Wiener klinische Wochenschrift
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GABAA-benzodiazepine receptors and epilepsy. gamma-Aminobutyric acid (GABA) is quantitatively one of the most important neurotransmitters in the central nervous system. Since the predominant action of GABA on neurons is inhibitory, activation of GABA receptors, and especially of GABAA receptors, causes an anticonvulsive effect. GABAA receptors can be activated either directly by GABA or GABA-agonists, or indirectly by allosteric modulation of these receptors. ⋯ These compounds cause convulsions and are called "inverse agonists" of the benzodiazepine receptors. Recent evidence indicates the existence of several different benzodiazepine receptor (and, thus, GABAA receptor) subtypes. Since these receptor subtypes exhibit a different regional distribution in the central nervous system, the development of subtype-selective GABAA receptor agonists or benzodiazepine receptor agonists should result in anticonvulsants with less side effects.
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Wien. Klin. Wochenschr. · Mar 1990
[Benign Rolandic epilepsy in children. Topographic EEG analysis].
Topographic EEG investigation with instant voltage mapping showed maximal negativity of "Rolandic" spikes over central or midtemporal electrodes with spread to parietal or upper frontal areas with a dipol formation (centro-temporal negativity, frontal positivity). Spike amplitude or duration was not correlated with spread to adjacent areas. ⋯ Spike activity was pronounced during light sleep and was often associated with generalized spike wave activity, which is more likely to be a sign of functional disturbance rather than the sequelae of brain damage. A review of literature shows that this pattern is helpful in the differentiation from focal abnormalities due to brain lesions.
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Wien. Klin. Wochenschr. · Sep 1989
[The place of selective proximal vagotomy in complicated duodenal ulcers].
From 1980 to 1988 417 patients underwent surgery for peptic duodenal ulcer. Complications were present in 217 patients: perforation (40%), bleeding (32%), stenosis (20%) or penetration (8%). Highly selective vagotomy was performed in 67% of all patients. ⋯ Whereas highly selective vagotomy was performed frequently for stenosing (72%) and bleeding (68%) ulcers it was the exception in perforate duodenal ulcers (13%). A tendency to increased performance of highly selective vagotomy in complicated cases is evident (1981 40%, 1988 70%). A further increase seems possible by using more liberal indications for selective vagotomy in perforated ulcers and by more frequently carrying out preoperative endoscopic hemostasis in bleeding duodenal ulcers.
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Wien. Klin. Wochenschr. · Jun 1989
[Human herpesvirus 6 (HHV-6): incidence in healthy blood donors and in patients with acute infections caused by other herpes viruses].
Antibodies to HHV-6 were detected by immunofluorescence in 8.04% of 460 healthy blood donors in West Austria. Testing sera from patients with acute or reactivated infections with other herpesviruses, such as cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus (HSV) and varicella zoster virus (VZV) we observed a remarkably higher prevalence of antibodies to HHV-6 in patients with CMV infections (75%) and also in patients with EBV infections (50%). ⋯ The high incidence of positive HH 6 serology in these patients could be due to new infection by HHV 6 or to the reactivation of a previous infection with HHV 6 by means of allogenic cell stimulation. Furthermore, preliminary results from our laboratory point to a serological cross-reaction between HHV 6 and CMV, which may also contribute to this result.
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Within a 3-years period the presence of nosocomial bacteriaemias was analyzed retrospectively among 13.878 hospitalized patients. The incidence was 0.050%. Antibiotic prophylaxis and the operative technique play an important role in achieving a low incidence of morbidity due to infection. The management of a severe infection includes antibiotic therapy according to culture sensitivity and intensive care.