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T Becker

Publications and source records attributed to T Becker.

At least 109 records · Page 6Linked to original sources
PubMed1999

Postoperative neuroimaging of high-grade gliomas: comparison of transcranial sonography, magnetic resonance imaging, and computed tomography.

BACKGROUND: A precise and comprehensive knowledge of tumor burden and its extent and growth pattern in the pre- and postsurgical states is required to optimize tumor therapy and to determine treatment success and failure. This prospective study compares the diagnostic potential of computed tomography (CT), magnetic resonance imaging (MRI), and transcranial sonography (TCS) in the postoperative follow-up of brain tumors. METHOD: Twenty-six patients with high-grade gliomas were included in the study. After tumor debulking, a total of 31 biopsy specimens were obtained from the resection margin in 21 patients and histological findings were compared with the findings of early postoperative TCS, CT, and MRI. Findings indicating residual tumor tissue were nonlinear contrast enhancement at the resection site revealed by CT or MRI or hyperechogenic lesions revealed by TCS. Follow-up examinations using all three imaging techniques were performed every 3 months. The end points of the follow-up were tumor recurrence as defined by CT and MRI, death, or severe clinical deterioration. RESULTS: On the basis of the above criteria, TCS identified residual tumor more often than did CT or MRI. In the group of 19 patients with histologically proven tumor remnants, residual tumor tissue was identified by TCS in all patients, whereas MRI and CT failed to show contrast enhancement in three and eight patients, respectively. However, the results of the TCS were false positive for one patient because of hemorrhage into the resection site. The average time to identification of tumor regrowth was 27 weeks using TCS, 29 weeks using CT, and 33 weeks using MRI. Only the differences between TCS and MRI reached statistical significance. For one patient, multicentric tumor recurrence was not detected using TCS. CONCLUSION: TCS may complement CT and MRI in the postoperative follow-up of patients with high-grade gliomas. Because none of these modalities alone is both sensitive and specific, an integrated analysis of imaging findings is recommended.

Adult↗
PubMed1999

The EPSILON study of schizophrenia in five European countries. Design and methodology for standardising outcome measures and comparing patterns of care and service costs.

BACKGROUND: There is a lack of cross-national research on care for people with schizophrenia. AIMS: To produce standardised European versions of five instruments in key areas of mental health service research in five languages, and to compare data from five European countries regarding patients with schizophrenia and mental health care provision and costs. METHOD: Five centres, in Amsterdam, Copenhagen, London, Santander and Verona, participated. Instruments assessing needs, service use, informal career involvement, quality of life, and service satisfaction were subjected to a conversion procedure including translation, back-translation, focus group discussion and reliability assessment. Patients of local mental health services with a Schedules for Clinical Assessment in Neuropsychiatry diagnosis of schizophrenia were interviewed. RESULTS: Service provision varied between sites; 404 patients were studied. Instrument reliability was found to be good. CONCLUSIONS: The instruments developed were reliable across the range of countries, and will facilitate future comparative health service research.

Adolescent↗
PubMed1999

[Does education prevent dementia?].

PURPOSE: The association of education and the risk of developing dementia are reviewed. Proposed underlying mechanisms are discussed with the particular reference to social aspects. METHODS: The discussion is based on recent work published on the association of education and dementia risk dealing with incident cases. RESULTS: Strength and consistency of the association as well as the partly established dose response relationship indicate that higher education is associated with a lower risk of developing dementia. This had been explained as a consequence of a greater "brain reserve capacity", which might be constituted by different mechanisms in early periods of CNS-development and during adulthood. CONCLUSIONS: Education rather compensates neuro-degenerative changes than protects from dementia. Clinical signs of dementia will be delayed but not prevented. The knowledge about social aspects of this process implies the search for interventions.

Achievement↗
PubMed1999

[Development of a standardized documentation system for outpatient non-hospital based psychiatric care].

An instrument documenting the care process in in-patient psychiatric services within the German mental health care system has been developed (BADO). This paper reports on the development of a documentation system for all non-hospital based mental health services (day centres, community mental health centres, supported accommodation, work rehabilitation services for general adult psychiatric patients and people with substance misuse). The development process and the instrument (PC and paper and pencil version) are described. The documentation system (BADO-K) could be an important prerequisite for quality assurance in non-hospital based mental health care, and its structure ensures compatibility with the corresponding hospital-based documentation system.

Adult↗
PubMed1998

Readiness of zebrafish brain neurons to regenerate a spinal axon correlates with differential expression of specific cell recognition molecules.

We analyzed changes in the expression of mRNAs for the axonal growth-promoting cell recognition molecules L1.1, L1.2, and neural cell adhesion molecule (NCAM) after a rostral (proximal) or caudal (distal) spinal cord transection in adult zebrafish. One class of cerebrospinal projection nuclei (represented by the nucleus of the medial longitudinal fascicle, the intermediate reticular formation, and the magnocellular octaval nucleus) showed a robust regenerative response after both types of lesions as determined by retrograde tracing and/or in situ hybridization for GAP-43. A second class (represented by the nucleus ruber, the nucleus of the lateral lemniscus, and the tangential nucleus) showed a regenerative response only after proximal lesion. After distal lesion, upregulation of L1.1 and L1.2 mRNAs, but not NCAM mRNA expression, was observed in the first class of nuclei. The second class of nuclei did not show any changes in their mRNA expression after distal lesion. After proximal lesion, both classes of brain nuclei upregulated L1.1 mRNA expression (L1.2 and NCAM were not tested after proximal lesion). In the glial environment distal to the spinal lesion, labeling for L1.2 mRNA but not L1.1 or NCAM mRNAs was increased. These results, combined with findings in the lesioned retinotectal system of zebrafish (Bernharnhardt et al., 1996), indicate that the neuron-intrinsic regulation of cell recognition molecules after axotomy depends on the cell type as well as on the proximity of the lesion to the neuronal soma. Glial reactions differ for different regions of the CNS.

Animals↗
PubMed1998

Links between social network and quality of life: an epidemiologically representative study of psychotic patients in south London.

Quality of life has been found to be associated with social networks in patients with psychiatric disorders. We aimed to determine whether quality of life was related to social network size in group of severely mentally ill subjects living in the community. In a population-based, prospective controlled study of two sector mental health teams in South London, a random sample of representative 1-year prevalent cases of non-organic psychosis was identified. Patients were interviewed at baseline, and associations between quality of life and social network size were analyzed cross-sectionally. For average quality of life there was increase up to a certain level of social network size (about 20 social contacts). For the quality of life subscore on social relations there appeared to be an optimal middle level of network size (10-12), with lower subscores for smaller and larger networks. Multivariate analysis confirmed the associations between quality of life and social network size. In analyses of network subgroups the importance of confiding contacts was underlined.

Adolescent↗
PubMed1998

The diagnostic importance of eosinophil granulocytes in the CSF of children with ventricular-peritoneal shunt systems.

We investigated the occurrence of cerebrospinal fluid (CSF) eosinophilia in patients with ventriculo-abdominal shunt systems with regard to possible infection. For this purpose, we examined the CSF of 83 children at the time of shunt obstruction or malfunction. In 32 children (38.6%) we found more than 4% of eosinophil granulocytes in the CSF with a maximum of 76%. In 15 of these 32 children the CSF was sterile, whereas in 17 patients bacterial infection was present. In the CSF of 16 of those 17 children, Staph. epidermidis was cultivated. There was statistically significant correlation between positive Staph. epidermidis culture and the occurrence of CSF eosinophilia (P<0.05). The occurrence of CSF eosinophilia in patients with ventriculo-peritoneal shunts is well known and was mostly attributed to an allergic reaction. Our findings support the theory of an infectious etiology of the eosinophilia and are thus in line with new American and French studies. We believe that CSF eosinophilia indicates a persistent infection of the central nervous system by the contaminated shunt system. As the organism which is the most common cause we cultured Staph. epidermidis.

Child↗
PubMed1998

Social networks and mental health service utilisation--a literature review.

Social networks have been shown to be smaller in individuals with severe mental illness than in the general population. Patients' social networks and social support may impact on their utilisation of psychiatric services. This literature review focuses on social networks, social support and mental health service use in patients with mental illness. Most studies suggest that smaller social networks or less social support are associated with more frequent hospitalisation. Qualitative aspects of the social network are also related to the risk of hospitalisation. The relationship between social networks and other types of service use is not established.

Ambulatory Care↗
PubMed1998

Evolving service interventions in Nunhead and Norwood. PRiSM Psychosis Study. 2.

BACKGROUND: Service evaluation requires a detailed understanding of the services studied. METHOD: Community mental health services evaluated in the PRiSM Psychosis Study in south London are described. The intensive sector and standard sector services are contrasted. RESULTS: The intensive sector had two teams with extended opening hours: a psychiatric acute care and emergency (PACE) team, and a psychiatric assertive continuing care (PACT) team focusing on care for people with chronic illness. In the standard sector there was a generic community team providing office-hour assessments, case management of the severely mentally ill and close liaison with in-patient services. The team made use of the local psychiatric emergency clinic and of other local resources. The intensive sector was characterised by: more admissions to fewer beds, more nonhospital residential places, extended hours, on-call rota, wider range of interventions, more medical and nursing staff, a lower nursing grade mix and higher staff turnover. The standard sector had a less highly resourced generic community psychiatric service. CONCLUSIONS: Change in services has been more marked in the intensive sector.

Bed Occupancy↗
PubMed1998

Impact of community mental health services on users' social networks. PRiSM Psychosis Study. 7.

BACKGROUND: Social networks are important for people with severe mental illness, and services need to assess whether they succeed in improving social contacts. METHODS: In a prospective controlled study, social network data were obtained in an epidemiologically representative sample of people with psychotic disorders both before (Time 1) and two years after (Time 2) the introduction of two sectorised community mental health services in south London (one intensive service with two specialist teams, one standard service with a generic team). RESULTS: There were significant baseline differences between sectors with social networks being smaller in the sector later served by the intensive service. Social network size increased within the intensive service sector, but not in the standard service sector. There was a significant sector effect for the network component of relatives (intensive > standard) and in the other ('non friends') component (standard > intensive) after adjusting for baseline differences. CONCLUSIONS: The findings suggest that the intensive sector community mental health service enhanced people's social networks with their relatives, relative to the standard service. The reverse is the case for other contacts.

Community Mental Health Services↗
PubMed1997

Lead based paint hazards in early childhood centres in the Wellington region.

AIM: To determine the frequency of exposure to lead based paint (LBP) in early childhood centres (ECCs) in the Wellington region. METHODS: Senior staff at sixty nine randomly selected licensed ECCs in the Wellington region were contacted. Fifty two centres consented to participate. Senior staff at these centres were interviewed and centres built before 1980 were examined for damaged LBP surfaces accessible to children. The survey was carried out between July 1995 and January 1996. A centre was considered to be LBP positive if it had at least one damaged LBP surface accessible to children in the course of a normal day's activities. RESULTS: Fifty two per cent of surveyed centres were LBP positive. LBP hazards were detected in 60% of buildings built before 1965 and 30% of buildings constructed between 1965 and 1980, and were found more frequently in Te Kohanga Reo and childcare centres. Although children aged 2 years and under constituted only 27% of all children attending surveyed centres, over half (53%) of the children in this age group attended centres with an LBP hazard. Staff at ECCs were often uncertain about the causes and outcomes of lead toxicity and expressed a desire for further education. CONCLUSION: There is significant potential for exposure to lead in early childhood centres in Wellington as a consequence of accessible damaged lead based paint surfaces.

Administrative Personnel↗
PubMed1997

Distribution of metabotropic glutamate receptor type 1a in Purkinje cell dendritic spines is independent of the presence of presynaptic parallel fibers.

The metabotropic glutamate receptor type 1a (mGluR1a) is expressed at a high level in the molecular layer of the cerebellar cortex, where it is localized mostly in dendritic spines of Purkinje cells, innervated by parallel fibers. Treatment with methylazoxymethanol (MAM) of mouse pups at postnatal days (PND) 0 + 1 or 5 + 6 results in the partial loss of granule cells, the extent of which depends on the age of the animal at the time of injection. As a consequence of hypogranularity, the number of parallel fibers is decreased to such an amount that many of the postsynaptic Purkinje cell dendritic spines are devoid of axonal input, and only a limited number of spines participate in the formation of parallel fiber synapses, or, infrequently, in heterologous or heterotopic synapses with other presynaptic partners. At PND 30, 50% of the spines in the cerebella of mice treated with MAM at PND 0 + 1 was not contacted by any presynaptic element, compared to 5% in controls or 15% in the cerebella of mice treated with MAM at PND 5 + 6. The localization of mGluR1a was visualized by immunocytochemistry on ultrathin sections: approximately 80% of all Purkinje cell dendritic spines were immunopositive in controls and in both groups of MAM-treated mice, indicating that mGluR1a was present in Purkinje dendritic spines even when the corresponding synaptic input was absent. This observation indicates that the expression and subcellular distribution of mGluR1a are inherent, genetically determined properties of Purkinje cells.

Aging↗
PubMed1997

MRI T2 relaxation times of brain regions in schizophrenic patients and control subjects.

In this MRI investigation T2 relaxation times were studied in schizophrenic patients compared to normal control subjects. Approximate T2 relaxation times were calculated using signal intensity at two echo times in several brain regions of 25 male schizophrenic patients and 25 age-matched, normal male control subjects. The schizophrenic patients showed significantly longer T2 relaxation times as compared to normal control subjects in the left anterior column of the fornix. This is a small structure, prone to partial volume effects and this may account for these findings. There was a trend towards longer T2 times in the left frontal cortex and shorter T2 times in [corrected] right temporal cortex in schizophrenic patients as compared to control subjects. There were right/left differences in relaxation times within each group. In both patients and control subjects, frontal lobe white matter T2 was longer on the right than on the left side. This finding is probably due to brain asymmetry and unrelated to the presence or absence of psychiatric illness. In schizophrenic patients only the left temporal cortex showed longer T2 times than the right side. This observation could indicate left sided temporal lobe pathology in schizophrenia.

Adolescent↗
PubMed1997

Axonal regrowth after spinal cord transection in adult zebrafish.

Using axonal tracers, we characterized the neurons projecting from the brain to the spinal cord as well as the terminal fields of ascending spinal projections in the brain of adult zebrafish with unlesioned or transected spinal cords. Twenty distinct brain nuclei were found to project to the spinal cord. These nuclei were similar to those found in the closely related goldfish, except that additionally the parvocellular preoptic nucleus, the medial octavolateralis nucleus, and the nucleus tangentialis, but not the facial lobe, projected to the spinal cord in zebrafish. Terminal fields of axons, visualized by anterograde tracing, were seen in the telencephalon, the diencephalon, the torus semicircularis, the optic tectum, the eminentia granularis, and throughout the ventral brainstem in unlesioned animals. Following spinal cord transection at a level approximately 3.5 mm caudal to the brainstem/spinal cord transition zone, neurons in most brain nuclei grew axons beyond the transection site into the distal spinal cord to the level of retrograde tracer application within 6 weeks. However, the individually identifiable Mauthner cells were never seen to do so up to 15 weeks after spinal cord transection. Nearly all neurons survived axotomy, and the vast majority of axons that had grown beyond the transection site belonged to previously axotomized neurons as shown by double tracing. Terminal fields were not re-established in the torus semicircularis and the eminentia granularis following spinal cord transection.

Afferent Pathways↗
PubMed1997

[Not Available].

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Journal Article↗
PubMed1997

Fenoterol but not dobutamine increases erythropoietin production in humans.

OBJECTIVE: This study assessed the role of adrenergic signal transmission in the control of renal erythropoietin (EPO) production in humans. METHODS: Forty-six healthy male volunteers underwent a hemorrhage of 750 ml. After phlebotomy, they received (intravenously for 6 hours in a parallel, randomized, placebo-controlled and single-blind design) either placebo (0.9% sodium chloride), or the beta 2-adrenergic receptor agonist fenoterol (1.5 microgram/min), or the beta 1-adrenergic receptor agonist dobutamine (5 micrograms/kg/min), or the nonselective beta-adrenergic receptor antagonist propranolol (loading dose of 0.14 mg/kg over 20 minutes, followed by 0.63 micrograms/kg/min). RESULTS: The AUCEPO(0-48 hr)fenoterol was 37% higher (p < 0.03) than AUCEPO(0-48 hr)placebo, whereas AUCEPO(0-48 hr)dobutamine and AUCEPO(0-48 hr)propranolol were comparable with placebo. Creatinine clearance was significantly increased during dobutamine treatment. Urinary cyclic adenosine monophosphate excretion was increased only by fenoterol treatment, whereas serum potassium levels were decreased. Plasma renin activity was significantly increased during dobutamine and fenoterol infusion. CONCLUSIONS: This study shows in a model of controlled, physiologic stimulation of renal erythropoietin production that the beta 2-adrenergic receptor agonist fenoterol but not the beta 1-adrenergic receptor agonist dobutamine is able to increase erythropoietin levels in humans. The result can be interpreted as a hint that signals for the control of erythropoietin production may be mediated by beta 2-adrenergic receptors rather than by beta 1-adrenergic receptors. It appears to be unlikely that an increase of renin concentrations or glomerular filtration rate is causally linked to the control of erythropoietin production in this experimental setting.

Adrenergic beta-Agonists↗