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Biomedical subjects

M Berger

Publications and source records attributed to M Berger.

At least 541 records · Page 30Linked to original sources
PubMed1990

Influence of local radiotherapy of breast cancer patients on the frequency of cytotoxic T lymphocyte precursor cells.

Alloantigen-specific cytotoxic T lymphocyte precursor (CTL-p) frequencies were analyzed in ten patients with histologically proven breast cancer receiving prophylactic RT. The frequency of CTL-p was assessed by limiting dilution (LD) analyses before, immediately after discontinuation of treatment and at various times following RT. The number of pbmnc, adherent cells and T cells was determined in parallel. Local RT led to a minor and transient reduction of CTL-p frequencies lasting approximately three months: on average a 25% decrease of CTL-p numbers was seen immediately after RT. Three months following treatment, a 20% reduction was still evident. Values subsequently returned to pretreatment levels. Moreover, these changes in the frequency of antigen-specific CTL were accompanied by a 25% to 39% decrease in the blood T cell counts lasting for more than 12 months. The reductions following local RT were less pronounced than those induced by immunosuppressive drugs in allograft recipients.

Adult↗
PubMed1990

High-dose trimipramine in acute schizophrenia. Preliminary results of an open trial.

Trimipramine and clozapine show some similarities in receptor-binding profiles. Both have the same dissociation constant for D2-receptors and marked binding potencies for H1-receptors and muscarinic acetylcholine receptors. Based on these similarities an antipsychotic efficacy of trimipramine might be postulated. To generate hypotheses 15 schizophrenic patients with a BPRS total score of at least 50 were treated with trimipramine up to 400 mg per day. Four patients deteriorated under this treatment and had to be withdrawn from the study between the 4th and the 10th day. One patient stopped participating after the 15th day due to lack of improvement. These drop-outs showed a mean impairment in BPRS total score from 56 at baseline to 66 at endpoint. Ten patients were treated for 4 to 5 weeks successfully and improved on the BPRS from 57 at baseline to 31 at endpoint. High-dose trimipramine was tolerated well. In schizophrenic patients the expected sedative effect was small. One patient developed a modest parkinsonism, no acute dystonia was seen.

Acute Disease↗
PubMed1990

REM-suppressing effects of amitriptyline and amitriptyline-N-oxide after acute medication in healthy volunteers: results of two uncontrolled pilot trials.

Almost all tricyclic and tetracyclic antidepressants as well as the MAO (monoamineoxidase) inhibitors suppress REM sleep significantly and sustainedly. This does not seem to be an epiphenomenon of antidepressant pharmacotherapy, since initial REM sleep suppression during pharmacological treatment correlated positively with antidepressant effect after three weeks. Furthermore, selective REM-sleep deprivation (by waking patients) had a marked antidepressive effect in depressed patients. The present study used rapid eye movement (REM) sleep suppression in healthy volunteers as a marker to compare the central nervous effects of 150 mg amitriptylineoxide (AMINO) with those of 75 mg amitriptyline (AMI). Both compounds exerted comparable sleep-inducing effects; suppression of REM sleep tended to be more pronounced after application of AMI, despite the higher dose of AMINO used. While this result is evidence of the immediate central nervous effects of a single dose of AMINO, they seem less marked than those of AMI.

Adult↗
PubMed1990

Moclobemide versus placebo in the treatment of depression: a multicentre study in Belgium.

Moclobemide was compared with placebo for antidepressant activity, tolerance and safety in 2 parallel groups of 23 and 24 depressed patients. At the end of treatment (4 weeks or longer), 9 patients on moclobemide (41%) showed an improvement greater than or equal to 50% on the Hamilton Rating Scale for Depression, compared with only 4 (17%) of those on placebo. The overall assessment of efficacy was significantly better for moclobemide (good or very good results in 50% of patients) than for placebo (80% poor results). Moclobemide was well or very well tolerated by 85% of patients and placebo by 100%. Moclobemide was thus shown to be clearly more effective than placebo and only slightly less well tolerated.

Antidepressive Agents↗
PubMed1990

Moclobemide versus clomipramine in the treatment of depression: a double-blind multicentre study in Belgium.

Moclobemide and clomipramine were compared for efficacy, tolerance and safety in 63 mixed endogenous and nonendogenous depressed patients. Treatment was given for at least 4 weeks in a double-blind, randomized, parallel-group design. The mean Hamilton Rating Scale for Depression score decreased gradually during treatment with no differences between groups. Two patients on clomipramine and none on moclobemide were withdrawn for lack of efficacy, and poor tolerance caused 3 patients on moclobemide and 7 on clomipramine to stop treatment prematurely. Patients with endogenous depression responded better to clomipramine, whereas nonendogenous disorders did better on moclobemide. Adverse events were more frequent in the clomipramine group and more of these were severe or very severe than for moclobemide. Thus, although no significant difference in efficacy was seen, moclobemide appeared to be tolerated better than clomipramine. The numbers were small, however, and many patients received concomitant medication, and the results are therefore difficult to interpret.

Antidepressive Agents↗
PubMed1990

Moclobemide versus amitriptyline in the treatment of depression: two small double-blind multicentre studies in Belgium.

Moclobemide was compared with amitriptyline for antidepressant efficacy, safety and tolerance. Two studies were conducted, both over at least 4 weeks; in the first, 8 patients were given moclobemide in doses ranging from 300 to 328 mg, and 9 patients amitriptyline in doses of 75 to 96 mg; in the second, the numbers were 13 on moclobemide and 14 on amitriptyline, and the mean doses were 294-408 mg and 95-129 mg respectively. Both studies showed the 2 treatments to be equally effective, and there were no significant differences at any point. Moclobemide appeared slightly more effective and slightly better tolerated than amitriptyline, but the numbers were too small for any valid conclusion.

Adult↗
PubMed1990

Efficacy of a reversible monoamine oxidase-A inhibitor versus imipramine in subgroups of depressed patients.

Two multicentre studies comparing moclobemide with imipramine under similar conditions in patients undergoing a major depressive episode (DSM-III) were combined in the present analysis. A total of 353 patients received moclobemide (300-600 mg/day) and 356 imipramine (100-200 mg/day). In each study, the antidepressant efficacy of the 2 drugs was comparable, and subgroup analysis showed that moclobemide and imipramine were equally effective in endogenous depression. The response rate did not appear to be influenced by sex, but patients older than 60 years tended to respond less well to both drugs than did those under 60. The conclusion from the 2 studies is that, contrary to what is frequently stated for monoamine oxidase inhibitors, moclobemide appears as effective as a tricyclic in treating endogenous depression.

Antidepressive Agents↗
PubMed1990

The effects of total sleep deprivation and subsequent treatment with clomipramine on depressive symptoms and sleep electroencephalography in patients with a major depressive disorder.

In the present study patients with a major depressive disorder were first subjected to total sleep deprivation (TSD) and then treated with clomipramine. Sleep electroencephalography (EEG) was registered prior to and after TSD, during the 2 initial nights of antidepressive treatment and after 19 days. A negative correlation between response to TSD and clomipramine was found. TSD did not differentially influence the sleep EEG (responders vs nonresponders): responders tended, however, to show a more classical depressive sleep pattern prior to TSD. Clomipramine profoundly suppressed rapid eye movement (REM) sleep; the amount of initial REM sleep reduction, however, did not correlate significantly with therapy response after 3 weeks of treatment.

Adolescent↗
PubMed1990

Adaptation to ischemia during percutaneous transluminal coronary angioplasty. Clinical, hemodynamic, and metabolic features.

The clinical, electrocardiographic, and coronary hemodynamic responses to sequential 90-second occlusions of the left anterior descending coronary artery in 12 patients undergoing elective percutaneous transluminal coronary angioplasty were examined. Transmyocardial lactate metabolism was examined in an additional group of seven patients with clinical and hemodynamic features similar to the first group. We noted that in comparison with the initial balloon occlusion the second occlusion was characterized by less subjective anginal discomfort, less ST segment shift (0.44 +/- 0.13 versus 0.21 +/- 0.07 mV, p = 0.01), and lower mean pulmonary artery pressure (25 +/- 1.0 versus 20 +/- 1.7 mm Hg, p = 0.005). In addition, for the same heart rate-blood pressure product, cardiac vein flow during the second inflation was significantly lower than that recorded during the first inflation (96 +/- 1.4 versus 83 +/- 2.4 ml/min, p = 0.005). Finally, there was significantly less myocardial lactate production during the second inflation (lactate extraction ratio: first inflation, -0.11 +/- 0.03; second inflation, -0.03 +/- 0.02; p = 0.04). We conclude that the lessened clinical, electrocardiographic, hemodynamic, and metabolic evidence of myocardial ischemia during the second of two periods of coronary artery occlusion during percutaneous transluminal coronary angioplasty supports the concept of adaptation to myocardial ischemia (ischemic preconditioning).

Adaptation, Physiological↗
PubMed1990

Neutrophil elastase cleaves C3bi on opsonized pseudomonas as well as CR1 on neutrophils to create a functionally important opsonin receptor mismatch.

Neutrophil elastase has been implicated as a factor that impairs local host defenses in chronic Pseudomonas aeruginosa (Pa) lung infection in cystic fibrosis (CF). We recently showed that this enzyme cleaves the C3b receptor, CR1, from neutrophils (PMN) in the lungs of infected CF patients. The C3bi receptor on these cells, CR3, is resistant to elastase. We now show that purified neutrophil elastase markedly impairs complement-mediated PMN-Pa interactions including phagocytosis of opsonized Pa, stimulation by opsonized Pa of PMN superoxide production, and killing of opsonized Pa by PMN. When PMN and opsonized Pa were treated separately with elastase, additive levels of inhibition were observed in each of the above assays. The effects on the bacteria were due to cleavage of the bound C3bi from the surface of opsonized Pa by neutrophil elastase. C3bi was also cleaved by pseudomonas elastase, or bronchoalveolar lavage fluid from CF patients with chronic Pa lung infection. Inhibitors of neutrophil elastase eliminated C3bi cleavage by BAL fluid, while inhibitors of pseudomonas elastase had no effect. Blocking CR1 and CR3 on PMN with specific monoclonal antibodies reduced phagocytosis of opsonized Pa to an extent similar to that caused by elastase cleavage of CR1 on PMN and C3bi on Pa. We conclude that neutrophil elastase in the lungs of chronically infected CF patients cleaves C3bi from opsonized Pa as well as CR1 from PMN, creating an "opsonin-receptor mismatch" that severely impairs complement-mediated phagocytic host defenses against these bacteria.

Bacterial Adhesion↗
PubMed1990

[Original treatment of a supramalleolar pseudarthrosis in an impaired position].

The authors report the case of a nonunited supra-malleolar fracture with severe angulation in an elderly patient. Poor vascular condition and severe osteoporosis prevented the use of either a surgical approach or internal fixation. Gradual realignment and union were nevertheless achieved within 6 months post operatively using the "Sequoïa" external fixation system, while weight-bearing was continued throughout the course of treatment.

Aged↗
PubMed1990

[Tendency of concrete interpretation of the "Anna threefold" fantasy in "late" mothers and in the area of reproduction technology].

Leonardo da Vinci's painting "The Virgin and Child with St. Anne" ("Anna Selbdritt" = Anne Threefold) is used here to explain and illustrate early infantile female fantasies deriving from the narcissistic desire to correspond to the omnipotent mother and infantile ideas about the imaginary child. The painting is analyzed as an image of the central female fantasy in need of development. It is argued, on the basis of observation of the psychodynamic singularities found among a clinical sample of "late mothers" and their "planned" children that among women with a personal history of disturbance of the development of female identity there can be an acting out and concretization of these early fantasies during a narcissistic crisis with the fulfillment of an urgent desire for children. The central female developmental phases are, as it were, subverted. This "bypassing" of a developmentally adequate transformation of early infantile fantasies involves not only a disturbance in the relationship to the mother's own child and to her mother but also an impairment of the sense of female and maternal identity and of the ability to establish heterosexual relationships. There is also discussion of the degree to which reproductive medicine encourages and strengthens female willingness to concretize untransformed infantile fantasies and thus threatens to become a tempting instrument of power over more than just a woman's body.

Adult↗
PubMed1990

[Dosimetry with thermoluminescence during mammography].

A dosimetry study using lithium fluoride TL dosimeters was carried out during mammography in 34 patients in order to evaluate in vivo the dose of mammography rays received by these patients. The measures are made for one breast only, using two views: cranio-caudal and medio-lateral views with compression. The results show that skin entrance doses are going from 0.20 to 1.67 cGy in cranio-caudal view and from 0.15 to 1.75 cGy in medio-lateral view. The skin exit doses are from 0.001 to 0.21 cGy in cranio-caudal view and from 0.001 to 0.13 cGy in medio-lateral view. The midplane doses estimated from the skin entrance dose and the graph of the deep yield are from 0.07 to 0.48 cGy. These doses are comparable with those founded by other authors, and though maximum, they stay very low. This is important for detect the breast cancer in order to reduce radiation risks.

Adolescent↗