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We studied 56 pregnant women and 24 partners after ultrasound examination in the 18-24h gestational week revealed a fetal malformation. The subjects were followed through the process of examination, information sharing and counselling about the option of terminating the pregnancy. Regardless of sociodemographic variables or attitude towards the pregnancy, the diagnosis was always traumatic. A detailed critique of the physician's behavior and function emphasized his important role in the process of coming to terms with the malformation and gave clear indications of the positive expectations parents had. The affected patients expected the role of the professionally competent expert to be combined with that of the empathetic approachable counsellor, whose ste-by-step explanation would allow them to decide for themselves whether to terminate the pregnancy. The partner's participant was an essential aid to adjustment. It remains to be seen to what extent the functions of the doctor are realistic and justified. 相似文献
14.
Michael Weller Helmut Wilhelm Norbert Sommer Johannes Dichgans Horst Wiethölter 《Journal of neurology》1992,239(4):231-234
Summary Two patients are described with the triad of tonic pupil, hyporeflexia and segmental anhidrosis (Ross syndrome). Only 18 cases of this syndrome have been reported in the literature so far. While tonic pupil and reduced sweating can be attributed to the affection of postganglionic cholinergic parasympathetic and sympathetic fibres projecting to the iris and sweat glands, respectively, the pathogenesis of diminished or lost tendon jerks remains obscure. To identify the characteristic clinical features, the previous cases of Ross syndrome are reviewed. Recent evidence of subclinical disturbances of sweating in most patients with Adie's syndrome, i.e. tonic pupil and areflexia, casts doubt on the nosological concept of Ross syndrome as a distinct clinical entity. 相似文献
15.
Surber Christian Wilhelm Klaus-P. Bermann David Maibach Howard I. 《Pharmaceutical research》1993,10(9):1291-1294
Etretinate and acitretin are given orally to treat psoriasis and various keratinization disorders. Acitretin, the main active metabolite of etretinate, has the pharmacokinetic advantage of being rapidly eliminated, but it shares etretinate's toxicologic profile. Thus a topical delivery of acitretin with no or reduced systemic adverse effects is desirable. To characterize the therapeutic potential of topically delivered acitretin, we quantitatively assessed its percutaneous penetration in healthy human volunteers. Additionally, three skin sampling techniques, the punch biopsy, the shave biopsy, and the suction blister technique, were validated to quantitate acitretin in the skin. The results suggest that topical delivery of acitretin renders skin concentrations which exceed those reported after oral administration of etretinate or acitretin. However, because of possible interlaminate drug contamination, drug localization within a particular skin compartment cannot be determined. 相似文献
16.
Heinrich Schulze Mönking Wilhelm P. Hornung Karl Stricker Gerhard Buchkremer 《European archives of psychiatry and clinical neuroscience》1997,247(1):31-34
This study examines the correlation between development of expressed emotion (EE) in relatives and course of illness of 99
DSM-III schizophrenic patients. Patients whose relatives were high EE at baseline and at the 2nd CFI approximately 20 months
later had a poor prognosis at the very outset of the study and an unfavourable course of illness. They had a higher rehospitalisation
rate, more symptoms, lower psychosocial assessment, and a poorer 2-year and even 8-year outcome. Patients from families with
a fluctuating EE or a consistently low EE had better courses. Expessed emotion is therefore a valid predictor not only of
symptomatic relapses, but also of other important aspects of schizophrenia. The connection between EE index and course of
illness seerns not to be simply reactive or causal, but complex and non-uniform. 相似文献
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18.
Zum Thema
Zell- und molekularbiologische Methoden haben es in den letzten 25 Jahren erm?glicht, Erkenntnisse in intra- und interzellul?re
Funktionsabl?ufe und deren St?rungen zu gewinnen. Besonders in der Onkologie kam es zu einem zunehmenden Wissen über dysregulierte
Gene, sog. Onkogene, welche ein dysfunktionelles (Onko)Protein produzieren und damit Zellwachstum und Proliferation in Richtung
Malignit?t beeinflussen k?nnen. Tumorsuppressorgene (TSG) wirken regulierend auf den Zellzyklus ein, und im Falle einer vererbten
Mutation des einen Allels und einer Deletion des intakten Allels durch Funktionsverlust k?nnen Malignome induziert bzw. Malignomentstehung
begünstigt werden. Ein Beispiel hierfür ist das Li-Fraumeni-Syndrom, bei welchem es aufgrund einer Mutation des Tumorsuppressorgens
p53 zu einer geh?uften Inzidenz von Mamma- und Ovarialkarzinomen kommt. ?nderungen von Proteasen- oder Adh?sionsmolekülfunktionen
von Zellen spielen eine wichtige Rolle bei der Tumorzellinvasion und Metastasierung. Blockierung von Proteasesystemen, z.
B. Urokinase/Plasmin-System oder Matrixmetalloproteasen, führen zu einer Inhibierung von Tumorzellinvasion und Metastasierung
in vitro und in vivo. Bei einigen Malignomen kommt es zu einer Vermehrung von Genkopien, einer sog. Genamplifikation, wie
sie z. B. für Rezeptoren der epidermal „Growth-factor-Familie“ (EGF-R, erbB2, erbB3, erbB4) beschrieben sind. Die betroffenen
Zellen reagieren dadurch vermehrt auf autokrine und parakrine Signale und hyperproliferieren. Die Gentherapie stellt durch
Wiederherstellung physiologischer Funktionsabl?ufe einen vielversprechenden Ansatz zur Behandlung maligner Erkrankungen dar.
Der vorliegende übersichtsartikel wird ohne Anspruch auf Vollst?ndigkeit nach einer kurzen Einführung in die Grundlagenaspekte
der Gentherapie und deren derzeitigen Probleme pr?klinische und erste klinische Ergebnisse darstellen. 相似文献
19.
The numbers of neurons of the ganglion cell layer (GCL) and their distribution in the retina of an Australian lizard Ctenophorus nuchalis were investigated. Retinal wholemounts and sections were prepared for light microscopic and optic nerves for electron microscopic study. Counts of cell numbers in the GCL from wholemounts varied from 200,000 to 380,000. Neurons in the GCL were non-uniformly distributed, forming a high cell density streak along the naso-temporal axis of the retina. Neurons of the GCL formed 2 to 9 layers in the visual streak and a single layer in the rest of the retina. The number of neurons of the GCL in this area was estimated at about 2,100,000. Although the visual streak represented only 16% of the total retinal surface area, it contained about 90% of all neurons of the GCL. Optic axon counts yielded 147,000 myelinated and 2,643,000 unmyelinated fibres. The estimated optic fibre number of 2,790,000 was 18.2% less than the total number of neurons counted from sections in the GCL of the same eye. The unexpected high number of neurons in the area of the visual streak indicates that cell numbers obtained only from wholemount preparations may vastly underestimate the total neuron numbers in the GCL of the lizard retina. 相似文献
20.
Dieter Ulrich Preiss Delawer Abdullah Bruno Eberspcher Karlheinz Wilhelm 《Thrombosis research》1992,65(6):677-686
In a prospective clinical trial the risk of infection after application of virus inactivated antithrombin III concentrate ANTITHROMBIN III IMMUNO (AT III) was investigated in patients undergoing cardiovascular surgery. The study was conducted according to the recommendations of the International Committee on Thrombosis and Hemostasis (ICTH), with the exception that most patients required additional blood products as well as AT III.
Twenty-seven patients were eligible to test for the risk of acquiring hepatitis B. Twenty-six patients could be evaluated in terms of hepatitis NANB transmission considering ALT-levels whereas 20 patients could be tested for anti-HCV one year after surgery. Samples from 78 patients could be monitored for anti-HIV-1. None of these patients showed any signs of infection. AT III IMMUNO seems to be an antithrombin III concentrate with low or absent infectivity. 相似文献