[Hepatorenal syndrome].
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Biomedical subjects
Publications and source records attributed to R Wenzel.
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Mycoplasma pneumoniae, a bacterium pathogenic for humans, has a relatively small genome size of 840 kbp. Even though, several repeated DNA elements have been identified in the genome of this prokaryote, particularly within the P1 gene which codes for a major adhesin protein of M. pneumoniae. These elements were characterized in detail with respect to size, number and distribution on the genome, represented by an ordered cloned library covering the complete chromosome. Three different repetitive elements were detected in and around the P1 gene designated as RepMP2/3, RepMP4 and RepMP5. The length of these elements varies between 1.1-1.5 kbp (RepMP4), 1.8 kbp (RepMP2/3) and 1.9-2.2 kpb (RepMP5). They occur at least 8 to 10 times on the chromosome. Possible functions are discussed and a uniform nomenclature for these repeats is proposed.
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A comparison was carried out between 237 hospitalised patients with emotional disorders during the years 1972-1975, and 316 patients between 1982 and 1985. The number of admissions as a percentage of all psychiatric admissions rose from 18.21% to 26.49%. There was a significant rise in the number of readmissions, notably from the third admission upwards, but a considerable reduction in the length of stay in hospital. During the period the number of admissions to general hospitals within the catchment area was reduced by about one half, with the result that there was no appreciable overall increase in the number of admissions for in-patient treatment of emotional disorders in the ten-year period.
The complete genome of Mycoplasma pneumoniae was cloned in an ordered library consisting of 34 overlapping or adjacent cosmids, one plasmid and two lambda phages. The genome size was determined by adding up the sizes of either the individual unique EcoRI restriction fragments of the gene bank or of the XhoI fragments of genomic M. pneumoniae DNA. The values from these calculations, 835 and 849 kbp, are in good agreement. An XhoI restriction map was constructed by identifying adjacent DNA fragments by probing with selected cosmid clones.
Cilofungin (LY121019) was shown to have potent fungicidal activity against clinical isolates of Candida albicans and Candida tropicalis but not Candida parapsilosis. Fungicidal activity was evident against both replicating and non-replicating Candida albicans and was progressive over the first 12 h of incubation. The combination of cilofungin (LY121019) with anticapsin but not with amphotericin B, ketoconazole or 5-fluorocytosine resulted in synergistic fungicidal activity. This compound warrants further investigation of its safety and efficacy in the treatment of Candida infections.
A total of 911 sera from 171 patients at risk for systemic candidiasis and 24 sera from 24 non-hospitalized control subjects were analyzed for the presence of candida antigen using a commercially available latex agglutination test (Cand-Tec). Thirty-seven (22%) patients had systemic candidiasis documented by positive blood cultures, deep biopsy culture and histopathology or autopsy. Six patients had transient candidemia, 20 patients had candiduria, 53 patients had mucous membrane colonization, 21 patients were not colonized but received empiric amphotericin B, and 34 patients were not colonized and not treated with amphotericin B. The intraobserver reproducibility was 90% for the exact titer and 100% for a deviation of one dilution. The sensitivity and specificity of the candida antigen test in detection of systemic candidiasis was 95% and 50% (greater than or equal to 1:2), 73% and 72% (greater than or equal to 1:4), and 46% and 80% (greater than or equal to 1:8) respectively. Despite the poor specificity, serial antigen determinations in patients with documented systemic candidiasis demonstrated both an early diagnostic and prognostic role for the candida antigen test. Seventy-one percent of patients whose antigen titer increased during the course of amphotericin B therapy of documented infection died versus only 13% of those whose titer decreased while on therapy (p = 0.01). The candida antigen test has a limited yet potentially useful role in the diagnosis and management of systemic candidiasis in high-risk patients.
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Over a period of four years, 316 emotionally disordered patients were inspected for the frequency of seasonally conditioned hospitalisation, considering however solely the most recent prior hospitalisation within the four-year period. A cautious interpretation of the results would suggest significant differences in the seasonal frequency of emotional disorders that have resulted in hospitalisation. Manic depressive disorders, endogenous depression, and involutional depressions treated in hospital occur with the greatest frequency in autumn. These results suggest the possibility of employing thymoleptic treatment, notably to effect an influence on biorhythms, for instance, lithium, deprivation of sleep, and bright-light therapy.
In order to study the genome organization of Mycoplasma pneumoniae a cosmid library of M. pneumoniae DNA was established using a newly designed cosmid vector (pcosRW2). From this library 32 overlapping clones were isolated covering a contiguous 720 kbp DNA segment representing about 90% of the genome assuming a genome size of about 800 kbp.
Two types of different repetitive DNA sequences called RepMP1 and RepMP2 were identified in the genome of Mycoplasma pneumoniae. The number of these repeated elements, their nucleotide sequence and their localization on a physical map of the M. pneumoniae genome were determined. The results show that RepMP1 appears at least 10 times and RepMP2 at least 8 times in the genome. The repeated elements are dispersed on the chromosome and, in three cases, linked to each other by a homologous DNA sequence of 400 bp. The elements themselves are 300 bp (for RepMP1) and 150 bp (for RepMP2) long showing a high degree of homology. One copy of RepMP2 is a translated part of the gene for the major cytadhesin protein P1 which is responsible for the adsorption of M. pneumoniae to its host cell.
The psychiatric adjustment centre is an important link in the treatment of chronic alcoholics. The adjustment centre attached to the County. Neurological Hospital at Lübben is used as an example to discuss the problems associated with sheltered work, living and recreation places. On the basis of four years of experience it can be said that some 10% of our patients with alcohol problems, most of whom have already broken links with their families and some of whom have already rejected society, require this form of treatment. Attention is drawn to the gradual transition from ward to outpatient treatment of patients with alcohol problems.
The problem of paranoiac development has been a subject of interest to psychopathologists since Jasper 's times. The clinical psychiatrist should still take pains to make a careful diagnosis of paranoiac developments and to prevent them from deteriorating into schizophrenia. The author presents a case study involving a querulous form of paranoiac development and discusses possibilities of counselling and treatment.
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