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Biomedical subjects

K Klein

Publications and source records attributed to K Klein.

At least 73 records · Page 4Linked to original sources
PubMed1992

Effect of instructions on isokinetic trunk strength testing variability, reliability, absolute value, and predictive validity.

Although isokinetic strength testing has been in use for more than two decades, and numerous studies have addressed isokinetic performance of the lumbar spine, the effect of instructions on isokinetic trunk strength has not been studied. In a sample of 30 healthy women, this study examined the effect of "high-demand" instructions on lumbar strength performance. High-demand instructions were found to have a substantial positive effect on performance variability, reliability, absolute magnitude, and validity. Under these conditions, isokinetic trunk strength was found to be predictive of performance in a frequent lifting-lowering task.

Adult↗
PubMed1992

Patient education programmes in obstructive airway disease. The Ingelheim Model for promoting health through patient education.

Chronic obstructive airway diseases (COAD) can be regarded as one of the major health problems needing environmental actions and screening programs for early detection and intensive patient education programs to cope with the needs of tertiary prevention. On the basis of our epidemiological study focused on COAD carried out in FRG (sample size August 1988: 63,000 participants) a patient education program has been developed and evaluated. In cooperation with general practitioners and pneumologists the program has been installed at practice and community level. The need for a patient education program has been assessed during the three years of the PNEUMOBIL-Project. It is not just a matter of cutting costs, but to a large extent a matter of the wellbeing of the patients and of reducing side effects to a minimum. The objective of the project can be split into three dimensions: (1) The cognitive aspect. Here significant lack of knowledge has to be overcome. At this point it has to be stated clearly that at the present time the medical community is not able to solve this problem on their own. (2) The psychomotoric aspect. Here the competent use of medication has to be trained. (3) The emotional aspect. The patient has to be motivated and integrated into the therapeutic process in a way that his compliance contributes significantly. The didactical concept consists of modules that can be used in varying sequences according to the needs of the target audience.(ABSTRACT TRUNCATED AT 250 WORDS)

Airway Obstruction↗
PubMed1992

[Reproducibility of bone density measurements of the distal radius using a high resolution special scanner for peripheral quantitative computed tomography (Single Energy PQCT)].

Reliable determination of bone loss in the skeletal system depends on the accuracy of bone mineral density (BMD) measurements. We investigated short-term and long-term accuracy in vitro and in vivo using a new, commercially available special-purpose computed tomography scanner (Single Energy Peripheral QCT: XCT 900, Stratec FRG) for BMD measurements. Using a phantom, the long-term accuracy (3 months) in vitro yielded a coefficient of variation (cv) of 0.18%. Repeated measurements in 37 patients showed excellent reproducibility, with a cv of 0.71%. The differentiation into groups of low, average and high trabecular bone density demonstrated values of 0.61%, 0.59% and 0.98%, respectively for cv. BMD determination with pQCT is a high-precision method. It seems to be suitable for detection of trabecular bone loss in the range of the annual decrease in bone mass, provided the forearm is positioned with maximum care.

Bone Density↗
PubMed1991

Glutathione levels during thermal induction of the yeast-to-mycelial transition in Candida albicans.

Glutathione (GSH) levels were directly monitored by reverse phase HPLC during the thermal yeast-to-mycelial induction of Candida albicans. The GSH levels decreased approximately 100-fold within 120 min which corresponded to the time of maximal yeast-to-mold conversion. The yeast to mold conversion was inhibited by 1-p-chlorophenyl-4,4-dimethyl-5-diethylamino-1-penten-3-one (CDDP), a thiol-specific alkylator, which prevented the decline in GSH levels. These results are discussed with respect to the potential involvement of intracellular GSH levels in regulation of the yeast-to-mold dimorphism in Candida albicans.

Candida albicans↗
PubMed1990

Differential gene expression of IFN-alpha and tumor necrosis factor-alpha in peripheral blood mononuclear cells from patients with AIDS related complex and AIDS.

Human PBMC from HIV-1-infected individuals produced ex vivo in response to vesicular stomatitis virus only low amounts of IFN-alpha. This impairment was significant as early as Walter Reed (WR) stage 2; at WR stage 4-5, the production was almost zero. At WR stage 2 of infection, IFN-alpha mRNA was exclusively found in association with polyribosomes, indicating that IFN-alpha gene was transcriptionally inactive under the experimental conditions used. A similar decrease of the level of transcripts as a function of the progression of the disease was also observed for the IFN-gamma mRNA. In contrast, TNF-alpha production was strongly enhanced in PBMC from HIV-1-infected individuals after stimulation with LPS compared to the TNF-alpha production of activated PBMC from healthy donors. Almost parallel with the increase of the level of the transcript for TNF-alpha, the level of TNF-beta increases as well. Data are presented which show that the increased TNF-alpha production is due to a longer half-life of TNF-alpha transcripts in PBMC from infected individuals. These results let us suggest that the up-regulation of TNF-alpha gene expression in PBMC from HIV-infected individuals is controlled predominantly on the posttranscriptional level, whereas transcriptional events regulate the level of IFN-alpha transcripts. This assumption is supported by run-on experiments which revealed that the extent of transcription of TNF-alpha gene is almost identical in nuclei from stimulated PBMC of noninfected and HIV-infected donors, whereas the transcription of IFN-alpha gene is strongly suppressed in nuclei from HIV-infected individuals at WR stages 3 and 6.

AIDS-Related Complex↗
PubMed1990

Preserved recognition of familiar personal names in global aphasia.

Recognition of proper and common nouns was compared in four patients diagnosed with global aphasia secondary to ischemic left-hemisphere infarction. For proper noun recognition, subjects matched the spoken or written name of a famous person to a photograph, and for common nouns, subjects were tested on standardized and special word recognition tests. As expected, common noun recognition was severely compromised in the aphasic patients. In contrast, familiar personal names, despite their greater length and complexity, were recognized equally well by aphasic and normal control subjects. The right hemisphere may mediate the ability to recognize personally familiar names, as it may be specialized for establishing personally relevant environmental stimuli.

Aged↗
PubMed1990

Do instructions modify effects of beta-adrenoceptor blockade on anxiety?

To study the interaction between physiological and cognitive factors in anxiety, 44 subjects with public speaking anxiety were allocated to four different groups. Two groups received either beta-adrenoceptor blockade (100 mg of atenolol) or placebo orthogonally crossed with an instruction that heart rate would decrease or an instruction that did not mention cardiovascular effects. During the delivery of a speech, measures of heart rate, systolic and diastolic blood pressures, and self-reported anxiety were obtained. All variables increased during an anticipation period before speech, and heart rate, systolic blood pressure, and self-reported anxiety increased further during speech. Regardless of instructions, atenolol decreased heart rate and systolic blood pressure during both anticipation and speech, whereas no differences were found in self-reported anxiety. This lack of a relationship was seen in spite of the correctly perceived heart rate reduction in the atenolol-treated group receiving an instruction that heart rate would decrease. Cardiac aware subjects, according to the Autonomic Perception Questionnaire, showed higher levels of heart rate and self-reported anxiety at rest than did cardiac unaware subjects. During speech, even though heart rate was similar in atenolol treated groups, self-reported anxiety was higher in cardiac aware than in cardiac unaware subjects. The lack of a relationship between heart rate and self-reported anxiety is discussed in terms of primary and secondary emotions. It is suggested that the perception of external rather than internal cues determines situationally elicited anxiety.

Adult↗
PubMed1990

Decision strategies in neuropsychology II: determination of age effects on neuropsychological performance.

The relationship of age to neuropsychological test performance was explored on the subtests comprising the Halstead-Reitan Battery and allied tests. Performance of 192 pseudo-neurologic control patients across 10-year age intervals from 16 to 65 was analyzed. The findings indicate a strong age-performance effect on spatial and more complex integrative tests with peak performance between 25 to 35 years of age and a decline thereafter. A lack of significant decline was noted on sensory, motor, and language tasks. The findings reveal that there is a curvilinear change in performance as a function of age and were discussed with regard to the obvious need to modify decision strategies to account for the age of the patient.

Journal Article↗
PubMed1989

Phase II trial of a new biological response modifier (ImuVert) in advanced prostate cancer.

ImuVert, a new biological response modifier of bacterial origin, was evaluated in a Phase II trial of patients with metastatic prostate cancer. Sixteen patients with hormone refractory measurable or evaluable disease were treated with ImuVert 1.0 mg subcutaneously once weekly for 5 weeks. After a 1 week rest period, the dose was escalated to 3.0 mg weekly for 5 additional weeks. Eleven patients received the full 10 weeks of therapy. Toxicity consisted of mild transient flu-like symptoms as well as the development of tenderness and induration at injection sites. No patient responded to treatment. ImuVert at this dose and schedule is inactive in advanced prostate cancer.

Aged↗
PubMed1989

Effects of acute alcohol ingestion on the left ventricular performance of normal subjects before and after incomplete autonomic blockade.

The effects of acute alcohol ingestion on the left ventricular performance of nine normal subjects, mean age 25 years, were studied before and after incomplete autonomic blockade, produced by atropine, 0.04 mg/kg body weight, and propranolol, 0.2 mg/kg body weight. Left ventricular (LV) function curves (stroke volume vs. end-diastolic volume) were plotted from data generated before and after large variations in cardiac preload. Increase in preload was produced by five degrees of head-down tilt for 90 minutes; decrease in preload was produced by graduated lower body negative pressure to -40 mmHg. After incomplete autonomic blockade, the negative inotropic effects of acute alcohol ingestion were minimal but significant and manifest by the reduction in mean velocity of circumferential fiber shortening (p less than 0.05). Studies during wide variations in preload confirmed the importance of maintaining central blood volume after alcohol ingestion. Lower body negative pressure after both incomplete autonomic blockade and alcohol produced a further deterioration in mean velocity of circumferential fiber shortening (p less than 0.05).

Adult↗
PubMed1989

[The value of sonography in salivary gland tumors].

In a prospective study, 178 patients with tumours of the salivary glands were examined both clinically and by ultrasound. All patients have since been operated upon, and the diagnosis was confirmed histologically. The diagnostic accuracy of clinical examination is compared with that of ultrasound. Every tumour of the salivary glands could be diagnosed by ultrasound. In the benign group, an exact diagnosis of the tumour type was possible in 83% of cases. In the malignant group an exact diagnosis was only possible in 57% of cases. Furthermore, it is possible with ultrasound to recognise multiple and bilateral tumours, to determine whether a tumour is intra- or extraglandular, and to show the nature of the tumour (cyst, abscess, central necrosis) to a much greater extent than with clinical examination alone. In addition, a fairly good assessment of the cervical and intraglandular lymph nodes is obtained. We believe that ultrasound is of great importance in the diagnosis of tumours of the salivary glands.

Adenolymphoma↗
PubMed1988

Inhibitors of collagenase IV and cell adhesion reduce the invasive activity of malignant tumour cells.

The invasive activities of some malignant cells appear to be activated by contact with laminin. This protein occurs solely in basement membranes and the binding of malignant cells to the surface of this extracellular matrix initiates the invasion process. Passage of the cells across basement membrane requires degradative activity and laminin induces the production of collagenase IV which lyses the collagen IV network. The motility of the cells is enhanced by chemo-attractants and by matrix molecules. Peptides that inhibit the binding of tumour cells to laminin, inhibitors of collagenase IV, and inhibitors of specific pathways of arachidonic acid metabolism prevent invasion as well as the metastasis of malignant cells and could be employed to stop the spread of cancer.

Animals↗
PubMed1987

Adolescents' compliance with the use of oral contraceptives.

To elucidate the factors that might influence compliance with oral contraceptive use among sexually active adolescents, we undertook a study of 209 unmarried adolescents initiating use of oral contraceptives in three different settings: an inner-city adolescent clinic, a birth control clinic in a midsized industrial city, and a suburban private practice. At the three-month follow-up visit, factors associated with compliance included older age, suburban residence, white race, health care in the suburban private practice, payment status, prior use of contraception, mother's unawareness of oral contraceptives, married parents, older boyfriend, lack of worry about being pregnant, and satisfaction with pill use. Compliance at long-term follow-up (13.5 +/- 3.7 months) was additionally associated with educational goals, father's education level, and absence of side effects. Ten pregnancies occurred during the study period among noncompliant site I patients. Inner-city clinic patients were at high risk of noncompliance and unplanned pregnancy.

Adolescent↗
PubMed1986

Pace variation and control of work pace as related to cardiovascular, neuroendocrine, and subjective responses.

Two studies of paced and self-paced arithmetic performance are reported. Heart rate and blood pressure were recorded and ratings of subjective arousal obtained. In one of the studies, plasma levels of catecholamines and cortisol were determined. Under externally paced experimental conditions pace variation was found to be quantitatively related to changes in systolic and diastolic blood pressure, as well as to ratings of stress and irritation. This was not the case for heart rate or positively evaluated aspects of subjective arousal. Performance was better and ratings of stress and irritation were lower during self-paced than during paced work at a comparable work pace. In one of the studies the diastolic blood pressure increased less when subjects controlled the pace. Plasma catecholamines did not increase significantly during either externally or self-paced work, but adrenaline tended to increase during paced work. Our findings give partial support to the suggestion that personal control may attenuate sympathoadrenal activation and cardiovascular reactivity.

Adrenal Glands↗
PubMed1986

Depression and hemispheric site of cerebral vascular accident.

In order to investigate the possible role of left and right hemisphere neural structures in the manifestation of depression, 50 left brain damaged and 50 right brain damaged stroke inpatients were administered the Zung Depression Scale (ZD S) during the course of the rehabilitation phase of their treatment. These subjects were randomly chosen from all stroke patients receiving rehabilitation services who could be administered the ZDS. Approximately 30% of these subjects, regardless of the site of lesion, were clinically depressed. The severity of depression was independent of demographic factors and time since injury. Right brain damaged patients reported significantly more sleep disturbance, psychomotor agitation and pervasive sense of sadness. These results were discussed in light of previous findings that damaged to the left hemisphere results in greater depression. A model of reactive depression that results from neurological disability was proposed to partially account for these findings.

Journal Article↗
PubMed1986

Personal control over work pace--circulatory, neuroendocrine and subjective responses in borderline hypertension.

Cardiovascular and neuroendocrine reactivity during arithmetic task performance were studied in 24 patients with borderline hypertension and normotensive controls. Personal control (self-paced versus externally paced performance) resulted in an attenuated blood pressure (BP) response to task performance in normotensives but not in borderline hypertensives. In response to self-paced work, systolic blood blood pressure (SBP) reactivity was significantly greater in borderline hypertensives, but the heart rate (HR) reactivity was similar in borderline hypertensives and normotensives under the different pacing conditions. Task difficulty (pace variation during external pacing) did not differentially affect reactivity in borderline hypertensives and normotensives. Venous plasma noradrenaline and adrenaline were unaffected by task performance. At rest after the task performance plasma noradrenaline was elevated in both normotensives and borderline hypertensives. The latter group also showed a persistent elevation of diastolic blood pressure after task performance, suggesting a prolonged vasoconstrictor response. The present findings indicate that, in terms of circulatory responses, borderline hypertensives may profit less than normotensives from personal control over environmental demands.

Adult↗