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Biomedical subjects

A Kruse

Publications and source records attributed to A Kruse.

At least 55 records · Page 3Linked to original sources
PubMed2001

Double-blind randomised placebo-controlled phase III study of an E. coli extract plus 5-fluorouracil versus 5-fluorouracil in patients with advanced colorectal cancer.

The primary aim of this study was to evaluate the toxicity (mucositis, diarrhea and leucopenia) of a therapy with 5-fluorouracil (CAS 51-21-8; 5-FU) plus an E. coli extract (LC-Extract, Laves coli extract, Colibiogen inject, cell-free soluble fraction from lysed E. coli, Laves strain) in comparison with 5-FU plus placebo. Secondary endpoints included general toxicity, response rate according to WHO, survival time and quality of life. 164 patients with advanced colorectal cancer were enrolled in this randomised, placebo-controlled, double-blind, multicenter phase III study. The treatment consisted of 0.167 ml/kg/d LC-Extract or placebo followed by 500-750 mg/m2/d 5-FU on five consecutive days, repeated every three weeks for up to six treatment cycles. 158 (77 verum, 81 placebo) patients were evaluable for toxicity, 144 (72 verum, 72 placebo) evaluable for response. The therapy with LC-Extract was well tolerated. Adverse events that occurred during the study were mainly judged as 5-FU- or tumor-related. Toxicity from treatment with 600 mg/m2/d 5-FU in both treatment groups was very low. After treatment with 750 mg/m2/d 5-FU patients in the placebo-group experienced a higher CTC toxicity than in the LC-Extract groups. Remission rate and survival time showed a slight trend in favour of LC-Extract. These results suggest a positive benefit-risk ratio of the additional application of LC-Extract to 5-FU in the treatment of advanced colorectal cancer especially for administration of high doses of 5-FU.

Adolescent↗
PubMed2001

Variant Creutzfeldt-Jakob disease (vCJD) and gastrointestinal endoscopy.

Variant Creutzfeldt-Jakob disease (vCJD) is a transmissible form of spongiform encephalopathy believed to be contracted from the consumption of bovine spongiform encephalopathy (BSE) infected beef products. To date over 100 individuals have developed this incurable disease. There have been no documented cases of iatrogenic infection, but there is a theoretical risk that surgical procedures could transmit the disease. This review describes the background of the disease and assesses the possible risks of transmission through endoscopic procedures. The risk of transmission by endoscopy is small and probably negligible if suitable procedures are followed. The greatest potential danger arises from healthy individuals who are incubating the disease. Pathological prions (PrP(sc)) may be found in lymphatic tissue of these individuals (particularly tonsils), but smaller amounts have been identified in the appendix and Peyer's patches. These prions are resistant to all forms of conventional sterilization. There is a theoretical risk that biopsy forceps and the operating channel of endoscopes could become contaminated. This review gives recommendations as to how these small risks can be minimized. They include the employment of single-use forceps for biopsies taken from the terminal ileum, greater attention to the maintenance of endoscopic equipment and accessories, more rigorous manual cleaning of endoscopic equipment and the use of well designed, disposable cleaning brushes for the operating channel of the endoscope.

Animals↗
PubMed2000

[MR-cholangiography in patients suspected with choledochus calculi].

To test a new non-invasive imaging method, magnetic resonance cholangiography (MRCP), we compared MRCP with intraoperative cholangiography (IOC) or endoscopic retrograde cholangiography (ERC). In 55 patients with 11 common bile duct stones MRCP identified all 11 stones and incorrectly found stones in seven additional patients. Predictive value of positive test was 61%, predictive value of negative test was 100%. As a consequence of MRCP, ERC or IOC can be avoided in 67% of the patients.

Adult↗
PubMed2000

[Detection of cholangiocarcinoma in primary sclerosing cholangitis by positron emission tomography].

Primary sclerosing cholangitis (PSC) predisposes to cholangiocarcinoma (CC). PET scanning can assess metabolism in vivo. The glucose analogue [18 F]fluoro-2-deoxy-D-glucose (FDG) accumulates in malignant tumours because of high glucose metabolism. PET scanning of the liver was performed after intravenous FDG in nine patients with PSC, six with PSC + CC, and five controls. "Hot spots" with radioactivity accumulation were seen in each PSC + CC patient, but not in the two other groups. Values of net metabolic clearance of FDG, K (ml min-1 100 ml-1 tissue), was in CC hot spots 1.59 to 4.17 (median, 2.34; n = 6); in reference liver tissues of these patients 0.40 to 0.69 (0.49); in PSC 0.23 to 0.53 (0.36); in controls 0.20 to 0.34 (0.31). The difference between K in CC hot spots and the other groups was statistically significant (P < 0.001). FDG-PET may detect small CC tumours and be useful in therapeutic management of PSC.

Bile Duct Neoplasms↗
PubMed2000

Differential expression of the B cell-restricted molecule CD22 on neonatal B lymphocytes depending upon antigen stimulation.

Newborns respond poorly to certain antigens and produce mainly IgM antibodies. By flow cytometry we analyzed on neonatal and adult B cells the expression of CD22, a B cell receptor (BCR)-associated membrane molecule, known as negative modulator of BCR signaling. After T cell-independent (TI-)stimulation with anti-mu F(ab')(2) fragments we found a dramatic decrease in the percentage of neonatal CD22(+) B cells and CD22 mean fluorescence intensity (MFI) shift, whereas adult B cells remained unaffected. Survival and proliferation rates of neonatal B cells were higher compared to adult B cells whereas the degrees of apoptosis and necrosis were comparable. Surprisingly, after stimulation with lower doses of anti-mu apoptosis as well as proliferation increased significantly in contrast to adult B cells. T cell-dependent (TD)-stimulation with anti-CD40 monoclonal antibody and IL-4 resulted in a dramatic increase in the percentage of CD22(+) neonatal B cells in contrast to unaffected adult B cells. CD22 MFI shifts showed no significant changes, respectively. The survival rate was higher for adult B cells, whereas apoptosis and cell death were comparable. These results suggest that TI antigens lower the neonatal BCR signaling threshold via down-regulation of CD22, resulting in hyperresponsive B cells apt to premature apoptosis. On the other hand, up-regulation of CD22 after TD stimulation may allow increased inhibiting influence of CD22 on neonatal BCR signaling, impairing B cell activation and differentiation.

Antigens, CD↗
PubMed2000

[Time, biography and life course].

In this contribution implications of perspectives on the past and on the future for the experience of the present and actual behavior are described. It is argued that in a retrospective look on personal history (or selected periods of personal history) people give meaning to events and processes--these events and processes can be interpreted as "knots" around which other moments and periods (that are subjectively judged as of less importance) do organize themselves. Subjectively important aspects of the past are present in actual experiences and behavior: Therefore, studying biography--subjects' interpretation of the life course--is a pre-condition of understanding actual experiences and behavior. Moreover, people are directed towards the future (e.g., in the sense of controllability vs. non-controllability). The perspectives on the past and future do constitute a human time horizon. It is shown that the development of a time horizon and the application of structure to the perception of time is a constructive performance of human consciousness. Moreover, it is argued that the perception of time is a basic antecendent of the experience of freedom. The contribution begins with the analysis of a microsituation--the results of this analysis are then transferred to the life course and biography. Life course and biography are analysed in the context of the central theoretical positions that Ursula Lehr has developed and tested empirically in her contributions to life span psychology.

Adaptation, Psychological↗
PubMed1999

Evidence of specialized leukocyte-vascular homing interactions at the maternal/fetal interface.

In normal pregnancy, the maternal immune system fails to reject the fetus or the placenta as an allogeneic graft. We hypothesize that specialized mechanisms of leukocyte recruitment might limit access of circulating maternal immune cells to the maternal/fetal interface. During the critical period of initial trophoblast invasion there is an elegantly orchestrated progression of leukocyte homing events in the decidua basalis, associated with highly regulated expression of vascular addressins and segregation of specialized leukocyte subsets into well-defined decidual microdomains. Neutrophils are limited to the region of necrosis associated with enzymatic digestion at the leading edge of the invading trophoblast, where an almost linear array of maternal blood vessels displays the neutrophil ligand E-selectin. Cells with the phenotype of monocytes but expressing alpha4beta7 integrin are localized in the blood vessels of the specialized "vascular zone", which display the unusual combination of P-selectin (partially associated with platelets) and the alpha4beta7 ligand mucosal vascular addressin-1 (MAdCAM-1). Granulated metrial gland cells (alpha4+beta7-, probably alpha4beta1+) constitute a well-defined cluster positioned in the central decidua basalis around venules prominently expressing the alpha4beta1 ligand VCAM-1 (but not MAdCAM-1). T and B lymphocytes are rare. Our results suggest that selective mechanisms for regulating leukocyte access, associated with microdomain specialization within the decidua basalis, may play a fundamental role in immune regulation during the invasive period of placental development.

Animals↗
PubMed1999

[Psychological gerontology in German-speaking countries 1988-1998: introduction, cognitive development in aging (I)].

In this four-part review article, an update of psychological gerontology since 1988 in German speaking countries is given as follows: Cognitive development in old age (part I), personality development in old age (part II), social relations in old age (part III), tasks, burdens, and border situations in old age (part IV). In part I of the update which is presented in this issue, the description of recent trends in cognitive research serves as a background to highlight, in a first step, the basic research in the field concerned with the mechanics as well as the pragmatics of intelligence in the later years. In a further step, research on memory processes including psychological work with relevance for the investigation of dementia is reviewed. Finally, cognitive intervention studies reflecting the impact of an applied cognitive gero-psychology and aimed to support the potential and limits of the plasticity of the intelligence and memory development in old age find consideration.

Aged↗
PubMed1999

[Personality development in old age].

In this four-part review article, an update of Psychological Gerontology since 1988 in German speaking countries is given. Part II of this review focuses an personality development in old age. In accordance with their current relevance within research on personality development, concepts and empirical studies concerned with coping, psychological resilience and development regulation in old age are addressed in the first part of this review (contributions to basic research). First, research based on the two-process-model of coping, the personality theory of Thomae and the life-span theory of control is summarized. Next, work on subjective well-being, self and self-regulation are highlighted. In the second part of the review (contribution to applied research), an overview of the scope of potential of psychotherapeutic intervention in old age is given.

Adaptation, Psychological↗
PubMed1999

[III. Social relationships].

In this four-part review article, an update of psychological gerontology from 1988 to 1997/1998 in German speaking countries is given. Part III of this review focuses on social relationships in old age. Two perspectives are chosen for this analysis. The first perspective describes the process of actively coping with developmental tasks in social relationship - the elderly are not seen as a "passive" but as an "active" part in social relationships. Moreover, this perspective focuses on empirical relations between different patterns of social integration and the psychological situation in old age. The second perspective stresses on a special aspect of social engagement: the engagement and productivity in intergenerational relationships. Empirical data make clear that the elderly not only receive (emotional and instrumental) support, but also give a lot of support in these relationships.

Aged↗
PubMed1999

[Tasks, burdens and borderline situations in old age. General discussion].

In this four-part review article, an update covering the geropsychological research since 1988 in German speaking countries is given as follows: Cognitive development in old age (part I), personality development in old age (part II), social relations in old age (part III), age-related tasks, burdens, and border situations (part IV). In part IV of the update presented in this issue, research contributing to a competence perspective of old age and aging is summarized under four main headings: (1) Independence, everyday life, and everyday competence; (2) aging in spatial, physical, and technical environments; (3) health and coping with illness; (4) coping with death and dying. The article ends with a general discussion considering as well the findings of our survey addressing gerontologists from German speaking countries.

Aged↗
PubMed1999

Identification of human cytomegalovirus variants by analysis of single strand conformation polymorphism and DNA sequencing of the envelope glycoprotein B gene region-distribution frequency in liver transplant recipients.

Single strand conformation polymorphism analysis (SSCP) of PCR-amplified DNA and subsequent DNA sequencing of human cytomegalovirus (HCMV) glycoprotein B (gB) gene were applied to identify known HCMV strains and to detect new virus variants. 61 HCMV PCR positive patients were studied out of a cohort of 410 patients after liver transplantation (LTX). SSCP was able to distinguish between strains Davis, AD169, and Towne, and in addition could identify five new virus variants (Berlin B, C, E, F, and H). Their frequency, gB and gH types were determined. Simultaneous infections with two or three strains or variants, as well as a switch from one virus to another virus were observed during long-term follow-up. No correlation between the occurrence of certain virus strains or gB types and defined clinical manifestations of HCMV infection after LTX was drawn.

Base Sequence↗
PubMed1999

Imaging of fibrosis of the oral mucosa by 20 MHz sonography.

OBJECTIVES: To compare the ultrasonographic (US) appearances of the oral mucosa in health with patients with systemic sclerosis (SSc). METHODS: An innovative 20 MHz US scanner was used to examine the lips, cheeks and oral vestibule of ten healthy persons and ten patients with SSc. The clinical, US and histopathological features of one patient with a fibro-epithelial polyp of the buccal mucosa are reported in detail. RESULTS: Two patients with SSc displayed increased echogenicity due to fibrotic deposits. A similar echo pattern was seen in the case of the histopathologically verified fibro-epithelial polyp of the buccal mucosa. CONCLUSION: 20 MHz sonography may be suitable as a non-invasive tool for evaluation of fibrosis of the oral mucosa.

Adolescent↗