Biomedical subjects
Publications and source records attributed to K Gebauer.
Haemorrhagic epidermal bullae developed in a patient with Darier's disease undergoing long term treatment with the retinoid, etretinate. We suggest that these lesions result from cumulative toxic effects of long term retinoid therapy upon the abnormal keratinocyte found in Darier's disease.
The role of GABAB receptors in control of central respiratory system was evaluated by cycle-triggered averaging of phrenic nerve activity (PNA) of the rabbit. Blockade of GABAB receptors of the caudal brainstem by intracerebroventricular administration of phaclofen augmented PNA, decreased the duration of inspiration and to about the same extent increased the duration of expiration thus unmasking intrinsically active GABA. Analogously, stimulation of brainstem GABAB receptors by exogenous baclofen decreased PNA. Preceding administration of larger doses of phaclofen could block the effects of baclofen. It is proposed that GABAB receptors are involved in tonic and phasic modulation of central respiratory activity.
We report an adult with listeriosis. Sequential liver biopsies demonstrated the resolution of associated granulomas and microabscesses after the administration of high doses of penicillin for ten days. This observation has not previously been reported.
INTRODUCTION: This paper deals with basic rational antiepileptic therapeutic procedures in children with special consideration of numerous specificities which occur in childhood: difficulties in establishing correct syndrome diagnosis, predominantly after the first or first few seizures which makes it difficult to decide about appropriate syndrome-specific therapy in regard to efficacy, mechanism of action and range of antiepileptic action; difficulties in assessment of subjective factors (their adverse effects and recognition of seizures with subjective symptoms), children's vulnerability in regard to drug toxicity; age-specific pharmacokinetics of these drugs. MATERIAL AND METHODS: The number of available antiepileptics today is great due to new drugs, but carbamazepine (CBZ) and valproate (VAL) are still basic antiepileptics, although carbamazepine's action is reduced to partial epilepsies. The paper describes range of action of available antiepileptics in regard to classification of epileptic seizures and most frequent epileptic syndromes. DISCUSSION: Adverse effects of antiepileptic agents depend on the age, so examples of age-dependent adverse effects are given considering conventional and new antiepileptics. It is well known that optimal control of seizures depends not only on correct choice of drug, but also on appropriate dosage; it is necessary to be informed about age-dependent characteristics of clinical pharmacokinetics: resorption, metabolism, elimination and half-life of antiepileptics. Although 70-80% of children may be well treated with monotherapy, 15% of children require combination of 2 or more drugs causing drug interactions in resorption, distribution, metabolism and elimination. Examples of antiepileptic interactions as well as interactions of other drugs and antiepileptics are given. The paper also deals with special importance of the psychosocial aspects of epilepsy. These children are often unaccepted by others, mostly because others are afraid of their disease, which contributes to poor quality of life of these children. Development of intellectual, emotional functions, physical development and socialization, apart from affecting the choice of drug, make epilepsy treatment in children more complex, with special emphasis on mental-hygienic aspects of complete management of children. CONCLUSION: Only a complex approach to child suffering from epilepsy may provide optimal development, quality of life improvement and complete social integration. Rational therapy of epilepsy in children requires good knowledge not only of age-specific syndromes, clinical pharmacology of anticonvulsants, their efficacy and range of action, but also specificity of their metabolism in children, profile of adverse effects as well as facing numerous nonmedical problems.