bluuebunny/crossref_metadata_2025 huggingface dataset:
Increased Expression of Fas (APO-1, CD95) on CD4+ and CD8+ T Lymphocytes during Total Body Irradiation
Authors: Fujimori Yoshihiro , Saheki Kaname , Itoi Hisayuki , Okamamoto Takahiro , Kakishita Eizo
Published: April 2003

Fas/APO-1 (CD95) is a cell surface molecule that can transduce apoptotic signals into cells. We examined the expression of Fas antigen on CD4+ and CD8+ T cells of patients who received total body irradiation (TBI) as a preparative regimen for allogeneic bone marrow transplantation. Numbers of peripheral blood lymphocytes were significantly reduced after TBI. Cytofluorometric analysis revealed a significantly higher expression of Fas on CD4+ and CD8+ T cells after TBI. Serum soluble Fas concentrations were significantly elevated after TBI. Changes in the Fas system were therefore accompanied by TBI-induced lymphocytopenia, suggesting that Fas plays a role in irradiation-induced apoptosis in vivo.
dup(12)(q13–q22) and 13q14 Deletion in a Case of B-Cell Chronic Lymphocytic Leukemia
Authors: Chena Christian , Sarmiento Marcela , Palacios María Fernanda , Scolnik Mariano , Slavutsky Irma
Published: April 2003

Cases with partial trisomy 12 have rarely been found in B-cell chronic lymphocytic leukemia (CLL). We report our clinical, cytogenetic and fluorescence in situ hybridization (FISH) findings in a CLL patient with a duplication of part of the long arm of chromosome 12 between bands q13–q22. This patient was the only case with this duplication among the 112 cases (0.9%) of CLL cytogenetically analyzed in our laboratory. FISH studies using unique-sequence specific probes for the RB-1 (retinoblastoma) gene and the D13S319 locus at the 13q14 band showed a monoallelic loss for the D13S319 locus (20% of cells) with a diploid RB-1 gene. Our case showed an atypical morphology (35% prolymphocytes), a high proliferation rate and progression of the disease, indicating that the duplication of this region may be equivalent to complete trisomy 12 in CLL patients.
Investigation of Ethnic Neutropenia by Assessment of Bone Marrow Colony-Forming Cells
Authors: Rezvani Katy , Flanagan Adrienne M. , Sarma Usha , Constantinovici Niculae , Bain Barbara J.
Published: April 2003

Healthy individuals with African ancestry have lower neutrophil counts than Caucasians. It has previously been postulated that this was consequent on either a diminished bone marrow granulocyte reserve or an altered distribution of neutrophils between the circulating and marginated granulocyte pools. Recent indirect evidence supports the former hypothesis. In this study we have compared the number of granulocyte plus granulocyte-macrophage colony-forming units (CFUs) in the bone marrow of healthy African and Afro-Caribbean subjects with the number of CFUs in the bone marrow of healthy age and sex-matched Caucasians. We found the group with African ancestry to have significantly fewer CFUs than the Caucasian group. There was no evidence of any qualitative difference between the CFUs of the two ethnic groups: they showed similar sensitivity to granulocyte-monocyte colony stimulating factor and similar enhancement of growth when cultured with a larger range of cytokines. These observations suggest that ethnic neutropenia observed in those with African ancestry is likely to result from reduced numbers of bone marrow progenitor cells in comparison with numbers present in Caucasians.
Increased Warfarin Sensitivity as an Early Manifestation of Occult Prostate Cancer with Chronic Disseminated Intravascular Coagulation
Authors: Munter Gabriel , Hershko Chaim
Published: April 2003

Increased sensitivity to warfarin anticoagulation is usually attributed to liver disease, vitamin K deficiency, or drug interactions. We describe a patient with unexplained sensitivity to warfarin and mildly elevated prostate-specific antigen levels in whom subsequent developments indicated that warfarin sensitivity was the first manifestation of occult prostatic cancer. A review of all published cases of coagulopathy associated with cancer of the prostate shows that, unlike other solid tumors with secondary disseminated intravascular coagulation (DIC), in prostate cancer increased bleeding is more common than thrombotic phenomena. Chronic DIC due to occult prostate cancer should be included in the differential diagnosis of excessive prothrombin time prolongation in patients receiving anticoagulants.
Detection of Epithelial Cells in Hematopoietic Organs of Patients with Breast Cancer
Authors: Chabannon Christian , Olivero Sylvain , Viret Frédéric , Arnoulet Christine , Sainty Danielle , Maraninchi Dominique , Viens Patrice
Published: April 2003

Breast cancer is the most frequent neoplastic disease in populations of developed countries. It will affect 1 of every 6 or 7 women during their lifetime. The disease eventually evolves to a metastatic stage, and currently appears to be not curable at that stage. Thus, understanding mechanisms that result in the establishment of tumor at sites distant from the primary location is of the utmost importance. Equally important is the definition of a metastatic state, especially in regard to the detection of micrometastases. Finally, the presence of circulating tumor cells in the peripheral blood of patients who undergo progenitor mobilization, collection and reinfusion may be of clinical significance in the setting of high-dose chemotherapy for breast cancer.
Immune Reconstitution following Transplantation of Autologous Peripheral CD34+ Cells
Authors: Sica Simona , Laurenti Luca , Sorà Federica , Menichella Giacomo , Rumi Carlo , Leone Giuseppe , Rutella Sergio
Published: April 2003

The recovery of lymphocyte count, CD4+ and CD8+ T-cell subsets, natural killer (NK) cells and CD19+ B cells has been evaluated during the first 4 months after the infusion of autologous CD34+ peripheral blood progenitor cells (PBPC; group A; 33 patients) or autologous unselected PBPC (group B; 36 patients) for hematological malignancies. Lymphocyte count promptly recovered in both patient cohorts, although the repopulation of CD3+ T cells occurred more rapidly in group B compared with group A. The count of CD4+ T lymphocytes remained <200/µl during the study period in patients transplanted with CD34+ PBPC, being significantly lower compared with group B (p = 0.0019 and p = 0.0035 on days 30 and 60, respectively). CD8+ T cells rapidly increased both in group A and B and CD4 to CD8 ratio was severely reduced. CD4+ and CD8+ T cells displayed an activated phenotype in both groups of patients, coexpressing the HLA-DR antigen throughout the study period. No differences in the repopulation kinetics of NK cells and CD19+ B cells were observed. Further investigations are encouraged to characterize T cell competence following transplantation of CD34+ PBPC.
Influence of Cytokines and Autologous Lymphokine-Activated Killer Cells on Leukemic Bone Marrow Cells and Colonies in AML
Authors: Walburg Braun Susanne , Gerhartz Helmut Heinrich , Schmetzer Helga Maria
Published: April 2003

We have already shown that cytokine cocktails (IL-1β, IL-3, IL-6, SCF, GM-CSF) and/or lymphokine-activated killer (LAK) cells can reduce the amounts of clonal, CD34-positive mononuclear bone marrow cells (BM-MNC) in acute myeloid leukemia (AML). In addition, the influence of those cocktails and/or LAK cells on the clonogenic potential of AML BM-MNC was investigated. BM colonies cultured in agar during different stages of the disease were immunophenotyped in situ: 17 patients at diagnosis, 14 patients in complete remission, 8 patients at relapse, 8 healthy donors. A significant reduction in leukemic cells and colonies positive for CD34 after in vitro culture of BM-MNC with cytokine cocktails was achieved with all samples obtained at diagnosis (n = 8, p < 0.01), in 6 of 8 cases in complete remission but only in 2 of 6 cases at relapse. Cytokine cocktails stimulated granulopoiesis as well as B and T lymphopoiesis. Colonies with leukemic phenotype could never be detected in healthy BM. A significant reduction in leukemic colonies was achieved by coculture of BM-MNC (uncultured or cytokine precultured) with autologous LAK cells in all 4 cases at diagnosis and in 1 case at relapse. An additive effect of in vitro cytokine preincubation of BM samples on the leukemia-reducing effect of LAK cells could be demonstrated in all samples studied (p < 0.001; diagnosis: n = 10, relapse: n = 3, complete remission: n = 7). Patients had a better prognosis if CD34-positive colonies in AML could be reduced by cytokine incubation (p = 0.03) or coculture with autologous LAK cells in vitro (p = 0.04). Our data show that cytokines as well as LAK cells alone and in combination can reduce, however not eliminate clonogenic AML cells. Such mechanisms might be responsible for maintaining stable remissions in AML.
Cytoreduction and Stem Cell Mobilization with a Regimen of Paclitaxel, Etoposide and Cyclophosphamide Followed by Autologous Transplantation Using a Preparative Regimen of Busulfan, Etoposide and Cyclophosphamide for Patients with Advanced Lymphoma
Authors: Tutschka P.J. , Bilgrami S.A. , Feingold J.M. , Edwards R.L. , Bona R.D. , Naqvi B. , Clive J.
Published: April 2003

Forty-one patients with advanced Hodgkin’s disease or intermediate or high-grade lymphoma, after having received standard salvage chemotherapy, were treated with a nonablative high-dose regimen of paclitaxel, etoposide and cyclophosphamide (D-TEC) to optimally cytoreduce their disease and simultaneously mobilize peripheral blood stem cells. This regimen produced a response rate of 78% (35% complete and 43.2% partial response) and mobilized sufficient peripheral blood stem cells in 94% of the patients. Thirty-two of these patients then underwent autologous progenitor cell transplantation after ablative conditioning with busulfan, etoposide and cyclophosphamide. Actuarial overall survival at 61 months was 71.9% with an event-free survival (EFS) of 65.6%. Median EFS was 24.4 months. EFS of patients responsive to salvage chemotherapy was 75% at 61 months, compared to 33.3% at 51.4 months in patients resistant to salvage chemotherapy. EFS of patients with disease sensitive to D-TEC was 75% at 61 months compared to 0% at 13.1 months in patients resistant to D-TEC. In a multivariate analysis, the only significant parameter for transplant outcome was sensitivity to D-TEC (p = 0.016), but not sensitivity to standard salvage chemotherapy. Aggressive cytoreduction may permit even those patients who are resistant to standard salvage chemotherapy to become successful transplant candidates.
Autologous Hematopoietic Stem Cell Transplantation in Chronic Myeloid Leukemia with Different Clinical Stages
Authors: Gopcsa Laszlo , Barta Aniko , Banyai Aniko , Foldi Janos , Kalasz Laszlo , Pajor Laszlo , Gidali Julia , Regeczy Nora , Paloczi Katalin
Published: April 2003

Seven patients with Philadelphia (Ph) chromosome-positive chronic myeloid leukemia (CML) were treated with an ICE-based regimen plus G-CSF with the aim of mobilizing and collecting Ph-negative peripheral stem cells in the setting of an autologous transplant program. Five patients had CML in the first chronic phase and 2 in the accelerated phase. All patients had been previously treated with interferon-α. Median value and ranges for harvested mononuclear cells, CD34+ cells and CFU-GM, respectively: 5.65 × 108/kg (2.61–11.38); 1.48 × 106/kg (0.216–3.5), and 3.43 × 104/kg (0.243–11.6). FISH was the only useful method for detection of minimal residual disease on apheresis product showing <5% t(9;22) positive cells in 2 cases and <10% positive cells in 4 other cases. Four of seven autologous grafts have been transplanted to date. Busulfan conditioning was used in 1 case and TBI/Cy conditioning in 3 other cases. All patients are alive and well following transplantation and are on interferon-α therapy.
Role of Hematopoietic Growth Factors in Angiogenesis
Authors: Ribatti Domenico , Vacca Angelo , De Falco Giuseppe , Ria Roberto , Roncali Luisa , Dammacco Franco
Published: April 2003

In early ontogeny, hematopoiesis is closely associated with angiogenesis. This article reviews recent studies of the effect of hematopoietic growth factors on several endothelial cell functions together with recent findings about angiogenesis and antiangiogenic therapies in hematopoietic malignancies such as leukemia, lymphoma and myeloma.
Angiogenesis in Acute Myeloid Leukemia and Myelodysplastic Syndrome
Authors: Albitar Maher
Published: April 2003

Increased angiogenesis is important in the pathophysiology of solid tumors. Recent studies show that angiogenesis and angiogenic factors play an important role in hematological malignancies. Both acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) are associated with a substantial increase in vascularity in the bone marrow as well as increased levels of various angiogenic factors including vascular endothelial growth factor (VEGF), basic fibroblast growth factor, angiogenin, angiopoietin-1, platelet-derived growth factor, hepatocyte growth factor, epidermal growth factor, tumor necrosis factor-α, and transforming growth factor-α and transforming growth factor-β. Most of these angiogenic factors appear to be secreted by the neoplastic hematopoietic cells and appear to promote the growth and proliferation of the leukemic cells in an autocrine fashion. More importantly, angiogenic factors play a role in the clinical behavior and outcome of both AML and MDS. Despite significant overlap between MDS and AML in many aspects, higher levels of cellular VEGF and lower levels KDR are seen in MDS than in AML. Antiangiogenic therapy may play a role in AML and MDS and some differences in response may exist between MDS and AML.
Angiogenesis in Lymphoproliferative Disorders
Authors: Salven Petri
Published: April 2003

In this review, the cellular and molecular mechanisms underlying angiogenesis in lymphoproliferative disorders are summarized, alongside with possible therapeutic applications. Although most of the initial studies in angiogenesis were done on solid tumors, recent data demonstrate the importance of angiogenesis in hematological malignancies including leukemia, lymphoma, and multiple myeloma. Expression of angiogenic polypeptides vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) correlate with clinical characteristics in leukemia and lymphoma, and their serum concentrations serve as predictors of poor prognosis. Antiangiogenic drugs, including thalidomide, arsenic trioxide, endostatin, vasostatin, and neutralizing antibodies to VEGF receptors, used alone or in combination with established chemo- or immunotherapy regimens, constitute a promising approach for the treatment of lymphoproliferative disorders.
Antiangiogenic Therapy in Leukemia
Authors: Thomas Deborah A. , Giles Francis J. , Cortes Jorge , Albitar Maher , Kantarjian Hagop M.
Published: April 2003

Angiogenesis is a fundamental element of the physiological processes of embryogenesis and wound healing. During malignant transformation, dysregulation of angiogenesis leads to the formation of a vascular network of tumor-associated capillaries promoting survival and proliferation of the cancerous cells. Activation, migration, proliferation and differentiation of endothelial cells into mature blood vessels is driven by several cytokines and growth factors, known to be dysregulated in hematological malignancies. Thus, therapeutic interventions designed to eradicate the malignant clone should incorporate modulation of the angiogenic cascade. Antiangiogenic agents which target different components of the neovascularization process are being investigated in various solid tumors known to have increased vascularity. The role of angiogenesis in hematological malignancies, the rationale for the use of angiosuppressive therapy for these entities, and the status of novel antiangiogenic agents in clinical trials are discussed.
Antiangiogenic Therapy in Multiple Myeloma
Authors: Tosi Patrizia , Tura Sante
Published: April 2003

In the recent years, several pieces of evidence have pointed out that disease progression in multiple myeloma (MM) is characterized by an increased bone marrow neovascularization. Targeting the mechanisms that control angiogenesis could thus represent an innovative therapeutic approach to MM. Thalidomide, a glutamic acid derivative with sedative properties, is able to inhibit angiogenesis in murine models; this compound has recently demonstrated to be effective in relapsed/refractory MM, leading to a 30–40% response, coupled with mild systemic toxicity. Inhibition of angiogenesis is probably just one of the mechanisms by which thalidomide exerts its action in MM, as immunomodulation and inhibition of cytokine production by bone marrow stroma could also be involved. At present, several studies are ongoing, aiming at testing thalidomide-based drug combinations, mainly with dexamethasone, but also with conventional chemotherapy; the results that have been obtained so far show a synergistic effect of the drug combinations, with a response rate ranging from 50 to 70% in pretreated patients. There is now growing interest in novel compounds with potential antiangiogenic effects, among them a promising activity both in vitro and in animal models has been displayed by thalidomide analogs, inhibitors of vascular endothelial growth factor receptor-2 and endostatin.
Effect of Granulocyte-Colony-Stimulating Factor on Serum Lactate Dehydrogenase Levels and Isoenzymes in a Rabbit Model
Authors: Menekay Serra , Ozsan G. Hayri , Demirkan Fatih , Ozbek Defne , Ozcan Mehmet Ali , Fadıloğlu Meral , Undar Bulent
Published: April 2003

We investigated the effect of granulocyte-colony-stimulating factor (G-CSF) alone (G-CSF group, n = 7) or after cyclophosphamide (CY) administration (CY+G-CSF group, n = 7) on serum lactate dehydrogenase (LDH) levels and LDH isoenzymes in a rabbit model. In the G-CSF group, an elevation of LDH (all isoenzymes) which was parallel to a sharp increase in leukocyte counts was noted on the first day of G-CSF administration. Despite the increased leukocyte counts on day 5, LDH levels were decreased. In the CY+G-CSF group, the peak elevation of LDH levels, which was prominent in isoenzymes LDH3, LDH4 and LDH5, occurred on day 5 of G-CSF administration and corresponded to the peak levels of leukocytes. In both groups, there was no correlation between LDH levels and leukocyte counts. Our data suggest that an elevation of LDH during the administration of G-CSF may be related to the differentiation of myeloid progenitors.
Cytogenetic and Molecular Genetic Abnormalities in Systemic Mastocytosis
Authors: Gupta Rajeev , Bain Barbara J. , Knight Caroline L.
Published: April 2003

Clonal cytogenetic abnormalities similar to those observed in other haematological neoplasms are demonstrable in a proportion of patients with systemic mastocytosis and in a smaller proportion of adults with urticaria pigmentosa without apparent systemic disease. These clonal abnormalities are not likely to represent the primary event in mast cell neoplasms. Although no recurrent cytogenetic abnormalities specific for mastocytosis have yet been recognized, the majority of cases display one of several mutations in c-KIT, the gene encoding the receptor for stem cell factor. That most commonly observed is the Asp816Val mutation, which permits proliferation independent of growth factors. c-KIT mutations may play a significant role in the biology of mast cell malignancies, although other mutations may be needed for a malignant phenotype.
Sodium Ion Specifically Modifies Plasma Ionized Calcium Concentration
Authors: Akimoto Tetsu , Ando Yasuhiro , Takahashi Hideaki , Miyata Yukio , Kusano Eiji , Asano Yasushi
Published: April 2003

Background/Aim: Recently, we observed a progressive decline in the plasma ionized calcium (iCa) concentration after ingestion of Na-free beverage. Although both plasma pH and Na significantly correlated with iCa, the correlation of the latter was stronger than that of the former. Therefore, we explored the effect of Na on plasma iCa. Methods: Pooled human plasma was diluted with normal saline, 5% glucose, 0.9% KCl, or distilled water to examine the effect of plasma dilution on iCa. Also, to evaluate the effects of an isovolemic increase in ion concentration and osmolarity on plasma iCa, NaCl, KCl, and D-glucose were added to plasma. Electrolytes (Na+, K+, Cl–, iCa, HCO–3), pH, and osmolarity were measured by using ion-selective electrodes. Results: In the plasma dilution study, although all solutions significantly decreased the iCa concentration, the decrease in iCa concentration in the normal saline treated solution was significantly lower than in others. When the plasma osmolarity was isovolemically increased, the iCa concentration significantly increased in parallel with the increase in osmolarity in the NaCl group (r = 0.604, p < 0.01, n = 50). In contrast, no significant change in the iCa concentration was seen in the other solutions. NaCl did not increase, but rather decreased the iCa concentration when added to a protein-free solution. Conclusion: The present study demonstrated that Na specifically affects plasma iCa independently of pH, presumably via modulating Ca binding to plasma proteins.
Rapidly Progressive Interstitial Renal Fibrosis Associated with Chinese Herbal Medications
Authors: Chang Chung-Hsin , Wang Yi-Ming , Yang An-Hang , Chiang Shou-Shan
Published: April 2003

Background/Aim: Nephropathy after ingestion of Chinese herbs is known as a rapidly progressive form of interstitial renal fibrosis after a slimming regimen containing aristolochic acid that was identified first in Belgium. Intake of traditional Chinese herbal medicines is very popular in Taiwan. So we looked for similar cases in our hospital. Methods: From 1994 to 1998, we observed 20 Taiwanese patients who underwent renal biopsy for rapidly progressive renal failure of unknown origin. The medical history of these patients gave no clue to the origin of renal impairment, except for the administration of Chinese herbs before the development of renal failure in all cases. Results: Although these patients took herbal medications from various sources for different purposes, their renal biopsy specimens showed strikingly similar histological patterns: extensive paucicellular interstitial fibrosis and tubular atrophy, but the glomeruli were apparently intact. They also had similar clinical features, such as a nearly normal blood pressure, obvious anemia, insignificant edema, low-grade proteinuria, and glucosuria. The renal function declined rapidly in most cases; 15 patients underwent dialysis within 3 months of renal biopsy, and 7 patients received emergency dialysis when they first came to our hospital. On clinical and morphological grounds, the nephropathy in our patients appears similar to Chinese herb nephropathy. Conclusions: Because of the diversity of the herbal regimens used, in addition to aristolochic acid, other unidentified phytotoxins may also play a role in this particular disease entity. There is a strong relation between rapidly progressive interstitial renal fibrosis and the consumption of Chinese herbs.
The Hemodialysis Patient and Hand Amputation
Authors: Levine Max P.
Published: April 2003

The hemodialysis patient requires continued attention once an access surgery has been performed. These procedures lead to an anticipated physiological steal in the involved hand, but rarely lead to hand loss. When the patient has had previous peripheral vascular disease, known diabetes mellitus, multiple interventions on the same extremity, and the use of a synthetic graft, the incidence of digital or hand ischemia is significantly increased. This article represents 3 individuals who required hand amputation for severe ischemia. The pertinent clinical features in each individual will be explained and the literature reviewed for the factors promoting this complication and the all-autogenous access policies which may help to prevent hand ischemia.
The Three-Factor Eating Questionnaire in the Evaluation of Eating Behaviour in Subjects Seeking Participation in a Dietotherapy Programme
Authors: Boschi Velia , Iorio Daniela , Margiotta Nunzia , D’Orsi Pasqualina , Falconi Claudio
Published: April 2003

Aim: To evaluate the eating behaviour in normal-weight, overweight, and obese women seeking participation in a diet-based programme of weight reduction or achievement of ideal body weight. Methods: Thirty-seven obese, 42 overweight, and 14 normal-weight subjects, seen at an Italian university outpatient clinic, were asked to complete the Stunkard and Messick three-factor eating questionnaire (TFEQ). The TFEQ is designed to evaluate three different factors in eating behaviour: restraint, disinhibition, and hunger. Forty-eight mothers of children attending public primary schools (25 normal weight and 23 overweight) served as controls. Results: Significantly altered scores of cognitive restraint were observed both in normal-weight and in overweight subjects of the outpatient clinic as compared with normal-weight and overweight control women. Outpatient clinic overweight women scored significantly higher in terms of disinhibition as compared with overweight control subjects. Among outpatient clinic subjects, overweight women showed higher scores of disinhibition but similar values of cognitive restraint as compared with outpatient clinic normal-weight subjects. In obese patients, the scores of disinhibition and hunger were higher than those observed in outpatient clinic normal-weight subjects, whereas values of cognitive restraint were significantly lower. As compared with outpatient clinic overweight women, obese subjects showed significantly lower values of cognitive restraint. Conclusions: Alterations in TFEQ results are a frequent feature in subjects seeking participation in programmes of weight reduction or ideal body weight achievement. This may reflect a possible impairment in eating behaviour.
Ziele in der Psychoanalyse: Überlegungen zum Subjekt des Unbewussten im analytischen Prozess1
Authors: Lesmeister Roman
Published: April 2003

Leider besteht für diesen Artikel keine Zusammenfassung. Als Einstieg stellen wir den Textanfang zur Verfügung. In der psychoanalytischen Diskussion um die Ziele der Analyse bestand von früher Zeit an ein Spannungsverhältnis, das in der Frage zum Ausdruck kam, ob sich die analytische Arbeit an der Massgabe grösstmöglicher Erkenntnis oder am Erreichen messbarer therapeutischer Veränderungen in der Persönlichkeit des Analysierten auszurichten habe. Das Erkenntnisziel der Analyse fand seine weithin gültige Formulierung in der Rede von der «Bewusstmachung des Unbewussten», während die therapeutischen Zielsetzungen von Freuds Zeiten an eine wechselhafte Karierre mit unterschiedlichen Schwerpunktsetzungen auf innerpsychisch-strukturellen und/oder Verhaltensänderungen durchliefen [Sandler und Dreher, 1999]. Das eigentümliche und schon für Freud charakteristische Schwanken zwischen dem Primat des Erkenntnisziels und dem des therapeutischen Ziels lässt auf eine gewisse Unsicherheit darüber schliessen, ob es in der Analyse mehr um Wahrheit oder mehr um Gesundheit gehe. Die Differenz, die sich in dieser Hinsicht offenbar ergeben kann, ist insofern erstaunlich, als Erkenntnisziel und therapeutisches Ziel ursprünglich in enger funktionaler Verknüpfung miteinander standen und in dieser Zusammengehörigkeit ein Ideal bildeten, dessen Leuchtkraft das Denken und die klinische Arbeit der Pioniere inspirierte.
Wirksamkeit und Inanspruchnahme von Krankenkassenleistungen bei Langzeitanalysen: Ergebnisse einer empirischen Follow-up-Studie zur Effektivität der (Jungianischen) Psychoanalyse und Psychotherapie
Authors: Keller W. , Westhoff G. , Dilg R. , Rohner R. , Studt H.H.
Published: April 2003

Leider besteht für diesen Artikel keine Zusammenfassung. Als Einstieg stellen wir den Textanfang zur Verfügung. Jungianer stehen nicht in der Tradition empirischer Psychotherapieforschung. Sie fühlen sich eher der Individualität ihrer Patienten verpflichtet und sind daher gegenüber den Ergebnissen der empirischen Psychotherapieforschung mit dem Anspruch nach Generalisierbarkeit meist skeptisch eingestellt. Mit dieser skeptischen Einstellung stehen die Jungianer allerdings nicht alleine. Auch anderere psychoanalytische Schulrichtungen sind nur zögerlich und unter dem wachsenden Druck der Gesundheitsadministration bereit, die Qualität ihrer Behandlungen empirisch zu überprüfen.
Theorie und heutige Naturerkenntnis
Authors: Obrist Willy
Published: April 2003

Ausgehend von dem Vorurteil, Tiefenpsychologie sei «Mystik», wird dargelegt, dass sie zwar empirische Wissenschaft im Wortsinn ist, dass jedoch mit dem Nachweis des Unbewussten – und damit der inneren Wahrnehmung – der positivistische Empiriebegriff erweitert wurde, wodurch in Gestalt der Tiefenpsychologie ein neuer Typus empirischer Wissenschaft zustandegekommen ist. Dieser wird mit den anderen beiden Wissenschaftstypen – dem positivistisch-empirischen und der Theologie – verglichen. Dann wird Jungs Modellvorstellung der normalen unbewusst-bewussten Psyche in der heute in den Naturwissenschaften üblichen Sprache skizziert. Auch wird gezeigt, dass dieses Modell seither von positivistischen Disziplinen untermauert worden ist und dass es sich ins heutige Wissen über Lebewesen integrieren lässt. Dies wird nachgewiesen, indem das einschlägige Material um vier Begriffe, welche Grundbegriffe sowohl der theoretischen Tiefenpsychologie als auch der Biowissenschaften sind, gruppiert wird: um die Begriffe Artspezifität, Selbstregulation, Kommunikation und Spontaneität.
Psychotherapie oder medikamentöse Behandlung bei psychischen Erkrankungen?
Authors: Jarmer Ute
Published: April 2003

Leider besteht für diesen Artikel keine Zusammenfassung. Als Einstieg stellen wir den Textanfang zur Verfügung. Psychotherapie geht den psychischen Ursachen seelischer Erkrankungen nach und versucht dort den Heilungsprozess einzuleiten. Bei der medikamentösen Therapie handelt es sich nicht um ursächliche Behandlung, sondern um Symptombehandlung. Dennoch lässt die neuere Entwicklung in der Psychiatrie die Frage aufkommen: Ist die Zeit der Psychotherapie bei seelischen Erkrankungen vorbei und kommen nur noch Medikamente zur Behandlung in Frage? Es hat sich ja gezeigt, dass bei vielen dieser Leiden in ihrer schweren Ausprägung körperliche Veränderungen vorliegen, z.B. in bestimmten Hirnzentren Störungen im Gleichgewicht von Botenstoffen (Neurotransmittern), wie Serotonin, Noradrenalin, Dopamin und anderen. Diese Veränderungen sind durch Psychopharmaka zu beeinflussen. So ist erwiesen, dass Antidepressiva meist äusserst wirksam sind und eine durch ihre Suizidgefahr lebensgefährliche qualvolle schwere Depression in ihrer Dauer erheblich abkürzen können. Ähnlich ist es bei Angsterkrankungen, z.B. Panikattacken, und oft wirken sie gut bei Zwangsstörungen. Bei den schizophrenen Störungen ist seit der Entwicklung der neuroleptischen Medikamente vor etwa 45 Jahren eine grundlegende Änderung des Verlaufs bei den meisten Erkrankten eingetreten. Die Schizophrenie ist noch immer ein schwerwiegendes Leiden (das allerdings in nicht so seltenen Fällen auch wieder völlig ausheilen kann!). Während aber früher die meisten an einer Schizophrenie Erkrankten sehr lange Zeiten ihres Lebens in psychiatrischen Kliniken verbringen mussten, hat sich dies heute entscheidend geändert.
Functional Recovery of Hearing following AMPA-Induced Reversible Disruption of Hair Cell Afferent Synapses in the Avian Inner Ear
Authors: Reng Diana , Müller Marcus , Smolders Jean W.T.
Published: April 2003

Hair cells in the avian inner ear can regenerate after acoustic trauma or ototoxic insult, and significant functional recovery from hearing loss occurs. However, small residual deficits remain, possibly as a result of incomplete reestablishment of the hair cell neural synaptic contacts. The aim of the present study was to determine if intracochlear application of α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA), an excitotoxic glutamate agonist, causes reversible disruption of hair cell neural contacts in the bird, and to what extent functional recovery occurs if synaptic contacts are reestablished. Compound action potential (CAP) responses to tone bursts were recorded to determine hearing thresholds during a recovery period of up to 4 months. Subsequently, the response properties of single auditory nerve fibers were analyzed in the same animals. Instillation of AMPA into the perilymph of the scala tympani led to immediate abolition of CAP thresholds. Partial recovery occurred over a period of 2–3 weeks, without further improvement of thresholds thereafter. High-frequency thresholds did not reach control values even after 3–4 months of recovery. Single-ganglion cell response properties, obtained 3–4 months after AMPA treatment, showed elevated thresholds at the fiber’s characteristic frequency (CF) for units with CF above 0.3 kHz. Sharpness of tuning (Q10 dB) was reduced in units with CF above 0.4 kHz. The spontaneous firing rate was higher in units with CF above 0.18 kHz. The maximum sound-evoked discharge rate was also increased. Transmission electron micrographs of the basilar papilla showed that, following AMPA treatment, the nerve endings went through a sequence of swelling, degeneration and recovery over a period of 3–7 days. The process of neosynaptogenesis was completed 14 days after exposure. The present findings are strong evidence for a role of glutamate or a related excitatory amino acid as the afferent transmitter in the avian inner ear. In addition they show that functional recovery after disruption and regeneration of hair cell neural synapses, without apparent damage to the hair cells, is incomplete.
Functional β2-Adrenergic Receptors Are Present in Nonstrial Tissues of the Lateral Wall in the Gerbil Cochlea
Authors: Schimanski Sven , Scofield Margaret A. , Wangemann Philine
Published: April 2003

Recently, we have demonstrated that functional β1-adrenergic receptors are the dominant β-adrenergic receptor subtype in the stria vascularis and that β1-adrenergic receptors stimulate K+ secretion in strial marginal cells. The goal of the present study was to determine whether nonstrial tissues in the cochlear lateral wall contain β-adrenergic receptors and if so which subtype is present. Pharmacological tools were used to identify receptors in functional studies where cAMP production was measured. Further, receptors were identified as transcripts by cloning and sequencing of reverse-transcriptase polymerase chain reaction (RT-PCR) products. Experiments were performed on gerbil nonstrial lateral wall tissues. Tissues stimulated with 10–5M isoproterenol produced 0.42 ± 0.22 pmol cAMP per ear within 12 min (n = 14). The selective β-adrenergic receptor agonist isoproterenol stimulated cAMP production with an EC50 of (2 ± 3) × 10–7M (n = 7). Isoproterenol-stimulated cAMP production was inhibited by the β2-adrenergic receptor antagonist ICI 118551 with an IC50 of (7 ± 7) × 10–6M, which corresponds to an affinity constant of 1 × 10–7M (pKDB = 6.89 ± 0.23, n = 3). Isoproterenol-stimulated cAMP production was not inhibited by the highly selective β1-adrenergic receptor antagonist CGP 20712A. The IC50 and the affinity constant for CGP 20712A were estimated to be >3 × 10–4 and >6 × 10–6M, respectively. RT-PCR of total RNA isolated from nonstrial lateral wall tissues using primers specific for β1-, β2- and β3-adrenergic receptors revealed products of the predicted sizes for the β1- and β2- but not for the β3-subtype. Sequence analysis confirmed that amplified cDNA fragments encoded gene-specific nucleotide sequences. These results demonstrate that nonstrial lateral wall tissues contain transcripts for β1- and β2- but not for β3-adrenergic receptors and that the β2-adrenergic receptor is the dominant functional receptor subtype. The cellular localization and function of the β2-adrenergic receptors remains to be determined.
Role of Biophysical Specialization in Cholinergic Modulation in Neurons of the Ventral Cochlear Nuclei
Authors: Oertel Donata , Fujino Kiyohiro
Published: April 2003

In contacting arrays of different types of neurons whose axons have differing targets in the brain stem, the auditory pathway is subdivided into parallel ascending pathways, each of which carries a different type of information. Several distinct arrays of neurons in the ventral cochlear nuclei have anatomical and biophysical specializations which enable them to extract differing facets of acoustic information and to convey it up the auditory pathway. T stellate cells have higher input resistances and have lower firing thresholds than bushy or octopus cells, enabling their firing to be modulated by small currents. Cholinergic currents, driven by neurons in the ventral nucleus of the trapezoid body that are likely to include medial olivocochlear efferents, excite T stellate cells, but have subtle effects on the firing of bushy cells, and have no detectable influence on octopus cells and D stellate cells. We suggest that cholinergic excitation of T stellate cells contributes toward shifting their acoustic dynamic ranges and increasing the encoding of spectral peaks in noisy conditions and in awake animals.
Injury- and Use-Related Plasticity in Adult Auditory Cortex
Authors: Irvine Dexter R.F. , Rajan Ramesh , Brown Mel
Published: April 2003

After restricted cochlear lesions in adult animals the frequency selectivity of neurons in the cortical region deprived of its normal input by the lesion is changed such that the region is occupied by expanded representations of adjacent (perilesion) frequencies. These changes reflect a dynamic process of reorganization (plasticity) and are not explicable as passive consequences of the lesion. Analogous plasticity of cortical frequency selectivity and organization is seen following behavioural training that enhances the significance of particular acoustic stimuli. The occurrence of injury- and use-related auditory cortical plasticity gives rise to a number of questions relating to the mechanisms involved, the perceptual consequences and functional significance of such plastic changes, and their implications for the central processing of input from prosthetic devices. Evidence relating to these issues is briefly summarized in this review, and the directions of future research are considered.
Auditory Learning as a Cause and Treatment of Central Dysfunction
Authors: Moore David R. , Hogan Sarah C. , Kacelnik Oliver , Parsons Carl H. , Rose Marina M. , King Andrew J.
Published: April 2003

Conductive hearing loss produced by middle ear disease (MED) is very prevalent in the first 5 years of childhood. Both MED in children and prolonged ear plugging in animals lead to a binaural hearing impairment that persists beyond the duration of the peripheral impairment. However, after cessation of the MED, or removal of the ear plug, binaural hearing gradually improves. We suggest here that this improvement is a passive form of auditory learning. We also show that active auditory learning, through repetition of discrimination tasks, can accelerate performance increments, both after hearing loss and in unimpaired individuals. A more detailed understanding of auditory learning holds out the prospect of improving rehabilitation strategies for the language- and hearing-impaired.
Of Kittens and Kids: Altered Cortical Maturation following Profound Deafness and Cochlear Implant Use
Authors: Ponton Curtis W. , Eggermont Jos J.
Published: April 2003

Profoundly deaf children who use a cochlear implant (CI) provide a unique opportunity to investigate the effects of auditory sensory deprivation on the maturing human central nervous system. Previous results suggest that children fitted with a CI show evidence of altered auditory cortical maturation, based on evoked potentials. This altered maturation was characterized by both latency delays and morphological changes in the cortical auditory evoked potentials (AEPs). Based on prolonged P1 latencies compared to age-matched normal-hearing (NH) peers, these data suggested a delayed maturation nearly equivalent to the period of deafness. However, rates of maturation for this AEP peak were essentially the same in NH and CI children. This suggests that, given enough time, the AEPs of CI children would assume the characteristic morphology found in older NH teens and NH adults. However, the data also indicated a substantial alteration of the typical set of obligatory P1-N1b-P2 peaks, specifically related to the absence of the N1 potential. Recent analyses of more extensive sets of longitudinal and cross-sectional data indicate that even after many years of implant use, the AEPs of CI users in their late teens remain very different from those of their NH peers. The P1 peak latency remains prolonged and P1 amplitude remains much larger in CI users than in age-matched NH teens. These findings suggested that age-related changes in the P1 peak are completed by 12 years of age. In addition, the normal N1b peak fails to emerge in virtually all of the CI children tested in our laboratory. A major new interpretation of the abnormal maturation of AEP waveforms in CI children is presented. It is based on direct evidence showing that a persistent immaturity of the superficial layer axons has persistent negative effects on the generation of the N1b and, consequently, on the morphology of the AEPs. A comparison of scalp-recorded AEPs from implanted children with local field potentials measured from the cortical surface in deaf white kittens suggests the effects of deafness and CI use are similar across these mammalian species. For both species, a period of profound deafness followed by CI stimulation reveals a substantial immaturity in cortical activation even after a period of electrical stimulation by the CI.
Exploring the Living Cochlea Using Confocal Microscopy
Authors: Ulfendahl Mats , Boutet de Monvel Jacques , Le Calvez Sophie
Published: April 2003

To obtain a more integrated view of the cellular behaviour of the cochlea it is essential to observe not only wider regions of the exposed turns but also to visualize structures below the reticular lamina. Using confocal microscopy and in vitro preparations of guinea pig and mouse inner ears, cellular structures within the intact organ of Corti can be visualized at high resolution. The approach thus offers a means to investigate detailed cellular events, e.g. structural reorganization following acoustic overstimulation. Confocal microscope images, although sharper than images acquired using regular light microscopy, are still subject to problems related to light scattering within the optical system and low signal-to-noise ratio. Significant image restoration can, however, be obtained by applying a combination of wavelet denoising techniques and deconvolution algorithms. Future work will focus both on more dynamical cellular events and on new in vivo models where the inner ear is visualized at a better functional state.
Roles of Fibroblast Growth Factors in the Inner Ear
Authors: Pickles James O. , Chir Brian
Published: April 2003

The basic biology of the fibroblast growth factor (FGF) receptors and their splice variants is first reviewed, followed by a review of the known roles of FGFs in the inner ear. They include induction of the otocyst by FGF19, followed by FGF3 in further development of the otocyst. In later development, FGF3 or FGF10 acting on FGF receptor 2b is likely to be involved in development of the walls of the cochlear spaces, while FGF receptor 3 is involved in differentiation of the pillar cells of the organ of Corti. FGF1 and FGF2 act as trophic factors for the developing cochlear nerve fibres.
Very High Daily Intraperitoneal Doses of Carbonyl Compounds Affect the Morphology, but Not the Exchange Characteristics, of Rat Peritoneum
Authors: Musi Barbara , Braide Magnus , Wieslander Anders , Rippe Anna , Albrektsson Ann , Henle Thomas , Rippe Bengt
Published: April 2003

Glucose degradation products (GDP) are carbonyl compounds, that are formed by heat sterilization of conventional peritoneal dialysis (PD) fluids. Carbonyl compounds are known to be toxic in vitro and potentially toxic also in vivo. The aim of this study was to evaluate the effects of daily, short-term exposure of the peritoneum to very high concentrations of GDP in vivo on peritoneal transport parameters and on peritoneal morphology in a well-established rat model of PD. Rats were exposed to three daily intraperitoneal (IP) injections (10 ml) for 9 days of a largely neutral (pH 7.2) PD fluid containing 1.5% glucose and sterilized by filtration, with (n = 8) or without (n = 8) the presence of different carbonyl compounds in concentrations 100 times higher than those reported in commercial PD fluids. Seven rats, not subjected to any exposure, served as controls. After the exposure, the rats were subjected to acute PD in 4-hour dwells. Twenty milliliters of 4% glucose dialysis fluid were instilled into the rat peritoneal cavity. Blood and dialysate samples were taken during the dwell for measurements of dialysate sodium, and for assessments of the mass transfer area coefficient (PS) for glucose and 51Cr-EDTA and of transperitoneal clearance (Cl) or radiolabelled albumin (RISA). At the end of the dwell, parts of the liver, diaphragm and peritoneum were removed for measurements of tissue cell density and thickness of the submesothelial peritoneal tissue. The exposure of the peritoneum to very high doses of carbonyl compounds did not affect the peritoneal transport of fluid and small solutes significantly, but seemed to slightly reduce lymph flow and albumin clearance out of the peritoneal cavity. Assessed after a hypertonic dwell, and compared to the situation in nontreated rats after the same kind of dwell, there was a significant thinning of the submesothelial tissue, but no difference in tissue cell density. It is concluded that short-term exposure of the peritoneum in vivo to very high doses of GDP resulted in almost no signs of acute toxicity.
Analysis of β2-Microglobulin Kinetics in Hemodialysis by a Modified Variable-Volume One-Compartment Model
Authors: Yamada Toshio , Akiba Takashi , Sasaki Sei
Published: April 2003

It has been reported that deposition of β2-microglobulin (BMG) is associated with the occurrence of dialysis-related amyloidosis (DRA) in long-term hemodialysis (HD) patients. Though reduction of the BMG burden is essential in preventing DRA, simple BMG kinetic models applicable to clinical practice have not been established. We have reported a modified variable-volume one-compartment model (1CM) for analyzing urea nitrogen (UN) kinetics, in which no specific parameters other than a modification factor are necessary. If there is a constant relation between the BMG concentration of the dialyzer arterial line and the mean BMG concentration in the body during HD, the modified 1CM may also be applied to BMG. As such, in order to verify its validity, we analyzed UN and BMG kinetics by the modified 1CM in 28 HD patients in whom polysulfone dialyzers were used, and compared the calculated and measured solute rebound. In 3 of the patients, the spent dialysate was collected in a tank, and the BMG removal mass, calculated by the modified 1CM, was compared with that recovered in the tank. The BMG rebound ratio (%), calculated by the modified 1CM, was not different from the measured one (36.3 ± 9.9 vs. 36.5 ± 11.5, p = 0.954), as in the case of UN (15.8 ± 4.5 vs. 16.3 ± 4.6, p = 0.541). The solute dilution in the blood circuit by solute disequilibrium and blood recirculations for BMG was estimated to be 74% stronger than that for UN. The normalized solute generation rate (mg/min/l) and the time-averaged solute concentration over a 1-week period (mg/l) were 0.142 ± 0.023 and 448 ± 68 for UN and 0.00578 ± 0.00125 and 22.4 ± 4.6 for BMG, respectively. The differences between these two solutes resulted in a Dilution index for BMG that was 23% lower than that for UN (2.62 ± 0.44 vs. 3.21 ± 0.39, p < 0.0001). The modified 1CM overestimated the BMG removal mass (mg) by about 20% compared with that recovered in the tank (195 ± 22 vs. 162 ± 17, p < 0.0001). One of the causes of this discrepancy was speculated to be adsorption of BMG by polysulfone dialyzers. It was concluded that, despite several problems in quantitative analysis, the modified 1CM would be a useful model for estimating the dialysis efficiency for BMG removal in clinical practice.