Biomedical subjects
Publications and source records attributed to S Kasper.
The authors compared platelet monoamine oxidase activity in schizophrenic patients and normal controls. A significant reduction in the enzyme activity was found in the male schizophrenic patients but not in the females. No differences were detected among the subgroups of schizophrenia. Sources of bias and the possible mechanism for the findings are discussed.
Significantly more individuals with human leucocyte antigens (HLA) A9 and B27 have been identified in the group of chronic paranoid schizophrenics with early onset of the disease. It is known that individuals with HLA B27 have a markedly increased risk to fall ill from arthropathies (i.e. Bechterew's disease). Generally, it seems extremely rare that arthropathies and schizophrenia occur together in the same person. In 16 chronic paranoid schizophrenics with HLA B27 no form of arthropathy and in 288 arthropathic patients no case of schizophrenia could be detected (evidenced in a psychiatric case register). Furthermore in 131 arthropathic patients with HLA B27 no psychiatric disease (except one feeble-minded and one with alcohol problems) could be identified. On the other hand, in the group of arthropathic patients without HLA B27 the incidence of psychiatric diseases was 5 times higher than in the group with HLA B27 and so comparable to the morbidity of the normal population. It is conceivable that HLA B27 is a 'genetic marker' for arthropathy as well as for a defined subgroup of schizophrenia. These data agree with the hypothesis that schizophrenia and arthropathies are mutually exclusive in one individual.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Myo-inositol (mI) as a precursor in the phosphatidylinositol second messenger system has been reported to be reduced in depression. By means of proton-magnetic resonance spectroscopy (1H-MRS) the mI levels in the frontal brain were investigated in vivo in the present study. Twenty-two patients (mean age: 42.8 +/- 10.7 years) with depressive episodes according to ICD 10 (HAMD score > 17) were compared to 22 healthy subjects (28.0 +/- 5.3 years). Two voxels (30 x 20 x 20 mm3) in the frontal lobes were examined in a Siemens Magnetom SP 4000 at 1.5 T (STEAM sequence: TR = 3500 ms, TE = 55 ms). With the total creatine (Cr) as an internal standard, mI/Cr ratios were calculated to follow the mI levels. In the left frontal lobe, mI/Cr was 0.43 +/- 0.06 in depressive patients and 0.46 +/- 0.07 in healthy subjects; concerning the right frontal lobe, mI/Cr was 0.46 +/- 0.08 and 0.48 +/- 0.06, respectively. There were neither significant differences between the two groups nor between the hemispheres. Since there was a significant positive correlation (R = 0.6) between the age and the mI/Cr in the right frontal lobe of depressed patients, age matched pairs analysis was performed (n = 2 x 10, in each group: nine females, one male, < 40 years). In the right frontal lobe, the patients' mI/Cr of 0.40 +/- 0.05 was now significantly lower than the controls' mI/Cr of 0.45 +/- 0.06. However, most of the patients were on antidepressive medication. Interestingly, it was exactly this group of patients which showed significantly lower mI levels. We regard our investigation as a pilot study which suggests an influence of age and antidepressants on mI levels and should be taken into consideration in further investigations in depressive patients.
Osteopenia is a well recognized medical complication of anorexia nervosa (AN). The mechanism of bone loss is not fully understood and there is uncertainty about its management. New markers of bone turnover have been developed. C-terminal type 1 propeptide (PICP) is a measure of bone formation and urinary pyridinolines such as deoxypyridinoline (DPYRX) and serum carboxyterminal crosslinked telopeptide (ICTP) are markers of bone resorption. The aim of this study was to examine these bone markers in patients with AN. Twenty female patients with AN and 12 healthy controls were included in the study. Bone mineral density (BMD) of AN patients was measured by dual energy X-ray absorptiometry (DEXA). Lumbar bone density was significantly reduced in the AN group compared to standardised values of thirty year old adults (t-score 83.2%, S.D. 12.1). Femoral neck bone density showed an even greater reduction (t-score 79.4%, S.D. 13.5). We found a significant negative correlation between femoral BMD and the duration of the illness. Femoral BMD correlated significantly with minimal body weight (r(16) = 0.504, p = 0.033). The markers of bone resorption were significantly higher in the patients with AN compared to the values of the control group (ICTP t(30) = -2.15, p = 0.04, DPYRX t(25) = -2.26, p = 0.033), whereas the markers of bone formation did not differ significantly between the groups. AN appears to be a low turn over state associated with increased bone resorption without concomitant bone formation. This pattern differs from osteopenia in menopausal women and should, therefore, lead to the development of specific therapeutic strategies in AN associated osteopenia. Hormone replacement therapy as well as calcium and vitamine D-supplementation are so far discussed controversially. Long-term treatment studies are warranted.
We compared the subtype diagnoses of schizophrenia (ICD-10) of 58 Japanese and 61 European psychiatrists matched for clinical experience using 10 case summaries. As a result, there are marked differences between Japanese and European psychiatrists in the mode of subtype diagnoses of schizophrenia rather than in the clinical pictures of the patients themselves; the hebephrenic type (F20.1) was more likely to be diagnosed by Japanese psychiatrists, while the paranoid type (F20.0) was more frequently diagnosed by European psychiatrists. Japanese psychiatrists take into account the patient's age at onset and the clinical course of the disease in identifying the subtype, while European psychiatrists tend to focus on the presenting symptoms, particularly paranoid symptoms.
A meta-analysis was performed to compare the efficacy of tianeptine and selective serotonin reuptake inhi-bitors (SSRI) in the short-term treatment of depression. Consecutive selection and inclusion processes allowed five stu-dies to be selected: two studies on tianeptine versus fluoxetine, two studies on tianeptine versus paroxetine, and one study on tianeptine versus sertraline. A total of 1 348 patients were included in the five studies; 681 subjects received an SSRI and 667 tianeptine. A strict step-by-step methodology was applied in order to legitimize this meta-analysis and to interpret the results. Considering all the patients or those with a Montgomery-Asberg Depression Rating Scale (MADRS) inclusion score greater or equal than 28, none of the assessed parameters (MADRS total score and responder rate) revealed any significant difference between the two treatment groups. Further analysis based on clinical global impression (CGI) items found no significant difference, except for CGI item 3 (therapeutic index), where a tendency (p=0.06 or 0.07 depending on the methodology) was found in favor of tianeptine. All in all, this study confirmed that tianeptine is at least as effective as SSRI, with a trend for a better acceptability profile in the treatment of depressed patients.
We studied the response of the human ornithine decarboxylase (ODC) promoter to androgen in human prostate cancer cell lines. In the well-differentiated, androgen-sensitive human prostate cancer line LNCaP, a genomic ODC promoter fragment that includes putative androgen response elements was suppressed by androgen. In contrast, the androgen-regulated probasin promoter was induced by androgens. The ODC promoter was also induced by cotransfected androgen receptor in the poorly differentiated, androgen-insensitive human prostate cancer cell line PPC-1. We examined the effects of cotransfected mutant androgen receptors containing the LNCaP mutation or DNA-binding mutations. All cotransfected androgen receptors switched the ODC androgen response from suppression to induction in LNCaP cells. Gel-shift and DNA footprint assays demonstrated androgen receptor binding to an ODC sequence that does not contain a consensus androgen response element. Deletion of the sequence abolished androgen suppression of the ODC promoter. We propose a model of pleiotropic gene regulation by androgen that requires a regulatory balance between androgen receptor and a transcription factor binding to the nonconsensus androgen response element.