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Biomedical subjects

C Egger

Publications and source records attributed to C Egger.

At least 19 recordsLinked to original sources
PubMed2006

Intravenous mirtazapine is safe and effective in the treatment of depressed inpatients.

Mirtazapine is a third-generation antidepressant with a dual mode of action. The oral administration has been shown to be effective and safe in the treatment of depressed patients. In this multicenter naturalistic study, we assessed the safety, tolerability, and therapeutic efficacy of intravenously administered mirtazapine in 80 moderately to severely depressed inpatients during a treatment period of 14 days. We found a significant decrease of the Hamilton Depression Rating Scale total score compared to baseline. Side effects were mild and transient. Our data indicate that intravenous mirtazapine is an effective, safe and well-tolerated treatment for depressed inpatients.

Adolescent↗
PubMed2006

[Treatment motivation and results of inpatient psychotherapy for women with depressive disorders: a prospective study].

Whether the treatment results in inpatient psychotherapy are significantly influenced by the patient's motivation is a subject of discussion. The goal of this study was to assess whether the primary motivation for therapy in depressive women influences the results of psychotherapeutic treatment. In a prospective study, the monitored results from 64 female inpatients (32 who were highly motivated to enter therapy, and 32 who were minimally motivated) were compared to each other. The period of observation was six weeks. As instruments of assessment, the Fragebogen zur Therapiemotivation (FMP) (Questonnaire on Motivation for Entering Therapy) and the Beck Depression Inventory (BDI) were aministered upon admission; after the fourth and sixth weeks of therapy, the Veränderungsfragebogen des Erlebens und Verhaltens (VEV) (Questionnaire of Changes in Experience and Behavior) was administered as well. All patients who had applied for a pension were found in the group of less motivated patients and consolidated into a subgroup. The analysis was carried out according to the intent-to-treat principle. The variance analysis for the repeat measurements showed significant differences on all the FMP scales and on the BDI (all P< 0.001). The measurements with VEV likewise resulted in a significant difference (P< 0.01). The subgroup of "pension patients" showed significantly less change in all three of the above measurements. Patients with depressive symptomology who essentially are relatively highly motivated for therapy could profit significantly more from inpatient psychosomatic treatment than those who are less motivated. Establishing and developing motivation prior to inpatient hospitalization could possibly contribute to more efficient and cost-effective clinical treatment. Where legal proceedings pertaining to a pension are pending, relatively less motivated patients fare significantly worse not only in their motivational development for therapy, but also in their final treatment results. It should be noted, however, that the relatively small random sample, the restricted blinding, which was only partially possible, could have led to possible distortions.

Attitude to Health↗
PubMed2006

[Treatment results from inpatient psychosomatic rehabilitation of Turkish migrants: a prospective study].

Psychosomatic rehabilitation and the concluding social-medical assessment constitute a particular challenge. The aim of this study was to examine whether inpatient psychosomatic rehabilitation in the context of an integrated treatment concept, conducted in Turkish and German, is effective in the rehabilitation of Turkish migrant laborers, and what concluding socio-medical assessment results from this treatment. 195 Turkish patients--44 male and 151 female--received inpatient psychosomatic treatment for approximately 40 days. Sociodemographic, psychiatric and social-medical data were recorded, as well as Symptom Checklist (SCL-90-R) testing upon admission and discharge. A predominant number of patients were laborers, with a low level of primary education, who were afflicted with psychosocial problems and dissatisfaction with their workplace and who first came into psychosomatic treatment many years following the onset of their illness. Many of them had a clearly defined desire to retire. At the end of their admission, a significant improvement in almost all the scales of the SCL-R-90 was ascertained on the one hand, but on the other, adequate socio-medical results were hardly observed. The symptoms' improvement would confirm that the combination of service offerings in Turkish and German proved themselves. A portion of the patients (approx. 40 %) were classified subsequent to treatment as capable of working for 6 hours or more. Nevertheless, approximately approx. 75 % still sought to retire. Timely psychosomatic treatment could counteract chronification of the illness and the establishment of a steadfast desire to enter retirement, and consequently represent an improvement in the prognosis. Likewise, consistent psychosomatic training of physicians, as well as systematic prophylactic measures with the migrant laborers, should be considered.

Adult↗
PubMed2000

[CT- and ultrasound-guided biopsies: prospective comparison of fine-needle aspiration with true-cut biopsy in 103 patients].

PURPOSE: A prospective comparison of FNAB and TCB was performed in an identical set of patients and lesions. METHODS: In 103 patients focal lesions were biopsied by US- or CT-guidance with at least one FNAB and TCB each. Complications were registered and documented. Cytological and histological specimens were evaluated independently. A final diagnosis was then attempted by consensus. RESULTS: A total of 253 punctures was performed with sufficient tissue in 72.8% (FNAB) and 85.4% (TCB) of the cases. Diagnosis was possible in 68% (FNAB) and 80.6% (TCB). After combined evaluation of both specimens the diagnostic yield increased to 91.3%. Minor complications without clinical sequelae were observed in 21 patients. CONCLUSION: A diagnostic strategy with the combined use of FNAB and TCB increases the diagnostic yield in image-guided punctures. Even though this approach needs at least two separate punctures, the complication rate does not increase.

Biopsy↗
PubMed1998

Modulation of iron metabolism in monocytic THP-1 cells and cultured human monocytes by the acute-phase protein alpha1-antitrypsin.

The reticuloendothelial (RE) system plays an important role in the changes in iron metabolism associated with the anemia of chronic disease (ACD). We previously reported that the acute-phase protein alpha1-antitrypsin (alpha1-AT) reduced growth and proliferation in cells of the erythroid cell system by interfering with transferrin (Tf)-mediated iron uptake. The regulation of iron metabolism in cells of the RE system is distinctly different from that in other cell systems; moreover, monocytes and macrophages play an essential part in the regulation of the production and clearance of alpha1-AT. In the present study we examined the effect of alpha1-AT on cells of the monocyte-macrophage lineage. Alpha1-AT completely inhibited the binding of Tf to its receptor (TfR) on THP-1 human myelomonocytic cells and cultured human monocytes. Results of equilibrium saturation and kinetic studies indicated that this inhibition was competitive. No other acute-phase protein demonstrated the same inhibitory potency. Furthermore, alpha1-AT almost completely prevented internalization of the Tf-TfR complex in a dose-dependent manner. Interestingly, and in sharp contrast to the results of our studies with erythroid cells, this inhibition did not reduce the growth and proliferation of THP-1 cells. Furthermore, alpha1-AT significantly increased the concentration of intracellular ferritin in THP-1 cells and monocytes, whereas the number of TfR remained unchanged. Because alpha1-AT showed no enhancing effect on ferritin transcription and translation, we believe that an as-yet unidentified posttranslational mechanism may be responsible for this phenomenon. In addition, our results indicate that the increase in ferritin concentration caused by alpha1-AT is mediated independently of iron supply, as has previously been shown for several proinflammatory cytokines. These data provide further evidence that alpha1-AT is a mediator of the alterations in iron metabolism characteristic of ACD.

Cell Division↗
PubMed1997

A skin homing molecule defines the langerhans cell progenitor in human peripheral blood.

We have recently described a system for the generation of dendritic cells (DC) and Langerhans cells (LC) from defined CD34+ precursors purified from peripheral blood of healthy adult volunteers. This study has now been extended by the characterization of two distinct subpopulations of CD34+ cells in normal human peripheral blood as defined by the expression of the skin homing receptor cutaneous lymphocyte-associated antigen (CLA). CD34+/CLA+ cells from normal peripheral blood were found to be CD71LOW/CD11a+/CD11b+/CD49d+/CD45RA+ whereas CD34+/CLA- cells displayed the CD71+/CD11aLOW/CD11bLOW/CD49d(+)/ CD45RA(LOW) phenotype. To determine the differentiation pathways of these two cell populations, CD34+ cells were sorted into CLA+ and CLA- fractions, stimulated with GM-CSF and TNF-alpha in vitro, and then were cultured for 10 to 18 d. Similar to unfractionated CD34+ cells, the progeny of both cell populations contained sizable numbers (12-22%) of dendritically shaped, CD1a+/HLA-DR cells. In addition to differences in their motility, the two dendritic cell populations generated differed from each other by the expression of LC-specific structures. Only the precursors expressing the skin homing receptor were found to differentiate into LC as evidenced by the presence of Birbeck granules. In contrast, CLA precursor cells generated a CD1a+ DC population devoid of Birbeck granule-containing LC. Provided that comparable mechanisms as found in this study are also operative in vivo, we postulate that the topographic organization of the DC system is already determined, at least in part, at the progenitor level.

Adult↗
PubMed1997

Growth patterns of piriform sinus carcinomas.

Advances in functional surgery have encouraged many head and neck surgeons to treat piriform sinus carcinomas, whenever possible, by conservation surgery. An increased understanding of the histopathologic growth pattern and spread of piriform sinus carcionomas is needed to define criteria for appropriate application of voice preservation surgery. The purpose of this study was to analyze the patterns of tumor spread to laryngeal and parapharyngeal structures. A total of 42 specimens obtained by laryngopharyngectomy were subjected to a whole-organ section study. Carcinomas confined to the lateral wall tended to extend laterally beyond the thyroid ala and rarely infiltrated the intrinsic laryngeal muscles. As a result, conservation surgery could be possible in many cases, including T4 carcinomas. Carcinomas confined to the medial wall or occupying the whole piriform sinus tended to infiltrate laryngeal structures early, and hemilaryngeal fixation was observed in 61% of these cases; tumor spread to the contralateral side in 64%. The hemilarynx fixation was due to an invasion of intrinsic laryngeal muscles. An isolated perineural or cricoarytenoid joint involvement was never observed. For these tumors, conservation surgery would be inadequate in most cases, as they often present extensive laryngeal involvement with spread to the contralateral side.

Humans↗
PubMed1997

Neoplastic invasion of the laryngeal cartilage: reassessment of criteria for diagnosis at CT.

PURPOSE: To evaluate eight different diagnostic criteria to help detect neoplastic invasion of laryngeal cartilage at computed tomography (CT). MATERIALS AND METHODS: In a prospective series, 111 patients with carcinoma of the larynx or hypopharynx underwent thin-section, contrast material-enhanced CT before total or partial laryngectomy. The following CT criteria were evaluated: extralaryngeal tumor, sclerosis, tumor adjacent to nonossified cartilage, serpiginous contour, erosion or lysis, obliteration of marrow space, cartilaginous blowout, and bowing. Histologic findings were correlated with findings on CT scans obtained at each level. RESULTS: Histologically, 122 of 412 cartilages were invaded. Depending on the diagnostic criteria and each specific cartilage, there was great variation in sensitivity (7%-83%) and specificity (40%-100%). Sclerosis was the most sensitive criteria in all cartilages but often corresponded to reactive inflammation in the thyroid cartilage. Extralaryngeal tumor and erosion or lysis yielded the highest specificity. Tumor adjacent to nonossified cartilage, serpiginous contour, and obliteration of marrow space were specific although not sensitive signs of invasion in the arytenoid and cricoid cartilage and were nonspecific in the thyroid cartilage. Blowout and bowing were not useful. Selection of the appropriate combination of criteria enabled an overall sensitivity of 91% (associated specificity, 68%) or an overall specificity of 79% (associated sensitivity, 82%). CONCLUSION: Detection of neoplastic cartilage invasion with CT greatly depended on the appropriate use of individual and combined CT criteria.

Adult↗
PubMed1997

Gastric antral vascular ectasia with portal hypertension: treatment with TIPSS.

Gastric antral vascular ectasia, or "watermelon stomach," is a distinct clinical entity within the spectrum of upper gastrointestinal mucosal vascular abnormalities. The pathobiology of the disease is unclear. We here describe a case that emphasizes the importance of the "watermelon stomach" as differential diagnosis of occult gastrointestinal blood loss and report on its successful treatment through installation of a transjugular intrahepatic portosystemic stent shunt (TIPSS).

Aged↗
PubMed1996

Generation of human dendritic cells/Langerhans cells from circulating CD34+ hematopoietic progenitor cells.

Human Langerhans cells (LC) are CD1a+ dendritic cells (DC) that function as potent antigen-presenting cells for primary and secondary immune responses. Limitations in DC/LC numbers, imposed by difficult and tedious isolation procedures, have so far precluded their use as immunogens in the generation and/or augmentation of host responses against various pathogens. Therefore, we have developed a procedure for the generation of human DC/LC from CD34+ hematopoietic progenitor cells (HPC) isolated (mean: 0.7 x 10(6)/ buffy coat and 2.6 x 10(6)/leukapheresis product) and purified ( > 95%) from the peripheral blood of healthy adults. In vitro stimulation of these cells with granulocyte-macrophage colony-stimulating factor (GM-CSF) and tumor necrosis factor (TNF)-alpha led to their vigorous proliferation and differentiation resulting in the emergence of CD45+/CD68+/CD3-/CD19-/CD56- leukocytes some of which (mean: 12%) express CD1a and exhibit anti-CD4 and anti-major histocompatibility complex (MHC) class II reactivity. These CD1a- leukocytes include (1) LC as evidenced by the presence of Birbeck granules (BG), (2) CD14+ monocytes, and (3) Birbeck granule-negative cells with a dendritic morphology. Addition of interleukin (IL)-4 to the cytokine cocktail interfered with the development of monocytes and led to a reduction in the overall yield but, on the other hand, resulted in an increased percentage of CD1a+ cells (mean: 24%) among all cells generated. In vitro generated CD1a+, but not CD1a- HPC-derived cells are potent stimulators of the primary mixed leukocyte reaction and, as such, promising candidates for vaccination purposes.

Adult↗
PubMed1996

Nicotine and prostaglandin E induce secretogranin II levels in bovine chromaffin cells.

The synthesis regulation of secretogranin II was investigated in bovine chromaffin cells by treatment with various first messengers. Nicotine and prostaglandin E2 elevated secretogranin II mRNA and protein up to three-fold. Angiotensin II, atrial natriuretic peptide, apomorphine, bradykinin and clonidine on the other hand had no effect. The prostaglandin E induced elevation of secretogranin II mRNA was transduced via the calcium/calmodulin pathway but not via the protein kinase A or C pathways as shown by using specific inhibitors. Exposure of chromaffin cells to drugs specifically activating second messenger pathways both elevated and decreased secretogranin II mRNA. The calcium channel agonist Bay K, forskolin and phorbol esters increased secretogranin II mRNA whereas 8-Br-cGMP repressed the secretogranin II message. Thus, although secretogranin II expression can be altered by all major second messenger transduction systems, regulation of secretogranin II in vivo occurs mainly via the calcium/calmodulin pathway. Chromogranin A and B mRNA were not changed by any of the first messengers investigated indicating a differential synthesis regulation of components co-stored in bovine chromaffin granules.

Animals↗
PubMed1995

[Systemic fibrosis (generalized form of Ormond's disease). Report of a case which achieved complete remission with cyclophosphamide and corticosteroids].

A 51-year-old engineer was admitted with progressive lower back pain which had started 4 months before. We found an elevated ESR and anemia. Chest X-ray showed bilateral polycyclic thickening of the pleura, and abdominal CT examination revealed a paraaortic tumorous lesion and a solid kidney tumor with a diameter of 5 cm on the left side. During the course of the disease we also observed an infiltration in the apex of the upper lobe of the left lung. Histological examination showed fibrotic tissue typical of Ormond's disease in the kidney tumor as well as in the pulmonary infiltrate. We diagnosed a systemic form of retroperitoneal fibrosis. Treatment with cyclophosphamide (combined with prednisone during the first 4 months) resulted in complete remission of the disease.

Antineoplastic Agents, Alkylating↗
PubMed1995

Postprandial state and atherosclerosis.

Accumulating evidence suggests that triglyceride-rich lipoproteins are an independent risk factor for atherosclerosis. This epidemiological evidence first emerged as a result of studying postprandial lipaemia that characterized the metabolic capacity of triglycerides in the postabsorptive state, that is, under challenge. Studies of postprandial lipaemia were helpful to explain several effects of triglyceride-rich lipoproteins on cholesteryl-ester-rich lipoproteins. From these studies it became apparent that peculiarities of cholesteryl-ester-rich lipoproteins, such as small LDL and small HDL, which have been associated with risk for atherosclerosis, were caused by impaired triglyceride metabolism.

Arteries↗
PubMed1994

Bovine chromaffin cells: studies on the biosynthesis of phospholipids in chromaffin granules.

We have studied the biosynthesis of chromaffin granules by labelling primary cultures of bovine chromaffin cells with either [35S]methionine or various precursors for lipids. After labelling the cells were subjected to subcellular fractionation including density gradient centrifugation. After [35S]methionine significant label (mainly represented by labelled chromogranin A) was found in the soluble proteins of chromaffin granules, whereas the membranes were relatively little labelled. However incorporation into membrane bound dopamine beta-hydroxylase and cytochrome b-561 could be demonstrated. Neither of the used lipid precursors ([3H]glycerol, [3H]choline, [3H]palmitic acid or [3H]arachidonic acid) was incorporated to any significant extent into the soluble components of chromaffin granules. Thus there is no evidence that this secretory compartment contains any lipids or acylated proteins. Incorporation of lipid precursors into the membranes of chromaffin granules was apparently low. After short chases labelled lysolecithin was not present in these organelles. However with prolonged chase times labelled lysolecithin, apparently appeared in chromaffin granules irrespective of whether the cells were stimulated or not. We can conclude that the reusable membranes of chromaffin granules have a very low lipid turnover. Lysolecithin is not transferred into these organelles during biosynthesis but is formed in them during their long life span. This formation of lysolecithin is independent of stimulation of these cells and therefore unlikely to be involved in exocytosis.

Adrenal Medulla↗