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Biomedical subjects

F Resch

Publications and source records attributed to F Resch.

At least 19 recordsLinked to original sources

[Side effects of clozapine in therapy of psychotic disorders in adolescents. A retrospective clinical study].

A retrospective study was conducted of 53 consecutive inpatients (through 1990) with psychotic disorders. The patients were between 13 and 18 years of age. In all cases this was the first time they had been treated with clozapine. The adverse effects seen under clozapine are discussed. During the use of clozapine assessments were made of liver enzymes, leukocytes, blood pressure and body temperature. There was an increase in liver enzyme values in 37.7% of the patients, leukopenia under 4000/mm3 in 15.1%, an increase in body temperature in 3.8% and bradycardia together with hypotensive dysregulation in 1.9%.

Adolescent

[Ruptured abdominal aortic aneurysm with aortocaval fistula].

Aortocaval fistula is an uncommon complication of ruptured abdominal aortic aneurysm and is only seen in 4% of all ruptured aneurysms. The symptoms may vary from one patient to another but the characteristic physical findings are high output heart failure, widened pulse pressure with low diastolic blood pressure and venous hypertension. When these signs are combined with an abdominal aortic aneurysm and a continuous abdominal bruit, the diagnosis of aortocaval fistula must be seriously considered. It is important to diagnose the fistula before surgical intervention, so as to prevent intraoperative bleeding and complications. In our surgical department we have operated 103 ruptured abdominal aortic aneurysms but only one with an aortocaval fistula. This case is discussed in the light of the literature on the subject.

Aorta, Abdominal

[Developmental psychological aspects of schizophrenic thinking].

Based on a phenomenological analysis of psychotic interpretation of the world concretism is supposed to represent an important mechanism of schizophrenic thinking: Schizophrenic concretism is the result of an ontological regression of cognitive functioning onto the archaic level of actional representation. Following Jean Piaget's theories about the children's constructions of reality a hypothesis about the structure of psychotic interpretations of the world is being proposed: In psychotic thinking the knowledge about the world is structured in an adualistic way which is characterized by an alloy of significance and notion, inner and outer world, physis and psyche. The structural similarity of psychotic thinking and thinking in early developmental stages is illustrated concretely on the basis of examples. Fundamental differences between childish and schizophrenic ways of interpreting the world will be presented, showing the specificity of cognitive representation in schizophrenic thinking.

Defense Mechanisms

Psychophysiological research in psychiatry and neuropsychopharmacology. I. Methodological aspects of the Viennese Psychophysiological Test-System (VPTS).

In order to find a psychophysiological paradigm for clinical application we have developed the Viennese Psychophysiological Test-System (VPTS), which includes a special selection and combination of experimental situations, physiological measurements, behavioral measurements and data analysis. This study presents detailed information concerning these four aspects. Experimental situations are related to the human model of information processing, where short changes of stimulus-reaction-correlated processes are selected: resting conditions (eyes open, eyes closed), habituation-orienting test, psychomotor-performance test, signal-detection test and reaction-time test. Physiological measures include central and peripheral activity of the cerebrospinal and autonomic nervous system: cortical activity (spontaneous electroencephalogram, auditory evoked potentials, late positive components, slow potentials), ocular activity (eye and eyelid movements), electrodermal activity (skin conductance), cardiac activity (heart rate measurement), respiratory activity (rate of respiration) and peripheral vascular activity (finger pulse volume). Behavioral measurements extend from micro behavior to complex diagnostic systems: psychomotor measurements, self-reported mood, arousal and visceral perception, psychological and psychiatric interviews. The application of this test system in 15 elderly subjects of both sexes aged 58-77 years gives information which exceeds the sum of the singular constructing elements of the VPTS.

Electrocardiography

Psychophysiological research in psychiatry and neuropsychopharmacology. II. The investigation of antihypoxidotic/nootropic drugs (tenilsetam and co-dergocrine-mesylate) in elderlies with the Viennese Psychophysiological Test-System (VPTS).

In a double-blind placebo-controlled study, the effects of tenilsetam, a novel antihypoxidotic/nootropic agent, on spontaneous and event-related activity of the central and autonomous nervous system were studied in 15 elderly subjects of both sexes aged 58-77 years by means of the Viennese Psychophysiological Test-System (VPTS). The VPTS includes a special selection and combination of experimental situations, physiological measurements, behavioral measurements and data analysis. At weekly intervals, the subjects received randomized single oral doses of placebo, 150 mg, 300 mg and 900 mg tenilsetam (TEN) and 5 mg co-dergocrine-mesylate (CDM) as reference drug. Psychophysiological testings were carried out before and 2 h after drug administration. Evaluation of the spontaneous EEG-activity demonstrated no significant drug effects as compared to placebo. In contrast, TEN showed a dose-dependent augmentation of the N1-P2 and N2-P300 amplitudes of the event-related potentials (ERPs) in specific experimental conditions. In reference to placebo, the increase of N2-P300 amplitude after the highest dosage of TEN, as well as after CDM, amounted to approximately 5 microV, which confirms the hypothesis that nootropic drugs may influence the P300 amplitude in the sense of an improved availability of cognitive processing resources. There was no effect on ERP latencies, on mean amplitudes of contingent negative variation and of post-imperative negative variation, on autonomous nervous system, on psychological measurements, nor on reaction time. However, specific improvements were observed in psychomotor measures, such as synchronization accuracy and rhythmicity. These findings highlight the importance of using EEG and ERP measures in different experimental situations in conjunction with behavioral, psychological and autonomous nervous system measures to study nootropic drug effects.

Aged

[Suicide in schizophrenic patients].

Based on retrospective investigation using hospital records of 44 schizophrenic patients of a rehabilitation department, who committed suicide between 1966 and 1986, the paper discusses demographic and psychological features of schizophrenic suicide in comparison with international literature. Subjects who committed suicide were found to be accumulated within age-range 25 to 30 years and between one or two years of duration of illness. 20% of subjects died in an acute psychotic state, 58% had been found within a depressive episode and 66% had confronted themselves with their social situation and/or future in the light of their illness.

Adolescent

[The function of lytic effector cells in schizophrenic patients].

The present study aimed at elucidating lytic effector cell function in 32 schizophrenic patients and comparing the results with data obtained in 27 normal probands. Natural killer cell (NK) activity and antibody dependent cellular cytotoxicity (ADCC) were tested. Schizophrenics did not differ from normal controls in either test system. Within the schizophrenic group, higher NK activity was detected in patients with neuroleptic monotherapy (p less than 0.05). Patients given a combination of neuroleptics, antidepressants and/or lithium did not differ from drug-free patients in either test system. There was no influence of psychopathological variables on lytic effector cell function.

Adult

Lytic effector cell function in schizophrenia and depression.

Natural killer (NK) cell activity and antibody-dependent cellular cytotoxicity (ADCC) were tested in patients with schizophrenia or depression. It was found that NK activity as well as ADCC were significantly lower in both groups, as compared to healthy control individuals (P less than 0.001). Psychopharmacologic treatment with neuroleptics and antidepressives resulted in a significant increase in NK activity and ADCC (P less than 0.005) in patients with schizophrenia but not in treated patients with depression. In patients with schizophrenia, no correlation could be established between the dose of neuroleptic given and the increase in NK activity. Lithium also did not produce an increase in NK activity and ADCC. The addition of serum, derived from untreated patients with schizophrenia, to cell cultures in concentrations of 10 and 20% had an inhibitory effect upon the ADCC and, to a lesser degree, upon NK activity (20% serum concentration only); sera from treatment schizophrenics produced no inhibition of NK activity, but did affect ADCC. No serum-derived inhibitory effect upon either NK activity or ADCC was found to be present in sera from patients with depression. We conclude that lytic effector mechanisms are impaired in patients with schizophrenia or depression and that this defect is reversed in schizophrenic patients on treatment, but not in depressives on therapy. Patients with schizophrenia also tend to have a reversible serum-mediated inhibition of NK activity which is absent in patients with depression.

Adult

Plasma concentrations of haloperidol and prolactin and clinical outcome in acutely psychotic patients.

This study was aimed at disclosing possible relationships between short term therapeutic outcome and certain ranges in plasma concentrations of haloperidol and of prolactin. Acutely psychotic patients (n = 28) were diagnosed (by RDC) as schizophrenics acute subtype (n = 17), schizoaffectives manic type, acute subtype (n = 8) and manics (n = 3). Parenteral haloperidol was the pharmacological treatment mostly given; the dose was kept constant intraindividually but varied between patients from 5 to 40 mg/d (median 15 mg/d). Data for statistical analyses of possible psychobiological relationships were analyzed at 12 days (median) of haloperidol regimen, that is at a relatively early cut-off in treatment. Keeping the methodological difficulties in mind, certain ranges in plasma concentrations of haloperidol (16-26.9 mg/ml; (Fig. 1) and of prolactin (64-159.9 mg/ml; (Fig. 2) were found to be associated-statistically independently-with a favourable therapeutic outcome. The rate of recovery was best if a patient came to lie with both plasma levels within these therapeutic ranges (Fig. 3). It is concluded that the combination of pharmacological and neuroendocrinological techniques in psychiatric research may be of substantial use for clinical purposes.

Acute Disease

Functional alpha-adrenoceptors in human atrial preparations in the presence of beta-receptor blockade.

Inotropic effects via cardiac alpha-adrenoceptors were studied in electrically driven auricular strips (1 Hz, 37 degrees C) from patients treated with beta-blockers for months prior to open heart surgery. Marked alpha-mediated positive inotropic effects were demonstrated with adrenaline (A), noradrenaline (NA) and phenylephrine (PHE) in the presence of beta-blocker and with blockers of the muscarinic receptor and of the neuronal and extraneuronal uptake mechanisms for the catecholamines. In the presence of approximately 10(-6) M propranolol the maximal effects as well as the potencies (pD2-values) for A and NA were not significantly different while higher than for PHE. The alpha 1-blocker, prazosin (10(-6) M), markedly reduced the pD2-values but not the intrinsic activities (alpha-values) for A, NA and PHE in the beta-blocked preparations. Methoxamine, however, induced negative inotropic responses at normal and low frequencies (1, 0.5 and 0.1 Hz) of stimulation, suggestive of non-specific, cardiodepressant effects. Other agonists with alpha-effects in other types of tissue (oxymethazoline, xylomethazoline and clonidine) were without effects on the force and velocity of contraction in the auricular strips under the present experimental conditions. The results show alpha 1-type of adrenoceptor-induced inotropic effects for A, NA and PHE during beta-blockade in human auricular strips, indicating that cardiac alpha 1-receptors may have clinical importance by increasing the inotropy of the human myocardium treated with beta-blocking agents.

Adrenergic alpha-Agonists

[Comparative studies of the effect of a cardioselective and a noncardioselective beta-blocker on peripheral circulation in patients with arterial occlusive disease].

The effect of celiprolol at a daily dosage of 300 mg (19 patients) was compared with that of propranolol at a daily dosage of 120 mg (14 patients) on peripheral blood flow of the calf and foot in a randomized double-blind trial. Altogether 33 patients (47 extremities) suffering from arterial occlusive disease (stage II according to Fontaine) and hypertension, were treated for 25 days. Blood flow was measured by strain-gauge plethysmography. Celiprolol led to a small, insignificant increase in resting blood flow of the muscle. Propranolol produced a small decrease in resting blood flow of the muscle, and a significant fall in resting blood flow of the skin of the foot. At the completion of treatment with celiprolol there was a small increase in the initial value of reactive hyperaemia of the calf. Propranolol led to a decrease in the initial, and in the maximum values of reactive hyperaemia of the calf and foot. Celiprolol and propranolol led to a comparable decrease in resting blood pressure.

Aged

Response of thyrotropin to thyrotropin-releasing hormone as predictor of treatment outcome. Prediction of recovery and relapse in treatment with antidepressants and neuroleptics.

We determined whether the response of thyrotropin (TSH) to thyrotropin-releasing hormone could predict the outcome of treatment with antidepressant and neuroleptic drugs. We studied 114 female patients diagnosed as having major and minor depressive, manic, schizoaffective, and schizophrenic disorders. A blunted TSH response (less than 5 microU/mL [less than 5 mU/L]) at admission was associated with recovery after nine weeks of inpatient treatment using clomipramine hydrochloride for depression and haloperidol for psychosis. A blunted TSH response at discharge was associated with early relapse in depressives receiving clomipramine maintenance therapy. Our findings support the notion that the thyrotropin-releasing hormone test is a "state" marker that may be of use in predicting the outcome of treatment with antidepressant and neuroleptic drugs.

Adolescent

[Comparison of the bioavailability of two diazepam preparations. Clinical comparison between a new commercial preparation and a standard preparation after oral and intramuscular administration].

The following pharmacokinetic study was aimed at a comparison of the bioavailability of two different preparations of diazepam (Gewacalm and a further wellknown formulation). 40 healthy volunteers were subjected to a cross-over design in which plasma levels of diazepam were assayed after oral and intramuscular application of 10 mg of a preparation. In the comparison (N = 30) of oral bioavailability (rate and completeness of enteral absorption) no statistical difference between both preparations was observed. In the study of intramuscular bioavailability (N = 10), a trend of quicker and more complete resorption of Gewacalm was of statistical significance (p less than 0.05), however, because of the small number of subjects tested in the intramuscular study a replication study is advisable.

Administration, Oral

Functional beta 1- and beta 2-adrenoceptors in the human myocardium.

Functional beta-adrenoceptor populations in the human heart were studied in vitro in electrically-paced strips of the right auricular and ventricular myocardium. The relative potency of selected agonists in producing inotropic responses (Tmax, T'max) in the presence of blockers for neuronal and extraneuronal uptakes was found to be as follows: isoprenaline greater than noradrenaline = adrenaline = salbutamol greater than dobutamine. Prenalterol had a negative inotropic effect in these preparations. The selective beta 1-(practolol) and beta 2-(H 35/25) blockers reduced inotropic responses to adrenaline (Tmax, T'max) and noradrenaline (T'max) in the auricular strips. These results indicate the participation of beta 2-adrenoceptors in inotropic responses in the human auricular and ventricular myocardium. For comparison, inotropic responses of electrically-paced rat myocardium to beta-adrenergic agonists in the presence of blockers for neuronal and extraneuronal uptakes were likewise studied. The relative potencies for Tmax were: noradrenaline = adrenaline greater than prenalterol greater than dobutamine = salbutamol. Given the high relative potency of salbutamol in the human myocardial strips (analogous to that previous shown in the beta 2-dominated atria of the frog and trout) and the low relative potency of salbutamol in the rat tissue, these findings indicate a greater population of functionally active beta 2-adrenoceptors in the human than in the rat myocardium.

Adrenergic beta-Agonists

In vivo haemodynamic evaluation of the Hall-Kaster central flow prosthetic heart valve.

The first in vivo haemodynamic observations of the recently developed Hall-Kaster central flow prosthetic heart valve are reported. Haemodynamic evaluation of valve function was performed both in acute and chronic experiments following implantation of the Hall-Kaster prosthesis in the mitral position in dogs. These studies showed a low transvalvular pressure gradient, an effective opening angle of about 70 degrees and good diastolic flow through both the large and small orifices of the prosthesis. A slow rotational movement was depicted by the disc during opening and closure.

Animals