Angiographischer Nachweis und Embolisation einer hämodynamisch wirksamen Blutung aus der rechten Arteria dorsalis penis bei Symphysenruptur

Pelvic fractures are frequently complicated by concomitant vascular lacerations involving, particularly, branches originating from the internal iliac arteries. Massive hemorrhage may be difficult to be treated surgically. In such cases interventional radiology can be helpful and able to treat definitely extensive hemorrhage caused by pelvic trauma.     

Inhibition of mast cell histamine release by flavonoids and biflavonoids

The effect of 11 flavonoids and 4 biflavonoids on the release of histamine from peritoneal rat mast cells induced by compound 48/80 and calcium ionophore A23187 was studied. Dihydroflavonoids (flavanones) and (+)-catechin did not modify histamine release induced by both secretagogues. Flavone, apigenin and cromoglycate inhibited the secretion elicited by compound 48/80 but did not modify the A23187-induced secretion. The effect of kaempferol on the compound 48/80-induced histamine release was biphasic. Low doses (10 (-6) to 10 (-5)M) of the compound potentiated secretion whereas higher doses inhibited histamine secretion. Some of the drugs tested revealed a higher potency as referred to quercetin. Luteolin, a tetrahydroxyflavone and amentoflavone, a biapigenin, exhibited the highest inhibitory effects of mast cell histamine secretion.     

Measuring treatment outcomes and client satisfaction in a partial hospitalization program

Mental health practitioners are increasingly being called on to evaluate the effectiveness of the treatment they provide. The partial hospitalization component of the mental health industry also has felt this call for outcome research. This article presents the results of one program's attempts to answer that call through an assessment of treatment outcome and client satisfaction at a partial hospitalization program. Participants (N=287) were evaluated at admission, discharge, and 3-month follow-up. The article outlines the procedures used for assessment and uses the results as an example of the type of data that can be obtained through outcomes measurement. The article is intended to provide an example of program evaluation that is easy and inexpensive to administer.     

Repetitive transcranial magnetic stimulation (rTMS) in pharmacotherapy-refractory major depression: comparative study of fast, slow and sham rTMS

In previous studies, fast repetitive transcranial magnetic stimulation (rTMS) with a frequency > 1 Hz demonstrated substantial antidepressant effects compared to sham rTMS. However, it is not clear whether fast rTMS is superior to slow rTMS (frequency < or = 1 Hz) which is safe at therapeutically promising higher intensities. The aim of this double-blind study was to compare the action of fast, slow and sham rTMS. Eighteen patients with pharmacotherapy-resistant major depression were randomized to receive fast (10 Hz), slow (0.3 Hz) or sham rTMS with 250 stimuli/day for 5 successive days. rTMS was applied at 90% motor threshold intensity to the left dorsolateral prefrontal cortex. Scores on the Hamilton Depression Rating Scale (HDRS), but not on the Montgomery-Asberg Depression Rating Scale (MADRS), showed a statistically significant time x group interaction with a reduction of 19% after slow rTMS. However, the effect was clinically marginal and not reflected by self-rating scores. Verbal memory and reaction performance were not impaired after rTMS, and there was even a statistically significant time x group interaction with improvement of verbal memory performance after fast rTMS. In conclusion, this study further supported the safety of rTMS but does not show any clinically meaningful antidepressant efficacy of rTMS at 250 daily stimuli over 5 days in pharmacotherapy-refractory major depression.     

EEG mapping investigations of psychomotor and music perception brain dysfunction in untreated schizophrenic patients

Twenty-six untreated schizophrenic inpatients and 34 control persons were investigated using 16-channel EEG mapping during resting, manumotor and music perception tasks. Power values of activation tasks were each referenced to a separate, immediately preceding resting condition, using conventional delta, theta, alpha and 2 beta frequency bands. Results in delta and alpha bands, which maximally separated the two groups, are reported only for space reasons. Results indicated a “nonreactivity” (in all frequency bands) on the two activation paradigms in schizophrenic patients as a group. Major gender effects were obtained in normal persons, but not signs of nonreactivity comparable to patients. Subdividing patients exclusively by means of their EEG changes on activation produced meaningful clinical subgroups of “positive/negative” schizophrenics. This latter finding could contribute towards clinical utility of EEG mapping in psychiatry.

Résumé

Vingt-six malades schizophrènes non traités par des médicaments étaient étudiés par l'EEG topographique à 16 voies pendant des tâches psychomotrices et de la perception musicale. Ils étaient comparés à 34 personnes contrôles. Les valeurs de la puissance étaient calculées dans les états de repos et d'activation dans les bandes de fréquences (conventionnelles) delta, theta, alpha et bêta 1 et 2. Seules les bandes delta et alpha, qui séparaient au maximum les deux groupes, sont montrées dans l'article en raison de l'espace. Tandis que les sujets normaux montraient des changements majeurs de l'EEG pendant les deux types de tâches — modifié par le sexe, les malades schizophrènes montraient au contraire des signes de « non-réactivité . L'essai de grouper les malades exclusivement par leurs changements de l'EEG pendant l'activation cérébrale qu'effectuait un groupe était cliniquement significative, en séparant les malades portant des symptomes « positivesde ceux avec des symptomes « négatives . Le résultat final pourrait indiquer une valeur clinique de l'EEG quantifié pour la psychiatrie.     

Psychomotor disturbances in psychiatric patients as a possible basis for new attempts at differential diagnosis and therapy

Parts I-III of this series used psychometric assessment of motor performance in psychiatric patients and indicated a "psychotic-motor syndrome" (PMS) in schizophrenic and affective psychoses, which was not found in "neurotic"/reactive or healthy persons. Part IV yielded signs of concomitant brain dysfunction in these patients, demonstrated by EEG mapping as well as other (SPECT/PET) neuroimaging methods. Apart from this "basic science" interest into the pathophysiology of endogenous psychoses we engaged in the development of motor training programs using the PMS as "target" syndrome. We hypothesized, that motor training would not only improve disturbed motor behaviour, but ameliorate other symptoms of psychopathology also. These assumptions were supported in the first two independent studies involving n = 45 and n = 31 ICD-9 mono- and/or bipolar endogenous depressed patients, respectively (the studies on schizophrenic patients being reported finally as part VI of this series, along with the final version of our modified motor test battery). Examples of the motor training programs are provided in this paper, although the final version of the complete programs will be published separately for space reasons and for better availability for routine clinical use.