Search PubMed⌕ Search

Biomedical subjects

N Fischer

Publications and source records attributed to N Fischer.

At least 73 records · Page 4Linked to original sources
PubMed1992

The psychoanalytic experience and psychic change.

In an effort to examine psychic change and the factors promoting this therapeutic growth on the psychoanalytic situation, the analytic material from three sequential stressful periods in an analysis is compared. The patient, an 8-year-old child, was particularly vulnerable to conflicts surrounding separation and abandonment and there were three long summer vacations in the course of his treatment. Reflections of his psychic growth are first underscored and clarified, and then elements of the psycho-analytic experience that prompted this change and growth are delineated and discussed. An integration of the insight oriented aspects and the interactional components of the psycho-analytic experience is suggested.

Adaptation, Psychological↗
PubMed1990

The major histocompatibility complex and human evolution.

Many alleles at the human major histocompatibility complex (HLA) loci diverged before the divergence of humans and great apes from a common ancestor. This fact puts a lower limit on the size of the bottleneck in human evolution: the genus Homo must have been founded by no less than ten and probably by more than 10,000 individuals.

Alleles↗
PubMed1989

[Thromboxane A2 and granulocyte elastase after severe trauma--relationship to complications and survival rates].

Of 64 polytraumatized patients with a mean injury severity score of 33.1, 42 showed marked systemic release of thromboxane B2 and granulocyte elastase during the initial 18 hours after trauma, reaching peak arterial levels of greater than 1,000 pg/ml and ng/ml, respectively. If those patients ("responders": plasma TXB2 greater than 250 pg/ml) were compared with the remaining 22 ("non-responders": TXB2 less than 250 pg/ml) the following became obvious: "Late" mortality (greater than 3 d) was 31% in responders, which is significantly higher than in non-responders (9%). No correlation was observed between "early" mortality (less than 3 d) and mediator release. There was no difference in the incidence of the adult respiratory distress syndrome (ARDS) (38% versus 32%) or the late sepsis syndrome (17% versus 18%) between responders and non-responders. Morbidity, however, differed markedly in that ARDS in responders was associated with significantly higher elastase levels, a higher mortality and 10 times higher incidence of sepsis as compared to responders without ARDS. ARDS in non-responders, by contrast, did not change elastase maxima or the mortality rate as compared to non-responders without ARDS. It is concluded that TXB2 is not a predictor of posttraumatic ARDS, but is related to a complicated course, in particular to sepsis and mortality. Elastase with high probability predicts ARDS and/or the late sepsis syndrome. Simultaneous determination of TXB2 further enhances the predictive value of elastase.

Adult↗
PubMed1989

Interleukin 4 inhibits the interleukin 2-induced production of its functional antagonist, interferon gamma.

Interferon gamma (IFN gamma) inhibits many effects of interleukin (IL)-4. Its production largely parallels cell proliferation but is regulated independently. As IL-4 inhibits several IL-2-induced effects including proliferation of human peripheral blood mononuclear cells, we investigated its influence on the IL-2-induced IFN gamma production. We found that both absolute IFN gamma production and IFN gamma production per proliferation unit (1000 cpm) in response to IL-2 were inhibited by IL-4. IL-2-induced interferon production was inhibited by IL-4 in both sheep red blood cell rosetting and non-rosetting cells. In bidirectional mixed lymphocyte culture, IL-4 alone enhanced proliferation but suppressed IFN gamma production. As 48% of IFN gamma-producing cells are known to show T cell phenotype, the nearly total inhibition of IFN gamma production is evidence for suppression of T cell response to IL-2. Additionally, we found that the inhibition of IL-2-induced proliferation by IL-4 was significantly more pronounced at low cell densities. Basal proliferation was only inhibited in serum-containing media. These data stress the importance of other lymphokines or accessory cells in the regulation of early lymphocyte activation.

Cells, Cultured↗
PubMed1989

Anorexia nervosa and unresolved rapprochement conflicts. A case study.

The psychoanalysis of a 16-year-old young girl with the classical signs and symptoms of anorexia nervosa: the early phase of treatment is described. The intense, disruptive, and affect-laden transference and countertransference engagement is selectively portrayed. Utilizing the developmental perspective of the separation-individuation process as formulated by Margaret Mahler, this segment of clinical material could be best clarified and appreciated. This developmental framework enabled the analyst and patient to make sense out of a relationship which initially seemed chaotic and to be stagnating. The reconstructive, interpretive interventions based on this developmental understanding, with particular focus on the rapprochement subphase of the separation-individuation process, appeared to have major therapeutic impact and allowed for ongoing psychoanalytic work and for personality growth. After a four year analysis, a seven year follow-up is outlined. Discussion and speculation are put forth as to the nature of the therapeutic impact in this case and, more generally, in clinical situations wherein there is evidence of a 'developmental lag'.

Adolescent↗
PubMed1989

[A new concept for conventional x-ray diagnosis in intensive medicine].

A modified examination concept to improve conventional x-ray diagnostics in a intensive-care unit is presented. This planning is based on the development of new technical components in the field of mobile diagnostics and the availability of improved basic materials that can certainly promote such a project. This is presently being installed in the Clinical Centre of the University of Göttingen and will be subjected to a critical cost/efficiency analysis during a run of one year.

Academic Medical Centers↗
PubMed1988

[Anaphylactic reaction to human insulin. Successful desensitization].

A 48-year-old woman with diabetes mellitus (type IIb) had to be treated with insulin because of poor blood-sugar control. Infiltrates at the sight of injection occurred with two different porcine insulin preparations, necessitating a switch to human insulin. After the third injection of the latter an anaphylactic reaction developed within minutes. During a pregnancy in 1968 the patient had briefly received bovine insulin. Tests now revealed an immediate-type allergy against all three available species insulins, which was successfully treated by hyposensitisation.

Anaphylaxis↗
PubMed1988

Adverse reactions in long-term interferon treatment.

Adverse reactions in interferon treatment were studied in long-term treatment schedules. Thirteen patients with metastatic renal cell carcinoma treated with 10(7) units interferon-2b s.c. daily for 6 months showed serious side effects. The general condition worsened in 10 patients. The average weight loss was 7 kg per patient. The remissions achieved (1 complete, 2 partial) were seen after 2-3 months of treatment. In 11 patients treated in an adjunctive setting (10(7) units interferon-2b s.c. 3 times weekly) side effects were less severe. Generally the treatment was tolerated well. In one patient the general condition worsened, weight loss was mild and restricted to the first treatment month.

Body Weight↗
PubMed1988

Combined treatment of stone-obstructed hepatico-jejunostomy with interventional techniques and ESWL.

In a 37-year-old woman with recurrent stenosis of a biliary digestive tract anastomosis and subsequent formation of bile stones, current methods of percutaneous management were useful in dilating the stenotic areas but could not remove a single bile stone within the left hepatic duct. It was successfully treated by using extracorporeal shock wave lithotripsy (ESWL) without major side effects.

Adult↗
PubMed1988

Natural history and treatment of low and high risk superficial bladder tumors.

Since 1979 a prospective randomized trial was done to examine the efficacy of intravesical doxorubicin as prophylaxis against recurrence. After complete transurethral resection of the tumor, patients were divided into 3 groups at random: group 1-no further treatment after transurethral resection, group 2-doxorubicin twice weekly for 6 weeks and group 3-doxorubicin for 1 year. A total of 268 patients entered the study. Neither frequency of recurrences, tumor progression nor survival rate was improved significantly by the adjuvant treatment, so that only a limited number of patients will profit by instillation therapy. Analysis of previously reported data suggests that patients with superficial bladder tumors can be stratified into groups with appreciable differences in risk of progression. With regard to these results a differentiated use of a "wait and see" adjuvant intravesical therapy and more aggressive treatment after transurethral resection of superficial bladder tumors seems to be indicated rather than a general practice of chemoprophylaxis.

Administration, Intravesical↗
PubMed1987

[Diagnosis of obstruction and stone passage following ESWL therapy (extracorporeal shock-wave lithotripsy)].

78 patients with ureteral formations of stone fragments after ESWL therapy have been controlled by both ultrasound and plain abdominal films. Detection of renal stone fragments was possible similarly by sonography or radiographs. The plain films demonstrated well location and length of the "Steinstrasse", which did not necessarily cause obstruction. Combination of sonography and plain abdominal film allows an easy follow-up after ESWL therapy, so i.v. urogramm is not aquired routinely.

Adult↗