[Diagnosis and therapy of attention deficit-/hyperkinetic disorder in adulthood].
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Biomedical subjects
Publications and source records attributed to J Krause.
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The charge state of ions produced in electrospray ionization (ESI) was reduced in a controlled manner to yield predominantly singly charged species by exposure of the aerosol to a bipolar ionizing gas. Analysis of the resulting ions on an orthogonal time-of-flight mass spectrometer yielded mass spectra greatly simplified compared with conventional ESI spectra. The decreased spectral complexity afforded by the charge reduction facilitates the analysis of mixtures by ESI mass spectrometry.
We investigated the mechanisms and functions of shoal choice in relation to nutritional state in the zebrafish. Single fish that had been well fed or food deprived for 2 days were presented with a choice between two stimulus shoals. Food-deprived test fish showed a significant preference for well-fed stimulus fish over food-deprived ones whereas well-fed test fish did not exhibit any significant preference. Subsequent experiments showed that food-deprived test fish had a significantly higher foraging success in shoals consisting of well-fed individuals than in ones that comprised food-deprived fish. No difference in the locomotory behaviour of food-deprived and well-fed stimulus fish was found with respect to the proportion of time spent swimming (as opposed to being motionless), the proportion of time spent in the upper part of the test tank and the number of sharp turns. However, body weight, stomach width (measured directly behind the pectoral girdle) and ventro-dorsal height significantly decreased over a 48-h food-deprivation period. The potential use of the latter factors for the recognition of food-deprived individuals is discussed. Copyright 1999 The Association for the Study of Animal Behaviour.
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Angiotensin-converting enzyme (ACE) inhibitor-induced angioedema is supposed to be an uncommon cause for oropharyngeal edema. Between January 1, 1993 and February 1, 1997 we treated 20 patients with edema of the oropharyngeal region that was not caused by infection or irradiation. The most common reason was an ACE-inhibitor-induced angioedema and occurred in 9 cases, all of whom required inpatient treatment. The medical management consisted of the administration of intravenous (i.v.) glucocorticosteroids in all cases, H1-blockers in 6 cases, epinephrine by inhalation in one case and i.v. epinephrine in another case. Tracheostomy had to be performed in one patient. In our experience it is necessary to reconsider ACE inhibitor-induced angioedema in any case of an oropharyngeal edema. However, there is no reason for the routine application of epinephrine in these cases.
The clinical picture of adult hyperkinetic syndrome (HKS) or attention deficit/hyperactivity disorder is nearly unknown in Germany. It can be estimated, that approximately one third of affected children also show symptoms as adults. In the combined type of the syndrome symptoms of inattention as well as of hyperactivity and impulsivity are present, a predominantly inattentive or hyperactive-impulsive type is possible. Retrospective diagnosis of HKS in childhood can be difficult. Disorganization, emotional disturbances and stress intolerance are common in adults with HKS as well as residual symptoms of learning disorders like dyslexia, dyscalculia and dysgraphia. In differential diagnosis especially affective, anxiety and antisocial personality disorders have to be considered, for which on the other side a frequent comorbidity with HKS is known. There is strong evidence for genetic transmission. Neurobiological findings revealed dysregulation of neurotransmitters. For treatment stimulants as pemoline and methamphetamin are effective, in addition tricyclic antidepressants or beta blockers; positive effects are probable for moclobemide, bupropion, fluoxetine and venlafaxine.
Two mouse monoclonal antibodies, 11H9.1 and 1G7.10, raised against the COOH-terminus peptide (359-390) of the rat neurokinin-2 receptor, were used to visualize by light and electron microscope immunocytochemistry the distribution of this receptor in adult rat spinal cord. At all spinal levels, immunoreactivity was mainly observed in two narrow crescentic zones bordering the gray matter of the dorsal and ventral horns, and around the central canal. In the light microscope, this labelling was the densest within the outer part of lamina I facing the dorsal column, where it took the form of minute dots and streaks scattered in the neuropil. In the electron microscope, such a localization was exclusively astrocytic and essentially involved astrocytic leaflets, as indicated by the size and irregular shape of the immunostained processes, their location between and around neuronal profiles, and their occasional display of glial filaments. The diaminobenzidine reaction product showed some predilection for the plasma membrane and was occasionally seen at gap junctions of these labelled processes. Many labelled astrocytic leaflets were observed in the immediate vicinity of axon terminals containing large dense-cored vesicles, and around fibres morphologically identifiable as primary afferent, unmyelinated C-fibres. These observations suggest that astrocytic neurokinin-2 receptors could define the effective sphere of neurokinin A neuromodulation in rat spinal cord, via alterations in the regulation of the extracellular environment and glutamate uptake by astrocytes and/or the release of putative astroglial mediators. The astrocyte neurokinin-2 receptors, activated by extrasynaptic neurokinin A, might thus co-operate with neurokinin-1 and neurokinin-3 neuronal receptors in the modulation of nociceptive information.
Standard photographic technique in plastic surgery is an important topic that has been stressed in the discipline over the past several years. Clinical photographs should always be taken with the same camera lens, lens setting, lighting, film, and patient position to ensure reproducibility and to enable valid pre- and postoperative comparisons. A 35-mm single lens reflex camera is highly recommended for this type of photography. Two lenses are suggested, one with a focal length range of 50 to 60 mm and one with a focal length range of 90 to 105 mm. Both should have macro capability. Two or more flash units are recommended, either camera-mounted or a studio system set-up in the office. Using the patient preparation method and technique outlined in the text, the Standards in Clinical Photography achieve consistency from patient to patient and also in the same patient in pre- and postoperative photographs. Henceforth, the information discussed in the article forms the basis for standard views, regardless of the image-capture medium.
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BACKGROUND: Clinical trials have demonstrated that platelet glycoprotein (GP) IIb/IIIa antagonists effectively prevent acute thrombotic events. Orally active GP IIb/IIIa antagonists are essential to evaluate the clinical benefit of long-term treatment. We therefore investigated platelet inhibition by the GP IIb/IIIa antagonist Fradafiban (BIBU 52; Fradafiban is the recommended INN of BIBU 52) and its orally administered prodrug, Lefradafiban (BIBU 104; Lefradafiban is the recommended INN of BIBU 104) in healthy subjects. METHODS AND RESULTS: The activity and plasma levels of Fradafiban and Lefradafiban were evaluated in double-blind, placebo-controlled studies in 130 healthy male subjects. One to 15 mg Fradafiban continuously infused over 30 minutes reversibly inhibited platelet aggregation in platelet-rich plasma ex vivo in response to 20 micromol/L ADP (5 mg, 100% inhibition at 27 minutes after administration) and to both 1.0 (5 mg, 100%) and 10 microg/mL (15 mg, 97+/-3%) collagen. Single oral doses of Lefradafiban inhibited ADP-induced aggregation by 59+/-14% (50 mg [mean+/-SD]; n=8), 90+/-12% (100 mg), and 99+/-2% (150 mg) 8 hours after administration. Correlations between activity and Fradafiban plasma levels were identical after Fradafiban and Lefradafiban treatment. After day 1, oral TID Lefradafiban treatment for 7 days inhibited aggregation by > or = 31+/-9.6% (25 mg TID; n=8), 53+/-12% (50 mg; n=7), and 88+/-6.6% (75 mg; n=8) just before the next dose. A similar correlation between the activity and Fradafiban plasma levels was observed at days 1, 2, and 7. CONCLUSIONS: Oral administration of Lefradafiban maintains the potent platelet GP IIb/IIIa antagonism of Fradafiban during treatment of healthy subjects for 1 week without signs of loss of the antiplatelet activity.
The immunocytochemical localization of tachykinin NK-3 receptor (NK-3R) was studied in rat spinal cord using a mouse monoclonal antibody directed against the C-terminus peptide (434-465) of the human NK-3R. Light microscopic labeling prevailed in lamina II and lamina X. Under the electron microscope, the immunolabeling in lamina II involved mainly dendritic spines inside glomeruli, preterminal axons and axon terminals. This suggests that neurokinin B can modulate primary afferent, sensory information, both post- and pre-synaptically. These actions are likely to involve extrasynaptic diffusion of the peptide, since NK-3R immunoreactivity was not found in association with postjunctional differentiations.
Cerebrovascular accidents in patients with sickle cell anemia are among the most devastating complications of the disease. It has recently been demonstrated that some patients have a hypercoagulable state on the basis of the presence of an abnormal factor V molecule, factor V Leiden. We undertook this study to evaluate the presence of factor V Leiden in sickle cell patients with stroke. Eighty-two patients with either Hgb SS, Hgb SC, or Hgb S(beta+)-thalassemia comprised the study population. Of the 82 patients in the study, 19 of them had a history of stroke. In our study population, none of the stroke patients possessed the factor V Leiden mutation. One of the non-stroke patients was a heterozygote for the mutation (P = 1.00). The overall frequency of the factor V Leiden allele in our population is 0.6%. The estimated prevalence for this mutation is reportedly between 3 and 7% in Caucasian populations. We conclude that the gene frequency for factor V Leiden is less common in Africa Americans with sickle cell disease. Furthermore, factor V Leiden does not appear to be responsible for the development of stroke in sickle cell patients.
Polymerase chain reaction (PCR) assays have been developed for follicular lymphoma-associated BCL-2/J(H) translocations. Few data are available on the quantitation by PCR of these translocations in peripheral blood mononuclear cells (PBM) of follicular lymphoma (FL) patients. We report that only one of five studied FL patients had a high level of these translocations in the circulation, namely, about 35,000 translocations per 5 x 10(6) PBM. This patient was stable with an excellent performance status at the time of this assay; however, he died of leukemia 1 month later.
A new group of compounds has been successfully tested as matrices for ultraviolet matrix-assisted laser desorption/ionization mass spectrometry (UV-MALDI MS). Several new matrices for UV-MALDI MS have been found by choosing, as potential matrices, compounds that perform an intramolecular proton transfer along an intramolecular H-bond under UV irradiation. Compounds of this type are, for example, salicylamide, salicylanilide, several ortho-hydroxyacetophenones and ortho-hydroxybenzophenones. The matrix activity of these compounds is compared to the corresponding meta- and para-isomers and to the matrix activity of such well known matrices as 2,5-dihydroxybenzoic acid and 2,4,6-trihydroxyacetophenone. It was found that meta- and para-substituted hydroxycarbonyl compounds show either a significantly lower or no matrix activity compared with the ortho isomers.
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In the period from 1960 to 1990 about 1.4 million tonnes of asbestos were imported by the former German Democratic Republic (GDR) and mainly processed into asbestos-cement products for the building industry. The production was concentrated in the former counties of Magdeburg and Dresden. In the past, asbestos was primarily used as insulation and fire prevention material, etc. in the large-scale chemical industry. Chrysotile was predominantly imported from the former Soviet Union, partly from Canada. Very small amounts of amphiboles came from Mozambique, but they were not processed in the counties of Magdeburg and Halle. In the German Federal State of Saxony-Anhalt, approx. 600 asbestoses, almost 2,700 pleural changes caused by asbestos, 843 asbestos-induced mesotheliomas and 787 bronchial and laryngeal carcinomas caused by asbestos were recorded in the period from 1960 to 1990. A considerable percentage of the mesotheliomas are solely due to exposure to chrysotile asbestos.
The authors evaluated in a group of 23 women with carcinoma of the endometrium the possibility of reliable assessment of prognostic factors and their part in the selection of a suitable surgical method. They used computed tomography for preoperative assessment of the extent of myometrial invasion which is considered from the prognostic aspect an important factor of first order. They also evaluated the contribution of CT to assessment of the state of regional lymph nodes and to assess the stage of the disease. They proved the reliability of CT in the assessment of myometrial invasion in 87% and a significant contribution to the assessment of the stage of the disease. Preoperative histological assessment of the subtype and grading of the endometrial carcinoma made it possible to differentiate patients with a low and high risk of development of a malignant neoplasm.