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Biomedical subjects

C Haag

Publications and source records attributed to C Haag.

35 records · Page 2Linked to original sources

Prophylaxis of fungal infections.

Considering the high morbidity and mortality of deep-seated opportunistic mycoses in severely immunosuppressed patients, strategies for prophylaxis appear to be indicated. Exposure to Aspergillus spp. can be prevented by air filtration which has been shown to reduce the rate of infection. However, Candida infections are predominantly caused by colonizing fungi; therefore drug prophylaxis is more promising. Prospective randomized studies proved the effectiveness of fluconazole (FLU) to prevent infections in patients after bone marrow transplantation.

Antifungal Agents↗

[Clinical and radiologic results of surgically treated patellar dislocation].

In this retrospective study 72 patients were followed up clinically and radiologically after surgical treatment for dislocation of the patella. The period of observation varied between 13 and 76 months, with an average of 32 months. Acute traumatic dislocation of the patella was only rarely encountered (n = 6 [8%]). Primary dislocation occurred most frequently during the second and third decades of life. Chondral and osteochondral fractures were fairly frequent (n = 24 [33%]). Additional injuries involved the anterior cruciate ligament, the medial collateral ligament and the menisci. At clinical examination 32 patients (44%) could be assessed as "very good" and "good" (classification of Larsen and Lauridsen). Redislocation occurred in 12 patients (16.7%). The radiological condition of the patella and that of the trochlea femoris were assessed in terms of the classification of Wiberg and Baumgartl and of Hepp, respectively. The condylar-joint angle (Brattström) and the condylar depth index (Ficat and Bizou) were also evaluated.

Adolescent↗

Quantitative EEG analysis during motor function and music perception in Tourette's syndrome.

Gilles de la Tourette's syndrome (TS) is a neurobehavioral disorder of childhood onset that is characterized by motor and vocal tics and associated behavioral disturbances including obsessive-compulsive symptoms. We performed 30 channel quantitative electroencephalograms (EEGs) on 13 Tourette patients and 26 controls and studied both resting and manumotor/music perception activation conditions. Resting EEGs did not show any differences between patients and controls, as known from the literature. However, during simple and complex hand movements, as well as music perception tasks, there were subtle differences predominantly in alpha frequency. They suggested reduced brain activation during motor tasks in frontal and central regions, and on music perception in temporal and parietal regions, respectively. These findings may add evidence to the functional neuroanatomy of Tourette syndrome, affecting more areas than disturbed motor circuits.

Adolescent↗

Lateralization of the Bereitschaftspotential to the left hemisphere in patients with major depression.

Fourteen patients with major depression and 18 healthy subjects performed a Bereitschaftspotential (BP) paradigm, which required them to clench the right fist at self-paced intervals. The BP was calculated as the integrated negative amplitude from BP onset to movement onset. The latter was defined by recording the electromyogram (EMG) from the right forearm. To evaluate lateralization, the integrated BPs at C3, C4, P3, and P4 were analyzed. In depressives, a significant asymmetry of the BP to the left was found, whereas in normals the BP was nearly symmetrically distributed around the midline. Three patients were retested when clinically improved. At that time the asymmetry to the left hemisphere had nearly vanished. This asymmetry to the left hemisphere is interpreted as a cortical deactivation of the right cerebral hemisphere and seems to be a state marker of depression.

Adolescent↗

[Angiography detection and embolization of a hemodynamically significant hemorrhage from the right dorsal penile artery in symphysis rupture].

Pelvic fractures are frequently complicated by concomitant vascular lacerations involving, particularly, branches originating from the internal iliac arteries. Massive hemorrhage may be difficult to be treated surgically. In such cases interventional radiology can be helpful and able to treat definitely extensive hemorrhage caused by pelvic trauma.

Adult↗

Profiles of spontaneous 24-hour and stimulated growth hormone secretion in male patients with endogenous depression.

Abnormalities of both the spontaneous and the stimulated release of growth hormone (GH) have been described in patients with endogenous depression. In this study, six unmedicated male patients with endogenous depression (ICD 296.1/3) were compared with six age-matched healthy men. Levels of GH were determined at 15-minute intervals over 26 hours. A combined releasing hormone test was performed during the last 2 hours of blood sampling. The 24-hour profile of GH secretion was significantly lower in the depressed patients than in the healthy control subjects due to a significantly diminished sleep-related GH secretion. GH stimulation following releasing hormones was lower in the depressed patients than in healthy subjects. Hypersecretion of GH before the stimulation test might therefore not explain the blunted GH response to stimulation that has been observed in depressive patients.

Adult↗

Dependency of growth hormone (GH) stimulation following releasing hormones on the spontaneous 24-hour GH secretion in healthy male and female subjects.

The purpose of this investigation was to evaluate whether in healthy subjects the GH response following stimulation with releasing hormones is dependent on the spontaneous GH secretion within 24 hr prior to the stimulation test. In 18 male and 9 female healthy subjects (21-59 years) GH was measured every 15 min over 26 hr. Twenty-four hours after the beginning of blood sampling, a GH stimulation test was performed by using a combined releasing hormone test. Sleep was recorded in three consecutive nights. A positive correlation was found between the AUCs of the 24-hr GH secretion and the AUCs of GH stimulation, which could not be explained by an age effect only. This study demonstrates that subjects with comparatively high amounts of GH secreted within 24 hr also show good GH secretory responses when immediately after the 24-hr sampling period a stimulation test is undertaken. Therefore, a low GH response to stimulation cannot be explained by feedback effects of high GH amounts secreted during the 24 hr before the test or by empty pituitary GH storages.

Adult↗

Findings of electroencephalographic brain mapping in mild to moderate dementia of the Alzheimer type during resting, motor, and music-perception conditions.

Sixteen-channel electroencephalographic (EEG) brain mapping studies were carried out under resting conditions in 41 patients with mild to moderate dementia of the Alzheimer type, diagnosed according to DSM-III-R criteria. The patients showed diffuse patterns of EEG slowing, as known from the literature. They showed increases of theta power in large bilateral brain areas and bitemporal increases of delta power as compared with both age-matched and younger control subjects. In addition, the patients had increased beta activity in comparison with the younger control group, but not with the age-matched control subjects. Functional brain mapping revealed decreases of EEG power during manual-motor and music-perception tasks in delta frequencies for patients, which was not seen in either of the two control groups. All frequency bands revealed major gender-related differences in EEG activity, which should receive more attention in future research.

Aged↗

EEG mapping investigations of psychomotor and music perception brain dysfunction in untreated schizophrenic patients.

Twenty-six untreated schizophrenic inpatients and 34 control persons were investigated using 16-channel EEG mapping during resting, manumotor and music perception tasks. Power values of activation tasks were each referenced to a separate, immediately preceding resting condition, using conventional delta, theta, alpha and 2 beta frequency bands. Results in delta and alpha bands, which maximally separated the two groups, are reported only for space reasons. Results indicated a "nonreactivity" (in all frequency bands) on the two activation paradigms in schizophrenic patients as a group. Major gender effects were obtained in normal persons, but not signs of nonreactivity comparable to patients. Subdividing patients exclusively by means of their EEG changes on activation produced meaningful clinical subgroups of "positive/negative" schizophrenics. This latter finding could contribute towards clinical utility of EEG mapping in psychiatry.

Adult↗

Psychomotor disturbances in psychiatric patients as a possible basis for new attempts at differential diagnosis and therapy. V. Evaluation of psychomotor training programs in depressed patients.

Parts I-III of this series used psychometric assessment of motor performance in psychiatric patients and indicated a "psychotic-motor syndrome" (PMS) in schizophrenic and affective psychoses, which was not found in "neurotic"/reactive or healthy persons. Part IV yielded signs of concomitant brain dysfunction in these patients, demonstrated by EEG mapping as well as other (SPECT/PET) neuroimaging methods. Apart from this "basic science" interest into the pathophysiology of endogenous psychoses we engaged in the development of motor training programs using the PMS as "target" syndrome. We hypothesized, that motor training would not only improve disturbed motor behaviour, but ameliorate other symptoms of psychopathology also. These assumptions were supported in the first two independent studies involving n = 45 and n = 31 ICD-9 mono- and/or bipolar endogenous depressed patients, respectively (the studies on schizophrenic patients being reported finally as part VI of this series, along with the final version of our modified motor test battery). Examples of the motor training programs are provided in this paper, although the final version of the complete programs will be published separately for space reasons and for better availability for routine clinical use.

Adult↗

[Adult form of metachromatic leukodystrophy with predominantly psychotic manifestations].

This is a report of one of the few cases of an adult form of metachromatic leukodystrophy with almost exclusively psychiatric symptoms. This should point out the importance of a careful organic diagnostic assessment in all patients with the first manifestation of a psychiatric disease. In this case an investigation of the patient's family confirmed the heterozygote genetic origin of the disease.

Adult↗

On the distribution of REM and NREM sleep under two benzodiazepines with comparable receptor affinity but different kinetic properties.

Two clinical-pharmacological investigations were performed to give a retrospective and explorative record, based on electroencephalographic parameters, of spindle density and REM distribution in the first and second halves of the night under a short-acting (triazolam) and medium-acting (lormetazepam) benzodiazepine. A further aim was to determine whether a suitable dose of a short-acting benzodiazepine could lead to a REM suppression in the first sleep cycles and a REM compensation in later sleep cycles on the same night. Since sleep spindles are increased and rapid eye movements reduced under benzodiazepines, the two phenomena were respectively taken as indicators of drug effects on NREM and REM sleep. According to the receptor affinity of the two substances, dosages of triazolam and lormetazepam ought to be equieffective in a ratio of about 1:2. Yet clinical experience has shown that a ratio of 1:4 (0.5 mg triazolam vs. 2 mg lormetazepam) gives the doses that are equieffective and which are widely used in clinical practice. The changes in the number of sleep spindles and rapid eye movements documented the different kinetic properties of the two substances. Even after clinically equieffective doses, the changes in the parameters were less marked under lormetazepam than under triazolam. This suggests that the two benzodiazepines different effects on spindle and REM distribution were not attributable to their kinetics, but that pharmacodynamic aspects must also be considered, even if this does not fit in with the prevalent picture of the benzodiazepines mechanisms of action.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Therapy of peritoneal carcinosis with intraperitoneal administration of cis-diamminedichloroplatinum and systemic sodium thiosulfate protection. Clinical results of a pilot study and pharmacokinetics].

Six patients with peritoneal carcinosis and ascites received 13 courses of ip cis-platinum (c-DDP). C-DDP (170-250 mg in 2L saline, dwell 4 h) was administered via Pig-Tail-Cordis catheter with concurrent infusion of sodium thiosulfate (bolus 7.5 g/m2 followed by 2.13 g/m2/h for 12 h). The patients received pre- and post-therapy hydration (250 ml/h) and mannitol-induced diuresis. Courses were given in 4 weekly intervals. With a dwell time of 4 h 27.0% +/- 14.6% (mean +/- SD) of platinum were recovered. Total serum platinum peaked at 3.1 +/- 1.0 microgram/ml. The peritoneal/serum ratio of platinum concentration was 49.5 +/- 12.6 after 1 h, 7.4 +/- 1.7 after 5 h and 4.2 +/- 1.7 after 12 h. Within 12 h 30.9% +/- 10.0% of the administered dose were excreted in urine. In 4 patients the ascites had disappeared lasting 14+, 15+, 5+, 3+ months. 2 patients died within 1 month caused by systemic tumor progression. Following toxicity was observed: 9/13 nausea and vomiting grade 1 (WHO), 2/13 hematological toxicity grade 2, 1/13 sterile peritonitis, no renal or neurological toxicity. This pilot study demonstrates a pharmacokinetic advantage of ip chemotherapy with c-DDP and an effectiveness against peritoneal carcinosis.

Adenocarcinoma↗

Interstitial deletion of the long arm of chromosome no. 7 (7q-) in an infant with multiple anomalies.

An infant is reported with partial deletion of the long arm of chromosome no. 7. She presented with hypertonia, seizures, feeding difficulty, and multiple congenital anomalies. The abnormalities include low-set dysplastic ears, hypoplastic orbital bones, upslanting and small palpebral fissures, prominent cheeks with a relatively large mouth, micrognathia, abnormal creases of the hands and a congenital heart defect. With age her hypotonia and feeding difficulty have improved. Her mother has no detectable chromosome abnormality.

Abnormalities, Multiple↗