Biomedical subjects
Publications and source records attributed to U John.
In a basic part are discussed: aims of the diagnosis, psychological and somatic dependence, psychological defence of the reality of dependence, the estimation of alcoholism and its "severity", the alcohol dependence syndrome and approaches to a multidimensional diagnosis. A second part deals with single diagnostic methods. Combinations out of self-statements of the probands and medical results provide a differentiated diagnosis.
The aim of the study is to analyse memory deficits of alcohol dependents after detoxification with regard to the degree of recovery since the beginning of abstinence. Four samples include in the whole 168 alcohol dependent in-patients of same age and sex. Psychological tests of verbal as well as visual memory with retention times of a few seconds to 30 minutes were applicated, among others the Auditory-Verbal-Learning-Test, the digit span as well as the Benton-Visual-Retention-Test. The results show that the performance grows with time of abstinence. This increase, however, is nearly finished after seven days. In the discussion the idea of a dichotomization of the detoxification development concerning the memory performance is encouraged according to which in a first stage of about seven days the most pronounced disturbances become less. In a second stage lasting weeks cognitive deficits of a minor degree remain. This is in accordance with other studies in which however the age was not controlled well.
The ICD-10 field trial of section F1 (mental and behavioural disorders due to psychoactive substance use) shows comparatively high acceptance of the new classification in German-speaking countries. Goodness of fit and subjective confidence of the main diagnosis are above average. Analysis of interrater reliability with regard to main diagnostic categories reveal certain problems. The reliability values are flow average within the ICD-10 field study. Possible causes for low interrater reliability are inadequate differentiation from section F0 (organic disorders) and uncertainties in the differential assessment of psychopathological symptoms between F1 and F2, as also between F1 and F4. Interrater reliability could be improved by introducing "psychoactive substance use" as a separate axis in a forthcoming multiaxial scheme for ICD-10.
Bone-marrow stem cell culture allows an insight into the regulatory system of normal and disturbed haemopoiesis. However, the prerequisite for it is that defined conditions of cultures are created. One step in this direction is the application of conditional media as a source of colony stimulating activity. The capacity of various conditioned media to stimulate proliferation and differentiation of human bone-marrow cells was examined and compared with the traditional feeder technique. In this respect the addition of 15% of umbilical cord conditioned medium proved to be well suited to achieve reproducible results.
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One hundred and four alcoholics who had undergone detoxification in two psychiatric hospitals in West Germany were examined regarding psychological defence, attitudes and norms towards abstinence. Results show that along with loss of well-being and the increasing perception of the negative consequences of alcohol abuse, there is a lessening of defence, an advanced stage of dependence and pronounced abstinence intention. One conclusion is that psychological defence mechanisms of alcohol dependent persons can be explained on the basis of threat to the sense of self worth or cognitive dissonance.
On grounds of the literature about significant others of psychiatric patients it is to look for by what kind of characteristics different groups of significant others (mothers, spouses, others) may be differentiated and which variables characterize confident relationships and bonds. Significant others of psychiatric patients were investigated as well as the patients who belong to the diagnostic groups schizophrenia, depression or mania (RDC-criteria). They were investigated during and after an inpatient stay in one of the three psychiatric inpatient treatment centers in a large city of West Germany. For data analysis correspondence analysis was used, a method which is able to show correspondence between several characteristics by a computational as well as graphical way. Results show particularly two groups of significant others: burdened mothers and partners of depressed or manic patients. A confident relationship exists if daily contact was given as well as feeling attached to the patient and feeling burdened. Maintaining a confident relationship in spite of burden is explained by cognitive processes of attachment.
Alcohol-dependent women undergoing detoxification treatment in psychiatric wards are compared to men with respect to sociodemographic and treatment-oriented variables. For these comparisons, patient documentation from all psychiatric hospitals in one large West German city were analyzed. Representativeness is shown by data of the general population of corresponding age. Findings are presented in relation to data of long-term inpatient therapy. Results show that the detoxified women are socially less poorly integrated than men and suggest that our common ideas about a drinking career are based on experience with male alcoholics.
Detoxified alcoholics in psychiatric hospitals of a West German large city are investigated with regard to the question who of them get recommendations for further rehabilitation: to take part in a self help group or therapy. Patient documentations of two years are analysed. Results show that few detoxified alcoholics get advice for further rehabilitation. These persons are socially more integrated than those without advice.
The incidence of bacterial contamination under ICU-conditions of two solutions designed for enteral feeding; the oligopeptide mixture Peptisorb and the nutrient defined diet Biosorb, were investigated. 54% of the specimens taken prior to use from the oligopeptide mixture, which is marketed as a powder and brought into solution before application, were found to be bacterially contaminated. At the end of the 6-12 h application period this percentage has risen to 79%. Prior to use the sterile packed prepared nutrient defined diet was found to be free of bacterial contamination in 97% of cases, while at the end of the period of application 21% of the samples taken contained bacteria. In most instances the solutions prepared on ICU were contaminated with gram positive spore forming bacteria and typical gram negative hospital flora. Based on the results of this investigation, only those enteral feeds which are marketed as sterile solutions should be used, in order to protect ICU patients from potential sources of contamination.
Two groups of alcoholics not motivated to take part in therapy 6 months after detoxification are differentiated using various aspects of their career. The 'career' covers the development of alcoholism including drinking, social and psychological characteristics not necessarily resulting from alcohol abuse. The study is an explorative one. The results suggest that the career is a useful dimension for distinguishing groups of alcoholics who are not motivated towards therapeutic intervention.
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A mitochondrial gene (denoted aap1) in Saccharomyces cerevisiae has been characterized by nucleotide sequence analysis of a region of mtDNA between the oxi3 and oli2 genes. The reading frame of the aap1 gene specifies a hydrophobic polypeptide containing 48 amino acids. The functional nature of this reading frame was established by sequence analysis of a series of mit- mutants and revertants. Evidence is presented that the aap1 gene codes for a mitochondrially synthesized polypeptide associated with the mitochondrial ATPase complex. This polypeptide (denoted subunit 8) is a proteolipid whose size has been previously assumed to be 10 kilodaltons based on its mobility on SDS-polyacrylamide gels, but the sequence of the aap1 gene predicts a molecular weight of 5,815 for this protein.
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Haemolytic substances produced by ichthyotoxic algae often are unknown in molecular structure or specific mechanism of toxicity. Detection and quantification of such substances are dependent on bioassays, using markers that are sensitive for haemolytic impairment and generation of a recordable response. The erythrocyte lysis assay (ELA) represents an advantageous bioassay in this respect, because the lytic response can be measured photometrically by the amount of released haemoglobin. The aim of the present study was to establish an improved assay based on the ELA principle, for sensitive determination of haemolytic substances of microalgae and for high sample throughput. For this purpose we adapted the ELA to a 96-well microtitre plate format, which significantly reduced the sample volumes and allowed rapid processing of samples. Further improvement was achieved by measuring absorption of lysed erythrocytes at 414 nm, which significantly increased the sensitivity of the ELA compared to the measurements at 540 nm that are usually applied in this type of assay. Using carp (Cyprinus carpio) erythrocytes it was possible to detect haemolysis induced by 4 microg ml(-1) of saponin and as little as two haemolytic Alexandrium tamarense cells. It is suggested that this improved ELA in microtitre plates be used as a low-cost monitoring tool for detection and analysis of potential harmful algae. Furthermore, this ELA can be useful as a sensitive screening system for substances of pharmacological interest, e.g. selectively acting cytolytic antibiotics.
Previous research may have underestimated physicians' detection rates of alcohol dependence or abuse because case findings have been based on screening questionnaires instead of using in-depth diagnostic criteria and detection rates have been assessed by analyzing patient records instead of directly interviewing the physician. To test this hypothesis, consecutive patients of a general hospital (N=436) and of 12 randomly selected general practices (N=929) were examined. A two-step diagnostic procedure included screening questionnaires and a diagnostic interview (SCAN). The analysis compares detection rates based on methods used in previous studies to data using more precise methods. Physicians' detection rates ranged from 37.0% to 88.9% in the general hospital and from 11.1% to 74.7% in general practices depending on methods used. The physicians' detection rates could be improved by 10% (general hospital) and 20% (general practice) through the additional use of a screening questionnaire. Of those patients assessed by the physicians as problem drinkers in the general hospital, 13.9% were referred to an addiction consultation-liaison service. Data reveal that physicians' abilities to detect problem drinkers have been underestimated. Routine screening procedures could play a major role in improving detection rates and reminding the physician to intervene.