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Biomedical subjects

J Kruse

Publications and source records attributed to J Kruse.

At least 55 records · Page 3Linked to original sources
PubMed1993

[Value of nuclear medicine procedures in evaluating the hemodynamics in physical medicine and cardiac rehabilitation].

This is a report on the application and importance of nuclear-medical procedures in physical therapy and rehabilitation. In particular, attention is focused on the parameters of peripheric haemodynamics (T1/2 and -A) and of the left ventricular ejection fraction. The authors aim at demonstrating their own results gained during the last 10 years in different groups of patients suffering from cardiovascular diseases at rest and under load. The results are critically estimated, including the relevant literature, and conclusions are drawn for clinical practice.

Adult↗
PubMed1992

[Potential use of the sauna in the long-term treatment of hypertensive cardiovascular circulation disorders--a comparison with kinesiotherapy].

The authors report about the long-term response (one and three years) of blood pressure and heart frequency under rest and load (50 W) in patients with hypertension, coronary heart disease, essential hypertension and after aortocoronary venous-bypass operation (ACVB) (n = 65) under regular visits (twice a week) to the Finnish sauna. In comparison, 68 hypertensive patients who took a regular kinesiotherapy (running and swimming) were studied. Besides the parameters of heart circulation mentioned above, peripheric microcirculation (M. tibialis anterior) by means of xenon-133 muscle clearance and central hemodynamics by means of LVEF (single probe with In 113) were studied in CHD-patients. Cardiac output at rest and under 50 W load was recorded in hypertensive patients. It was shown that regular balneotherapy had a positive effect on regulation of blood pressure and hemodynamics in patients with hypertension or CHD with hypertension, as had kinesiotherapy in hypertensive patients.

Adult↗
PubMed1992

[Negative cortisone attitude in patients with bronchial asthma].

Patients with bronchial asthma often exhibit irrational fears of cortisone medication beyond justified worries about side-effects. A negative cortisone image, which means overemphasizing the damaging and threatening aspects of cortisone, often underlies non-compliant illness behaviour. In the present study, cortisone image was investigated in 54 patients with bronchial asthma before and after participation in the Düsseldorf Asthma treatment and teaching programme (ATTP) and one year later. By participating in ATTP, a significant reduction of the negative cortisone image and thus a more realistic view of cortisone could be achieved in most patients. This effect was also evident at the follow-up examination one year later. On the other hand, persistence of a negative cortisone image in a subgroup of patients turned out to be a potent predictor of later non-compliant illness behaviour. Psychological implications of a persistent negative cortisone image are discussed.

Adult↗
PubMed1992

[Affective-cognitive coping with attacks and illness behavior in patients with bronchial asthma].

The purpose of this study was to investigate attack-related cognitive coping styles in 80 patients with bronchial asthma and to relate them to outcome parameters of illness behaviour. All patients had participated in a 5-day-lasting asthma treatment and teaching programme (ATTP). Outcome variables to be predicted were: The number of days in hospital due to asthma during the year following the training programme and the patients' adherence to the recommendations of the programme one year later. Independent predictor variables were: pre-training attack frequency, hospitalization due to asthma, medication intensity, pulmonary function, asthma symptom anxiety, trait anxiety and attack-related cognitive coping styles. Multiple regression analyses show the importance of a "minimizing/self-confident" coping style in predicting days in hospital, while a "diverting" style predicts best a poor management of attacks in patients on oral steroids.

Adaptation, Psychological↗
PubMed1992

Behavioral science education in family medicine: a survey of behavioral science educators and family physicians.

A mailed questionnaire was used to provide a profile of behavioral science educators in family practice residency programs, to examine some aspects of behavioral science curriculum development, and to compare the attitudes of behavioral science educators and family physicians regarding the proper level of involvement of family physicians in a variety of psychosocial problems. The study populations consisted of all 383 behavioral science coordinators of US family practice programs and a national sample of 400 residency-trained family physicians. Eighty percent of the behavioral science educators were familiar with the Core Competency Objectives in Behavioral Science Education, published by the Society of Teachers of Family Medicine, and 61% had used this document to aid in curriculum development. Both behavioral science educators and family physicians perceived that the training provided in the areas of physician-patient relationships, family awareness, and personal and professional relationships was quite effective. The physicians felt significantly less effectively trained in the areas of biopsychosocial assessment and management. A high level of concordance was found between the responses of physicians and educators regarding the appropriate level of involvement of family physicians in various psychosocial problems. One exception between the two groups involved the problems of family and social functioning, for which family physicians advocated a more active level of involvement than did behavioral science educators.

Adult↗
PubMed1991

Aortocoronary vascular prosthesis made of siliconized homologous vein or bovine sacral artery.

The purpose of our study was to develop and prepare aortocoronary prostheses, test them experimentally in multivascular and coronary reoperations in case of missing autologous grafts and to use them for shunt operations in cardiac surgery. Human vein or bovine sacral artery were used for preparing aortocoronary prostheses. As for metrics of 9-14 Charr. and a length of 20-30 cm were obtained. Aortocoronary prostheses were preformed according to the coronary configuration for left descending artery, circumflex artery and right coronary artery. Aortocoronary prostheses meet the conditions of desantigenicity, sterility, athrombogenicity, tightness and high tensile strength, tear propagation strength, bursting pressure and shrinkage temperature. Experimental testing was performed in dogs in aortofemoral and aortocoronary positions. Infections did not occur. The healing process and structural changes of aortocoronary vascular prostheses (grafts) were examined histologically and evaluated by means of scanning electron microscopic examinations. Athrombogenicity and healing-in without inflammation and calcification were proved.

Animals↗
PubMed1991

[Early childhood violent and sexual traumatization].

Violent and sexual child abuse represents an extreme traumatization that can continue to influence the lives of affected children into adulthood. Freud (1917) provided a concept of the influence of this extreme form of traumatization in his model of the traumatic neurosis. It is described as an after-the-fact attempt to master the flood of sensations that characterizes the trauma. More recent theoretical models identify a collapse of the ego during trauma as well as the effects of this collapse on the formation of self and object representants at the heart of the traumatic event. As a result of the collapse of the ego during trauma, the traumatized individual does not succeed in forming mature memories of the experience. Immature memories of trauma are marked by, among other things, very diffuse, near physical feelings that cannot be integrated into the ego (Cohen 1980). From the perspective of object relation theories, the lack of integration of "bad" and "good" self of the traumatized individual is emphasized by the abuser. Drawing on case studies, the authors illuminate the importance of the principle of the answer (Heigl-Evers/Heigl 1979, 1983) to the efforts to differentiate and integrate in the treatment of extremely traumatized patients.

Adolescent↗
PubMed1990

[Significance of echocardiography for the diagnosis and strategy in infectious endocarditis].

The echocardiographic results of 29 patients--clinically suspected of infective endocarditis--were compared with clinical, intraoperative, histologic, autoptic data and the available outcome of cardiac catheterization. The purpose of this retrospective study was to define the potential valence of echocardiography for planning of therapy and success. Valvular vegetations of different histological ages were established on 35 valves. The sensitivity was 96.3%, the specificity 100% considering this topic. Following visual assessed sonographical intensity of such vegetations echographical floridity was postulated. In 26 vegetations the sensitivity--considering this floridity statement--was 92% and the specificity 86% compared with the results of histology and intraoperative assessment. The type of pathogens and the time interval between beginning of the clinical symptomatic and the echocardiographic procedure were important for the prognosis in this study. In the case of longer latency time prevailed bivalvular vegetations (n = 6) combined with a high mortality. No patient died in the case of univalvular vegetations. The whole group had a mortality of 17.2%. Considering these results using echocardiographic methods an exact identification of vegetations (infective and noninfective) and additional a quantification of subsequent valvular damaging and actual ventricular function is possible. A qualified sonographical technique permits an earlier diagnosis of bacterial endocarditis (especially in the absence of bacteriaemia) and in the followings a more opportune indication for prosthetic valve replacement.

Adult↗
PubMed1990

J1/tenascin is a repulsive substrate for central nervous system neurons.

J1/tenascin mediates neuron-astrocyte interactions in vitro and is transiently expressed during CNS development in vivo. It is detectable in discrete zones, for example on astrocytes delineating "barrels" in the rodent somatosensory cortex. To investigate the effects of J1/tenascin on neural cell behavior in vitro, we have generated two monoclonal antibodies specific for protein epitopes on J1/tenascin and used them for immunoaffinity isolation of the molecule from postnatal mouse brain. The purified ECM molecule alone did not support attachment and growth of cerebral astrocytes or E14 mesencephalic, E18 hippocampal, and P6 cerebellar neurons. When various ECM constituents were adsorbed to polyornithine-conditioned glass, a favorable substrate for neural cells, the neurons avoided J1/tenascin-, but not laminin- or fibronectin-coated surfaces, while they grew on J1/tenascin-free, polyornithine-containing areas of the coverslip. In contrast, astrocytes formed uniform monolayers on all of these substrates. We conclude that J1/tenascin could serve to define repulsive territories for CNS neurons from different stages of neural development.

Animals↗
PubMed1990

Binding of the J1 adhesion molecules to extracellular matrix constituents.

The J1 glycoproteins can be obtained in multiple forms in the soluble fraction of developing and adult mouse brain tissue. They are recovered as two forms of apparent molecular weights of 160,000 and 180,000 (J1-160) from adult mouse brain and as forms of apparent molecular weights of 200,000 and 220,000 (J1-220) from developing brain. J1-160 and J1-220 share common epitopes but are considered as separate entities, with J1-220 being immunochemically closely related if not identical to tenascin. Based on the observation that J1 immunoreactivity appears on basement membrane and interstitial collagens after denervation of the neuromuscular junction in adult rodents, we became interested in investigating the binding properties of J1 glycoproteins to extracellular matrix constituents in vitro. Both J1-160 and J1-220 bound to collagens type I-VI and IX but not to laminin, fibronectin, bovine serum albumin, or gelatin under hypotonic buffer conditions. Under isotonic buffer conditions, J1-220 bound to all collagen types, whereas J1-160 bound only to collagen types V and VI with values that could be examined by Scatchard analysis. Binding of J1-220 to collagens displayed two binding constants (KD) between 1.5 and 4.4 X 10(-9) and 1.8 and 5.5 X 10(-8) M, respectively, under hypotonic buffer conditions and a single KD of 2.1-8.0 X 10(-8) M under isotonic buffer conditions. Binding of J1-160 to collagens had an apparent KD of 1.9-8.0 X 10(-9) M under hypotonic buffer conditions. Under isotonic buffer conditions, binding constants of J1-160 to collagen types V and VI were approximately 2 X 10(-8) M. Binding of J1-220 to collagen type I could be inhibited by J1-220, J1-160, and collagen type VI but not by fibronectin or gelatin. Conversely, binding of J1-160 was inhibited by J1-220, J1-160, and collagen type VI (in order of decreasing efficacy of competition). J1-160 and J1-220 were retained on a heparin-agarose column and eluted in a salt gradient at approximately 0.5 M NaCl. The formation of the J1-heparin complexes was inhibited 100-fold more efficiently by heparin than by chondroitin sulfate. These experiments show that J1 glycoproteins resemble in many respects the extracellular matrix constituents fibronectin, laminin, vitronectin, and von Willebrand factor.

Animals↗
PubMed1990

Withdrawal from maternity care. A comparison of family physicians in Ontario, Canada, and the United States.

To determine the relative importance of factors influencing the withdrawal of family physicians from maternity care, two studies, one done in Ontario, Canada, and the other done in the United States, were compared. The proportion of residency-trained family physicians who provide maternity care at the initiation of their careers and the proportion who have given up maternity care are nearly identical in the United States and Canada. Both studies found that about one half of the family physicians who currently provide maternity care were giving consideration to stopping. The reasons underlying this withdrawal were multifactorial. Malpractice issues were the predominant concern of United States family physicians, but the data from the studies indicate that other issues, such as interference with lifestyle and office practice and the effect of attitudes of obstetricians, should not be overlooked.

Adult↗
PubMed1990

[Nosocomial infections and sternum osteomyelitis].

A prospective study of the nosocomial infection rate in the Department of Cardiac Surgery of the Surgical Clinic (Charité) was done between January and December 1987. The investigation was performed computer aided. Data were recorded by an infection register. From 474 hospitalized operated patients 66 (14%) had some kind of nosocomial infection: at the first place wound infections with 5.1% (sternum osteomyelitis 2.1%), respiratory infections with 3.8% and infections of the urogenital system with 3.4%. The way of infection, selected predisposing and exposing factors, the microbacterial spectrum of wound infection, the antimicrobacterial chemotherapeutic strategy and surgical therapy are analyzed and demonstrated.

Bacteria↗
PubMed1990

Melanoma metastatic to the gastrointestinal tract.

Melanoma is increasing in incidence. An often-unsuspected complication is metastasis to the gastrointestinal tract, which leads to bowel obstruction or intussusception. The most common symptoms in patients with gastrointestinal metastasis are vomiting, abdominal pain and abdominal distention. Metastatic disease should be suspected in any patient with gastrointestinal symptoms and a history of cutaneous melanoma.

Female↗
PubMed1989

Phototherapy for seasonal major depressive disorder: effectiveness of bright light of high or low intensity.

Eleven females and five males with fall/winter seasonal affective disorder were randomly assigned to 7-day treatment regimens from 8 p.m. to 10 p.m. using identical light at 2000 or 300 lux. A modified Hamilton Rating Scale for Depression and a Beck Depression Inventory were administered before treatment, after treatment # 7, and 2 weeks after phototherapy was terminated. Analysis of variance with repeated measures revealed a significant interaction between sex of the patient, intensity of the lights, and day of rating for scores on both the modified Hamilton Rating Scale for Depression and the Beck Depression Inventory. For both measures, the interaction occurred because all groups showed a decrease in depression ratings during the phototherapy exposure period, but only females at the higher intensity continued to have low depression scores 2 weeks after light treatment had stopped. These data indicate that bright light at both high (2000 lux) and low (300 lux) intensities is able to reduce depression in patients with seasonal affective disorder. The data also indicate that both sex of the patient and intensity of the light may interact to determine the latency to relapse.

Adult↗
PubMed1989

Factors influencing changes in obstetric care provided by family physicians: a national study.

In an effort to determine the factors underlying changes in obstetric practice by family physicians, a random sample of 505 residency-trained family physicians was surveyed by mailed questionnaire. Of the 329 who responded, 65% had at some time practiced obstetrics, but only 45% were practicing obstetrics at the time of the survey. Rising malpractice insurance premiums and fear of lawsuit were factors most likely to influence a family physician's decision to cease obstetric practice. Lifestyle concerns and the number of obstetricians practicing in the area were also important factors for all family physicians. Important differences were found between family physicians who never delivered babies and those who had at some time practiced obstetrics. Family physicians who have given up obstetric practice were found to feel well trained and competent in this practice. Since changes in obstetric practice patterns have had an adverse effect on the obstetric care of women in rural areas and for the medically indigent, these findings have important public health implications.

Attitude of Health Personnel↗
PubMed1988

The high-molecular-weight J1 glycoproteins are immunochemically related to tenascin.

The J1 glycoproteins have been shown to mediate neuron-astrocyte adhesion and appear in the nervous system as four species of Mr 160,000 (J1-160), 180,000 (J1-180), 200,000 (J1-200), and 220,000 (J1-220), respectively. Tenascin is a disulfide-linked oligomeric, extracellular matrix glycoprotein of subunit Mr 170,000, 190,000, 200,000, and 220,000, which has been proposed to promote epithelial cell proliferation. In view of the structural similarities of the molecules we have used immunohistochemical and immunochemical techniques to compare them. Immunohistochemically, polyclonal J1 and tenascin antibodies yielded identical staining patterns in non-nervous-system tissues, and staining could be completely blocked by preincubating the sera with purified tenascin. In the central nervous system all structures expressing tenascin immunoreactivity were also recognized by J1 antibodies. However, not all J1-positive structures were also tenascin-positive, indicating that J1 antibodies recognized additional epitopes not present on tenascin. Western-blot experiments performed with affinity-purified polyclonal J1 antibodies showed that J1 glycoproteins can be subdivided into two separate pairs, J1-160/180 and J1-200/220, which share a small degree of homology. Western-blot experiments and sequential immunoprecipitations on biosynthetically [35S]methionine- or 125I-radiolabeled J1 glycoproteins carried out with polyclonal J1 and tenascin antibodies demonstrated that J1-200/220 is immunochemically indistinguishable from tenascin. These observations suggest that one set of extracellular glycoproteins is associated with processes as different as neural histogenesis and carcinogenesis of mammary glands.

Animals↗
PubMed1988

[Use of walking and sauna therapy in the rehabilitation of hypertensive patients with ischemic heart disease following aortocoronary venous bypass operation with special reference to hemodynamics].

Rehabilitation results are reported concerning the behavior of blood pressure and heart rate, peripheral and central hemodynamics, after resting and during exercise and physical conditioning by running as training and sauna, respectively, in hypertensive patients with IHD after aortocoronary venous bypass (ACVB) surgery. Bicycle ergometric examinations an xenon wash-out (for the determination of the mean functional vessel cross section A) were performed in 43 male untrained patients before and after physical therapy. The left ventricular ejection fraction (EF) at rest was also determined in these patients. Significant increases in the ejection fraction at rest (on average by 7-8%) could be demonstrated in both therapy groups. The group average value for peripheral microcirculation improved only in the sauna group. Blood pressure after resting and on exercise was not influenced. Results are discussed on the basis of the literature and practical conclusions drawn.

Adult↗