PubMed Health⌕ Search

Biomedical subjects

U Müller

Publications and source records attributed to U Müller.

At least 289 records · Page 16Linked to original sources
PubMed1994

A comparison of the effects of two monophasic low dose oral contraceptives on the inhibition of ovulation.

Fifty-three women were randomly allocated to one of two combined low-dose monophasic oral contraceptives (20 micrograms ethinyl estradiol with 75 micrograms gestodene or 20 micrograms ethinyl estradiol with 150 micrograms desogestrel). The ability of these formulations to inhibit ovulation was compared using hormonal parameters and ovarian ultrasound. The effects on three treated cycles were compared with pre- and post-treatment cycles. No ovulations occurred in either group during therapy. Twenty-one percent of women were observed to show some follicle-like structures accompanied by raised serum estradiol in at least one treatment cycle. No significant differences between the two preparations were demonstrated on residual ovarian function. The secretion of estradiol and progesterone was significantly reduced throughout all three treatment cycles. Mean LH and FSH concentrations were comparable with both treatments. A secondary analysis of cycle control and tolerance was undertaken. Significantly less bleeding was seen in the gestodene group during cycle 2 (p = 0.02). There were no differences between the two treatments with respect to the other cycle control parameters. Approximately half the women recorded intracyclic bleeding during the first treatment cycle. This improved during cycles 2 and 3. Both formulations were tolerated well.

Adolescent↗
PubMed1994

Molecular basis and diagnosis of neurogenetic disorders.

Over the past few years, molecular neurogenetics has developed into one of the most promising and active research fields. The new discipline applies modern molecular genetic techniques to the investigation of classical neurological disorders. In the following article, a definition of neurogenetic disease is introduced, the molecular basis of four groups of neurogenetic disorders is described and recent diagnostic developments are presented. The first group of diseases is caused by trinucleotide expansions. "Expanding" trinucleotide repeats were not known to occur in any species until about three years ago. Today, disorders such as Huntington's disease, spinocerebellar ataxia type 1, fragile X mental retardation, spinobulbar muscular atrophy and myotonic dystrophy are all known to be caused by the expansion of trinucleotides. The second group is characterized by chromosomal deletions or uniparental disomies. Lissencephaly and the Miller-Dieker syndrome, Prader-Willi and Angelman syndromes and Duchenne and Becker muscular dystrophies belong to this category. The third group includes those neurogenetic disorders that are mainly caused by point mutations such as the X-linked leukodystrophies, including Pelizaeus-Merzbacher disease and adrenoleukodystrophy, Charcot-Marie-Tooth syndrome type 1, familial forms of amyotrophic lateral sclerosis, several types of craniosynostoses and some CNS tumor syndromes. Finally, Alzheimer's and Parkinson's disease are discussed as representatives of group four, i.e. genetically heterogeneous neurological disorders.

Animals↗
PubMed1994

The therapeutic potential of bromocriptine in neuropsychological rehabilitation of patients with acquired brain damage.

1. Activation of neuropsychological rehabilitation by pharmacological agents is a promising therapeutic strategy. 2. Reports of single cases and case series claim improvement of akinetic mutism, non-fluent aphasia, apathy, attentional and other neuropsychiatric disturbances after treatment with bromocriptine, a D2 dopamine receptor agonist. 3. A critical review of published reports and own experiences discusses the results in the light of pharmacological and neurobiological considerations. 4. Dopaminergic stimulation after certain kinds of brain damage might influence neuronal recovery and/or substitute dopaminergical linked functions after destruction of the corresponding neurons. 5. Although controlled clinical studies are very difficult to design and such evidence is still lacking, preliminary recommendations are given with regard to differential indications, drug regime and evaluation criteria.

Brain Injuries↗
PubMed1994

[Does intravenous gadolinium-DTPA administration have advantages in magnetic resonance imaging of acute injuries or chronic damage to the knee joint?].

79 patients with acute or chronic lesions of the knee were evaluated by MRI prior to and after application of Gd-DTPA. The MRI examination was performed by a 1.0 tesla imager with SE as well as FEDIF sequences. These MR studies were compared prior to and after intravenous Gd-DTPA application, focusing on the visibility and the definition of a possible lesion, and scored with a 3-point score. Statistic analysis and case analysis revealed that in patients with meniscus degeneration without a tear, Gd application yields no additional diagnostic information. However, in patients with meniscus tears Gd-DTPA significantly facilitates the definition of the lesion. Furthermore, Gd-DTPA makes differentiation possible between the synovial fluid and the synovial membrane. Whereas in cases with capsule or collateral ligament tears Gd-DTPA facilitates the documentation of the lesion, we found no advantage in using Gd-DPTA in patients with ACL tears. In patients with chondropathia patellae Gd-DTPA application supports the visualization of the secondary synovial reaction.

Anterior Cruciate Ligament↗
PubMed1994

Deliverability of psychoeducational family management.

As part of an open clinical trial currently underway at the Max Planck Institute of Psychiatry in Munich, the feasibility of behavioral family management (Falloon et al. 1984) for schizophrenia in combination with two different neuroleptic medication strategies was investigated. The treatment approaches were psychoeducational family management with a standard dose or with targeted medication. In this article the following questions were addressed: (1) What proportion of the total schizophrenia population admitted as inpatients might be eligible for psychoeducational family treatment (assessment based on n = 411 over a 33-month period)? (2) How representative of this population are the patients who were randomized to the experimental groups? (3) How many patients dropped out of treatment after entering the trial? The results show that about 60 percent (247) of the patients were eligible for a psychoeducational treatment approach. Of these, 34 percent (85) participated in the trial and were randomized to the treatments. Only 4 percent of the relatives but 20 percent of the patients refused to take part in the study. The 85 trial patients did not differ from the total eligible on the numerous socioeconomic and symptom variables assessed. The treatment dropout rate was 11 percent. Those patients who accepted treatment did not differ from those patients who dropped out on socioeconomic or illness variables. The results indicate that early identification of dropouts is not possible at least with the methods used in this study.

Adolescent↗
PubMed1994

Intra-urethral ultrasound in women with stress incontinence.

OBJECTIVE: To investigate whether the sphincter area in women can be seen and quantified with intra-urethral ultrasound (IUUS). Currently, sphincter capacity in women is determined by clinical tests, vaginal palpation, urodynamics and urethral pressure profile. PATIENTS AND METHODS: A pilot study using IUUS was carried out in 32 stress incontinent and 12 healthy women to enable the urethra and para-urethral tissue to be visualized. Round-tipped miniature transducer-containing (20 MHz) catheters (6 and 9 F) were tested. Both provided 15 frames per second. Real-time 360 degrees cross-sectional ultrasound images were obtained by using a standard intraluminal ultrasound system. The external urethral sphincter was visualized and its circumference and area were measured. RESULTS: IUUS provided high resolution imaging of the urethra and surrounding tissues. The whole length of the urethra was visualized. The external sphincter was easily recognized as an oval-shaped, hypoechoic structure. Examination of 44 stress incontinent and healthy women revealed a negative correlation between the external urethral sphincter (area and circumference) and the grade of stress incontinence (P < 0.01). In no patient with normal urinary continence was the sphincter reduced in size (< 2.8 cm circumference). CONCLUSION: IUUS is a useful technique in the diagnosis of incontinence, as conventional methods provide little information on the sphincter itself. The evaluation of sphincter size and morphology could help in the choice of therapy.

Female↗
PubMed1994

Familial half cryptic translocation t(9;17).

A half cryptic translocation t(9;17) (p24.2; p13.3) was detected in a large family by fluorescence in situ hybridisation. Unbalanced karyotypes resulted either in lissencephaly and early death or in mental retardation, microcephaly, high arched palate, and deformities of the vertebrae. Some of the features observed in affected persons are characteristic of known syndromes involving either 17p or 9p.

Adolescent↗
PubMed1994

Calcium-activated release of nitric oxide and cellular distribution of nitric oxide-synthesizing neurons in the nervous system of the locust.

Nitric oxide (NO) is generated by a Ca2+/calmodulin-activated NO synthase and diffuses as a short-lived transcellular messenger through the plasma membrane. This study investigates the neurochemistry and anatomical distribution of NO-releasing cells in the CNS of the locust. Ca2+/calmodulin-activated NO synthase is responsible for fixation-sensitive NADPH diaphorase (NADPHd) activity in cell homogenates of the nervous system. Therefore, neurons expressing NO synthase were detected by NADPHd histochemistry performed in whole-mounts. The anatomical screening revealed fewer than 1% NADPHd-positive cells in the ventral nerve cord, some of which were single potentially identifiable neurons, and groups of cell bodies in several regions of the cerebral ganglion. A prominent feature of the histochemical survey in the cerebral ganglion is a group of 45 intensely stained cells innervating the olfactory neuropil of the antennal lobe. A basic requirement for identifying NO as a messenger molecule is the Ca(2+)-dependent release during nerve cell depolarization. With a sensitive photometric assay we demonstrated that dissociated cells from brain areas rich in NADPHd-positive neurons release NO after stimulation by agents elevating cytoplasmic Ca2+ levels and by the excitatory neurotransmitter acetylcholine. The combined anatomical and biochemical experiments therefore provide firm evidence that NO is a messenger molecule released in the CNS of the locust. Since locust neurons can be readily grown in primary culture, NO-induced elevations of CGMP levels and other signal transduction mechanisms in target cells will also be amenable to a cellular analysis.

Amino Acid Oxidoreductases↗
PubMed1994

[Detection of early warning signs in schizophrenic patients. Possible applications in prevention of recurrence].

In the treatment of schizophrenia, two new strategies have been developed with the aim of adequate relapse prevention accompanied by lowest possible risk of side-effects. One strategy is to have the patient continue to take medication at a highly reduced dosage (10-20% of the standard dose). The other is to gradually stop neuroleptic medication after remission and to reinstitute medication only in the case of prodromal symptoms (termed targeted or intermittent treatment). According to Herz and Melville [13] many schizophrenic patients show signs of relapse well before recurrence of overt psychotic features. Monitoring to detect prodromal symptoms is especially important in targeted treatment because, otherwise, neuroleptic medication often cannot be initiated in time. In the present study of 51 schizophrenic patients we were able to replicate the results of Herz & Melville in the German-speaking countries. Prior to acute exacerbation of psychosis, most patients experience alterations of feelings and behaviour. These alterations may also be recognized by family members. Such early warning signs of relapse mainly consist of non-specific, non-psychotic symptoms: tenseness and nervousness, eating less, trouble concentrating and sleeping, depressive mood and seeing friends less. Furthermore, the regular monitoring and use of early warning signs specific to each patient in the aftercare of schizophrenic patients seems to be practicable, especially in psychoeducative family therapy.

Adult↗
PubMed1994

[Symptomatic acoustic hallucinations after traumatic brain damage. Review of the literature and case report].

Symptomatic hallucinosis can be observed after subcortical lesions of different localisation with a predominance of complex-visual perceptive disturbances. Only single cases with complex acoustic hallucinosis have been reported in the literature. A 30-year-old patient is presented who suffered from a midbrain syndrome after severe traumatic brain injury and developed an acoustic hallucinosis in the chronic stage of rehabilitation. The functional relevance and therapeutic strategies are considered with regard to the relevant literature.

Adult↗
PubMed1994

[The apolipoprotein E-epsilon 4 allele is a risk factor for Alzheimer disease with early and late onset].

The apolipoprotein E genotype was determined in 50 patients with clinically diagnosed and prospectively confirmed Alzheimer's disease of mild to moderate severity and in 50 healthy age- and sex-matched controls. The frequency of the epsilon 4 allele was increased in the patients irrespective of the age at onset and of a possible familial transmission of the disease. It was associated with a relative risk of 2.97. In patients who experienced first symptoms after the age of 65 years there was an inverse correlation between the number of epsilon 4 alleles and age at onset. The results suggest that in the absence of amyloid precursor protein mutations and of a gene which has not yet been precisely localized on chromosome 14, apolipoprotein E is involved in the pathogenesis of Alzheimer's disease. It probably exerts its influence by an acceleration or retardation of amyloid formation and/or tau hyperphosphorylation.

Aged↗
PubMed1994

[Malignant meningeal "histiocytosis"].

Two cases of patients with unusual pleomorphic tumors in the meninges are reported. Histologically and immunohistologically, the tumor cells may be histiocytic in appearance. Computed tomography and magnetic resonance imaging scans, however, revealed no lesions in the parenchyma or in the meninges. The cytological examination of the cerebrospinal fluid revealed only a light lymphocytic reaction without tumor cells in both cases and thus led to misinterpretations as meningoencephalitis. One patient presented psychiatric symptoms. Related clinical problems and the possible histogenesis of the tumors are discussed.

Adult↗
PubMed1993

A mutation in the homeodomain of the human MSX2 gene in a family affected with autosomal dominant craniosynostosis.

Craniosynostosis, the premature fusion of calvarial sutures, is a common developmental anomaly that causes abnormal skull shape. The locus for one autosomal dominant form of craniosynostosis has been mapped to chromosome 5qter. The human MSX2 gene localizes to chromosome 5, and a polymorphic marker in the MSX2 intron segregates in a kindred with the disorder with no recombination. Moreover, a histidine substitutes for a highly conserved proline at position 7 of the MSX2 homeodomain exclusively in affected members. In the mouse, transcripts of the Msx2 gene are localized to calvarial sutures. These results provide compelling evidence that the mutation causes this craniosynostosis syndrome.

Acrocephalosyndactylia↗
PubMed1993

Distinct NF-kappa B/Rel transcription factors are responsible for tissue-specific and inducible gene activation.

The NF-kappa B/Rel family is a growing class of transcriptional regulators whose members share the conserved Rel-homology domain, involved in specific DNA binding and dimerization. They interact with the regulatory elements of many different genes and are involved in the regulation of lymphoid-specific and inducible transcription. We tested whether these factors could alone activate a gene in transgenic mice. We report here that a minimal promoter containing three copies of a binding site for these proteins allows tissue-specific and inducible transgene activation. In lymphoid tissues constitutive transgene expression correlates with the presence of a constitutively active p50/RelB heterodimer. Other organs that only contain the p50 homodimer do not express the transgene. In contrast to this constitutive activity mediated by p50/RelB, the p50/p65 heterodimer (which is NF-kappa B) could confer inducible transgene activation in embryo fibroblasts. Thus two different members of the NF-kappa B/Rel family of transcriptional activators are involved in tissue-specific and inducible gene activation in transgenic mice.

Animals↗