Prevalence of tardive dyskinesia in elderly samples.
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Biomedical subjects
Publications and source records attributed to K Bergmann.
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The total activity of lactate dehydrogenase (LDH) of perilymph (PL), plasma, and cerebrospinal fluid (CSF) of unexposed and sound-exposed guinea pigs was examined with due consideration of the principal sources of error. To test the purity of PL samples, protein, potassium, and sodium were determined simultaneously (Table 1). The LDH was analysed fluorometrically. It was found that there are considerable differences in the LDH activities of PL, CSF, and plasma (Table 2). The mean activity of PL was three to four times higher than that of CSF and only about half that of plasma. No significant difference was found between the PL in scala tympani and scala vestibuli. The most frequent LDH values of the individual fluids (Fig. 2) were somewhat lower than the mean values calculated. Immediately (less than or equal to 60 min) after exposing the animals to wide-band noise at an intensity of 140 dB SPL for 10 min, the mean PL values of the scala tympani and scala vestibuli were found to be somewhat higher than in unexposed animals (Table 3). Eighteen hours after the exposure, slightly higher activity was only detectable in PL of the scala vestibuli. The differences were not found to be significant. The LDH values of CSF and plasma remained unchanged both less than or equal to 60 min and 18 h after noise exposure.
Patients with bilateral paresis of the recurrent laryngeal nerves have primarily breathing difficulties. But on the other hand the common operations for widening the glottis produce voice problems. To overcome these difficulties a muscle stimulation device was developed, which is triggered by the inspiratory motion of the thorax. With this device impulses are transmitted by radiofrequency from a transmitter located outside the body to a receiver implanted into subcutaneous tissue of the neck and thence by electrode wires to the posterior cricoarytenoid muscle (PCA). In the dogs with one cut recurrent laryngeal nerve the paralyzed vocal cord (VC) moved regularly with abductions at inspiration by stimulating the PCA. The efficiency of that stimulating device was proved by taking photographs of the VC-motion and by recording the subglottal air pressure changes.
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It is impossible to make general statements on obesity, and apply them to all adipose patients. These statements can be more or less valid for various populations of obese subjects depending on the definition of obesity chosen. Obesity in infancy should not be disregarded, although it has not been proven that obese infants become obese adults, whereas obese adolescents tend to remain obese. Obesity is genetically determined yet exogenous factors are more or less necessary for its development. The significance of risk factors changes during childhood, depends on the gender, and varies with different populations. The hypothesis that obese patients have a diminished thermogenesis should be considered although it is not clear whether this applies to all obese patients. Research on disregulation of appetite could result in further clarification of the pathogenic mechanism causing obesity. Treatment of obesity is necessary in patients with 120% or more overweight related to height, preferably before age of 7 years to take advantage of further growth as a regulating factor.
In sets of mice congenic at H-2 and upon two backgrounds, and selected according to known differences in strain-specific lifespans, DNA repair efficiency in spleen cells was compared by two techniques: excision repair capacity following UV-irradiation, and bleomycin sensitivity. Significant differences between certain congenic partner sets were noted with both techniques, suggesting that the main histocompatibility complex influences DNA repair capacity.
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Lymphoid cells from 20 patients with lymphoproliferative disorders, including chronic lymphocytic leukemia, hairy cell leukemia, Sezary syndrome, lymphoma, and lymphadenitis, were studied for redistribution of surface membrane immunoglobulins (SmIg) and concanavalin A (Con-A) receptors. Fluorescein-labeled polyvalent goat anti-human immunoglobulin and fluoresceinated concanavalin A were used as ligands. Results were similar with both ligands. The highest percentage of capping of ligand-membrane receptors was noted in mononuclear cells from patients with "hairy" cell leukemia: from 24% to 90%. These cells showed moderate to marked fluorescein activity and were able to cap within 15 min at 4 degrees C. Chronic lymphocytic leukemia cells showed a weak fluorescein stain with a very low percentage of cells (0%--16%) capping. Lymph node cells from patients with lymphoma demonstrated moderate to strong fluorescein activity with only an average of 3% of the cells capping; while lymphoid cells from patients with lymphaedenitis showed an average of 27.5% capping and moderate fluorescein activity. Capping of Con-A receptors in mononuclear cells from patients with Sezary syndrome was poor (0%--14%) with moderate fluorescein intensity. This report demonstrates difference in density and mobility of binding sites for SmIg and Con-A on the surface membrane of lymphoid cells from various subclasses of lymphoproliferative disorders. These differences may assist in the differential diagnosis and classification of these conditions.
To prevent the perilymph (guinea pig) from contamination with CSF during the sampling the aqueductus cochleae (AC) was blocked by injection of tissue adhesive into the meningeal aperture. The control of an exact blockage of AC was carriedout by examination of perilymph-outflow after opening the cochlea (injection of fluorescein-Na into the CSF-space), analysis of perilymph-protein-concentration, macroscopic and microscopic examination of the temporal bones. In all cochleae we have found the same morphological structures, notwithstanding whether the AC was blocked (for a time from 30 min to 7 weeks) or not: The cochlear aqueduct is filled with a mesh of mesenchymal tissue, which grows more dense towards the cochlear aperture andcontinues into the round window membrane. From scala tympani the AC is always limited by one layer of cells forming a sort of membrane (under light microscope). It seems possible that CSF moves in the inner of the round window membrane between AC and subepithelian space of middle ear mucosa, whereas perilymph of scala tympani is not in direct contact with the flow of CSF. The scala tympanic side of the round window membrane may be a big area for diffusion and there also may be an exchange between CSF and perilymph. The outflow of CSF into the cochlea after experimental opening of the cochlea is an artifact, caused by damage of pressure equilibration between CSF-space and cochlea. 30 min and 5--7 weeks after blockage no morphologicaland electrophysiological alterations from those of the control ears were to be seen. The protein concentration, however, increased significantly 5--7 weeks after blockage from normally about 200 mg/100 ml toalmost the double especially in the scala tympani (see Table 1).
The myocardial infarct size was assessed on the basis of serial analyses of serum creatine phosphokinase (CPK) in 70 patients with first transmural myocardial infarction. Clinical symptoms of heart failure (Killip II-III) were found in patients with infarcts larger than 50 CPK-g-equ; in patients with lung oedema the infarct size averaged 104.2 CPK-g-equ. Patients without clinical and roentgenological evidence of left heart failure (Killip I) had infarct sizes always lesser than 50 CPK-g-equ, averaging 31.7 CPK-g-equ. Precordial mapping of the QRS complex in patients with anterior wall infarction revealed a significant correlation (r = 0.916) between the sum of voltages of Q waves on a 30-lead map recorded 24 hours after hospitalization and the enzymically assessed infarct size. Exact skiagraphic and auscultatory examinations of the heart and lungs, together with precordial mapping of the QRS complex, in patients with anterior wall infarct allow a relatively accurate quantification of the infarct size for prognostic classification of the patients.
Necropsy brain tissue from normal (control) patients and patients with depression and dementia was examined for activities of various cholinergic components, and these related to the degree of senile plaque formation and extent of intellectual impairment. Choline acetyltransferase and acetylcholinesterase activities decreased significantly as the mean plaque count rose, and in depressed and demented subjects the reduction in choline acetyltransferase activity correlated with the extent of intellectual impairment as measured by a memory information test; muscarinic cholinergic receptor binding activity remained unchanged with increasing senile plaque formation but butyrylcholinesterase activity increased. The results suggest a close relation between changes in the cholinergic system and Alzheimer's dementia, but the precise role of the system in this disease remains to be elucidated.
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Because oxygen is at least ten times as soluble in fluorocarbon liquids as in plasma or saline, we investigated the principle possibility of perilymphatic perfusion of the cochlea with perfluortributylamin. Our experiments show that fluorocarbons in spite of the excellent O2-solubility in it are not suitable for the perilymphatic perfusion due to their physical properties (density 1.91 g/ml, non-solubility in water, necessity and difficulties of emulsification).
The GP records of 200 elderly people living at home were scrutinized and estimation made of physical and psychiatric disability. These estimations were compared with those made independently by a psychiatrist interviewing the subjects at home. There was a reasonable agreement between the two assessments of functional disorder and between the two assessments of physical disabilities. Whereas the survey psychiatrist's diagnoses of mental disorder correlated positively with the presence of physical illness, this did not hold for those considered to have evidence of psychiatric illness using GP records alone. The duration of a positive psychiatric history obtained from GP records was consistent with a discrimination between late onset (recent) and chronic neurosis.
Eighty-three consecutive patients with organic mental disorder were studied on their first admission to a psychiatric day hospital assessment unit in a general hospital. They were evaluated medically, psychiatrically and by social work, re-evaluated after 3 months, and again after 12 months or at death. The types of care, and the number of days in each setting, were recorded. Nearly three-quarters were dead or in institutions by 12 months: those initially living with spouses did worst, and those with their children did best, while those on their own became long-stay residents in institutions. Family support seeemed the most important factor determining continued life in the community, and increased help to families from social services appeared to be needed. The value of earlier psychiatric diagnostic and earlier treatment of physical ills is also discussed.
The incidence, circumstances, and mechanism of development of cardiac arrest in 786 patients with myocardial infarction treated at a coronary care unit within a five-year period were studied and clinical factors are analysed with respect to success of resuscitation. One or more episodes of cardiac arrest occurred in a total of 156 patients (19.8%). Of these, 25 (16.0%) were successfully resuscitated and 131 (84.0%) died. At the clinical ward where the patients had been transferred after the acute stage, cardiac arrest occurred in additional 22 patients, of whom two were successfully resuscitated. Thus, the total number of successfully resuscitated patients throughout the five-year period was twenty-seven. The results of resuscitation were poorer in elderly patients, in those with anterior infarction, and above all in patients with severe symptoms of mechanical heart failure. Anamnestic factors (chronic angina pectoris, previous myocardial infarction, hypertension, diabetes mellitus, ischaemic disease of the lower limbs) were not significantly associated with the results of resuscitation. Primary ventricular fibrillation was the principal mechanism of cardiac arrest in 24 of the 27 patients successfully resuscitated, and its total incidence in the investigated group was 3%. The prognosis of resuscitation in patients with primary ventricular fibrillation was very good, and in all of them the resuscitation was successful and permanent.
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