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Biomedical subjects

A Büssing

Publications and source records attributed to A Büssing.

At least 37 records · Page 2Linked to original sources

[Modernizing nursing with holistic nursing systems? Results of a formative assessment].

A project aiming at the implementation of a holistic nursing system was conducted on selected wards of a general hospital. The results of a formative evaluation are presented from a work psychological perspective. The reorganisation of nursing led to a higher degree of patient and employee orientation. Most aspects of nurses' work load were reduced but the improvement did not effect nurses' strain to the expected degree. Decision latitudes at the workplace were enlarged, whereas only few changes in decision latitudes were stated with regard to areas outside the ward. The project is discussed as a reflexive strategy of modernization; its success is a result of a process-oriented management which is able to react on unavoidable consequences in the reorganization process.

Burnout, Professional↗

Herpes virus (KSHV) associated Kaposi sarcoma in a 3-year-old child with non-HIV-induced immunodeficiency.

UNLABELLED: A 3-year-old boy of German descent suffered from two episodes of Streptococcus pneumoniae meningitis within 2 months. One month previously, the first skin lesion of Kaposi sarcoma (KS) had been observed behind his right ear. During the following 2 years KS disseminated not only mucocutaneously but also to visceral organs. Immunological evaluation revealed severe lymphocytopenia with reduced helper/suppressor T-cell ratio and impaired humoral immune response to pneumococci. Extensive laboratory tests gave no evidence for known immunocompromising infections. However, recently described DNA sequences from a Kaposi sarcoma-associated herpesvirus (KSHV) could be identified within skin tissue. As chemotherapy failed to stop tumour progression the patient was referred for bone marrow transplantation. Eighteen months later the KS is in remission and the patient in a good general condition. CONCLUSION: The case supports the hypothesis that KSHV is involved in the aetiology of KS. Bone marrow transplantation is possibly a therapeutic option for KS in patients with immunodeficiency not related to human immunodeficiency virus infection.

Bone Marrow Transplantation↗

Differences in the apoptosis-inducing properties of Viscum album L. extracts.

Viscum album L. (mistletoe) extracts are widely used in adjuvant cancer therapy. In contrast to purified components, such as mistletoe lectins and viscotoxins, whole plant extracts of mistletoe resulted in DNA stabilizations in cyclophosphamide-treated lymphocytes but also provided cytotoxicity in tumour cells and lymphocytes. The killing capacities of mistletoe extracts were host tree-specific and not correlated with mistletoe lectin or viscotoxin content. In human lymphocytes, only mistletoe lectins induced a pathway of apoptotic killing. Within 72 h, the lectin B chains also increased the number of lymphocytes undergoing apoptosis. This finding suggests that inhibition of protein synthesis by the A chain of the hololectin may accelerate a receptor-mediated killing pathway induced by the B chains. An unexpected finding was related to the mistletoe-mediated killing, which was more effective against CD8+T cells with an activated phenotype than CD19+ B cells and CD4+ T cells. In vitro treatment of human neutrophils with mistletoe resulted in a slight decrease of phagocytosis and burst activity. The observed dose-dependent occurrence of two neutrophil subsets with different burst activities indicates differences in their susceptibility to mistletoe and suggests the implication of an induction of the apoptotic killing pathway.

Animals↗

Stimulation of antitumour immunity by intrapleural instillation of a Viscum album L. extract.

Intrapleural administration of mistletoe extracts is reported to result in pleurodesis in cancer patients with malignant pleural effusions. In a recent study, 20 consecutive cancer patients with malignant pleural effusions were treated intrapleurally with the mistletoe extract Helixor. The overall response rate for pleurodesis was 72%, with only 1.2% displaying side effects of the World Health Organization classification I. The decline of tumour cells in the effusion liquid correlated negatively with the number of instillations. However, the elimination of tumour cells was associated with a transient increase in macrophages and eosinophils, and a constant increase in CD8+T cells. Compared to the responder group, the non-responders exhibited high proportions of macrophages, CD8+T cells and T cells with human leukocyte antigens with DR specificity (HLA-DR) in the effusion liquid, compatible with a disturbance of macrophage/T cell co-operation and thus failure to eliminate the malignant cells. The preliminary results suggest that mistletoe-mediated pleurodesis is due to a stimulation of antitumour immunity rather than mechanical sclerosis.

Animals↗

[Comparison of expectations and competencies of USA and German nursing students].

This study is concerned with the impact of job expectations and job competence in the development of burnout. In an intercultural and longitudinal comparison expectations of job competence of US and German nursing students are investigated by means of half-standardized interviews at the end of their training. First results indicate that American nursing students regard themselves as better prepared for job reality with respect to job competence and theoretical training than German nursing students. On the other hand, they report distinct deficits of their practical training. These results are discussed against the background of the different training courses in the USA and in Germany. Prognoses for different courses of burnout processes are given which have to be tested in future investigations of the longitudinal study.

Attitude of Health Personnel↗

Induction of apoptosis in human lymphocytes treated with Viscum album L. is mediated by the mistletoe lectins.

Viscum album L. (VAL) is a phytopreparation used in adjuvant cancer therapy with both immunostimulatory and DNA stabilizing properties at low drug concentrations and cytostatic/cytotoxic properties at higher concentrations. The present work examines the cytotoxic effects of VAL extracts produced from mistletoes grown on different host trees and of purified toxic proteins from VAL, such as the D-galactose-specific lectin I (ML I), the N-acetyl-D-galactosamine-specific ML II and ML III, and crude viscotoxins towards cultured human lymphocytes. The decrease in the number of cultured lymphocytes and blast cells treated with whole plant extracts from VAL was host tree-specific. Nevertheless, there was no close correlation to the content of MLs or viscotoxins. Using the purified proteins, it became obvious that the cell killing was mediated by the induction of apoptosis, as measured by the appearance of a hypodiploid DNA peak using flow cytometry. ML III was the most effective to induce apoptosis, followed by ML II and ML I, while the viscotoxins and oligosaccharides from VAL did not. By measuring the surface expression of IL-2R alpha chains, transferrin receptors and APO-1/Fas molecules on non-apoptotic T cells, no significant changes were observed at low ML concentrations (1 ng/ml), but their decrease at higher ones. Our findings suggest that there might be at least two different ways of cell killing operative in VAL-mediated cytotoxicity: (a) the typical apoptotic cell death with the appearance of hypo-diploid nuclei, and (b) a direct or indirect killing by damaging the cell membrane with subsequent influx of Ca2+ and of the DNA intercalating dye propidium iodide and cell shrinkage. These effects might not be exclusive, as they probably occur simultaneously.

Apoptosis↗

[Holistic nursing--definition and realization].

Holistic nursing This article focuses on the current discussion on holistic nursing. Looking at holistic nursing from a work psychological perspective a classification of nursing models is presented. So far, the prevalence of holistic nursing models was overestimated in empirical studies since there was a lack of relevant criteria. The proposed classification allows to differentiate models of nursing along the two dimensions: design of nursing organization and nursing principle. Preconditions and prospects of holistic nursing are discussed with regards to the completed and the current implementation of projects.

Classification↗

Effects of Viscum album L. on cyclophosphamide-treated peripheral blood mononuclear cells in vitro: sister chromatid exchanges and activation/proliferation marker expression.

Based on recently published data, Viscum album L. (VAL) extracts have been shown to provide a DNA stabilizing effect which seems to be restricted to the peripheral blood mononuclear cells (PBMC). We have now investigated whether VAL exerts effects of cellular protection for phytohemagglutinin-activated PBMC treated with cyclophosphamdie (CP) in vitro. The addition of VAL resulted in a slight reduction of CP-induced sister chromatid exchanges of cultured PBMC from healthy individuals. The incubation with CP significantly reduced the expression of the low affinity interleukin-2 receptor (IL-2R alpha chain) and of transferrin receptor (TfR) on PHA-stimulated T lymphocytes. The addition of 10 micrograms/ml VAL was protective against the CP-induced depression of IL-2R alpha chain and TfR expression on these cells. The simultaneous addition of CP and purified VAL components, such as ML I, ML II/III, and viscotoxins did not significantly change expression of IL-2R alpha chain and TfR on T cells. Thus, so far undefined VAL components might be responsible for the observed protection effects of the whole plant extract. The results presented here should encourage investigation of this drug, which might become an interesting adjuvant in cancer therapy.

Adult↗

Measuring resistance to phagocytosis of group A and G streptococci: comparison of direct bactericidal assay and flow cytometry.

M protein is thought to contribute to the ability of non-opsonized group A and group G streptococci (GAS and GGS, respectively) to resist phagocytosis by polymorphonuclear leukocytes. In previous studies, correlation between M protein expression and phagocytosis was determined by incubating these pathogens in human blood and comparing colony-forming bacterial counts prior to and after exposure to blood (direct bactericidal assay; DBA). Here, we report the application of flow cytometry to measure GAS and GGS resistance to phagocytosis. The results of the assays were in complete agreement with those from DBAs. Nevertheless, flow cytometry was regarded as superior to DBA because of its speed and potential uses for quantitative studies. In addition, the use of anti-CD11b monoclonal antibody for granulocyte staining guaranteed a non-compromized granulocyte function. The optimized protocol for flow cytometry presented here could be utilized to directly measure the involvement of individual protein types in bacterial resistance to phagocytosis.

Blood Bactericidal Activity↗

Sister chromatid exchange-inducing DNA lesions and depression of activation markers on the surface of cultured peripheral blood mononuclear cells after the addition of streptococcal pyrogenic exotoxins A and C.

Cultivation of peripheral blood mononuclear cells (PBMC) in the presence of streptococcal pyrogenic exotoxins (SPE) A and C resulted in a significant induction of sister chromatid exchange (SCE)-inducing DNA lesions. Concomitantly, the expression of interleukin-2 receptor alpha chain (IL-2R alpha chain), transferrin receptor (TfR), and major histocompatibility complex class II molecule HLA-DR on the surface of phytohemagglutinin-activated T cells from whole blood culture cells (WBCC) significantly decreased within 72 h, that is at least two cell cycles, whereas unstimulated T cells from WBCC did not express these markers but had lost their CD3 molecules, an effect reported to precede apoptosis as part of a T cell inactivation pathway. However, no apoptotic cells were observed within a cultivation period of 120 h. We observed clearcut differences in the responses towards SPE A in WBCC and isolated lymphocytes, since SPE A-treated lymphocytes showed an increase in the [3H]thymidine incorporation and did express IL-2R alpha chain and TfR on their cell surface. Regardless of the precise underlying mechanism, T cells from WBCC seem to be in a state of functional incompetence. The data presented here are the first to provide strong evidence that streptococcal toxins produce SCE-inducing DNA lesions in PBMC, an effect that might contribute to the process of immune cell lethality in streptococcal toxic shock-like syndrome and could be of pivotal importance in the pathogenesis of severe streptococcal disease.

Adult↗

Childhood acute lymphoblastic leukemia (ALL): sister chromatid exchange (SCE) frequency and lymphocyte subpopulations during therapy.

Sister chromatid exchanges (SCE) and lymphocyte subsets of children with acute lymphoblastic leukemia (ALL) were investigated during chemotherapy. The treatment followed protocol ALL-BFM-90. Children with ALL at the time of diagnosis showed statistically significant higher SCE frequencies (4.9 +/- 0.77) than healthy controls (3.6 +/- 0.93; P = 0.002). The in vivo effects of cyclophosphamide (CP) resulted in a dramatic increase of the SCE frequency (20.5 +/- 3.76). This increased SCE level of lymphocytes might reflect an instability of DNA or a deficiency of DNA repair. One could suggest that lymphocytes of children with ALL might have a higher susceptibility to harmful influences; and this could be a co-factor towards the development of the malignant disease. However, immediately 1 week after the administration of CP, the SCE rate decreased. This decline of SCE frequency correlated with a severe reduction of the absolute number of T lymphocytes. The observed reduction of SCE frequency may be due to a loss of T lymphocytes, or SCE became repaired during 1 week.

Adolescent↗

Effect of Viscum album L. on rapidly proliferating amniotic fluid cells. Sister chromatid exchange frequency and proliferation index.

Amniotic fluid cells (AFC) from 10 women undergoing amniocentesis were investigated. The 5-bromo-2'-deoxyuridine-induced sister chromatid exchange (SCE) frequency of AFC remained stable after the addition of a therapeutical concentration of Viscum album L. preparation Iscador P but decreased significantly after administration of high drug doses. As the proliferation index remained stable, even at extremely high drug concentrations, this effect could not be ascribed to a reduction of proliferation. No indications of cytogenetic damage or effects of mutagenicity were seen after the addition of Viscum album L. preparation P.

Amniotic Fluid↗

Recurrent systemic pneumococcal infection in an immunocompromised patient.

A case is reported of a splenectomized patient who experienced four episodes of systemic pneumococcal infection after receiving appropriate therapy in every instance. Serogrouping showed at least two different strains to be responsible for these infections. Immunological investigations showed a reduction in immunoglobulins, a decrease in in vitro immunoglobulin synthesis and a disorder of immunoregulatory T-cells, but immunological changes could not be readily explained by splenectomy alone.

Adult↗

Viscum album L. extracts reduce sister chromatid exchanges in cultured peripheral blood mononuclear cells.

Increasing concentrations of Viscum album L. extracts were shown to significantly reduce sister chromatid exchange (SCE) frequency of phytohaemagglutinin (PHA)-stimulated peripheral blood mononuclear cells (PBMC) of healthy individuals. This decrease of SCE could not be explained either by changes in lymphocyte subpopulations, by cytostatic effects of the drug or by accelerated proliferation of PHA-stimulated PBMC. Currently, no other cells tested have shown this effect. One therapeutic effect of these anti-mutagenic drugs could be a stabilisation of mononuclear blood cell DNA.

Adult↗

[The nursing situation in the old and new parts of the Federal Republic of Germany: a comparison of requirements, obstacles and nursing autonomy].

Differences with regard to demands, obstacles and elbow room, affecting nursing activities in general hospitals are examined. An instruments measuring various facets was devised (TAA KH). The results reveal that in all three areas there are significant differences between activities of nursing staff in East and West German Hospitals. The differences are being discussed against the background of the situation in the new Bundesländer.

Germany, East↗