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Biomedical subjects

D Kraus

Publications and source records attributed to D Kraus.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Acute pancreatitis--conservative versus surgical therapy].

Based on own studies and on results of other centers the multiorgan failure (MOF) resp. the systemic inflammatory response syndrome (SIRS) in acute necrotizing pancreatitis seems to be no longer an compelling reason for surgery in the absence of proven infection of pancreatic necrosis. Growing experience of continuous veno-venous hemofiltration (CVVH) facilitates successful conservative treatment of-formerly often lethal-cases of serious necrotizing pancreatitis. If infection of necrosis is documented surgical intervention should be performed. Our present regime of therapy of necrotizing pancreatitis consists in conservative intensive medical treatment, immediately after admission; a pancreas penetrating antibiotic medication starting on admission; early use of continuous veno-venous hemofiltration if MOF or SIRS occurs, surgical intervention, if infection of necrosis is proved. Other indications for surgery are massive bleeding or bowel perforation due to tryptic lesions.

Acute Disease↗
PubMed1997

[Significance of membership in new religious movements for regulation of self concept exemplified by the Hare Krischna movement].

222 members of the Hare-Krishna-Movement were investigated with the Narcissism Inventory by Deneke and Hilgenstock (1989). The results show that life in the Hare-Krishna-Movement makes certain defensive functions possible. The Hare Krishnas seem to reach a stabilization of their self experience through idealizing transferences and overemphasizing their value-system. High scores on the scale derealisation/depersonalisation hint at an ego-weakness of the members.

Adult↗
PubMed1996

Long-term subjective functional outcome of surgery plus postoperative radiotheraphy for advanced stage oral cavity and oropharyngeal carcinoma.

BACKGROUND: Although long-term cures have been achieved for locally advanced squamous cell carcinomas of the head and neck, there is a paucity of information available regarding patients' perspectives of their functional outcome. PATIENTS AND METHODS: Thirty-five long-term survivors free of disease following surgery and postoperative radiotherapy for advanced cancers of the oral cavity and oropharynx were sent questionnaires to evaluate their long-term functional outcome after therapy. The questionnaires included a subjective performance status scale that assessed the patient perceived (1) ability to eat in public, (2) understandability of speech, and (3) normalcy of diet. Twenty-nine of 35 patients participated in this function assessment and are the subjects of this report. RESULTS: The mean function scores for all patients were as follows: 72 for eating in public, 69 for understandability of speech, and 58 for normalcy of diet. Functional results were further analyzed by T stage and anatomic subsite. Inferior results were noted with increasing T stage. A two-way analysis of variance showed that this difference was significant even after adjusting for the effect of anatomic subsite (P = 0.0002, P = 0.018, and P = 0.0018 for the three outcome variables). In addition, patients with base of tongue lesions had a worse functional outcome for both early T state (T1/T2) and advanced T stage (T3/T4) when compared to other subsites. This difference averaged across T stage was statistically significant for understandability of speech (P = 0.0019) and normalcy of diet (P = 0.013), but was not significant for eating in public (P = 0.16). CONCLUSIONS: This performance status scale was found to be a useful tool for functional assessment following definitive therapy for advanced stage head and neck carcinomas. These subjective functional scores deteriorated with increasing T stage. In addition, functional scores for oral tongue, floor of mouth, and tonsillar primaries were superior to those for base of tongue lesions. These functional outcome scores are consistent with the extent of surgery required for the base of tongue subsite and are in direct relation to the patients' T stage in this study population.

Adult↗
PubMed1996

Sulfide may directly modify cytoplasmic hemoglobin deoxygenation in Solemya reidi gills

The clam Solemya reidi, which survives in sulfide-rich sediments, houses intracellular sulfide-oxidizing bacteria as symbionts in its gills. The gill bacteriocytes also contain a high concentration of cytoplasmic hemoglobin. Although the in situ hemoglobin optical spectrum was not altered in the presence of hydrogen sulfide, hemoglobin deoxygenation was significantly slowed and incomplete when sulfide was present. A sulfide-mediated decrease in oxygen consumption rate, a shift in intracellular pH or the conversion of hemoglobin to an unusual derivative could all slow in situ hemoglobin deoxygenation. However, under low sulfide levels at which deoxygenation is incomplete, oxygen consumption rate was not inhibited, intracellular pH decreased by less than 0.1 units and the only hemoglobin derivatives present were deoxyhemoglobin and oxyhemoglobin. These results and preliminary measurements of the isolated gill hemoglobin dissociation rate constants suggest that sulfide or a rapidly formed oxidation product may directly influence the rate of Solemya reidi gill hemoglobin deoxygenation.

Journal Article↗
PubMed1995

A comparison of the gill physiology of two euryhaline crab species, Callinectes sapidus and Callinectes similis: energy production, transport-related enzymes and osmoregulation as a function of acclimation salinity

Callinectes sapidus and C. similis co-occur in estuarine waters above 15 salinity. Callinectes sapidus also inhabits more dilute waters, but C. similis is rarely found below 15 . Previous work suggests that C. sapidus may be a better hyperosmoregulator than C. similis. In this study, energy metabolism and the levels of transport-related enzymes in excised gills were used as indicators of adaptation to low salinity. Oxygen consumption rates and mitochondrial cytochrome content of excised gills increased in both species as acclimation salinity decreased, but to a significantly greater extent in C. similis gills. In addition, C. similis gills showed the same levels of carbonic anhydrase and Na+/K+-ATPase activities and the same degree of enzyme induction during low-salinity adaptation as has been reported for C. sapidus gills. However, hemolymph osmolality and ion concentrations were consistently lower in C. similis at low salinity than in C. sapidus. Therefore, although gills from low-salinity-acclimated C. similis have a higher oxygen consumption rate and more mitochondrial cytochromes than C. sapidus gills and the same level of transport-related enzymes, C. similis cannot homeostatically regulate their hemolymph to the same extent as C. sapidus.

Journal Article↗
PubMed1994

Management of unresectable malignant tumors at the skull base using concomitant chemotherapy and radiotherapy with accelerated fractionation.

Between January 1988 and June 1992, 20 patients with unresectable malignant tumors at the skull base were treated. Eleven had T4 lesions of the paranasal sinus/cavity complex, and 9 had T4 nasopharynx cancer. All patients had stage IV disease by the American Joint Committee on Staging Criteria. The histology was squamous cell cancer in 15 patients and other minor salivary gland histologies in 5. There was brain and/or dural invasion in 11 patients and orbital invasion in 9. All patients received radiation therapy with accelerated fractionation to a total of 70 Gy in 6 weeks. Concomitant cisplatin (100 mg/m(2)) was given on days 1 and 22 of radiation. Seven patients received mitomycin C (7.5 mg/m(2)) on days 1 and 22, plus adjuvant chemotherapy with cisplatin and vinblastine. Median follow-up was 11 (range: 1 to 43) months. At 2 years, local progression-free survival was 94%, distant metastases-free survival was 57%, and overall survival was 80%. Complications occurred in 20% and caused the death of 1 patient. Treatment of this group of patients with aggressive chemotherapy and radiation therapy produced excellent local control in our early experience, but longer follow-up is needed. There is a high rate of distant failure. Future strategies are outlined.

Journal Article↗
PubMed1994

Modifying alcohol-related expectancies in grade-school children.

Expectancies for reinforcement from alcohol appear to form during the grade-school years and play a causal role in problem drinking behavior. Using a sample of 268 second through fourth graders, we investigated whether children's expectancies could be modified successfully. Children were randomly assigned to one of four conditions: two experimental expectancy modification conditions (using 10-minute video interventions), one control condition involving a 10-minute video presenting facts concerning alcohol's deleterious effects, and one no-intervention control condition. Relative to controls, expectancies were increased by one experimental condition and decreased by the other; these changes were sustained at 4-week follow-up. This suggests expectancy modification should be tested as an adjunct to current prevention programs. Relations of gender and family history of problem drinking or alcoholism to expectancy endorsement are described.

Alcohol Drinking↗
PubMed1994

[Changes in therapy of severe acute pancreatitis].

Report about the treatment of necrotizing pancreatitis in the years 1988 until 1991. A rigorous conservative therapy was preferred, so that only 8.6% of the 140 patients underwent surgery. In 11 cases a continuous venous-venous hemofiltration (CVVH) was applied to patients with most serious clinical course and multi-system failure. The overall lethality rate of all treated patients was 7.9%. The present results show, that, eliminating mediators by hemofiltration, system failure in connection with sterile necrosis can be treated with a good success rate. Therefore toxic organ failure should no longer be regarded as an imperative indication for operation. We recommend strict intensive care including CVVH and antibiotical prophylaxis for treatment of sterile necrosis, while surgical therapy should only be applied to patients with bacterial contamination of pancreatic necrosis.

Acute Disease↗
PubMed1993

The management of the clinically positive neck as part of a larynx preservation approach.

PURPOSE: For patients with squamous cell carcinoma of the head and neck with palpable neck node metastases, the standard management of the neck usually involves neck dissection and postoperative neck irradiation. A strategy of larynx preservation with induction chemotherapy and radiation therapy has been utilized for patients with locally advanced resectable cancer of the larynx, hypopharynx, and oropharynx. For patients treated in this non-surgical manner for the primary site, the optimal management of the clinically positive neck has not been clarified. To determine whether response to induction chemotherapy could help to select patients in whom neck dissection could be omitted in favor of definitive radiation therapy alone, we have analyzed our prospective larynx preservation experience. METHOD AND MATERIALS: Between 1983-1989, 80 patients were entered onto larynx preservation protocols involving 1-3 cycles of cisplatin based chemotherapy followed by radiation therapy with or without neck dissection. There were 54 patients with clinically positive necks to treatment, of whom 44% (24/54) had a complete response, and of whom 20% (11/54) had a partial response to chemotherapy in the neck. In 22 of these 35 patients with clinically positive necks who achieved a major neck response to chemotherapy, radiation therapy (median 66 Gy) was used as the only subsequent treatment of the neck. RESULTS: At a median follow-up of 25 months (range 7-83 months), neck control for this subset is 91% (20/22). Neck failure occurred in 20% (1/5) of patients with a partial response to chemotherapy treated without neck dissection and 6% (1/17) of node positive with a complete response. CONCLUSION: These results suggest that patients with clinically palpable cervical nodal metastases who have a complete response to chemotherapy and receive high dose radiation therapy have excellent neck control and may not need neck dissection. Further experience will be required to confirm these preliminary data and to determine if patients who achieve a partial response in the neck after induction chemotherapy can be treated with radiation therapy without neck dissection.

Adult↗