Lewy body disease in a patient with REM sleep disorder.
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Aged↗
Biomedical subjects
R Faber
Publications and source records attributed to R Faber.
[Predictive value of Doppler ultrasound findings in twin pregnancies].
In a prospective study we investigated 100 twin pregnancies in order to assess the predictive value of doppler-sonographic measurements regarding the pregnancy outcome. We used the pulsatility index of the uterine arteries, the umbilical artery, the fetal aorta thoracica and the fetal middle cerebral artery. The measurements were obtained at various gestational ages between 24 and 32 weeks. Significant differences between unselected twin pregnancies and normal single pregnancies were not found. Moreover, there is no relation between the severity of an impaired perfusion and an adverse outcome of the pregnancy. The prediction of fetal distress (hypoxia, preterm birth, poor fetal growth, acidosis, and disturbed neonatal adaption) with doppler-score has a sensitivity of 25% and a positive predictive value of 63%. From this rather insufficient result we conclude that doppler screening in unselected twin pregnancies hardly proves to be useful.
Birth Weight↗
Escherichia coli glycerol kinase: role of a tetramer interface in regulation by fructose 1,6-bisphosphate and phosphotransferase system regulatory protein IIIglc.
Escherichia coli glycerol kinase (EC 2.7.1.30; ATP:glycerol 3-phosphotransferase) is a key element in a signal transduction pathway that couples expression of genes required for glycerol metabolism to the relative availability of glycerol and glucose. Its catalytic activity is inhibited by protein-protein interactions with IIIglc, a phosphotransferase system protein, and by fructose 1,6-bisphosphate (FBP); each of these allosteric effectors constitutes a positive signal that glucose is available. Loss of glucose inhibition of glycerol metabolism was used to screen for regulatory mutants of glycerol kinase after hydroxylamine mutagenesis of the cloned glpK gene. Two mutant enzymes were identified and shown by DNA sequencing to contain the mutations alanine 65 to threonine (A65T) and aspartate 72 to asparagine (D72N). Initial velocity studies show the mutations do not significantly affect the catalytic properties, hence active-site structures, of the enzymes. Both mutations decrease inhibition by FBP; A65T eliminates the inhibition while D72N appears to decrease the affinity for FBP and the extent of the inhibition. However, neither mutation significantly affects inhibition by IIIglc. Gel-permeation chromatography studies show that both of the mutations alter the dimer-tetramer assembly reaction of the enzyme and the effect of FBP in increasing the molecular weight. The effects of the mutations on the assembly reaction are consistent with the locations of these two amino acid residues in the X-ray structure, which shows them to be associated with an alpha-helix that constitutes one of the two subunit-subunit interfaces within the tetramer.(ABSTRACT TRUNCATED AT 250 WORDS)
Adenosine Triphosphate↗
[Hydatidiform mole of the placenta and coexisting, living premature infant].
A pregnancy with a partial or complete hydatidiform mole and a coexistent living fetus is a rare condition. Most cases are consistent with a twin pregnancy, with distinct borders between placenta and mole on sonography. We report a case with a single placenta with cystic structures resembling histologically a complete hydatidiform mole. The pregnancy resulted in a diploid female fetus in the 34th week of gestation with marked hypotrophy. The non-molar part of the placenta showed a complex alteration of villous maturity resulting in intrauterine growth retardation but a living fetus. No malignancy occurred post partum. The clinical and pathogenetic aspects of this rare entity are discussed.
Adult↗
[Simultaneous coexistence of a hydatidiform mole and a live premature infant].
Moles and coexisting living fetus are rare. Most cases are twin gestations. We report a case of a single placenta with focal hydatidiform mole of the placenta and a coexisting living fetus. The fetus with hypotrophy was born in the 34th weeks of gestation with a normal diploid female karyotype. The placenta showed a complex alteration of the non molar part with consecutive vascular hyperplasia. The differential diagnosis of molar pregnancies and coexistent living fetuses are discussed. Postpartal are cytogenetic examination of fetal tissue (skin biopsy) and both parts of the placenta, the molar and non molar, necessary. In each case should be a postpartal measurement of beta-HCG in serum of the mother to rule out a gestational trophoblastic disease.
Adult↗
[Doppler ultrasound perfusion measurements of uterine, fetal and fetoplacental vessels in pregnancies with ultrasonically suspected fetal growth retardation].
The aim of the present study was determination of the complex character of hemodynamic disturbances in uteroplacental, fetoplacental and fetal vessels as well as their influence on the outcome of pregnancies suspected to have IUGR on ultrasound examination. A special form of Doppler scoring was implemented for documentation of the hemodynamic disturbances. Of 82 single pregnancies with sonographically suspected IUGR, 30 women gave birth to eutrophic babies whereas 52 mothers delivered hypotrophic newborns. However, 43 cases of the hypotrophic babies had birth weight below the 5th percentile. The median values of Doppler indices for those with eutrophic babies revealed no significant differences compared to normal collective. However, significantly elevated RI and PI values in both uterine arteries, the umbilical artery and fetal descending aorta of pregnancies which resulted in hypotrophic babies indicated hemodynamic disturbance. The umbilicoplacental and uteroplacental vasculature compartments were almost equal involved with a proportion of 39% or 30% respectively. Birth weight < or = 5th percentile was associated with a further increase of pathological values in this both vascular areas. Significant rang correlations between values of Doppler indices and clinical parameters indicated a direct association between perfusion disturbances and fetal outcome of the pregnancies studied. The present Doppler score, which is a summary of all separately evaluated examined blood vessels, is suitable for clinical implementation and showed a good correlation to the clinical parameters in our study. Therefore Doppler perfusion measurements should play an important role in the clarification of suspected fetal growth retardation.
Birth Weight↗
[Comparison of Doppler ultrasound assessment of utero-placento-fetal perfusion in normal pregnancies and in those with threatened premature labor].
The aim this study to compare perfusion parameters, measured by Doppler sonography, between normal pregnancies and pregnancies with symptoms of preterm labor. The patient collective comprised of 3 groups: 62 normal pregnancies (group 1), 23 preterm labor before tocolysis (group 2) and 114 preterm labor up to 48 hours under tocolysis (group 3). In each case pulsatility index was measured in the uterine artery on the placental side and non-placental side, umbilical artery, fetal descending aorta and middle cerebral artery. In the contrary to patients in group 1, patients in group 2 and 3 showed significantly elevated PI values in uterine artery placental side and non-placental side, respectively. The median of PI for both uterine arteries in both groups was significantly higher compared to that of group 1. However, 1/3 of patients with preterm labor showed pathologic uterine perfusion before or during tocolysis. The values of PI in umbilical artery, fetal descending aorta and middle cerebral artery did not reveal significant difference in all group. Nevertheless, 30% of pregnancies with preterm labor have pathological perfusion in the fetal descending aorta. We conclude that some patients with symptoms of preterm labor have pathological perfusion in uterine arteries and fetal descending aorta not induced by uterine contractions. We believe that the complex assessment of uterine perfusion should include the median PI value of both uterine arteries in order to have a reliable information. A short-term intravenous tocolysis with betamimetics does not seem to have a positive influence on the hemodynamic insufficiency.
Adult↗
More on ECT and delirium in Parkinson's disease.
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Caudate Nucleus↗
Electroconvulsive therapy in Parkinson's disease and other movement disorders.
Early case reports note marked improvements in the signs of Parkinson's disease (PD) in several patients with coexisting psychiatric disorders after treatment with electroconvulsive therapy (ECT). Studies since 1959 reveal improvement of parkinsonism in over half of PD patients receiving ECT, regardless of the presence or absence of psychiatric comorbidity. Drug-induced parkinsonism, tardive dystonia, and tardive dyskinesia have also been shown to improve with ECT administration; tic syndromes have achieved mixed results. In animals, ECT enhances dopamine-mediated effects and increases GABA concentrations in the CNS. Optimal parameters relevant to the antiparkinsonism effects of ECT require further study.
Depressive Disorder↗
[Effect of pregnancy and perinatal parameters--including mode of delivery--on survival rate of "low birth weight premature infants" (less than 1,500 g)].
A retrospective analysis of 225 very low birth weight infants (less than 1500 g) was made, to assess the influence of the mode of delivery on the survival rate. In 186 preterm deliveries which could not be prevented by therapeutic measures, we included additionally certain gestational and perinatological parameters. Generally, an average survival rate of 72% was found in this study. In addition to the well-known negative influence of birth weight less than 1000 g and gestational age of less than 28 weeks, such parameters as antenatal pre-pathological CTG findings, haemorrhages at the time of hospitalisation, and ineffectuousness of tocolytic drugs, were associated with a reduced survival rate. In contrast, the presence of anamnestic risk factors of preterm delivery and prolongation of gestation by one day and more improved the survival rate. Additional consideration of foetal presentation showed, that abdominal delivery was fundamentally safer in cases with breech and transverse presentation. Whether a higher survival rate can be achieved by vaginal delivery in cases of breech presentation with premature rupture of membranes or a gestational age greater or equal to 28 weeks, remains to be proved. A gestational age of less than 28 weeks or antenatal prepathological cardiotocographic findings will facilitate in future the decision to perform Cesarean section in cases of inevitable premature deliveries with cephalic presentation.
Cesarean Section↗
Doppler sonographic examinations of uteroplacental, fetoplacental, and fetal hemodynamics and their prognostic value in preterm labor.
Doppler examinations of different uteroplacental vessels (uterine arteries, arcuate arteries), umbilical artery, fetal thoracic aorta, and median cerebral artery were performed on 55 patients with idiopathic preterm labor (24.5 to 32.5 weeks). Thirty normal pregnancies of corresponding gestational age served as a control group. Significant differences of median values between the preterm labor and control group were found only for the resistance index (RI) in the central arcuate artery and for the pulsatility index (PI) in the fetal thoracic aorta. In about twenty percent of pregnancies in preterm labor, pathological values of RI and PI in uteroplacental and fetal vessels account for the presence of an impaired perfusion. Elevated PI in the uterine artery placental site and normal RI in the fetal thoracic aorta, correlate significantly to a shorter prolongation of pregnancy, lower gestational age on birth, and lower birth weight. The combination of these two blood flow indices (maternal PI greater than 0.90 and fetal RI less than 0.90) allow us to predict a preterm birth in a high percentage of cases (sensitivity 87.5%, specificity 100%, positive predictive value 100%, negative predictive value 93%).
Aorta, Thoracic↗
[Predictive value of selected examination parameters in anamnestic risk for premature labor].
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Female↗
[Reproducibility of the Doppler ultrasound blood flow profile of the umbilical artery with special reference to threatened premature labor].
The reproducibility of Doppler blood velocity profiles of the umbilical arteries within the umbilical cord is a special problem because of the difficult separation and extreme torsion of both vessels. Resistance-(RI) and pulsatility index (PI) have been assessed on two different locations immediately one after the other in 90 pregnancies with signs for premature labor, including 16 cases with premature rupture of membrane. For comparison the same measurements have been performed in 33 normal pregnancies. There was a significant correlation between the first and second assessment. However, the correlation coefficients of cases with premature labor are lower than in normal pregnancy. This underlines the necessity of at least two repeated measurements for these patients with signs of premature labor.
Blood Flow Velocity↗
Subjective utility ratings of neuroleptics in treating schizophrenia.
This study developed a method for measuring subjective costs and benefits of psychiatric treatments. Forty-one patients rates the relative bothersomeness of symptoms of schizophrenia and side effects of neuroleptics. Thirty-four psychiatrists made parallel ratings from the perspective of the average patient (individual utility) and of the patient's family and society (institutional utility). Psychiatrists predicted patients' ratings moderately well, but misjudged the bothersomeness to patients of 24% of side effects and 20% of symptoms. When considering the patient's perspective, both schizophrenic patients and psychiatrists rated symptoms as no more bothersome than side effects. However, psychiatrists saw side effects as significantly less bothersome than symptoms when considering costs to society. The subjective utility of neuroleptic medications for schizophrenia is most justifiable from an institutional perspective.
Antipsychotic Agents↗
Dextroamphetamine and dexamethasone suppression test prediction of desipramine response.
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Adult↗
[Relation of uteroplacental hemodynamics and fetal respiratory behavior in pregnancy with threatened premature labor or intrauterine retardation].
The results of uteroplacental hemodynamics obtained by nuclear medicine were correlated with the corresponding antepartal and intrapartal cardiotocographic findings in 52 patients with preterm labor and in 53 patients with intrauterine-growth-retarded fetuses. With the existence of continued disturbance in pregnancy the relationship between primary maternal hemodynamic disorders and decreased fetal respiratory performance is already evident antepartum and unambiguously intrapartum. The dependence of the antepartal cardiotocographic findings on therapeutical improvements in perfusion is of clinical relevance.
Cardiotocography↗
Neuroleptic radioreceptor activity and clinical outcome in schizophrenia.
The relationship between serum haloperidol concentration and clinical response was examined in 27 schizophrenic inpatients between the ages of 18 and 56 years. All patients were treated with haloperidol, 20 mg/day for the first 2 weeks. Dosage adjustment after 2 weeks of treatment was made in seven subjects based on poor clinical response or side effects. Haloperidol activity was determined by the radioreceptor assay for neuroleptics on weeks 2 and 4 serum samples. The results indicated that higher radioreceptor activity levels, particularly above 22 ng/ml, were associated with poorer clinical response. The data suggest that radioreceptor activity levels are not at a steady state after 2 weeks drug treatment. Additionally, problems secondary to low sensitivity of the radioreceptor assay may limit its utility at low serum concentrations.
Adolescent↗
[Hemodynamic placental insufficiency and its therapeutic modification in threatened premature labor].
The authors are involved in a study in the field of nuclear medicine aimed at further clarifying the connection between premature delivery and placental insufficiency. They are particularly concerned with uteroplacental perfusion at the time when a trend is emerging toward premature birth, and with ways of treating this by exclusive therapy using betamimetics and/or additional maternal oxygen inhalation/additional maternal transcutaneous dorsal nerve stimulation (TNS). The significantly longer half-life periods of activity increase found at the time of hospitalization similar to pregnancies with intra-uterine fetal retardation, as compared with a normal control group, are interpreted as expressing a hemodynamic placental insufficiency and a risk of premature delivery. In contrast to exclusive betamimetic therapy, additional O2 inhalation/additional TNS significantly shorten the half-life period both in short-time and long-time tests. The better therapeutic effect on uteroplacental perfusion in cases of imminent premature delivery which is thus demonstrated can be seen also in an improved respiratory condition of the fetus as shown in a cardiotocogram. From a clinical point of view, the authors call attention to the clearly prolonged pregnancy periods regardless of the duration of gestation, at the time when a trend is emerging toward premature birth, as compared with exclusive betamimetic therapy, the duration of tocolysis/amount of betamimetic applied being the same.
Combined Modality Therapy↗