Antibiotics from basidiomycetes. XXXI. Aleurodiscal: an antifungal sesterterpenoid from Aleurodiscus mirabilis (Berk. & Curt.) H?hn

Aleurodiscal, an antifungal antibiotic has been isolated from mycelial cultures of Aleurodiscus mirabilis (Berk. & Curt.) H?hn. It causes abnormal apical branchings of Mucor miehei hyphae at very low concentrations. The structure and absolute configuration of the antibiotic has been determined by a single crystal X-ray analysis and hydrolysis to D-(+)-xylose. Aleurodiscal is a hydroxysesterterpene aldehyde beta-D-xyloside with a novel carbon skeleton.     

Localization of the gene encoding the {alpha}2/{delta}-subunits of the L-type voltage-dependent calcium channel to chromosome 7q and analysis of the segregation of flanking markers in malignant hyperthermia susceptible families

Malignant hyperthermia susceptibility (MHS) is an autosomaldominant disorder of skeletal muscle which manifests as a potentiallyfatal hypermetabolic crisis triggered by commonly used anaestheticagents. This demonstration of genetic heterogeneity in MHS promptedthe investigation of the roles played by calcium regulatoryproteins other than the ryanodine receptor (RYR1), which isknown to be linked to MHS in fewer than half of the EuropeanMHS families studies to date. Previously, we have excluded thegenes encoding the skeletal muscle L-type voltage-dependentcalcium channel     

Assessment of adverse drug reactions in psychiatric hospitals

Summary A system for monitoring adverse drug reactions (ADR) in psychiatric inpatients was introduced in psychiatric hospitals in the FRG in May 1979. It consists of intensive drug monitoring (IDM) and a so-called organized spontaneous reporting system (OSR). ADR are rated separately according to impact on therapy and probability of causal relationship. With IDM all ADR (Grades I–III) are assessed in a randomly selected sample of inpatients. With OSR only ADR leading to discontinuation of the drugs in question (=ADR Grade III) are assessed. In 406 drug-treated inpatients monitored by IDM in the psychiatric hospitals of Berlin and Munich from May 1979 to Dec. 1981, ADR were observed in 60,4%. In 15% of IDM-patients ADR led to discontinuation of the drugs in question; with OSR the relative frequency of these Grade III ADR was 9,0% in 5096 patients monitored throughout the entire period. Life-threatening events were observed in 1,2% of patients undergoing IDM as well as 1.2% of those undergoing OSR. The most frequently observed ADR by IDM were sedation, extrapyramidal signs, disturbances of the autonomic nervous system and increase in transaminases, and by OSR Parkinsonism, akathisia, sedation, toxic delirium and increased transaminases. The relative frequency of Grade III ADR was similar for neuroleptics and antidepressants (5,4% and 5,3% in OSR); a very low relative frequency of ADR Grade III was found for tranquilizers and hypnotics (0,7% and 0,2%). Methodological aspects of this drug monitoring system are discussed in the light of current literature.     

Microendoscopy of the Eustachian tube and the middle ear. Indications and clinical application

Progressive miniaturization of flexible fibreoptic systems has made it possible for the first time to perform atraumatic endoscopy of the Eustachian tube and tympanic cavity with the ear drum intact. With the aid of special actively steerable microcatheters, flexible fibrescopes having outer diameters of 350 to 650 microns are inserted into the opening of the naso-pharyngeal tube and advanced into the tympanic cavity under direct visual control. This new technique is indicated for any disturbance of sound conduction and in those sensorineural hearing disorders in which direct inspection of the middle ear cavity can provide information on the pathogenesis of the disturbance. In the future it may thus replace purely diagnostic tympanoscopy. In combination with fibre-delivery laser systems, this new method forms the basis of "microendoscopically controlled laser surgery" of pathological changes within this anatomical region.     

A time-series perspective on effectiveness of a health teaching program on chronic obstructive pulmonary disease

The purpose of this research was to study the long-term effects of attendance at "Help Yourself to Better Breathing" classes on knowledge attainment, coping strategies, and anxiety, depression, and hostility in individuals with chronic obstructive pulmonary disease. Data were gathered immediately and six months following completion of the program. The results were then compared to those obtained before program attendance. The data showed a significant difference between the pretest, immediate post-test, and the six-month knowledge scores. Coping scores remained the same, which may indicate that not enough emphasis is placed on the development of these skills. There was a significant lowering of the depression scores at the six-month post-testing, and anxiety and hostility scores were lower, but not significantly so. In addition, some participants after the classes were completed chose to enroll in the Better Breathers Program support group and in a pulmonary rehabilitation program. Overall, this study indicates that beneficial effects are evidenced six months following attendance at "Help Yourself to Better Breathing" classes.     

Neutrophilic superoxide production can assess pharmacological and pharmacogenetic β‐adrenoreceptor effects

Asthma can be controlled well in most patients by inhaled β‐adrenoreceptor (β₂AR) agonists and steroids. Poor response to β₂AR agonists is difficult to predict, especially in young children and by lung function testing, which may be affected by multiple influences. As an alternative approach, we analyzed ex vivo neutrophilic superoxide inhibition in response to β₂AR stimulation. In 60 healthy volunteers, this assay was unaffected by sex, age, smoking, atopy or asthma status. Furthermore, we assessed effects of genetic variants in β₂AR by sequencing the ADRB2 gene in our cohort and relating genotypes to β₂AR‐mediated neutrophilic superoxide inhibition. Gly16Arg genotypes correlated with minor decrease in overall adrenoresponse in this small study population. Taken together, ex vivo testing of the β₂AR response in human neutrophils represents a robust tool with good signal‐to‐noise ratio at physiological β₂AR agonist concentrations, and this assay may be useful to complement future pharmacogenetic studies in asthma.     

Update zur Therapie des externen Rektumprolapses

Treatment of full thickness rectal prolapse lies in the hands of colorectal surgeons and still represents a special interdisciplinary challenge due to the close proximity to other urogenital compartments of the pelvic floor and simultaneous functional disorders. For this purpose, abdominal and perineal surgical techniques with appropriate modifications are available. In a comparison of the various techniques and approaches primary endpoints, such as recurrence rate, improvement of fecal incontinence and constipation are not significantly different between the many studies. A clear recommendation or preference for an appropriate treatment and approach cannot be given even in this update because of the heterogeneous evidence level of studies. However, minimally invasive techniques for the perineal and abdominal approaches seem to result in faster recovery, shorter hospital stay and reduction of postoperative pain and raise hopes for further developments with respect to anatomical reconstruction of the pelvic floor.