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Biomedical subjects

H Becker

Publications and source records attributed to H Becker.

At least 37 records · Page 2Linked to original sources
PubMed1992

[Circulating CD8 as an indicator of inflammatory rheumatic disease].

An enzyme-linked immunoassay detecting soluble CD8 (s-CD8) was applied to study activation of CD8(+)-(suppressor/cytotoxic) T-cells in patients with rheumatic diseases. Compared with normals, s-CD8 levels were elevated in patients with rheumatoid arthritis, ankylosing spondylitis, and polymyositis. In contrast, low s-CD8 values were observed in patients with progressive systemic sclerosis/scleroderma. In systemic lupus erythematosus (SLE), s-CD8 values were correlated with C-reactive protein. This finding and an association with other parameters of clinical activity were confirmed by longitudinal studies. In summary, our findings support the view that implication of CD8(+)-T-cell activation is different in the pathogenesis of each rheumatic disease. Elevated s-CD8 indicates active disease, and can be used to monitor CD8(+)-T-cell activation in SLE while determination of s-CD8 seems to be of little clinical value in the other rheumatic diseases studied.

Adult↗
PubMed1991

Neurovascular compression and essential hypertension. An angiographic study.

The pathogenesis of essential hypertension still remains unclear. Recently, it has been supposed, that an arterial compression of the left root entry zone (REZ) of the cranial nerves IX and X by looping arteries may play a pathogenetic role. In this report we verified this hypothesis retrospectively by vertebral angiographies in 99 hypertensive and 57 normotensive patients. The angiographic findings were compared with the results obtained from an anatomic study, in which the positions of 10 left vagus/glossopharyngeal nerves in the skull were radiographically determined in 10 cadavers. By using a pattern of REZ topography developed from this information we obtained the following results: In 81% of the evaluable angiographies of hypertensive patients we found an artery in the left REZ of cranial nerves IX and X. The normotensive patients showed an artery in the REZ only in 41.7% of cases. Our results support the hypothesis that essential hypertension may be combined with neurovascular compression of the left REZ of cranial nerves IX/X.

Adult↗
PubMed1991

Induction of tumor necrosis factor expression by a lectin from Viscum album.

A purified lectin (MLI) from Viscum album was used to test whether peripheral monocytes from human blood can be activated for the production of tumour necrosis factor (TNF). Cytotoxic activity was detected in the supernatant of MLI-stimulated monocyte cultures. This cytotoxic activity was completely inhibited by monoclonal antibodies to TNF alpha. Small amounts of soluble TNF protein were measured in a TNF alpha-specific enzyme-linked immunospecific assay system. Strong expression of TNF alpha mRNA was induced in human monocytes as well as in macrophage cultures from C3H/HeJ mice having a low response to endotoxin after 2 h of stimulation. Both chains of the MLI were found to induce TNF mRNA equally well in human monocytes. In macrophages of endotoxin-low-responder mice the toxic A chain was a better inducer of TNF mRNA than the galactose-specific lectin B chain. Thus, MLI has immunomodulating effects in activating monocytes/macrophages for inflammatory responses.

Animals↗
PubMed1991

The European experience with laparoscopic cholecystectomy.

A retrospective survey of 7 European centers involving 20 surgeons who undertook 1,236 laparoscopic cholecystectomies was performed. The procedure was completed in 1,191 patients. Conversion to open cholecystectomy was necessary in 45 patients (3.6%) either because of technical difficulty (n = 33), the onset of complications (n = 11), or instrument failure (n = 1). There were no deaths reported, and the total postoperative complication rate was 20 of 1,203 (1.6%), with 9 being serious complications requiring laparotomy. The total incidence of bile duct damage was 4 of 1,203. The median hospital stay was 3 days (range: 1 to 27 days) and the median time to return to full activity after discharge was 11 days (range: 7 to 42 days).

Adolescent↗
PubMed1991

Cosmetics: saving face at what price?

Arguably, women (and men) are willing victims of exploitation by cosmetics makers and advertisers, exchanging dollars and good sense for the hope of rejuvenation. This does not justify, however, lack of regulation, use of potentially harmful ingredients, or exaggerated claims. Consumers of cosmetics deserve safe effective products at reasonable prices.

Advertising↗
PubMed1991

Detection of circulating Fc epsilon R2/CD23+ monocytes in patients with rheumatic diseases.

Recently, in vitro studies have demonstrated that expression of Fc epsilon R2/CD23 on normal monocytes can be specifically induced by IL-4. In order to investigate the interaction of IL-4 and monocytes in rheumatic diseases, flow cytometry studies were performed. Elevated numbers of circulating Fc epsilon R2/CD23+ monocytes were detected in patients with progressive systemic sclerosis (PSS) as compared with controls. In addition, supernatants derived from phytohaemagglutinin-stimulated peripheral blood mononuclear cells of PSS patients contained high activity to induce Fc epsilon R2/CD23 on CD14+ monocytes. An increased frequency of Fc epsilon R2/CD23+ monocytes was also observed in rheumatoid arthritis, and sequential studies in patients with systemic lupus erythematosus showed a close relationship between Fc epsilon R2/CD23+ monocytes and disease activity. It is suggested that IL-4 has an important role in the pathogenesis of PSS by activating monocytes, and might also contribute to monocyte activation in other rheumatic diseases.

Adult↗
PubMed1991

Blood pressure and sleep apnea: results of long-term nasal continuous positive airway pressure therapy.

Arterial blood pressure patterns in 12 men with sleep apnea and arterial hypertension were studied at baseline and after 6 months' therapy with nasal continuous positive airway pressure (nCPAP). Preexisting antihypertensive medication was discontinued 1 week before baseline measurements. Weight did not change during the study period; body mass index was 29.3 (range, 25.4-38.5) vs. 29.3 (25.0-38.5). During therapy the apnea index decreased from 58 (range 30-73) to 2 (range 0-7) apneic episodes per hour (p less than 0.01). Intra-arterial systolic (BP sys.) and diastolic (BP dias.) blood pressure and heart rate decreased during therapy (p less than 0.001). Mean values +/- 95% confidence intervals were as follows: BP sys., 147.1 (+/- 1.6) mm Hg vs. 126.4 (+/- 1.5) mm Hg; BP dias., 81.6 (+/- 0.8) mm Hg vs. 69.4 (+/- 0.6) mm Hg; heart rate, 68.8 (+/- 0.7) beats/min vs. 65.4 (+/- 0.7) beats/min. Furthermore, the variability of these parameters decreased during therapy: variability BP sys., 53.8 (+/- 1.1) mm Hg vs. 25.6 (+/- 1.1) mm Hg; variability BP dias., 35.6 (+/- 0.7) mm Hg vs. 17.9 (+/- 0.7) mm Hg; variability of heart rate, 28.1 (+/- 0.7) beats/min vs. 14.9 (+/- 0.7) beats/min (p less than 0.001). During treatment we found that blood pressure scores already dropped during the awake phase, with a further decrease during non-REM and REM sleep (p less than 0.001). Our results, which demonstrate the reversibility of high blood pressure upon treatment of sleep apnea, indicate that sleep apnea can be an etiological factor in hypertension. Sleep apnea should therefore be considered in the differential diagnosis of arterial hypertension.

Adult↗
PubMed1991

Cyclic-alternating versus response-oriented chemotherapy in small-cell lung cancer: a German multicenter randomized trial of 321 patients.

To test whether alternating chemotherapy is a favorable treatment modality in small-cell lung cancer (SCLC), 334 patients were randomized to receive either fixed cyclic-alternating treatment with ifosfamide/etoposide (IE), cyclophosphamide, doxorubicin, and vincristine (CAV), or response-oriented treatment with IE therapy up to maximal response and subsequently an immediate switch to CAV. In both arms, six cycles were given in 3-week intervals. After chemotherapy, patients with limited-stage disease received chest irradiation with 45 Gy. Prophylactic cranial irradiation with 30 Gy was applied to all complete responders. No maintenance therapy was given to patients with complete response. Minimum follow-up was 2 years. Of 321 assessable patients, the overall response rate was 70% for cyclic alternating and 77% for response-oriented treatment. Complete remission (CR) rates were 26% versus 26%. The median survival times were 9.7 months for cyclic-alternating versus 10.7 months for response-oriented treatment; the 2-year survival rates were 11% versus 9%. In limited-stage disease (LD) patients, there was a median survival of 12.5 months versus 12.3 months and a 2-year survival rate of 21% versus 18%. In extensive-stage disease (ED) patients, median survival was 8.5 versus 9.1 months, and the 2-year survival rate 3% versus 4%. From these results, we conclude that the cyclic-alternating treatment according to the hypothesis of Goldie et al has no advantage in comparison to a sequential treatment strategy with an immediate switch to a second-line protocol at the time no further response to first-line therapy is seen. Our major aim in the treatment of SCLC is to administer an active regimen at any time during the course of treatment regardless of whether sequential or alternating therapy is used.

Adult↗
PubMed1991

An innovative program for multihandicapped deaf students using the FSSI.

Teachers in public schools now have more students with more severe disabilities than they did in the past. Unfortunately, efforts to provide them with a quality education have been hampered by a lack of focused instructional planning. This article describes an innovative program developed for deaf multihandicapped students that has created an integrated focus for instruction. The organizing framework for the program incorporates the Functional Skills Screening Inventory, a domain referenced assessment of living and working skills. This structured approach enables teachers to identify current functional levels, develop meaningful short- and long-term objectives, and monitor student progress throughout their educational programs. It also facilitates long-range planning and evaluation of the instructional program on an ongoing basis.

Adolescent↗
PubMed1991

[Neuroleptic malignant syndrome].

The neuroleptic malignant syndrome (NMS) is presumably caused by neuroleptic blockade of dopamine receptors, mainly in the basal ganglia and hypothalamus. Symptoms include hyperthermia, muscular rigidity, and elevated serum creatine phosphokinase level, also autonomic dysfunction and, facultatively, impairment of consciousness. Clinical features, differential diagnosis and pathogenesis are discussed, as well as therapy with standard drugs as well as intravenous lisuride.

Antipsychotic Agents↗
PubMed1991

[T-helper cell subsets in patients with inflammatory rheumatic diseases undergoing immunosuppressive therapy].

To determine the influence of immunosuppressive therapy on T-helper-cell subsets in patients with systemic lupus erythematosus and rheumatoid arthritis flow cytometric analysis was performed. Longitudinal studies showed reduced numbers of CD45R+CD4+ lymphocytes in patients treated with cyclophosphamide or azathioprine. Patients receiving steroids had low frequencies of CD29+CD4+ cells. The data suggest that cytotoxic drugs and steroids affect T-helper cells at different activation stages.

Antineoplastic Agents↗
PubMed1991

[Treatment of primary and secondary therapy failure in patients with sleep apnea treated with nasal CPAP].

Two forms of treatment failure of nCPAP therapy should be distinguished: 1. Primary treatment failure: the reversal of apnoeas and hypopnoeas cannot be achieved due to central SA or a combination of MSA and central hypoventilation. In 10 patients who did not respond to nCPAP (7 patients with purely central SA and 3 patients with MSA who still demonstrated long phases of central hypoventilation during nCPAP) we performed a nasal intermittent positive pressure ventilation (nIPPV) during at least 3 treatment nights. In all patients a reversal of apnoeas and hypopnoeas could be achieved, despite a few phases of mask leakage. Due to possibly life threatening side effects continuous monitoring is required during the initial treatment phase. 8 patients who reported a reduction of symptoms have been successfully using the treatment at home for up to 22 months. 2. Secondary treatment failure: nCPAP leads to a normalisation of breathing pattern but patients refuse nCPAP or discontinue treatment. Besides patients who are poorly motivated there are four major side effects of nCPAP as a reason for non-compliance: a) drying out of the nasopharyngeal mucosa or rhinitis; b) pressure marks caused by the nose mask; c) intolerance to the high expiratory pressure; d) noise. Drying out of the mucosa and rhinitis are the most important side effects. If an increase of room temperature and humidity, nasal cream and small amounts of mint-oil as well as a heat-moisture exchanger (HME) prove inadequate, we use a heated humidifier (Dräger, Aquapor).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

[Managing conflict in psychiatric institutions].

Several observations made by the author in everyday practice during his activity as a supervisor of psychiatric therapy teams, are described. These can be classified as "subcultural phenomena". It is shown how the members of a therapy team will modify certain institutional conditions and parameters unconsciously but purposefully and make use of them for coping with conflict situations. This is demonstrated, inter alia, by the manner in which the duty schedule is handled and how the team deals with the sickness of a team member. This type of conflict management is then placed in relation to two major conflict potentials that come into play during everyday work in a psychiatric hospital: on the one hand, the pathogenic relationship offers made by the mentally ill patients, and on the other hand the adaptation strategies acquired during professional and institutional socialisation and moored in the conscious depths of the team member's soul. These adaptation strategies are interpreted by the team members as components of their professional identity. The therapeutic quality of an institution can thus be measured by the extent to which that institution succeeds in supporting these adaptive elements of its members and hence in relieving them of some of the mental stress to which they are exposed.

Conflict, Psychological↗
PubMed1991

[Team supervision in the psychiatric clinic--methods and practice].

In this article the supervision of psychiatric therapy teams is conceptualised within the overall framework of psychoanalytical theory and practice. Supervision can be interpreted as a process in the course of which there are scenic representations of unconscious conflict situations within the group of the team. These conflicts derive their dynamics from two different sources. On the one hand, we have a reflection of the therapeutic relationship between the team and the patient in the mutual relations between the team members themselves (this perspective has been adopted from the Balint group concept). On the other hand, we have, when discussing the case of a patient, a reversal of this perspective in so far as this discussion reflects the themes and conflicts originating from the professional socialisation of the team members. In this manner, supervision develops into a dialectic process that mutually interrelates these two poles of what goes on in the subconscious mind. This concept of supervision is demonstrated in detail by means of two case examples.

Conflict, Psychological↗