Biomedical subjects

Udo Reulbach

Publications and source records attributed to Udo Reulbach.

42 records · Page 3Linked to original sources

PubMed2003

P27 does not predict histopathological response to radiochemotherapy in rectal cancer.

BACKGROUND: Tumor response to radiochemotherapy (RCT) varies considerably, even among patients treated in accordance with the same protocol. The aim of the present study was to test the predictive value of the cell-cycle inhibitor p27kip1 with regard to neoadjuvant RCT response in rectal cancer. MATERIALS AND METHODS: P27kip1 was evaluated by immunohistochemistry in pretreatment biopsy material obtained from 42 patients with rectal cancer treated uniformly in accordance with an identical prospective neoadjuvant RCT protocol (CAO/AIO/ARO-94). Four expression patterns (staining intensity [-,+,++,+++] and the percentage of positive cells, evaluated separately for nuclei and cytoplasm) of p27kip1 were investigated for correlation with tumor response, which was assessed in the resected surgical specimen using a histopathological five-point grading system. Additionally, p27(kip1) expression was investigated for correlation with several pathological features, overall survival, and disease-free survival. RESULTS: p27kip1 expression was as follows: nuclear intensity: -: 8, +: 19, ++: 11, +++: 4 cases, median percentage of positive cells: 18.75%; cytoplasmic intensity: -: 0, +: 25, ++: 12, +++: 3 cases, median percentage of positive cells: 70%. Histopathological tumor regression was acceptable in 30 patients (3 complete; 27 good) and inadequate in 12 patients (7 moderate; 5 minimal). No tumor failed to show some regression. No significant correlation was found between any of the p27kip1 expression patterns and RCT response, tumor differentiation (low grade versus high grade), cT- and ypT-category, UICC stage, overall survival, and disease-free survival. CONCLUSIONS: p27kip1 cannot aid the individualization of multimodal treatment strategies in rectal cancer, nor can it serve as a predictor of survival.

Adenocarcinoma↗

PubMed2003

Improvement in response times for simple and complex tasks after electroconvulsive therapy.

BACKGROUND: Electroconvulsive therapy (ECT) has gone through fundamental changes since its introduction in 1938 and has developed from a frightening and distrusted procedure into an effective and safe treatment for people with severe psychiatric disorders. This study suggests that ECT has an effect on the response times of simple and complex tasks. METHODS: We had two groups. The first group consisted of eight patients suffering from severe therapy-resistant depression. They were treated with ECT. The second group consisted of eight sex- and age-matched persons who were treated conventionally with antidepressive medication. The authors measured auditory and visual response times of both simple and complex tasks in run A and run B on two different days. In the ECT group, the first measurement took place 1 day before a session of ECT, the second 3 h following a session of ECT. In the depressive control group, the two measurements were performed on two different days but at most within 4 days. RESULTS: The response times of the depressive subjects treated with ECT are prolonged in both run A and run B compared to those of the depressive control group. The response times in run B are reduced compared to run A on the whole. However the reduction is stronger in the ECT group than the one taking place in the depressive control group between the two runs. CONCLUSIONS: The considerable decrease of the response times from run A to run B in the ECT group compared to the depressive control group gives further evidence that ECT has a positive effect on important information processing parameters.

Adult↗

PubMed2003

Incidence and characteristics of segmental postsystolic longitudinal shortening in normal, acutely ischemic, and scarred myocardium.

OBJECTIVE: Myocardial longitudinal shortening after aortic valve closure (postsystolic shortening [PSS]) is considered a marker of pathology with diagnostic potential. However, PSS can also occur in healthy subjects. We, therefore, investigated the occurrence and characteristics of PSS in control subjects and patients, and how to distinguish normality from disease. METHODS: In 20 young control subjects, 10 older control subjects, 30 patients with acute myocardial infarction (acute ischemia), and 10 patients with postischemic myocardial scar, longitudinal myocardial deformation was measured with Doppler tissue strain rate (SR) imaging. Segmental SR and strain were visually and quantitatively analyzed and compared. RESULTS: In young control subjects, PSS was found in 98 of 313 segments (31%) and showed gaussian distribution (median 1.3%). During ejection time, median peak SR was -1.4 s(-1) and median strain -16.6%. In older control subjects, parameters differed only slightly. In acutely ischemic and scarred myocardium, both systolic strain and SR were significantly reduced or inverted. In disease, PSS occurred significantly more often (78% and 79%, respectively), was significantly higher in magnitude, and its peak occurred later than in young and older control subjects. CONCLUSION: PSS is a normal finding in healthy subjects occurring in approximately one-third of myocardial segments and, thus, is not always a marker of disease. Our data indicate that pathologic PSS can be detected by coexisting reduction in systolic strain and, second, by exceeding a postsystolic strain magnitude cutoff.

Echocardiography, Doppler, Color↗

PubMed2003

Symmetry reversal in schizophrenia.

Schizophrenia is associated with cortical asymmetries concentrated in the left fronto-temporal hemisphere. In order to look for functional asymmetries between the two hemispheres, the stimulus-response times of patients were split into smaller periods and the interhemispheric and intrahemispheric correlations between these periods were investigated. Three groups were compared to each other: 22 patients with schizophrenia (Diagnostic and Statistical Manual of Mental Disorders, 4th edn; DSM-IV) treated with neuroleptics; 24 psychiatric neuroleptic-treated patients without schizophrenia; and 30 healthy subjects. All subjects were investigated by simple (one stimulus-one response) and complex (two stimuli-two responses), auditory and visual, right-hemispheric and left-hemispheric stimulus-response tasks. There were no intrahemispheric but significant interhemispheric correlations between the two auditory and between the two visual time fragments in both the healthy and the neuroleptic control group. In contrast there was a significant intrahemispheric correlation between the auditory and visual time fragment in the left hemisphere of patients with schizophrenia and no interhemispheric correlation between the auditory times. The reduction of the interhemispheric auditory correlation is interpreted as an auditory disintegration, the appearance of the left-hemispheric audiovisual correlation as an audiovisual 'hyperintegration' in patients with schizophrenia. It is questionable as to whether these findings are due to schizophrenia or to the neuroleptic treatment.

Acoustic Stimulation↗

PubMed2003

Health-related quality of life of patients with multiple organ dysfunction: individual changes and comparison with normative population.

OBJECTIVE: To determine health-related quality of life in medical intensive care patients with multiple organ dysfunction. DESIGN: Prospective, observational study. SETTING: A 12-bed, noncoronary, medical intensive care unit of a university hospital. PATIENTS: Between June 1998 and May 1999, 318 consecutively admitted adult patients with an intensive care unit stay of >24 hrs were studied. MEASUREMENTS AND MAIN RESULTS: Health-related quality of life was assessed using a generic instrument, the Medical Outcomes Study Short Form-36 Health Survey, at admission and at 6-month follow-up. Patients who developed multiple organ dysfunction (n = 170) consumed 85% of the therapeutic activity provided in the intensive care unit. Compared with age- and sex-adjusted general population controls, multiple organ dysfunction patients had a worse preadmission health-related quality of life than other intensive care unit patients, predominantly due to a higher burden of comorbid disease. In a multivariate analysis, multiple organ dysfunction was the only variable independently associated with deteriorated physical health domains at follow-up (odds ratio, 4.4; 95% confidence interval, 1.3-14.6; p =.015), but it had no impact on dimensions of mental health. Analyzing the impact of different organ system failures, respiratory failure (odds ratio, 4.1; 95% confidence interval, 1.6-10.3; p =.002) and acute renal failure (odds ratio, 3.3; 95% confidence interval, 1.0-11.5; p =.05) increased the risk of deteriorated physical health at follow-up. No impact of the various organ system failures on mental health was noted. At 6-month follow-up, 83-90% of survivors had regained their previous health-related quality of life, and 94% were living at home with their families. CONCLUSIONS: This study has shown that preadmission health-related quality of life of our medical, noncoronary patients was substantially reduced compared with a matched general population. This demonstrates the need to take prehospitalization health-related quality of life into account when examining the outcomes of intensive care unit survivors. Multiple organ dysfunction was the major determinant of poor physical health at follow-up, but it had no impact on mental health domains.

Aged↗

PubMedDate not supplied

Plasma homocysteine concentrations do not influence craving in alcohol withdrawal.

Results of a number of studies indicate that the glutamate system, especially the N-methyl-D-aspartate (NMDA) receptor, has a major function in chronic alcoholism, including craving. Homocysteine and other excitatory amino acids, such as glutamate and aspartate, lead to an overstimulation of NMDA receptors. Because alcoholism is associated with elevated plasma homocysteine concentrations, we designed the current study to determine whether elevated plasma homocysteine concentrations have an influence on craving in alcohol withdrawal. Two groups of patients with an established diagnosis of alcohol dependence were compared. Group A comprised 50 consecutively admitted alcohol-dependent individuals who had been abstinent from alcohol between 24 and 72 h before hospitalization. Group B comprised 146 consecutively recruited alcohol-dependent individuals who were admitted, acutely intoxicated, for withdrawal treatment. All patients were assessed with the Obsessive Compulsive Drinking Scale (OCDS) on the day of admission and after 7 days of treatment. The mean (27.1, S.D. 18.4) plasma homocysteine concentration for group B was significantly higher than the mean (12.5, S.D. 5.3) plasma homocysteine concentration for group A (Mann-Whitney U test: P < .001). No significant influence of homocysteine concentration on the extent of craving was found for either group with the use of the Spearman correlation (day 0: group A, r = -.076, P = .601; group B, r = .120, P = .148) and logistic regression analysis. Although homocysteine is a potent modulator of glutamatergic neurotransmission, results of the current study provide no evidence for a pathophysiologic role of homocysteine in withdrawal craving. Therefore, further research about alcohol craving should focus on neurobiologic factors other than homocysteine.

Adult↗