Zur Struktur der schizophrenen Antriebsstörung

Zusammenfassung Nach der näheren Begriffsbestimmung und nach dem Eingehen auf die bisherige Literatur wurde das Ergebnis von Untersuchungen an 33 schizophrenen Patienten mit ausgesprochenem Antriebsdefekt vorgelegt. Bei diesen Kranken wurden mit einem differenzierten Fragesystem, mit experimental-psychologischen Methoden, ergänzt durch Beobachtungsprotokolle, die einzelnen Bereiche untersucht, in denen der Antrieb vorwiegend seinen Niederschlag findet.Bei der Untersuchung der Psychomotorik stand eine Rhythmusstörung im Vordergrund, die in dieser Eindringlichkeit bei analogen Studien bei hirnorganisch Erkrankten nicht gesehen wurde. Weiter fanden sich Abweichungen im Bereich des Antriebsniveaus im Sinne einer Tempo- und Intensitätsänderung und drittens war die Antriebsverteilung als solche im Sinne eines unökonomischen Verhaltens gestört.Bei der Prüfung der sensorischen Leistungen waren die Empfindungsreaktionen reduziert, das Wahrnehmungsvermögen war als solches intakt, doch schienen die Wahrnehmungen an plastischer Frische verloren zu haben. Dieses ließ sich auch im Rahmen der Farbwahl nach Pfister belegen.Die assoziativen Leistungen ließen eine schon früher von Störring beobachtete Dissoziation erkennen. Das sach- und gegenstandsgebundene Denken war nicht gestört. Dagegen setzte eine Auflockerung der Vorstellungsabläufe ein, sowie das Denken auf das Personale und Wertende eingestellt war.Im Zusammenhang mit der Beeinträchtigung des wertenden Denkens mußte auch die Entscheidungsschwäche, die über eine Ambivalenz zur Standpunktlosigkeit bis auf das Niveau eines unbeteiligten Verharrens heruntersank, bei diesen Kranken konstatiert werden.Die vital zentrierten Triebe wurden fast stufenförmig abgebaut. Zunächst erfolgte eine Einschränkung der Bewegungstriebe, dann setzte eine Verschiebung in der Schlaf-Wachsteuerung ein, die Gefahrenschutztriebe verkümmerten, die Sexualtriebe ließen nach, während der Nahrungstrieb am geringsten betroffen wurde. Der polare Charakter der Triebe ging verloren.Sehr früh abgebaut wurden die komplexer strukturierten Strebungen religiöser, ethischer und ästhetischer Art.Die prämorbide Persönlichkeit schien für die Ausformung des Defektes mitbestimmend zu sein.An Hand des spezifischen Charakters des schizophrenen Defektes wurden vergleichende psychopathologische Betrachtungen zur Struktur hirnorganischer Antriebsstörungen, insbesondere der frontalen und diencephalen Antriebsschwäche, angestellt.Nach einem Vortrag auf der Tagung der Gesellschaft Nord- u. Nordwestdeutscher Neurologen und Psychiater in Kiel am 22./23. 4. 1961.     

Implementation of a web-based,interactive polytrauma tutorial in computed tomography for radiology residents: How we do it

Purpose

Due to the time factor in polytraumatized patients all relevant pathologies in a polytrauma computed tomography (CT) scan have to be read and communicated very quickly. During radiology residency acquisition of effective reading schemes based on typical polytrauma pathologies is very important. Thus, an online tutorial for the structured diagnosis of polytrauma CT was developed.

Materials and methods

Based on current multimedia theories like the cognitive load theory a didactic concept was developed. As a web-environment the learning management system ILIAS was chosen. CT data sets were converted into online scrollable QuickTime movies. Audiovisual tutorial movies with guided image analyses by a consultant radiologist were recorded.

Results

The polytrauma tutorial consists of chapterized text content and embedded interactive scrollable CT data sets. Selected trauma pathologies are demonstrated to the user by guiding tutor movies. Basic reading schemes are communicated with the help of detailed commented movies of normal data sets. Common and important pathologies could be explored in a self-directed manner.

Conclusions

Ambitious didactic concepts can be supported by a web based application on the basis of cognitive load theory and currently available software tools.     

Acute goiter hematoma following blunt neck trauma

Traumatic hemorrhage into the thyroid gland is rarely reported. We report the case of a 30-year-old man who sustained blunt trauma to his neck, resulting in hemorrhage into a previously existing goiter. The patient's goiter was drained in the hospital. He was doing well at a three-month follow-up.     

Mycobacterium tuberculosis Coinfection Has No Impact on Plasmodium berghei ANKA-Induced Experimental Cerebral Malaria in C57BL/6 Mice

Cerebral malaria (CM) is the most severe complication of human infection with Plasmodium falciparum. The mechanisms predisposing to CM are still not fully understood. Proinflammatory immune responses are required for the control of blood-stage malaria infection but are also implicated in the pathogenesis of CM. A fine balance between pro- and anti-inflammatory immune responses is required for parasite clearance without the induction of host pathology. The most accepted experimental model to study human CM is Plasmodium berghei ANKA (PbANKA) infection in C57BL/6 mice that leads to the development of a complex neurological syndrome which shares many characteristics with the human disease. We applied this model to study the outcome of PbANKA infection in mice previously infected with Mycobacterium tuberculosis, the causative agent of tuberculosis. Tuberculosis is coendemic with malaria in large regions in the tropics, and mycobacteria have been reported to confer some degree of unspecific protection against rodent Plasmodium parasites in experimental coinfection models. We found that concomitant M. tuberculosis infection did not change the clinical course of PbANKA-induced experimental cerebral malaria (ECM) in C57BL/6 mice. The immunological environments in spleen and brain did not differ between singly infected and coinfected animals; instead, the overall cytokine and T cell responses in coinfected mice were comparable to those in animals solely infected with PbANKA. Our data suggest that M. tuberculosis coinfection is not able to change the outcome of PbANKA-induced disease, most likely because the inflammatory response induced by the parasite rapidly dominates in mice previously infected with M. tuberculosis.     

Mate calling behavior of male South African clawed frogs (Xenopus laevis) is suppressed by the antiandrogenic endocrine disrupting compound flutamide

Several environmental pollutants have been identified as antiandrogenic endocrine disrupting chemicals (EDC), with flutamide (FLU) being a model compound for this type of action. Despite impacts of EDC interfering with sexual differentiation and reproduction in amphibians, established information about suggested effects on sexual behavior is still lacking. In this study adult male Xenopus laevis were injected with human chorionic gonadotropin (hCG) to initiate mate calling behavior. After one day hCG-stimulated frogs were treated via aqueous exposure over three days without and with FLU at concentrations of 10⁻⁸ and 10⁻⁶ M in comparison to untreated frogs. Androgen controlled mate calling behavior was recorded during the 12 h dark period. At the end of exposure circulating levels of testosterone (T) and 17β-estradiol (E2) were determined and furthermore gene expression was measured concerning reproductive biomarkers such as hypophysial luteinizing hormone (LH), follicle-stimulating hormone (FSH), testicular aromatase (ARO), 5α reductase type 1 (SRD5α1) and 5α reductase type 2 (SRD5α2). Both concentrations of FLU caused a significant decrease in calling activity starting at the second day of exposure. HCG injected positive controls had elevated levels of T compared to negative control frogs while in parallel treatment with FLU did not affect significantly the hCG elevated sex steroid levels. Furthermore, hCG treatment led to significantly decreased levels of gene expression for ARO and SRD5α2 but no impacts were detected on LH, FSH or SRD5α1 mRNA levels compared to negative controls. In summary, the behavioral parameter mate calling is the most sensitive biomarker detecting antiandrogenic modes of action in this challenge-experiment indicating that this non-invasive method could markedly contribute for sensitive assessment of antiandrogenic EDC.