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Biomedical subjects

T Kraus

Publications and source records attributed to T Kraus.

At least 109 records · Page 6Linked to original sources
PubMed1995

Soluble thrombomodulin--a marker of reperfusion injury after orthotopic liver transplantation.

Thrombomodulin is an endothelial cell membrane protein that is released into the blood in soluble forms (soluble thrombomodulin [sTM]) in response to endothelial cell damage. We evaluated intraoperative sTM as a marker of reperfusion injury in 29 liver transplant recipients using an ELISA. Preoperative sTM levels were significantly elevated, as compared with healthy control subjects (75 +/- 61 ng/ml vs. 17 +/- 10 ng/ml; P < 0.001) and remain unchanged at the end of the anhepatic phase (58 +/- 40 ng/ml). There is an increase to 194 +/- 182 ng/ml 3 min after reperfusion (P < 0.001). Post-reperfusion sTM levels correlate significantly with the early liver enzyme release (aspartate transaminase) (P < 0.001). Patients with pronounced reperfusion injury (postreperfusion arterial sTM > 138 ng/ml, n = 16) present significantly higher maximum aspartate transaminase levels within the first 24 postoperative hr, as compared with patients with less reperfusion injury (arterial sTM < 138 ng/ml, n = 12) (P = 0.001). Released sTM is derived from the graft, since patients with pronounced reperfusion injury present significantly higher sTM levels in the hepatic vein 3 min after reperfusion compared with the portal vein (P < 0.001) and artery (P = 0.025), respectively. In patients with higher reperfusion injury, we found significantly more adherent intrasinusoidal granulocytes in the liver biopsy taken 1 hr after reperfusion (P = 0.006), indicating an interrelation of endothelial damage and the important phenomenon of "leukocyte sticking" in reperfusion injury. Thus the postreperfusion increase of sTM as a marker of reperfusion injury correlates with the early liver enzyme release and the accumulation of intrasinusoidal granulocytes.

Adolescent↗
PubMed1995

[Asbestos dust-induced laryngeal carcinoma--a new occupational disease? Current scientific knowledge and social health regulations].

According to the current regulations pertaining to occupational diseases lung cancer and mesothelioma can be compensated as asbestos-related malignomas under certain circumstances. For several years there has been controversial discussion as to whether laryngeal carcinomas can also be caused by occupational asbestos exposure and should therefore be added to the list of occupational diseases. Critical evaluation of the available scientific knowledge with the scope of currently applicable regulations does not warrant adding asbestos-related laryngeal carcinomas to the list of occupational diseases at present. Further investigations are urgently necessary and may possibly bring new insights.

Aged↗
PubMed1995

The association of occupational asbestos dust exposure and laryngeal carcinoma.

Controversy exists as to whether occupational asbestos dust exposure is responsible, or at least partially responsible, for the development of laryngeal carcinoma. The aim of this study is to present the current scientific knowledge on this subject based on a comprehensive literature research and to critically review the epidemiological investigations published. The results of 31 cohort studies and 24 case-control studies, and the conclusions in 11 more recent reviews are contradictory. In most studies there was no statistically significant indication of a casual relationship. It is noteworthy that an increased risk of laryngeal carcinoma among persons exposed to asbestos dust was observed mostly in older studies in which smoking habits and/or alcohol consumption as the most important nonoccupational risk factors were usually not taken into account. In addition, since most of the calculated positive associations are very weak, no reliable conclusion can be reached. While there may be a causal relationship between occupational exposure to asbestos dust and the occurrence of laryngeal carcinoma, this cannot be regarded as certain on the basis of the evidence reviewed.

Asbestosis↗
PubMed1995

[Induction of impaired hepatic microcirculation by in situ hilus preparation in liver explantation].

AIM: Usually, in-situ preparation of the hepatic hilar structures is performed prior to the perfusion with preservation solution. Aim of this study was to investigate mechanical effects of liver preparation on the hepatic microcirculation. METHODS: 16 pigs (German landrace) were randomized in two groups. In both groups, laparotomy was performed after intratracheal intubation. Subsequently, a thermal diffusion probe was implanted into the medial left liver lobe for quantification of microperfusion. In group A (n = 8), bile duct, hepatic artery, and portal vein were exposed and the lesser omentum transsected thereafter. Ultrasound-volume-probes were placed around the hepatic artery and portal vein. Simultaneous measurement of hepatic microperfusion and total liver blood flow was performed five minutes after the end of liver preparation. In group B (n = 8) hepatic microperfusion was quantified 45 minutes after laparotomy without further manipulations. RESULTS: By the preparation, liver perfusion was significantly reduced in group A from 78 +/- 13 ml/100g/min to 61 +/- 16 ml/100g/min. After preparation a total liver blood flow of 137 +/- 46 ml/100g/min was recorded indicating a shunt fraction of 51 +/- 21%. In contrast, hepatic microperfusion in group B remained at baseline during the whole observation period (79 +/- 3 ml/100g/min vs. 78 +/- 5 ml/100g/min). CONCLUSION: In-situ liver preparation induces a relevant disturbance of hepatic microcirculation. Preservation perfusion shortly after surgical manipulation could become ineffective because of an increase in shunt flow. If the regeneration period is too short, e.g. lack of heart explantation, the quality of the liver graft could be limited.

Animals↗
PubMed1995

[Individual medical diagnosis in clinical environmental medicine--references for single-case risk analysis].

In the general population there is an increasing tendency to attribute health damage to exposure to hazardous substances in the environment. With the increasing demand for consultation and care there is at present a growing need for doctors specialised in environmental medicine. In the Federal Republic of Germany environmental medicine is represented in particular by environmental hygiene and clinical environmental medicine. Clinical environmental medicine can be characterised as being halfway between care and clinical diagnosis with emphasis on secondary prevention (early recognition of any disturbance of health). The discipline is geared to the individual and this means that the diagnostic strategy and risk evaluation must be considered individually for every case. In addition to scientific facts of environmental toxicology and epidemiology, fundamental medical and pathophysiological knowledge must also come into play. A scientifically founded medical appraisal clarifying possible negative effects on health due to hazardous substances in the environment is presented, based on long-standing experience gathered during consultation work on environmental medical problems at the Institute for Occupational, Social and Environmental Medicine of the University of Erlangen-Nuremberg. Focus is mainly on the effects of chemicals. To evaluate the individual risk, an analytical procedure of many steps is required which includes in particular the collection of anamnestic data specific to the problem, objectifying and quantifying of exposure to hazardous substances and/or specific biological effect reactions, limitation of competing influences and an overall medical assessment of environmental toxicity.

Environmental Exposure↗
PubMed1994

[Localized amyloidosis in the area of the head-neck. A retrospective study].

Localized amyloidosis is a benign rare process in the head and neck. From 1972 to 1992, 12 patients with amyloid deposits of the head and neck were treated at the ENT Department of the University of Erlangen-Nürnberg. Negative congo red staining of rectal biopsy specimens established that the amyloidosis was not systemic. Localized amyloidosis appeared as a diffuse grey-to-yellow mass in the nose (n = 1) or larynx (n = 11). In 10 of the 12 cases excision of amyloid was possible with preservation of adjacent functional structures. Two patients refused surgery and underwent only symptomatic treatment with clinical followup investigations. Amyloid deposits completely excised did not recur during a mean postoperative period of 10 years. When not operated, the amyloid tumors showed a slowly progressive growth pattern.

Adolescent↗
PubMed1993

Biomonitoring of nickel and chromium in human pulmonary tissue.

Nickel (Ni) and chromium (Cr) and some of its compounds may be able to induce cancer in the lungs as well as in the nose and paranasal sinuses after occupational exposure. Latency periods amount to 20 years and more. Therefore objective exposure data are not available in the most cases and expert evaluation of the causal connection is often difficult. Recent investigations have shown, that Ni and Cr can cumulate in human lung tissue after occupational exposure. For the evaluation of "normal" Ni- and Cr-values a total of 495 human lung tissue samples of 30 occupationally non-exposed persons were analysed by AAS including ZEEMAN-compensation after wet oxidative digestion. Additional samples of 10 deceased persons who have been occupationally exposed to nickel in previous times by nickel-refining and welding, especially flame spraying have been investigated. The median Ni- and Cr- concentrations in the lungs of the non-exposed persons ranged between 20-40 resp. 133-277 ng/g (wet weight). In nickel refinery workers Ni- concentrations were found which exceeded the normal range about 1,000. In welders, especially flame sprayers, also values more than 100 times higher could be analysed for Ni and Cr. Partially these concentrations were found years after the end of the inhalative exposure.

Chromium↗
PubMed1993

[Adenocarcinoma of the vermiform appendix].

Primary adenocarcinoma of the appendix vermiformis is very rare. We report on a patient who died with the age of 75 years. On the occasion of an inguinal herniotomia scrotal mucinous metastases were discovered. After appendectomy the diagnosis of primary adenocarcinoma of the appendix vermiformis was ensured. The further course was very unusual. Even though metastases were spread all over the abdominal cavity, the patient survived for further 13 years without therapy. At the postmortem examination there was found a widespread carcinosis of peritoneum and pleura as well as several liver metastases.

Adenocarcinoma, Mucinous↗
PubMed1992

Liver transplantation for acute or chronic liver failure by hepatitis non-A, non-B and hepatitis C viral infections: a postoperative follow-up.

Orthotopic liver transplantation (OLT) was performed for liver failure related to hepatitis non-A, non-B (HNANB) or hepatitis C (HCV) infections in 12 patients. Of those, 8 patients had chronic and 4 acute hepatic failure. To determine the incidence of recurrent infection, the clinical course, histological findings and serological HCV markers (HCV-RNA and detection of anti HCV antibodies, respectively) were comparatively studied in these patients. Recurrent infection was apparent in 5 of 6 patients transplanted for liver cirrhosis attributable to chronic HCV infection and with HCV-RNA detectable in serum. The clinical course of infection after OLT varied considerably. Chronic active hepatitis, progressing to liver cirrhosis 13 months postoperatively and an acute hepatitis, resolving spontaneously were seen in one case each. Recurrent infection led to chronic persistent hepatitis in the remainder. None of the patients with acute liver failure experienced recurrent infection. HCV-RNA was detectable in all the patients after OLT, with HCV-RNA present pretransplant, however the presence of HCV-RNA in serum was not necessarily associated with clinical illness.

Budd-Chiari Syndrome↗
PubMed1992

Progressive changes in CD45RB phenotype and lymphokine production by murine CD4+ T cells after alloantigen exposure.

Changes in CD45R expression correlate with changes in phenotype in mouse, rat and human T cells. It has been shown in mouse that CD45RB high T cells produce mostly interleukin-2 (IL-2) while CD45RB low T cells produce more IL-4 than IL-2 after mitogen stimulation in vitro. CD45RB expression also decreases when T cells are stimulated. In this study we compared responses of CD45RB high and low CD4+ T cells to alloantigens. Although a majority of unstimulated murine T cells from unimmunized mice are CD45RB high, we were able to isolate and purify sufficient numbers of T cells to study their response to alloantigens. When separated cells were stimulated in vitro with alloantigen the CD45RB high T cells became heterogeneous for their expression of CD45RB, indicating that high cells decrease their expression of CD45RB epitopes. Surprisingly, only CD45RB high T cells from unimmunized mice were alloreactive, as measured by proliferation and lymphokine secretion. In contrast, both CD45RB high and low populations from mice primed with allogeneic spleen were responsive to alloantigens. The 'primary' response of T cells from alloantigen-primed mice to third party stimulators is 10-fold greater in the CD45RB high population than in the CD45RB low, as would be predicted by our results in the primary mixed lymphocyte/leucocyte reaction (MLR). Furthermore, the response of CD45RB low T cells from unprimed mice and the response to third party alloantigen from primed mice was reconstituted by the addition of exogenous IL-2. The response of CD45RB low cells from primed mice was specific, as the third party alloresponsive cells were again primarily contained within the CD45RB high population. In the CD45RB high population in the secondary MLR we observed an increase in the production of IL-4 relative to IL-2.

Animals↗