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Biomedical subjects

E Klinger

Publications and source records attributed to E Klinger.

At least 19 recordsLinked to original sources
PubMed2005

Virtual reality therapy versus cognitive behavior therapy for social phobia: a preliminary controlled study.

Social phobia is one of the most frequent mental disorders and is accessible to two forms of scientifically validated treatments: anti-depressant drugs and cognitive behavior therapies (CBT). In this last case, graded exposure to feared social situations is one of the fundamental therapeutic ingredients. Virtual reality technologies are an interesting alternative to the standard exposure in social phobia, especially since studies have shown its usefulness for the fear of public speaking. This paper reports a preliminary study in which a virtual reality therapy (VRT), based on exposure to virtual environments, was used to treat social phobia. The sample consisted of 36 participants diagnosed with social phobia assigned to either VRT or a group-CBT (control condition). The virtual environments used in the treatment recreate four situations dealing with social anxiety: performance, intimacy, scrutiny, and assertiveness. With the help of the therapist, the patient learns adapted cognitions and behaviors in order to reduce anxiety in the corresponding real situations. Both treatments lasted 12 weeks, and sessions were delivered according to a treatment manual. Results showed statistically and clinically significant improvement in both conditions. The effect-sizes comparing the efficacy of VRT to the control traditional group-CBT revealed that the differences between the two treatments are trivial.

Adaptation, Psychological↗
PubMed2003

Definition of a VR-based protocol to treat social phobia.

Social phobia is an anxiety disorder that is accessible to two forms of treatment yielding scientifically validated results: drugs and cognitive-behavioral therapies. Graded exposure to feared social situations is fundamental to obtain an improvement of the anxious symptoms. Traditionally, exposure therapies are done either in vivo or by imagining the situations. In vivo exposure is sometimes difficult to control and many patients have some difficulties in using imagination. Virtual reality (VR) seems to bring significant advantages. It allows exposures to numerous and varied situations. This paper reports the definition of a clinical protocol whose purpose is to assess the efficiency of a VR therapy compared to a CBT and to the absence of treatment for social phobic patients. It explains the illness' diagnosis and its usual treatments. It exposes all the architecture of the study, the assessment tools, the content and unfold of the therapy sessions. It finally reports first results of a clinical trial in a between-group design in 10 patients suffering from social phobia. The virtual environments used in the treatment reproduce four situations that social phobics feel the most threatening: performance, intimacy, scrutiny and assertiveness. With the help of the therapist, the patient learns adapted cognitions and behaviors with the aim of reducing her or his anxiety in the corresponding real situations. The novelty of our work is to address a group of situations that the phobic patient is most likely to experience and to treat patients according to a precise protocol.

Adult↗
PubMed2003

The VEPSY UPDATED Project: clinical rationale and technical approach.

More than 10 years ago, Tart (1990) described virtual reality (VR) as a technological model of consciousness offering intriguing possibilities for developing diagnostic, inductive, psychotherapeutic, and training techniques that can extend and supplement current ones. To exploit and understand this potential is the overall goal of the "Telemedicine and Portable Virtual Environment in Clinical Psychology"--VEPSY UPDATED--a European Community-funded research project (IST-2000-25323, www.cybertherapy.info). Particularly, its specific goal is the development of different PC-based virtual reality modules to be used in clinical assessment and treatment of social phobia, panic disorders, male sexual disorders, obesity, and eating disorders. The paper describes the clinical and technical rationale behind the clinical applications developed by the project. Moreover, the paper focuses its analysis on the possible role of VR in clinical psychology and how it can be used for therapeutic change.

Computer Simulation↗
PubMed2002

The VEPSY UPDATED project: technical and clinical rationale.

The emergence of new shared media, such as the Internet and virtual reality are changing the ways in which people relate, communicate, and live. Health care, and in particular clinical psychology, is one of the areas that could be most dramatically reshaped by these new technologies. To exploit and understand this potential is the overall goal of the "Telemedicine and Portable Virtual Environment in Clinical Psychology"--VEPSY UPDATED--an European Community funded research project (IST-2000-25323, http://www.vepsy.com) whose specific goal is the development of different PC based virtual reality modules to be used in clinical assessment and treatment. In particular the developed modules have been using to address the following pathologies: anxiety disorders; male impotence and premature ejaculation; obesity, bulimia and binge-eating disorders. The chapter details the general technical and clinical characteristics of the developed modules.

Diagnosis, Computer-Assisted↗
PubMed1998

The effects of current-concern- and nonconcern-related waking suggestions on nocturnal dream content.

In previous research, presleep suggestions influenced nocturnal dream content. It was hypothesized that suggesting topics associated with participants' current concerns would influence dream content more than suggesting other topics. Ten students spent 4 nights in a sleep laboratory: an adaptation night, a baseline night, and 2 nights under suggestions to dream about a concern-related or other topic. Concern-related suggestions influenced dream content--largely its central imagery--more than did other suggestions, which did not differ from nonsuggestion. Number of transformations within dreams was uncorrelated with dream vividness, contrary to extended activation-synthesis theory. Thus, the concern-related status of suggestions moderates their effectiveness and, inconsistent with extended activation-synthesis theory but consistent with current-concerns and distributed-activation theories, motivational and volitional processes actively influence dream content.

Adolescent↗
PubMed1998

Motivational structure of alcoholic and nonalcoholic Czech men.

This investigation examined the motivational structures of 26 patients diagnosed with alcoholism in comparison to 30 demographically similar technical university students. Responding to the Motivational Structure Questionnaire, the clinical group listed 40% fewer goals, responded as if they needed richer incentives to form strong commitments to goal striving, displayed marginally less average commitment to their goals, and, after other variables were partialled out, expressed less ability to influence the course of goal attainment. There were no differences in their scores on over-all subjective probability of success, the time frame for goal attainment, and their relative scores on anticipated positive and negative emotions and ambivalence. The results suggest group differences in the effects of brain-reward mechanisms.

Adult↗
PubMed1993

The interaction of cytosolic components of neutrophil NADPH oxidase with phosphoinositides.

The superoxide-generating NADPH oxidase of neutrophils can be activated in a cell-free system consisting of cell membranes, cytosol and an activating detergent (e.g. arachidonate or SDS). It has previously been reported [Aviram and Sharabani (1989) Biochem. Biophys. Res. Commun. 161, 712-719] that a mixture of phosphoinositides (PPIs), as well as the individual inositol lipids, interfere with the activation process. In the present study it is shown that exposure of the cytosol to PPI results in a progressive (t1/2 = 30 s) loss of its oxidase-supporting activity and that Mg2+ ions eliminate this inactivation. Neomycin, previously described as an inhibitor of cell-free activation, counteracted the effect of PPI and vice versa. Fractionation experiments implicated the p67-phox cytosolic component of the oxidase in the association with PPI. PPI blocked activity of recombinant p67-phox also and quenched the fluorescence intensity of its tryptophan residues. It is suggested that PPIs may mediate the interaction of the oxidase with the cytoskeleton and/or with the membrane.

Cell Fractionation↗
PubMed1992

Involvement of GTP in cell-free activation of neutrophil NADPH oxidase. Studies with GTP analogues.

Activation of superoxide-producing NADPH oxidase of neutrophils requires the presence of cell membranes, cytosolic components and arachidonate and is markedly enhanced by non-hydrolysable analogues of guanine nucleotides, i.e. guanosine 5'-[gamma-thio]triphosphate and guanosine 5'[beta gamma-imido]triphosphate (p[NH]ppG). Gel filtration and ultrafiltration of the cytosol decreased the basal activity of NADPH oxidase. Activity could be restored by GTP, suggesting participation of the nucleotide in basal activation. Preincubation of neutrophil cytosol with periodate-oxidized p[NH]ppG (ox-p[NH]ppG) followed by gel filtration resulted in a time-dependent enhancement of basal oxidase activity. The presence of GDP or GTP, but not ATP, during the incubation with ox-p[NH]ppG abolished this enhancement. These data are consistent with a stable association of ox-p[NH]ppG with an oxidase-linked cytosolic protein. SDS/PAGE of neutrophil cytosol preincubated with [3H]ox-p[NH]ppG revealed radioactivity in bands migrating as 100, 70, 47, 34 and 22 kDa proteins. Evidence for covalent labelling of the cytosolic protein p47-phox with [3H]ox-p[NH]ppG is presented. Heterogeneity of cytosolic GTP-binding sites and possible participation of protein p47-phox in functional interaction with GTP analogues during cell-free activation are suggested.

Blotting, Western↗
PubMed1992

Solubilization, purification, and characterization of a truncated form of rat hepatic squalene synthetase.

Rat hepatic microsomal squalene synthetase (EC 2.5.1.21) was induced 25-fold by feeding rats with diet containing the hydroxymethylglutaryl-coenzyme A reductase inhibitor, fluvastatin, and cholestyramine, a bile acid sequestrant. A soluble squalene synthetase protein with an estimated mass of 32-35 kDa, as determined by gel filtration chromatography on Sephacryl S-200 column, was solubilized out of the microsomes by controlled proteolysis with trypsin. Approximately 25% of the activity was recovered in a soluble form. The enzyme was purified to homogeneity utilizing a series of column chromatography purification steps on DEAE-cellulose, hydroxylapatite, and phenyl-Sepharose sequentially. The purified enzyme showed a single band on sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Initial kinetic analysis indicated an S0.5 values for trans-farnesyl diphosphate of 1.0 microM and for NADPH of 40 microM. The Vmax with respect to trans-farnesyl diphosphate was calculated at 1.2 mumol/min/mg. NADH also serves as substrate for the reaction with S0.5 value of 800 microM. Western blot analysis utilizing rabbit antisera raised against the purified, trypsin-truncated enzyme showed a single band for the isolated solubilized enzyme at 32-33 kDa and a band for the intact microsomal enzyme at about 45-47 kDa.

Animals↗
PubMed1991

Dialdehyde-GDP blocks activity of cytosolic components of neutrophil NADPH oxidase.

Superoxide production by neutrophil NADPH oxidase activated in a cell-free system consisting of plasma membranes, cytosol and arachidonate is enhanced by nonhydrolyzable analogs of GTP and reduced by GDP. To characterize the interaction of guanine nucleotides with the system, dialdehyde analogs of GTP and GDP (oGTP and oGDP) were employed. oGDP or oGTP caused an irreversible and dose dependent inactivation of NADPH oxidase-supporting cytosolic activity. Cytosol was fractionated on S and Q Sepharose ion exchange columns into three fractions, combinations of which synergistically supported activation of NADPH oxidase. Two fractions shown by immunoblotting to contain the oxidase-linked p47 and p67 proteins were inactivated by oGDP. Labeling with [alpha-32P]-oGTP lead to incorporation of the label into several proteins.

Chromatography, Ion Exchange↗
PubMed1991

[Castability and accuracy of fit of a titanium casting system].

The titanium casting system Cyclarc (Morita) was examined for its suitability for the fabrication of dense, fitting restorations. The investment material Titavest CB exhibited no setting expansion. Instead, thermal expansion, highly dependent on the liquid/power ratio and the temperature during preheating, was observed. The castability of unalloyed titanium is fully acceptable for the fabrication of prosthetic restorations. Single crowns showed a high accuracy of fit, if an optimal liquid/power ratio was used for investment.

Crowns↗
PubMed1989

Inactivation and activation of various membranal enzymes of the cholesterol biosynthetic pathway by digitonin.

The activity of rat liver microsomal squalene epoxidase is inhibited effectively by digitonin. Concentrations of 0.8 to 1.2 mg/ml of digitonin cause total inhibition of microsomal (0.75 mg protein/ml) squalene epoxidase either in microsomes that were pretreated with digitonin and subsequently washed and subjected to epoxidase assay or when digitonin was added directly to the assay. The inhibition of squalene epoxidase by digitonin is concentration-dependent and takes place rapidly within 5 min of exposure of the microsomes to digitonin. Octylglucoside, dimethylsulfoxide, CHAPS, as well as cholesterol or total microsomal lipid extract were ineffective in restoring the digitonin-inhibited squalene epoxidase activity. Epoxidase activity in digitonin-treated microsomes was fully restored by Triton X-100. The reactivation by Triton X-100 displays a concentration optimum with maximal reactivation of the epoxidase (0.7 mg protein/ml) occurring at 0.2% Triton X-100. Microsomal 2,3-oxidosqualene-lanosterol cyclase is also inhibited by digitonin. Higher concentrations of digitonin are required to obtain full inhibition of the cyclase activity and only 40% inhibition of cyclase activity is observed at 1 mg/ml of digitonin. Solubilized (subunit size 55 to 66 kDa) and microsomal (subunit size 97 kDa) 3-hydroxy-3-methylglutaryl CoA reductase are totally unaffected by the same concentration of digitonin. Squalene synthetase, another microsomal enzyme in the biosynthetic pathway of cholesterol, is activated by digitonin. A 2.2-fold activation of squalene synthetase is observed at 0.8 mg/ml of digitonin. The results agree with a model in which squalene, and to a lesser degree 2,3-oxidosqualene, are segregated by digitonin into separate intramembranal pools.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1986

Motivational predictors of alcoholics' responses to inpatient treatment.

Motivational patterns of 60 alcoholic inpatients were assessed by use of the Interview Questionnaire (IntQ) and were related to staff judgments regarding patients' success or failure in completing an inpatient treatment program. The IntQ was administered soon after intake, one month later, and at the end of treatment. It elicits patients' idiographic accounts of their current concerns and patients' nomothetic ratings of them on variables related to commitment, active participation in goal striving, and goal valence, value, expectancy, and imminence. Structural variables demonstrated significant stability over the first two IntQ administrations, whereas goal content and affect variables did not. Stepwise discriminant analysis of treatment outcome as well as correlational analyses indicated that successful outcomes were significantly related to smaller size of community, concerns appetitive to treatment, lack of concerns about avoiding alcohol, and expecting goal attainments to occur sooner. Goal orientations toward treatment and alcohol were related to other variables in ways consistent with the view that recovery from alcohol is associated with having emotionally positive alternative goals.

Adult↗
PubMed1985

Plasma ferritin in old age. Influence of biological and pathological factors in a large elderly population.

The effects of biological (age, sex, weight) and pathological factors on plasma ferritin concentrations were documented in 776 unselected elderly patients aged 80.9 +/- 9.7 yr. A marked shift towards high values (159 +/- 142 micrograms/l) was observed in this elderly population together with the persistence of the well-known sex-related difference in ferritin levels (higher levels in men). Twenty-five percent of the population had high levels of ferritin (greater than or equal to 220 micrograms/l) but 75% of these high values (i.e. 18.5% of the population) could be readily explained by their known association with a particular pathology (inflammatory syndrome, renal failure, cardiovascular diseases, alcoholism). Only 6% of the population had unexplained high ferritin concentrations. Therefore, our data strongly suggest that the repeatedly reported increase of ferritin in the aged population is merely related to an age-associated pathology and may not be a normal physiological event occurring during the process of aging.

Aged↗
PubMed1985

Biological and pathological factors affecting plasma gamma-glutamyl transpeptidase and alkaline phosphatase activity in the elderly.

A high percentage of abnormally elevated plasma alkaline phosphatase (AP) and gamma-glutamyltranspeptidase (GGT) was found in a homogeneous population of 741 elderly subjects. The respective role of pathological and biological factors (age, sex, weight) upon the two plasma enzymatic activities has been analyzed. In disagreement with previous reports, it was observed that abnormal AP and GGT values could be readily explained by their association with specific diseases. The apparent relationship between abnormal levels of plasma AP and GGT activities and age, sex or weight reflected merely a different distribution of the pathology according to these biological parameters. In the absence of non-specific elevations of plasma AP and GGT activities with age, the usual reference values for these tests, although established on younger populations, still apply to the aged.

Age Factors↗
PubMed1985

Age- and sex-associated modification of plasma melatonin concentrations in man. Relationship to pathology, malignant or not, and autopsy findings.

Plasma melatonin concentrations were determined in 757 unselected elderly patients aged 80.9 +/- 9.7 years. The daytime (8-9.30 h) plasma levels of melatonin were in the so-called normal range in only one third of the population whereas 65% of the subjects had abnormal levels of the hormone, most often decreased i.e. less than 0.17 nmol/l (53%) and sometimes increased i.e. 0.43 nmol/l or higher (12%). A control group of healthy elderly subjects showed the same distribution as the entire population. A sex-difference with significantly higher levels of plasma melatonin in elderly women was observed. With respect to pathology and autopsy findings high levels of the hormone correlated with cancer, chronic renal failure, cardiovascular disease, biological inflammatory syndrome and diabetes. Low levels correlated with neurologic disease, tobacco or alcohol addiction. However, some of these relations were found to be sex-related as they were observed in women but not in men. Our data indicate that pineal function seems to be often altered in elderly human subjects and suggest potential diagnostic applications of melatonin determination.

Age Factors↗