Search PubMed⌕ Search

Biomedical subjects

J Forster

Publications and source records attributed to J Forster.

At least 127 records · Page 7Linked to original sources
PubMed1994

Effect of moderate NO2 air pollution on the lung function of children with asthmatic symptoms.

In the course of a 2 1/2-year longitudinal study, the influence of outdoor NO2 and of the heating device at home on lung function was investigated in 467 children of school age in the urban area of Freiburg. Data were gathered in three surveys using standardized interviews, lung function measurements, skin prick tests with inhalant allergens, and NO2 measurements from October to April near the child's home. Regarding the lung function of a subpopulation with asthmatic symptoms (n = 106) in the three consecutive surveys, multivariate regression analyses adjusted for confounders indicate negative associations between five dependent variables, FEV1%FVC (P = 0.004), FEV1% (P = 0.02), MEF75% (P = 0.038), MEF50% (P = 0.052), and MEF25% (P = 0.002), on the one hand, and outdoor NO2 for average NO2 concentrations exceeding 40 micrograms/m3 on the other. The use of individual room heaters is associated with decreased lung function and is significant only for FEV1%FVC (P = 0.033). Neither NO2 nor individual room heating is significantly associated with one of the lung function parameters in the subpopulation without asthmatic symptoms (n = 361). In conclusion, children with asthmatic symptoms are identified as being susceptible to having reduced lung function under outdoor air pollution where average NO2 concentrations exceed 40 micrograms/m3.

Air Pollutants↗
PubMed1994

Eosinophils and eosinophil cationic protein in children with and without sensitization to inhalant allergens.

Eosinophil inflammation is a common feature of allergic disorders and particularly in allergic asthma interest has been paid to related markers. In a community-based survey of 10-year-old children, the association of eosinophil count (EC) and serum eosinophil cationic protein (ECP) with allergic sensitization, clinical history and exposure to mite allergen was studied. Relying on the results of skin prick tests, the children were divided to three groups: (1) children showing no sensitization to one of the seven inhalant allergens (n = 16); (2) children with sensitization to at least one of five non-mite allergens (n = 16); and (3) children with sensitization to mite allergens (n = 75). Clinical history of asthma and hay fever was ascertained using standardized questionnaires. EC in peripheral blood and serum ECP were measured on one single occasion. Prior to blood sampling, mite allergen exposure at home had been assessed by taking dust samples and measuring the mite antigen concentration by means of an enzyme immunoassay. Compared to group 1, higher ECs were obvious in group 2 (P = 0.037) and in group 3 (P = 0.0013). Regarding serum ECP, higher levels occurred in group 2 (P = 0.0033) as well as in group 3 (P = 0.0001) when comparing them to the reference group. Sensitized children with neither asthma, nor asthma-like symptoms, nor hay fever (n = 28) did not have significantly lower ECs and serum ECP levels than those with hay fever (n = 15; P = 0.09, P = 0.17) and those with asthma (n = 22; P = 0.69, P = 0.64).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Mite allergen exposure is a risk for the incidence of specific sensitization.

BACKGROUND: Mite allergen exposure is essential for the process of specific allergic sensitization. However, it is not clear whether incidence of specific sensitization at school age depends on the level of mite antigen exposure. Therefore the relationship between mite allergen exposure and incidence of specific sensitization was investigated. METHODS: Eighteen hundred twelve primary school children were enrolled in a population-based 2-year follow-up study. In three consecutive skin prick tests (SPTs), each 12 months apart, sensitization to Dermatophagoides pteronyssinus (Dpt) and six non-Dpt allergens was ascertained. To assess exposure to Der p I between the first and second SPTs (period I) and the second and third SPTs (period II), the amount of antigen per gram of dust (taken from the children's mattresses was measured. By using the SPT reactions to Dpt as a basis, conversions after "no wheal" were classified as doubtful incidence (average yearly incidence = 6.7%) or definite incidence (average yearly incidence = 3.2%). Then, with the use of multiple logistic regression, the risk of exposure to Der p I (medians: 1.4 micrograms/gm in period I, 1.6 micrograms/gm in period II) was analyzed with adjustment being made for gender, low gestational age, parental atopy, and initial sensitization to non-Dpt allergens. RESULTS: Regarding doubtful incidence, the analysis failed to identify a reliable cutoff point of exposure. For definite incidence, the Der p I exposure represents a significant risk in the total population, starting from a concentration of 9 micrograms/gm. This effect is modified by an initial sensitization to non-Dpt allergens: for these children exposure to concentrations above 2 micrograms/gm poses a significant risk, whereas for the population without other initial sensitizations, only an extremely high cutoff limit (> 80 micrograms/gm) gains significance. CONCLUSION: Our data suggest that a concentration limit of 2 micrograms Der p I antigen per gram of dust should be regarded as minimal avoidance level for primary prevention in children with sensitization to other inhalant allergens.

Animals↗
PubMed1994

New state markers for alcoholism. Comparison of carbohydrate deficient transferrin (CDT) and alcohol mediated (triantennary) transferrin (AMT).

Carbohydrate deficient transferrin (CDTect-RIA, Pharmacia) was compared with an Immunoluminometric assay for isotransferrin separated by a short column Con-A sepharose which we have called alcohol mediated triantennary transferrin (AMT). 101 in-patients with alcohol dependency syndrome (alcohol consumption of more than 60 g/day) were grouped according to the time of abstinence A1 (0-7 days), A2 (8-14 days), A3 (> or = 15 days). Serum samples were obtained at admission (U0) and under abstinent conditions after 10-20 days (U1). All groups were controlled for AMT, CDT, GGT, MCV. Control groups were 30 in-patients with non alcoholic liver disease (NALD) and 31 healthy volunteers (alcohol consumption of less than 20g/day). Results showed for CDT and AMT highly significant differences between short abstinence period (group A1) and more than two weeks abstinence (group A3) alcoholics and between group A1 and healthy controls. In group A1 CDT was significantly elevated (P < or = .001) compared to NALD group whereas AMT showed no differences. CDT (cut off 22 mg/l) showed a high diagnostic specificity (A1/controls 97%, A1/NALD 83%, A1/A3 78%) but only a diagnostic sensitivity of 61%. AMT (cut off 260 mg/l) revealed a diagnostic test sensitivity of 74%. The diagnostic test specificity of AMT was inferior to CDT (A1/controls 74%, A1/NALD 50%, A1/A3 70%). Initial CDT and AMT values in alcoholics were highly correlated (P < or = .001) with time of abstinence. CDT and AMT decline was correlated with time of abstinence. CDT was proved for high significant (P < or = .001) decline over a longer period of abstinence (11-30 days) while AMT decline was significant (P = .008) only in early abstinence (0-10 days). Presence of a withdrawal syndrome was highly correlated (P < or = .01) with CDT values above 22 mg/l and AMT values above 260 mg/l. Furthermore in selected follow up cases it was shown that AMT seemed to be a more sensitive indicator for short alcoholic relapses than CDT.

Adult↗
PubMed1994

The role of pancreatojejunostomy in patients without dilated pancreatic ducts.

OBJECTIVE: To determine the safety and efficacy of longitudinal pancreatojejunostomy in patients with chronic pancreatitis and intractable pain who do not have a markedly dilated pancreatic duct. BACKGROUND: Ductal decompression by side-to-side, longitudinal pancreatojejunostomy has become the operation of choice for patients with chronic pancreatitis and intractable pain when the pancreatic duct is markedly dilated. However, markedly dilated pancreatic ducts are found in less than 40% of patients with disabling pain. PATIENTS AND METHODS: Twenty-eight consecutive patients with intractable pain from chronic pancreatitis, most of whom had minimal or no dilation of the pancreatic duct, were treated with side-to-side, longitudinal pancreatojejunostomy between 1970 and 1993. RESULTS: There were 18 (64%) males and 10 (36%) females. The mean age was 41 years (range 11 to 72). The etiologies for chronic pancreatitis were alcohol (82%), gallstones (7%), trauma (7%), and familial trait (4%). Intractable pain was present for a mean of 4 years (range 0.5 to 12). Thirteen patients (46%) were dependent on narcotics prior to surgery. Twenty-five patients (89%) had minimal (< 8 mm) or no dilation of the pancreatic duct and 3 (11%) had markedly dilated pancreatic ducts (> 10 mm). All experienced complete pain relief in the immediate postoperative period. Twenty-four patients (86%) have remained free of pain after a mean follow-up of 3.5 years (range 1 to 8). CONCLUSIONS: In patients with chronic pancreatitis and intractable pain, small pancreatic duct size should not be considered a contraindication to side-to-side, longitudinal pancreatojejunostomy.

Adolescent↗
PubMed1994

Natural variation in mite antigen density in house dust and relationship to residential factors.

To investigate the year-to-year variation of mite antigen density (Der p I, Der fI) in dust from mattresses and the relevance of residential factors for antigen load, information derived from an epidemiologic study including two surveys carried out in the households of a cohort of elementary school children (n = 1291) was analysed. When considering residences with measurements taken in both years in question (n = 1050), rank-correlation indicated a predominance of stability for both antigens (Der p I: rs = 0.82, P = 0.0001; Der f I: rs = 0.72, P = 0.0001). Using multiple regression analyses, significant associations between antigen concentrations and a variety of residential factors were found. Use of a blanket of animal hair, use of a cover or underblanket, wet spots in the bedroom, higher relative humidity and a low storey level were significantly associated with increased concentrations of Der p I, whereas inverse relationships between this antigen and room temperature, number of persons per m2 as well as use of underfloor heating were seen. Regarding Der fI, older mattresses, use of a cover or underblanket, higher weight of sampled dust, high educational level and higher ratio of inhabitants per m2 were significantly associated with increased concentrations of the antigen. On the other hand, lower Der fI concentrations were found when interior sprung mattresses were used and when the mattress was 'treated regularly'. In conclusion, two measurements, 1 year apart from each other, show that stability of mite antigen concentrations predominated.(ABSTRACT TRUNCATED AT 250 WORDS)

Allergens↗
PubMed1994

The role of transjugular intrahepatic portosystemic shunts in the management of patients with end-stage liver disease.

BACKGROUND: Transjugular intrahepatic portosystemic shunt (TIPS) has been reported to successfully treat complications of portal hypertension; however, not all reports have been favorable. METHODS: Forty patients underwent 41 attempts to place a TIPS. All patients but 1 had a Wallstent placed. RESULTS: Thirty-nine procedures (95%) were successful. Thirty-one patients were treated for gastrointestinal bleeding, and 9 for refractory ascites. The average fall in portal pressure was 13.7 +/- 0.9 mm Hg. Major postprocedure complications included 4 deaths. Minor problems included liver capsular perforation, fever, self-limited bleeding, and a pseudoaneurysm. Follow-up evaluation revealed that by 5 months, 50% of the shunts developed a portal-venous-to-right-atrial pressure gradient requiring balloon dilatation or a new stent. The 1-year actuarial patient survival was 72%. Eighteen patients were candidates for orthotopic liver transplantation (OLT) and 5 have been transplanted. CONCLUSIONS: TIPS may be best used for stabilization, prior to OLT or as a temporizing measure prior to elective shunt surgery.

Actuarial Analysis↗
PubMed1993

PC-based system for an objective quantification of manual movement disability for clinical and scientific purposes.

In clinical management and research of movement disorders exact knowledge about the extent of motor impairment is essential. This paper presents a computer program which allows for an objective measurement of manual movement disability. The program was developed for standard hardware and can easily be used in a variety of clinical and research environments. The program runs on MS-DOS computers and uses a Microsoft computer mouse as the only input device. The temporal resolution is 100 Hz, the spatial resolution 400 dots per inch. The user may choose between standard test sets or he may design sets according to his individual needs from a pool of available protocols which includes tracking tasks, ballistic tasks, complex sequential tasks, and finger tapping. All tasks are implemented in a similar way in order to keep the test environment as consistent as possible for the patient. The patient must usually carry out movements which correspond to the movements of a target symbol on the computer screen. This entails the manipulation of a follower symbol, also visible on the computer screen, via the computer mouse. The program itself and the theoretical background of the protocols are described in the paper. Additionally, preliminary results from pilot experiments are presented.

Computer Simulation↗
PubMed1993

Improving resectability and survival in patients with primary duodenal carcinoma.

Of 35 patients with primary duodenal carcinoma (PDC), 13 were treated between 1960 and 1974 (group I) and 22 between 1975 and 1990 (group II). PDCs were found in the first 5 portions of the duodenum (14%), second 18 (51%), third 8 (23%), and fourth 4 (12%). Five patients (38%) in group I were deemed to have unresectable disease compared with only one patient (5%) in group II. Eight patients (62%) in group I underwent resection by either pancreatoduodenectomy (4) or segmental resection (4), and 20 patients (95%) in group II had pancreatoduodenectomy (17) or segmental resection (3). Operative mortality was 31% in group I and 0% in group II. Mean survival was 7 months (range: 0 to 22 months) in group I and 48 months (range: 6 to 218 months) in group II. None of the patients in group I survived for 2 years, whereas the 5-year survival for patients in group II was 62%. This experience suggests that resectability, operative mortality, and survival in patients with PDCs have improved markedly in recent years.

Adenocarcinoma↗
PubMed1993

Sensitization to four common inhalant allergens within 302 nuclear families.

The coincidence of allergic sensitization was investigated in 302 school-aged children and their parents. Specific sensitization to four common inhalant allergens (grass and birch pollens, cat dander, Dermatophagoides pteronyssinus) was ascertained by means of skin-prick tests (SPT) carried out on the complete family unit at the beginning of a 22-month follow-up period. The same test procedure was then repeated on the children twice at 11-month intervals to provide cumulative prevalences of sensitization. A clinical history of atopy in the children (hay fever or asthma; n = 47), which was derived from an interview, is associated with sensitization (positive SPT in 89%). For three allergens (grass and birch pollens, cat dander) sensitization occurs significantly more frequently in the children of mothers who are sensitized to the same allergen (odds-ratios (ORs), 2.5-4.1). Additionally, in three of the four explanatory models related to a single antigen, maternal sensitization to one of the complementary allergens is of importance (ORs, 2.7-3.7). In contrast to this finding, none of the paternal sensitizations has statistical significance. Based on a reaction to at least one of the four allergens, the child's relative risk to be sensitized is increased in case of maternal (OR, 2.88; P = 0.001) but not of paternal (OR, 1.06; P = 0.83) sensitization. In conclusion, our data indicate that the maternal status is more predictive than that of the father with regard to the child's risk of sensitization.

Administration, Inhalation↗
PubMed1993

Atopic family history. Validation of instruments in a multicenter cohort study.

In order to identify newborns at risk for atopic diseases, we developed a family questionnaire and selected specific answers which were suitable to identify atopic family members. The validity of the questionnaire was evaluated by the Phadiatop test results of 793 mothers and 353 fathers. As both screening instruments do not measure the same, the Phadiatop test identifies sensitization to inhalant allergens and the history reflects the clinical manifestation of atopic disease, the agreement between sensitization and manifestation is incomplete. Sensitivity and specificity of the questionnaire screening conditions to reproduce the Phadiotop test result was 64% and 84% for mothers, and 58% and 88% for fathers, respectively. The relative risk for lifetime prevalence of atopic manifestations in Phadiatop positive over negative mothers was calculated to be 3.88 (95% confidence interval = 3.12 to 4.81), and for Phadiatop positive over negative fathers to amount 4.84 (95% confidence interval 3.25 to 7.23). A few relevant answers of 20 were identified by logistic regression analysis to predict the Phadiatop test result nearly, as well as the total questionnaire.

Adult↗
PubMed1993

Relation between response to exercise and diurnal variability of peak expiratory flow in primary school children.

BACKGROUND: Variability in peak expiratory flow (PEF) has been proposed as a simple method of screening for asthma in epidemiological studies. This study was designed to assess whether the bronchial response to exercise and the diurnal variation in PEF identified the same subjects. METHODS: Bronchial response to a free running exercise test was assessed in a cohort of 918 seven year old children and was compared with variability of PEF as assessed by twice daily recordings for a one week period. Mini Wright peak flow meters were used throughout the study. RESULTS: Baseline PEFs of both tests were highly correlated but there was no significant correlation between a response to exercise and variability of PEF. Of 33 children with a physician's diagnosis of asthma, 18 had at least one abnormal test, but only five children were abnormal in both tests, showing that the tests did not identify the same subjects. CONCLUSION: Increased variability of PEF, as well as a response to exercise, was associated with respiratory symptoms, but only a response to exercise was closely associated with atopy (defined as a positive skin test to any of seven aero-allergens).

Asthma↗
PubMed1993

Ambient ozone causes upper airways inflammation in children.

Ozone constitutes a major air pollutant in Western Europe. During the summer national air quality standards are frequently exceeded, which justifies concern about the health effects of ozone at ambient concentrations. We studied upper airways inflammation after ozone exposure in 44 children by repeated nasal lavages from May to October 1991. During this time period five to eight lavages were performed for each child. On 14 days following high ozone exposure (daily maximum > or = 180 micrograms/m3) 148 nasal lavages were performed, and on 10 days following low ozone exposure (daily maximum < or = 140 micrograms/m3) 106 nasal lavages were performed. A significant increase of intra-individual mean polymorphonuclear leukocytes (PMN) counts from low ozone days (median, 20.27 x 10(3)) to high ozone days (median, 27.38 x 10(3); p < 0.01) was observed. Concomitant with a decrease of ozone concentrations in the fall mean PMN counts showed a downward trend. Linear regression analysis of log-PMN counts yielded a significant effect for ozone (p = 0.017). In a subsample humoral markers of inflammation were measured for each child's highest and lowest exposure. A significant increase was observed for eosinophilic cationic protein (median, 77.39 micrograms/L on low ozone days versus 138.6 micrograms/L on high ozone days; p < 0.05). Thus we conclude that ozone at ambient concentrations initiates a reversible inflammatory response of the upper airways in normal children.

Air Pollutants↗