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Biomedical subjects

R Wolf

Publications and source records attributed to R Wolf.

At least 19 recordsLinked to original sources
PubMed1992

The case for unstable angina pectoris as a primary end point in primary prevention studies.

Coronary artery disease (CAD) primary end point definitions used in previous prevention trials are reviewed, as well as trends over time for CAD mortality, incidence and hospital discharges to see if new primary end points should be considered. CAD mortality has shown a dramatic decline in the U.S. in the last 20 years, whereas the decrease in the incidence of acute myocardial infarction (AMI) is less consistent. The decline in CAD incidence and mortality has been attributed to changes in lifestyle and increased medical/surgical intervention. Hospital discharge rates for CAD have risen during the past decade. In addition, although the rate of discharge for AMI appears to have stabilized, the rates for angina, and more dramatically for unstable angina, have increased. Unstable angina made up 4% of CAD discharges in 1980, and increased to 25% of CAD discharges in 1989. Because of these trends, future trials that rely solely on AMI as a primary end point will not reflect the actual experience with CAD presentation in the U.S. Given the greater availability of methods to diagnose unstable angina more accurately, and because of its high risk pathology, it is concluded that unstable angina should receive serious consideration as a primary end point in future primary prevention trials.

Adult↗
PubMed1992

The Munich Diagnostic Checklist for the assessment of DSM-III-R Personality Disorders for use in routine clinical care and research.

Diagnostic checklists for the assessment of DSM-III-R Axis I diagnoses have proven to be a reliable and feasible instrument in research and routine clinical care. Therefore, a checklist for the assessment of the DSM-III-R Personality Disorders (MDCL-P) has been developed. An English version of the MDCL-P is available. The MDCL-P has been tested for reliability in a test-retest design. The average duration of the interview was 36 min. Of the patients, 48% received a diagnosis of at least one personality disorder. The Kappa value concerning the distinction personality disorder as opposed to no personality disorder was 0.62. The range of Kappa values of specific personality disorders, which were diagnosed at least five times, was from 0.35 to 0.79.

Adult↗
PubMed1992

Valproate treatment of mania.

1. Acute as well as prophylactic effects of the anticonvulsant valproate are described in patients with mania and bipolar affective psychoses. 2. In a long-term evaluation of valproate prophylaxis ranging up to 14 years, an average improvement of the phase chart of 12 patients was observed by a factor of 12. 3. The mode of action of this effect appears to be related to the GABAergic properties of the compound.

Adult↗
PubMed1992

Surgical versus non-surgical treatment of fractures of the articular process of the mandible.

In a clinical, radiographic and angiographic study, we reinvestigated 34 patients with dislocated fractures of the condylar neck. 20 of them had been treated by open reduction, 14 in a conservative-functional way. The clinical results were nearly equal in both groups. The instrumental registration and the X-ray findings showed considerable deviations in the joint physiology in the conservative group. 19 of 20 patients operated on showed near-anatomical reconstruction with good functional results.

Adolescent↗
PubMed1992

Use of bromocriptine to prevent puerperal lactation during neuroleptic treatment of chronic schizophrenia.

Bromocriptine, the ergotamine alkaloid 2-bromo-alpha-ergocriptine, is known as a dopamine D-2 receptor agonist with strong prolactin-lowering actions and potential mental side-effects. The case reported here involves a female chronic schizophrenic patient in childbed who was treated both with neuroleptics and with bromocriptine; the latter was given in order to prevent inappropriate puerperal lactation. The described therapeutic regimen succeeded in preventing puerperal lactation without exacerbating schizophrenic symptoms. The simultaneous use of neuroleptics and bromocriptine was accompanied by monitoring for changes in mental status and plasma prolactin level. The high prolactin plasma levels that persisted in spite of treatment with bromocriptine would seem to be a reason to carry out further research into the mechanism of action of the drug.

Adult↗
PubMed1992

Nonbullous bullous pemphigoid.

Three patients had a rare form of bullous pemphigoid, clinically similar to the erythematous type of bullous pemphigoid without vesiculobullous lesions. All the patients displayed immunofluorescence features of bullous pemphigoid. This form of the disease presents a substantial diagnostic problem because it lacks the principal morphologic feature of bullous pemphigoid, namely the vesicles and bullae.

Aged↗
PubMed1992

Systemic ketoconazole treatment for Fusarium leg ulcers.

Fusarium oxysporum was isolated from a large foot ulcer in an otherwise healthy 69-year-old man. Although tissue invasion could not be proven histologically, systemic antifungal treatment was administered with satisfactory response. Fusarium species are common soil-inhabiting organisms and plant pathogens. In humans, Fusarium is considered an opportunistic agent in skin ulcers, interdigital spaces, and burned skin, but can also cause mycotic keratitis, onychomycosis, and rarely deep-seated or disseminated infections, especially in an immunocompromised host. The distinction between skin infection and saprophytic growth, as well as optimal treatment regimens for the two types of infection, have not been clearly defined. We describe a case of leg ulcers caused by Fusarium oxysporum in a 69-year-old man treated successfully with oral ketoconazole. "Silent" immunologic disturbances were found in this apparently healthy patient. The case illustrates a relatively benign infection caused by Fusarium that responded to systemic antifungal drug treatment.

Aged↗
PubMed1992

The effect of long-term lithium treatment on the mortality of patients with manic-depressive and schizoaffective illness.

Clinical research centers in Aarhus, Berlin, Hamilton and Vienna collected mortality data for 827 manic-depressive and schizoaffective patients given lithium treatment for more than 6 months. The average duration of the treatment was 81 months and the total time on lithium 5600 patient-years. For each patient, the mortality risk was calculated by entering the appropriate national life tables for the general population. The number of observed deaths was 44; the number of expected deaths was 49.7. The standardized mortality ratio, 0.89, did not differ significantly from 1.0. The mortality of manic-depressive patients is 2-3 times that of the general population. Our data show that the mortality of manic-depressive and schizoaffective patients given long-term lithium treatment does not differ significantly from that of the general population.

Adult↗
PubMed1992

A multicenter double-blind study of three different doses of the new cAMP-phosphodiesterase inhibitor rolipram in patients with major depressive disorder.

A multicenter randomized 4-week interindividual double-blind study was carried out in 58 hospitalized patients with major depressive disorder (DSM III 296.23, 296.22, 296.33, 296.32, 296.53 and 296.52) to test the dose-effect relationship of three different doses of the new cAMP-phosphodiesterase inhibitor rolipram: 3 x 0.25 mg, 3 x 0.50 mg and 3 x 1.00 mg rolipram/day. With respect to the desired effect, the 3 x 0.50 mg dosage stood out from the others in almost all relevant parameters. With respect to the response rate, the efficacy of the 3 x 0.25 mg dosage was about the same as that reported in the literature for placebo. The inferior performance of the 3 x 1.00 mg dosage compared to the 3 x 0.50 mg dosage might indicate a reverse U-shaped dose-effect relationship. There was good tolerance to all three dosages. There were no findings that might cast doubt on the safety of the dosages tested.

Antidepressive Agents↗
PubMed1992

Squamous cell carcinoma--70 years after irradiation.

The rare event of invasive squamous cell carcinoma 70 years after irradiation to the scalp for tinea capitis, occurred in a 75-year-old Caucasian male. The clinical, histological, roentgenologic and magnetic resonance imaging picture are described, and the literature is reviewed.

Aged↗
PubMed1992

No-bridge of Drosophila melanogaster: portrait of a structural brain mutant of the central complex.

The mutant no-bridge (nobKS49) has its name from a structural defect in the protocerebral bridge of the central complex. This rod-shaped neuropil in nobKS49 has a large gap at the sagittal midplane, with some of the missing material accumulated more laterally. Mutant nob flies have a reduced maximal and average walking speed. Leg coordination is disturbed during turning but not while walking straight. Motivation for walking is low and steps are small due to slow forward swinging of the legs. Flies spontaneously may pass into an autistic (and possibly spastic) state in which they can move their legs and even perform cleaning movements but do not walk or fly. They spontaneously recover if left undisturbed. Gynandromorph experiments place the focus of the walking defects into the head. Mutant flies have a reduced tendency to escape when mechanically stimulated. In a brightly lit arena they do not avoid a black square above the horizon and they are negatively phototactic. In tethered flight optomotor responses are normal but the amplitude of spontaneous torque modulations as well as the number of torque spikes are reduced. If a single black bar is slowly rotated around the fly, the normal response pattern is observed. It vanishes, however, at moderately fast angular velocity at which the wild type still is fully responsible. The behavioral defects support the notion that the protocerebral bridge is part of a higher center for the regulation of behavior.

Animals↗
PubMed1992

Mutations in the proximal region of the optomotor-blind locus of Drosophila melanogaster reveal a gradient of neuroanatomical and behavioral phenotypes.

Mutations in the complex optomotor-blind (omb) gene locus (4C4-6) lead to a number of different phenotypes in various tissues of the adult Drosophila melanogaster fly. At the core of the locus lies a lethal complementation group, named l(1)omb, whose mutations cause larval and pupal lethality. Some 40% of all males hemizygous for lethal omb alleles develop to the pharate adult stage. These flies can be rescued from the pupal case and show a severe disturbance in optic lobe development. The recessive viable allele In(1)ombH31 reduces the optomotor response in walking flies and during stationary flight of tethered flies. At the neuroanatomical level, these animals lack a subset of lobula plate giant neurons (LPGNs), which are thought to mediate optomotor behavior. Chromosomal aberrations deleting the proximal, non transcribed part of the locus complement the lethality, but still cause neuroanatomical and optomotor defects. Analysis of different allelic combinations of such mutations, in which increasing amounts of DNA downstream of the transcribed region are removed, reveals a step gradient of increasing severity of the neuroanatomical defects and behavioral phenotypes. On this basis the 3'-regulatory region is divided into three domains each having specific effects on optic lobe development.

Alleles↗
PubMed1992

Pityriasis alba in a psoriatic location.

Three patients with pityriasis alba whose lesions were confined to the knees only are reported. Such cases can be misdiagnosed as psoriasis. The key to the correct diagnosis lies in the physician's awareness of the existence of this variant of pityriasis alba.

Adult↗
PubMed1992

Intertriginous drug eruption.

Presented are two patients who developed an unusual, and as yet unreported eruption due to amoxycillin. They exhibited an eruption confined to the intertriginous areas, which mimicked intertrigo. Although drug eruption can mimic a variety of idiopathic skin diseases, intertrigo is easily distinguished from drug eruption and has not been mentioned in the differential diagnosis of this reaction. It is suggested that drug reactions should be considered in the differential diagnosis of intertrigo, in particular of atypical and therapy-resistant cases. Early detection of these cases has practical importance since the elimination of the causative drug is essential for therapy success. Case 2 showed a response of the toxic epidermal neurolysis (TEN) type, which could have been very severe and dangerous had the diagnosis not been made in an early stage before the development of generalized TEN.

Adult↗