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Biomedical subjects

R Ammann

Publications and source records attributed to R Ammann.

At least 19 recordsLinked to original sources
PubMed2005

Impact of etiology on the painful early stage of chronic pancreatitis: a long-term prospective study.

BACKGROUND AND AIM: This prospective study aimed to investigate the impact of etiology on the pain profile in relation to alterations of function and morphology from early to advanced chronic pancreatitis (CP). METHODS: Our mixed medico-surgical cohort comprised 265 patients with alcoholic (ACP), 21 with idiopathic "juvenile" (IJCP), 46 with idiopathic "senile" (ISCP) and 11 with hereditary CP (HPCP). The patients were followed regularly from onset of disease according to the protocol published previously. RESULTS: Males predominated in ACP, IJCP, ISCP (> 71%) but not in HP (46%). Age at onset (median) was 10, 23, 36 and 62 years in HP, IJCP, ACP and ISCP, respectively. Follow-up from disease onset ranged from 14 to 36 years. The progression to late-stage CP, documented by exocrine insufficiency (86-100%) and calcification (80-91%) lasted 2 to 5-fold longer in HP/IJCP compared to ACP. Early stage CP, characterized by recurrent pancreatitis prevailed in > or = 90% of patients, except for those with ISCP (48%), and lasted up to 5-fold longer in HP/IJCP compared to ACP. Surgery for severe pain was required for ACP/IJCP in 57% of the patients compared to < 27% in HP/ISCP. Permanent pain relief regularly occurred in late-stage CP irrespective of etiology and surgery. CONCLUSION: The clinical profile of the 4 "etiological" subgroups is predictably different in the painful early (precalcific) CP stage.

Adolescent↗
PubMed2001

A cell number-counting factor regulates group size in Dictyostelium by differentially modulating cAMP-induced cAMP and cGMP pulse sizes.

A secreted counting factor (CF), regulates the size of Dictyostelium discoideum fruiting bodies in part by regulating cell-cell adhesion. Aggregation and the expression of adhesion molecules are mediated by relayed pulses of cAMP. Cells also respond to cAMP with a short cGMP pulse. We find that CF slowly down-regulates the cAMP-induced cGMP pulse by inhibiting guanylyl cyclase activity. A 1-min exposure of cells to purified CF increases the cAMP-induced cAMP pulse. CF does not affect the cAMP receptor or its interaction with its associated G proteins or the translocation of the cytosolic regulator of adenylyl cyclase to the membrane in response to cAMP. Pulsing streaming wild-type cells with a high concentration of cAMP results in the formation of small groups, whereas reducing cAMP pulse size with exogenous cAMP phosphodiesterase during stream formation causes cells to form large groups. Altering the extracellular cAMP pulse size does not phenocopy the effects of CF on the cAMP-induced cGMP pulse size or cell-cell adhesion, indicating that CF does not regulate cGMP pulses and adhesion via CF's effects on cAMP pulses. The results suggest that regulating cell-cell adhesion, the cGMP pulse size, or the cAMP pulse size can control group size and that CF regulates all three of these independently.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMed2001

Relationship between APC genotype, polyp distribution, and oral sulindac treatment in the colon and rectum of patients with familial adenomatous polyposis.

PURPOSE: Familial adenomatous polyposis is an inherited colorectal cancer syndrome characterized by the presence of multiple adenomatous colorectal polyps. Molecular studies have revealed that germline mutations in the APC gene are the underlying cause of the disease. The nonsteroidal anti-inflammatory agent sulindac has been shown to reduce the number of colorectal adenomas. Most sulindac trials in the large bowel have focused on the distal colon and relatively little is known about its effect on the proximal colon. Moreover, it is unknown whether the site of the APC mutation affects the efficacy of sulindac. METHODS: This study investigated whether there were regional differences in the effect of sulindac on the colon and whether response to sulindac was dependent on the site of mutation in the APC gene. In an open prospective study 17 patients with familial adenomatous polyposis were treated with 300 mg oral sulindac daily for four months followed by a washout phase of six months. Ten of the patients had an intact colon and seven had rectal stumps only. The number, size, and the degree of dysplasia of the adenomas were evaluated by colonoscopy at entry, end of treatment and end of the study. RESULTS: Overall, a statistically significant decrease in the number of adenomas was observed (120 +/- 112 to 28 +/- 64, P = 0.007). After cessation of sulindac treatment the number of adenomas increased to 48 +/- 44.5, but remained significantly lower than the values observed at baseline. In the ten patients with intact colons, adenomas decreased by sevenfold in the proximal colon (103 +/- 73 to 15.1 +/- 47.4, P = 0.011) and twofold in the distal colon (80 +/- 52 to 29.6 +/- 37.2, P = 0.005). The size of adenomas and the grade of dysplasia also decreased. No correlation could be seen between the APC mutation site and the response to treatment. CONCLUSION: These data indicate that sulindac reduces the number of adenomas in the entire colon and that the effect seems to be more pronounced in the proximal colon.

Adenomatous Polyposis Coli↗
PubMed1999

5'-Cytosine DNA-methyltransferase mRNA levels in hereditary colon carcinoma.

DNA methylation plays an important part in the regulation of gene expression. Alterations in DNA methylation in tumours have been reported and have been used to generate hypotheses about mutagenesis and silencing of tumour suppressor genes. However, the underlying mechanism is still poorly understood, and conflicting data on the levels of overexpression of 5'-cytosine DNA methyltransferase in sporadic colon carcinoma have been published. We used a competitive RT-PCR assay for quantification of mRNA of 5'-cytosine DNA methyltransferase in colon biopsies obtained from patients with hereditary colon carcinoma syndromes and compared the results with those obtained in a control group. No significant difference was found between the flat mucosa of FAP patients and the mucosa of the control group. In FAP and HNPCC patients, the 5'-cytosine DNA methyltransferase mRNA levels of adenomas were significantly higher (P<0.05) than of flat mucosa in the same group, but both showed great variability from patient to patient. Our findings suggest that the mRNA levels of methyltransferase cannot be used as predictive marker for screening in families affected by hereditary colon carcinoma.

Adenomatous Polyposis Coli↗
PubMed1998

Faecal immunoreactive lipase: a simple diagnostic test for cystic fibrosis.

UNLABELLED: The study evaluates faecal immunoreactive lipase (IRL) measurement in spot stool samples as an index of exocrine pancreatic function in patients with cystic fibrosis (CF). Stool samples (211) from 183 healthy volunteers (age range: 2 days-14.2 years) showed a normal log distribution of IRL values with a median concentration of 71.4 micrograms/g (range: 0.53-4160 micrograms/g). In 156 stool samples from 58 patients with proven CF, the median IRL concentration of 0.4 microgram/g (range: 0.003-107 micrograms/g) was significantly lower (P < 0.001) than that of normal controls. In healthy controls, IRL levels were age related with significantly higher levels (P < 0.001) shortly after birth compared to older children. Stimulation of the exocrine pancreas by oral milk feeding resulted in a significant (P < 0.001) increase in a faecal IRL concentration. Faecal IRL concentrations in meconium were very low and of the same magnitude as in patients with CF. CONCLUSION: Faecal IRL determination had a high diagnostic sensitivity (87%) and excellent diagnostic specificity (97%) in patients with CF. A negative test result (PVneg. 99%) virtually excluded CF under screening conditions.

Adolescent↗
PubMed1997

Criminal behavior in males with affective disorders.

Prevalence of criminal behavior in a population of 261 male inpatients with affective disorders was studied. The patients were divided into 3 RDC subgroups and compared with the same number of matched subjects drawn from the general population. The full account of conviction records in the criminal register was used as a measure of criminal behavior. Altogether, 42% of patients and 31% of non-patients had a criminal record. A higher criminality rate was found in bipolar patients and in patients suffering from unipolar minor or intermittent depression, whereas no increased criminality rate was found in patients with unipolar major depression.

Adolescent↗
PubMed1996

[Amiodarone pigmentation].

Amiodarone can occasionally lead to a slate-coloured pigmentation in chronically UV-expose skin. A 63 year old patient presented with a pruritic bluish-purple pigmentation of the face 2 years after taking 400 mg of amiodarone daily for 2 years. During the 24 months after the dose was reduced to 200 mg daily, the pigmentation remained unchanged. Amiodarone pigmentation is caused by the UV-induced accumulation of lipofuscin in dermal macrophages, depending on both the daily dose and the duration of therapy. In the differential diagnosis, pigmentation caused by other drugs is the main consideration. Cessation of therapy eventually leads to complete normalization of skin colour.

Amiodarone↗
PubMed1996

Mental disorder and criminality: male schizophrenia.

This study investigated lifetime prevalence of criminal behavior in a population of male schizophrenia patients. A total of 282 schizophrenia patients was divided into three subgroups (representing schizophreniform disorder, acute schizophrenia, and chronic schizophrenia). The same number of control subjects was drawn from the general population and matched with the patients for sex, age, marital status, occupational level, and community size. The full account of conviction records in the criminal register was used as a measure of criminal behavior. Patients were 5 times more likely to have been convicted of violent crimes, 2 1/2 times more likely to have been convicted of crimes against property, and almost 3 times more likely to have violated drug laws. Criminality rates in schizophrenia depended, however, not only on the type of offense but also on the type or stage of the illness, which contributed to criminal behavior to some extent independently of sociodemographic factors.

Adolescent↗
PubMed1996

Mental disorder and criminality. Male alcoholism.

This study investigated the lifetime prevalence of criminal behavior in a population of 360 Research Diagnostic Criteria alcoholics. The same number of control subjects were drawn from the general population of the same catchment area and matched with the patients with regard to sex, age, marital status, occupational level, and community size. The full account of conviction records in a criminal register was used as a measure of criminal behavior. Altogether, 68% of patients vs. 37% of controls had any criminal record. Higher rates were found for alcoholics than for controls for all types of crime; differences were especially pronounced in crimes against property and in violent crimes. We conclude that alcoholism contributes to criminal behavior to a considerable degree, independently of sociodemographic factors.

Adolescent↗
PubMed1995

[Initial personal experiences with alpha-1-antitrypsin determination in feces].

Fecal alpha-1-antitrypsin is recommended as a marker of enteric protein loss and in patients with Crohn's disease as an index of intestinal inflammatory activity. We describe our experience in 88 patients with chronic diarrhea or suspicion of protein-losing enteropathy. We measured alpha-1-antitrypsin concentration in random stool samples (n = 7), quantitative alpha-1-antitrypsin excretion in a 24 h feces collection (n = 59) and fecal alpha-1-antitrypsin clearance (n = 22). 13 of 88 patients with the following diagnoses had increased values: Crohn's disease (3/9), other inflammatory diseases of the small intestine (3/3, Whipple's disease, eosinophilic gastroenteritis, celiac disease), hypertrophic gastropathy (1/4), infectious diarrhea (2/6), irritable bowel syndrome (2/29), chronic pancreatitis (2/32) and diarrhea of other reasons (0/5). In patients with Crohn's disease, alpha-1-antitrypsin excretion correlated with the clinical disease activity. All 3 patients with other inflammatory diseases of the small intestine showed increased fecal alpha-1-antitrypsin. All but 2 of the 32 patients with diarrhea due to chronic pancreatitis had normal values. Of 29 patients with idiopathic diarrhea, only 2 showed slightly increased fecal alpha-1-antitrypsin. 10 of the 11 patients with increased alpha-1-antitrypsin excretion in 24 h stool collection had normal alpha-1-antitrypsin concentration in random stool samples. Of the 5 patients with increased alpha-1-antitrypsin clearance, 4 also had increased alpha-1-antitrypsin in 24 h stool collection, but only one had increased alpha-1-antitrypsin concentration in random stool sample. Fecal alpha-1-antitrypsin measurement proved helpful in differing between inflammatory and non-inflammatory diarrhea.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute-Phase Proteins↗
PubMed1995

[Abnormal increase in pancreatic polypeptide in the secretin-provocation test: hypoglycemia-induced?].

Pancreatic polypeptide (PP) can be used as a marker for endocrine active tumors originating from the pancreas. After intravenous administration of secretin, individually divergent increases in plasma PP concentration can be observed hampering interpretation of the stimulation test. Under certain circumstances elevated basal PP concentrations can be observed. Besides age, renal insufficiency and diabetes, hypoglycemia can cause high PP levels. We therefore inquired whether in patients with atypically high increase of PP after secretin this increase could be caused by hypoglycemia during the secretin stimulation test. In order to test this hypothesis we prospectively determined the plasma glucose and insulin concentrations in addition to the routinely measured gastro-intestinal hormones in 19 patients referred for secretin provocation test. In the 16 patients in whom the increase of PP was not due to an endocrine active tumor or renal insufficiency, PP rose to 170 +/- 57 pmol/l (+/- SEM) 2 minutes after secretin administration. In parallel, plasma insulin concentration increased to 365 +/- 51 pmol/l 2 minutes after secretin. The maximal insulin concentrations correlated significantly with the PP concentrations observed at the same time (R = 0.73, p < 0.01). The mean glucose concentration, however, remained constantly between 4.8 +/- 0.3 and 5.2 +/- 0.3 mmol/l and there was no correlation between the peak plasma PP concentrations after secretin and the plasma glucose concentrations (R = 0.07). The minimal glucose concentrations observed were 3.3 mmol/l in three patients (30 minutes after secretin in 2 patients and 45 minutes after secretin in one). The mean plasma glucagon concentration rose to 22.5 +/- 4.1 pmol/l 10 minutes after secretin.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[Significance of subtype pattern of antimitochondrial antibodies in primary biliary cirrhosis for prognostic parameters and response to ursodeoxycholic acid].

Antimitochondrial antibodies are of considerable importance for the diagnosis of primary biliary cirrhosis. Several subtypes of antimitochondrial antibodies have been identified and the pattern has been associated with prognosis of the disease in the long term course. 22 patients with primary biliary cirrhosis (19 female, 3 male; age 29-66, mean 49 years) were examined for the occurrence of the subtypes of antimitochondrial antibodies anti M2, anti M4 and anti M9. Diagnosis of primary biliary cirrhosis was based on elevated cholestatic enzymes, antimitochondrial antibodies, histology and exclusion of other chronic liver disease in all patients and elevated serum IgM concentration in 18/22 patients. Most patients were included in a study protocol of the Swiss Association for the Study of the Liver and treated with 10 mg/kg/day oral ursodeoxycholic acid. According to the subtype pattern of antimitochondrial antibodies, patients were divided into 4 groups A to D (A: anti M2-, anti M4-, anti M9+; B: anti M2+, anti M4-, anti M9+; C: anti M2+, anti M4-, anti M9- and D: anti M2+, anti M4+, anti M9-). The groups were compared with respect to the prognostically relevant parameters age, bilirubin, albumin, prothrombin time and peripheral edema, as well as the occurrence of granulomas in liver biopsy, galactose elimination capacity and response to treatment with ursodeoxycholic acid during one year. Treatment response was expressed as decrease of the serum concentration of IgM, GPT, alkaline phosphatase, gamma glutamyl transpeptidase and bilirubin. No significant differences between the four groups were found with respect to the prognostically relevant parameters, histology and galactose elimination capacity at study entry.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Season of birth: comparison of patients with schizophrenia, affective disorders and alcoholism.

The distribution of patients suffering from schizophrenia, affective disorders and alcoholism by months of their birth was studied, all patients having been reliably diagnosed using Research Diagnostic Criteria. Significant differences were found between the three groups. The winter-spring birth rate excess in schizophrenia was confirmed, a spring-summer birth rate excess in alcoholics was demonstrated. Different distributions are due to different reasons: for schizophrenic patients the harmful effects hypothesis and for alcoholics the procreational hypothesis seem to be appropriate explanations.

Alcoholism↗
PubMed1995

Topical photodynamic therapy in verrucae. A pilot study.

BACKGROUND: Topical photodynamic therapy (PDT) has shown good response rates in solar keratoses and superficial skin cancers. OBJECTIVE: To investigate the efficiency and tolerance of PDT in refractory verrucae vulgares. METHOD: In an open pilot study, 6 patients were treated with 5-aminolevulinic acid-PDT and followed up for 2 months. RESULT: One patient showed a complete response, the other 5 patients were treatment failures. CONCLUSION: Topical PDT is probably not efficient in treating verrucae vulgares.

Administration, Cutaneous↗
PubMed1995

Mental disorders and criminal behaviour.

BACKGROUND: Using improved methods, findings of higher criminality in a psychiatric population were tested. METHOD: An unselected sample of 1265 Swiss in-patients and a matched control group drawn from the general population were studied. Detailed accounts of conviction records served as a measure of criminal behaviour. RESULTS: Apart from traffic law violations by men, and violent crimes and sexual offences by women, patients were more frequently registered in all crime categories. However, there were significant differences between the diagnostic groups. Alcoholics and drug users of both sexes had a significantly higher criminality rate. A higher rate was also found among female, but not male, patients suffering from schizophrenia or related disorders and other, mostly organic, disorders. CONCLUSIONS: Alcoholism and drug abuse contribute significantly to criminal behaviour, independent of sociodemographic factors; however, with a few exceptions, mental disorders such as schizophrenia and affective disorders do not contribute to criminal behaviour.

Accidents, Traffic↗