Effects of electroconvulsive therapy on amygdala function in major depression - a longitudinal functional magnetic resonance imaging study.

BACKGROUND: Electroconvulsive therapy (ECT) is one of the most effective treatments for severe depression. However, little is known regarding brain functional processes mediating ECT effects. METHOD: In a non-randomized prospective study, functional magnetic resonance imaging data during the automatic processing of subliminally presented emotional faces were obtained twice, about 6 weeks apart, in patients with major depressive disorder (MDD) before and after treatment with ECT (ECT, n = 24). Additionally, a control sample of MDD patients treated solely with pharmacotherapy (MED, n = 23) and a healthy control sample (HC, n = 22) were obtained. RESULTS: Before therapy, both patient groups equally showed elevated amygdala reactivity to sad faces compared with HC. After treatment, a decrease in amygdala activity to negative stimuli was discerned in both patient samples indicating a normalization of amygdala function, suggesting mechanisms potentially unspecific for ECT. Moreover, a decrease in amygdala activity to sad faces was associated with symptomatic improvements in the ECT sample (r spearman = -0.48, p = 0.044), and by tendency also for the MED sample (r spearman = -0.38, p = 0.098). However, we did not find any significant association between pre-treatment amygdala function to emotional stimuli and individual symptom improvement, neither for the ECT sample, nor for the MED sample. CONCLUSIONS: In sum, the present study provides first results regarding functional changes in emotion processing due to ECT treatment using a longitudinal design, thus validating and extending our knowledge gained from previous treatment studies. A limitation was that ECT patients received concurrent medication treatment.

Ischemic myocardial damage in spontaneously hypertensive rats (SHR) is enhanced after long-term feeding of an alpha-linolenic acid enriched diet.

In this study the influence of long-term feeding of an alpha-linolenic acid (LNA) enriched diet on the sensitivity of SHR to catecholamine-induced myocardial injury was investigated. An enhanced ischemic vulnerability after LNA supplementation was observed as indicated both by a marked decrease of enzyme activities in the myocardium and by a pronounced elevation of plasma enzymes. Distinctly higher TBARS levels in heart tissue and plasma of LNA rich fed SHR suggest that an exaggerated lipid peroxidation might contribute to the increased ischemic vulnerability. Non-enzymatic lipid peroxidation is favoured by a feeding-provoked enrichment in highly unsaturated fatty acids in tissue phospholipids. Under such conditions of enhanced substrate availability for radical-induced lipid peroxidation an increased requirement for antioxidants can be assumed which might not sufficiently be met by tocopherol-supplementation in SHR because of their known defects in antioxidative defense mechanisms.

[Isoenzymes after physical loading in ischemic heart disease]. / Izoénzimy posle fizicheskoi nagruzki u bol'nykh ishemicheskoi bolezn'iu serdtsa.

The enzyme and isoenzyme pattern was investigated in the plasma of patients with ischaemic heart disease (IHD) after exercise (bicycle test). In comparison to the "exercise profile"and "cardiac profile" differences exist between the characteristic changes of IHD patients. IHD patients with severe impairment of the left ventricle showed a changed enzyme pattern after exercise. The LDH-H-activity and the ratio LDH-H/LDH-M were increased between 1.5 and 8 hours after the exercise. The initially increased LDH-H/LDH-M ratio decreased to normal levels about 24 hours after exercise. The isoenzyme pattern after exercise is discussed in relation to the results of complete heart catheterisation.

[Usefulness of a balanced protocol method for the assessment of protein intake of ambulatory hemodialysis patients]. / Nutzung einer Wäge-Protokollmethode zur Erfassung der Proteinzufuhr von ambulanten Hämodialysepatienten.

Dietary intake of 10 hemodialysis patients was quantitatively analysed for a period of 13 weeks using a modified "record" method and a computer-aided evaluation. Some patients showed an insufficient intake of catabiotic energy and protein. The protein intake was reflected in various parameters of the protein metabolism. For patients with a good dietetic compliance, the record method is suitable to detect an individual malnutrition and to give recommendations for the correct diet.

[Recommendations for the training of specialty candidates in internal medicine in laboratories]. / Vorschläge für Hospitationen von Facharztkandidaten der Inneren Medizin in den Laboratorien.

A full-time visit for several weeks of candidates of specialists of internal medicine in laboratories, in which competent specialists of clinical chemistry are working, contributes to the improvement of the interdisciplinary cooperation. By recognition of the pre- and post-analytic errors and by the scientifically proved indication on the basis of diagnostic strategies as well as an effective interpretation the effectiveness of the laboratory diagnostics in the process of medical care can be increased. Practical abilities ready for use are particularly demanded for bed-side methods and in the fields of haematology and haemostaseology.

[Diagnosis of acute hepatitis]. / Diagnostik der akuten Hepatitis.

The following recommendations are to be given for the basis diagnosis of hepatitis: --In the blood donation and blood transfusion institutions the control of the donors is performed by means of the combination ALAT and HBs-antigen (transmigration electrophoresis); depending on methods limits were established showing a high diagnostic specificity. Thus, no doubt, the diagnostic sensitivity is decreased, but the number of the examined persons with falsely positive findings probably diminishes. --For the diagnostics in the clinic the parameters ALAT, ASAT, bilirubin and the thymol turbidity test are at the disposal as criteria of the liver cell damage as well as AP (alkaline phosphatase), AAP and GGT as criteria of the cholostasis and the thymol turbidity test, serum protein including immunoglobulins as criteria of the mesenchymal reaction. The reference areas must be established method-specifically corresponding to the interrogation of the physician. --The isoenzymes of the ALD, the ASAT and the LDH represent an essential enrichment of the diagnostic and prognostic estimation of hepatitis. But at present it is not yet possible to determine these parameters in routine work. However, there gradual introduction into practice should be the aim.

[Pre-, intra- and postoperative behavior of LDH and GOT isoenzymes in the plasma of patients with chronic ischemic heart disease]. / Das prä-, intra- und postoperative Verhalten der Isoenzyme der LDH und GOT im Blutplasma von Patienten mit chronisch ischämischer Herzerkrankung.

The isoenzymes of LDH (types H and M) and the isoenzymes of GOT (cytoplasma, mitochondria) were examined in 14 male patients with chronic ischaemic heart disease before, during and after operation. The present study compares them with clinical parameters. Considering the combination of the two isoenzyme ratios, it can be generalized that chronic ischaemia of the heart is characterized both by a decrease of the ratio H : M of the LDH and an increase of the ratio M : C of the LDH and an increase of the ratio M : C of the GOT. Confirming the function of the open by-pass by recoronarography, the isoenzyme values are normal both with regard to their ratio and to their absolute values.

[Prenatal diagnosis of genetic defects from the amniotic fluid. Report of experiences]. / Pränatale Diagnostik genetischer Defekte aus dem Fruchtwasser - Erfahrungsbericht.

42 pregnancies were monitored by transabdominal amniocentesis followed by karyotyping. Biochemical assays of cultured amniotic fluid cells, 50 analysis of alpha1-fetoprotein and estimations of the number of y-bodies in the amniotic fluid cells was also made. One chromosomal aberration (47, XY, + 18) was found in 13 pregnancies tested because of advanced maternal age. In 6 pregnancies with a recurrence risk of Down's Syndrom, one fetus with abnormal karyotype (46, XY, 5p-) was detected.

[Amino acid imbalances in blood of pregnant women with diabetes and in blood of their newborns--limit values for screening (author's transl)]. / Aminosäureimbalancen im Blut von schwangeren Diabetikerinnen und deren Neugeborenen--Trennwerte für ein Screening.

Blood-borne free amino acids of 100 mothers were tested immediately after birth. Fifty of the probands had diabetes, while the other 50 were metabolically intact. Amino acid imbalance was recorded by means of multidimensional variance analysis from the diabetics and found to have been largely associated with glutamic acid threonine, alanine, glycine-serine, and glutamine.--A formula, derived from the aforementioned relevant amino acid concentrations, is given in this paper together with a nomogram (which might be used instead of the formula) for determination of diabetes-caused alterations in the amino acid spectrum

[Amino acid imbalance in the blood of pregnant diabetic women and their newborn infants--limit values for screening. II. Neonatal amino acid imbalance]. / Aminosäureimbalancen im Blut von schwangeren Diabetikerinnen und deren Neugeborenen--Trennwerte für ein Screening. Teil II: Neugeborenenaminosäureimbalancen.

Free amino acids were studied in the blood of 50 newborns each of women with intact metabolism and of diabetic mothers. The tests were conducted immediately after delivery and on the fifth day of age. Amino acid imbalance reflected, after birth, in changed concentrations of glutamic acid-threonine, alanine and glycin-serine was recordable from newborns of the diabetic mothers. However, nothing but significant changes in concentrations of glutamic acid-threonine and alanine was recordable on the fifth day of age. --An account is given of the formulae and nomograms (applicable instead of these formulae) for postpartum amino acid concentrations and for concentrations on the fifth day of age, being established by discriminant analysis. These can be used to identify alterations inflicted upon amino acid metabolism by diabetes mellitus.

[Changes in protein metabolism in arteriosclerosis patients]. / Veränderter Eiweissstoffwechsel bei Arteriosklerosepatienten.

The sequence of the incorporation of the stable isotope 15N in plasma protein and fibrinogen has been followed by an 15N labelling test in 11 patients with arteriosclerosis and a control group of 7 persons. The investigation showed a higher turnover of plasma protein and especially of fibrinogen in the patients with arteriosclerosis.

Isoenzymes in plasma of acute leukaemia patients: prevention of anthracycline cardiomyopathy.

During the diagnosis and subsequent monitoring of patients with acute leukaemia, and of those with terminal blastic crisis in chronic myelogenous leukaemia, the activity of total LDH, ALAT, AP, ASAT as well as the isoenzymes LDH-H, LDH-M were measured in the plasma. Enzyme and isoenzyme activity of LDH, which differed in quantity at the various times of measurement, reflected the varying proliferation rate, depending upon the individual and upon the time of measurement and, consequently, the tumour cell mass.

[Liver diagnostics]. / Aspekte der Leberdiagnostik.

Prerequisite of a scientific and rational liver diagnostics is the knowledge of the physician of function and structure of the liver. The laboratory demand should always be an accomplishment of the physician and should be performed only upon such a scale that it is also followed by therapeutic consequences and/or consequences concerning the expert's opinion. The biochemical blood analysis gives information about the size of the injury to the parenchyma and about the disturbance of the various partial functions of the liver. In this case is to be taken into consideration that biochemical and histological parameters are no concurrent, but supplementing diagnostic methods. A progress in liver diagnostics is the use of the isoenzymes of the aspartate aminotransferase and the lactate dehydrogenase as well as of the enzymes of the metabolism of the connective tissue. With the entering into selected parameters of the liver diagnostics possibilities to the establishment of the disturbed liver metabolism by means of markers are shown and at the same time recommendations for the praxis of the liver diagnostics are derived.

[Significance of isoenzymes for the prognostic evaluation of acute hepatitis--studies under load]. / Zur Bedeutung der Isoenzyme für die prognostische Einschätzung der akuten Hepatitis--Belastungsuntersuchungen

100 patients who got over a virus hepatitis underwent a bicycle ergometry. At the beginning and at the end of the experiment as well as 24 hours after this the isoenzymes of aldolase, GOT and LDH in the plasma were determined by means of kinetic methods. On the basis of the activities of the isoenzymes for the test persons (children and adults of either sex) an arrangement in the groups pathologic--suspicious--normal can be carried out which is compared with the physiologic parameters and the clinic. The results of bicycle ergometry much differ. High effects without pathological changes of the activities of isoenzymes are an objective criterion of the quick, riskless rehabilitation of the test persons.

[Isoenzymes of alkaline phosphatase - reference values in young people and effects of protein diet (author's transl)]. / Isoenzyme der alkalischen Phosphatase - Referenzwerte im jugendlichen Alter und Einfluss der Eiweissernährung

In 260 normal students, 20-25 years old, the variation in the activities of serum alkaline phosphatase and its isoenzymes with sex, ABO blood groups, and protein intake were studied. The values are on the whole higher in males than in females. The activity of the intestinal isoenzyme was higher in subjects taking protein-rich diet than in those taking protein poor diet.

[Diagnostic evaluation of skeletal scintigraphy in comparison to roentgen studies in histiocytosis X in childhood. Case report]. / Diagnostische Wertigkeit der Skelettszintigraphie im Vergleich zur Röntgenuntersuchung bei der Histiozytose X im Kindesalter. Erfahrungsbericht.

We have compared whole body skeletal scintigraphy with X-ray examination in 15 children suffering from histiocytosis X, 14 of whom also showed involvement of the skeleton. In 9 of 20 cases, relapses, included, involvement of the skeleton was found both in scintigraphy and X-ray examination. In 7 cases only X-ray examinations have revealed lessons, which could not be proved by scintigraphy. Vice versa, in 4 cases scintigraphy was positive alone. These results confirm the necessity to use both methods for an exact documentation of the extent of the disease before undertaking any therapy. Dispensing with one of the two methods may cause incorrect therapeutic decisions and increase the risk of relapses and late complications.

Isoenzyme (lactate dehydrogenase, aspartate aminotransferase) and dipeptidyl peptidase IV activity changes in blood plasma likely indicative of organ involvement due to arterial hypertension.

The plasma activities of LDH and ASAT isoenzymes as well as of DP IV were studied in patients with essential hypertension and related to blood pressure, haemodynamic indicators of latent heart failure and to ischaemic heart risk indicators. Patients with elevated systolic or diastolic blood pressure showed significantly increased activities of ASAT m. In hypertensives with elevated pulmonary artery pressure markedly increased activities of ASAT, ASAT m, LDH M and DP IV could be observed. Distinctly increased activities of ASAT, ASAT m, LDH M and DP IV were also found in patients with elevated plasma cholesterol. The results obtained suggest that changes of LDH and ASAT isoenzymes as well as of DP IV indirectly reflecting alterations in organ metabolism might provide useful additional information with respect to uncovering hypertension-linked complications.

[Anthracyclin-cardiomyopathy (author's transl)]. / Anthrazyklin-Kardiomopathie.

Doxorubicin is one of the most effective antineoplastic drugs in clinical practice. Its clinical usefulness extends from acute leucemia and lymphoma to a wide range of solid tumors. However, the use of this drug is limited by its cardiac toxicity, that is often life-threatening. A number of clinical approaches discussed in this paper have been used to circumvent the problem of doxorubicin-induced congestive heart failure. A summarizing survey of the literature has led to establish two principles for prevention of doxorubicin-induced congestive heart failure with clinical meaning in the moment: --the way of administration --the clinical use of Ca-antagonist. The two principles provide an objective basis for preventation of congestive heart failure. The pathobiochemical background, analysed in this paper in detail, demonstrates that the same metabolic condition exist in the myocardial cell as in red blood cell. These interactions are the basis for a further analysis of metabolism in the cell, especially the redox metabolism of glutathione.

[Isoenzyme diagnosis in the clinical course of acute myocarial infarct]. / Isoenzymdiagnostik bei der Verlaufsbeobachtung des akuten Myokardinfarktes.

For the observation of the course of the disease of patients after an acute myocardial infarction by the estimation of the isoenzymes of the LDH (LDH-H and LDH-M) the possibility of the repeated four- to eight-hour-measurement of these isoenzymes in larger groups of patients after myocardial infarction is given. Instances of the use during the observation of the course of the disease after acute myocardial infarction are discussed. In which cases at the same time the isoenzymes of the LDH (LDH-H and LDH-M) as well as of the CK (CK-MB) were repeatedly estimated.