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Biomedical subjects

M Berger

Publications and source records attributed to M Berger.

At least 613 records · Page 34Linked to original sources
PubMed1988

Influence of the cholinergic agonist RS 86 on normal sleep: sex and age effects.

In 36 healthy control subjects (21 females, 15 males; age range 18-65 years; mean age 41.8 years, SD 15.6 years), a bedtime dose of 1.5 mg RS 86, an orally acting cholinergic agonist, shortened rapid eye movement (REM) latency, increased REM sleep, and decreased slow-wave sleep. Six of the subjects (greater than 40 years old) even displayed sleep-onset REM periods after the drug. Results of the present study agree well with those of studies using other cholinomimetics (i.e., physostigmine, arecholine) and confirm the importance of the cholinergic system for REM sleep regulation. Since RS 86 mimicked some of the REM sleep abnormalities specific for patients with depressive disorders, the cholinergic system may play a role in the pathogenesis and pathophysiology of depressive diseases.

Adolescent↗
PubMed1988

EEG sleep and the cholinergic REM induction test in anorexic and bulimic patients.

The electroencephalographic (EEG) sleep of 20 anorexic patients, 10 bulimic patients, and 10 age-matched healthy controls was studied. In addition, six anorexic patients and six bulimic patients had a cholinergic rapid eye movement (REM) sleep induction test (RIT) performed with the cholinergic agent RS 86. The three samples showed no major differences in sleep patterns. The same held true when attention was focused on patients who additionally met DSM-III criteria for major depression. The RIT results were similar in the patients with eating disorders and in controls, but differed from those reported in depressives. Therefore, the present study found no hints of depression-like sleep patterns in patients with eating disorders.

Adult↗
PubMed1988

Hepatic arterial infusion (HAI) chemotherapy proves to be advantageous in the treatment of experimental liver tumors.

To evaluate the best locoregional approach in the treatment of hepatic tumors we investigated four different treatment modalities. Sixty female Sprague-Dawley rats were randomized to the following treatment groups: (1) untreated control; (2) hepatic artery ligation; (3) hepatic artery ligation plus portal 5-FU chemotherapy; (4) arterial 5-FU chemotherapy; (5) portal 5-FU chemotherapy. All animals received Novikoff hepatoma cells inoculated in the median liver lobe. After tumor inoculation animals were treated according to their randomization and surgery was performed for repeated tumor size measurements. Through hepatic artery ligation, hepatic artery ligation plus portal 5-FU infusion as well as through arterial 5-FU infusion a significant tumor growth inhibition compared to the untreated control could be achieved. The portal infusion group even showed an accelerated tumor growth; however, this effect was not significant. We conclude that the intraarterial application in terms of clinical feasibility and duration of response should be the preferred approach in locoregional therapy of liver malignancies.

Animals↗
PubMed1988

Methodological aspects of hCRF-stimulated ACTH and cortisol secretion in healthy subjects.

This study, aimed at clarifying some methodological problems of the hCRF stimulation test, was performed on 12 healthy male volunteers. ACTH and cortisol increases after 30 min and their maximum increase proved to be highly reliable response parameters for the net area under the response curve of both hormones. An influence of baseline hormone values on the maximum response was apparent for cortisol but not for ACTH. Cortisol, but not ACTH, revealed a stable test-retest reliability. There were no correlations between ACTH and cortisol responses to hCRF.

Adrenocorticotropic Hormone↗
PubMed1988

Adenosine deaminase deficiency with late onset of recurrent infections: response to treatment with polyethylene glycol-modified adenosine deaminase.

We report a 5-year-old girl with adenosine deaminase (ADA) deficiency who was asymptomatic during the first years of life. At 3 years of age, she developed chronic and recurrent sinopulmonary infections, and at 4 1/2 years of age she had one major infection with Streptococcus pneumoniae (bacteremia and septic arthritis of the hip). Immunologic evaluation at 5 years of age revealed persistent lymphopenia, decreased helper-suppressor T cell ratios, and low proliferative responses to mitogens. The IgG, IgM, and IgA levels were normal; the IgG2 level was low normal or below normal. The patient had specific antibodies against toxoids and viral antigens but failed to produce antibodies against Haemophilus influenzae type b and pneumococcal polysaccharides. Although no symptoms of allergy were present, she had persistent eosinophilia and elevated IgE levels. The patient had 0.6% of normal ADA activity in erythrocytes and approximately 1% of normal ADA activity in peripheral blood mononuclear cells. Beginning at 6 years of age, she was treated with weekly injections of polyethylene glycol-modified bovine ADA. This treatment was well tolerated and effectively reversed the biochemical consequence of ADA deficiency. Concomitantly, she improved clinically and her T lymphocyte numbers and blastogenic responses to mitogens in vitro became normal. The late onset of clinical symptoms and relatively benign clinical course in this patient emphasize the need to consider ADA deficiency in a broad spectrum of immunodeficient children.

Adenosine Deaminase↗
PubMed1988

Enhanced serum levels of beta-2-microglobulin, neopterin, and interferon-gamma in patients treated with recombinant tumor necrosis factor-alpha.

The effect of different doses of recombinant human tumor necrosis factor-alpha (rTNF-alpha) on serum levels of neopterin, beta-2-microglobulin and interferon-gamma (IFN-gamma) was investigated in tumor patients. Twelve patients with advanced malignant disease were treated and received single doses of either 1, 10, or 100 micrograms/m2 rTNF-alpha on days 0 and 7. Neopterin, beta-2-microglobulin and IFN-gamma serum levels were measured from day -2 to day 12 of the study. Application of rTNF-alpha leads to a marked and dose-dependent increase of neopterin and beta-2-microglobulin levels; no rTNF-alpha-dependent changes were observed after 1 microgram/m2, and maximum increments were seen in patients receiving 100 micrograms/m2. Serum levels of both parameters peaked after 2 days and returned to baseline values within 1 week. IFN-gamma levels were also elevated after application of rTNF-alpha. We failed, however, to demonstrate a clear correlation between the serum levels of IFN-gamma, beta-2-microglobulin, and neopterin because of the wide range of pre- and posttreatment levels of IFN-gamma. We conclude that neopterin and beta-2-microglobulin represent useful markers for monitoring biological response to treatment with rTNF-alpha.

Adult↗
PubMed1988

Significance of solitary spine abnormalities on technetium-99m bone imaging.

Solitary abnormalities located within the spine from 75 bone images with Tc-99m MDP were reviewed. For the sake of convenience, patients were grouped in three classes of age: 15-50, 51-65, and 66-90 years. In 67 cases, the diagnosis was apparent from clinical studies, x-ray examinations, or biopsies. In eight cases, no diagnosis could be made. The maximum percentage of lesion sites were within the lumbar spine (45 cases). Metastatic lesions were the most common solitary abnormalities within the spine (29.3%). Osteoporosis was second (24%) with the maximum percentage in age group 66-99 years (83%) with a greater female predominance (67%).

Adult↗
PubMed1988

Transcutaneous oxygen pressure measurements in type I diabetic patients for early detection of functional diabetic microangiopathy.

Seventy-six type I diabetic patients free of peripheral artery disease and 82 age-matched healthy volunteers were studied by means of transcutaneous oxygen pressure measurements. Two transcutaneous probes were attached to the skin at the subclavian region and at the supramalleolar region. Basal transcutaneous oxygen pressure values and values during breathing of 5 and 10 1 O2 min-1, the rate of rise of oxygen pressure and the time required from the beginning of the oxygen pressure increase to the achievement of its maximum were recorded, and a regional perfusion index was calculated. Nearly all the measured transcutaneous oxygen parameters showed significant differences between diabetic and control subjects. The differences were most pronounced with the transcutaneous oxygen pressure values during oxygen breathing. Even patients with a diabetes duration of less than 1 year and free of any detectable microangiopathic complication, differed significantly from control subjects. These findings may indicate a microcirculatory disturbance in diabetic patients, which might be considered as the manifestation of a functional diabetic microangiopathy preceding any morphological alterations of the vasculature in diabetes mellitus.

Adult↗
PubMed1988

Uncontrolled hypertension in type 1 diabetes: assessment of patients' desires about treatment and improvement of blood pressure control by a structured treatment and teaching programme.

Control of arterial blood pressure at near-normal levels is of importance for the prognosis of patients with Type 1 (insulin-dependent) diabetes mellitus. In non-diabetic populations patient compliance to antihypertensive therapy is frequently poor, especially in young people. Thirty-seven consecutive eligible patients with longstanding Type 1 diabetes and persistently uncontrolled hypertension were questioned about their preferences regarding hypertension treatment. Throughout they expressed a strong desire for more information about hypertension and for active participation in monitoring of blood pressure and therapeutic decision-making. In addition, they showed considerable reluctance to accept a pharmacological intervention. Therefore, in order to improve blood pressure control, the patients participated in a structured outpatient hypertension treatment and teaching programme for groups of about 6 patients consisting of four teaching sessions at weekly intervals. The programme comprised home-monitoring of blood pressure and involvement of the patients in treatment decision-making. In 34 patients who had a complete follow-up examination after an average of 16 months, mean sitting arterial pressure had decreased from 111 to 101 mmHg (p less than 0.001) and 53% of the patients were below 140/90 mmHg. The number and dosage of prescribed antihypertensive agents remained unchanged by the intervention. Sodium intake was not reduced during the study, but pulse rate decreased significantly in patients treated with beta-adrenergic blockers and serum uric acid rose in patients on diuretic therapy, suggesting increased adherence of the patients to prescribed antihypertensive drug therapy. In 34 comparable Type 1 diabetic patients who were not subjected to a hypertension treatment and teaching programme mean arterial blood pressure remained unchanged during a 12-month period.

Adult↗
PubMed1988

Modifications and problems of behavioural inpatient management of anorexia nervosa: a "patient-suited" approach?

Several treatment modalities, especially behaviour therapy, had been successfully administered in order to normalize body weight in anorexia nervosa inpatients. However, improvement in affective, cognitive and psychosocial features and associated psychopathologic symptoms was rather poor. It is hypothesized that the limited effect of behaviour therapy may be also due to therapeutic shortcomings of the behavioural treatment programme. In the present study of 16 anorectic inpatients a behavioural treatment programme, which had been applied in a former investigation at the same unit, was modified and yielded the following results: rapid increase in weight, good improvement of anorectic and depressive symptoms and a treatment duration of less than 3 months. Although the short-term outcome of the modified treatment programme is encouraging, the therapeutic difficulties encountered in this programme deserve special attention and its long-term effects on the course and prognosis of anorexia nervosa have to be established.

Adaptation, Psychological↗
PubMed1988

Past and present strategies of research on the HPA-axis in psychiatry.

Hypercortisolism in depression has been extensively studied during the last three decades. The main hypothesis regarding origin and clinical relevance of this phenomenon, however, has changed significantly. Up to the mid-seventies hypercortisolism was conceived as consequence of stress modified by the degree of unconscious defense mechanisms in different forms of depressive or non-depressive psychiatric disorders. At the end of the seventies this point of view changed considerably. Hypercortisolism was regarded as a biological statemarker of the endogenous subtype of depression with clinical differential-diagnostic relevance. An abnormal dexamethasone suppression test (DST) was assumed to be the best indication of increased activation of the cortisol system. These conclusions turned out to be wrong. DST results are not specific for melancholia and the test seems to be of limited value for measuring the function of the HPA-axis. Intervening variables, such as weight loss, drug and alcohol withdrawal or situational stress, influence the test results significantly, independent of the nosological classification. Additionally, interindividual differences in the susceptibility of the HPA-axis may decisively influence the the activation of the HPA-axis as well in healthy subjects under stress as in psychiatric patients.

Depressive Disorder↗
PubMed1988

Abnormalities in estrogen, androgen, and insulin metabolism in idiopathic hemochromatosis.

Of 44 male patients with idiopathic hemochromatosis who were diagnosed at an early stage without morphological or biochemical evidence of liver disease, 25% suffered from impotence and 34% manifested glucose intolerance. Impotence was correlated with a 50% reduction in plasma testosterone, resulting from a 63% decrease in testosterone production. Testicular atrophy was caused by insufficient secretion of gonadotropins due to the selective accumulation of iron in gonadotropic cells of the pituitary gland. However, peripheral sexual hormone metabolism, in particular the conversion of androgens to estrogens, remained unaltered. It was therefore possible to employ substitution therapy successfully with testosterone in these men, and hyperestrogenism was not observed as a side effect. The pathogenetic factors in the development of diabetes mellitus in patients with idiopathic hemochromatosis include impaired insulin secretion caused by the selective deposition of iron in B-cells of the pancreas and insulin resistance due to iron accumulation in the liver. In particular, the insulin resistance is markedly improved after depletion of body iron stores by phlebotomy treatment, resulting in lower insulin requirements in patients with insulin-dependent diabetes as well as improvement of carbohydrate metabolisms in about half of the patients with non-insulin-dependent diabetes. We have concluded that hypogonadism and carbohydrate intolerance are caused by the specific distribution pattern of excess iron in the organism, accompanied by functional impairment of affected parenchymal cells.

Adult↗
PubMed1988

Cortisol response to various stressful situations: relationship to personality variables and coping styles.

Studies on personality traits and coping styles as determinants of interindividual differences in neuroendocrine responses to stress have not yet yielded conclusive results. In a previous investigation, strong hints to distinct interindividual differences in the susceptibility of the HPA axis of 12 male volunteers aged 27 +/- 5 years exposed to five different stress situations were found. In the present report, psychometric variables (personality traits and coping styles) assessed in the same subjects before the study were analyzed to test whether specific psychometric variables were related to the interindividual differences in the susceptibility of the HPA axis. The results revealed that interindividual differences in the frequency of cortisol responses to stress situations could not be predicted by any of the psychometric variables investigated. The question if psychological factors contribute to neuroendocrine stress response and to what degree warrants further interest. These preliminary findings suggest, however, that nonpsychological factors should be considered more seriously as determinants of interindividual differences in neuroendocrine stress responses in healthy subjects as well as in psychiatric patients.

Adaptation, Psychological↗