Biomedical subjects

W Ehlers

Publications and source records attributed to W Ehlers.

At least 19 recordsLinked to original sources

PubMed1995

Operational diagnostic approaches in the assessment of defense mechanisms.

A model for the operationalization of empirical research of defense mechanisms is presented. Measures for operationalized defense diagnoses are discussed against the background of a cognitive model of different coding of information channels (linguistic and perceptual coding). Studies for the operationalized diagnoses in the clinical assessment of defense mechanism are discussed for the identification of the defense mechanism, reliability of rating procedures, and the prognostic aspects in psychotherapy and psychosomatics. The regulation of defense on different levels of a hierarchy of complex systems of variables is demonstrated with paradigmatic results.

Defense Mechanisms↗

PubMed1995

[Structure and structural disorder].

One of the central tasks of psychodynamic diagnosis, next to determining intrapsychic conflicts, central relational patterns, and subjective forms of experiencing is assessing the psychic structure or the structural disorder. This article develops the structure term from object relationship theoretical, ego-psychological, and self-psychological concepts of psychoanalysis. This "Structure of the self in the relationship to others" thus obtained is described with six structural criteria (self-perception, self-control, defence, object perception, communication, attachment). In order to be able to distinguish the extent and the quality of structural disorders four structure levels of integration based on psychoanalytic experience in the out-patient and the in-patient setting are differentiated. A basis for an operationalization is then made; it is made in the system OPD (Operationalized Psychodynamic Diagnostics). First studies regarding practicalibility and reliability are promising.

Communication↗

PubMed1994

The induction of anterior chamber inflammation by factors released from hydrogen peroxide-injured corneas: effect of dexamethasone and indomethacin.

Studies from our laboratory have demonstrated the release of high levels of neutrophil chemotactic factors (NCF) from isolated rabbit corneas injured by hydrogen peroxide (H2O2). The purpose of the present study was to determine the biological activity of these factors and to test the hypothesis that the intracameral injection of these factors can induce inflammation of the anterior segment. Under sterile conditions, the epithelial surfaces of isolated rabbit corneas were incubated with a 300 ul mixture of glucose (G) (1mg/ml) and glucose oxidase (GO) (20 U/ml) at 37 degrees C for 6 hours. This supernatant solution was collected and a 100 ul sample containing NCF, but not H2O2, was injected into the anterior chamber of anesthetized rabbit eyes (n = 8). Anterior chamber inflammation, characterized by moderate corneal edema associated with a fibrinous anterior chamber reaction, was evident 2 and 4 hours after injection. Aqueous humor analysis revealed the presence of fibrin and a large number of neutrophils (32 +/- 5 x 10(4) cells/ml). Control eyes, on the other hand, showed normal morphology and low levels of neutrophils after the injection of 100 ul minimum essential medium (MEM) (n = 8) (1.2 +/- 0.14 x 10(4) cells/ml), G/GO mixture (n = 8) (5 +/- 0.86 x 10(4) cells/ml), or supernatant solutions collected from MEM-treated corneas (n = 8) (15 +/- 2 x 10(4) cells/ml). To determine whether the inflammatory reaction observed was due to a direct effect of the chemoattractants or mediated through stimulation of arachidonic acid (AA) metabolites, we pretreated rabbit eyes with a sterile solution of 0.1% dexamethasone (n = 8 eyes) or with a sterile solution of 3.4% indomethacin (n = 8 eyes) three times a day, for one day, prior to the injection of NCF supernatant solution. Examination 2 hours and 4 hours after injection revealed inflammation characterized by mild-to-moderate corneal edema associated with a fibrinous anterior chamber reaction was observed with or without prior treatment with AA metabolite inhibitors. No difference in the degree of inflammation was detected clinically. Results of these studies suggest that NCF released from H2O2-injured corneas can directly induce inflammation of the anterior segment, and that metabolites of AA are not mediating the observed in vivo response.

Animals↗

PubMed1994

Diagnosis of narcissistic self-esteem regulation in patients with factitious illness (Munchausen syndrome).

A quantitative taxonomy for the identification of patients with narcissistic pathology and with borderline personality disorders based on test results is presented. The quantitative identification of these subgroups was produced using a Q-factor analysis. Based on the correlation of the subjects by means of the 241 questions from the narcissistic inventory of Deneke and Müller [27], three subgroups could be defined. Two of these groups exhibited a pathology of the self-system which corresponded to the pathology described by Kernberg [24] for narcissistic and borderline personality disorders. The third group is characterized by reduced observable self-pathology traits from the narcissistic inventory. By means of the reclassification of these three taxonomical groups with the discriminant analysis, two discriminant functions could be calculated, using the weighting of the single test scales for a classification of new patients. These classification functions were used to examine 18 patients suffering from factitious disorders. The evaluation of test profiles with the reduced narcissistic inventory of Deneke and Müller [11] in order to identify the three taxonomical groups showed that 9 patients (50%) had a borderline personality disorder and 6 patients (33%) a narcissistic personality disorder, while 3 patients (17%) could be assigned to the subgroup without self-pathology. In summary, 83% of the examined patients with factitious disorders exhibited a disorder in self-regulation. The previous clinical observations of self-regulation for patients with factitious disorders could thus be confirmed. It becomes clear that different high levels of disorder in self-regulation (position in the sphere of the discriminant function) correspond to varying degrees of prognostic significance.

Adult↗

PubMed1988

[Objective diagnosis of pre-Oedipal disorders].

According to the diagnosis of preoedipal disturbances it should be worked out, that the test-results are not inconceivable formality and uncomprehension. From the selfrating of 74 neurotic patients we determined on 8 scales of narcism clinical description of well-known personality-dimensions of preoedipal fixation. With a Q-factor-analysis 3 subgroups could be established, which are marked as borderline- and narcistical typus against a typus without narcistic disturbance. The validity of such classification can be estimated about the clinical diagnose of 28 patients of this sample. It proves to be much promising for the diagnostic of preoedipal disturbances.

Humans↗

PubMed1984

Taxonomic aspects of clinical character typology.

Whereas clinical character typology is based upon one typological idealized personality description of the same illness model, empirical character typology is concerned with the identification of the different personality structures for the same illness model. We have been able to prove that in a taxonomical analysis (Q-factor analysis) of patients and healthy persons subgroups can be identified whose mean-value profiles justify designation as depressive, compulsive, and hysterical personality. This classification was replicated from a second sample. Through this personality classification it becomes possible to determine the distribution of the three personality structures from a clinical group. The distribution of the personality structure in neurotic depression was 59% for the depressive, 19% for the compulsive, and 22% for the hysterical personality. We were able to prove that they can be characterized by various coping strategies which presumably require different psychotherapeutic interventions.

Adult↗

PubMed1984

[Changes in reaction potentials in neurotic depression].

An investigation, comparing the event related potential (ERP) of depressive patients and a control group is presented. The components N100, P200, N200 and P300 have been recorded during the Stroop colour-word-interference test. The task is to name the colour of a colour word presented in a different colour, to read the word of an achromatic colour word and to name the colour of colour strips. The reaction time to name the colour or the word resulted in a general retardation for the patients with neurotic depression in comparison to the control group. The components of the acoustic evoked potentials, recorded after a warning stimulus S1, 4 s before the single Stroop stimuli showed no differences in amplitude or latency. The visual evoked potentials, associated to the Stroop stimuli showed, in case of the neurotic depressive patients an increase of the P300-amplitude. This result is interpreted as an increased cognitive effort of the patients in case of the employed experimental approach.

Cerebral Cortex↗

PubMed1979

Congenital factor VII deficiency. A report of four new cases.

Four new cases with congenital homozygous factor VII deficiency are described. Factor VII levels were reduced to less than 1%, 3%, 8% and 10%, respectively. The incidence and severity of bleeding symptoms were well correlated with the measured factor VII activity. In the severe case of factor VII deficiency (less than 1%) a home treatment program was started because of severe recurrent hemarthroses. This entailed transfusions of 20 U/kg body weight prothrombin complex or factor VII concentrate in case of acute bleeding approximately every three weeks. These transfusions have been carried out successfully without any problems. In contradiction, two brothers with hypoproconvertinemia (factor VII 8% and 10% respectively) reached an age of more than 70 years. Despite replacement therapy postoperative bleeding followed one appendectomy, whereas no postoperative bleeding followed patients requiring Achilles tendon lengthening and an above knee amputation and only slight bleeding followed a tonsillectomy. Based on our experience we suggest that in patients with factor VII deficiency of less than 10%, when undergoing surgery, should be maintained a minimal factor VII activity of 10--15% during the first three postoperative days.

Adolescent↗

PubMed1978

The effect of bezafibrate on the fibrinolytic enzyme system and the drug interaction with racemic phenprocoumon.

The influence of a new hypolipidaemic agent, bezafibrate, on anticoagulant requirements and fibrinolysis was studied in 15 patients with hyperlipidaemia on long-term treatment with racemic phenprocoumon. Our results suggest a dose-dependent augmentation of the anticoagulant response to the coumarin drug. Treatment with bezafibrate at 450 and 600 mg daily required a reduction of the phenprocoumon dose by 18.5 and 33.5%, respectively. Correspondingly, the serum level of phenprocoumon decreased by 11.6 and 35.3%. No evidence for an altered drug elimination of racemic phenprocoumon could be found during treatment with bezafibrate. The results support the hypothesis that bezafibrate and analogous hypolipidaemic drugs enhance the response to oral anticoagulant drugs by increasing the affinity of the receptor site for coumarins or the rate of degradation of the vitamin-K-dependent clotting factors. The investigation of the fibrinolytic enzyme system demonstrated an increase of the fibrinolytic activity by enhancing the activity of the plasminogen activator. The lysis time for euglobulin clot was reduced significantly, plasma fibrinogen only moderately. The antiplasmin activity could not be altered substantially by a decrease of alpha1-antitrypsin and a slight increase of alpha2-macroglobulin. In contrast with the inhibition of platelet function the effect of bezafibrate on the fibrinolytic enzyme system showed no dose dependence.

4-Hydroxycoumarins↗

PubMed1978

[Effect of hypnosis and suggestion on the EEG-powerspectrum in the preparatory interval (author's transl)].

Fourier-analysis of the EEG (P4 02, P3 O1, CZ A1) in the stimulation period (1 sec) before acoustic stimulation showed significant differences between hypnosis and waking. Diminished power was found in the slower spectrum (0-3 and 4-7 c/sec) over the right hemisphere (P4O2) during hypnosis. Increased power was found in the alpha-spectrum (8-13 c/sec) over the Vertex (CZA1) during suggestion. We interpreted this effect as inhibition of exteroceptive perception during suggestion. Powerspectrum was averaged over 30 stimulation periods before acoustic stimulation with identic tones (sinus of 500 c/sec, 70 dB, duration 40 msec, stimulus interval 3--10 sec). The combination of experimental conditions (Hypnosis/Waking and Suggestions) were given in a balanced order to control seriel effects. We examined 12 persons in a repeated measurement design.

Adult↗

PubMed1977

[Oral anticoagulants and platelet function in hypolipemic therapy using a new clofibrate analog (BM 15.075) (author's transl)].

When testing the effect of a new clofibrate analogue (BM 15.075) on oral anticoagulation and blood clotting in 15 patients for over four weeks it was demonstrated that, depending on the dose of the drug, there was an increase in anticoagulation. The dose of phenprocoumon had to be reduced by 20.6 or 28.7%, respectively, when BM 15.075 was given at a dose of 450 or 600 mg. There was an inhibition of collagen-induced platelet-aggregation. In parallel there was an increase in bleeding time. Fibrinogen concentration was slightly but statistically not significantly decreased. Euglobulin lysis was shortened, especially if previously abnormally long. There was no direct influence on other plasmatic clotting factors.

Aged↗

PubMed1977

[Severe factor XIII-deficiency. Studies on subunits and turnover of the fibrin stabilizing factor (author's transl)].

An infant with congenital homozygous factor XIII deficiency demonstrated a severe retroperitoneal and intracerebral bleeding with development of a posthemorrhagic hydrocephalus in the first months of life. Factor XIII activity was not measurable by means of enzymatic method and the antiserum inhibition test. Quantitative immunoelectrophoresis according to Laurell presented absence of the subunit A, whereas the concentration of subunit S was reduced to 47% the normal value. After replacement therapy factor XIII activity was estimated at 23% and corresponded to the concentration of the subunit A, concentration of subunit S increased by 20%. The turnover rate of fibrin stabilizing factor could be observed over a period of 39 days. The half life was estimated at 4,7 days. The child developed normally after continous substitution with 250 units of factor XIII concentrate every 6 weeks.

Cerebral Hemorrhage↗

PubMed1975