[Implementation of the principle of supported employment in Germany : Position paper of a task force of the DGPPN]. / Umsetzung der Prinzipien des Supported Employment in Deutschland : Positionspapier einer Task-Force der DGPPN.

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.

[Effect of surgery of pulmonary cysts related to immunoglobulin light chain deposits]. / Intérêt de la chirurgie de kystes pulmonaires liés à des dépôts de chaînes légères.

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.

[Thoracic impairment from familial Mediterranean fever: review of the literature and a case study]. / Atteintes thoraciques de la fièvre méditerranéenne familiale : revue de la littérature - à propos d'un cas.

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.

[Thyroid metastasis of lung cancer and abnormal thyroid function--a case report]. / Métastase thyroïdienne d'un cancer bronchique et dysthyroïdie--à propos d'un cas.

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.

[Cytomegalovirus infection in an immunocompetent patient complicated with pulmonary embolism and mimicking giant cell arteritis associated with polymyalgia rheumatica]. / Embolie pulmonaire compliquant une infection à cytomégalovirus, infection mimant une maladie de Horton associée à une pseudopolyarthrite rhizomélique chez un sujet immunocompétent.

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.

[Possible genetic link between Darier's disease and depression. Review of the literature and case history]. / Morbus Darier und Depression - besteht eine genetische Verbindung? Ubersicht und klinischer Fall.

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.

Vitamin A in liposomes. Inhibition of complement binding and alteration of membrane structure.

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.

Terminal stages of complement hemolysis: technical comment.

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*.

Carbohydrate and protein contents of grain dusts in relation to dust morphology.

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.

Cultured trout liver cells: utilization of substrates and response to hormones.

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)

The first component of complement as a constituent of human salivary sediment.

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).

[Psychopathology of Ganser's syndrome. Literature review and case report]. / Psychopathologie des Ganser-Syndroms. Literaturübersicht und Falldiskussion.

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.

[Indications and prognosis of preventive and simultaneous operations of the abdominal cavity]. / Indikation und Prognose prophylaktischer und simultaner Operationen in der Bauchhöhle.

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.

Elemental analysis of airborne grain dusts.

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.

Vitamin A antibodies: application to radioimmunoassay.

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.

Reactivity of vitamin A derivatives and analogues with vitamin A antibodies.

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.

Immunoelectron microscopy of rhodopsin and vitamin A in the pineal organ and lateral eye of the lamprey.

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.

[Some considerations on the integration of the disabled with particular regard to the placement of dysmelic and spastic persons in the printing industry (author's transl)]. / Zur beruflichen Integration von Behinderten unter besonderer Berücksichtigung des Einsatzes von Dysmelie- und spastisch Behinderten in der Druckindustrie.

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.

Large scale isolation of functionally active components of the human complement system.

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.