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Biomedical subjects

D Franke

Publications and source records attributed to D Franke.

At least 19 recordsLinked to original sources
PubMed2006

Correlation of residual leukocyte subsets with neutropenic fever during severe leukopenia after high-dose chemotherapy and autologous stem cell transplantation.

BACKGROUND: High-dose chemotherapy with autologous stem cell transplantation is the standard treatment of eligible patients with multiple myeloma. However, this treatment is associated with a substantial risk of infectious complications during leukopenia. The aim of our pilot study was to determine the residual leukocyte subsets during severe cytopenia after high-dose melphalan and to correlate this with the occurrence of neutropenic fever. METHODS: Residual leukocyte subsets in the peripheral blood on days 4-7 following autologous stem cell transplantation were analyzed by three-color flow cytometry in 20 patients with multiple myeloma. In addition, we determined the number of T cells that were transfused with the autografts. RESULTS: Absolute numbers of lymphocytes (mean 25/microL) and monocytes (mean 4/microL) were strongly reduced but rather constant during the period of severe neutropenia. Neutrophil engraftment and duration of neutropenia were very similar in patients with and without neutropenic fever. Low absolute lymphocyte counts and absolute CD4+ T-cell counts on days 4-7 after stem cell transplantation correlated with neutropenic fever. Furthermore, T-cell numbers in the autologous stem cell grafts that the patients received were significantly lower in patients with neutropenic fever. DISCUSSION: These observations suggest that the number of T cells, and in particular CD4+ T cells, in the blood during severe cytopenia is playing a role in defense of infection. T-cell numbers in the graft could provide a predictive factor for the risk of infection in the post-transplant period. However, this needs to be confirmed in a larger study.

Aged↗
PubMed2003

Early stages of particle formation in precipitation reactions-quinacridone and boehmite as generic examples.

For many products, such as nanoparticulate systems, particle formation by precipitation is an essential procedural step. To learn more about the processes involved in precipitation, we investigated particle formation during precipitation reactions by means of online and offline methods. As model systems we chose the catalyst boehmite and the organic pigment quinacridone. The reactants were mixed in a mixing device and led into a reaction tube. At the end of the tube, a free jet of the suspension was produced. By varying the length of the reaction tube the time between mixing the reactants and the moment of observation was varied. Thus a time resolution down to 10 ms from the beginning of the reaction was obtained. Small-angle X-ray scattering on the free jet yielded online information about the structural inhomogeneities within the reacting systems. Transmission electron microscopy patterns obtained from quenched samples, which were taken by shooting copper grids through the free jet into liquid nitrogen, provided complementary information about structural features. Immediately after mixture an emulsion-like structure develops indicating that classical nucleation theory does not apply in the present systems. This finding can be explained by assuming instantaneous reaction at the interfaces of the two reactants that meet in the mixing device. From this preliminary state primary particles form with a size in the nanometer range. The observations can be rationalized by considering the underlying hydrodynamics of turbulent mixing of the reactants.

Journal Article↗
PubMed2002

Intermediate results of health related quality of life after vertical banded gastroplasty.

OBJECTIVES: The purpose of this study is to evaluate (a) health-related quality of life (HRQL) after vertical banded gastroplasty (VBG) (Mason) and (b) predictors of HRQL. SUBJECTS: Eighty-two consecutive patients were assessed preoperatively and then after 6, 12 and 24 months. Patients filled out questionnaires for subjective appraisal of HRQL (physical well-being, mood, physical performance, perceived health, social support and coping/adjustment). RESULTS: The greatest improvement in weight and HRQL was seen within 6 months of surgery. Twenty-four months after VBG weight reduction (P<0.05), perceived health (P<0.05), physical well-being (P<0.05), physical performance (P<0.05), mood (P<0.05), coping/adjustment (P<0.05) continued to be better than before surgery. Preoperative binge eating was the most important predictor of HRQL. CONCLUSION: Two years after VBG weight loss and a significant improvement of HRQL can be found. HRQL and weight loss are not associated in terms of outcome, indicating that weight loss alone may not be enough to improve HRQL.

Adaptation, Psychological↗
PubMed2001

Brain microembolic counts during extracorporeal circulation depend on aortic cannula position.

Thrombofibrinous and gaseous brain microemboli are commonly observed during extracorporeal circulation in patients undergoing cardiac surgery. Recent studies showed a preference of microemboli to the left hemisphere. We hypothesized that placement of the aortic cannula tip within the aorta descendens rather than in the aorta ascendens as commonly used reduces the number of microemboli to the brain and also reduces the side preference. Of 60 patients undergoing elective coronary artery bypass grafting primarily randomized to either a short aortic cannula (aorta ascendens) or an elongated one (aorta descendens), 29 (16 and 13) patients had complete and technically perfect continuous intraoperative transcranial Doppler sonography with embolus detection bilaterally. The number of high-intensity transient signals (HITS) was 994 +/- 2118 (mean +/- SD) for the short cannula group and was significantly lower with the elongated cannula (223 +/- 208; p < 0.02). HITS counts per min also differed significantly in favour of the aorta descendens group (p < 0.02), but there was an overlap. Thus, elongated cannulas can reduce, but not prevent microembolism to the brain. The side-to-side ratio of microemboli revealed more events in the left hemisphere, but this was similar in both groups. This suggests that individual anatomic factors may be responsible for this hemodynamically-mediated effect.

Aorta↗
PubMed2001

Analysis of cognitive and motor functioning during pubertal development: a new approach.

We investigated cognitive-motor abilities in 303 (156 female) school children from Zagreb, Croatia, in the age span 10 to 14 years using a newly developed chronometrical reactionmeter system (CRD). The following tests were applied: CRD-311 (simple visual discrimination of signal location), CRD-324 (short-term memory actualisation), CRD-21 (simple convergent visual orientation), and CRD-11 (arithmetically conceptualised/operationalised convergent thinking). In both gender a statistically significant age related improvement of the performance for time related parameters (minimum time of test item solving (MT), total ballast (TB), and total time of test solving (TT) was observed. In contrast, the number of errors (NE), which was the only non-time related parameter tested, did not significantly change with age. Significant differences between boys and girls were observed for the time related parameters TB and MT. TB was significantly lower in girls, whereas boys tended to be faster in MT measurements. In TT as a composed measure of the mentioned parameters, no major differences were observed. We conclude that the CRD system is a new useful tool for investigating the complexity of cognitive-motor abilities in children. Our cross-sectional study demonstrated that the time-related parameters were significantly affected by age and gender during puberty.

Adolescent↗
PubMed2000

Treatment of FSGS with plasma exchange and immunadsorption.

In primary focal and segmental glomerulosclerosis (FSGS) renal prognosis is poor if no remission of proteinuria can be achieved with treatment. Currently, most children with FSGS are treated with cyclosporine and steroids after establishing steroid resistance, and approximately 60% of patients benefit from this therapy. For the remaining 40%, no generally approved therapeutic recommendations exist for children. We treated nine children with cyclosporine-resistant primary FSGS with plasma exchange (PE), two with relapsing FSGS after renal transplantation and seven with FSGS in their native kidneys. Three patients did not respond to PE, but five came into complete remission and one patient achieved partial remission. Three patients relapsed between 6 weeks and 2 years following cessation of PE, and were subsequently treated with plasma immunadsorption (PIA), which also reliably reduced proteinuria. The patients without response to PE tended to have a longer duration of the disease. We conclude that PE and PIA are a useful option for treatment of steroid- and cyclosporine-resistant FSGS, particularly if applied early in the course of the disease. Although more demanding on supportive resources, PIA seems preferable to PE, since there is no necessity for additional albumin or fresh-frozen plasma, as with PE.

Adolescent↗
PubMed2000

Does growth hormone therapy harmonize distorted morphology and body composition in chronic renal failure?

Recombinant human growth hormone (rhGH) therapy of growth retardation in chronic renal failure (CRF) has become well established. While there are ample data about its effectiveness in restoring longitudinal growth delay, data on complex anthropometry are scarce. Twenty-three children with CRF (6 after renal transplantation) were investigated using 24 different parameters. The analysis revealed disproportionate growth in CRF. While parameters of the trunk and transverse dimension of the head were preserved, the extremities were affected more severely. Bone dimensions of the legs and arms as well as muscle mass were affected the most. RhGH therapy was effective in restoring impaired longitudinal dimensions of the body in CRF. The restoration of growth retardation occurred predominantly in the extremities. This was accompanied by an increase in transversal dimensions, circumferences and soft tissue of the extremities, as well as an increase in bone and muscle volume, indicating harmonization of the total body shape. The dimensions of trunk, forehead diameter and morphological face height remained within the normal range. There was no evidence of acromegaly in children with CRF and rhGH therapy. We conclude that rhGH therapy at a dose of 28 iU/m2/week is effective in restoring previously disproportional body structure and shape in children with CRF.

Anthropometry↗
PubMed2000

Molecular biology and clinical manifestation of hereditary factor VII deficiency.

Inherited factor VII (FVII) deficiency is a rare autosomal recessive disorder. Mutations and polymorphisms of the FVII gene were characterized in more than 40 unrelated patients with FVII deficiency. Among the 29 different mutations, the most frequent were Ala294 Val, Ala294Val;404delC, IVS7+7, and Val281 Phe. Four novel mutations (IVS2+1G>C, Arg247 Cys, Glu265 Lys, Asp343 His) were detected. The relationships between genotypes of mutations and polymorphisms of the FVII gene, FVII deficiency, and clinical phenotype were investigated. Homozygosity of the Phe4 Leu, IVS4+1G>A, Cys135 Arg, Ala244 Val, and Ala294 Val;404delC and the double heterozygosity of Tyr68 Cys / IVS3-1G>A, Val252 Met / IVS2+5G>T, Val281 Phe / Cys135 Arg, Ala294 Val / Val281 Phe, Ala294 Val;404delC / Val281Phe, Ala294 Val;404delC / Arg152 stop, Ala294Val;404delC / Gln(-35) stop, Ala294 Val / Val252 Met, Ala294 Val / Gly156 Asp, and Thr359 Met / Asp242 His were related to clinical symptoms. Double heterozygotes for Arg247 Cys / IVS2+1G>C, Ala206 Thr / Pro303 Arg, Leu(-20) Pro / Val252 Met as well as IVS7+7 /Ala294 Val, IVS7+7 /Ala206 Thr, and IVS7+7 / Met298 Ile were asymptomatic. The clinical symptomatology is rather poor in correlation with the FVII activity. Concerning the clinical phanotype, a correlation seems to exist between specific mutations and clinical symptoms.

Factor VII↗
PubMed1999

Sonomorphologic evaluation of goiter in an iodine deficiency area in the Ivory Coast.

OBJECTIVES: This study evaluated the extent of thyroid abnormalities in a remote iodine-deficient area of the Ivory Coast. METHODS: Ultrasonography was used in detecting the presence of goiter. RESULTS: The overall prevalence rates of goiter were 64.7% among females and 53.3% among males. In children aged 6 to 15 years (n = 314), the prevalence of goiter was 62% regardless of sex. Thyroid volume increased steadily with age, with significantly larger goiters in women 25 years and older. Frequency of cysts and calcifications did not correlate with sex. CONCLUSIONS: Especially in developing countries, prophylaxis of iodine deficiency disorders must be improved in iodine-deficient areas to prevent substantial morbidity, which is more severe in women and elderly persons.

Adolescent↗
PubMed1999

Cost saving with ultrasonography in a developing country district hospital.

OBJECTIVE: To estimate the potential monetary reduction induced by the introduction of an ultrasound unit in a major district hospital in a developing country. DESIGN: Propective study. SUBJECTS: Patients referred with abnominal diseases and pregnancy. SETTING: Wad Medani Teaching Hospital, Central Sudan. RESULTS: Local specialists referring the patients stated that an estimated 792 radiologic procedures would have been carried out to obtain the same amount of information as achieved by ultrasound. Such procedures budgeted approximately 8100 US dollars, in terms of equipment, material and personnel by 1987 rates. Such savings have benefited all departments of the hospital. CONCLUSION: The authors consider this as evidence for the fact that despite its initial high investment (15,000 US dollars), availability of ultrasound virtually reduced expenditure on other radiological diagnostic procedures. This is of special benefit for the limited budgets of hospitals in non-industrialised countries.

Capital Expenditures↗
PubMed1998

Reversible diabetes mellitus during growth hormone therapy in chronic renal failure.

A 12-year-old girl with short stature due to idiopathic Fanconi syndrome and chronic renal failure was treated with recombinant human growth hormone (rhGH). There was no family history of diabetes mellitus and the glucose tolerance before treatment was normal. Intravenous glucose tolerance tests were performed before, during and after treatment. Two months after starting rhGH the early phase of insulin secretion (1-+3-min values) was diminished, and the patient developed manifest diabetes mellitus with hyperglycemia and an elevated hemoglobin A1c. Following discontinuation of rhGH, glucose tolerance slowly returned to normal.

Child↗
PubMed1997

Evaluation of a novel immunoglobulin A capture enzyme immunoassay for diagnosis of cytomegalovirus infection in renal and heart transplant recipients.

In a retrospective cohort study of 68 organ transplant patients, the usefulness of a new commercial immunoglobulin A (IgA) antibody capture enzyme immunoassay (EIA) specific to human cytomegalovirus (CMV) for the early diagnosis of CMV disease was investigated. The results were compared with those obtained with the CMV pp65 antigen assay in peripheral blood leukocytes, an IgM immunoblot assay, and six other commercial EIAs. In 21 of 28 patients with CMV disease, the pp65 antigen assay and the immunoblot assay identified patients before the onset of disease more frequently than any other serological test method (17 and 13 patients, respectively; p = 0.0029). In patients at risk for primary CMV infection, the pp65 antigen assay was the only method that identified all patients prior to the onset of CMV disease (p = 0.008). For the other patients who were at risk for CMV infection, the pp65 antigen assay and the immunoblot assay detected infection before CMV disease more frequently than any other test system (p = 0.026). With respect to CMV disease, both immunoblotting and the pp65 antigen assay showed excellent sensitivity (100% and 89%, respectively). However, the specificity of the immunoblot was poor (41%), while the specificity of the pp65 antigen assay was reasonably good (68%). The IgA capture EIA showed moderate sensitivity (61%) and reasonable specificity (76%). In conclusion, the pp65 antigen assay, which detects pp65 antigen in leukocytes, is the method of choice for diagnosis of either primary or recurrent CMV infection. The specificity of the pp65 antigen assay was improved by additional testing for specific IgA and IgM antibodies (95% vs. 68%). The IgA assay is of limited value in renal and heart transplant patients, since it detected IgA antibodies only sporadically, and even then, too late for a timely therapy.

Adult↗
PubMed1997

Urinary tract morbidity due to Schistosoma haematobium infection in Mali.

A total of 824 Malian villagers in a region endemic for Schistosoma (S.) haematobium were examined clinically, parasitologically and by abdominal ultrasound. Systematic schistosomicidal treatment had never been applied to this population. Prevalence of S. haematobium infection ranged from 77% in adolescents to 51% in adults older than 40 years. Intensity of infection was generally mild, 91% of all patients excreting less than 100 ova/10 ml urine. Bladder wall enlargement and irregularities, bladder masses, pseudopolyps and dilation of the upper urinary tract were found ultrasonographically in about one third of infected individuals. Bladder lesions were more frequent in children than in adults and correlated with the intensity of infection in younger age groups only. Hydronephrosis was rare (7 of 824) and never seen in uninfected individuals. Prevalence of urinary tract pathology dropped significantly with age (P < 0.001) and was lowest in patients older than 40 years. Logistical regression identified age and infection as independent parameters affecting the prevalence of urinary tract pathology (P < 0.001). We conclude that Schistosoma haematobium infection causes substantial morbidity in children and younger adults. The reduction of urinary tract morbidity with age despite a considerable prevalence of infection in older age groups suggests spontaneous resolution during adulthood in most cases.

Adolescent↗
PubMed1996

Evidence for genetic control of vaccine-induced antibody responses in cattle.

The purpose of our study was to identify evidence for genetic control of immune responses in cattle. To address this question, we evaluated the variation of antibody responses induced by vaccination with Brucella abortus Strain 19, a live attenuated bacterial vaccine, in large half-sibling families. The data were analyzed using a parametric statistical model that incorporated the effects of sire, bovine major histocompatibility complex (BoLA) types and parameters related to the experimental design. The BoLA types represented a readily identifiable marker, analogous to those known to be associated with genetic control of immune responses in other mammals. Variation between individual animals within our test population was significant but we were able to identify both individual animals and families with high or low antibody production phenotypes. In several cases, these traits were significantly correlated with individual bulls, suggesting the existence of sire effects, or with individual BoLA types. These findings are consistent with the theory that at least two separate genes or genetic systems contribute to the control of bovine antibody responses to B. abortus vaccination. These genetic effects are likely to be analogous to those identified in several species of laboratory rodents and humans.

Animals↗
PubMed1996

Ultrasonographic organometry: liver and spleen dimensions among children in Zimbabwe.

Attempts have been made to develop a staging system of sonographic Schistosoma mansoni morbidity for use in epidemiological studies and for evaluation of control programmes. Therefore, normal dimensions of livers and spleens in children in countries with endemic S. mansoni infections need to be established. Normal dimensions of livers and spleens are presented, based on examination of 144 Zimbabwean children between 8 and 16 years of age found to be S. mansoni egg negative 12 months after treatment with praziquantel. Based on the liver and spleen measurements, an index of liver size and the spleen volume were calculated. Height was employed as the independent variable in all multiple regression models. The organometric data are presented as prediction plots, with observed values and fitted regression line with 95% confidence and prediction intervals. The mean spleen volume was 30% larger for boys than for girls, whereas there was no consistent difference in liver size. No effect of growth Z-scores was seen. The measurements were compared with normal dimensions of livers of German children. For a given height, the mean index of liver size was lower in Zimbabwean than in German children, but inter-observer variation could be a possible explanation for this difference.

Adolescent↗
PubMed1996

Ultrasonographic assessment of Schistosoma mansoni and S haematobium morbidity in Zimbabwean schoolchildren.

Ultrasound examinations for Schistosoma haematobium - and S. mansoni-related morbidity were done in 174 schoolchildren from a subsistence farming community in southern Zimbabwe. The examinations were done according to the standardized protocol elaborated by the Cairo Working Group (the Cairo classification) and the Managil classification. Forty-six percent of the children had grade I periportal thickening (PPT) on ultrasound according to the Cairo classification, but none had grade II or higher. The significance of grade I PPT in the Cairo classification is questionable, since there were no differences between those without and those with grade I PPT with respect to intensity of S. mansoni infection or liver size. The prevalence of grade I PPT according to the Managil classification was 10%, and no association between the two classifications was seen. In multiple regression analysis, S. mansoni egg output was found to be a significant predictor of liver size, when controlling for height and sex. An interaction between S. haematobium and S. mansoni infection is suggested because the positive relationship between S. mansoni and liver size was seen in the presence but not in the absence of S. haematobium infection.

Adolescent↗