Death anxiety and the paranormal: the primacy of belief over experience.
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Adult↗
Biomedical subjects
R Lange
Publications and source records attributed to R Lange.
GB virus C infection in patients who underwent liver transplantation.
To elucidate the impact of an infection with the recently discovered GB virus C (GBV-C) on the clinical course after orthotopic liver transplantation (OLT), we studied eight patients who were GBV-C RNA positive after transplantation. Five individuals had been viraemic before transplantation, three became GBV-C RNA positive thereafter. A control group comprised eight patients without pre- or post-transplant GBV-C infection. GBV-C RNA was detected by reverse-transcription followed by nested polymerase-chain-reaction (PCR) with primers corresponding to the NS5 genome region. Nested PCR products were sequenced directly. The five patients infected with GBV-C before transplantation remained GBV-C RNA positive throughout the time of observation. Pre- and post-transplant GBV-C RNA titres were almost identical. Phylogenetic analysis revealed a very close relationship between the pre- and post-transplant viral nucleotide sequences indicating persistent GBV-C infection. No signs of hepatitis could be detected after transplantation in all GBV-C infected patients. However, four out of eight GBV-C RNA positive patients had a clinical course complicated by severe cholestasis, which was not observed in the control group. Although GBV-C infection does not lead to an increase in the rate of post-transplant hepatitis, it might be associated with severe unexplained cholestatic courses after OLT.
Adult↗
The RNA-binding protein HF-I plays a global regulatory role which is largely, but not exclusively, due to its role in expression of the sigmaS subunit of RNA polymerase in Escherichia coli.
The hfq-encoded RNA-binding protein HF-I has long been known as a host factor for phage Qbeta RNA replication and has recently been shown to be essential for translation of rpoS, which encodes the sigmaS subunit of RNA polymerase. Here we demonstrate that an hfq null mutant does not synthesize glycogen, is starvation and multiple stress sensitive, and exhibits strongly reduced expression of representative sigmaS-regulated genes. These phenotypes are consistent with strongly reduced sigmaS levels in the hfq mutant. However, the analysis of global protein synthesis patterns on two-dimensional O'Farrell gels indicates that approximately 40% of the more than 30 proteins whose syntheses are altered in the hfq null mutant are not affected by an rpoS mutation. We conclude that HF-I is a global regulator involved in the regulation of expression of sigmaS and sigmaS-independent genes.
Bacterial Proteins↗
Context-induced paranormal experiences: support for Houran and Lange's model of haunting phenomena.
Houran and Lange's psychological model of haunting phenomena predicts that contextual variables alone are sufficient to induce poltergeist-like perceptions. 22 subjects individually visited five areas of a performance theater and were asked to notice the environment. 11 subjects in an informed condition were instructed that the location was haunted, while 11 in the control condition were told that the building was simply under renovation. Subjects' perceptions in both conditions were recorded via Green, et al.'s 1992 experiential questionnaire which contains 10 subscales related to psychological and physiological perceptions. Analysis yielded significantly more intense perceptual experiences on nine of the ten subscales in the informed condition, indicating that demand characteristics alone can stimulate paranormal-type experiences.
Adult↗
Hallucinations that comfort: contextual mediation of deathbed visions.
A sample of 49 accounts of deathbed visions from Barrett's 1926 classic collection were analyzed using the classification scheme for contextual variables proposed recently by Lange, Houran, Harte, and Havens. Consistent with previous research, the contents of the contextual variables operating during these deathbed visions were consistent with the contents of the percipients' experiences. In addition, contextual variables were related to the modalities of the experience, e.g., visual, auditory, and sensed presences, as well as the number of contents, e.g., deceased relatives, angelic beings, and the perception of symbolic borders or limits including water and heavenly gates, as perceived during the dying process. These findings are consistent with the interpretation that deathbed visions are comforting hallucinations and that contextual variables serve to structure these otherwise ambiguous experiences.
Death↗
An assessment of contextual mediation in trance states of shamanic journeys.
30 experiences of shamanic journeys derived from Harner (1990) were analyzed based on a recent coding scheme for contextual variables proposed by Lange, Houran, Harte, and Havens. Consistent with previous research, the experiential content of the trances was quite consistent with the content of the available contextual variables, and embedded cues in particular (r = .68, p < .001). As predicted, trance states of shamanic journeys are sufficiently structured to suppress contextual effects on the modality of experience. The findings suggest that the contents of shamanic trance are not solely influenced by psychopathology, biochemical effects, or cultural influences.
Female↗
Evaluation of Doppler ultrasonography as a means of monitoring in vitro fertilization and embryo transfer cycles: preliminary results and findings.
In vitro fertilization imposes an emotional and financial burden on infertile couples and has a relatively low success rate, but it offers their only means of conception. As uteroovarian perfusion varies during the menstrual cycle and may be related to uterine receptivity, we sought to identify hemodynamic parameters that would be of use in monitoring stimulated cycles and in making decisions about the timing of in vitro fertilization. Uteroovarian perfusion patterns in patients undergoing ovulation induction and embryo transfer were compared with normally cycling volunteers. Significant changes in ovarian perfusion were seen with suppression and stimulation. Despite manipulation, no difference in uterine perfusion was seen between the groups in the late luteal phase, the crucial time of implantation. We conclude that Doppler ultrasonography may be useful in monitoring artificial cycles and in predicting uterine receptivity.
Adult↗
Detection of Borrelia burgdorferi DNA (B garinii or B afzelii) in morphea and lichen sclerosus et atrophicus tissues of German and Japanese but not of US patients.
OBJECTIVE: To elucidate the geographic and genospecific association of Borrelia with morphea and lichen sclerosus et atrophicus (LSA). DESIGN: The association of Borrelia burgdorferi with morphea and LSA has been reported, but is still controversial. We conducted a retrospective survey of Borrelia DNA in skin biopsy specimens. SETTINGS: The samples were collected from the outpatient clinic of university hospitals and a dermatopathology laboratory. PATIENTS: Skin biopsy specimens (19 morphea and 34 LSA) were obtained from patients in the United States, Japan, and Germany. DNA samples were subjected to amplification with polymerase chain reaction for B burgdorferi flagellin gene, and for the genotype-specific detection of B burgdorferi sensu stricto, Borrelia garinii, and Borrelia afzelii. RESULTS: Five cases of morphea and 2 cases of LSA in Germany and Japan yielded positive signals for B garinii or B afzelii, the European species. None of the American samples were positive for Borrelia polymerase chain reaction. Borrelia burgdorferi sensu stricto was not detected in any of the specimens. CONCLUSION: Morphea and LSA in Germany and Japan can be related with European genotypes of Borrelia.
Adolescent↗
Transferral of extrathoracic donor neoplasm by the cardiac allograft.
The transference of neoplasm from the donor to the recipient is a rare but recognized complication of organ transplantation. It has been reported after kidney transplantation from cadaver donors. We report a case in which an extrathoracic tumor was transmitted by the donor heart. The donor heart was harvested from a 46-year-old local donor and immediately transplanted to a 62-year-old female recipient. While implantation was performed, a hypernephroma was detected in the multiorgan donor. The ongoing heart transplantation could not be stopped. Four weeks after operation, the patient was discharged from the hospital. During the first year after transplantation, the clinical course was uneventful. One year after operation, the patient was admitted to the hospital with symptoms of weakness and fever. A right facial hemiparesis occurred, and a soft tumor was palpable subcutaneously in the right supraorbital region. Histologic examination revealed a malignant tumor with characteristics identical to the donor hypernephroma. In spite of chemotherapy and radiation therapy, dramatic tumor progression occurred with multiorgan metastases, which led to the death of the patient 2 months after admission.
Brain Neoplasms↗
[Anticoagulation of cerebral infarct].
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Anticoagulants↗
Circadian variation of skin perfusion in arterial occlusive disease.
BACKGROUND: Many physiological processes are subjected to circadian variation. We tested if circadian changes of skin perfusion can be detected by measuring laser Doppler flux (LDF) in the foot and if such variations are different in patients with peripheral arterial occlusive disease (PAOD). PATIENTS AND METHODS: LDF was recorded hourly during a 24-hour period in 10 healthy subjects and in 19 PAOD patients, 9 presenting with claudication (stage II according to Fontaine, ankle artery pressures (AP) 80 +/- 11 mmHg) and 10 with skin necrosis (stage IV, AP 42 +/- 29 mmHg). RESULTS: Circadian variability of LDF was significantly reduced in stage IV patients compared both with stage II patients and controls (p < 0.01). An increase in LDF could be observed early in the afternoon and, more pronounced, during the night, occurring to the same extent in healthy and PAOD patients in stage II (p < 0.001). In stage IV the increase in LDF was not significant and a decrease was observed in two patients. LDF and local skin temperature were correlated in controls and stage II patients (mean r = 0.69 +/- 0.12 and 0.7 +/- 0.14, respectively), but not in stage IV (mean r = 0.23 +/- 0.18). A further limitation of LDF variability and nocturnal increase was seen in the presence of diabetes. CONCLUSION: Circadian variations of skin blood flow are comparable in controls and patients with claudication but markedly reduced in patients with severe PAOD presenting with ulcers, in whom skin perfusion seems uncoupled from temperature regulation, possibly due to local factors causing continuous arteriolar vasodilation.
Aged↗
[Bile duct lesions in laparoscopic cholecystectomy--methods of reconstruction and results].
From 1/1991 to 1/1997 a total of 18 patients with major biliary lesions after laparoscopic cholecystectomy were treated. Besides 4 biliary strictures (Bismuth III, Siewert II), which were found between 20 and 180 days after laparoscopic cholecystectomy, large defects (Siewert III, IV) of the proximal parts of the hepatic duct (Bismuth III, IV) occurred in the majority of cases (n = 14). Except for 3 intraoperatively realized lesions, diagnosis was made during the first 3 weeks. Subsequent reinterventions resulted in a high morbidity rate and the need of further procedures to establish definitive biliary reconstruction. Selection criteria of the technique used for repair were the extension of the biliary lesion and the exposure of the distal stump of the common bile duct. A small defect was treated by direct suturing protected by a t-tube (n = 1). Large defects and biliary strictures were reconstructed using either a Roux-en-Y bilio-digestive anastomosis (n = 7) or jejunal interposition (n = 10). The results suggest, that early repair of biliary lesions after laparoscopic cholecystectomy should be achieved. Besides the standard procedure of bilio-digestive anastomosis, reconstruction of major biliary lesions should be performed by jejunal interposition in selected cases.
Adolescent↗
["Necessary" diagnostic procedures in traumatic aortic rupture, acute dissecting and chronic aortic aneurysms].
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Acute Disease↗
[Surgical treatment of acute endocarditis--which preoperative diagnosis does the surgeon need?].
In a group of 140 patients undergoing operation for acute infectious endocarditis in an 8-year period, the value of preoperative diagnostic procedures was analyzed in a retrospective study. Echocardiography was sufficient to establish the diagnosis in each case, angiography did not add any information about the endocarditis, but detected severe coronary heart disease in 19 patients. Abdominal sonography is mandatory to exclude intestinal foci, while CT scan of the brain only has to be performed in patients with neurologic deficits.
Acute Disease↗
Determination of hepatocellular enzymes in effluent of human liver grafts for preoperative evaluation of transplant quality.
In 50 human livers harvested for transplantation, injury was assessed by determination of liver enzymes (lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, glutamate dehydrogenase, and creatine kinase) and of thrombomodulin in the effluent perfusate after cold ischemia. The results were compared with the morphology and the clinical course after transplantation. Whereas the release of the markers of endothelial cell injury correlated neither with the history of the graft nor with the postoperative course, the release of hepatocellular enzymes into the perfusate did indicate the severity of liver injury, even when biopsy showed normal liver tissue. Seven of 12 livers with high activities of hepatocellular enzymes in the effluent (activity of more than twice the median) showed delayed onset of function or primary nonfunction. In the other 38 livers with enzyme activities below this borderline, no delayed functioning or primary nonfunction was observed. Thus, determination of liver enzyme activities in the effluent makes it possible to identify those livers in which initial nonfunction is very unlikely, a potential that is especially valuable in livers shown by anamnesis or morphology to be of borderline quality.
Biomarkers↗
Injury to hepatocytes and non-parenchymal cells during the preservation of human livers with UW or HTK solution: a determination of hepatocellular enzymes in the effluent perfusate for preoperative evaluation of the transplant quality.
In 50 livers harvested for transplantation, injury was assessed by determination of the enzymes in the effluent perfusate after cold ischemia. The results were compared to the histology and the clinical course after transplantation. Whereas the release of the markers of endothelial cell injury did neither correlate with the history of the graft nor with the postoperative course, the release of hepatocellular enzymes in the perfusate did indicate preexisting damage of the liver even when the biopsy showed normal liver tissue. Of 12 livers with high activity of hepatocellular enzymes in the effluent (activity of more than twice the median), 7 showed delayed onset of function or a primary non-function. In the other 38 livers with an enzyme activity below this borderline no delayed function or primary non-function was observed. Because of additional influences a prognosis of the function after transplantation was not possible, but the determination of the enzymes in the effluent of marginal livers probably allows the preoperative recognition of organs which will do well.
Adenosine↗
The anastomotic stoma: a useful procedure in emergency bowel surgery.
In emergency surgery of the bowel a primary anastomosis may be risky. Discontinuing colostomies have the disadvantage that a secondary laparotomy is necessary to restore continuity. If sufficient bowel loop mobilization is possible, we prefer to perform an anastomotic stoma. After resection of the diseased bowel segment, we bring the proximal and distal loop together and proceed to the anastomosis of the posterior wall. The anterior wall of the anastomosis remains open and is then fixed to the abdominal wall as a stoma. So far, we have used this method in 91 patients. In 73 cases this technique was performed during emergency operations. No patient died as a result of complications of the method: 21 patients, however, died as a consequence of their primary disease. Bowel continuity could be restored in 78 cases. The anastomotic stoma protects the posterior wall from elevated pressure and allows daily control of the anastomosis. In the case of extraperitoneal closure, a secondary laparotomy for reconstruction of the continuity is not necessary. The anastomotic stoma can be performed in most regions of the small and large bowel.
Adult↗
Pharmaceutical analysis of the oral iron chelator deferiprone (DMHP,L1).
The oral iron chelator deferiprone (1,2-dimethyl-3-hydroxy-pyrid-4-one, DMHP, LT or CP20) can be a useful drug in patients with transfusional hemosiderosis. From 1987 about 1000 patients in 16 countries have taken this drug on the base of clinical trials or compassionate use. Since this compound is only available as a raw substance, it is important to ascertain its purity before bringing the drug into a pharmaceutical formulation. Because deferiprone is administered chronically and in high doses, intake of potential toxic impurities can be substantial. In this article a proposal for the quality control of deferiprone is presented in the form of a pharmaceutical monograph. This includes the analytical methods required for identification, purity checking and assay. Furthermore the way we synthesized the drug to get hold of it in a pure form is described. This synthesis is also used in manufacturing the drug commercially. The monograph can be used as a guideline for standardization of the quality of deferiprone to be used for further study and treatment.
Administration, Oral↗