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T Fuchs

Publications and source records attributed to T Fuchs.

At least 55 records · Page 3Linked to original sources
PubMed1993

[Delusion syndromes in sensory impediment--overview and model presentation].

Since Kraepelin's description of the "paranoia of the deaf" in 1915, the connection between sensory impairment and paranoid states in old age has been repeatedly confirmed. Parallels may be drawn to delusional syndromes caused or triggered by linguistic isolation, sensory aphasia and the perceptual disturbances in early schizophrenia. An overview on the different delusional phenomena in sensory-perceptual dysfunction is given, followed by a pathogenetic model proposed in analogy to the "perceptual-release" theory of hallucinations: Reduction of sensory input and blurring of afferent schemas in the perception process result in a compensatory stimulation and "release" of paranoid patterns of information processing. Consistency of perception is reestablished at the price of rigid, delusional interpretation of ambiguous social situations.

Aged↗
PubMed1993

Influence of implantable cardioverter-defibrillators on the long-term prognosis of survivors of out-of-hospital cardiac arrest.

BACKGROUND: Survivors of out-of-hospital cardiac arrest not associated with acute myocardial infarction are at high risk for recurrent cardiac arrest and sudden cardiac death. The impact of the implantable cardioverter-defibrillator on long-term prognosis in these patients is uncertain. METHODS AND RESULTS: Three hundred thirty-one survivors of out-of-hospital cardiac arrest (age, 56 +/- 13.7 years) underwent electrophysiologically guided therapy. Implantable defibrillators were placed in 150 patients (45.3%), and 181 patients (54.7%) received pharmacological and/or surgical therapy alone. Left ventricular ejection fraction was 35.2 +/- 16.6% in defibrillator recipients and 45.3 +/- 18.2% in nondefibrillator patients. Median patient follow-up was 24 months in the defibrillator group and 46 months in the nondefibrillator group. In a proportional hazards model, the independent predictors of total cardiac mortality were left ventricular ejection fraction of less than 0.40 (relative risk, 4.55; 95% confidence interval, 2.44 to 8.33; P = .0001), absence of an implantable defibrillator (relative risk, 2.70; confidence interval, 1.41 to 5.00; P = .017), and persistence of inducible sustained ventricular tachycardia (relative risk, 1.84; 95% confidence interval, 0.97 to 3.49; P = .045). The 1- and 5-year probabilities of survival free of cardiac mortality in patients with left ventricular ejection fraction of less than 0.40 were 94.3% and 69.6% with a defibrillator and 82.1% and 45.3% without a defibrillator, respectively. For patients with left ventricular ejection fraction of 0.40 or more, the 1- and 5-year probabilities of survival free of cardiac mortality were 97.7% and 94.6% with a defibrillator and 95.4% and 86.9% without a defibrillator, respectively. CONCLUSIONS: In survivors of out-of-hospital cardiac arrest, the implantable defibrillator is associated with a reduction in cardiac mortality, particularly in patients with impaired left ventricular function.

Anti-Arrhythmia Agents↗
PubMed1993

Influence of injection speed on the subarachnoid distribution of isobaric bupivacaine 0.5%.

The purpose of this study was to compare the anesthetic characteristics after two radically different speeds of intrathecal injection of isobaric 0.5% bupivacaine during continuous spinal anesthesia. Forty consenting patients, undergoing hip surgery using continuous spinal anesthesia, were allocated randomly to two groups of 20 each according to the rate of injection of 2 mL (10 mg) of isobaric 0.5% bupivacaine: FI (fast injection = 2 mL during 2 to 3 s or approximately 0.75 mL/s) or SI (slow injection = 1 mL/min). No difference was observed between the two groups in terms of sensory and motor block or hemodynamic changes. However, the onset time to maximal sensory level was significantly shorter in the SI group (16 +/- 9 min vs. 24 +/- 6 min; P < 0.05). Those patients requiring reinjection entered the second part of the study (n = 23; 15 in the FI group and 8 in the SI group). Each of these remaining patients was used as his or her own proper control. Those in the FI group received a slow reinjection and those in the SI group received a fast reinjection which consisted in all cases of 10 mg (2 mL) of isobaric 0.5% bupivacaine. When looking at the anesthetic characteristics after reinjection, maximal sensory levels, as well as onset times, were very similar in both groups. At all times, the maximal sensory level obtained after reinjection was two dermatomes higher than after the initial injection. Duration of sensory block, which was calculated only in these 23 patients, was also comparable (126 +/- 44 min for FI and slow reinjection group vs 146 +/- 25 min for SI and fast reinjection group). In conclusion, regardless of the speed of injection, there are no differences in anesthetic characteristics of spinal anesthesia using isobaric 0.5% bupivacaine.

Aged↗
PubMed1993

Successful pregnancy in a 28-year-old patient autografted for acute lymphoblastic leukemia following myeloablative treatment including total body irradiation.

We report a successful pregnancy in a woman who at the age of 28 years received total body irradiation (TBI; 7.5 Gy) and high-dose chemotherapy prior to autografting of purged bone marrow for acute lymphoblastic leukemia. Four years after transplantation she delivered a healthy girl. Only five previous cases of successful pregnancies are described in the literature after conditioning regimens including TBI. This case shows that restored ovarian function is possible after TBI in spite of prolonged exposure to chemotherapeutic agents during induction and consolidation therapy and relatively high age at the time of transplantation.

Adult↗
PubMed1993

[Benzalkonium chloride--a relevant contact allergen or irritant? Results of a multicenter study of the German Contact Allergy Group].

At eight dermatological clinics, a total of 2146 patients were tested between May 1990 and December 1991 to determine the significance of the preservative benzalkonium chloride in inducing allergic contact dermatitis and to evaluate recommendations for patch testing. In 225 cases an allergic reaction was proven, with 258 irritant reactions in addition. Only 12 cases were clinically relevant. Therefore, benzalkonium chloride is considered a weak allergen. A doubtful (erythema) or an incipient positive (with occasional papules) reaction may be regarded as an irritant reaction. In isolated cases a "repeated open application test" (ROAT) should be applied to determine clinical relevance. Our recommendation for patch testing is 0.1% benzalkonium chloride in vaseline, and also in water for special cases.

Benzalkonium Compounds↗
PubMed1992

[Immediate allergic reaction to natural latex with special reference to surgical gloves].

There is an increasing incidence of contact urticaria (CU) and systemic reactions to rubber products. 34 patients are presented: Most were atopic (22/34) and women (29/34). 24 worked in the medical field. 13 patients showed signs of hand dermatitis. In 31 patients, rub and/or pricktests with liquid latex in different dilutions and with latex gloves led to positive reactions. The allergen(s) appear in part to be watersoluble: 23 of 31 patients revealed positive test reactions to an aqueous glove extract. In two patients, urticarial test reactions to TMTD, Mercapto-Mix, and PPD-mix were considered as possible contributing factor of CU. Scratch tests with corn-starch were negative in all patients. 17 of 29 sera showed RAST (radioallergosorbent test) class 0 using latex allergen disks. SDS-PAGE (sodiumdodecylsulfate-polyacrylamide-electrophoresis) determined protein bands of less than or equal to 14 kD (not allergen specific) and approximately 28 kD. The Western Blot detected the 28 kD protein as allergen in the sera of three patients. Isoelectric focusing (IEF) proved no protein bands. Immunoprinting performed with sera of five patients presented allergen bands in an pH range between 3.8 and 4.55. This shows that radiostaining (immunoprint) is more sensitive than the Coomassie Blue staining. Although three sera showed RAST class 0, immunoblotting detected allergen bands. In these cases the immunoblot appears to be more sensitive than the RAST. A cross reactivity between latex and banana could not be established. Alternative gloves are Neolon (neoprene) or Elastyren (styrene-butadiene polymer).

Adult↗
PubMed1992

The tRNA(Tyr) multigene family of Nicotiana rustica: genome organization, sequence analyses and expression in vitro.

Tobacco tRNA(Tyr) genes are mainly organized as a dispersed multigene family as shown by hybridization with a tRNA(Tyr)-specific probe to Southern blots of Eco RI-digested DNA. A Nicotiana genomic library was prepared by Eco RI digestion of nuclear DNA, ligation of the fragments into the vector lambda gtWES.lambda B and in vitro packaging. The phage library was screened with a 5'-labelled synthetic oligonucleotide complementary to nucleotides 18 to 37 of cytoplasmic tobacco tRNA(Tyr). Eleven hybridizing Eco RI fragments ranging in size from 1.7 to 7.5 kb were isolated from recombinant lambda phage and subcloned into pUC19 plasmid. Four of the sequenced tRNA(Tyr) genes code for the known tobacco tRNA1(Tyr) (G psi A) and seven code for tRNA2(Tyr) (G psi A). The two tRNA species differ in one nucleotide pair at the basis of the T psi C stem. Only one tRNA(Tyr) gene (pNtY5) contains a point mutation (T54-->A54). Comparison of the intervening sequences reveals that they differ considerably in length and sequence. Maturation of intron-containing pre-tRNAs was studied in HeLa and wheat germ extracts. All pre-tRNAs(Tyr)--with one exception--are processed and spliced in both extracts. The tRNA(Tyr) gene encoded by pNtY5 is transcribed efficiently in HeLa extract but processing of the pre-tRNA is impaired.

Base Sequence↗
PubMed1992

[Visual hallucinations in elderly patients with reduced vision: Charles Bonnet syndrome].

The authors report on a 81-year-old-lady with Charles Bonnet-syndrome. This syndrome is a special form of a visual hallucinosis, which affects typically otherwise healthy, elderly people, who mostly suffer from reduced vision. Ophthalmologic and psychiatric findings are demonstrated in detail, in particular a reduced left-occipital perfusion in this syndrome is shown with a spect (single photon computed tomography) and discussed with the published literature.

Aged↗
PubMed1992

Life-threatening allergic reaction to clozapine.

Clozapine, an 'atypical' antipsychotic drug, rarely induces allergic complications, which usually present as cutaneous reactions. We report the case of a 69-year-old woman, suffering from chronic schizophrenia, who developed an allergic asthmatic reaction following clozapine therapy. Intensive-care treatment was necessary. The reaction could be repeated by further exposure to the drug. Skin tests for hypersensitivity were negative.

Aged↗
PubMed1992

Consumer's attitude to hysterectomy. The experience of 678 women.

A total of 678 women were interviewed about symptoms before as well as advantages and disadvantages after abdominal hysterectomy. Medical complications, side effects, days of hospitalization and some possible differences between supravaginal hysterectomy (SVH) and total hysterectomy (TH) were also investigated. TH had been performed in 79% and SVH in 21% of the women. Leiomyoma was the most frequent diagnosis (79%). Heavy menstrual bleeding and dysmenorrhea were the dominant symptoms before surgery. After the operation, 71% of the women had no subjective gynecological complaints. Relief from heavy bleeding and pain was considered the major advantage and as many as 29% of the women experienced no disadvantage at all with the operation. Regarding sexual life, 39% experienced intercourse as much improved or better and 40% as unchanged. An intraabdominal abscess was more often found postoperatively in patients operated with TH than with SVH but with this exception no objective finding favoured one method more than the other. When new, alternative treatments such as endometrial ablation and GnRH analogues are introduced and promoted they should be subjected to careful evaluation and compared with the therapeutic efficacy of hysterectomy.

Adult↗
PubMed1992

[The hypochondriacal delusion].

Hypochondriacal delusions are not bound to a specific mental disorder, but occur in the whole spectrum of psychoses. In spite of the implicitly wrong conception of reality, the significance of these delusions as an attempt to express, interpret and cope with mental illness should not be neglected if an approach to the patient's own experience is sought. On the one hand, hypochondriacal delusions are based on altered body perceptions in mental illness, characterized by primary local or general dysaesthesias to the point of depersonalisation, or caused secondarily by the patient's increased attention to his own body. This alienated bodily experience is named in (lay) medical terms by the delusional hypochondriac. On the other hand, "illness" with its manifold cultural and psychological meanings stands as a polyvalent metaphor for the incomprehensible alteration of the patient's self-experience in general: thus, the feeling of exposure to external attacks, of guilt, sinfulness, shame, loss of self-esteem or even the experience of a disruption of personality may find their expression in the hypochondriacal delusion.

Adult↗