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Biomedical subjects

R Manz

Publications and source records attributed to R Manz.

At least 37 records · Page 2Linked to original sources
PubMed1993

[KOPS: a self-rating instrument for assessment of physical, psychological and social communication impairments].

In this article the development of a self-rating symptom questionnaire is described. The questionnaire records physical, psychological and social-interactionary impairments typical for neurotic and psychosomatic disorders. Contrary to most of the established self-assessment instruments the KOPS-questionnaire consequently records symptoms from these three areas. The questionnaire contains 64 items scaled on four steps and can be filled out by the test person in a short period of time. The results depicted here from different sample groups which were examined verify the differential and criterion related validity and furthermore an explorative factor analysis also verifies the content validity. The instrument is suited for screening purposes as well as for clinical course studies of psychological disorders. The problems of the assessor perspective (by an expert or by a patient) in recording symptoms is discussed.

Adult↗
PubMed1991

[Social support and its relation to physical and emotional findings in Crohn's disease patients].

It was the aim of the present study to identify correlations between social, psychological and physical findings in 57 unselected patients with Crohn's disease from a gastroenterological outpatient department. Social support was registered using the confidant rating and the social network using a network questionnaire. Additional internal-medical and psychodiagnostic test instruments were used for a specific description of the sample. Anxieties, depressive moods and emotional lability were significantly less pronounced in patients with a confidant than in those without or with a less supportive partner. And the former also seemed to be more able to adequately cope with the disease than the patients of the other groups. With respect to the physical findings, the differences between the groups were less pronounced: Nevertheless, patients who were supported by a partner tended to show lower activity levels for Crohn's disease (Best index) than the others. The results obtained by the network questionnaire were less specific but altogether confirmed the results of the confidant rating. The study confirms the results of comparable investigations done in other clinical patient groups. The construct of social support is discussed critically with respect to psychoanalytical and family-dynamic concepts.

Adaptation, Psychological↗
PubMed1990

[A 20-year follow-up study of a sample of 50 pairs of twins with neurotic-psychosomatic disorders].

As part of a research project, examination was made of a sample of 50 pairs of twins (21 pairs of identical twins, 16 pairs of non-identical twins of the same sex, and 13 pairs of male-female twins [n = 100 test persons]) between 1963 and 1969 and again recently after a period of 20 years. The index twins were drawn from among the patients who made use of the services of an out-patient psychotherapeutic clinic, and they were determined to be either psychoneurotic, character neurotic, or psychosomatically ill. The question examined was again one of nature vs. nurture. Identical twins showed a significantly higher similarity with regard to the seriousness of their neuroses and the manifestation of neurotic symptoms than did non-identical twins. Noticeable similarities existed in cases of depressive disturbances, disturbances of oral and aggressive behavior, and disturbances of interpersonal contact. With regard to the influence of variables in the environment, we examined the effect of factors in early childhood on neurotic development. Lack of a reference person, a negative attitude on the part of parents toward the child, etc., frustration within and outside the family have an effect on the manifestation of neuroses and on the course of their development. The influence of early childhood factors on the degree of neurotic disorder is still to be noted in the current point prevalence.

Adult↗
PubMed1989

The epidemiology of psychogenic disorders and consequences for prevention.

After discussing social issues of epidemiologic research on neurotic, character and psychosomatic disorders, we outline the main results of a field cohort study on 600 representative adults of Mannheim, a West German industrial city. According to ICD 300-307 (WHO 8th revision) and to a quantitative case definition clinically based on the severity of the symptoms we find an overall case rate of 26% in which females prevail over men by a ratio of approximately 2:1 and the rate of lower social class members over that of higher ones. We then turned to conclusions of our research for matters of primary and secondary prevention. Concerning primary prevention of psychogenic diseases life circumstances during childhood proved to be relevant as predisposing variables and risk factors often indicating poor emotional relationships between the child and its caretakers. Furthermore, we deal with protective factors preserving mental and physical health in spite of heavy burdens during childhood. Turning to secondary prevention we examine risk factors in present life, the importance of the lay system, and the influence of life events as well as the true demand for psychotherapy.

Adult↗
PubMed1988

[Life events, coping and social support: attempt at integration from the psychoanalytic viewpoint].

In the Federal Republic of Germany, few attempts have been made to subject psychoanalytical theories of illness to empirical examination using the modern methods of science. There are also very few established connections between these theories and recognized socio-psychological concepts, and theoretical constructs that are in fact quite similar have thus led a separate but parallel existence because of differences in terminology. In our epidemiological research project (begun in 1978), we concentrate on the observation of psychic health and/or psychogenic illness as influenced by factors of personality and of symptom-causing conditions, drawing on the methods of socio-psychological research. In this study, we present 1) our results from the areas "Life-events", "Coping", and "Social support" and 2) a quantification of the pathogenic influence of these three factors based on regression analysis; finally, 3) we try to establish the connection to psychoanalytic concepts of symptom-causing temptation and failure situations and to ego-related models of defense and adaptation.

Adaptation, Psychological↗
PubMed1987

[Social support and psychogenic disease. Results of an epidemiologic field study].

Within the framework of an Extensive epidemiological field study on the prevalence of psychogenic illness among the "healthy" population of a large city, the question of social network and stressful personal experiences was asked in order to test a hypothesis. The results showed that people who suffer more intensely from psychogenic symptoms (psychoneuroses, psychosomatic illnesses, manifestations of character neurosis) clearly often lack a protective network of close reference persons.

Adult↗
PubMed1984

Effectiveness of respiratory hyperoxia, of normobaric and of hyperbaric oxygen atmospheres in improving tumor oxygenation.

Tumor oxygenation during respiratory hyperoxia is dependent on the tumor growth site, on the growth stage, and hence on the vascular pattern. Diffusion of O2 from the surrounding atmosphere contributes considerably to the oxygenation of subcutaneous tumors during normobaric exposure to a pure O2 atmosphere. However, hypoxia is still present in the tumor core under these conditions, and pressurization up to 4 bar is required to completely eradicate these hypoxic areas, thus enhancing the radiosensitivity of the tumors.

Animals↗
PubMed1984

Impact of various thermal doses on the oxygenation and blood flow in malignant tumors upon localized hyperthermia.

Upon localized hyperthermia at modest thermal doses an increase in tumor blood flow can be observed in many tumors which is paralleled by an improvement of the oxygenation status of the tissue. At intermediate or high thermal doses a pronounced restriction of the tumor circulation becomes obvious leading to a deterioration of the tumor oxygenation. As a consequence, a further enhancement of the thermal response of tumors relative to normal tissues has to be expected at intermediate or high thermal doses.

Animals↗
PubMed1984

Heterogeneous oxygenation of rectal carcinomas in humans: a critical parameter for preoperative irradiation?

Tissue oxygenation was measured in 10 patients with differentiated adenocarcinoma in a very localized region in the middle part of the rectum (grade I - II, clinical stage II) by means of a cryophotometric micromethod. The results obtained clearly show that the oxygenation of differentiated rectal adenocarcinoma is distinctly lower than that of the normal rectal mucosa; tissue hypoxia or even anoxia are a common feature in those tumors; There exist considerable inter- individual differences among tumors of the same clinical staging and histological grading; substantial intra- individual heterogeneities in the oxygenation are evident within the same tumor and even within neighbouring microareas of the tissue. These findings imply that the commonly used classifications do not allow any conclusions concerning the oxygenation status, and probably the radiosensitivity of a tumor, respectively.

Adenocarcinoma↗
PubMed1983

Relationship between size and oxygenation status of malignant tumors.

Analyzing the oxygenation status of tumors by means of the oxyhemoglobin saturation of single red blood cells within microvessels, there is clear evidence that tissue hypoxia and anoxia are inherent features during advanced stages of malignant growth. This is a consequence of distinct deteriorations of the convective and diffusive O2 transport with increasing tumor size leading to an O2 depletion in peripheral tissue layers around nutritive blood vessels. These alterations are combined with inhomogeneities of the oxygen distribution, both spatial and temporal. With enlarging tumor mass, the heterogeneities of the O2 supply distinctly intensify. Although in vitro experiments utilizing multicell spheroids failed to show very low oxygen tensions in necrotic regions, it is still proposed that chronic oxygen depletion is a paramount factor for the induction of necrosis in solid tumors under "physiological" in situ conditions.

Animals↗
PubMed1983

Effect of acclimation temperature on oxygen transport in the blood of the carp, Cyprinus carpio.

The temperature dependence of the O2 equilibrium in whole blood was measured in carp acclimated for more than 3 weeks at 10 degrees C or 20 degrees C water temperature. O2 combining curves were obtained for the same samples at 10 degrees C or 20 degrees C using blood from the 10 degrees C or 20 degrees C acclimated fish (group A) or only at the acclimation temperature (group B). Whereas in group B the P50 was about the same at both temperatures, in group A P50 was higher at 20 degrees C than at 10 degrees C, yielding an apparent heat of oxygenation delta H = -9.9 kcal/mol at pH = 8.0. The CO2 Bohr effect in group A was delta log P50/delta pH = -0.93 at 20 degrees C and -1.17 at 10 degrees C, whereas in group B no temperature effect was seen (-0.98 and -0.97). The acclimation temperature had no effect on the electrophoretic Hb pattern. As expected, the in vivo pH changed inversely with temperature from 8.06 at 10 degrees C to 7.73 at 20 degrees C, enhancing the temperature-induced shift in P50. Acclimation reverses partly the changes in O2 affinity, thereby improving the uptake of oxygen in the gills.

Acclimatization↗
PubMed1983

Tumour oxygenation under normobaric and hyperbaric conditions.

Tumour oxygenation during exposure to normobaric and hyperbaric oxygen was assessed by means of a cryophotometric micromethod and a specially constructed pressure chamber. The tumours investigated were DS-carcinosarcomas implanted subcutaneously into the thigh of Sprague-Dawley rats. The animals were anaesthetised and put on a heating pad. Mean arterial blood pressure was monitored throughout the entire time of pressurisation. Cryobiopsies were removed from the tumours after exposure to O2 for 30 min at 1 bar (atmospheric pressure), 2, 3, or 4 bar. Oxyhaemoglobin saturation (HbO2) values of single red blood cells in tumour microvessels were determined photometrically in the frozen tissue samples as a quantitative measure for tumour oxygenation. Frequency distribution curves of HbO2 showed that there was a marked improvement of the O2 supply to tumour tissue in O2 atmospheres at 1 bar compared with exposure to air at 1 bar. Pressurisation in O2 atmospheres up to 2 and 3 bar did not substantially alter the distribution curve of the HbO2 values in comparison with the data sampled at 1 bar O2 exposure, yet led to a significant drop in the occurrence of HbO2 values below 5% saturation. Thus, pressurisation particularly raises those tissue O2 partial pressures (pO2) that are in a range where the radiosensitivity is critically influenced by the pO2. Pressurisation up to 4 bar caused a shift of the HbO2 distribution curve to values significantly higher than those from tumours exposed to O2 at 1 bar, with no values below 35% saturation. Using these data and a previously published model for computing tissue pO2 values it can be shown that radiobiological hypoxia is unlikely to occur in DS-carcinosarcomas exposed to an O2 atmosphere at 4 bar under the conditions chosen. Hyperbaric oxygenation is recommended as an efficient adjuvant of X irradiation, particularly in superficial tumours.

Animals↗
PubMed1982

Impact of localized microwave hyperthermia on the oxygenation status of malignant tumors.

Upon heating at 40 degrees C for 30 minutes, the oxygenation of the tumor tissue significantly improved as compared with control conditions at 35 degrees C. In contradistinction to this, the tumor oxygenation significantly decreased directly after 43 degrees C- hyperthermia. A further temperature rise to 45 degrees C caused the oxygenation to drastically drop due to an almost complete cessation of nutritive blood flow. The changes in tumor oxygenation during hyperthermia seem to be predominatly mediated through changes in tumor blood flow, which showed the same directional changes.

Animals↗
PubMed1982

Oxygenation of malignant tumors after localized microwave hyperthermia.

The oxyhemoglobin saturation (HbO2) of single red blood cells within tumor microvessels (diameter: 3-12 micrometers) of DS-Carcinosarcoma was studied using a cryophotometric micromethod. In untreated control tumors (mean tissue temperature approx. 35 degrees C) the measured values scattered over the whole saturation range from zero to 100 sat. %, the mean being 51 sat. %. Upon heating at 40 degrees C for 30 min, the oxygenation of the tumor tissue significantly improved as compared with control conditions. After 40 degrees C-hyperthermia a mean oxyhemoglobin saturation of 66 sat. % was obtained. In contradistinction to this, after 43 degrees C-hyperthermia the tumor oxygenation was significantly lower and reached a mean HbO2 saturation value of 47 sat. %. A further temperature rise to 45 degrees C caused the oxygenation to drop drastically (mean oxyhemoglobin saturation value: 24 sat. %). This is due to a severe restriction of nutritive blood flow. The changes in tumor oxygenation after hyperthermia seem to be predominantly mediated through changes in tumor blood flow, including tumor microcirculation, which showed a similar temperature dependence. Metabolic effects probably play a minor role in the oxyhemoglobin saturation distribution within tumor microvessels.

Animals↗
PubMed1982

Changes in tumor oxygenation after localized microwave heating.

Upon heating at 40 degrees C for 30 min, the oxygenation of the tumor tissue significantly improved compared with control conditions at 35 degrees C. In contradistinction to this, the tumor oxygenation significantly decreased directly after 43 degrees C hyperthermia. A further temperature rise to 45 degrees C caused the oxygenation to drop drastically because of a severe restriction of nutritive blood flow. The changes in tumor oxygenation during hyperthermia seem to be predominantly mediated through changes in tumor blood flow, which showed the same directional changes.

Animals↗