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Biomedical subjects

J Rauh

Publications and source records attributed to J Rauh.

16 recordsLinked to original sources

[Treatment of perivascular extravasation of cytostatic agents].

In the intravenous administration of cytostatic drugs, top priority is given to preventive measures, and to immediate countermeasures in the event of an accidental paravenous injection. In contrast to earlier recommendations, the use of antidotes has been minimized. Only those with proven efficacy and no tissue toxic potential are to be used. The intradermal application of sodium bicarbonate and sodium thiosulfate, and the subcutaneous administration of glucocorticoids are no longer applicable. As a specific antidote in the case of anthracycline, topical dimethylsulfoxide (DMSO) is used, and for perivascular injection of vinca alkaloid, subcutaneous hyaluronidase is administered.

Animals↗

["Folie a deux" in the age of lasers].

We report on a 59-year-old teacher suffering for approximately 5 years from multiple dermatological changes, some of which are artificially induced and some of which are imaginary. The patient believes these manifestations are the result of neighbors shooting at her with lasers. Her husband is also convinced of the veracity of these impressions. We interpret her notion of almost daily laser attacks to a skin-related paranoid/hallucinatory psychosis with the involvement of her husband in a "folie à deux".

Delusions↗

Pharmacology of skeletal muscle GABA-gated chloride channels in the cockroach Periplaneta americana.

The pharmacology of -aminobutyric acid (GABA)-gated chloride channels of the coxal levator (182c,d) muscle of the cockroach Periplaneta americana has been investigated and the data compared with similar findings for the cell body of the cockroach fast coxal depressor motor neurone (Df). Muscle GABA receptors resembled those of the motor neurone cell body in their sensitivity to picrotoxinin and insensitivity to bicuculline. However, muscle GABA receptors were insensitive to the neuronal GABA receptor agonists isoguvacine (10(-4) mol l-1) and 3-aminopropane sulphonic acid (10(-3 )mol l-1). The benzodiazepine flunitrazepam, which at 10(-6 )mol l-1 greatly enhances the amplitude of the motor neurone GABA-induced responses, failed to affect muscle responses to GABA when tested at the same and at a higher (10(-4 )mol l-1) concentration. The convulsant t-butylbicyclophosphorothionate was a weak antagonist of cockroach muscle GABA receptors, whereas several cyclodienes were much more effective antagonists. Thus, studies using a benzodiazepine and several convulsant antagonists reveal differences in the pharmacology of muscle and neuronal GABA receptors of the cockroach Periplaneta americana.

Animals↗

[Rhombencephalitis caused by Listeria monocytogenes].

We report the case of a 57-year-old man with Listeria rhombencephalitis. This had been ascertained by means of Listeria isolation from the cerebrospinal fluid. After an nonspecific prodromial period with nausea and headache, he developed fever, meningism, brain stem dysfunction and an organic psychosis. With early antibiotic therapy (ampicillin/gentamycin), it was possible to bring about a restitio ad integrum. Different brain-imaging methods (computed tomography, MRI, brain SPECT) in the acute and follow-up stages are discussed.

Ampicillin↗

Development of an in vitro cell culture system to mimic the blood-brain barrier.

Primary cultures of brain capillary endothelial cells (BCECs) cocultured together with astroglia cells were used to investigate the induction of blood-brain barrier (BBB) characteristics in vitro. By immunofluorescence, histochemical staining, two-dimensional gel electrophoresis and enzyme activity tests we are able to show that BCECs in vitro loose typical blood-brain barrier properties but not their common endothelial phenotype. Astrocytes induce the expression of the blood-brain barrier characteristic enzymes gamma-glutamyltranspeptidase and alkaline phosphatase but only in a coculture system with direct cell to cell contact between BCECs and astroglia cells. C6-glioma cells also re-establish the BBB phenotype but were less effective compared to astrocytes. The susceptibility of the BCECs to an astroglial stimulus depends on the proliferative state of the BCECs.

Alkaline Phosphatase↗

The susceptibility of cerebral endothelial cells to astroglial induction of blood-brain barrier enzymes depends on their proliferative state.

Primary cultures of brain capillary endothelial cells (BCECs) were used to investigate the induction of blood-brain barrier (BBB) characteristics in vitro. Enzymatic activities of gamma-glutamyltranspeptidase (gamma-GT) and alkaline phosphatase (ALP) were taken as indicators for the expression of the BBB phenotype. We were able to show that a coculture system with a direct cell-cell contact between astroglial cells and BCECs is the necessary precondition for an increase of these enzyme activities that are lost in pure BCEC cultures. Coculture with both astrocytes and C6-glioma cells reestablishes the BBB phenotype whereas conditioned media as well as an astrocyte-derived extracellular matrix were ineffective. The susceptibility of the BCECs to an astroglial stimulus depends on the proliferative state of the BCECs. Cells in an early highly proliferative culture phase were stimulated to express an enzymatic activity level similar to the in vivo situation. Confluent BCEC monolayers were not induced at all. With the ALP we observed a spatial induction within a BCEC colony. Astrocyte-induced ALP activity was first observed at an outer belt of BCEC colonies in direct contact with the astrocyte layer. However, this signal is transferred to the center of the colony with time in culture. We conclude that direct contact of BCECs with astroglial cells is necessary for the induction of the BBB phenotype in cultured BCECs and that this signal may be transferred from induced to noninduced BCECs.

Alkaline Phosphatase↗

Issues in fertility control for mentally retarded female adolescents: I. Sexual activity, sexual abuse, and contraception.

Little information is available about sexual activity, sexual assault, and contraceptive use among mentally retarded adolescents. The experience in these areas among 87 mentally retarded females is reviewed. (A companion paper focuses on these patients' parental attitudes toward sterilization.) All subjects attended a multiservice adolescent clinic with a large developmentally disabled patient group. Charts were reviewed and 69 parents were interviewed. The patients had an age range from 11 to 23 years (mean 16.7). Forty-one subjects were mildly retarded (IQ 55 to 69), 23 were moderately retarded (IQ 41 to 54), and 23 were severely retarded (IQ less than 41). Half of the mildly retarded had had sexual intercourse, a proportion comparable to the general adolescent population. Thirty-two percent of the moderately retarded and nine percent of the severely retarded adolescents had had intercourse. One third of the mildly retarded and one fourth of the moderately retarded adolescents had been victims of rape or incest. Continued sexual activity correlated with sexual abuse, but the majority of victims had no prior or subsequent evidence of intercourse. Forty-two subjects (48%) had used contraception at some time; intrauterine devices and injectable medroxyprogesterone acetate were preferred to oral contraceptives. Six of the 14 patients (43%) who continued sexual activity became pregnant, suggesting that currently available contraception is not providing sufficient protection.

Adolescent↗

Issues in fertility control for mentally retarded female adolescents: II. Parental attitudes toward sterilization.

Knowledge of the issues involving sterilization for mentally retarded adolescents is limited. Data were obtained from 69 interviewed parents whose mentally retarded daughters were attending the Cincinnati Adolescent Clinic. (A companion paper focuses on the experience of these girls with sexual activity, sexual abuse, and contraceptive use.) Forty-six percent of the parents had considered sterilization for their daughters. Twenty-six percent were still seeking the operation. Interest in sterilization especially correlated with increased severity of retardation (P less than .005) and with difficulty teaching menstrual hygiene (P less than .005). Parents of mildly retarded females sought tubal ligation, and those with severely retarded daughters chose hysterectomy and stressed their concern about menstrual management. Eighty-five percent of the parents favored a state statute that would enable sterilization under certain conditions and limitations. In general, few parents supported either an extremely restrictive or permissive position about sterilization.

Adolescent↗

[Haemodynamic investigations with the new antihypertensive drug guanfacine (author's transl)].

Guanfacine, a new centrally acting alpha-mimetic antihypertensive drug, was given to two groups of 7 patients each, one with essential and the other with renal hypertension. Both in the acute trial (after short-term intermittent initial blood pressure increase) and in the long-term treatment (4 weeks) lowering of blood pressure occurred, mediated via decrease of peripheral vascular resistance. In addition, support of cardiac function, especially of the afterload and possibly also the preload, was induced. This was demonstrated by results obtained after ergometric loading.

Adult↗

Haemodynamics in hypertensive patients before and during guanfacine treatment.

1. The haemodynamic mechanisms underlying the antihypertensive effect of guanfacine during chronic oral administration were studied. 2. Ten patients with essential hypertension were submitted to haemodynamic measurements at rest and during exercise, before and after 12 weeks' treatment with guanfacine alone at a daily dose of between 3 and 15 mg orally. 3. The relevant haemodynamic values were obtained by means of an arterial catheter in the aorta, a venous catheter in the right atrium, and the measurement of cardiac output using the thermodilution method. 4. The antihypertensive efficacy of guanfacine was confirmed. 5. In the seven patients with a high peripheral resistance the main effect of guanfacine was a marked decrease in total peripheral resistance. In three patients with hypertension characterized by high stroke volume and cardiac output, the main effect of guanfacine was to reduce these variables.

Adult↗