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Biomedical subjects

M Berger

Publications and source records attributed to M Berger.

At least 253 records · Page 14Linked to original sources
PubMed1997

Lithium-induced inositol depletion in rat brain after chronic treatment is restricted to the hypothalamus.

The influence of acute and chronic lithium administration on inositol content was examined in five different regions of the rat brain: caudate, cerebellum, cortex, hippocampus and hypothalamus. After acute administration of lithium at doses of 3, 6 or 10 mEq kg-1, no significant reductions of inositol were found in any brain region. Also no significant changes were observed in cortex, caudate, hippocampus and cerebellum after chronic treatment with lithium-containing diet, which led to brain concentrations of lithium in the therapeutic range. However, a moderate but significant reduction of inositol was under these conditions observed in the hypothalamus. At basal conditions, ie in control rats not treated with lithium, the inositol content in various brain areas was different, the hypothalamus containing the highest inositol concentration (4.4 mmol kg-1 wet weight) and the cortex the lowest (2.3 mmol kg-1 wet weight). It is concluded that chronic lithium treatment at therapeutically relevant brain concentrations does not evoke major changes in the inositol content of the brain but induces a moderate decrease which is restricted to the hypothalamus. The results are discussed with respect to the potential function of the hypothalamus in affective disorders.

Animals↗
PubMed1997

Prostaglandin E2 induces interleukin-6 synthesis in human astrocytoma cells.

Prostaglandins (PGs) and cytokines, such as interleukin-1 (IL-1) and interleukin-6 (IL-6), have been implicated in the etiopathology of various inflammatory and degenerative disorders, including Alzheimer's disease (AD) and prion diseases. Nonsteroidal antiinflammatory drugs (NSAIDs), potent inhibitors of PG synthesis, appear to be beneficial in the treatment of AD. To assess whether PGs are able to induce IL-6 synthesis in cells of the CNS, IL-6 mRNA and protein syntheses were measured in a human astrocytoma cell line after stimulation with different PGs. PGE1 and PGE2, but not PGD2 and PGF2 alpha, led to a rapid and transient induction of IL-6 mRNA, followed by IL-6 protein synthesis. Furthermore, PGE2 potentiated IL-1 beta-induced IL-6 mRNA synthesis. These results are discussed with respect to the participation of PGs in neurodegenerative diseases (and its inhibition by NSAIDs) by affecting cytokine expression.

Alprostadil↗
PubMed1997

Psychosis during chronic levodopa therapy triggered by the new antidepressive drug mirtazapine.

We report the case of a patient developing psychosis after the addition of mirtazapine, a novel antidepressant enhancing serotonergic neurotransmission, to a chronic levodopa regimen. There was complete and rapid recovery upon low-dose clozapine treatment. To our knowledge, this is the first published case of a mirtazapine-levodopa interaction and the second case report of a psychosis induced by a serotonergic antidepressant in a patient with Parkinson's disease (PD). This phenomenon might be due to a postsynaptic serotonin receptor supersensitization caused by low central serotonin levels in treated PD.

Adult↗
PubMed1997

A retrospective analysis of revision sphincter pharyngoplasty.

This retrospective study was undertaken to determine the revision rate for dynamic sphincter pharyngoplasty (DSP) at the University of Michigan Medical Center to analyze the determinants contributing to the need for revision pharyngoplasties, and ultimately to improve primary pharyngoplasty to avoid the need for revision. The records of 30 children with repaired palatal clefts who presented with velopharyngeal insufficiency and hypernasal speech, and who underwent DSP from January 1988 through July 1994 were reviewed. Clinical follow-up ranged from 6 to 48 months (mean, 20.2 months). Seven of the original 30 patients (23%) had persistent, moderate-to-severe hypernasality that required reoperation, while 1 patient (3%) demonstrated hyponasality requiring revision. Seven of 8 patients who underwent revision pharyngoplasty had acceptable speech after revision. Dehiscences, low-lying pharyngoplasty flaps, and end-to-end suturing of the flaps were the main determinants resulting in the need for revision. In our study, female gender and older age was associated with a higher success of primary operation.

Adolescent↗
PubMed1997

Sleep deprivation combined with consecutive sleep phase advance as a fast-acting therapy in depression: an open pilot trial in medicated and unmedicated patients.

OBJECTIVE: The authors' goal was to test the hypothesis that the antidepressant effect of total sleep deprivation can be maintained by initially avoiding sleep during a supposedly "critical" time period in the early morning. METHOD: They studied 33 inpatients with major depression, melancholic type, all of whom responded positively to total sleep deprivation. Twelve of the patients were men and 21 were women; their mean age was 46.7 years (SD = 13.7). After total sleep deprivation, the patients started a sleep schedule from 5:00 p.m. to 12:00 midnight, which then was shifted back by 1 hour each day until a sleep time of 11:00 p.m. to 6:00 a.m. was reached. RESULTS: Twenty (61%) of the 33 patients who responded to total sleep deprivation with an improved state of mood maintained this improvement during sleep phase advance therapy. Drug-free and medicated patients did not differ from each other. CONCLUSIONS: The rapid amelioration of mood observed with total sleep deprivation can be preserved with a succeeding phase shift of the sleep period.

Antidepressive Agents↗
PubMed1997

Incidence of blindness in relation to diabetes. A population-based study.

OBJECTIVE: A reduction of diabetes-related blindness was declared a primary objective for Europe (St. Vincent Declaration). We collected data about incidence rates of blindness in the diabetic population compared with the nondiabetic population. Up to now, such data are scarce-even worldwide. RESEARCH DESIGN AND METHODS: A complete list of newly registered blindness allowance recipients was drawn up in the district of Württemberg-Hohenzollern, Germany, between 1990 and 1993. From these data, we estimated age-specific and standardized incidence rates of blindness in the entire, the diabetic, and the nondiabetic population, as well as relative and attributable risks due to diabetes. RESULTS: There were 2,714 people meeting the inclusion criteria; 1,823 (67.2%) were female and 781 (28.8%) had diabetes. In 318 subjects, diabetes was likely to be the only cause of blindness; in 192 subjects, it was one of several contributory causes. Age of women was 73.9 +/- 19.4 years (mean +/- SD) and of men 63.3 +/- 25.5 years. Results standardized to the (West) German population are as follows: incidence rates (per 100,000 person-years): total population: 13.5; diabetic population: 60.6; nondiabetic population: 11.6; relative risk: 5.2; attributable risk among exposed: 0.81; and population attributable risk: 0.14. The relative risks decreased considerably with increasing age. When the study is repeated to monitor the St. Vincent targets, a reduction in the incidence rate of blindness in the diabetic population by 17% will be detected with 95% power. CONCLUSIONS: Great relative and attributable risks, especially in younger age-groups, indicate the need for increased attention to preventive measures for microvascular complications.

Adolescent↗
PubMed1997

Issues in the measurement of satisfaction with treatment.

Patients satisfaction with treatments is a growing area of research that has tremendous potential to provide outcome measures for clinical trials and disease management programs. It also has applications in marketing and product development, especially for the treatment of chronic diseases. The objective of this review is to demonstrate that treatment satisfaction is a distinct area of research that has produced some important initial results. We define treatment satisfaction and provide a conceptual framework that clarifies the role of treatment expectations, preferences, and satisfaction in the context of healthcare in general. Nineteen articles were selected from more than 1,400 abstracts and were reviewed for the following information: (1) topics covered; (2) method used to design the measure; (3) descriptive statistics; (4) assessment with respect to the attributes in the Instrument Review Criteria of the Medical Outcome Trust's Scientific Advisory Committee; and (5) covariates. We conclude that some important initial results about treatment satisfaction have been obtained, but that much work remains to be performed. We recommend that future research devote more attention to qualitative research with patients, assessment of the measures, and the covariates presented in the conceptual model. We also recommend that decision makers insist on measures that meet these criteria.

Chronic Disease↗
PubMed1997

[Quality assurance in inpatient treatment of depression. Aspects of quality monitoring and external quality assurance exemplified by a pilot project of inpatient treatment of depression].

Aspects of a Pilot Study on Depression Treatment According to Quality Monitoring and External Quality Assurance: Experiences and results of a pilot study on quality of the treatment of depressed inpatients in 4 different psychiatric hospitals (2 state mental hospitals, 1 university clinic, 1 psychiatric clinic at a city general hospital) according to so-called process and outcome quality, are reported. Outcome data (self-ratings, observer rating, clinical global impression admission versus discharge, patient satisfaction with treatment, duration of inpatient stay/and patient data are reported while comparing the 4 hospitals. Difficulties and problems of data collection, assessments and comparison of 4 different hospitals are discussed.

Adult↗
PubMed1997

Pointing arm movements in short- and long-term spaceflights.

Accuracy and kinematics of horizontal arm pointing movements to visual targets were studied on three cosmonauts in 10-, 140-, and 172-d spaceflights in order to investigate mechanisms of the sensorimotor adaptation to microgravity. The Austrian equipment MONIMIR was mounted on board the Russian space station MIR and used for three-dimensional recording of the arm position and presentation of the targets. It was found that movement accuracy remained constant whereby movement durations significantly increased in all inflight sessions compared to the preflight baseline values. Inflight, movement peak velocities as well as acceleration and deceleration peak values decreased significantly. Analysis of the velocity-time profiles showed that the ratio between acceleration and deceleration phases decreased slightly for one cosmonaut and increased insignificantly for the other two cosmonauts. All phases of the acceleration-time profiles increased inflight by the same factor. These data fail to support the assumption of an increased role of the direct visual guidance in movement execution in microgravity. This suggests that the movement slowing in microgravity may be caused by a control strategy employed by the CNS to avoid the specific disadvantage of the absence of gravity. It is hypothesized that intra-movement control mechanisms play an important role in the movement coordination in the altered gravity environment.

Acceleration↗
PubMed1997

Effects of UV and visible radiation on DNA-final base damage.

Several mechanisms are likely to be involved in the solar radiation-mediated modifications of cellular DNA. Direct excitation of DNA bases by the UVB component (290-320 nm) of solar light gives rise, mostly through oxygen independent reactions, to the formation of dimeric pyrimidine lesions including cyclobutadipyrimidines, pyrimidine (6-4) pyrimidone photoproducts and related valence Dewar isomers. In addition, photoexcitation of cytosine and guanine may lead to the formation in relatively minor yields of 6-hydroxy-5,6-dihydrocytosine and 8-oxo-7,8-dihydroguanine, respectively. A second mechanism that requires the participation of endogenous photosensitizers together with oxygen is at the origin of most of the DNA damage generated by the UVA (320-400 nm) and visible light. Singlet oxygen, which arises from a type II mechanism, is likely to be mostly involved in the formation of 8-oxo-7,8-dihydroguanine that was observed within both isolated and cellular DNA. However, it may be expected that the latter oxidized purine lesion together with DNA strand breaks and pyrimidine base oxidation products are also generated with a lower efficiency through Fenton type reactions. A more definitive assessment of these mechanisms would require further studies aimed at the identification and quantification of the different DNA photolesions including both dimeric pyrimidine photoproducts and photooxidized lesions.

Animals↗
PubMed1996

Increased sensitivity of the inositol-phospholipid system in neutrophils from patients with acute major depressive episodes.

Evidence from in vitro and in vivo studies suggests that the therapeutic and prophylactic effects of lithium in recurrent affective disorders are due to an attenuation of the inositol-phospholipid (IPL) second messenger system. An increased sensitivity of this signal transduction system might therefore constitute a risk factor for affective illness. The extent of the agonist-induced release of intracellular Ca2+ (Ca2+ response) can be used as an indicator of the sensitivity of the IPL system. Using this paradigm, we have measured the agonist-induced Ca2+ response in neutrophils of 17 unmedicated patients who were experiencing an acute major depressive episode. The neutrophils were stimulated by the chemotactic peptide formylmethionylleucylphenylalanine, which activates the IPL system in the cells. The sensitivity of the IPL system in these patients was significantly greater (dose-response curve shifted to the left) compared with its sensitivity in healthy age- and sex-matched control subjects. The results indicate that acute episodes of major depression are associated with an increased sensitivity of the IPL system.

Adult↗
PubMed1996

[Dementias--diagnosis, differential diagnosis and therapy].

The most common cause of primary (degenerative) dementia in old age is Alzheimer's disease, with vascular forms of dementia taking second place. Endocrinopathies, normal pressure hydrocephalus and space-occupying lesions are frequent causes of secondary dementia. A multitude of further, more rare clinical presentations results in a wide differential diagnostic spectrum necessitating a careful diagnostic work-up of the demential syndrome before considering treatment. This work-up must include clinical, laboratory and equipment-based investigations. The multimodal therapeutic approach to dementia covers not only the elimination of treatable underlying causal conditions and the medical treatment of cognitive symptoms and psychiatric accompanying symptoms, but also non-medicamentous aspects.

Alzheimer Disease↗
PubMed1996

Carbamazepine inhibits the potentiation by adenosine analogues of agonist induced inositolphosphate formation in hippocampal astrocyte cultures.

Carbamazepine (CBZ) resembles lithium in its beneficial effects in therapy and prophylaxis of affective disorders. Since lithium is presumed to act via an attenuation of the inositolphosphate/Ca(2+)-second messenger system, it is of particular interest whether or not CBZ might also have inhibitory effects on this type of signal transduction. CBZ is an antagonist of adenosine A1-receptor subtypes. We show here that activation of adenosine A1-receptors potentiates the phenylephrine induced formation of inositolphosphates in hippocampal astrocytes and that this potentiating effect is inhibited by CBZ at a therapeutically relevant concentration. These results indicate that CBZ can by antagonism of adenosine A1-receptors inhibit the inositolphosphate/Ca(2+)-signalling in neural pathways regulated by adenosine.

Adenosine↗
PubMed1996

[Parenthood and child development after reproduction medicine treatment. Psychosomatic follow-up of 46 parents after assisted reproduction].

On the basis of a longitudinal study on "parenthood and child development after successful conception by IVF" in which 46 couples with 64 children born after reproductive medical treatment (IVF or ICSI) were followed up for three years, we now discuss several aspects of the psychological situation of those involved. Reference is made to the characteristics of the "structure" of the couples, their attitude towards the treatment, their experience of the pregnancy, features of child development and of the parent-child relationship, as well as to the prevailing psychological strategies of the couples for coping with the stresses and risks of assisted fertilization. Preliminary results show that during the course of treatment and following the birth of the children, the partnerships remained stable, and that relationships between family members are, for the most part, developing favorably.

Adaptation, Psychological↗
PubMed1996

Effect of tetrahydroaminoacridine on sleep in healthy subjects.

The present study investigated the impact of the cholinesterase inhibitor tetrahydroaminoacridine (THA; tacrine) on sleep in healthy subjects. According to the reciprocal interaction model of non-rapid eye movement (NREM) and REM sleep regulation, which postulates a primary role in cholinergic neurotransmission for the initiation and maintenance of REM sleep, it was expected that THA would lead to an earlier onset of REM sleep. In 12 healthy subjects aged from 21 to 50 years two different doses (20 mg, 40 mg) were administered 1 hour prior to bed time and compared to placebo. Only the higher dose of THA significantly shortened REM latency. No other significant effects on sleep architecture were observed, although administration of 40 mg tacrine was associated with a decrease in sleep efficiency and a prolongation of sleep latency. Blood plasma levels of tacrine and its metabolite 1-hydroxytacrine measured prior to sleep and during the first 90 min of sleep were significantly correlated with the onset of REM sleep in relation to the timing of drug administration (only for the 20 mg dose). The reversible cholinesterase inhibitor THA exerts effects on REM latency comparable to those observed with other cholinomimetic agents.

Adult↗
PubMed1996

Effects of NSAIDs on IL-1 beta-induced IL-6 mRNA and protein synthesis in human astrocytoma cells.

Inflammatory processes contribute to the aetiopathology of Alzheimer's disease (AD). Interleukin-6 (IL-6), a proinflammatory cytokine, is found in the brains of AD patients, but not in brains of normal control persons. In the present study, the effects of seven non-steroidal anti-inflammatory drugs (NSAIDs) on interleukin-1 beta (IL-1 beta)-induced IL-6 mRNA expression and protein synthesis in a human astrocytoma cell line were investigated. Tenidap, naproxen and meloxicam inhibited the IL-1 beta-induced synthesis of IL-6, whereas ibuprofen, piroxicam, diclofenac and indomethacin had no effect. While the effects of naproxen and meloxicam were small and restricted to protein synthesis, tenidap strongly inhibited IL-6 protein synthesis and also affected IL-6 mRNA levels. It is concluded that NSAIDs, and particularly tenidap, may be useful for the treatment of inflammatory processes associated with AD.

Anti-Inflammatory Agents, Non-Steroidal↗