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Biomedical subjects

A Möller

Publications and source records attributed to A Möller.

At least 55 records · Page 3Linked to original sources

A qualitative study to explore the experience of fatigue in cancer patients.

Fatigue--which is a complex, multicausal, and multidimensional subjective experience--is today the most frequently reported symptom from patients with cancer. The aim of this study was to explore the experience of fatigue in cancer patients and to describe the categories and dimensions of the symptoms. A qualitative method--grounded theory--was used. Unstructured, tape-recorded interviews with 15 cancer patients were used for data collection. The categories found in this study illustrate fatigue as a process. Three major categories were found: (1) experiences (of loss, need, malaise, psychological stress, emotional affection, abnormal weakness, difficulties in taking the initiative); (2) consequences (social limitation, affected self-esteem, affected quality of life); and (3) actions (coping). The categories were constructed on the basis of dimensions with subordinated qualities. Knowledge concerning the different expressions of fatigue is important in caring for patients with cancer. The results from this study may contribute to a better understanding of how a cancer patient can experience and express fatigue and how the symptoms may affect the patient.

Activities of Daily Living↗

[The general psychological concept in the later work of Eugen Bleulers. Comparison with a summarized description from a forgotten theory 60 years after the final publication (1939)].

Documents by Eugen Bleuler from 1921 to 1939 that go into general psychological topics of meaning of consciousness, formation of motive and will, are presented. An effort towards integration of seemingly incompatible, side by side standing, unrelated biological and psychological concepts that probably is most likely explainable by the contemporary background of ideas, is recognizable. In this context, Eugen Bleuler refers to an already (especially by Richard Semon) systematically developed theory called "Mnemism" that he interpreted and applied to the psychological circumstances mentioned above. That theory of "mnemism" that can be most adequately described as a biogenetic-vitalistic theory, is assuming, that all organic life--independent of the possibility of a self-reflecting consciousness--is able to learn experiences made by analysis of environment and to pass it on following generations. Pattern of stimulus reactions are in the sense of this theory memorized ("engraphiert") and reactivated under similar situational circumstances ("ekphoriert") by the psychological mode of association.--It can be shown that Bleuler pursued this theory for a period of more than ten years. It represents the benchmark for Bleuler's standpoints, for example for the question of determination of human acting, that as itselves are already known from his earlier documents, but here have found a more theoretically based explanation. The assumption of the efficacy of specific, not necessary consciously remembered "engramms" of memory, suggests the hypothesis of the existence of unconsciousness; in this context textual points of contact to the psychological concepts of S. Freud and C. G. Jung--mnemic memory and collective unconscious--are shown.

Consciousness↗

Obstetric outcome and psychological follow-up of pregnancies after embryo reduction.

The obstetric outcome and psychological follow-up of the parents after embryo reduction performed at Sahlgrenska University Hospital between 1993 and 1997 in 13 women treated for infertility is described. A comparison is made with non-reduced multiple pregnancies, both spontaneous and multiple pregnancies after assisted reproduction technology. Altogether 10 triplets, two quadruplets and one quintuplet pregnancy underwent embryo reduction. The surgical procedure was performed in gestation week 7-8 by transvaginal, ultrasound-guided aspiration of embryonic tissue. The psychological follow-up included personal interviews and psychological evaluations by a Psychological General Well-being Scale (PGWB) and Beck's Depression Inventory (BDI). In 11 cases reduction was performed to twin pregnancies. In two cases of triplets after in-vitro fertilization and transfer of two embryos, reduction was performed on the monozygotic, monochorionic twins. No complete miscarriages occurred. Ten women delivered twins and three women delivered singletons. The mean gestation length was 40.4 weeks for singletons and 35.9 weeks for twins. The mean birthweight was 3411 g for singletons and 2392 g for twins. No complications related to the reduction were detected in the children.The psychological follow-up showed that the psychological well-being of the parents was good. However, the events around the reduction were experienced as chaotic and emotionally disturbing. One woman regretted the reduction. All couples emphasized that avoidance of high order pregnancies should be of primary importance. In conclusion, embryo reduction appears to improve the perinatal outcome of multiple pregnancies obtained after assisted reproduction technology. It is important that the surgical procedure is performed at a centre with experience of this type of intervention, by a limited number of surgeons and in a regulated manner. Psychologically, however, the intervention is traumatic and psychological management is essential for good final outcome.

Adult↗

Repeat abortion: a qualitative study.

In a qualitative study of 20 women seeking a repeat abortion, interviews lasting for 1.5-2 hours were conducted after the first appointment with a gynecologist when the abortion was planned. The women were aged 20-29 years and had experienced one to five abortion(s) during the previous 5 years. The aim of the study was to attain understanding of the phenomenon of repeat abortion. The women were asked to express their thoughts related to their situation and their choices. The following categories were found: psychosocial background factors, reactions to previous abortion(s), reflections on fertility, sexuality, psychological factors, social factors, contraceptive use, the present pregnancy, motives for the planned abortion, feelings about the planned abortion and risk-taking process. Most of the women seemed to have a psychological vulnerability with many current and previous problems, as well as problems regarding sexuality. It was evident that insecurity was present in the use of contraceptives and in relation to sexual activities and to sexual partners. The main reason for an unplanned pregnancy is not a lack of information or even a lack of knowledge, but rather a failure to integrate the knowledge with situational, intrapsychic and social factors.

Abortion, Legal↗

Prevalence of physical and sexual abuse before and during pregnancy among Swedish couples.

BACKGROUND: To estimate the prevalence of threats and actual acts of physical and sexual abuse during pregnancy. METHODS: Two hundred and seven pregnant Swedish women married to or cohabiting with Swedish men were randomly selected from three antenatal clinics in the city of Göteborg, Sweden. A standardized questionnaire was used for personal interviews about the women's experience of physical and sexual abuse by a husband or a boyfriend at some point in the past, during the last year and during current pregnancy. RESULTS: Twenty-seven point five percent of the women reported that they had been exposed to physical violence at some point in the past by their husband/boyfriend. Twenty-four and a half percent of the women had experienced some form of threat, physical or sexual violence during the last year. At some time (once or more) during their current pregnancy, the proportions of women who had been exposed to the following categories of violence, were as follows: 14.5%-symbolic violence, 14.5%-threats of mild violence, 2.9%-threats of moderate violence, 2.9%-threats of serious violence, 11%-mild violence, 4.3%-minor violence, 2.4%-moderate violence, 4.3%-serious violence and 3.3%-sexual violence. CONCLUSIONS: This study demonstrates that a considerable number of women had experienced threats, physical and sexual abuse during pregnancy. There is an obvious need for screening of experience of domestic violence among pregnant women to enhance the safety of women and their unborn babies.

Adult↗

The disposition of 14C-labeled tacrolimus after intravenous and oral administration in healthy human subjects.

Tacrolimus is a macrolide lactone with potent immunosuppressive properties. It has been shown in clinical studies to prevent allograft rejection. The pharmacokinetics of tacrolimus in healthy subjects and transplant patients has been described in earlier studies using immunoassay methods; however, detailed information on the absorption, distribution, metabolism, and excretion of tacrolimus using a radiolabeled drug is lacking. The objective of the present study was to characterize the disposition of tacrolimus after single i.v. (0.01 mg/kg) and oral (0.05 mg/kg) administration of 14C-labeled drug in six healthy subjects. Tacrolimus was absorbed rapidly after oral dosing with a mean Cmax and Tmax of 42 ng/ml and 1 h, respectively. The oral bioavailability was about 20%. After i.v. and oral dosing, most of the administered dose was recovered in feces, suggesting that bile is the principal route of elimination. Urinary excretion accounted for less than 3% of total administered dose. In systemic circulation, unchanged parent compound accounted for nearly all the radioactivity; however, less than 0.5% of unchanged drug was detectable in feces and urine. The excretion of the metabolites was formation-rate-limited. The mean total body clearance at 37.5 ml/min was equivalent to about 3% of the liver blood flow. Renal clearance was less than 1% of the total body clearance. The mean elimination half-life was 44 h.

Administration, Oral↗

Decision-making about unwanted pregnancy.

BACKGROUND: The aim of the study was to focus on aspects of the decision-making process among women having first and repeat abortion, in comparison with women continuing their pregnancies with or without having experienced abortions. METHODS: In a study of 401 pregnant women, (simple random sample) 20-29 years of age, 137 having first abortion (A1), 64 repeat abortion (A2), 142 continuing their pregnancies with no experience of abortion (B1) and 58 continuing, having experienced abortion(s) (B2), were given a questionnaire and were interviewed. RESULTS: The pregnancy evoked ambivalent feelings in all groups. One third of the women in the A-groups and about 25% of those in the B-groups had ambivalent feelings. More than half of the women decided to have an abortion upon first finding out they were pregnant, and after a few weeks of thought most of them had decided to have the abortion. More than half of the women having an abortion said it was rather or very difficult to make a decision. Among these subjects, women having had contact with social services found it significantly harder to make this decision. A majority agreed with their partners on having an abortion. A majority did not feel influenced by someone else when deciding about the abortion. However, 10% in the A1-group and 6% in the A2-group felt much or comparatively much influenced by someone else. CONCLUSIONS: Counselling seems to be important among a considerable number of women finding it hard to make a decision about abortion. Special attention is required for women feeling influenced by someone else and/or having pronounced social problems.

Abortion, Induced↗

[Scientific psychology in the works of Eugen Bleuler].

The name of Eugen Bleuler is usually known in the context of the definition and conceptualization of schizophrenic disorders. Main other topics, less known in literature, are alcoholism, forensic psychiatry and general psychological topics of meaning of consclousness, formation of motive and will. Bleulers point of view presents itself as an empirically-based and anti-philosophic one, definitely deterministic concerning the topic of human "freedom of will". Eugen Bleuler refers to an already (especially by Richard Semon) systematically developed theory called "mnemism" that he interpreted and applied to the psychological circumstances mentioned above. That theory of "mnemism", that can be most adequately described as a biogenetic-vitalistic theory, is assuming, that all organic life--independent of the possibility of a self-reflecting consciousness--is able to learn experiences made by analysis of environment and to pass it on following generations. Pattern of stimulus reactions are in the sense of this theory memorized and reactivated under similar situational circumstances by the psychological mode of association. The influence of psychoanalytical theories, especially the presumed importance of infantil sexuality, on Bleulers understanding of a medical psychology seems to fade over the years.

Germany↗

Expression and functional activity of the IL-8 receptor type CXCR1 and CXCR2 on human mast cells.

To further elucidate mechanisms involved in mast cell accumulation at sites of cutaneous inflammation, we have studied the ability of human leukemic mast cells (HMC-1 cells) to express functionally active IL-8 receptors. Expression of mRNA for both types of IL-8 receptors (CXCR1 and CXCR2) was demonstrated by PCR and of both proteins by flow cytometry. Binding and competition studies with 125I-labeled IL-8 and its homologue melanoma growth stimulating activity (125I-labeled MGSA) revealed two specific binding sites for IL-8, K1 = 1.1 x 10(11) M(-1) and K2 = 5 x 10(7) M(-1); and for MGSA, K1 = 2.8 x 10(10) M(-1) and K2 = 5 x 10(7) M(-1). This finding was supported by a dose-dependent rise of cytosolic free calcium concentration ([Ca2+]i) induced by both chemokines and to a lesser extent by the homologue neutrophil-activating peptide-2 (NAP-2). A significant migratory response of human leukemic mast cells (HMC-1) was observed with all three chemokines at a range from 10(-8) M to 10(-9) M. Moreover, the formation of cellular F-actin was induced in a rapid, dose-dependent fashion, with a maximally 1.7-fold increase at 10(-7) M. Using postembedding immunoelectron microscopy, we could show the expression of CXCRI on the cytoplasmatic membrane of isolated human skin mast cells whereas CXCR2 was located in mast cell-specific granules. These findings demonstrate for the first time the functional expression of both types of IL-8 receptors on human mast cells, suggesting a role for their ligands during mast cell activation and recruitment.

Actins↗

Comparative cytokine gene expression: regulation and release by human mast cells.

Since data on the ability of human mast cells to produce various cytokines are scanty, we examined the mRNA expression, its modulation and the resulting protein expression of a number of well-characterized cytokines, using semi-quantitative reverse transcription-polymerase chain reaction of cell extracts and enzyme-linked immunosorbent assays for analysis of cell supernatants. One million cells/ml of the human mast cell line HMC-1 were stimulated with 25 ng/ml phorbol myristate acetate (PMA), 5 x 10(-7) M calcium ionophore A 23187 (ionophore) or both stimuli combined for various time periods. Constitutive expression in unstimulated cells was found for interleukin-1 beta (IL-1 beta) -3, -4, -8, tumour necrosis factor-alpha (TNF-alpha) and transforming growth factor-beta (TGF-beta). Maximal mRNA up-regulation was observed by 2-4 hr, with a second peak for TNF-alpha at 24 hr. After a 4-hr stimulation, IL-13 expression was detectable as well, whereas for IL-12, only the p35 but not the p40 chain was found, and IL-2, -5, -7 and interferon-gamma (IFN-gamma) were not expressed at all. Large quantities of IL-8, TNF-alpha, granulocyte-macrophage colony-stimulating factor (GM-CSF) and IL-3 were secreted time-dependently over a 72-hr period, with lower levels of IL-1 beta, -6, -10 and TGF-beta and no detectable IL-2, -4 and IFN-gamma protein. When IL-6 and IL-8 expression was compared in more detail, IL-6 mRNA was found to be up-regulated only with ionophore but not PMA, whereas both stimuli alone or combined increased IL-8 mRNA expression. Preincubation with cycloheximide inhibited IL-6 but not IL-8 transcription, and incubation of stimulated cells with actinomycin D stabilized IL-8 and also IL-6 mRNA. These data suggest a selective regulation of distinct cytokines in human mast cells at the transcriptional and post-transcriptional levels. Furthermore, the spectrum of cytokines produced by HMC-1 cells supports the well-recognized role of mast cells in immediate-type hypersensitivity reactions as well as their potential colony-stimulating and tissue-remodelling abilities.

Calcimycin↗

[Sensation seeking--critical review of personality psychological concepts and its application].

The term "sensation seeking" is part of a self-contained theory on personality psychology. It is meant to denote a disposition--peculiar to a certain personality, probably genetically founded and correlating with biological, f. e. neuroendocrine measures--to explore one's social environment in order to find new and diversified stimuli. In their work, researchers mainly refer to Zuckerman's Sensation Seeking Scale in its fifth version (SSS-V), which distinguishes between four aspects of sensation seeking based on factor analysis of the 40 SSS-V-items. There is partly an overlapping of the phenomenon with impulsiveness and extraversion. Whereas application studies show inter alia links between sensation seeking and dangerous driving or dangerous sexual practices, data on the expression of this trait in addictive persons do not point to definitely consistent links. In forensic terms, there is on a link between "boredom susceptibility"--the inability to stand uneventful, monotonous situations--and "disinhibition"--a lack of control of impulses--figuring as subscales of the SSS-V, on the one hand, and hyperkinetic attention deficit syndromes and "disactualisation weakness", as described by Janzarik, on the other. At present, there is no German-language SSS-inventory in line with basal testing theory requirements. Because of the apparently different modi of sensation seeking influenced by other cultural traditions, such a scale must be basically adapted to the life-style in Western Europe.

Exploratory Behavior↗

Synthesis, storage, and release of vascular endothelial growth factor/vascular permeability factor (VEGF/VPF) by human mast cells: implications for the biological significance of VEGF206.

Mast cells have been implicated in various diseases that are accompanied by neovascularization. The exact mechanisms by which mast cells might mediate an angiogenic response, however, are unclear and therefore, we have investigated the possible expression of vascular endothelial growth factor/vascular permeability factor (VEGF/VPF) in the human mast cell line HMC-1 and in human skin mast cells. Reverse transcription-polymerase chain reaction (RT-PCR) analysis revealed that mast cells constitutively express VEGF121, VEGF165, and VEGF189. After a prolonged stimulation of cells for 24 h with phorbol 12-myristate 13-acetate (PMA) and the ionophore A23187, an additional transcript representing VEGF206 was detectable, as could be verified by sequence analysis. These results were confirmed at the protein level by Western blot analysis. When the amounts of VEGF released under unstimulated and stimulated conditions were compared, a significant increase was detectable after stimulation of cells. Human microvascular endothelial cells (HMVEC) responded to the supernatant of unstimulated HMC-1 cells with a dose-dependent mitogenic effect, neutralizable up to 90% in the presence of a VEGF-specific monoclonal antibody. Flow cytometry and postembedding immunoelectron microscopy were used to detect VEGF in its cell-associated form. VEGF was exclusively detectable in the secretory granules of isolated human skin mast cells. These results show that both normal and leukemic human mast cells constitutively express bioactive VEGF. Furthermore, this study contributes to the understanding of the physiological role of the strongly heparin-binding VEGF isoforms, since these were found for the first time to be expressed in an activation-dependent manner in HMC-1 cells.

Blotting, Western↗

Specific-antibody-secreting cells in the rectums and genital tracts of nonhuman primates following vaccination.

To determine optimal strategies to induce specific-antibody-secreting cells (specific ASC) in the rectal and vaginal mucosae, we immunized monkeys with a prototype mucosal immunogen, cholera toxin (CT), given locally or via gastric or parenteral administration. Repeated rectal or vaginal CT immunizations induced strong mucosal and systemic ASC responses. The mucosal responses were, however, confined to the immunization sites and comprised high levels of both specific antitoxin immunoglobulin A (IgA) and IgG. Large numbers of specific IgA and IgG ASC were detected in cell suspensions from dissociated genital and rectal tissues, demonstrating local accumulation of effector B cells at these sites. Intragastric immunization with CT did not per se give rise to cervicovaginal or rectal ASC responses but did prime for a rectal IgA ASC response to local booster immunization. Both rectal and vaginal immunizations also induced circulating blood IgG ASC and IgA ASC. In conclusion, these results show that local administration of antigen to the rectal or vaginal mucosa results in higher ASC responses than systemic or distant mucosal delivery. Furthermore, both the vaginal and the rectal mucosae can serve as inductive sites for systemic ASC responses. These observations should be relevant to the development of vaccines against sexually transmitted diseases such as that caused by human immunodeficiency virus.

Administration, Intranasal↗

Role of antigen-induced cytokine release in atopic pruritus.

In order to further evaluate the role of cytokines in the induction of atopic pruritus, leukocytes from 10 atopic eczema patients or 10 nonallergic controls were stimulated in vitro with mite or birch pollen antigen for 1 and 4 days. Subjects were prick-tested with the supernatants, and whealing and itching were evaluated 20 and 60 min later. The supernatants were also examined for the contents of GM-CSF, IL-2, IL-6 and IL-8 by ELISA and TNFalpha. Two hours prior to testing, the antihistamine cetirizine (20 mg) or a placebo tablet were given to the patients according to a randomized, double-blind study protocol. After pricking with antigen-stimulated leukocyte supernatants, 6 of 10 patients but no controls reacted mostly at 20 min with whealing and/or pruritus. In the cetirizine-treated group, no decrease in these skin reactions was seen compared to placebo. Analysis for cytokines showed increased levels of IL-8 in allergen-stimulated samples, with no correlation to the induction of itching or whealing by these supernatants. IL-6 levels were low and variable, and GM-CSF, IL-2 and TNFalpha levels were always below standard values. These data show that leukocytes selectively release IL-8 in response to in vitro antigen stimulation. They furthermore provide additional support for the concept that as yet to be identified products play a role in atopic pruritus.

Adolescent↗