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Thomas Becker

Publications and source records attributed to Thomas Becker.

90 records · Page 5Linked to original sources
PubMed2003

[Life threatening neuroleptic malignant syndrome due to olanzapine].

The frequency of neuroleptic malignant syndrome (NMS) after clozapine or olanzapine is low and often of non-serious nature. A 49 year-old female patient developed NMS 12 days after olanzapine re-exposure. Olanzapine was stopped, the patient was transferred to an ICU and received a course of nine uni- and bilateral ECT treatments. This led to remission. 14 months earlier the patient had presented with a first severe NMS episode after haloperidol depot injection and 4 days after starting oral clozapine. Following the first NMS episode olanzapine (20 mg per day) was administered for 11 months without adverse effects.

Antipsychotic Agents↗
PubMed2003

Satisfaction with mental health services among people with schizophrenia in five European sites: results from the EPSILON Study.

Patient satisfaction with services is an important outcome variable that is increasingly used in mental health service evaluation. This study includes 404 people with schizophrenia in five European sites and addresses five questions focused on site, service, and patient characteristics as variables that might explain service satisfaction, using the Verona Service Satisfaction Scale. Patient satisfaction differed significantly across sites (highest in Copenhagen, lowest in London). In all sites, patients were least satisfied with involvement of relatives in care and information about illness. A multiple regression model showed that lower levels of total service satisfaction were associated with living in London or Santander, being retired/unemployed, having more hospital admissions, having more severe psychopathology, having more unmet needs, or having lower satisfaction with life. This model explained 31 percent of variance in service satisfaction. Our data show that service satisfaction can be seen as a result of (1) the ability of the service to provide a standard of care above a certain quality threshold, and (2) the perception of each patient that the care received has been tailored to the patient's own problems.

Adult↗
PubMed2003

People with schizophrenia in five countries: conceptual similarities and intercultural differences in family caregiving.

The European Psychiatric Services: Inputs Linked to Outcomes and Needs (EPSILON) study was a EU BIOMED-2-funded comparative, cross-national, cross-sectional study aimed (1) to produce standardized versions of five key research instruments in five languages, and (2) to compare the characteristics, needs, and life qualities of people with schizophrenia and their caregivers in these five countries. One of the key instruments was the Involvement Evaluation Questionnaire (IEQ), an instrument to assess caregiving consequences. In this article, the intercultural validity of the IEQ is described. It was concluded that the IEQ covers the same caregiving domains in all five countries: interpersonal tension, worrying, urging, and supervision. Differences in score levels between countries were found. When adjusted for variables known to correlate with IEQ scores (patient, caregiver, and relationship), these differences still persisted. It could not be determined how far the remaining variation could be explained by site-level characteristics, because only limited site-level data had been collected. This means that researchers must still resolve the question of whether levels of caregiver consequences that cannot be explained by the data presented here are caused by cultural factors or by differences in mental health care provision. As long as cultural bias cannot be ruled out, researchers are advised to compose their own national norm groups and use these as a local standard.

Adolescent↗
PubMed2003

Prediction of the plant beta-barrel proteome: a case study of the chloroplast outer envelope.

In the postgenomic era, the transformation of genetic information into biochemical meaning is required. We have analyzed the proteome of the chloroplast outer envelope membrane by an in silico and a proteomic approach. Based on its evolutionary relation to the outer membrane of Gram-negative bacteria, the outer envelope membrane should contain a large number of beta-barrel proteins. We therefore calculated the probability for the existence of beta-sheet, beta-barrel, and hairpin structures among all proteins of the Arabidopsis thaliana genome. According to the existence of these structures, a number of candidates were selected. This protein pool was analyzed by TargetP to discard sequences with signals that would direct the protein to other organelles different from chloroplasts. In addition, the pool was manually controlled for the presence of proteins known to function outside of the chloroplast envelope. The approach developed here can be used to predict the topology of beta-barrel proteins. For the proteomic approach, proteins of highly purified outer envelope membranes of chloroplasts from Pisum sativum were analyzed by ESI-MS/MS mass spectrometry. In addition to the known components, four new proteins of the outer envelope membranes were identified in this study.

Algorithms↗
PubMed2002

Repellent guidance of regenerating optic axons by chondroitin sulfate glycosaminoglycans in zebrafish.

We analyzed the role of chondroitin sulfate (CS) glycosaminoglycans, putative inhibitors of axonal regeneration in mammals, in the regenerating visual pathway of adult zebrafish. In the adult, CS immunoreactivity was not detectable before or after an optic nerve crush in the optic nerve and tract but was constitutively present in developing and adult nonretinorecipient pretectal brain nuclei, where CSs may form a boundary preventing regenerating optic fibers from growing into these inappropriate locations. Enzymatic removal of CSs by chondroitinase ABC after optic nerve crush significantly increased the number of animals showing erroneous growth of optic axons into the nonretinorecipient magnocellular superficial/posterior pretectal nucleus (83% vs 42% in controls). In vitro, a substrate border of CSs, but not heparan sulfates, strongly repelled regenerating retinal axons from adult zebrafish. We conclude that CSs contribute to repellent axon guidance during regeneration of the optic projection in zebrafish.

Animals↗
PubMed2002

Comparative genomic hybridization (CGH) and fluorescence in situ hybridization (FISH) in the diagnosis of hepatocellular carcinoma.

BACKGROUND: The histomorphological diagnosis of well differentiated hepatocellular carcinoma (HCC) may be a challenging task, because regenerative nodules and adenomas share similar microscopic features. Moreover, the differentiation of intrahepatic metastatic spread from multicentric growth in multinodular HCC is frequently not possible by histological criteria alone. Whether molecular cytogenetic analysis can contribute to the differential diagnosis of HCC was recently investigated by our group. METHODS: We applied comparative genomic hybridization (CGH) and fluorescence in situ hybridization (FISH) to 12 cases of hepatocellular adenoma (HCA) and 28 cases of well differentiated HCC. RESULTS: CGH revealed aberrations in 2/6 HCAs, affecting 7p in 1 sample each and 17q and 20 in the second case. In 4/4 well differentiated HCCs, aberrations occurred, with a mean of eight aberrations per case, focused on 1q, 4q, 8p, 8q, 16p, and 17p. In all HCC samples, at least two of these sites were affected. In 2 multinodular HCCs, six and four different tumor nodes, respectively, were analyzed. In the first case, aberration patterns of chromosomes 1, 4, 5, 9, 13, and 17 were almost identical in all six nodes, indicating metastatic spread. In the second case, three of the nodes showed very similar patterns of chromosome aberrations, including those of chromosomes 1, 4, 5, 7, 8, 10, 12, 14, 17, and 18. Aberrations of chromosomes 4, 5, 8, 10, 12, and 15 were shown in the fourth node, findings conclusive for both the metastatic spread and the multicentric origin of the HCC. Based on the CGH results, five probes, for chromosomes 1, 6, 7, 8, and X, were selected for FISH. Using this panel, we found no aberrations in 14 HCAs. By contrast, 13/14 HCCs demonstrated aberrations for two to five chromosomes in the FISH analysis. CONCLUSIONS: We conclude that CGH and FISH are helpful diagnostic tools for the histopathological differential diagnosis of HCC.

Adenoma, Liver Cell↗
PubMed2002

Multiple functions of LIM domain-binding CLIM/NLI/Ldb cofactors during zebrafish development.

The crucial involvement of CLIM/NLI/Ldb cofactors for the exertion of the biological activity of LIM homeodomain transcription factors (LIM-HD) has been demonstrated. In this paper we show that CLIM cofactors are widely expressed during zebrafish development with high protein levels in specific neuronal cell types where LIM-HD proteins of the Isl class are synthesized. The overexpression of a dominant-negative CLIM molecule (DN-CLIM) that contains the LIM interaction domain (LID) during early developmental stages of zebrafish embryos results in an impairment of eye and midbrain-hindbrain boundary (MHB) development and disturbances in the formation of the anterior midline. On a cellular level we show that the outgrowth of peripheral but not central axons from Rohon Beard (RB) and trigeminal sensory neurons is inhibited by DN-CLIM overexpression. We demonstrate a further critical role of CLIM cofactors for axonal outgrowth of motor neurons. Additionally, DN-CLIM overexpression causes an increase of Isl-protein expression levels in specific neuronal cell types, likely due to a protection of the DN-CLIM/LIM-HD complex from proteasomal degradation. Our results demonstrate multiple roles of the CLIM cofactor family for the development of entire organs, axonal outgrowth of specific neurons and protein expression levels.

Animals↗
PubMed2002

Expression of the zebrafish recognition molecule F3/F11/contactin in a subset of differentiating neurons is regulated by cofactors associated with LIM domains.

We have identified a zebrafish homolog of the F3/F11/contactin (F3) recognition molecule. The gene shares 55% amino acid identity with F3 molecules in other vertebrates. Expression of F3 mRNA is first detectable at 16 h post-fertilization (hpf) in trigeminal and Rohon-Beard neurons. At 18-24 hpf, additional weaker expression is present in discrete cell clusters in the hindbrain, in the anterior lateral line/acoustic ganglion and in spinal motor neurons. Transcription factors of the LIM homeodomain class (LIM-HD) and their associated cofactors CLIM/NLI/Ldb (CLIM) have been implicated in the development of peripheral axons of trigeminal and Rohon-Beard neurons. We demonstrate that ectopic overexpression of a dominant-negative CLIM molecule early during zebrafish development strongly reduces expression of F3 mRNA in these neurons indicating regulation of F3 by the LIM-HD protein network. These results and the spatiotemporal correlation of F3 expression with axonal differentiation in a subset of primary neurons suggest an important role of F3 for axon growth.

Amino Acid Sequence↗
PubMed2002

Expression of the zebrafish recognition molecule F3/F11/contactin in a subset of differentiating neurons is regulated by cofactors associated with LIM domains.

We have identified a zebrafish homolog of the F3/F11/contactin (F3) recognition molecule. The gene shares 55% amino acid identity with F3 molecules in other vertebrates. Expression of F3 mRNA is first detectable at 16 h post-fertilization (hpf) in trigeminal and Rohon-Beard neurons. At 18-24 hpf, additional weaker expression is present in discrete cell clusters in the hindbrain, in the anterior lateral line/acoustic ganglion and in spinal motor neurons. Transcription factors of the LIM homeodomain class (LIM-HD) and their associated cofactors CLIM/NLI/Ldb (CLIM) have been implicated in the development of peripheral axons of trigeminal and Rohon-Beard neurons. We demonstrate that ectopic overexpression of a dominant-negative CLIM molecule early during zebrafish development strongly reduces expression of F3 mRNA in these neurons indicating regulation of F3 by the LIM-HD protein network. These results and the spatiotemporal correlation of F3 expression with axonal differentiation in a subset of primary neurons suggest an important role of F3 for axon growth.

Animals↗
PubMed2002

Comparing patterns and costs of schizophrenia care in five European countries: the EPSILON study. European Psychiatric Services: Inputs Linked to Outcome Domains and Needs.

OBJECTIVE: To compare service utilization and cost profiles of people with schizophrenia living in Europe in order to understand differences in treatment and care costs. METHOD: Cross-sectional samples were taken of people with schizophrenia in five European locations. Sociodemographic, clinical and service use data were collected via interviewer-administered questionnaires. Site-specific unit costs were obtained, transformed subsequently into a single currency (UK pound). Multiple regression analyses were conducted. RESULTS: There were widespread and considerable differences between sites in service utilization patterns and associated costs. Higher needs, greater symptom severity and longer psychiatric history are associated with higher costs: quality of life and service satisfaction are not. Few differences were found between sites in patterns of association with cost. CONCLUSION: Comparative analyses of the use and cost of mental health services can highlight existing variations helpfully in service provision and uptake. Methodological consistency is required if meaningful conclusions are to be drawn from such comparative data.

Adult↗
PubMed2002

[High service users in communal socio-psychiatric services].

OBJECTIVE: Differences in the intensity of social psychiatric care for mentally ill people are examined in two communal socio-psychiatric services in Saxony. Service users are subdivided into three groups according to intensity of service use (low utilization, average utilization and high utilization). METHODS: The analyses are based on data from a standardized documentation system in a rural and urban catchment area. RESULTS: Intensity of care varies with structural parameters (geographical distance between patient home and service, staff resources). A small group (about 20 % of all clients) with a high frequency of contacts with service staff (high users) receive more than 50 % of all care contacts. CONCLUSION: Standardized documentation is a good basis for the description of different patterns of service utilization, but more information is needed about service users, e.g. data on their health care needs.

Adolescent↗
PubMed2002

Expansion of the donor pool in liver transplantation: the Hannover experience 1996-2002.

In the past decade liver transplantation has become the standard therapy for terminal liver failure. An increasing organ shortage, specific regional allocation systems within the Eurotransplant area and the lack of an efficient system to identify donors have resulted in decreasing numbers of liver transplants. Approximately 20% of patients are dying on the waiting list, a list that has exploded in numbers and waiting time in the past 3 years. In particular children and small adults are put at a disadvantage since standard donors have standard size livers. Two options to solve this dilemma are the expanded use of split-liver and living-donor liver transplantation. The specific experiences applying these techniques at the Medizinische Hochschule Hannover are discussed and compared with the results given in the European Liver Transplant Registry. The retrospective analysis demonstrates a shift in the use of resources, with decreasing numbers of full-size cadaver liver transplants and an increase in split- and living-donor liver transplantation. Both techniques are limited to specific patient populations, a notion that has to be considered in the comparison of results and outcome. According to our experience the full-size cadaver liver is still the standard option, while other techniques require careful attention to the chosen recipient population, advanced surgical skills and, for living donors, as a sine qua non the prerequisite of nihil nocere.

Europe↗
PubMedDate not supplied

Main determinants of Global Assessment of Functioning score in schizophrenia: a European multicenter study.

BACKGROUND: The Global Assessment of Functioning (GAF) scale is a measure widely used to assess the outcome of patients with schizophrenia. However, little is known about the importance of clinical and psychosocial variables in determining its final score. The aim of this paper is to identify which factors predict GAF scores of patients with schizophrenia and their variability in 5 different European settings. METHOD: A representative sample of 404 patients with schizophrenia was assessed with the GAF. A multiple regression analysis was performed to identify predictors of the GAF scores. RESULTS: Clinical factors are the main determinants of GAF score. However, the analysis also showed that social and functioning factors were also significantly associated with GAF scores. Finally, the study showed the presence of intercenter differences in the factors, mainly in social functioning. CONCLUSIONS: The GAF is a useful and easy-to-apply measure of global functioning, independent of cross-cultural differences. Clinical factors are the main determinants of its score, although social functioning variables also have a lesser effect.

Adult↗
PubMedDate not supplied

Accidental transplantation of a kidney with a cystic renal cell carcinoma following living donation: management and 1 yr follow-up.

Transmission of cancer is a fatal risk in organ transplantation. We present a case of incidental renal carcinoma in a kidney obtained from a living donor. A 56-yr-old father was evaluated for donation for his 28-yr-old daughter. An MRT scan revealed two cysts in the right kidney. Right-sided donor nephrectomy and subsequent transplantation was performed. The wall of the prominent cyst was partially excised prior to transplantation. Histology revealed a high-grade renal clear cell carcinoma 10 d after transplantation. Following careful evaluation the recipient underwent partial nephrectomy. Immunosuppression was switched to rapamune. The graft function remained stable. Donor and recipient are without evidence of tumor recurrence 1 yr after transplantation. Our policy to obtain the kidney presenting anatomical variations proved to be beneficial for the donor. In case of transmission of cancer partial resection preserving graft function might be justified.

Adult↗