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Biomedical subjects

A Kruse

Publications and source records attributed to A Kruse.

At least 127 records · Page 7Linked to original sources
PubMed1991

[Colorectal neoplasms. Study of the attitudes among Danish gastroenterologists].

The results of a questionnaire concerning colorectal neoplasms are discussed with reference to the relevant literature. Coloscopy is the examination of first choice in the diagnosis and follow-up of colorectal neoplasms but double-contrast barium enema (DCBE) is still justified, particularly in cases where coloscopy proves difficult. In the light of present knowledge, the replies to the questionnaire appear to attach too much importance to frequent early control examinations of patients with cancer and adenomata at the expense of more relevant long-term control. Before a control programme for colorectal neoplasm is commenced, a clean colon should be ensured. Patients attending control examinations should be informed about the symptoms of interval cancer.

Adenoma↗
PubMed1991

Increases of neuron-specific enolase, S-100 protein, creatine kinase and creatine kinase BB isoenzyme in CSF following intraventricular catheter implantation.

In 15 patients without acute brain injury the concentrations of Neuron-specific Enolase (NSE), S-100 Protein (S-100), Creatine Kinase (CK), and Creatine Kinase BB isoenzyme (CK-BB) in ventricular cerebrospinal fluid (CSF) were measured immediately after lateral ventricle cannulation for diagnostic or treatment purposes. From patients who were treated with a shunt another CSF sample was obtained one week after shunt implantation by puncture of the antechamber of the valve. The CSF concentrations of NSE, S-100, CK and CK-BB after cannulation were found to be of the same order as found in patients with severe head injury, stroke or subarachnoid haemorrhage. One week after shunt implantation the concentrations of S-100, CK and CK-BB had returned to normal levels in almost all patients, while the NSE concentrations remained elevated. These findings indicate that the sampling procedure may result in contamination of CSF with NSE, S-100, CK and CK-BB and they should be taken into account in the prognostic evaluation of enzyme concentrations after brain injury.

Brain Damage, Chronic↗
PubMed1991

Effect of cholecystectomy on the relationship between hydrostatic common bile duct pressure and sphincter of Oddi motility.

The sphincter of Oddi (SO) motility before and after an artificial elevation of the common bile duct pressure was studied by means of endoscopic manometry in nine female subjects, seven of whom had undergone previous cholecystectomy. An increase in the hydrostatic common bile duct pressure resulted in total inhibition of the phasic SO contractions in the two patients with gallbladders in situ, as well as in four of the cholecystectomized patients. The results thus indicate that the inhibitory effect of hydrostatic common bile duct pressure on the SO motility previously demonstrated in the cat is also present in man. On the other hand, as the inhibition of the phasic contractions failed to occur in three of the postcholecystectomy patients, the findings also suggest that cholecystectomy may result in altered regulation of SO motility in some patients. This mechanism could then contribute to development of pain in susceptible subjects postcholecystectomy. Finally, the results also showed that pain experienced by some patients upon contrast injection during ERCP bears no relationship to SO motility, but is due to an interindividually variable sensitivity of the bile duct wall to the intraluminal pressure variation.

Abdominal Pain↗
PubMed1991

In situ hybridization of interferon-gamma producing peripheral blood mononuclear cells.

Individual interferon-gamma (IFN-gamma) producing cells in activated human peripheral blood mononuclear cells (PBMC) were characterized by in situ hybridization using [35S]-labelled antisense RNA probes. The proportion of positive cells expressing IFN-gamma mRNA varied according to the substances used for stimulation. IFN-gamma mRNA expressed a relatively low percentage of 1-8% PBMC after a single stimulus with mitogens or OKT-3 antibody and 20-30% of the cells were identified to synthesize IFN-gamma mRNA after stimulation with PHA + P-MA + OKT-3 antibody. The expression of IFN-gamma mRNA and production of the lymphokine was dependent on accessory cells. If accessory cells were replaced by recombinant interleukin-1 (IL-1) plus interleukin-6 (IL-6), then T-cell proliferation to phytohaemagglutinin (PHA) could be partially restored and measurable amounts of IFN-gamma were detected. The addition of interleukin-2 (IL-2) or phorbol-12-myristate-13-acetate to T cells stimulated with PHA, IL-1 and IL-6 did not restore the production of IFN-gamma to an extent comparable to that produced by T cells stimulated in the presence of accessory cells. In further studies, depletion of T-cell subsets showed that CD3+, CD4+, CD8+, CD29+ and CD45RA+ cells were involved in IFN-gamma production after mitogenic stimulation. In conclusion, our data demonstrate that IFN-gamma production is dependent on signals from accessory cells and IFN-gamma is synthesized by only a small proportion of T cells, that did not belong to a unique population, characterized by conventional cellular surface antigens.

Blotting, Northern↗
PubMed1990

[Treatment of esophageal achalasia].

Achalasia is a motor disease of the oesophagus which can be treated surgically (myotomy), medically or by dilatation. After myotomy satisfactory results are obtained in 84%-95% of the patients. Unacceptable results are due primarily to gastro-oesophageal reflux, inadequate or healed myotomy. Dilatation provide good results in about 70% but generally repeated dilatation is required. The remaining 30% can usually be treated surgically. Dilatation is complicated by perforation in about 3% of the patients, but reflux is not as frequent as after myotomy. At present medical treatment is only indicated temporarily prior to dilatation or surgery. Surgical treatment is recommended for patients with contemporary delayed gastric emptying, hiatal hernia, vigorous achalasia, epiphrenic diverticula and for children with achalasia. For the remaining patients both methods can be used but after 2-3 dilatations myotomy is recommended.

Dilatation↗
PubMed1990

Histamine release from gut mast cells from patients with inflammatory bowel diseases.

Inflammatory mediators from intestinal mast cells may serve as initiators of acute and delayed inflammation. Mast cell histamine release was measured in 19 patients with inflammatory bowel diseases using gut mast cells from enzymatically dispersed endoscopic forceps biopsy specimens of macroscopically inflamed and normal tissue. Mast cells and corresponding basophils were challenged with anti-IgE, anti-IgG, subclass anti-IgG4, and formyl-methionyl-leucyl-phenylalanine (FMLP) and results were compared with those from nine patient control subjects. The mast cell count in patients with ulcerative colitis was increased compared with that in control subjects and patients with Crohn's disease, and the mast cell count obtained from inflamed tissue was greater than that of normal tissue. The study also shows the heterogeneity of the responsiveness of the histamine releasing cells to various secretagogues. Thus, mast cells released 0.4 (0.0-2.0) (median (range)) ng histamine per sample at anti-IgE challenge, and basophils were also anti-IgE responsive. In contrast, mast cells did not respond to FMLP but the corresponding basophils did. Gut mast cells released 0.3 (0.0-1.0) (median (range)) ng histamine per sample at anti-IgG4 challenge; however, the corresponding basophils did not respond to anti-IgG4. In addition, the anti-IgG4 mediated histamine release was primarily confined to patients with inflammatory bowel disease. This study substantiates previous histopathological findings that mast cells may play a functional role in the inflammatory process of inflammatory bowel diseases and provides evidence for a possible role of subclass IgG4 as a reaginic antibody.

Adolescent↗
PubMed1990

Food-stimulated cholescintigraphy as a supplement to ERC in patients with suspected bile flow obstruction. A preliminary study.

Cholescintigraphy after food stimulation was carried out in 40 patients (13 patients with biliary enteric bypass, 14 patients with bile duct stenosis, demonstrated by ERC, 5 patients with endoprothesis and 8 patients with clinically suspected post-cholecystectomy syndrome. Biliary-bowel transit time of one hour or less was considered to be normal. In patients with biliary enteric bypass 11 had a normal transit time; however, one with a concomitant anastomotic leakage, and 2 patients had prolonged transit time and a significant obstruction by the anastomosis. All 14 patients with demonstrated biliary stricture had normal transit time. In 5 patients with endoprothesis, 2 had prolonged transit time in spite of patent endoprothesis. Finally, in the 8 patients with suspected post-cholecystectomy syndrome, 4 had normal sphincter of Oddi manometry and normal transit time, and 4 had abnormal sphincter of Oddi manometry, but only one with prolonged transit time. It is concluded that in patients with biliary enteric bypass (hepatico-jejunostomia) or biliary strictures a biliary-bowel transit time of one hour will be discriminatory between normal and abnormal conditions. This is in contrast to patients with endoprothesis and suspected sphincter of Oddi dysmotility, where a transit time of one hour only will have limited predictive value.

Adult↗
PubMed1989

[Surgical treatment of cervical spondylotic myelopathy. A follow-up study].

The effect of operative treatment of spondylotic cervical myelopathy (SCM) was assessed by a follow up investigation of 33 patients submitted consecutively to operation. The patients were followed up on an average two years and two months after operation. As compared with the preoperative status, 39% of the patients had improved, 27% remained unchanged and 33% had a clinical status which was poorer than preoperatively. Age and sex were not found to be of significance for the prognosis. Patients with brief case histories had better effects of operation than patients with prolonged duration of the condition. The best results were found in patients in whom the duration of the condition was less than one year. Although 66% patients had obtained improved clinical condition or in whom progression of the condition has been arrested, 82% of the patients had been awarded social pensions at follow up examination as compared with 48% preoperatively. It is concluded that treatment of SCM should be instituted as early as possible in the course of the condition in the form of operative decompression of the cervical medulla.

Adult↗
PubMed1989

Passive sensitization of human intestinal mast cells.

Dispersed human intestinal mast cells were used for passive sensitization experiments. Eight biopsies (9.7 +/- 1.2 mg/biopsy) of human duodenum were collected from non-atopic children (5) and adults (5). The tissue was dispersed mechanically and enzymatically to yield single cell suspensions. The method produced 2 x 10(3) mast cells per mg wet weight of tissue in a purity of 2.8%. Passive sensitization of the mast cells was performed with the patients' own plasma and plasma obtained from atopic donors. The non-atopic mast cells were able to bind the allergen-specific IgE. In addition, passive sensitization with atopic donor-plasma enhanced the cell sensitivity and cell reactivity to anti-IgE challenge, but had no effect on the cellular response to the ionophore A23187. The study shows that the enzymatic dispersion of human intestinal mast cells produces functionally intact mast cells with preserved Fc-receptors which can be passively sensitized.

Aged↗
PubMed1989

Neutrophil and eosinophil involvement of the small bowel in patients with celiac disease and Crohn's disease: studies on the secretion rate and immunohistochemical localization of granulocyte granule constituents.

PURPOSE: The concentrations of myeloperoxidase (MPO), a neutrophil granule constituent, and eosinophil cationic protein (ECP), a specific eosinophil granule protein, were measured in jejunal perfusion fluid in an attempt to elucidate the neutrophil and eosinophil involvement of the small bowel in health and disease. PATIENTS AND METHODS: The control group consisted of 14 males and two females. Ten patients (seven males and three females) with Crohn's disease and seven patients (two males and five females) with celiac disease were also studied; in addition, one patient with relapsing giardiasis, one patient with giardiasis and complete absence of plasma cells in small intestinal lamina propria, and one patient with selective IgA deficiency and no IgA plasma cells in duodeno-jejunal lamina propria were evaluated. Segmental perfusion of the jejunum was performed according to a previously described method. MPO and ECP were measured by radioimmunoassays. RESULTS: In healthy control subjects, the concentrations of both granule proteins were in a narrow range and much higher than would have been anticipated from passive leakage from circulating blood. In patients with celiac disease, the perfusion fluid concentrations of MPO and ECP were on average 3.5 and eight times, respectively, higher than the values seen in the controls. The jejunal segment perfused in patients with Crohn's disease was endoscopically and histologically normal. The perfusion fluid concentrations of MPO and ECP were increased 3.5 and two times, respectively, compared with that in the control subjects. Both patient groups and the control group had similar perfusion fluid concentrations of albumin. Data on MPO and ECP expressed as jejunal secretion rates gave the same differences between patients and controls as just described for the jejunal fluid concentrations. Immunohistochemical studies of jejunal biopsy specimens from another group of patients with celiac disease demonstrated a prominent extracellular deposit of ECP in the lamina propria of the atrophic intestinal mucosa, whereas the release of neutrophil constituents (cathepsin G, MPO) was scarce. In Crohn's disease, an extracellular degranulation of ECP and, to a lesser extent, of cathepsin G was observed in relation to ulcerations only. CONCLUSION: Data obtained indicate that the local release of neutrophil and eosinophil granule components is enhanced in the jejunal tissue from patients with celiac sprue and Crohn's disease. The prominent extracellular deposit of eosinophil granule constituents with cytotoxic properties at the site of inflammatory intestinal lesions in celiac sprue might reflect a pathophysiologic mechanism.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1989

Longitudinal analysis of the developmental process in chronically ill and healthy persons--empirical findings from the Bonn Longitudinal Study of Aging (BOLSA).

Chronically ill and healthy persons are compared as to social roles, dominant concerns, and in coping with stress. The comparison is based on a longitudinal analysis of data which was collected in the Bonn Longitudinal Study of Aging (BOLSA). The empirical analysis indicates that both groups show great success in mastering life situations and in coping with challenges and restrictions. This competence persists over the eight measurement points. The empirical analysis also makes clear that chronically ill patients often cope actively with stress, that they are able to accept restrictions and to look simultaneously for new possibilities in life. Social contacts have a predominant position in coping with chronic disease. Intrafamilial and extrafamilial contacts are important and helpful for chronically ill patients. As the longitudinal analysis reveals, coping with challenges and demands of life is influenced by the individual life-style. The analysis points to the aging process as a process of growth and of new potentials. This applies not only to persons who are in good health, but to chronically ill persons as well.

Activities of Daily Living↗
PubMed1989

The pituitary-thyroid axis in patients with pituitary disorders.

The pituitary-thyroid axis of 12 patients, exposed to transsphenoidal pituitary microsurgery because of nonfunctioning adenomas (6), prolactinomas (3) and craniopharyngioma (1), or to major pituitary injury (1 apoplexy, 1 accidental injury), was controlled more than 6 months following the incidents. The patients did not receive thyroid replacement therapy and were evaluated by measurement of the serum concentration of thyroxine (T4), 3,5,3'-triiodothyronine (T3), 3,3',5'-triiodothyronine (rT3), T3-resin uptake test and thyrotropin (TSH, IRMA method) before and after 200 micrograms thyrotropin releasing hormone (TRH) iv. The examination also included measurement of prolactin (PRL) and cortisol (C) in serum. Apart from 1 patient with pituitary apoplexy all had normal basal TSH levels and 9 showed a significant TSH response to TRH. Compared to 40 normal control subjects the 12 patients had significantly decreased levels of T4, T3 and rT3 (expressed in free indices), while the TSH levels showed no change. Five of the patients, studied before and following surgery, had all decreased and subnormal FT4I (free T4 index) after surgery, but unchanged FT3I and TSH. The levels of FT4I were positively correlated to both those of FT3I and FrT3I, but not to TSH. The TSH and thyroid hormone values showed no relationship to the levels of PRL or C of the patients exposed to surgery. It is concluded that the risk of hypothyroidism in patients exposed to pituitary microsurgery is not appearing from the TSH response to TRH, but from the thyroid hormone levels.

Adenoma↗
PubMed1989

In vitro development of bone-marrow-derived macrophages. Influence of mouse genotype on response to colony-stimulating factors and autocrine interferon induction.

Responsiveness to granulocyte-macrophage colony-stimulating factor (GM-CSF) and macrophage CSF (M-CSF) of bone marrow cells derived from different mouse strains was investigated. There were great variations in proliferation between different strains of inbred mice. Bone marrow cells from mouse strains with a high rate of proliferation in response to GM-CSF also had a high proliferating capacity to M-CSF. The response to either CSF did not correlate with a certain H-2 haplotype. GM-CSF induced consistently higher proliferation than M-CSF. Proliferation in response to M-CSF, but not to GM-CSF, could be enhanced by the addition of antibodies against interferon (IFN). IFN is the only known inducer of (2'-5') oligoadenylate (oligo (A] synthetase. This enzyme was induced in macrophages grown in the presence of M-CSF, but not in GM-CSF promoted cells. Enzyme induction was completely abrogated by simultaneous treatment with anti-IFN alpha/beta. Infection of macrophages with herpes simplex virus type 1 (HSV) and vesicular stomatitis virus (VSV) revealed that GM-CSF-promoted cells were highly susceptible to lytic infection by these viruses. In contrast, virus titres in M-CSF-cultured cells were 100-fold lower. We conclude that, contrary to M-CSF, GM-CSF does not induce autocrine IFN during haematopoiesis. As judged from data with BALB/c mice, the sensitivity to the anti-proliferative effect of the autocrine IFN may be a factor which influences M-CSF-promoted proliferation.

2',5'-Oligoadenylate Synthetase↗
PubMed1989

Histamine release from dispersed human intestinal mast cells. A method using biopsies from children and adults.

To study the human intestinal mast cell of children and adults, we combined a sensitive glassfibre-based histamine assay with the enzymatic and mechanical dispersion of surgical specimens or mucosal biopsies. The method yields between 1.2 x 10(3) to 4.6 x 10(3) mast cells/mg tissue constituting 1.2% to 5.3% of total cell count. The mast cell yield, however, depends on the intestinal tissue specimen used for dispersion. Aliquots containing 1500 mast cells per sample are sufficient for measuring significant amounts of histamine (greater than or equal to 0.15 ng histamine per sample), thus making it possible, to carry out approximately 75 tests for four mucosal biopsies of 10 mg each. The intestinal mast cell releases histamine in a dose-dependent manner on challenge with anti-IgE (6-600 U/ml), ionophore A23187 (0.25-1.0 microM), and Concanavalin A (0.7-25.0 micrograms/ml). The histamine release shows interindividual variation with a net histamine release between 0 to 2.5 ng/samples dependent on the secretatogue. In general, it is not necessary to passively sensitize the mast cells to obtain a sufficient histamine release response to anti-IgE challenge, indicating the presence of intact and functional cell-bound IgE. However, it is shown that four of 10 non-atopic intestinal mast cell samples could be passively sensitized with human plasma containing either mite- or grass-specific IgE without stripping off the IgE first. This indicates the presence of free and preserved Fc-receptors on the dispersed mast cells in some subjects. In addition, it is found that the phorbolester TPA increases the histamine release response to A23187 and turns anti-IgE non-responding mast cells into responding mast cells, but TPA alone at 2 to 16 ng/ml has no histamine releasing effect. In patients with anti-IgE responding mast cells no additional effect of TPA is seen. Finally, no substantial differences between mast cells of children and adults are demonstrated.

Biopsy↗
PubMed1989

Comparison of intestinal mast cell and basophil histamine release in children with food allergic reactions.

The in vitro histamine release response of human intestinal mast cells and basophils challenged with anti-IgE, Concanavalin A, ionophore A23187 and food extracts was compared with skin prick test, RAST analysis and open food challenge. It was not possible to perform food challenge in all patients; however, seven children underwent open food challenge and in five the clinical diagnosis of "true" food allergy was confirmed. The intestinal mast cells were pooled from enzymatically dispersed duodenal biopsies obtained by duodenoscopy from 15 selected children suspected of food allergy, and five age-matched controls. In nine of 10 patients classified as "food allergic" intestinal mast cells released histamine to various food extracts in a dose-dependent fashion. From the mast cells of the nine food-allergic patients compared with non-allergics, the anti-IgE mediated mast cell histamine release was increased. Additionally, at 1000 U/ml anti-IgE the mast cell histamine release was increased compared with their corresponding basophils. However, in non-allergic subjects the histamine release of basophils was increased compared with their corresponding mast cells. Histamine release from basophils was positively correlated to the test scores of the RAST analysis, skin prick test, and food challenge. No apparent correlation between tests scores obtained from histamine release of intestinal mast cell and the other tests was demonstrated, except in children with diarrhoea as only symptom. However, the study gives evidence that duodenal mast cells actually are sensitized with specific IgE and thus may play a pathophysiological role in food hypersensitivity. In addition, the study shows that the ability of different stimuli, including food extracts, to trigger basophil histamine release does not correlate with their potency to induce histamine release from mast cells.

Allergens↗
PubMed1989

Flumazenil used for antagonizing the central effects of midazolam and diazepam in outpatients.

In a double-blind, randomized trial, the efficacy and safety of flumazenil, a benzodiazepine antagonist, was evaluated in patients after gastroscopy under midazolam or diazepam sedation. The criteria of efficacy were the degree of sedation and anterograde amnesia. Flumazenil significantly reduced the degree of sedation in both groups without significant intergroup differences. No sign of resedation was found during the observation period of 3 h. The anterograde amnesia was effectively antagonized in both groups. Flumazenil was well tolerated. Flumazenil is a safe and effective benzodiazepine antagonist which makes it possible to reduce the recovery period in outpatients sedated sufficiently with benzodiazepines for gastroscopy.

Adult↗