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Biomedical subjects

H Kruse

Publications and source records attributed to H Kruse.

At least 37 records · Page 2Linked to original sources

Occurrence of shigatoxinogenic Escherichia coli O157 in Norwegian cattle herds.

To investigate if there is a reservoir of Escherichia coli O157 in Norwegian cattle, faecal samples from 197 cattle herds were screened for E. coli O157 by the use of immunomagnetic separation (IMS) and PCR during the 1995 grazing season. Six E. coli O157:H-isolates were detected in two herds, one isolate in one and five in the other. The isolates carried the stx1, stx2, and eae genes, and a 90 MDa virulence plasmid. They were toxinogenic in a Vero cell assay. From 57 other herds, 137 faecal samples were positive for stx1 and/or stx2 genes detected by PCR run directly on IMS-isolated material. Among these samples, stx2 were the most widely distributed toxin encoding genes. No difference was found among milking cows and heifers in the rate of stx1 and/or stx2 in positive samples.

Animals↗

Transmission of VanA-type vancomycin-resistant enterococci and vanA resistance elements between chicken and humans at avoparcin-exposed farms.

The genetical relatedness between epidemiologically linked fecal VRE strains from poultry farmers (n = 5) and their broilers (n = 7) at five avoparcin-exposed Norwegian farms was examined. Pulsed-field gel electrophoresis (PFGE) of bacterial chromosomal digests and structural analysis of vanA resistance elements was performed. Animal and human Enterococcus faecium strains at one farm were genetically closely related with indistinguishable vanA elements and a single band position difference in PFGE analysis. Examination of the vanA elements in genetically unrelated strains by restriction enzyme digestion of Tn1546 long-PCR amplicons and ORF2-vanR intergenic sequencing revealed a pool of at least two distinct vanA gene cluster groups in the two reservoirs. The results indicate that transmission of VanA glycopeptide resistance in enterococci between human and animal at avoparcin-exposed farms can occur by direct transfer of VRE strains as well as horizontal spread of resistance genes between strains.

Animals↗

The pattern of organochlorines in mussels Mytilus edulis L. from the south west Baltic Sea.

The concentration of organochlorines (PCB, DDT and its metabolites, HCH isomers and HCB) were determined in mussel, Mytilus edulis, from the south west Baltic Sea. The harbor Kiel Innenförde showed the highest contamination with PCB (487 microg/kg dry weight), the Gelting bathing beach area the lowest contamination (38 microg/kg). The highest contamination with DDT was measured in Lübeck bay, which may be explained by the long term application of DDT in the former German Democratic Republic. Penta- and hexa-chlorinated PCB were selectively accumulated in Mytilus edulis whereas highly lipophilic PCB with more than seven chlorine atoms were found in negligible concentrations. The accumulation of these compounds in mussels is determined by equilibrium partitioning with ambient water.

Animals↗

The antimicrobial susceptibility of Staphylococcus species isolated from canine dermatitis.

In a retrospective study, 1538 strains of beta-haemolysin-producing Staphylococcus species isolated from dermatitis in dogs at three veterinary clinical microbiology laboratories in Norway during 1986-87 and 1993-94 were investigated for their antimicrobial susceptibility. None of the strains was resistant to cloxacillin, cephalexin or the quinolones enrofloxacin and ciprofloxacin. More than 96% of the strains were susceptible to trimethoprim-sulphonamide, bacitracin and fucidic acid. Between 67% and 89% of the strains were susceptible to erythromycin, lincosamides, tetracycline, neomycin and chloramphenicol. Only 37.9% of the strains were susceptible to penicillin. The frequency of penicillin resistance increased significantly between the first and second periods, from 46.0% to 58.6%. The frequency of resistance to lincomycin, clindamycin and erythromycin also increased significantly between the first and second periods, from 3.0%, 2.1% and 3.3% to 25.5%, 19.5% and 24.8%, respectively. A moderate increase in resistance to tetracycline was also noted, from 20.4% in the first to 27.6% in the second period. On the other hand, the frequency of resistance to trimethoprim-sulphonamide decreased significantly from 4.1% in the first to 0.9% in the second period. Many different resistance patterns were observed in each period. However, the proportion of multiresistant strains increased from 2.1% in the first to 10.2% in the second period. There was a decrease in resistance to the combination of trimethoprim-sulphonamide and penicillin from the first to the second period. Resistance to the combination of lincosamides and penicillin increased. For the combinations penicillin-tetracycline-lincosamides, penicillin-lincosamides-erythromycin, and penicillin-tetracycline-lincosamides-erythromycin, there was a striking increase in resistance between the first and the second periods.

Animals↗

Keratokyphosis in rabbits: a functional and morphologic study.

Keratokyphosis, a "nonfreeze keratomileusis" procedure, was applied in rabbits. The refractive changes were -6.5 +/- 0.7 (SD), -9.5 +/- 2.6, and -13.0 +/- 3.2 D for convex applanation surfaces with a vertex of +100 microns, +125 microns, and +150 microns in the microkeratome and +1.5 +/- 2.0 and +2.5 +/- 2.6 D for concave applanation surfaces with a vertex of -100 microns and -125 microns. The pachymetric corneal changes were +43 +/- 24 microns, +39 +/- 32 microns, and +71 +/- 24 microns for the convex applanation surfaces and -21 +/- 40 microns and -17 +/- 24 microns for the concave. Wound healing was uncomplicated. The scar at the interface was 0-5 microns wide. The mean central density of nerve endings was 1,255 +/- 532/mm2. The endothelial cell size was 25.1% (p < 0.01) greater as measured by specular microscopy than by vital preparation technique; this difference was greater with higher (33.4%) than with lower (18.02%) corneal refraction (p = 0.02). In addition, there was a method-independent correlation (correlation coefficient, -0.63) between endothelial cell count and corneal thickness. This may indicate an increased demand on corneal endothelium in thickened corneas.

Animals↗

A transferable multiple drug resistance plasmid from Vibrio cholerae O1.

Ten multiple antimicrobial-resistant isolates of Vibrio cholerae O1 isolated from patients in Uganda were characterized, and the transferability of resistance to bacteria of diverse origins was investigated. The isolates were toxigenic and belonged to biotype E1 Tor, serotype Ogawa, and ribotype 8, and possessed a 130-MDa plasmid of incompatibility group 6-C. This plasmid, designated pRVC1, was shown to confer resistance to trimethoprim (mediated by a dhfrI gene), sulfonamides (a suII gene), tetracycline [a tet(C) gene], chloramphenicol (a catI gene), ampicillin (a beta-lactamase gene other than blaTEM or blaSHV), and streptomycin. pRVC1 proved to be transmissible at frequencies between 1 x 10(-1) and 5 x 10(-6) transconjugants per recipient to a variety of bacterial pathogens, including those of humans, animals, and fish. Most efficient transfer was observed from V. cholerae to strains of Shigella flexneri, Escherichia coli, Vibrio parahaemolyticus, and three Aeromonas species. The present in vitro study suggests that pRVC1 may spread from V. cholerae to other bacteria pathogenic to man, animals, and fish in natural environments.

Animals↗

[Regional distribution of stomach and colon cancer mortality in the Dithmarschen and Nordfriesland districts--cartographic presentation].

In two counties (Dithmarschen and Nordfriesland) of the Federal State of Schleswig-Holstein (in the northern part of Germany) the cancer mortality rates, especially those of stomach and colon cancer, were evaluated for the time period 1980-1991. For this purpose the corresponding death certificates collected in these counties were analysed. The counties were subdivided into 16 and 17 smaller areas, respectively. The age-adjusted mortality rates were calculated and the obtained data scaled into eight sections, which were graphically mapped over the smaller areas of the two counties. The frequency of these cancer mortality rates reflects a wide range of distribution pattern in the smaller areas of the two counties, which greatly differ from the cancer mortality values calculated for the two counties as a whole. In comparison with the frequency of stomach cancer mortality for men published in the German Cancer Atlas in 1984 it could be demonstrated that this cancer mortality further decreased in these counties. However, in some smaller areas of these counties, especially in rural areas, the mortality rates of stomach cancer in men were still rather high. The opposite seems to be reflected regarding the frequency of colon cancer mortality. Here higher frequencies of mortality were seen in the small cities of these counties. We suggest that a more subtile cancer mortality mapping can be performed easily without any risk of hurting the requirements of personal data securities, because cancer mortality data are already continuously evaluated by a trained staff at the offices of statistical affairs. These data may be transferred and used for cancer mortality mapping as described in the present paper. In order to guarantee that there will be no violation of personal data secrecy the cancer mortality mapping must be restricted to cancer sites with high frequencies of mortality. All published data should be supervised by an official with special knowledge of the requirements of personal data protection. This study underlines the necessity for higher resolution (smaller areas) in cancer registries as essential prerequisite for systematical exploration of the origins of cancer mortality and as a basis for preventive measures.

Colonic Neoplasms↗

[Public health risk caused by emissions from refuse incinerators].

An irresponsible "approval on request" in favour of waste incineration written by a consulting committee of the German Federal Board of Physicians has meanwhile been widely distributed both nationally and internationally. The aim of this politically motivated paper is to dramatically increase the present number of 49 waste incinerators in Germany. It is our duty to warn of this intention. Health problems are known to exist both in workers at waste incinerators and in humans living in their vicinity. Furthermore, in the long run negative impact also to ecosystems should be expected from the emissions. Health problems in patients living downwind of waste incinerators repeatedly have been reported on by physicians. "Lack of statistical significance", often used as counter-argument, is only due to absence of funding of comprehensive epidemiological studies in Germany. Analyses of soil samples reveal the pollution from waste incineration. Considering the pre-load of the region, additional emissions caused by waste incineration and other sources have to be assessed. The application of preventive limit values is imperative. The presently used "limit values", being about 100 times too high, bear an unacceptable risk. Therefore, reliable regional registers of emissions have to be established immediately. Limit values continuously have to be adjusted to the progress of scientific knowledge. In this respect it is imperative to consider that the actual composition of emissions is unknown; isolated risk assessment of single compounds underestimates the total risk; the negative impact, e.g. of dioxins, on both the immune and hormone systems occurs at concentrations 100 times lower than those causing carcinogenic effects; the assumption of "threshold values" is obsolete; a considerable lack of knowledge exists about accumulation in food webs and in ecosystems; the demand of preservation of natural, geogenic situations is indispensable in assessments of soil and water pollution. Essential prerequisites for risk assessments of emissions from waste incineration are 1. actual, continual and comprehensive qualitative and quantitative analytical knowledge of the composition of emissions; 2. region-specific meteorologic dispersion models of the emissions; 3. evaluation of the complex mixtures in emissions for their kinetics in and toxicity for ecosystems and humans. Neither of these demands is so far fulfilled. Facing these problems, the present propagation of waste incineration must be stopped. As an alternative, efforts to optimize waste-avoiding and recycling concepts considerably have to be reinforced, and low-risk procedures, like compost and other decomposing methods, hydrogenation or freeze-griding of plastics, have to be widely promoted.

Air Pollution↗

[Toxic substances with silicone oil after intraocular injections].

In articles about the analysis of intraocular silicone oil, mostly the amount and toxicity of low-molecular-weight components (LMWC) have been investigated. This study was intended to analyze the components of silicone oil following a longer intraocular application. We analyzed silicone oil removed from human eyes with PVR a few months postoperatively. The fraction of LMWC was further investigated and we separated 16 different components belonging to hexachlorhexanes (HCH), polybiphenyls (PCB) and dichlor-diphenyl-trichlorethane (DDT). All these substances are said to have a toxic and cancerogenic effect as well as weakening the immune system. The concentration of these organic chloride components measured in intraocular injected silicone oil is about the same as fatty tissue but exceeds the concentration in human blood enormously. Possible damage to the retina by these toxic substances is another reason for early removal of silicone oil if the situation of the retina is stable.

Adolescent↗

Leflunomide therapy following penetrating keratoplasty in the rat.

BACKGROUND: The isoxal derivative, leflunomide (LF), is a new potent immunosuppressive which has been shown to be effective in preventing autoimmune disorders and reactions leading to organ transplantation rejection. LF is thought to antagonise cytokine activity and thereby to interfere with T-helper-cell-dependent B- and T-lymphocyte proliferation. METHODS: We used LF to treat corneal allograft rejection in the rat, comparing its effect with that of cyclosporin A (CSA). Corneal buttons were grafted from Lewis/Brown Norway rats to Lewis recipients. Animals were randomly assigned to the following treatment groups: I, untreated; II, CSA (10 mg/kg i.m.); III, LF (2.5 mg/kg p.o.); IV, LF (5 mg/kg p.o.); V, LF (10 mg/kg p.o.); VI, combined therapy (LF 10 mg/kg p.o. and CSA 10 mg/kg i.m). Treatment began on the first postoperative day and was continued until rejection occurred. RESULTS: The mean graft rejection time in the untreated allogeneic group was 12 days. A significant delay in graft rejection was observed in all treatment groups compared with group I (P < 0.001). Further, the delay in graft rejection resulting from combined therapy (group VI) was statistically significant compared with all other groups (P < 0.001). CONCLUSION: These results suggest that (a) LF when used alone is as effective as CSA in treating corneal allograft rejection in the rat, and (b) when LF and CSA are combined they are more effective than either drug alone in the prolongation of allograft survival.

Administration, Oral↗

Transfer of multiple drug resistance plasmids between bacteria of diverse origins in natural microenvironments.

Plasmids harboring multiple antimicrobial-resistance determinants (R plasmids) were transferred in simulated natural microenvironments from various bacterial pathogens of human, animal, or fish origin to susceptible strains isolated from a different ecological niche. R plasmids in a strain of the human pathogen Vibrio cholerae O1 E1 Tor and a bovine Escherichia coli strain were conjugated to a susceptible strain of the fish pathogenic bacterium Aeromonas salmonicida subsp. salmonicida in marine water. Conjugations of R plasmids between a resistant bovine pathogenic E. coli strain and a susceptible E. coli strain of human origin were performed on a hand towel contaminated with milk from a cow with mastitis. A similar conjugation event between a resistant porcine pathogenic E. coli strain of human origin was studied in minced meat on a cutting board. Conjugation of R plasmids between a resistant strain of the fish pathogenic bacterium A. salmonicida subsp. salmonicida and a susceptible E. coli strain of human origin was performed in raw salmon on a cutting board. R plasmids in a strain of A. salmonicida subsp. salmonicida and a human pathogenic E. coli strain were conjugated to a susceptible porcine E. coli strain in porcine feces. Transfer of the different R plasmids was confirmed by plasmid profile analyses and determination of the resistance pattern of the transconjugants. The different R plasmids were transferred equally well under simulated natural conditions and under controlled laboratory conditions, with median conjugation frequencies ranging from 3 x 10(-6) to 8 x 10(-3). The present study demonstrates that conjugation and transfer of R plasmids is a phenomenon that belongs to the environment and can occur between bacterial strains of human, animal, and fish origins that are unrelated either evolutionarily or ecologically even in the absence of antibiotics. Consequently, the contamination of the environment with bacterial pathogens resistant to antimicrobial agents is a real threat not only as a source of disease but also as a source from which R plasmids can easily spread to other pathogens of diverse origins.

Aeromonas↗

Mechanical methods in refractive corneal surgery.

Keratorefractive surgery has developed rapidly over the past decade. For patients with aphakia, however, posterior chamber lenses are safer and more predictable than refractive corneal surgery; myopia is the greatest challenge to this type of surgery. No technique as yet has an accuracy that is adequate for the general treatment of myopia. Keratotomy is the most common procedure currently performed for the correction of mild myopia and astigmatism. Results are less accurate and less stable with myopic than with aphakic epikeratoplasty. Although it is technically more difficult, keratomileusis seems to be more predictable than epikeratophakia. Nonfreeze lamellar corneal surgery accelerates wound healing. Synthetic lenses and ring-shaped implants are also being developed to modify corneal refraction. Current research is directed toward laser stromal keratomileusis on discs that are removed from the cornea using a microkeratome.

Corneal Stroma↗

Organochlorine pesticides, octachlorostyrene, and mercury in the blood of Elb River residents, Germany.

Blood samples of 135 residents living near the estuary of the Elb River (Schleswig-Holstein, Germany) were analyzed for organochlorines (e.g., beta-hexachlorocyclohexane (HCH) (less than 0.5-22.9 ng/ml), benzene hexachloride (HCB) (0.8-55.2 ng/ml), DDE (less than 0.5-29.2 ng/ml) and for mercury (Hg, n = 44) (1.1-79.2 ng/ml). It was the first time that octachlorostyrene (OCS) (n.d.-9.2 ng/ml) could be detected in Germans. The pollutants were determined by means of capillary gas chromatography and atomic absorption spectroscopy, respectively. Covariance analysis and log-linear models revealed correlation between increasing age and blood concentrations of HCB, beta-HCH, DDE and OCS, between relative body weight and HCB or DDE, between locality and all pollutants analyzed, and, finally, between fish consumption and OCS and Hg. Regarding the influence of locality on the body burden of pollutants it may be assumed that additional routes of uptake, e.g., via drinking water or air, might be important.

Age Factors↗

Effects of heat shock on neuroblastoma (N1E 115) cell proliferation and differentiation.

Heat shock (44 degrees C) applied for only 15 min induced the development of neurites in neuroblastoma cells 3-6 days later. During the first day after heat shock a transient increase in the rate of cytokinesis together with a synchronizing effect was observed, which led to waves of cytokinesis 14.5 h apart. Individual cell cycles were determined and showed a lengthening in the minimal cell cycle duration and a decrease in the cell cycle variance after shock. Two to 3 days after heat shock the proliferation rate decreased and then recovered. During the 6 days after heat shock, total protein synthesis was lower compared to the untreated cultures. The synthesis of heat shock proteins (100, 90, 84, 70, 68 kDa and some of lower MW) reached a maximum 6 h after heat shock. Parallel changes in the phosphorylation state of proteins were observed in an in vitro assay. Four proteins (100, 89, 67, and 15 kDa) increased and two proteins (97, 73 kDa) decreased their phosphorylation state significantly. Six days after heat shock two proteins (89, 55 kDa) increased their phosphorylation state; the 55-kDa phosphoprotein was identified as tubulin. The effect of heat shock on the intracellular calcium level was determined by measuring Fura 2 fluorescence. Six hours after shock, the Ca2+ level increased to a maximum (about three times the control value) and then dropped during the following days below the control values. We conclude from these results that a decrease in the calcium level may be causally involved in the differentiation process. The calcium effect is probably mediated by changes in the activity of different kinases. This assumption is compatible with the results of experiments with cyclic nucleotides when 10(-5) M cAMP and cGMP were added to in vitro assays of protein phosphorylation. They had different stimulating effects in heat-shocked, differentiating, and growing (control) cells.

Animals↗

Multiresistant Shigella species from African AIDS patients: antibacterial resistance patterns and application of the E-test for determination of minimum inhibitory concentration.

The antibacterial resistance pattern and minimum inhibitory concentrations (MIC) of 25 Shigella flexneri, 5 S. boydii, 8 S. sonnei, and 3 strains of S. dysenteriae type 2 isolated from Kenyan prostitutes with bacillary dysentery and AIDS were determined, and the applicability of the E-test for MIC determination evaluated. All strains were resistant to > or = 3 of 9 different antibacterial agents tested. All strains were resistant to tetracycline and erythromycin, 95% to trimethoprim/sulfonamide, 93% to streptomycin, 54% to ampicillin, 39% to chloramphenicol, 2% to nalidixic acid and none to gentamicin and ciprofloxacin. Six different resistance patterns were observed. The most common pattern was resistance to tetracycline, erythromycin, trimethoprim/sulfa and streptomycin (39%). The E-test was shown to be well-suited for susceptibility testing of multiresistant Shigella spp.; the reproducibility was excellent and the correlation with the microtiter dilution method and the disk diffusion method were 98% in both instances. The MIC measured with E-test and the microdilution method were within +/- 1 dilution step for 94.4% of the combinations tested.

Acquired Immunodeficiency Syndrome↗

Administering non-restricted medications in hospital: the implications and cost of using two nurses.

In an effort to improve patient safety, some hospitals require that two nurses rather than one administer all medications. Such a policy has not been subjected to an economic evaluation. The authors conducted a cross-over study comparing error rates when medication was administered by two nurses as against a single nurse. During a 46 week study period, 319 errors were detected among 129,234 medications administered in a geriatric assessment and rehabilitation unit, giving an overall error rate of 2.5 per 1000 medications. The vast majority of errors detected were relatively minor and had no serious adverse consequences. The error rate per 1000 medications administered by a single nurse was 2.98 (95% CI: 2.45-3.51) and was statistically significantly higher than 2.12 (95% CI: 1.69-2.55) per 1000 for two nurses. A time and motion study indicated that when two nurses rather than one administered medication an additional 17.1 h of nursing time was required per 1000 medications administered. The authors conclude that the use of two nurses to administer medication does statistically significantly reduce the medication error rate, but the clinical advantages are dubious and in our view such a policy cannot be recommended.

Economics, Nursing↗