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Biomedical subjects

W Schreiber

Publications and source records attributed to W Schreiber.

At least 91 records · Page 5Linked to original sources

Glucose metabolism in the caudate nuclei of patients with eating disorders, measured by PET.

Regional cerebral glucose metabolism was measured with 18F-2-fluoro-2-deoxyglucose and positron emission tomography in nine patients with bulimia nervosa and in seven patients with anorexia nervosa. Relative caudate glucose metabolism (caudate glucose metabolism divided by global cerebral glucose metabolism) was significantly higher in anorexia nervosa than in bulimia nervosa, suggesting that caudate hyperactivity is characteristic of the anorexic state. Whether increased caudate function is a consequence of anorexic behaviour or whether it is directly involved in the pathogenesis of anorexia nervosa is an issue still to be clarified.

Adult↗

Circadian pattern of large neutral amino acids, glucose, insulin, and food intake in anorexia nervosa and bulimia nervosa.

Insulin, glucose, and large neutral amino acids (LNAA) were studied in 10 patients with anorexia nervosa, 13 patients with bulimia nervosa, and 15 healthy controls. Blood samples were collected at hourly intervals during the day and at two-hour intervals during the night over a 24-hour period. Ad libitum caloric and relative carbohydrate intake was significantly reduced in the anorectic and bulimic patients. Elevated concentrations of beta-hydroxybutyric acid (BHBA) were seen in the bulimic group, and low triiodothyronine (T3) concentrations in the anorectic group. Mean plasma glucose and insulin concentrations were significantly lowered in both groups. The tryptophan (Trp) to LNAA ratio was reduced in anorectic, but not in bulimic patients. These findings suggest that Trp influx into the brain is reduced in anorectic patients, possibly impairing central serotonergic function.

Amino Acids↗

The action of clenbuterol on sleep and symptomatology in depressives.

Five female inpatients with major depression (melancholic type, DMS-III-R) were treated with the beta-adrenergic agonist clenbuterol for three weeks, with doses ranging from 100 micrograms to 150 micrograms. Remission of depressive symptomatology during treatment was observed in only one patient. All patients complained of side effects, especially tremor, agitation and restlessness. The sleep EEG showed no consistent effects on sleep parameters, including REM latency and percentage of REM sleep. Thus, the impact of clenbuterol on sleep clearly differs from that of most classical antidepressants. Regarding the lack of therapeutic efficacy, the data are compatible with the hypothesis of a relationship between REM sleep suppression and an antidepressant drug effect. Despite the small sample size, it can be concluded that clenbuterol is not likely to be a promising alternative to proven antidepressants in the treatment of major depression.

Adult↗

Alterations of nocturnal sleep in patients with HIV infection.

Nocturnal sleep of 14 patients with HIV infection was characterized by longer sleep onset latency, shorter total sleep time, reduced sleep efficiency, more time spent awake and in Stage 1. There was significantly less sleep Stage 2 than in healthy controls. REM latency was slightly reduced and correlated negatively with depressive symptomatology, while percentages of REM and slow wave sleep were normal. Patients without complaints at the time of the investigation exhibited similar sleep abnormalities. The results stress the usefulness of polysomnography as a sensitive methodology for detection and monitoring of CNS affection in HIV positive patients.

AIDS Dementia Complex↗

Molecular characterization and functional analysis of the leukocyte surface protein CD31.

The CD31 Ag is a surface glycoprotein of 130 kDa with a broad cellular distribution. We show that among peripheral human blood cells, it is expressed on monocytes, granulocytes, platelets, and a subpopulation of lymphocytes. Activation of granulocytes leads to down-regulation of CD31 molecule expression. Sequence analysis and quantitative measurements of the relatedness of the CD31 molecule to other known proteins demonstrate that it consists of six Ig constant domains and that each domain bears substantial similarity to Fc gamma R domains. We find, however, that the CD31 molecule does not bind Ig Fc domains. On human monocytes we demonstrate that CD31 mAb recognizing certain epitopes of the CD31 molecule induce the generation of reactive oxygen metabolites. No such effect was seen with human granulocytes. By using two CD31 mAb, termed 1B5 and 7E4, we analyzed the requirements for activation of the monocyte respiratory burst via CD31 Ag in more detail. We show that signal transduction occurs via formation of a CD31 Ag-mAb-Fc gamma R complex involving either Fc gamma RI (CD64) or Fc gamma RII (CDw32) molecules.

Amino Acid Sequence↗

Brain morphology and regional cerebral blood flow in anorexia nervosa.

Cranial computed tomography (CT) was performed in 12 patients with anorexia nervosa, revealing that the majority of the patients displayed ventricular dilatation and/or sulcal widening. In addition, regional cerebral blood flow (rCBF) was measured at admission and once again after weight gain, using xenon-133 dynamic single-photon emission tomography (dSPECT). The mean flow rates assessed at the first examination did not significantly differ from those assessed at the second examination and from those of a control group. There was a significant inverse relationship between the size of the cerebrospinal fluid spaces and the cerebral blood flow in the anorectics; a decrease in ventricular size after weight gain was associated with an increase in cerebral blood flow in this area. This finding, however, has to be interpreted with caution, as partial volume effects render the flow rates ambiguous in brain areas, which, in addition to neuronal tissue, also include ventricular and sulcal structures.

Adolescent↗

The effect of neuroendocrine secretion on brain morphology and EEG sleep in patients with eating disorders.

Neuroendocrine disturbances [low plasma levels of triiodothyronine (T3), high plasma concentrations of cortisol], morphological brain alterations [enlarged external cerebrospinal fluid (CSF) spaces, dilatation of the ventricles] and altered sleep patterns [fragmented sleep continuity, a reduction of slow wave sleep (SWS) or REM sleep] have been described in patients with anorexia nervosa and bulimia nervosa. The present study investigates to what degree these disturbances interact with each other. In ten anorexic and five bulimic patients cranial computed tomography (CT) to estimate the size of the CSF spaces, blood sampling to measure cortisol and T3 plasma concentrations, and all-night polysomnography were performed. In comparison with patients with normal CT scans, the patients displaying enlarged CSF spaces spent more time in SWS, and the duration of REM sleep was reduced. In the whole sample, a negative correlation was found between the amount of REM sleep and cortisol, whereas a positive association was found between the amount of REM sleep and the T3 level. In addition, the degree of brain shrinkage correlated positively with cortisol and negatively with T3. On the basis of these results, it can be assumed that in patients with eating disorders the disease process with its neuroendocrine alterations affects brain morphology as well as EEG sleep.

Brain↗

[Brain structure and brain function in anorexia nervosa: a computerized tomography study].

Cranial computed tomography (CT) was performed in 12 patients with anorexia nervosa revealing that the majority of the patients displayed ventricular dilatation and/or sulcal widening. In six patients re-examined these structural brain alterations showed a strong trendency towards normalization after weight gain. With the intention of finding a functional correlate of the CT abnormalities, the regional cerebral blood flow (rCBF) was measured at admission and once again after weight gain and compared with the flow rates of a healthy control group. The mean flow rates assessed at the first examination did not significantly differ from those assessed at the second examination and from those of a control group. Thus, despite the CT findings of structural brain abnormalities, the measurement of the regional cerebral blood flow gave no hint of a reduced functioning of certain brain areas in anorexia nervosa.

Adolescent↗

Vanadium K-edge absorption spectrum of bromoperoxidase from Ascophyllum nodosum.

With synchrotron radiation from the Bonn 2.5 GeV synchrotron, high-resolution absorption spectra have been measured at the vanadium K-edge of bromoperoxidase from the marine brown alga Ascophyllum nodosum and several model compounds. The near-edge structure (XANES) of these spectra was used to determine the charge state and the coordination geometry around the vanadium atom. For the active enzyme a coordination charge of 2.7 was found which is compatible with a formal valence of +5, assuming coordination by atoms with a high electronegativity such as oxygen or nitrogen. For the reduced enzyme the coordination charge value of 2.15 indicates the reduction of the valency by 1 unit. Our results suggest that the coordination sphere of the vanadium atom in the native enzyme consists of at least seven oxygen atoms in a distorted octahedral environment with an average bond length of about 2 A. Through the reduction process, the coordination sphere of the vanadium atom changes with a simultaneous decrease of the coordination cage. These results agree with those deduced from previous EPR and 51V-NMR measurements.

Eukaryota↗

[Toxic psychosis as an acute manifestation of diphenhydramine poisoning].

Acute manifestations of a toxic psychosis with optic and tactile hallucinations developed in a 46-year-old woman after having swallowed a total of 1600 mg diphenhydramine with suicidal intent. The acute hallucinations lasted for eight hours and then disappeared completely without any treatment. The patient reported a series of highly plastic and rapidly changing sensations of various insects, such as spiders, beetles and ticks, without any equivalent in reality, which to the patient seemed absolutely real throughout the psychotic episode. Diphenhydramine intoxication is to be differentiated from two organic psychiatric diseases, the dermatozoa delusion syndrome and alcoholic delirium.

Acute Disease↗

Methodological aspects of hCRF-stimulated ACTH and cortisol secretion in healthy subjects.

This study, aimed at clarifying some methodological problems of the hCRF stimulation test, was performed on 12 healthy male volunteers. ACTH and cortisol increases after 30 min and their maximum increase proved to be highly reliable response parameters for the net area under the response curve of both hormones. An influence of baseline hormone values on the maximum response was apparent for cortisol but not for ACTH. Cortisol, but not ACTH, revealed a stable test-retest reliability. There were no correlations between ACTH and cortisol responses to hCRF.

Adrenocorticotropic Hormone↗

Past and present strategies of research on the HPA-axis in psychiatry.

Hypercortisolism in depression has been extensively studied during the last three decades. The main hypothesis regarding origin and clinical relevance of this phenomenon, however, has changed significantly. Up to the mid-seventies hypercortisolism was conceived as consequence of stress modified by the degree of unconscious defense mechanisms in different forms of depressive or non-depressive psychiatric disorders. At the end of the seventies this point of view changed considerably. Hypercortisolism was regarded as a biological statemarker of the endogenous subtype of depression with clinical differential-diagnostic relevance. An abnormal dexamethasone suppression test (DST) was assumed to be the best indication of increased activation of the cortisol system. These conclusions turned out to be wrong. DST results are not specific for melancholia and the test seems to be of limited value for measuring the function of the HPA-axis. Intervening variables, such as weight loss, drug and alcohol withdrawal or situational stress, influence the test results significantly, independent of the nosological classification. Additionally, interindividual differences in the susceptibility of the HPA-axis may decisively influence the the activation of the HPA-axis as well in healthy subjects under stress as in psychiatric patients.

Depressive Disorder↗

Cortisol response to various stressful situations: relationship to personality variables and coping styles.

Studies on personality traits and coping styles as determinants of interindividual differences in neuroendocrine responses to stress have not yet yielded conclusive results. In a previous investigation, strong hints to distinct interindividual differences in the susceptibility of the HPA axis of 12 male volunteers aged 27 +/- 5 years exposed to five different stress situations were found. In the present report, psychometric variables (personality traits and coping styles) assessed in the same subjects before the study were analyzed to test whether specific psychometric variables were related to the interindividual differences in the susceptibility of the HPA axis. The results revealed that interindividual differences in the frequency of cortisol responses to stress situations could not be predicted by any of the psychometric variables investigated. The question if psychological factors contribute to neuroendocrine stress response and to what degree warrants further interest. These preliminary findings suggest, however, that nonpsychological factors should be considered more seriously as determinants of interindividual differences in neuroendocrine stress responses in healthy subjects as well as in psychiatric patients.

Adaptation, Psychological↗

Interindividual differences in the susceptibility of the cortisol system: an important factor for the degree of hypercortisolism in stress situations?

Whereas in psychophysiological research, the specificity of the individual responses has been assumed to be an important trait variable influencing the investigated parameters in stress experiments or in psychopathological states, in psychoneuroendocrinology, the individual differences in the susceptibility of the investigated neuroendocrine axes have been widely neglected. The present study on the cortisol response of 12 healthy young men to 5 different stress tests is considered to be an initial orientation step into this field. All five stress tests (quiz, arithmetic tasks, stress film, cold pressor test, and physical exercise test) could be proven to be effective stimuli regarding the cortisol system. There was, however, a broad spectrum of cortisol responses among the 12 subjects, with a continuum between complete reactors and nonreactors. This did not correlate with the subjective judgment of stress at all. Although the data showed a tendency toward an augmented dispersion of the response frequencies in comparison with random variation, the limited sample size of subjects and stress tests did not allow a statistically significant proof of a stimulus-independent, individual response specificity. Further experimental clarification seems to be necessary to avoid misinterpretations of neuroendocrine data in psychiatric disorders due to neglect of this variable.

Adult↗