Der p-Phenylendiamin(PPD)-Oxydasetest als eine Laboratoriumsmethode zur Diagnostik der Hyperthyreose

Zusammenfassung Bei 31 unbehandelten Hyperthyreosekranken wurde die p-Phenylendiamin(PPD)-Oxydaseaktivität und die Kupferkonzentration im Serum und gleichzeitig der Grundumsatz bestimmt. Der Grundumsatz lag bei allen Patienten über der Normgrenze. Die PPD-Oxydaseaktivität und der Serumkupferspiegel sind signifikant erhöht gefunden worden. Demzufolge scheint die PPD-Oxydasebestimmung im Serum ein guter Hinweis für die Diagnose unbehandelter Hyperthyreosen zu sein.Weiterhin wurden dieselben Untersuchungen bei Hyperthyreosekranken vor und während der Therapie mit einzelnen Thyreostatica der Thiouracilgruppe durchgeführt. Dabei konnte eine Verminderung von PPD-Oxydaseaktivität und Kupfergehalt im Serum, parallel zur Grundumsatzverminderung, beobachtet werden, sofern die Thyreostatica in genügenden Dosen angewandt wurden. Die Bestimmung der PPD-Oxydaseaktivität erscheint daher auch zur Beurteilung des Therapieeffekts und zur Ermittlung der therapeutischen Dosis von Wert zu sein.     

Quantitative histologic studies of the gonads of sand rats (Psammomys obesus) during the development of diabetes mellitus]

Quantitative-histological investigations (point counting method) are pointed out in 27 male and 15 female sand rats. The animals are divided in the IGT (impaired glucose tolerance), the diabetic and the control group. The LEYDIG cells are in the IGT-group increased, and in the diabetic group decreased. The female sand rats are characterized by the tendency of increase of size and number of follicles in the IGT-group. Corpora lutea are reduced but atretic follicles are increased in the diabetic group. The ovaries are greater in diabetic sand rats.     

An adjective list for assessing emotional expressivity in psychotherapy research

Background: Several forms of psychotherapy aim at improving their patients' emotional expressivity, which is considered to contribute to mental health. Studies on the success of such attempts are virtually absent. Aim: To develop a measure for assessing changes of emotional expressivity in the course of psychotherapy. Method: In study 1 (N = 321), we generated a pool of German adjectives referring to emotional expressivity and reduced the number of those adjectives by means of factor‐analysis. In study 2 (N = 103), we determined how emotional expressivity is related to the Big Five personality factors. Results: An expressivity scale of 12 items with highly satisfactory psychometric properties was construed. Emotional expressivity is substantially related to Extraversion and moderately related to Agreeableness and Openness. Conclusion: The scale is ideally suited for repeated assessments in the course of psychotherapy in multi‐agent (e.g., inpatient) settings. Copyright © 2007 John Wiley & Sons, Ltd.     

The pathological basis of conduction block in human neuropathies.

Conduction block was detected in patients with neuropathy by measuring a decrease in the size of the compound muscle action potential of more than 20% on proximal versus distal stimulation of the peroneal, median or ulnar nerve in the absence of excess temporal dispersion of the potential. The teased fibre analyses of nerve biopsies from four patients with "definite" and six patients with "probable" conduction block and from seven patients with neuropathy but without conduction block were compared. All patients with conduction block had significant demyelination (X% demyelinated and remyelinated fibres = 50%) while those without conduction block did not (X = 5.0%). Demyelination is the pathological basis of conduction block in human neuropathies.     

The source of 'paradoxical lateralization' of cortical evoked potentials to posterior tibial nerve stimulation

We report the potentials elicited by posterior tibial nerve stimulation and recorded simultaneously from the scalp and from electrodes within the interhemispheric fissure. The primary cortical potential was recorded from cortex contralateral but from scalp ipsilateral to the stimulated nerve. The scalp recordings thus demonstrated "paradoxical lateralization" as reported previously, and the similar morphology of the scalp and contralateral cortical recordings confirm that this "paradoxical lateralization" is most likely the result of a horizontal dipole located within the interhemispheric fissure.     

Endobronchiale Applikation von Adrenalin in der kardiopulmonalen Reanimation Pharmakokinetische und -dynamische Untersuchungen beim Hund

Zusammenfassung Das Ziel der vorliegenden Untersuchungen bestand darin, das pharmakokinetische Profil von Adrenalin bei endobronchialer (e.b.) und intravenöser (i.v.) Applikation zu erarbeiten und die gemessenen Adrenalin-Plasmaspiegel mit hämodynamischen Messungen zu korrelieren. Die e.b. Applikation von 100 g/kg Adrenalin erwies sich als ebenso effektiv, wie die i.v.-Gabe von 10 g/kg. Dabei war der Wirkungseintritt der e.b.-Gabe von Adrenalin nur geringfügig um einige Sekunden verzögert. Die Bioverfügbarkeit für e.b. verabreichtes Adrenalin lag zwischen 80 und 85%. Der therapeutische Effekt blieb nach e.b.-Applikation von 100 g/kg Adrenalin wesentlich länger erhalten (ca. 30 min) als nach i.v.-Gabe von 10 g/kg (ca. 3–5 min). Aus den Ergebnissen wird geschlossen, daß die tiefe endobronchiale Instillation von 2–3 mg Adrenalin (verdünnt in 5–10 ml Kochsalzlösung) als alternative Dosierungstechnik bei klinischen Reanimationen betrachtet werden kann.

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Pharmacokinetics and -dynamics of epinephrine administered endobronchially

Summary The present animal study was designed to investigate the pharmacokinetic behavior of epinephrine after endobronchial (e.b.) and intravenous (i.v.) administration and its correlation to pharmacodynamic measurements. We found the effectiveness of e.b.-epinephrine (100 g/kg BW) to be in the same magnitude as i.v.-epinephrine (100 g/kg BW) with only a slight delay in the pharmacodynamic onset of a few seconds. The bioavailability of e.b.-administration of epinephrine was in the range of 80–85%. The therapeutic effect of e.b.-epinephrine (100 pg/kg BW) lasted much longer (30 min) when compared to i.v.-epinephrine (10 g/kg BW) where the pharmacodynamic effect was terminated after 3 to 5 min. For the clinical situation of cardiopulmonary resuscitation a dose of 2–3 mg epinephrine in 5–10 ml of physiological saline instilled deeply into the bronchial system should be considered as alternative administration technique with fast onset and good effectiveness.

Herrn Prof. Dr. Dr. h.c. F. Stelzner zum 65. Geburtstag gewidmet     

Euthanasia in the Third Reich--only a problem of psychiatry? On the development of the euthanasia debate 1933-1941 in Germany

The devastating consequences of the Fascist dictatorship in Germany for the ethical thinking of the physicians are particularly clearly recognizable by the mass killings of severely damaged children and patients with chronic psychic diseases which were performed at that time. Recent investigations of the developments which began in 1938 show that by way of intensive efforts for a juridicial legalization of the "active euthanasia" an enlargement of this killing practice has been striven after. References to a motive of compassion and the free decision of the affected persons should cover the real intention for reducing welfare services. A bill presented in 1940 for a law "on euthanasia for incurable ill persons" found the unanimous consent of the renowned physicians consulted for this purpose. Though this law finally did not become legal beginning with 1941 the medical practice showed further forms of the repressive and antihumane association with ill persons who were regarded as incurable, which must be valuated as practical consequences of an unadmissible relativation of the life-preserving task of medicine.     

Mathematical model of volume kinetics and renal function after burn injury and resuscitation

This paper presents a mathematical model of blood volume kinetics and renal function in response to burn injury and resuscitation, which is applicable to the development and non-clinical testing of burn resuscitation protocols and algorithms. Prior mathematical models of burn injury and resuscitation are not ideally suited to such applications due to their limited credibility in predicting blood volume and urinary output observed in wide-ranging burn patients as well as in incorporating contemporary knowledge of burn pathophysiology. Our mathematical model consists of an established multi-compartmental model of blood volume kinetics, a hybrid mechanistic-phenomenological model of renal function, and novel lumped-parameter models of burn-induced perturbations in volume kinetics and renal function equipped with contemporary knowledge on burn-related physiology and pathophysiology. Using the dataset collected from 16 sheep, we showed that our mathematical model can be characterized with physiologically plausible parameter values to accurately predict blood volume kinetic and renal function responses to burn injury and resuscitation on an individual basis against a wide range of pathophysiological variability. Pending validation in humans, our mathematical model may serve as an effective basis for in-depth understanding of complex burn-induced volume kinetic and renal function responses as well as development and non-clinical testing of burn resuscitation protocols and algorithms.     

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