEE) by the doubly labeled water method in 6 patients with anorexia nervosa (body mass index [BMI] = 15.1 +/- 1.3 kg/m2), in 6 weight-recovered anorectics (BMI = 21.2 +/- 2.1 kg/m2), and in 12 healthy age-matched women (BMI = 20.5 +/- 1.9 kg/m2). No significant differences were found between the weight-recovered anorectic women and the healthy controls in RMR (1,330 +/- 131 kcal/day [weight-recovered]; 1,419 +/- 197 [controls]) and in TEE (2,602 +/- 637 kcal/day [weight-recovered]; 2,596 +/- 493 kcal/day [controls]). The RMR was significantly lower in the acutely ill anorectic patients (1,171 +/- 113 kcal/24 hr) than in weight-recovered anorectics and in healthy controls. The TEE was significantly lower in the anorectic group (1,946 +/- 192 kcal/day) than in the healthy controls.

Adult↗
PubMed1994

Validity and reliability of the first distal metatarsal articular angle.

A laboratory study was undertaken to quantify the validity, the intra- and interobserver reliability, and the effect of first metatarsal orientation on the distal metatarsal articular angle (DMAA). First metatarsals from six cadavers were isolated by sharp dissection and attached to a custom-made triplanar protractor. This allowed controlled positioning of the first metatarsal in the three cardinal planes. Each specimen was moved through a stepwise sequence of first metatarsal orientation changes. Radiographs were taken at each position. The distal (metatarsophalangeal) articular surface of the first metatarsal was then circumscribed with metallic paint and the radiographic series was repeated. DMAA measurements were made on each radiograph multiple times by two measurers blinded to the parameters of variation. The difference between the standard (clinical) radiographic technique for estimating the DMAA and the metallic paint DMAA averaged -0.9 degrees (SD = 2.4 degrees). Longitudinal rotation (P < .0001) and varus deviation (P < .02 at 10 degrees) of the first metatarsal had a significant effect on the radiographic determination of the DMAA. Although intraobserver reliability for DMAA measurement was high, interobserver reliability for the clinical technique of measurement was poor (pooled intraclass correlation coefficient = 0.14).

Cadaver↗
PubMed1993

Theoretical and empirical considerations on the relation between 'body image', body scheme and somatosensation.

The authors first discuss possible interactions between the hitherto neglected neurophysiological and neuropsychological factors and the traditionally accepted cognitive and affective factors in 'body image' formation. They then report on a study of the relation between body size perception (video distortion technique, image marking procedure, kinaesthetic size estimation apparatus) and somatosensation (thermal, pain and vibration thresholds) in young women. Included in the study were questionnaires on eating behaviour and motivation, body attitude or body satisfaction, and depressive mood and thoughts. Neither the somatosensory nor the questionnaire variables explained the difference between 'overestimators' and 'underestimators' of body size. However, these variables did explain the difference between 'good perceivers' and 'poor perceivers' (degree of deviation from actual body size) in the video distortion technique, with a somewhat larger contribution by the somatosensory variables. The latter finding, although clearly preliminary, should stimulate further investigations of the relationship between somatosensory variables and body size perception.

Adult↗
PubMed1993

Pain sensitivity in recovered anorexics, restrained and unrestrained eaters.

The heat pain threshold and local skin temperature were assessed in 23 former anorexic in-patients with an 'intermediate' (N = 9) or 'good' outcome (N = 14) and in 21 restrained and 20 unrestrained eaters. All subjects were female. The group means of the pain thresholds did not differ significantly from each other, suggesting that the homogeneous increase in pain thresholds we had previously observed in acutely ill eating disorder patients is state dependent. However, a sizeable percentage of the restrained eaters (29%) had pain thresholds clearly above the normal range. Thus it may well be that restrained eating carries a risk of reducing pain sensitivity. Pain threshold and skin temperature correlated significantly (r = -0.63) only in the group of patients with an intermediate outcome, a finding resembling that obtained in acute anorexics. This suggests that peripheral thermoregulation and pain sensitivity are linked in the acute and moderately improved phases of anorexia nervosa.

Adult↗
PubMed1992

Cholinergic REM sleep induction test in subjects at high risk for psychiatric disorders.

The influence of the cholinergic agonist RS 86 on electroencephalographic (EEG) sleep was investigated in 21 healthy members of families identified as being at high risk for psychiatric disorders and in 17 healthy control subjects without any personal or family history of a psychiatric illness. In comparison to the placebo night, the administration of RS 86 led to a shortening of rapid eye movement (REM) latency in both groups. This effect, however, was much more pronounced in the high-risk group, whereas in the control subjects the arousal system and the slow-wave sleep during the first nonREM period were more affected. These observations suggest that the cholinergic action on sleep regulating mechanisms has differing preferential targets in high-risk probands and in control subjects.

Adult↗
PubMed1992

Lifetime and six-month prevalence of mental disorders in the Munich Follow-Up Study.

The Lifetime and 6 month DSM-III prevalence rates of mental disorders from an adult general population sample of former West Germany are reported. The most frequent mental disorders (lifetime) from the Munich Follow-up Study were anxiety disorders (13.87%), followed by substance (13.51%) and affective (12.90%) disorders. Within anxiety disorders, simple and social phobia (8.01%) were the most common, followed by agoraphobia (5.47%) and panic disorder (2.39%). Females had about twice the rates of males for affective (18.68% versus 6.42%), anxiety (18.13% versus 9.07%), and somatization disorders (1.60% versus 0.00%); males had about three times the rates of substance disorders (21.23% versus 6.11%) of females. Being widowed and separated/divorced was associated with high rates of major depression. Most disordered subjects had at least two diagnoses (69%). The most frequent comorbidity pattern was anxiety and affective disorders. Simple and social phobia began mostly in childhood or early adolescence, whereas agoraphobia and panic disorder had a later average age of onset. The majority of the cases with both anxiety and depression had depression clearly after the occurrence of anxiety. The DIS-DSM-III findings of our study have been compared with both ICD-9 diagnoses assigned by clinicians independently as well as other epidemiological studies conducted with a comparable methodology.

Adolescent↗
PubMed1992

All-night electroencephalographic sleep and cranial computed tomography in depression. A study of unipolar and bipolar patients.

All-night electroencephalographic (EEG) sleep recording and cranial computed tomography were performed in 24 inpatients with major depression (14 unipolar, 10 bipolar). The patients showed the characteristic "depression-like" EEG sleep alterations and their ventricular brain ratio (VBR) was increased compared with the control subjects. No major differences were found between the unipolar and the bipolar groups. There was a close and positive association between the VBR values and several measures of slow wave sleep. It is hypothesized that this relationship is due to an altered function of the limbic-hypothalamic-pituitary-adrenocortical axis in depression that affects both EEG sleep and brain morphology.

Adult↗
PubMed1992

Body size perception and body satisfaction in restrained and unrestrained eaters.

In 21 restrained and 20 unrestrained eaters body size perception was measured using the video distortion technique (VDT), the image marking procedure (IMP) and the kinesthetic size estimating apparatus (KSEA). Body satisfaction was assessed by questionnaires (Body Shape Questionnaire, Dieting scale of the Eating Attitudes Test). Restrained eaters showed no systematic over- or underestimation of the body size but less perceptual accuracy (in VDT and KSEA). Furthermore, they were clearly more dissatisfied with their bodies than unrestrained eaters. Both findings were unrelated to each other. In both groups depressive mood or thoughts seemed to be associated with body dissatisfaction but not with body size misperception. Objective body measures (body mass index, body fat content) were not related to either body size perception or body satisfaction. The findings suggest that a perceptual uncertainty in regard to body size (either for visual or for somatosensory aspects) has already developed in restrained eaters, which may constitute a predisposition for more overt forms of body size misperception as found in eating disorder patients.

Behavior Therapy↗
PubMed1992

Predictors of short-term treatment outcome in bulimia nervosa inpatients.

Recent studies, mostly performed on bulimic outpatients, did not find consistent predictors of treatment outcome in bulimia nervosa. This is the first study to investigate anamnestic and clinical factors predictive of the short-term outcome of hospital treatment in 31 female bulimia nervosa patients with a mean age of 22.9 yr. Treatment outcome was assessed by several self-rating instruments measuring different features of the specific and unspecific psychopathology of bulimia nervosa. The most relevant predictors of the outcome of the 8-week hospital treatment were duration of previous inpatient treatments for bulimia, the intensity of anorexic tendency and the pretreatment level of depression. The majority of predictors tested did not show a strong relationship to treatment outcome. The findings are discussed in relation to results of other studies as well as to possible implications for treatment and research.

Adult↗
PubMed1992

Panic disorder and major depression: a comparative electroencephalographic sleep study.

Family studies suggest some common etiological factors in panic disorder and depression. The observation of characteristic depression-like polysomnographic alterations in panic disorder patients would further underline the assumed biological interface between the two psychiatric disorders. In a polysomnographic study of 22 inpatients with panic disorder, 12 inpatients with major depression, and 12 control subjects, we found that both groups of patients had one major feature of depression-like sleep: a shortened rapid eye movement (REM) latency. However, the patterns of the first hours of polysomnography showed more differences than similarities between these psychiatric disorders, indicating that the shortened REM latency apparently is merely a common final pathway of different alterations in sleep regulation. Our findings, therefore, provide more evidence against than for a significant biological interface between panic disorder and depression.

Adolescent↗
PubMed1992

Cortisol levels and vigilance in eating disorder patients.

Elevated plasma levels of cortisol, as well as deficits in cognitive processes such as attention, have been observed in patients with eating disorders. The association between plasma cortisol and performance in vigilance task was studied in 17 patients with bulimia nervosa or anorexia nervosa during the acute phase of their eating disorder. In comparison to normal young women, the patients had a significantly lower hit rate in a discrimination task and showed an impaired perceptual sensitivity index. They also displayed significantly longer reaction times to hits, but not to false alarms. Cortisol levels of the patients were significantly higher than those of the normal controls. When patients were divided according to their median cortisol level, the patients with higher levels performed significantly more poorly than did the patients with lower levels. In the total patient sample, cortisol levels showed a significant negative correlation with hit-rate (r = -.54) and a significant positive correlation with reaction time to hits (r = .70). Other clinical characteristics were not related to cognitive performance. These results suggest a possible role of cortisol in the development of attentional deficits in eating disorder patients.

Adult↗