[Responsible dealing with sexuality. Recommendations in a clinical institution]. / Verantwortlicher Umgang mit Sexualität. Empfehlungen in einer klinischen Einrichtung.

Sexuality is excluded in house regulations, guidelines, instructions and regulations in German hospitals. The English literature does not show much more, but more often the wish for clear guidelines is formulated. Under the guidance of the clinical Ethics Committee a paper with recommendations was prepared, which comprises regulations for responsible handling of sexuality in the Pfalzklinikum. This includes sexuality of acute patients in psychiatry, nursing home inhabitants, forensic patients and above all patients in the department of child and youth psychiatry. The right of self-realization on the one hand, the staff's responsibility for patients with limitations in the determination of one's intent on the other hand and the rules for staff members define the range of the paper.

Human recombinant EGF protein delivered by a biodegradable cell transplantation system.

We have previously shown a new approach to expand cultured human keratinocytes and reconstitute the epidermis in full-thickness wounds using a new microsperical transport system. This was a new approach to increase the cell yield for seeding without altering the anchoring proteins by enzymatic steps. That time we used Cytodex 3 which failed to be degraded and induced an inflammatory reaction in a t-cell-deficient organism. Therefore, we have investigated another microcarrier consisting of PLGA, which is a well-known carrier material for cell culture and transplantation. After coating the PLGA carrier with gelatine the seeding time of viable cells reached 4 h and the cell gain after 7 days of spinner culture was 16-fold. At 14 days after transplantation, we could detect a new stratified epithelium in our full-thickness wound healing model. Because cytokines play a major role in wound healing, we loaded this carrier material with different concentrations of rhEGF, showing a dose dependent release of the protein in vitro and in vivo. This result might lead to a different approach in the treatment of wounds.

Transformed target cell-derived superoxide anions drive apoptosis induction by myeloperoxidase.

Myeloperoxidase induces apoptosis in src- or raxs-transformed fibroblasts, but not in parental nontransformed fibroblasts. This selectivity seems to be based on superoxide anion production by transformed cells, a recently described characteristic feature of transformed cells. Myeloperoxidase-mediated apoptosis induction is inhibited by SOD, catalase, 4-aminobenzoyl hydrazide, taurine and DMSO. This pattern of inhibition allows us to conclude that transformed cell derived superoxide anions dismutate to hydrogen peroxide, which fosters HOCl formation by myeloperoxidase. Hydrogen peroxide formation thereby is the rate-limiting step and depends on the cell density. In a second step, HOCl interacts with superoxide anions to yield the highly reactive apoptosis inducing hydroxyl radical. This conclusion was verified through selective apoptosis induction in transformed cells by direct addition of HOCl, which was also inhibited by SOD and DMSO. Our findings demonstrate a specific interplay between target cell derived superoxide anions and MPO during selective apoptosis induction.

Intercellular induction of apoptosis through modulation of endogenous survival factor concentration: a review.

Fibroblasts constitutively express a functional apoptosis machinery which is under negative control by operationally defined endogenous survival factors. Oncogenic transformation causes a marked downmodulation of endogenous survival factor concentration which renders transformed cells more sensitive to various apoptosis stimuli compared to their nontransformed counterparts. Endogenous survival factors can be inactivated by reactive oxygen species (ROS). Endogenous survival factors are the ultimate targets for apoptosis-inducing factors derived from TGF-beta-triggered nontransformed cells during intercellular induction of apoptosis. During this control step of oncogenesis, endogenous survival factors in transformed cells are inactivated by ROS and the apoptosis machinery is released from negative control. This mechanism leads to the specific elimination of transformed cells. Our data show that the transformed state causes both the ability of the cells to perceive the apoptosis-inducing signal and a decrease in the concentration of endogenous survival factors. These two mechanisms are of central importance for the regulation of intercellular induction of apoptosis.

Three distinct roles for TGF-beta during intercellular induction of apoptosis: a review.

During intercellular induction of apoptosis, transformed fibroblasts are eliminated through the action of neighbouring nontransformed cells. TGF-beta thereby plays three distinct and central roles. a) TGF-beta released by transformed cells or added exogenously to the assay system triggers nontransformed cells to release a shortlived apoptosis inducing factor, which is specifically directed against transformed cells. b) TGF-beta is involved in the maintenance of the transformed state, which is required for expression of sensitivity for intercellular induction of apoptosis. c) TGF-beta further sensitizes transformed cells through downmodulation of their endogenous survival factors, which control a constitutively expressed apoptosis machinery. These data demonstrate that TGF-beta which is utilized by transformed fibroblasts for the maintenance of their transformed state, causes recognition of transformed cells by their nontransformed neighbours and triggers and enhances an apoptosis-inducing response which finally causes elimination of potential tumor cells.

TGF-beta and FGF-trigger intercellular induction of apoptosis: analogous activity on non-transformed but differential activity on transformed cells.

Transforming growth factor (TGF)-beta as well as fibroblast growth factor (FGF) are able to trigger intercellular induction of apoptosis. Interaction of either cytokine with non-transformed cells results in the production and release of apoptosis inducing factor (AIF) which is specifically directed against transformed cells. In both cases, AIF production is inhibited by the antioxidant N-Acetylcysteine, indicating that similar or identical signalling pathways are utilized. Whereas TGF-beta sensitizes transformed cells by down modulation of their endogenous survival factors, FGF is devoid of a similar activity. Therefore TGF-beta triggers and enhances intercellular induction of apoptosis by interaction with non-transformed and transformed cells, whereas the activity of FGF is based only on the interaction with non-transformed cells.

[Characteristics of sleep in abstinent alcoholics. A comparison of alcohol- and age-induced reduction of deep sleep]. / Besonderheiten des Schlafes bei abstinenten Alkoholikern Vergleich alkohol- und alterungsbedingter Tiefschlafreduktion.

Polygraphic sleep recordings were performed in 12 sober alcoholic patients, 8 young normals and 12 healthy elderly subjects. An automatic sleep analysis including two different methods (standard and adaptive) of SWS scoring was used. The standard method is based on amplitude dependent rules according to Rechtschaffen and Kales. The basis for classification of SWS in the adaptive method is the relative increase of the integrated delta-activity during NREM sleep. Whereas in young and elderly normal subjects the method used has no influence on the duration of SWS during the night, the amount of SWS in alcoholic patients is significantly higher when applying the adaptive sleep analysis compared with the results of the standard method. Alcoholics show the lowest level of integrated delta activity during NREM and also the shortest duration of SWS resulting from the standard sleep analysis. On the contrary the relative dynamic of EEG synchronization and the duration of SWS measured by the adaptive sleep analysis are comparable with the values of normal subjects. The general decrease of the delta activity during sleep in sober alcoholics is assumed to be not a reflection of the reduction of SWS.

[Personality characteristics and event related potentials (ERP)]. / Persönlichkeitseigenschaften in ereignisbezogenen Potentialen (ERP).

Our investigation deals with high interindividual variability of Event-Related-Potentials (ERP). We tried to find out systematic causes of these variability. In a performance situation 36 Ss were asked to solve arithmetical tasks. They got a weak electric shock applied at one finger when the result was wrong (negative feedback), at another finger when it was correct (positive feedback). The electrical stimulus triggered the ERPs. Special personality characteristics related to "need-achievement" (processing of success and failure) "and anxiety" had influence upon ERPs. We found various differences between ERPs following positive as well as negative feedback (success and failure) that point to the suggestion that there exist differences in processing feedback information in persons with different personality traits mentioned above.