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Biomedical subjects

U Krause

Publications and source records attributed to U Krause.

At least 127 records · Page 7Linked to original sources
PubMed1990

[Factitious disease in surgery. The problem of the self-induced disorder of wound healing].

Self-inflicted disorders of wound healing (lasting for 18 to 84 months and requiring 85 surgical interventions) were diagnosed in ten patients (8 women and 2 men, aged 29 years) nine of whom had undergone various operations. Retrospectively the indications for the primary operation (appendectomy in four, mastectomy, cholecystectomy, adnexectomy, removal of a lipoma and incision of a perineal abscess in one each) had not been unequivocal. One woman was also anorexic, two had "psychogenic seizures", and three had marital or partner problems. One man who had a self-inflicted skin emphysema committed suicide two years later, and one woman died of septicaemia after a self-induced wound healing disorder. The wound healing disorders finally healed in seven patients. Psychotherapy was successful in two patients.

Adolescent↗
PubMed1990

Fructose 2,6-bisphosphate and glycolytic flux in skeletal muscle of swimming frog.

Glycolytic flux in skeletal muscle is controlled by 6-phosphofructokinase but how this is achieved is controversial. Brief exercise (swimming) in frogs caused a dramatic increase in the phosphofructokinase activator, fructose 2,6-bisphosphate, in working muscle. The kinetics of phosphofructokinase suggest that in resting muscle, the enzyme is inhibited by ATP plus citrate and that the increase in fructose 2,6-bisphosphate is part of the mechanism to activate phosphofructokinase when exercise begins. When exercise was sustained, fructose 2,6-bisphosphate in muscle was decreased as was the rate of lactate accumulation. Glycolytic flux and the content of fructose 2,6-bisphosphate appear to be closely correlated in working frog muscle in vivo.

Animals↗
PubMed1990

Survival rates in patients with differentiated thyroid carcinoma. Influence of postoperative external radiotherapy.

Nine hundred thirty-two patients with papillary and follicular thyroid carcinomas were seen at the Departments of Medicine, Surgery, and Radiology of the University of Essen, Essen, Germany, between 1970 and 1986. In addition to standard treatment by surgery, radioactive iodine and medical thyroid stimulating hormone (TSH) suppression, 346 patients had received conventional external irradiation to the neck (mostly 40-60 Gy) before referral to our institutions, whereas 586 patients had not received radiotherapy. From the follow-up data of these patients, survival rates were calculated separately for tumor Stages T1 (n = 203), T2 (n = 552), and T3/T4 (n = 277) using life-table analysis. Distribution of risk factors (histologic type of tumor, grading of malignancy, presence of distant metastases, age and sex) was similar in all groups with the one exception, that the radiotherapy patients with Stage T3/T4 were older. There was no significant difference in the life expectancy of irradiated and not irradiated patients by Breslow and Mantel-Cox tests. In Stages T1, T2, and T3/T4, 75% of the radiotherapy patients survived for 10.6 +/- 0.32, 11.5 +/- 0.61, and 6.71 +/- 0.85 years, respectively; the figures for the nonirradiated patients were 9.4 +/- 0.17, 10.8 +/- 0.37, and 6.26 +/- 0.51 years, respectively. When survival rates were calculated separately for patients with Stage T3/T4 older and younger than 40 years, there was no obvious effect of radiotherapy in the younger group, whereas in the older patients, improvement of survival by radiation just failed to reach statistical significance (P less than 0.09). In conclusion, this retrospective analysis failed to prove that survival is prolonged in patients with differentiated carcinoma by administration of conventional external radiotherapy after surgery. A benefit to older patients with locally advanced tumors has still to be demonstrated.

Adenocarcinoma↗
PubMed1990

[Pre- and postoperative ultrasonic studies in stomach carcinoma and in colonic carcinoma].

Ultrasonographic findings in gastric cancer are essential for assessment of operability. In surveillance programs, endoscopy is important in detecting secondary gastric carcinomas, whereas ultrasonographic examination has no clinical value. Preoperative ultrasonography in colorectal carcinoma focuses on detection of liver metastases and, if metastases are detected, on assessment of resectability. Sonographic surveillance at short intervals in thus important for possible therapeutic interventions.

Colorectal Neoplasms↗
PubMed1990

Urinary glycosaminoglycans in Graves' ophthalmopathy.

An increased accumulation of glycosaminoglycans (GAG) in retrobulbar tissues has been reported in patients with thyroid eye disease. We examined the quantitative urinary GAG excretion in 101 patients with Graves' ophthalmopathy of different classes, 36 patients with Graves' hyperthyroidism without ophthalmopathy, 14 patients with toxic nodular goitre and 103 control subjects. Glycosaminoglycans were isolated from 24-h urine collections by precipitation with cetylpyridinium chloride and ethanol followed by photometrical quantification of hexuronic acids after reaction with carbazole. In comparison with the control group (15.8, 10.4, 21.6 mg/24 h; median, 25th, 75th percentile) a significant (P less than 0.005) elevation of urinary GAG excretion was found in patients with ophthalmopathy (19.2, 12.2, 28.7 mg/24 h), whereas patients with Graves' hyperthyroidism and no ophthalmopathy (16.2, 11.9, 21.7 mg/24 h) and patients with toxic nodular goitre (15.8, 11.5, 21.2 mg/24 h) exhibited no markedly increased values. Especially, patients with active, untreated ophthalmopathy showed on average a twofold increase (36.7, 28.1, 48.4 mg/24 h) in urinary GAG excretion. In contrast, high values were not found in patients with inactive ophthalmopathy and elevated values decreased under treatment, which correlated with clinical findings. Further, relapses were also accompanied by high GAG excretion. Thus, using a simple laboratory method, quantitative determination of urinary GAG excretion appears to present an effective parameter for the activity of Graves' ophthalmopathy.

Adolescent↗
PubMed1990

[Primary malignant melanoma of the esophagus].

We report two cases of primary malignant melanoma of the esophagus. Both were female, 83 and 68 years of age. Both had metastatic spread of the disease at the time of first treatment, either in regional lymph nodes or organ involvement. One patient underwent resection of the tumor (partial esophagectomy). The second patient is alive 22 months postoperatively with metastatic tumor (12/1989), the first died one year after diagnosis. Prognosis of primary melanoma of the esophagus is poor. Though, resection of the tumor is the most promising therapy.

Aged↗
PubMed1990

[Subtotal thyroid gland resection in immunogenic hyperthyroidism: results of a 9-year period].

UNLABELLED: From 01. 01. 1980-31. 12. 1988 149 patients with Graves' disease were subtotally thyreoidectomized with little rests of 2-3 g on each side. The nervi recurrente and the parathyreoids were exposed. RESULTS: There was only one permanent pulsy of the recurrence nerve and no permanent hypoparathyreoidsm. 146 patients could be observed: two had a recidiv and must be treated with radiojodine. 70% of our patients were hypothyreotic, 20% euthyreotic. We think that the operation is the therapy of choice in young patients with Graves' disease.

Adolescent↗
PubMed1990

[Coincidence of hyperparathyroidism and thyroid gland cancer].

127 patients, operated for hyperparathyroidism in a 4-years period (1986-1989) were analyzed retrospectively, regarding concurrent thyroid disease. In 42 patients (33%) thyroid resection was performed simultaneously. Of these, in five cases (4%), thyroid malignancy was discovered: there was one follicular carcinoma, one multilocular papillary tumor and three well differentiated small papillary carcinomas (less than 1.5 cm diameter). This prevalence of thyroid tumors is comparable to the results of different authors (2.5-8.5% in the literature). We conclude that preoperative examination should include the thyroid gland before parathyreotoid exploration.

Adenoma↗
PubMed1990

[Further studies of the respiratory stimulating effect of thyrotropin releasing hormone in the human].

The results of animal experiments, neuroanatomical and neurophysiological investigations reported in the literature suggest a central influence of TRH on respiration. In a group of 18 test subjects receiving 400 micrograms of thyrotropin releasing hormone i. v., we were able to demonstrate a clear stimulation of respiration on the basis of lung function parameters. We observed a highly significant increase (p less than 0.001) in minute volume from 8.2 to 10.6 l/minute, and in the PETO2 from 101.5 to 109.8 mmHg. TRH administered via a peripheral vein can reach areas of the brain via preformed passages in the tissue around the ventricles, and thus exercise an effect on the central respiration centres. Additional peripheral influences may be assumed.

Adult↗
PubMed1990

Treatment of severe reactive hypoglycemia with a somatostatin analogue (SMS 201-995).

Reactive (or postprandial) hypoglycemia can sometimes represent a severe disorder refractory to conventional therapeutic measures. We present in this first individual trial, to our knowledge, that the administration of a somatostatin analogue (SMS 201-995) may alleviate the severity of complaints and does not appear to be diabetogenic. The effects of the somatostatin analogue were documented in a 5-hour oral glucose tolerance test, where not only the glucose-induced and C-peptide rise was clearly attenuated, but also the blood glucose concentration did not fall low enough to induce hypoglycemic symptoms.

Blood Glucose↗
PubMed1990

Assessment of insulin needs in insulin-dependent diabetics and healthy volunteers under fasting conditions.

It is known from clinical observations, theoretical investigations as well as from data patients with intensified insulin therapy and wearers of insulin pumps that the body also requires insulin under fasting conditions. Therapeutic studies as well as the investigations carried out using the artificial pancreas indicate that just under half of the daily insulin requirement is not meal-related, and the other half is dependent on food. The question arose as to whether there are any differences in the basal insulin requirement depending on the time of day and whether differences can be detected between type I diabetics and healthy reference subjects. The results show that analogous changes occur in the early hours of the morning in type I diabetics and healthy normal subjects: these correspond to the clinical familiar dawn phenomenon. The different courses of blood glucose and insulin requirement as measured on the basis of the release of insulin by the Biostator as well as the insulin secretion profile in healthy normal volunteers under fasting conditions do not show any further differences which depend on the time of day.

Adult↗
PubMed1989

[Catheter break in an implantable central venous infusion system with embolization in the pulmonary artery].

A central venous catheter with a subcutaneous infusion port was implanted for chemotherapy into a 64-year-old woman with gastric lymphoma. Six weeks later, two weeks after a trivial trauma with hyperextension of the shoulder joint, it was found that the catheter had broken and its tip portion had embolized into the pulmonary artery: it was retrieved without difficulty via the femoral vein. This event suggests that pressure between clavicle and first rib can cause material fatigue in a silicon catheter. Such catheters should therefore not be implanted via the subclavian vein.

Antineoplastic Agents↗
PubMed1989

Comparison of glycemic response and insulin requirements after mixed meals of equal carbohydrate content in healthy, type-1, and type-2 diabetic man.

The postprandial insulin requirements after three mixed meals of equal carbohydrate and energy content were assessed in 10 type-1 and 12 type-2 diabetics by a glucose-controlled insulin infusion system. These were compared with the glycemic response to the same meals of 10 healthy individuals (glycemic index). In type-1 diabetics, we found the highest insulin requirements after consumption of a continental breakfast (low fibre, low protein, high fat). Ten percent less insulin was infused after milk (low fat, high protein) and 30% less after an English breakfast (high fibre, high protein). Type-2 diabetics showed no significant differences in insulin requirements between the three test meals. The glycemic response in healthy individuals had no relation to these insulin requirements. Continental and English breakfast had a similar glycemic effect, whereas milk produced only 30% of the blood glucose response observed after the continental breakfast. These results indicate that neither the carbohydrate content (exchange lists) nor the glycemic index enable prediction of postprandial insulin requirements in insulin-deficient diabetes. For this purpose, we propose the insulin-need index, elaborated by testing whole meals in closed-loop experiments with type-1 diabetics.

Adult↗
PubMed1989

[Thyroxine vs iodine and thyroxine. Comparison of the TSH suppression test].

In a crossover study 20 subjects (12 with non-toxic goiter) were given 150 micrograms levo-thyroxine (LT4) or a combination of 100 micrograms LT4 and 100 micrograms iodide daily for 8 weeks. Group I took 150 micrograms LT4 and group II the combination. After 4 weeks the two groups switched medications. A clinical examination, an intravenous TRH test and thyroid sonography were performed before the start of the study and 4 and 8 weeks thereafter. 150 micrograms LT4 daily resulted in significantly higher TSH suppression than the combination. A decrease in thyroid volume from 45 ml (mean range 24-85) to 26 ml (17-70 ml) was registered after as little as 4 weeks' therapy in 12 of 20 subjects with goiter.

Adult↗
PubMed1989

Ciclosporin and thyroid-stimulating immunoglobulins in endocrine orbitopathy.

The study investigated whether ciclosporin (C) affected the thyroid-stimulating immunoglobulins (TSI) in serum of patients with endocrine orbitopathy (EO). The effect of C was compared with that of prednisone (P). Fifteen patients with EO classes III-V received C (n = 7) or P (n = 8). In addition to the immunosuppressants, five patients with Graves' disease in each group received methimazole (MMI). The stimulation of the cAMP levels in the medium of thyrocyte cultures was determined as a parameter of TSI. The TSI levels were markedly lowered in both groups during and after therapy. C group: before therapy 6.2 pmol/ml +/- 1.63 (100%, mean +/- SEM), during treatment 4.6 pmol/ml +/- 2.28 (74%), after treatment 4.1 pmol/ml +/- 1.33 (66%). P group: before treatment 9.1 pmol/ml +/- 3.42 (100%), during treatment 5.9 pmol/ml +/- 2.90 (65%), after treatment 3.7 pmol/ml +/- 1.20 (41%). There is neither a significant difference between the two groups nor between the patients who received the combined therapy (MMI + immunosuppressants) or only received immunosuppressants (P more than 0.05). The mean cAMP value of the healthy reference group (n = 19) is 0.4 pmol/ml +/- 0.03. There is a significant difference between this value and the cAMP values of the patients both before and after therapy (P less than 0.01). Thus, both C and P markedly lower the TSI titers of patients with EO.

Adult↗
PubMed1989

Direct tubular effect on calcium retention by hydrochlorothiazide.

Previous studies with hydrochlorothiazide revealed a calcium retaining effect of this substance. The mechanism by what this is done is still matter of controverse discussion. Effects of hydrochlorothiazide on vitamin D metabolism have been reported as well as those on parathyroid function. To further clarify the calcium retaining potency of hydrochlorothiazide (HCTZ) we treated 10 healthy young volunteers for four weeks with 2 x 50 mg HCTZ. In all volunteers we observed a marked decrease in urinary calcium excretion as well as in calcium clearance. Furthermore, we found a slight rise in ionized serum calcium (6.7%) and in intact PTH, as well as a 36% drop in 1,25-(OH)2-D3-levels. These effects were reversible after discontinuation of the treatment. No change was observed in urinary cAMP, phosphate excretion, serum anorganic phosphate levels, serum calcitonin and magnesium levels. Data presented here suggest that treatment with HCTZ causes a persistent reduction in calcium excretion through direct tubular effects, inhibits hydroxylation of vitamin D, and does not affect parathyroid function.

Adult↗