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Biomedical subjects

R Kellner

Publications and source records attributed to R Kellner.

At least 109 records · Page 6Linked to original sources
PubMed1989

Anxiety and depression in patients with the abdominal pelvic pain syndrome.

The authors matched gynecologic patients with the abdominal pelvic pain syndrome (N = 41) with other gynecologic patients. They administered to both groups self-rating scales of anxiety, depression, anger-hostility, and somatization of the Hopkins Symptom Checklist and of the Symptom Questionnaire, a questionnaire about disruptions in early home life, and a questionnaire of recent stressful events. Patients with pain rated themselves on the average significantly more anxious, depressed, and hostile, and had more somatic symptoms than other patients; 56% of the patients with pain rated themselves within the normal ranges on all scales. There were no significant differences between the two groups in reports of disruptions of early home life and recent losses. The findings are consistent with the view that patients with the abdominal pelvic pain syndrome are psychologically a heterogeneous group; in many patients, depression and anxiety may be consequences of persistent pain.

Abdomen↗
PubMed1989

Structural gene isolation and prepeptide sequence of gallidermin, a new lanthionine containing antibiotic.

Peptide antibiotics containing lanthionine and 3-methyllanthionine bridges, named lantibiotics are of increasing interest. A new lantibiotic, gallidermin, has been isolated from Staphyloccus gallinarum. Here we report the isolation of its structural gene which we name gdmA. In all lantibiotics so far studied genetically, three peptides can be formally distinguished: (i) the primary translation product, which we call the prepeptide; (ii) the propeptide lacking the leader sequence and (iii) the mature lantibiotic. Unlike the plasmid-coded epidermin, gdmA is located on the chromosome. The gdmA locus codes for a 52 amino acid residue prepeptide, consisting of an alpha-helical leader sequence of hydrophilic character, which is separated from the C-terminus (propeptide) by a characteristic proteolytic processing site (Pro-2 Arg-1 Ile1). Although pro-gallidermin differs from pro-epidermin (a recently isolated lantibiotic) only by a single amino acid residue exchange. Leu instead of Ile, the N-terminus of the prepeptide differs by an additional two exchanges.

Amino Acid Sequence↗
PubMed1989

Anxiety, depression, and somatization in DSM-III hypochondriasis.

To assess the severity of distress and of somatization in hypochondriasis, the authors administered several validated self-rating scales of depression, anxiety, somatic symptoms, and anger/hostility to 21 psychiatric outpatients with the DSM-III diagnosis of hypochondriasis and to matched groups of other nonpsychotic psychiatric patients, family practice patients, and employees. Anxiety and somatic symptoms were highest in hypochondriacal patients; depression and anger/hostility did not differ from those of other psychiatric patients but were higher than in the other groups. The findings do not support the theory that hypochondriasis is a defense against anxiety or that it is a masked depression or depressive equivalent. The findings are consistent with the view that the interaction of severe anxiety and severe somatic symptoms is a common feature of the psychopathology of hypochondriasis.

Adult↗
PubMed1988

Gallidermin: a new lanthionine-containing polypeptide antibiotic.

Gallidermin is a new member of the class of lanthionine-containing peptide antibiotics, which are summarized under the common name lantibiotics. The lantibiotic gallidermin is produced by Staphylococcus gallinarum (F16/P57) Tü3928, and it exhibits activities against the Propionibacteria, involved in acne disease. Gallidermin differs from the recently discovered tetracyclic 21-residue peptide antibiotic epidermin only in a Leu/Ile exchange in position 6. The isolation procedures for gallidermin included adsorption directly from the culture broth, ion-exchange chromatography of the amphiphilic and basic polypeptide followed by desalting, and final purification by reversed-phase HPLC. The structural elucidation of the polypeptide containing four thioether bridges involved mainly a combination of automated gas-phase sequencing, thermospray liquid chromatography/mass spectrometry and fast-atom-bombardment mass spectrometry.

Alanine↗
PubMed1988

Prepeptide sequence of epidermin, a ribosomally synthesized antibiotic with four sulphide-rings.

The genetic basis for the biosynthesis of large polypeptide antibiotics such as nisin has not been explained so far. We show here that the structural gene epiA encoding the antibiotic epidermin from Staphylococcus epidermidis is located on a 54-kilobase plasmid and codes for a 52-amino-acid prepeptide, which is processed to the tetracyclic 21-peptide amide antibiotic. The mature sequence of epidermin corresponds to the C-terminal 22-peptide segment of pre-epidermin and contains the precursor amino acids Ser, Thr and Cys, from which the unusual amino-acid constituents are derived. The more lipophilic epidermin is cleaved at a hydrophilic turn between Arg-1 and Ile+1 from the N-terminal segment-30 to -1, which probably assumes a partially amphiphilic alpha-helix conformation. We propose that the N-terminus (-30 to -1) plays a cooperative role during modification reactions and prevents toxicity of the mature epidermin to the producing strain before the antibiotic is cleaved off and secreted.

Amino Acid Sequence↗
PubMed1988

Fears and beliefs in patients with the pelvic pain syndrome.

In order to explore attitudes and beliefs in patients with the pelvic pain syndrome, the authors matched gynaecological patients with this syndrome (N = 41) with other gynaecological patients. They administered the Illness Behavior Questionnaire and Illness Attitude Scales (that measure attitudes, fears and beliefs about illness) to both groups. In spite of thorough investigations, 18 patients (44%) with the pelvic pain syndrome believed that their physician had not diagnosed their illness correctly and feared that they had a serious disease. The findings appear to have implications for treatment.

Adolescent↗
PubMed1988

Distress and attitudes in patients perceived as hypochondriacal by medical staff.

The aim of this study was to examine the characteristics of patients perceived by general physicians as hypochondriacal. The authors requested physicians at a general hospital to refer patients for a study of hypochondriasis. In order to measure depression, anxiety, and somatic symptoms, the authors administered several rating and self-rating scales, and to measure hypochondriacal attitudes they administered the Illness Attitude Scales (IAS) and the Illness Behavior Questionnaire (IBQ). The referred patients (N = 29) had more psychiatric disorders, were more depressed and more anxious, and had more severe somatic symptoms than matched medical patients who had not been referred. Self-rated hypochondriacal fears and beliefs did not differ significantly between the groups. Five of the referred patients (17%) whose initial diagnosis was hypochondriasis were subsequently found to have physical diseases that accounted for their symptoms. The implications of these findings for treatment are discussed.

Adult↗
PubMed1988

Prolactin, cortisol, and antidepressant treatment.

In four depressed patients with abnormal dexamethasone suppression test results before treatment, plasma prolactin levels significantly increased after successful amitriptyline therapy. Such an increase did not take place in five depressed patients with normal dexamethasone suppression test findings.

Adult↗
PubMed1988

A rating scale of somatic symptoms.

The Rating Scale of Somatic Symptoms is an observer rating scale designed to measure the severity of somatic distress and to measure changes in research in therapeutics, such as in drug trials. The cues for rating are clearly defined, the scale is valid and reliable, and the ratings change sensitively with treatment.

Adult↗
PubMed1987

Hypochondriasis and somatization.

Between 60% and 80% of healthy individuals experience somatic symptoms in any one week. About 10% to 20% of a random sample of people worry intermittently about illness. A substantial proportion of patients present physicians with somatic complaints for which no organic cause can be found. Patients who are hypochondriacal do not understand the benign nature of functional somatic symptoms and interpret these as evidence of disease. Hypochondriacal concerns range from common short-lived worries to persistent and distressing fears or convictions of having a disease. Hypochondriasis can be secondary to other psychiatric disorders (eg, melancholia or panic disorder), and hypochondriacal attitudes remit when the primary disorder is successfully treated. Patients with primary hypochondriasis are also anxious or depressed, but the fear of disease, or the false belief of having a disease, persists and is the most important feature of their psychopathology. There are substantial differences among hypochondriacal patients in their personalities and psychopathologies. Psychotherapy as well as psychotropic drugs are effective in the treatment of functional somatic symptoms. There are no adequate controlled studies on the value of psychotherapy in hypochondriasis; the recommended guidelines are based on uncontrolled studies of hypochondriasis and on controlled studies of the psychotherapy in similar disorders. The prognosis of functional somatic symptoms as well as that of hypochondriasis is good in a substantial proportion of patients.

Diagnosis, Differential↗
PubMed1987

Hypochondriacal concerns and somatic symptoms in patients with chronic airflow obstruction.

In order to explore hypochondriacal concerns in patients with Chronic Airflow Obstruction (CAO) the authors administered the Illness Attitude Scales and the somatization, anxiety, depression and anger-hostility scales of the Hopkins Symptom Checklist to 50 patients with CAO and to matched family practice patients. Somatic symptoms were significantly correlated with fears of disease and hypochondriacal concerns in family practice patients, but were unrelated in CAO. Patients with CAO, although more anxious, depressed and with more severe somatic symptoms than family practice patients, had fewer hypochondriacal concerns. In this respect patients with CAO were unlike any other group previously studied.

Adaptation, Psychological↗
PubMed1987

Nocturnal prolactin and cortisol secretion and recovery from melancholia.

Spontaneous prolactin and cortisol patterns were determined at 20 min intervals over 3 hr during the night in eight patients with melancholia, both during illness and after treatment with amitriptyline. Mean plasma prolactin levels were greater after recovery in the seven patients who responded to treatment. Mean cortisol secretion decreased upon recovery from melancholia, and such changes in two patients paralleled normalization of dexamethasone suppression test responses. The influence of assumptions of lack of interaction on the statistical significance of the analysis of variance with repeated measures for prolactin and cortisol values was evaluated.

Adult↗
PubMed1987

Fears, beliefs, and attitudes in DSM-III hypochondriasis.

In order to explore fears, beliefs, and attitudes of patients with DSM-III hypochondriasis, the authors administered the self-rated Illness Attitude Scales to 21 patients with hypochondriasis, matched family practice patients, nonpatient employees, and nonhypochondriacal psychiatric patients. Hypochondriacal patients reported more fears of and false beliefs about disease; they attended more to bodily sensations, had more fears about death, and distrusted physicians' judgments more, yet sought more medical care than other subjects. They did not take better precautions about their health. The self-report of overt attitudes suggests a characteristic syndrome, consistent with the DSM-III description of hypochondriasis. Two of the subscales of the Illness Attitude Scales yielded characteristic responses in hypochondriasis.

Adult↗