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Biomedical subjects

M Knoke

Publications and source records attributed to M Knoke.

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

Mycological aspects of gastrointestinal microflora.

There are two aspects about the presence of Candida in the human orointestinal tract: (i) it is a part of normal human flora and (ii) it is a risk factor for immunocompromised patients. The orointestinal tract can be considered a reservoir for Candida species, several of which are from the oral cavity, stomach, duodenal juice and faeces. Their germ counts in normal small and large bowel do not exceed 10(4) cfu/ml resp.g. The input of Candida to a well-developed faecal flora system under continuous flow culture conditions did not lead to a multiplication of the yeast. The take in of faecal flora into a Candida continuous flow culture diminish Candida germ counts. If, however, the faecal flora was destroyed, e.g. by antibiotics, we found the yeasts multiplying, with the formation of germ tubes and mycelial structures. Colonization by Candida has to be seen as a starting-point of the development of subsequent candidosis in immunosuppressed or intensive care patients. The best protection against Candida colonization in the gut is the existence of a normal bacterial flora. Lactulose, which promotes the Gram-positive potential of faecal flora, may protect indirectly by supporting the indigenous flora.

Adult↗
PubMed1997

Dynamics of Candida isolations from humans from 1992-1995 in Greifswald, Germany.

In the period 1992-95 there was a significant shift in the spectrum of Candida species in the University Hospital in Greifswald. During this time, the annual number of specimens taken for mycological investigations of adults increased threefold (total n = 11,568). The isolation rate of Candida species was 50.5%. The percentage of C. albicans isolates decreased from 76% to 54.4% with the lowest level in 1994. The opposite trend in the occurrence of non-C. albicans species was seen, for example the occurrence of C. glabrata, from 11.7% to 28.4%. We found only 98 strains of C. parapsilosis (1.4%) during the 4 years. The occurrence of Candida species in a variety of habitats was different. During the 4 years, the same annual percentages of C. albicans (mean 87.9%) were isolated from endoscopic oesophageal smears, whereas the distribution of Candida yeasts from the oral cavity, the respiratory tract, faeces and urine had changed. Over the years, at these locations, C. albicans was less frequently isolated and non-C. albicans species clearly increased. The highest occurrence of C. glabrata was found in urine, in which the isolation percentage almost doubled from 23.1% to 40.9% in 1994. In contrast to adults, in all specimens originating from a paediatric clinic that included neonatology the occurrence of C. albicans was high (83.5% in 1995), but the isolation rate of Candida species was low (12.3%). These results are important because of the differences in yeast susceptibility, of non-C. albicans species in particular, against antifungal drugs.

Adult↗
PubMed1996

[Clinical pictures of orointestinal candidiasis. Fiction or reality?].

The oral cavity and the oesophagus are the main sites of involvement in orointestinal candidosis. The clinical pictures of these manifestations are characterized. Involvement of the stomach as well as the small and large intestine is an exceedingly rare but possible manifestation. There are obviously no repeatedly occurring characteristical symptoms, neither have controlled studies confirmed such characteristics. Recently a discussion has arised-undoubtedly to a large extent influenced by public media-to explain a variety of in particular gastrointestinal symptoms as a consequence of an apparent "mycotic infection of the orointestinal tract" as "a new mass disease". These reports lack any scientific basis supported by experimental or clinical studies. There are similarities to the "candidiasis hypersensitivity syndrome" or "the yeast connection", the existence of which has been critically denied by experts. Corresponding references are given. The author realizes the necessity to oppose this public debate on a critical scientific basis and to answer open questions by controlled studies.

Antifungal Agents↗
PubMed1995

[Growth of Candida albicans in normal and altered fecal flora in the continuous flow culture model].

We used the model of fecal microflora under continuous flow culture (cfc) conditions to study the growth of Candida albicans in mixed cultures. The development of Candida is usually limited by the high germ counts of aerobic and anaerobic bacteria. Neither by the continuous inflow of C. albicans-cfc-monocultures nor by intermittent input of highly concentrated suspensions of C. albicans into the system a growth in fecal flora could be obtained. If the system was run under aerobic conditions a development of C. albicans with few hyphal growth could be observed. After some days however, the fecal flora again suppressed a further development of the yeasts. Only a marked destruction of the aerobic and anaerobic microflora by antibiotics resulted in a growth or overgrowth of Candida albicans.

Anti-Bacterial Agents↗
PubMed1995

[Mycotic complications in patients with chronic liver diseases and pancreatitis].

UNLABELLED: We studied 15 patients with mostly alcoholic liver diseases and 25 patients with acute or chronic pancreatitis with regard to occurrence of yeasts in different microbiological samples and corresponding serological findings. In about a half of the patients with liver diseases yeast counts and serological titres were already raised in the first mycological investigation. Patients with pancreatitis, however, showed only little or negative cultural and serological results. This changed during the course of disease, where they developed significantly higher yeast counts and serotitres. Finally two case reports are presented: two patients with infected pancreatic pseudocysts (including a case of aspergillosis). CONCLUSIONS: in patients with decompensated chronic liver diseases an early search for mycological complications is recommended. In pancreatic diseases these complications are rather seen later in the course of the disease, especially under intensive care conditions. Therefore, we encourage surveillance cultures and control of serotitres in these patients.

Acute Disease↗
PubMed1994

[One hundred years of cryptococcosis. Medical mycology in the 19th century in Greifswald].

Not later than 1842 medico-mycological investigations began at Greifswald in Germany following the appointment of Wilhelm Baum (1799-1883) to the chair of surgery at the university. This is indicated by some theses as well as by the discovery of the contagious characteristics of pityriasis versicolor by Carl Ferdinand Eichstedt (1816-1892) who found a fungus as the cause (1846), which was named Microsporon furfur later (C. Robin 1853). In 1868 the physician (Karl) Friedrich Mosler (1831-1911) published clinical-mycological studies and investigations on animal feeding with yeasts. Some time later (1870) Friedrich Grohé (1830-1886) and his assistants Alwin R. A. Block (1843-?) and M. R. Roth of the Pathological Institute described results of transmission-studies with "Aspergillus glaucus, Penicillium glaucum and yeast". The successor to the chair, Paul Grawitz (1850-1932), also published results of his own mycological investigations. Finally, on 7 July, 1894, during the evening lecture of the Greifswald Medical Society Abraham Buschke (1868-1943) from the Hospital of Surgery gave a talk "on a peculiar disease caused by coccidia" followed by the talk of pathologist Otto Busse (1867-1922) on a "demonstration of a pathogenic coccidia species". Busse's subsequent publications are the first proper descriptions of cryptococcosis (1894 f). Nevertheless, Cryptococcus neoformans has been named in connection with F. Sanfelice, whose results were published later (1895).

Cryptococcosis↗
PubMed1994

[Dimorphism of Candida albicans in the model of continuous flow culture].

We investigated the opportunistic pathogen Candida albicans in a continuous flow culture with regard to particular growth conditions. Germ counts of only 10(7) cfu/ml were obtained in a steady state of an anaerobic culture. In a parallel experiment with aerobic conditions excessive growth occurred and the invasive forms of Candida, i.e. germ tubes and pseudomycelium, also developed. Neither by different carbohydrates and concentration of nutrients in the culture medium nor by changing the flow rate the growth of Candida could be influenced. Excessive overgrowth was triggered by a sufficient oxygen supply.

Aerobiosis↗
PubMed1991

[The significance of Candida antigen detection in internal medicine and surgical patients].

Three different Candida antigen tests were studied in internal-surgical patients: two tests for Candida mannan antigen (C-Mannan-Dresden, Pastorex-Candida and Cand-Tec test for cytoplasmatic antigen. Most positive findings could be seen by both tests for mannan. In cases with increased occurrence of fungi in feces, sputum, urine, and mouth smears the tests differently became negative. Some clinical cases are discussed. With increased positivity of titer courses of all 3 antigen tests the probability of detection of an endomycosis also increased.

Antigens, Fungal↗
PubMed1989

[Achalasia and mycosis].

Report on a massive candidosis of the oesophagus in a 73-year-old woman with achalasia. Discussion of the possible causes and the differential diagnosis of the achalasia. Reference to the mycotic oesophagitis as one complication, apart from many others, of the lesion of the oesophagus.

Aged↗
PubMed1989

[Therapeutic study of the effect of selective decontamination on microbial overgrowth syndrome of the small intestine].

The microbial overgrowth syndrome of the small bowel (MOS) is characterized by clinically found symptoms of increased metabolic activities of microorganisms existing in a great number in the intestinal juice of these patients. We treated 15 patients who suffered from MOS following a modified scheme of selective intestinal decontamination (SID) with oral doses of BerlocombinR (trimethoprim/sulfamerazin) and polymyxin for three weeks. Comparative investigations of duodenal juices before and after treatment showed unchanged high germ-counts (total aerobes and total anaerobes up to 10(7) germs/ml juice). Only the increase of Clostridium (up to 10(6)/ml) was statistically significant which has to be disapproved. In most of the patients there was no subjective improvement. SID in the examined manner is not able to cure a microbial overgrowth in the upper gastrointestinal tract or to reduce facultatively pathogenic microorganisms.

Adult↗
PubMed1987

[Gastrointestinal microecology in internal medicine].

Gastrointestinal microecology is a field with highest integrative pretension. Its clinical actuality is reflected in numerous diseases. Colonization anomalies may become relevant particularly in the case of microbial overgrowth-syndrome. Due to recent experimental results, intestinal microbes are gaining a certain importance with respect of the utilization of hard- or non-absorbable carbohydrates. With regard to a further thinking over the conception of selective decontamination gastrointestinal microecology is challenged, too. Hitherto, the various microbial alterations of drugs and contaminants got little consideration. A microbial participation in the genesis of chronic inflammatory intestinal diseases as well as of carcinoma of the colon becomes subject of discussion, increasingly.

Digestive System↗
PubMed1987

[Whipple's disease, an example of interactions between gastrointestinal flora and the macroorganism?].

Morbus Whipple is known as a systemic disease caused by bacteria and inducing the formation of mucopolysaccharides which is absorbed by macrophages. In a mucosal bioptate of a 60 years old patient suffering from this disease we could prove numerous rod-shaped bacteria (Propionibacterium) by electronmicroscopy. In the duodenal secretion aerobic and strictly anaerobic bacteria were to be found. Therapy with tetracycline was followed by a fast and distinct improvement of the clinical symptoms of the absorption disturbances but not so clear of the histological findings.

Digestive System↗
PubMed1987

[Simulation of intestinal microbial overgrowth by continuous culture].

By the aid of continuous flow culture of microbial populations it is possible to answer specific micro_ecological questions even under anaerobic conditions. We present some findings from a continuous flow model of human duodenal juice with microbial overgrowth. Germ counts and species were reproducible in a steady state over several days. Metabolic activity was very high. For example, this model allows the in vitro study of therapeutic possibilities against overgrowth syndrome, microbial fermentation of food, metabolism of drugs and the growth of microorganisms on surfaces in gastrointestinal tract.

Bacteria↗
PubMed1986

[Microbial pathogenesis of Whipple's disease].

In a case of Whipple's disease with electron microscopic demonstration of rod-shaped bacteria we could isolate Propionibacterium acnes (former name: Corynebacterium anaerobium), Actinomyces, and Lactobacillus from duodenal biopsies by the aid of modern anaerobic culture technique. Simultaneously we found a dysbiosis (increase of anaerobic coca and anaerobes) in du odenal juice. After antibiotic treatment Propionibacterium and Lactobacillus disappeared and an other type of dysbiosis (appearance of Bacteroides) was to be seen. In discussion is a change of immunologic state and following disturbed regulation of microbial colonization in the small bowel of patients with Whipple's disease.

Bacteria↗