Search PubMed⌕ Search

Biomedical subjects

B Kruse

Publications and source records attributed to B Kruse.

43 records · Page 3Linked to original sources

[Changes in serum lipoproteins under hormonal therapy of breast carcinoma and other endocrine-dependent tumors].

The higher the low-density-lipoprotein cholesterol (beta lipoprotein) level, the greater the risk that coronary heart disease will develop, alpha-lipoprotein fractions (high-density-lipoproteins) are considered to be protective factors. Medroxyprogesterone acetate is responsible for characteristic changes of the lipoprotein patterns indicating enhanced coronary risks. Medroxyprogesterone acetate is applied in the therapy of breast, uterus and ovarian cancer. A statistically significant decrease was observed in alpha-lipoproteins whereas beta-lipoproteins increased without statistical significance. A similar reaction can be observed under the combination therapy of aminoglutethimide and medroxyprogesterone acetate, whereas the combination of cortisone and aminoglutethimide has a distinct influence on beta-lipoproteins but the alpha-lipoprotein level remains uninfluenced. According to these data the effect of an adjuvant application of these drugs must be carefully evaluated due to an increase of coronary risks.

Aminoglutethimide↗

Rehabilitation nursing in home care.

A randomized sample of 83 members of the Association of Rehabilitation Nurses' (ARN's) Home Health Special Interest Group (SIG) responded to a survey in 1998 and 1999 to determine the role intensity of rehabilitation nurses in home care. An instrument was developed that was based on role descriptions formulated by ARN. Significant differences in the roles were reported for caregiver, case manager, counselor, family-client educator, advocate, administrator, student/staff educator, and researcher. Rewards of home nursing included one-to-one interaction with clients, teaching opportunities, promotion of function, nurse autonomy, and seeing rehabilitation results. Difficulties included poor interdisciplinary coordination, budget restrictions, lack of understanding of rehabilitation nursing, and inadequate home aides. Differences between inpatient and home rehabilitation nursing included less equipment and resources and increased levels of responsibility in the home. Barriers for the transition to home rehabilitation nursing included interdisciplinary team communication, reimbursement standards and documentation, time management, autonomous nursing roles, and separation from help or emergency services.

Home Care Services↗

Chronic effects of ACE-inhibition (quinapril) and angiotensin-II-type-1 receptor blockade (losartan) on atrial natriuretic peptide in brain nuclei of rats with experimental myocardial infarction.

Alterations of the central nervous system may be important for imbalance of cardiovascular and fluid regulation in heart failure. The central renin-angiotensin and atrial natriuretic peptide (ANP) systems act as mutual antagonists. The effects of angiotensin converting enzyme (ACE) inhibition (quinapril, 6 mg/kg/day) and angiotensin II type 1 (AT1) receptor blockade (losartan, 10 mg/kg/day) on ANP levels in 18 selected, microdissected brain nuclei were determined in sham-operated rats and rats with left ventricular dysfunction 8 weeks after myocardial infarction (MI). Plasma ANP tended to increase in MI rats and was further increased by quinapril. ANP was decreased in 12 brain areas of MI rats. ANP concentration was also significantly decreased by quinapril in six brain nuclei including subfornical organ and organum vasculosum laminae terminalis (areas lacking blood-brain barrier), and by losartan in 16 brain nuclei outside and within the blood-brain barrier in sham operated rats. However, both quinapril and losartan prevented a further reduction of central ANP as a result of myocardial infarction. These data suggest that there are effects on central ANP that result from chronic left ventricular dysfunction as well as an ACE-inhibitor and AT1-antagonist. Mechanisms and consequences of central ANP depression remain unclear. They could, however, support systemic vasoconstriction and sodium and fluid retention.

Angiotensin Receptor Antagonists↗

[L-2-hydroxyglutaric aciduria -- a rare cause of macrocephaly].

We report on a 9-year-old girl who was referred to our department because of increasing macrocephaly and school problems. The neurological examination disclosed mild cerebellar dysfunction and positive pyramidal tract signs. An MRI of the brain revealed extensive signal alterations of the white matter. Biochemical investigations established the diagnosis of L-2-hydroxyglutaric aciduria which has to be kept in mind as a rare cause of macrocephaly.

Adolescent↗

Proton NMR spectroscopy of cerebral metabolic alterations in infantile peroxisomal disorders.

Noninvasive studies of cerebral metabolism were performed with use of localized proton MR spectroscopy (MRS) in both healthy controls (n = 4, age 6 weeks to 2 years) and infants (n = 4, age 3-15 months) who had impaired peroxisomal functions classified as variants of Zellweger syndrome. All patients revealed a marked decrease of N-acetylaspartate in white and gray matter, thalamus, and cerebellum, indicating impairment of normal neuronal development as well as neuronal loss. In two cases an increase of cerebral glutamine and a decrease of the cytosolic polyol myo-inositol in gray matter and striatum reflected the impact of a concomitant effect on hepatic function. Two cases 3 and 6 months of age exhibited a notable elevation of mobile lipids and/or cholesterol in white matter. These patients with severe disease died within 4 weeks after the MRS examination. While an increase of free fatty acids generally associated with a lysosomal storage disease was not consistently observed by proton MRS of brain, this technique provides a convenient and safe tool for the direct assessment of neuropathologic aspects of Zellweger syndrome such as neuronal degeneration, demyelination, and consequences of compromised liver function.

Adrenoleukodystrophy↗

MR findings in adult-onset adrenoleukodystrophy.

PURPOSE: To describe the MR findings of brain and spinal cord in adult-onset adrenoleukodystrophy. METHODS: One hundred sixty-four adult patients ranging from 19 to 74 years of age (119 men and 45 women) with clinically and biochemically proved adrenoleukodystrophy underwent MR of the brain. In 30 patients the spinal cord also was evaluated with MR. RESULTS: The brain MR findings were abnormal in 54 of 119 males and in 9 of 45 female heterozygotes and consisted of varying degrees of demyelination of the cerebral white matter in 40 patients, corpus callosum in 25 patients, corticospinal tracts in 46 patients, visual tracts in 31 patients, and auditory tracts in 18 patients. The thoracic spinal cord showed diffuse atrophy in 18 of 20 men and in 8 of 10 women. CONCLUSION: It is important to recognize the MR findings of adult-onset adrenoleukodystrophy, because not uncommonly the clinical and MR findings of adrenoleukodystrophy are misdiagnosed as multiple sclerosis, olivopontocerebellar or spinocerebellar atrophy, amyotrophic lateral sclerosis, or dementia. Analysis of the MR findings and correlation of the clinical findings has permitted a tentative subdivision of adult-onset adrenoleukodystrophy population into four subtypes that appear to differ in respect to prognosis and possibly pathogenesis. MR evaluation of the brain in adrenoleukodystrophy also is helpful in patient selection for experimental therapy, which is most effective if offered in the early stage of the disease.

Adrenoleukodystrophy↗