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Biomedical subjects

K Held

Publications and source records attributed to K Held.

88 records · Page 5Linked to original sources
PubMedDate not supplied

Treatment with the CRH1-receptor-antagonist R121919 improves sleep-EEG in patients with depression.

Well documented changes of sleep electroencephalogram (EEG) in patients with depression include rapid eye movement (REM) sleep disinhibition, decreases of slow-wave-sleep (SWS) and increase in wakefulness. Twenty-seven inpatients with major depression were admitted subsequently to a clinical trial with the CRH(1)-receptor-antagonist R121919 administered in two different dose escalation panels. A random subgroup of 10 patients underwent three sleep-EEG recordings (baseline before treatment, at the end of the first week and at the end of the fourth week of active treatment). SWS time increased significantly compared with baseline after 1 week and after 4 weeks. The number of awakenings and REM density showed a trend toward a decrease during the same time period. Separate evaluation of these changes for both panels showed no significant effect at lower doses, whereas in the higher doses after R121919 REM density decreased and SWS increased significantly between baseline and week 4. Furthermore positive associations between HAMD scores and SWS at the end of active treatment were found. Although these data might indicate that R121919 has a normalizing influence on the sleep EEG, the design of the study does not allow to differentiate genuine drug effects from those of clinical improvement and habituation to the clinical setting.

Administration, Oral↗
PubMedDate not supplied

Reduction of ischaemic rest pain in advanced peripheral arterial occlusive disease. A double blind placebo controlled trial with iloprost.

Severe pain at rest is a major symptom of advanced peripheral arterial occlusive disease (PAOD). Preliminary studies of treatment with iloprost, a prostacyclin analogue, showed encouraging results in patients with ischaemic rest pain. Therefore a randomized, placebo-controlled multicentre study was undertaken in 113 patients admitted to hospital with rest pain of at least 2 weeks duration caused by severe PAOD. The patients were randomly assigned to receive 2-week placebo or iloprost infusions for 6 hours per day at a dose of 0.5-0.2 ng/kg/min in addition to conventional care. Demographic data and arteriographic findings were similar in the two groups. Eleven patients withdrew from the study before completion and 102 patients could be included in the final analysis. Significantly more patients in the iloprost group (62.5% of 48) than in the placebo group (42.6% of 54) had complete relief of pain without analgesic therapy during at least five consecutive days at the end of the treatment period (p less than 0.05, chi 2-test). Facial flush, headache and nausea were the most common side effects during iloprost infusion. Serious adverse reactions did not occur. Thus, a 2-week iloprost infusion was shown to be safe and effective as a treatment for ischaemic rest pain caused by PAOD.

Adult↗
PubMedDate not supplied

[Clinical, endocrinological, histological and chromosomal investigations on Klinefelter's syndrome].

In a clinical study 101 patients with Klinefelter's syndrome (Kl. sy.) are evaluated. Clinical, endocrinological and histometrical aspects were of main interest. The results were compared with a group of patients with azoospermia by obstruction. The statistical evaluation showed significant differences concerning body-height, volume of ejaculate, size of testis, and the concentration of FSH and LH in serum. Histometrical investigations showed significant differences for the diameter of seminiferous tubules and their wall-thickness. The various degrees of Leydig-cell-increase at Kl. Sy. are described as--increased--excessively increased--and adenomalike. Sex-Chromatin was found positive in 62 of 64 cases of Klinefelter's syndrome, verified by chromosome analysis. The number of Barr-bodies ranged from 1-45 (200 cells evaluated) x mean was 9,6. The analysis of chromosomes in 64 cases showed a karyotype of 47,XXY in 59 cases, a 46, XY/47,XXY mosaic in 4 cases and 46,XX/46,XY/47,XXY mosaic in 1 case. The discussion pointed out, that Kl. sy. has no typical, but a variety of symptoms. The position of the evaluation of sex-chromatin for diagnosis and the possibilities of errors are discussed. The problem of fertility in Kl. sy. is mentioned, as we found two cases with complete spermatogenesis, yet with azoospermia, among our patients. The pathogenesis of the characteristical histological changes in testis with Kl. sy. remains open. The mechanism which may lead to the striking increase of Leydig-cells is discussed.

Adolescent↗