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[What is concealed behind nonspecific emotional disorders (F93.8/9)--a diagnostic comparison with reference to 4 diagnostic codes of ICD-10].

Psychiatric diagnoses of three patient groups attending a clinical service in 1992 and 1993 were compared: children with rather inspecific diagnoses F93.8 and F93.9, children with specific diagnoses (f93.0 to F93.3 and children without psychiatric disorders. Data were gathered by the clinical documentation based on WHO recommendation. Result was a difference between the specific group and the inspecific group due to the psychopathological evidence. Further the variables of the fifth axis of MAS were analysed.

Adolescent↗
PubMed1996

[Improved prenatal diagnostic possibilities for congenital abnormalities and chromosomal disorders. Advantages and disadvantages of screening and diagnostic methods].

Significant progress has taken place in recent years regarding prenatal screening and diagnosis of severe foetal malformations and chromosomal disorders. This review describes blood sample screening in 15-16 week of pregnancy compared with the other prenatal examinations such as amniocentesis and chorionic villus sampling. Serological screening of all pregnant women based on a blood sample taken at 15-16 weeks of pregnancy would lead to identification of about 70% of the screened women having to undergo a conclusive investigation i.e. either a thorough ultrasound examination or an amniocentesis. This is compared with the present Danish prenatal program, where invasive examinations are carried out in about 13% pregnant women without a high detection rate for malformations and chromosome disorders. The Danish National Health Board has recently published new guidelines where the blood test is primarily offered to pregnant women over 34 years of age and not to all pregnant women as in many other countries.

Chromosome Aberrations↗
PubMed1996

[Diagnostic and differential diagnostic value of troponins].

PATIENTS AND METHOD: In consideration of own investigations and analysis of the most important publications of other authors, a critical interpretation of the concentrations of Troponin T (cut off: < 1 microgram/l) and Troponin I (cut off: < 0.4 microgram/l) was done in patients with acute and chronic muscle diseases, with chronic renal failure, with acute myocardial infarction, and stable and unstable angina pectoris, after coronary angioplasty, following cardiac surgery and critical care patients. RESULTS: In all cases with acute damage of the skeletal muscles (post operationem) the concentrations of TnT and TnI were in normal ranges. - In patients with chronic muscle diseases (M. Duchenne, Dermatomyositis) in 75% the TnT concentrations increased, while TnI concentrations were < 0.4 microgram/l. - In end stage renal disease patients undergoing chronic maintenance hemodialysis we found in 39% constantly elevated concentrations of TnT. TnI in all cases were in normal range. - In acute myocardial infarction in 97% of all patients both Troponins were increased, beginning 2 to 4 hours after onset. A normalization was observed between the 5th and 9th day. Very important is the differentiation between stable, and instable angina pectoris. In stable angina the concentration of both Troponins were in normal range, in contrast in 33 to 41% of all patients with unstable angina TnT and TnI were increased, in 9 to 16% even if the ECG showed no alteration. Elevated TnT or TnI concentrations predicted a significantly increased mortality. After coronary angioplasty and heparin treatment all patients had once more an elevation of TnT and TnI 8 and 27 hours after the invasive therapy. One of these substantial reasons for these minor myocardial cell necrosis is beside the endothelial injury the activation of the platelets and the coagulation system. - During the therapy with hirudin increases of TnT and TnI was not observed. Following cardiac surgery (ACVB) 6 to 48 hours after aortic unclamping 76 patients with TnI < 1 microgram/l had no perioperative myocardial infarction, while 14 patients with TnI concentrations > 1 microgram/l in 71.4% (n = 10) developed an acute infarction. - In patients in critical care units we observed only increased TnI concentrations in shock, especially in septic shock with multiple organ failures.

Adolescent↗
PubMed1997

Immunophenotyping as a diagnostic tool to differentiate lichen planus from chronic graft-versus-host disease: diagnostic observations on two patients.

BACKGROUND: Lichen planus (LP) and the lichenoid variant of chronic graft-versus-host disease (cGVHD) can present with similar clinical and histological findings. The distinction, although difficult, is important both prognostically and therapeutically. The mechanism and effector cell phenotypes have also shown to differ between the 2 entities. While the lichenoid infiltrate of LP is predominantly T lymphocytes helper/inducer cell phenotype, the suppressor/cytotoxic subset appears to play a major role in cGVHD. The aim of this study is to determine whether the immunophenotypic character of the lichenoid infiltrate can aid in distinguishing the 2 entities. METHODS: Biopsies were obtained from 2 patients with lichenoid papules and a history of transplantation. Light microscopy revealed lichenoid inflammation in both cases characterized by a band-like lymphohistiocytic infiltrate at the dermal-epidermal junction. Immunochemistry was performed on fresh tissue using a panel of monoclonal antibodies including anti-CD1a, CD3, CD4, CD8, CD16, CD20, CD28, and CD68. Results were quantitated using computer-assisted image analysis. RESULTS: We found that in both cases the majority of cells stained with pan T cell marker CD3+. One case demonstrated predominantly CD4+ T cells and increased numbers of CD1a positive Langerhans cells, while the lymphokine natural killer cell activity (LAK) markers anti-CD16 and anti-CD28 were largely nonreactive. Conversely, the second case contained predominately CD8+ lymphocytes and very few CD1a positive Langerhans cells with abundant LAK cell anti-CD16 and anti-CD28 reactivity. CONCLUSIONS: Based on these findings, the former was classified as lichen planus and the latter as lichenoid cGVHD. The diagnoses are substantiated with clinical history and follow-up information. We conclude that immunophenotypic characteristics of the infiltrate can be a useful tool in differentiating lichenoid cGVHD from lichen planus.

Adult↗