RESUMO
The effects of mental diseases on the employment and working situation can be substantial. They are one of the main reasons for inability to work and reduced earning capacity. Against this background the question arises about suitable occupational reintegration measures for people with severe mental illnesses. In recent years, the principle of supported employment has been internationally shown to be increasingly more successful. In this context mentally ill people are primarily placed at a position of the first employment market and supported on-site by a job coach. This concept is inclusive, individual and evidence based. Despite proven effectiveness, it has so far been insufficiently implemented in German-speaking regions. In the future it will be a matter of considering the individual needs for assistance of mentally ill people more intensively than previously and to respond with functional and in a best-case scenario, multiprofessional and flexible offers.
Assuntos
Readaptação ao Emprego , Transtornos Mentais , Pessoas Mentalmente Doentes , Comitês Consultivos , Alemanha , Humanos , Reabilitação VocacionalRESUMO
INTRODUCTION: Light chain deposition disease is a rare anatomo-clinical disorder, which rarely leads to cystic lung destruction. CASE REPORT: We report the case of a 62years old female patient with a history of a monoclonal gammopathy of unknown significance who developed progressive dyspnea. Thoracic CT-scan demonstrated a diffuse pulmonary cystic disorder with predominance in the right lower lobe. Thoracoscopic surgical resection of that lobe led to a diagnosis of non-amyloid kappa light chain deposits. Surgery also resulted in a lung volume reduction effect with clinical and functional benefits related to improved ventilation of adjacent segments. CONCLUSION: This report of pulmonary cystic disorder related to a light chain deposition disease highlights the potential clinical and functional benefits observed after lung volume reduction surgery.
Assuntos
Cistos/cirurgia , Cadeias Leves de Imunoglobulina/metabolismo , Pneumopatias/cirurgia , Gamopatia Monoclonal de Significância Indeterminada/cirurgia , Agregação Patológica de Proteínas/patologia , Cistos/metabolismo , Cistos/patologia , Diagnóstico Diferencial , Feminino , Humanos , Amiloidose de Cadeia Leve de Imunoglobulina/diagnóstico , Pneumopatias/metabolismo , Pneumopatias/patologia , Pessoa de Meia-Idade , Gamopatia Monoclonal de Significância Indeterminada/complicações , Gamopatia Monoclonal de Significância Indeterminada/diagnóstico , Gamopatia Monoclonal de Significância Indeterminada/patologia , Pneumonectomia , Agregação Patológica de Proteínas/complicações , Agregação Patológica de Proteínas/diagnóstico , Agregação Patológica de Proteínas/metabolismo , Resultado do TratamentoRESUMO
Familial Mediterranean fever (FMF) is a recessive autosomal disease, predominantly affecting the population around the Mediterranean. The main clinical signs consist of attacks of fever associated with abdominal, articular and thoracic pain. Based on a case report, the authors describe the main thoracic forms of this illness comprising pleural pain, pleural effusion and pulmonary amyloidosis. The authors also discuss the association of mesothelioma and FMF. Colchicine is successfully used in the treatment of FMF.
Assuntos
Febre Familiar do Mediterrâneo/complicações , Febre Familiar do Mediterrâneo/diagnóstico , Derrame Pleural/diagnóstico , Pleurisia/diagnóstico , Dor Abdominal/etiologia , Adulto , Amiloidose/diagnóstico , Artrite/etiologia , Colchicina/uso terapêutico , Diagnóstico Diferencial , Febre Familiar do Mediterrâneo/tratamento farmacológico , Febre Familiar do Mediterrâneo/genética , Feminino , Febre/etiologia , Genótipo , Humanos , Pneumopatias/diagnóstico , Mutação , Linhagem , Fenótipo , Derrame Pleural/complicações , Derrame Pleural/tratamento farmacológico , Derrame Pleural/genética , Pleurisia/complicações , Pleurisia/tratamento farmacológico , Pleurisia/genética , Resultado do Tratamento , Moduladores de Tubulina/uso terapêuticoRESUMO
The thyroid gland is a very rare location of metastasis and the metastatic involvement of the thyroid is mostly asymptomatic. The authors report one of the first cases of pulmonary adenocarcinoma associated with painful metastatic involvement of the thyroid gland. Temporary hyperthyroidism was noted, followed, two months later, by clinically and biologically proven hypothyroidism with positive antithyroglobulin antibodies. The suspect goiter was detected by diffuse hyperfixation on 18-FDG PET Scan and the ultrasonography revealed two hypoechogenic nodules. The fine needle biopsy confirmed the metastatic origin of these nodules. The evolution after five cycles of chemotherapy by cisplatine and docetaxel was marked by a complete regression of the thyroid metastasis and an improvement in the thyroid function.
Assuntos
Adenocarcinoma/patologia , Adenocarcinoma/secundário , Hipertireoidismo/etiologia , Hipotireoidismo/etiologia , Neoplasias Pulmonares/patologia , Neoplasias da Glândula Tireoide/secundário , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Cytomegalovirus infection is generally asymptomatic in immunocompetent patients but can also provide a wide spectrum of clinical and biological signs. We report the case of a cytomegalovirus infection in an immunocompetent adult mimicking giant cell arteritis associated with polymyalgia rheumatica and complicated with pulmonary embolism. We review and discuss the venous prothrombic properties of CMV in immunocompetent patients.
Assuntos
Infecções por Citomegalovirus/complicações , Infecções por Citomegalovirus/diagnóstico , Arterite de Células Gigantes/diagnóstico , Embolia Pulmonar/complicações , Infecções por Citomegalovirus/etiologia , Infecções por Citomegalovirus/imunologia , Feminino , Humanos , Imunocompetência , Pessoa de Meia-Idade , Prevalência , Embolia Pulmonar/imunologiaRESUMO
Darier's disease is a rare, inherited autosomal dominant skin disorder caused by a mutation in the sarcoendoplasmatic reticulum calcium transporter (SERCA)-2-gene. In a number of pedigrees, Darier's disease closely relates with affective disorder. The most likely hypothesis for this is a susceptibility gene for affective disorder near the SERCA-2-gene. A 6.5-megabase region could be identified as a susceptibility locus. This region constitutes a susceptability locus also in affective disorder without Darier's disease. The underlying gene has not yet been identified.
Assuntos
Doença de Darier/epidemiologia , Doença de Darier/genética , Depressão/epidemiologia , Depressão/genética , Medição de Risco/métodos , Adulto , Feminino , Predisposição Genética para Doença/epidemiologia , Predisposição Genética para Doença/genética , Humanos , Incidência , Fatores de RiscoRESUMO
Incorporation of vitamin A aldehyde (retinal) into liposomes had an inhibitory effect on the amount of human complement protein bound in the presence of specific antiserum. The total membrane-bound protein was directly measured on liposomes which were washed after incubation in antiserum and fresh human serum (complement). At every concentration of complement, decreased protein binding was found with liposomes which contained retinal. Binding of the third component of complement (C3) was also measured directly on washed liposomes and was found to be decreased in the presence of retinal. The diminution in protein binding due to retinal was not caused by differences in the amount of antibody bound and this was shown by two experiments. First, specific antibody protein binding to liposomes was directly measured and was essentially unaffected by retinal. Second, liposomes were prepared from lipid extracts of sheep erythrocytes. These liposomes were used as as immunoadsorbants to remove antisheep erythrocyte antibodies. The immunoadsorbant capacity was the same in both the presence and the absence of retinal. A further conclusion from these experiments was that retinal did not change the number of liposomal glycolipid antigen molecules available for antibody binding and thus presumably did not change the total number of lipid molecules present on the outer surface of the liposomes. Retinal did have an effect on the geometric structure of the liposomes. Size distribution measurements were performed in the diameter range of 1-6.35 mum by using an electronic particle size analyzer (Coulter Counter). Liposomes containing retinal were shifted toward smaller sizes and had less total surface area and volume. It was suggested that retinal-containing liposomes may have had a tighter packing of the molecules in the phospholipid bilayer. This effect of retinal on liposomal structure may have been responsible for the observed decreased binding of C3 and total complement protein.
Assuntos
Proteínas do Sistema Complemento , Lipossomos , Vitamina A , Animais , Sítios de Ligação , Cerebrosídeos , Colesterol , Testes de Fixação de Complemento , Eritrócitos/imunologia , Proteínas Hemolisinas , Humanos , Conformação Molecular , Fosfatidilcolinas , Fosfolipídeos , Ligação Proteica , Conformação Proteica , Coelhos/imunologia , OvinosRESUMO
In studying terminal lytic events of sensitized erythrocytes which have reacted with all 9 components of complement, we agree in general with the conclusions of Boyle and Borsos [1] that the cellular intermediate passes through the stages E*bound, E*inserted, and E*doomed. However, we differ with these workers on the influence of 3 variables on the terminal reactions. These variables are: time of hemolysis; temperature of E* preparation; and the use of EDTA to manipulate E*.
Assuntos
Proteínas do Sistema Complemento/metabolismo , Hemólise , Técnicas Imunológicas , Animais , Complemento C8/metabolismo , Complemento C9/metabolismo , Ácido Edético/farmacologia , Eritrócitos/metabolismo , Cobaias , Temperatura , Fatores de TempoRESUMO
Grain dusts contain a variety of materials which are potentially hazardous to the health of workers in the grain industry. Because the characterization of grain dusts is incomplete, we are defining the botanical, chemical, and microbial contents of several grain dusts collected from grain elevators in the Duluth-Superior regions of the U.S. Here, we report certain of the carbohydrate and protein contents of dusts in relation to dust morphology. Examination of the gross morphologies of the dusts revealed that, except for corn, each dust contained either husk or pericarp (seed coat in the case of flax) fragments in addition to respirable particles. When viewed with the light microscope, the fragments appeared as elongated, pointed structures. The possibility that certain of the fragments within corn, settled, and spring wheat were derived from cell walls was suggested by the detection of pentoses following colorimetric assay of neutralized 2 N trifluoroacetic acid hydrolyzates of these dusts. The presence of pentoses together with the occurrence of proteins within water washings of grain dusts suggests that glycoproteins may be present within the dusts. With scanning electron microscopy, each dust was found to consist of a distinct assortment of particles in addition to respirable particles. Small husk fragments and "trichome-like" objects were common to all but corn dust.
Assuntos
Poeira/análise , Grão Comestível/análise , Aminoácidos/análise , Carboidratos/análise , Poeira/efeitos adversos , Grão Comestível/efeitos adversos , Humanos , Microscopia Eletrônica de Varredura , Doenças Profissionais/etiologia , Proteínas de Plantas/análise , Doenças Respiratórias/etiologiaRESUMO
The characterization of a recently established system for the short-term culture of rainbow trout (Oncorhynchus mykiss) liver cells in chemically defined medium has been extended to studies on the metabolic competence of the cells and the characterization of their response to hormones. Three areas of metabolism have been addressed: a) the utilization of the exogenously added substrates fructose, lactate, glucose, dihydroxyacetone, and glycerol for glucose and lactate formation; b) the effects of the pancreatic hormones insulin and glucagon on cellular glucose formation, lactate formation, and fatty acid synthesis; and c) the effects of insulin and dexamethasone on the estradiol-dependent production of vitellogenin. Incubation of trout liver cells with fructose, lactate, glucose, dihydroxyacetone, or glycerol resulted in enhanced rates of cellular glucose and lactate production. Substrate-induced effects usually were more clearly expressed after extended (20 h) than after acute (5 h) culture periods. Addition of the hormones insulin or glucagon caused dose-dependent alterations in the flux of substrates to glucose and lactate. Rates of de novo synthesis of fatty acids from [14C]acetate were stimulated by insulin and inhibited by glucagon during acute and extended incubation periods. Treatment of liver cells isolated from male trout for 72 h with estradiol induced vitellogenin production and secretion into the medium. However, the addition of insulin or dexamethasone drastically reduced this estrogen-induced vitellogenesis. These results indicate that trout liver cells cultured in defined medium maintain central metabolic pathways, including glycolysis, gluconeogenesis, lipogenesis, and vitellogenesis as well as their responsiveness to various hormones, for at least 72 h.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Células Cultivadas , Fígado/citologia , Animais , Feminino , Glucagon/metabolismo , Glucose/metabolismo , Insulina/metabolismo , Lactatos/metabolismo , Ácido Láctico , Lipídeos/biossíntese , Glicogênio Hepático/metabolismo , Masculino , Oncorhynchus mykiss , VitelogêneseRESUMO
The sediment from human saliva is complement-reactive. Evidence presented shows that C1 (first component of complement) is a constituent of sediment from healthy human donors. Sediment (Sed) inactivated functionally pure C4 (fourth component of complement), and this action on C4 was inhibited by EDTA, phenylmethylsulphonylfluoride (PMSF, a serine-esterase inhibitor) and C1-inhibitor (C1-In). When Sed was incubated with 0.15 ionic strength buffer and separated by centrifugation, C1 haemolytic activity was found in the supernatant. By incubating Sed with EAC4 cells (sheep erythrocytes sensitized with rabbit antibody to which C4 has been fixed), transfer was shown of C1 from the Sed to the cells, resulting in the formation of EAC14; this transfer was inhibited by IgG directed against a subunit of C1 (anti-C1s).
Assuntos
Complemento C1/análise , Saliva/análise , Adulto , Complemento C1/metabolismo , Complemento C4/metabolismo , Feminino , Humanos , Masculino , Saliva/metabolismoAssuntos
Síndrome de Churg-Strauss/diagnóstico , Granulomatose com Poliangiite/diagnóstico , Doenças Pulmonares Intersticiais/diagnóstico , Doenças da Traqueia/diagnóstico , Úlcera/diagnóstico , Adulto , Brônquios/diagnóstico por imagem , Brônquios/patologia , Broncoscopia , Síndrome de Churg-Strauss/complicações , Diagnóstico Diferencial , Feminino , Granulomatose com Poliangiite/complicações , Humanos , Doenças Pulmonares Intersticiais/complicações , Doenças Pulmonares Intersticiais/patologia , Mucosa Respiratória/diagnóstico por imagem , Mucosa Respiratória/patologia , Doenças da Traqueia/complicações , Doenças da Traqueia/patologia , Úlcera/complicações , Úlcera/patologiaRESUMO
The key feature of Ganser's syndrome includes approximate answers to simple questions. The cause of this rare syndrome remains uncertain. Current classification systems categorise it as a dissociative disorder, the symptoms of which are judged as psychogenic in origin. Our review of the literature (n=151) demonstrates however that Ganser's syndrome is frequently associated with brain injury, although detailed imaging, neuropsychological, and neurological data of this for the most part do not exist. We describe a right-handed patient with Ganser's syndrome after a large left-hemispheric middle cerebral artery infarction. Detailed neuropsychological examination showed atypical lateralisation of cognitive functions with so-called crossed nonaphasia and pronounced frontal-executive dysfunctions. Regarding both psychiatric and neuropsychological aspects, we discuss how the key feature of approximate answers may be associated with frontal-executive cerebral dysfunctions.
Assuntos
Transtornos Autoinduzidos/classificação , Transtornos Autoinduzidos/diagnóstico , Transtornos Autoinduzidos/psicologia , Modelos Psicológicos , Psicopatologia , Adulto , Feminino , HumanosRESUMO
The potential risk implied in prophylactic operations is just as high as that elective interventions. Indications must be subject to stringent deliminating criteria. Required are thorough elucidation and documentation as well as comprehensive substantiation. Operations of that kind may be performed even without elaborate advance planning, if indications are urgent. Simultaneous operations are accompanied by higher risk in cases of major surgery or if one of the interventions is septic. High risk factors were recordable from combined stomach and bile duct surgery, when performed simultaneously. Morbidity amounted to 13 per cent (pulmonary embolism and pneumonia) and lethality to 15 per cent. Simultaneous operations should be performed by an experienced surgeon who should be a fast worker.
Assuntos
Abdome/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Neoplasias Abdominais/cirurgia , Apendicectomia , Apendicite/cirurgia , Humanos , Prognóstico , Reoperação , Fatores de Risco , CicatrizaçãoRESUMO
The elemental composition of a group of airborne and settled grain dusts is reported. This survey was undertaken as part of a study to systematically describe the chemistry and morphology of these representative dusts. Our data show that airborne or settled grain dusts differ from each other with respect to elemental composition. Such fundamental differences may be related to previously observed differences in the biological activities of the dusts.
Assuntos
Ar/análise , Poeira/análise , Grão Comestível/análise , Elementos Químicos/análise , Hordeum/análise , Espectrometria de Massas , Triticum/análise , Zea mays/análiseRESUMO
A radioimmunoassay for serum vitamin A is described which can detect as little as 1 ng of retinol. The statistical characteristics of this assay are presented and its use in a nutritional experiment is discussed.
Assuntos
Vitamina A/imunologia , Animais , Reações Cruzadas , Masculino , Radioimunoensaio/métodos , Ratos , Vitamina A/sangue , Deficiência de Vitamina A/sangueRESUMO
Vitamin A antibodies were obtained using retinoic acid conjugated to human serum albumin as an immunogen. The following constraints governed the reactivity of vitamin A analogues with such an anti-serum. The stereochemistry of the side chain is relatively unimportant, and 9- and 13-cis retinal react almost as well as all-trans retinal. The nature of the ring is important; all of the compounds that react readily carry a beta-ionic ring; all of the compounds bearing an aromatic ring react poorly; the two compounds that display intermediate reactivity have non-aromatic 6- and 5-membered rings, respectively.
Assuntos
Vitamina A/imunologia , Fenômenos Químicos , Química , Diterpenos , Epitopos/imunologia , Humanos , Fosfatos de Poli-Isoprenil/imunologia , Retinaldeído/imunologia , Tretinoína/imunologia , Vitamina A/análogos & derivadosRESUMO
Rhodopsin- and vitamin A-immunoreactive sites were studied in the pineal organ of the larval and adult brook lamprey (Lampetra planeri Bloch), as well as in the retina of the larval lateral eye, at the electron microscopic level. In the pineal organ, several types of photoreceptor cells could be distinguished by their morphology and the immunoreactivity of their outer segments. The different kinds of photoreceptor cells were located at different levels of the pineal organ according to their distance from the "pineal window". The most superficial level, the so-called pellucida, appears to represent an exclusively "cone-type" area containing slender, rhodopsin-immunonegative (UV-blue-sensitive?) photoreceptors only. The second level, the pineal retina, contained predominantly rod-type photoreceptors, i.e., large, strongly rhodopsin-immunopositive (green-sensitive) photoreceptors medially, and few, small, weakly rhodopsin-immunopositive (blue-green-sensitive?) cells bilaterally. At the deepest level, the pineal atrium, there were both rod- and cone-type photoreceptor cells, the latter possibly representing red-sensitive elements. Vitamin A immunoreactivity was found in the outer segments of the pineal photoreceptor cells, in the cytoplasm and mitochondria of inner segments and perikarya, as well as in nuclear euchromatin and compact nucleoli. A similar gold labelling of organelles was observed in the ependyma and pineal neurons. The vitamin A immunoreaction of the outer segments suggests retinoids are present as chromophores of the photopigments. In the peripheral retina of the larval lateral eye, vitamin A immunoreactivity was found in some organelles of the undifferentiated photoreceptor cells, neurons, pigment epithelium and Müllerian cells. The localization of immunoreactive vitamin A in nuclei, nucleoli and cytoplasm including mitochondria appears to strengthen the case for an interaction of retinoids in the function of these organelles.
Assuntos
Olho/análise , Peixes/metabolismo , Lampreias/metabolismo , Glândula Pineal/análise , Pigmentos da Retina/análise , Rodopsina/análise , Vitamina A/análise , Animais , Núcleo Celular/análise , Citoplasma/análise , Olho/ultraestrutura , Imuno-Histoquímica , Lampreias/anatomia & histologia , Microscopia Eletrônica , Mitocôndrias/análise , Mitocôndrias/ultraestrutura , Células Fotorreceptoras/análise , Células Fotorreceptoras/ultraestrutura , Glândula Pineal/ultraestrutura , Retina/análise , Retina/ultraestruturaRESUMO
The systematic vocational resettlement of the disabled necessitates the preparation of working place related requirement profiles which have to be compared with the work specific performance profiles of disabled job seekers. The authors use the example of a multiply handicapped dysmelic person to discuss and explain the different aspects of such a methodical approach from the angle of the employment opportunities in the printing industry.
Assuntos
Pessoas com Deficiência , Impressão , Reabilitação Vocacional , Atividades Cotidianas , Avaliação da Deficiência , Alemanha Ocidental , Humanos , Sistemas Homem-Máquina , Impressão/tendências , Educação VocacionalRESUMO
In the present work a scheme is presented for the isolation of multiple components of human complement in a functionally and biochemically pure state and with full hemolytic activity. These preparative procedures allow high recovery of milligram and gram quantities of particular complement components from a large pool (2-11 liters) of fresh EDTA plasma in no more than four chromatographic steps. Many components (C3bINA, C5, C3, C1EI, C4, and C9) are recovered functionally pure or highly purified following the first chromatographic step employing DEAE-Sephacel and may be utilized as reagents with no further purification. Prior to anion exchange, individual units of plasma are treated with inhibitors of complement activation and serum proteases, the pooled plasma is fractionated with polyethylene glycol, depleted of plasminogen on Sepharose-lysine, and rapidly ultrafiltered to low ionic strength and high protein concentration. The high degree of resolution of the components on DEAE-Sephacel subsequently obtained is demonstrated by the functional recovery and purification in a representative experiment as indicated (in their order of elution) for the following proteins: C3bINA (24%, 18-fold), C2 (74%, 12-fold), C7 (87%, 14-fold), factor B (55%, 8.7-fold),, C8 (50%, 16-fold), C6 (82%, 25-fold), beta 1H (39%, 12-fold), C5 (62%, 111-fold), C3 (99%, 64-fold), C1EI (42%, 135-fold), C9 (80%, 297-fold), and c4 (78%, 164-fold). Other components separated by these procedures include C1q and C4 binding protein. Additional steps described, which demonstrate the utility and effectiveness of this preparative scheme, have allowed isolation of C3, C5, and C7 as pure components with full hemolytic activity as judged by functional, immunochemical, and physicochemical criteria. C8, also isolated as a homogeneous protein, was recovered with partial hemolytic activity. All these components were recovered in high yield and in the purification as indicated: C3 (61%, 103-fold), C5 (24% 1350-fold), C7 (19%, 2260-fold), and C8 (32%, 547-fold). Complement components C6, beta 1H, factor B, and C2 in addition to C3bINA, C1EI, C4, and C9 are recovered partially purified with good activity and are amenable to further purification.