Electroencephalographic sleep studies in depressed outpatients treated with interpersonal psychotherapy: I. Baseline studies in responders and nonresponders.

Electroencephalographic (EEG) sleep measures have been examined as predictors of therapeutic response in patients with major depression. Although some studies have reported that EEG sleep measures are predictive of a favorable outcome with medications, two recent studies found no differences in the baseline sleep characteristics of responders and nonresponders to psychotherapy. To clarify this issue, we compared baseline EEG sleep in a group of patients with recurrent depression who responded to interpersonal psychotherapy (n = 19) and a comparable group who did not respond (n = 18). Baseline ratings of depression severity did not differ in the groups, but some differences in baseline sleep were noted. Psychotherapy nonresponders had longer sleep latencies, lower sleep efficiency, and increased automated measures of phasic rapid eye movement (REM) activity. In addition, the two groups had different EEG sleep adaptation patterns for REM latency and phasic REM density measures across the two study nights. These preliminary results suggest that baseline EEG sleep patterns, as well as the pattern of laboratory adaptation, may differ for depressed patients who respond to psychotherapy and those who do not.     

Aspects of the morphogenesis of cancer of the endometrium

The paper covers a number of morphogenetic problems of endometrial cancer with reference to multidirectional differentiation of the uterine epithelium affected by tumor. Metaplastic changes of the endometrium observable in three basic variants (tubal, endocervical, squamous cell) can entail dysplasia with resultant malignant transformation. Endometrial cancer shows complex structure of the tumor with sings of multidirectional epithelial differentiation: endometrial, tubal, endocervical, squamous). Morphological features of the tumor and adjacent mucosa, assessed comparatively, suggest a close relationship between the direction of endometrial epithelium differentiation and the new growth histological structure.     

Unterschenkel-Muskelatrophie bei Arthrose des oberen Sprunggelenks und deren Rehabilitation nach Implantation einer Sprunggelenksprothese

The aim of this orthopaedic-biomechanical study was to evaluate lower leg muscle function in ankle osteoarthritis (OA) patients and muscle rehabilitation after the implantation of a total ankle replacement (TAR). Patients with a severe unilateral ankle OA were assessed with an orthopaedic and biomechanical examination before and one year after TAR surgery. Visual analogue pain score, American Orthopaedic Foot and Ankle Society (AOFAS) ankle score, ankle range of motion for dorsi- and plantar flexion (ROM DF/PF), and calf circumference difference between affected and contralateral healthy leg were measured. Isometric maximal voluntary torque for ankle dorsiflexion and plantar flexion were measured simultaneously with surface electromyography (EMG; mean frequency and intensity) of the anterior tibial, medial gastrocnemius, soleus, and peroneus longus muscle. Data were compared to a group of age- and gender-matched normal subjects. The mean calf circumference difference between legs did not significantly decrease from preoperative to one year follow-up. The mean dorsiflexion torque and plantar flexion torque of the affected ankle increased significantly. The atrophic muscles were characterized by a reduction of the mean EMG intensity and mean EMG frequency. In the rehabilitation process, the mean EMG intensity recovered and was not significantly different for all muscles, however, not for EMG frequency, which remained low and unchanged. This study reports for the first time in the literature the clinical and biomechanical facts of lower leg muscle atrophy in ankle OA as well as the amount of the muscle rehabilitation after a total ankle replacement. Patients with a symptomatic ankle OA achieve better function with a total ankle replacement; however, one year after the operation neuromuscular and biomechanical deficits may still be present.     

Über den Vitamingehalt der Frauenmilch

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