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Biomedical subjects

A Kruse

Publications and source records attributed to A Kruse.

At least 181 records · Page 10Linked to original sources

Endoscopic retrograde cholangio-pancreatography in pancreatic cancer and chronic pancreatitis. Differences in morphologic changes in the pancreatic duct and the bile duct.

The radiological findings in ERCP in 49 patients (ERP 49 patients and ERC 24 patients) with pancreatic diseases were evaluated blindly (24 patients with chronic pancreatitis and 25 patients with pancreatic cancer as a final diagnosis). Obstructions of the main pancreatic duct were found in 16 out of 24 patients with chronic pancreatitis and in 24 out of 25 patients with pancreatic cancer. Irregularity of obstructions was seen significantly more often in patients with cancer. Cholangiography demonstrated obstructions of the distal part of the common bile duct in both groups of patients, but irregularity of obstructions was exclusively seen in the cancer group. Though characteristic radiological features were demonstrated, a safe diagnosis must probably still rely on biopsy.

Adult↗

X-ray examination of endoscopy? A blind prospective study including barium meal, double contrast examiniation, and endoscopy of esophagus, stomach, and duodenum.

One hundred and one consecutive patients with upper abdominal dyspepsia were examined by conventional barium meal, double contrast examination, and endoscopy of the stomach and the duodenum in a blind prospective investigation. All the examiners were specially trained. Only small differences between the sensitivity and the specificity of the methods were found, but the clinical importance of the false positive and the false negative errors of the three methods of examination was not the same. The sensitivity of the ordinary X-ray examination was found to be sufficiently high for still recommending this method for primary screening. In case of posivite findings in the stomach, supplementary gastroscopy ought to be performed in order to increase the diagnostic specificity.

Adult↗

Endoscopic papillotomy (EPT) with removal of common bile duct stones.

Endoscopic papillotomy with removal of common bile duct stones was successfully performed in 14 patients. In 11 patients stones were found after cholecystectomy. In the remaining 3 patients there was a high operative risk. No serious complications occurred. Consequently the removal of choledocholithiasis by endoscopic papillotomy is an alternative to traditional treatment.

Adult↗

Brief reports.

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Diploidy↗

The prevalence and differential diagnosis of subclinical depressive syndromes in inpatients 60 years and older.

BACKGROUND: Depressive syndromes that do not comply with the diagnostic criteria for specific depressive disorders are designated as 'subclinical' or 'subsyndromal' depressive syndromes. Using our own data from a clinical study, this paper outlines the significance of subclinical depressive syndromes and demonstrates the problems of differentiating between depressive and subclinical depression (SD) syndromes and organic mood disorders especially in an elderly population with medical comorbidity. METHODS: Two hundred and sixty-two patients aged 60 years and older in a general hospital were investigated, using a clinical psychiatric interview, expert ratings and self-report scales after extensive internal medical diagnostic evaluation. RESULTS: When, without further differentiation as to their origin, all symptoms required by symptom checklists according to ICD-10 were considered for the diagnosis of major depression (MD), 35.5% of the study participants fulfilled the diagnostic criteria. After differentiating for etiology of symptoms, MD was found in only 14.1%, SD was diagnosed in 17.6% and organic mood disorder in 12.2% of the study participants. In another 41 patients (15.6%), symptoms of depression not fulfilling ICD-10 criteria were classified as being of organic or drug-induced origin. SD patients were in a mean position between nondepressive and depressive patients with regard to social isolation and physical impairment; women were overrepresented in the depressive and subdepressive groups. CONCLUSIONS: SD and organic mood disorder are common and helpful diagnostic categories in the elderly. The results show that in old age there is substantial danger of confounding MD, SD and organic mood disorder, thus leading to erroneously high prevalence rates of MD and underestimations of organic mood disorder if depressive symptoms are recorded only by self-report scales or a symptom checklist. Both internal and psychosomatic-psychotherapeutic competence as well as a liaison service in general hospitals are necessary for the differential diagnosis of MD, SD and organic mood disorder in the elderly with medical comorbidity.

Age Factors↗

[The rehabilitation potential of the elderly].

This contribution points to the existence of potentials for rehabilitation in the elderly and underlines the necessity of rehabilitation in chronically ill patients. Especially important for the success of rehabilitation is a differential diagnosis and treatment. The potentials for rehabilitation differ among the several functions, abilities, and skills. For this reason, a differential profile of the rehabilitation potentials is necessary. Theoretical and empirical contributions to the plasticity, to developmental potentials, and to competence in the elderly form the basis for prognosis of rehabilitation potentials in old age. It is made clear that realizing these potentials is not only a task of the patient, but is also dependent on the ecological and social environment.

Activities of Daily Living↗

Nitric oxide synthase expression and enzymatic activity in human brain tumors.

Nitric oxide (NO) is synthesized by NO synthases (NOS), existing in 3 isoforms. NO influences a great variety of vital functions including vascular tone and neurotransmission. Under conditions of excessive formation, NO emerges as an important mediator of neurotoxicity in a variety of disorders of the central nervous system (CNS). Inhibitors of NOS are available that may modify the activity of all isoforms, which may be of clinical relevance. The expression of the 3 NOS isoforms nNOS, iNOS and eNOS and NOS enzymatic activity was examined in 40 patients with primary CNS tumors (gliomas WHO grades I - IV and meningeomas WHO grades I - III) and in 13 patients with metastases from adenocarcinomas or malignant melanomas. A polyclonal antibody directed against nNOS and monoclonal antibodies directed against iNOS and eNOS were used for immunohistochemical staining. NOS enzymatic activity, measured by labeled arginine to citrulline conversion, was assessed in tissue specimens obtained from the same tumors. NOS data were compared with clinical variables and the degree of edema as judged from MR scanning. nNOS expression was increased in tumor cells of glial neoplasms and most pronounced in high-grade tumors, WHO grades III and IV, and in the carcinoma and melanoma metastases. Low-grade gliomas, WHO grades I and II and meningeomas expressed no or only little nNOS. iNOS was only expressed in a few tumors. eNOS was expressed sporadically in the tumor cells while the expression was increased in vascular endothelial cells in both the tumor itself and the peritumoral area of glial neoplasms, and in metastases. eNOS expression was sporadic in endothelial cells of meningeomas. NOS enzymatic activities were heterogeneous among tumor types (0 - 13.8 pmol/min/mg of protein) without correlation to the NOS expression found by immunohistochemical techniques. Likewise, NOS activity and expression was not correlated to the clinical scores or brain edema. In conclusion, nNOS expression may be a putative useful indicator of brain tumor differentiation and malignancy. The enhanced expression of eNOS in vascular endothelial cells of glial neoplasms and metastases raises the possibility that NO production in tumor endothelial cells may contribute to tumor blood flow regulation and possibly brain edema.

Adenocarcinoma↗