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Biomedical subjects

A Kruse

Publications and source records attributed to A Kruse.

At least 19 recordsLinked to original sources
PubMed1992

[Check-ups of colorectal neoplasms--current practice].

In order to investigate the practice for control of patients with colorectal adenomata and cancer, a questionnaire investigation was carried out in 1990-1991 among 53 Danish surgical departments. The investigation revealed great differences in the control programmes offered to these patients as regards the methods, the intensity and duration. In addition, differences were present in the control pattern for adenomata in specialist departments as compared with the remaining departments where there was a tendency to very frequent but, on the other hand, brief control. On the basis of these results, it is considered necessary that a reference programme should be prepared on this subject.

Adenoma↗
PubMed1992

In situ hybridization of the mRNA for interferon-gamma, interferon-alpha E, interferon-beta, interleukin-1 beta and interleukin-6 and characterization of infiltrating cells in thyroid tissues.

Cytokine mRNA production in the thyroid tissues of patients with various thyroid diseases was analysed by in situ hybridization. In addition, infiltrating leukocytes were characterized by immunohistologic studies using the alkaline phosphatase anti-alkaline phosphatase (APAAP) staining technique. The following clinical material was investigated: two cases of Graves' disease, one with high and the other with a low amount of infiltrating leukocytes as well as two cases of non-toxic goitre also showing considerable quantities of infiltrating cells. The hybridization was performed on tissue sections with antisense probes for interferon-gamma (IFN-gamma), IFN-alpha E, IFN-beta, interleukin-6 (IL-6) and IL-1 beta. A small number of individual cells were found to express high levels of mRNA for IFN-gamma, IL-1 beta and measurable amounts of IL-6 throughout the tissue sections. However, IFN-alpha E or IFN-beta were not detected. Cytokine expressing cells were noted in the tissue of one patient with Graves' disease and in two cases with non-toxic goitre. In these samples a high amount of infiltrating leukocytes (CD45+) was detected, especially CD3+, CD8+, CD4+ and CD45RA+ T cells, in addition to B cells and macrophages. In one case an unusually large amount of T cell receptor gamma/delta+ (TcR gamma/delta+) cells was found. However, one sample of thyroid tissue derived from a patient with Graves' disease was poorly infiltrated and showed few cells expressing cytokines. In conclusion, using thyroid tissue as an example, our data suggest that the application of in situ hybridization with antisense RNA permits the study of cytokine production in tissues of both autoimmune and non-autoimmune origin.

Adult↗
PubMed1992

Endoscopic management of postoperative bile leaks.

Thirty-two patients aged 15-89 years developed postoperative bile leakage. Twenty-eight had undergone cholecystectomy, with choledocholithotomy in 11, and four had had miscellaneous operations. Endoscopic retrograde cholangiopancreatography (ERCP) was performed 2-75 days after operation and revealed leakage from the cystic duct stump in 19 cases, from a T tube track in five, from the gallbladder and liver abscess cavity in two and from the major bile ducts in six. Major bile duct lesions were not generally amenable to endoscopic treatment, but the remaining 26 patients were treated successfully with internal stenting (22) or endoscopic sphincterotomy (four); bile secretion in all cases stopped within 1 week. One patient with cholangitis after an ERCP procedure was managed by antibiotics; no other complication occurred and there were no deaths related to the procedure. ERCP procedures are well tolerated in the postoperative period and may be performed under sedation. ERCP is the method of choice for dealing with bile leakage and ERCP procedures are effective for the most common causes of postoperative bile leakage; complications are rare.

Adolescent↗
PubMed1992

Coping with health problems in old age. A longitudinal approach.

An analysis of medical, psychological, and social data of the Bonn Longitudinal Study on Aging, comparing a subgroup of the BOLSA sample, which developed different forms of chronic disease four to six years after the beginning of the study, and a healthy subsample, points to different patterns of coping in these two subgroups. The sequence of these response patterns provides some evidence for a special form of psychosocial competence of chronically ill aged persons, which developed in an 'accelerated' way in the ill group, and in a retarded way in the initially healthy group. The findings emphasize the need for continuing research into the psychosocial aspects of coping with chronic disease in old age.

Adaptation, Psychological↗
PubMed1992

Cytokine production after helium-neon laser irradiation in cultures of human peripheral blood mononuclear cells.

The effects of laser light on the immune system have not been extensively characterized. Low-power laser sources, such as the helium-neon (He-Ne) laser with a wavelength of 632.8 nm, have been found to produce photobiological effects with evidence of interference with immunological functions. We have investigated the effects of He-Ne laser irradiation on Ficoll-Hypaque-isolated human peripheral blood mononuclear cells (PBMC). Cultured cells were irradiated for various times at two selected intensities and then stimulated with different mitogens. The rate of incorporation of 3H-thymidine into the DNA of stimulated cells decreased with increasing energy density. The levels of interleukin-1 alpha (IL-1 alpha), interleukin-2 (IL-2), tumour necrosis factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma) in supernatants of the cultures were determined (irradiated either before or after stimulation). When stimulating cells after irradiation, significantly increased levels of all cytokines were detected after 30 min of irradiation (18.9 J cm-2), whereas after 60 min of irradiation (37.8 J cm-2) cytokine levels were found to be significantly decreased.

Cell Division↗
PubMed1992

Induction of cytokines in human whole blood cultures by a mitogen derived from Mycoplasma arthritidis and by staphylococcal enterotoxin B.

Mycoplasma arthritidis produces a so-far only partially characterized soluble material (MAS) that has a potent mitogenic effect on T lymphocytes of several species. Similar to staphylococcal enterotoxins and a number of related toxins secreted by other species of bacteria, nanogram quantities of these so-called superantigens are sufficient to induce significant amounts of cytokines in the supernatant of lymphocyte cultures. Induction of interleukin-6 (IL-6) by MAS in murine bone marrow-derived macrophages has recently been described. In our study, we examined the differential effects of MAS and Staphylococcus aureus enterotoxin B (SEB) on human blood cells. When compared to MAS, SEB induced a higher proliferative response and, accordingly, a higher release of IFN-gamma. In contrast, large amounts of the macrophage products IL-1, IL-6 and tumor necrosis factor alpha (TNF-alpha) were observed in supernatants of cell cultures stimulated with MAS, whereas only small amounts were induced by SEB. Staphylococci and mycoplasmas are responsible for a number of diseases with various symptoms in man and animals. Our results suggest that SEB and MAS show different qualities in lymphocyte and macrophage stimulation which may be relevant in the pathogenesis of diseases.

Antigens↗
PubMed1992

Interferon and lymphokine production by human placental and cord blood cells.

The placenta plays an important role in protecting the fetus from maternal infections and in preventing an effective immune response of the mother against the fetus. We compared lymphokine production by human placental leukocytes with that of adult and cord blood leukocytes. Decidual and adult blood lymphocytes synthesized comparable quantities of interferon-gamma (IFN-gamma) following incubation with phytohemagglutinin (PHA). In contrast, lymphocytes of cord blood and fetal placental tissue stimulated with PHA produced very low titers of IFN-gamma. This defect was less marked after stimulation with staphylococcus enterotoxin B (SEB). In the presence of SEB, cord blood cells produced interleukin-2 (IL-2) and significant amounts of IFN-gamma. Production of IL-4 could not be detected. Collectively, these results indicate that fetal T lymphocytes show certain defects of lymphokine production.

Enzyme-Linked Immunosorbent Assay↗
PubMed1992

Pituitary histology in Cushing's disease.

OBJECTIVE: We assessed pituitary histology in patients with Cushing's disease. DESIGN: Systematic histological assessment of pituitary tissue removed at surgery. PATIENTS: Thirty-six consecutive patients cured from Cushing's disease by transsphenoidal neurosurgery. MEASUREMENTS: Microscopical examination of all available tissue removed at operation. RESULTS: After selective removal of tissue supposed to represent an adenoma in 25 patients this could be histologically verified in 18. In the 11 patients who had undergone a total hypophysectomy an adenoma could be demonstrated in three patients only, despite a systematic search of the entire pituitary gland. Only in 21 of the 36 cured patients (58%) could an adenoma be verified. CONCLUSIONS: Combining the present results with previous reports there is strong reason to believe that in some patients with Cushing's disease no histological lesion in the pituitary is verifiable.

Adenoma↗
PubMed1992

Pressure and blood flow in pituitary adenomas measured during transsphenoidal surgery.

In 48 patients undergoing transsphenoidal surgery for pituitary adenoma, the intrasellar pressure was recorded during surgery. In 14 patients, adenoma blood flow was measured with the technique of local injection of 133xenon. Median intrasellar pressure was 30 mmHg (range 8-62), n = 48, and median adenoma blood flow was 8 ml/100 g/min (range 0-37), n = 14. In two patients, blood flow in the anterior pituitary gland was measured, and values of 26 and 22 ml/100 g/min were obtained. The finding that intrasellar pressure is above central venous and intracranial pressure suggests the possibility that the adenoma and the anterior pituitary gland are supplied not only with venous blood, but receive an additional arterial supply at a less than normal arterial pressure. In three cases perfusion pressures that caused arrest of adenoma blood flow were found, and these observations are discussed with reference to pituitary apoplexy.

Adenoma↗
PubMed1992

Induction of cytokines in human peripheral blood and spleen cells by the Mycoplasma arthritidis-derived superantigen.

Recently, the mitogenic effects of the Mycoplasma arthritidis supernatant, MAS, and the induction of interferon-gamma (IFN-gamma) and interleukin-6 (IL-6) by MAS have been described. In the present series of experiments we investigated human peripheral blood mononuclear cells (PBM) and human spleen cells with respect to their production of these and other cytokines. In human spleen cell cultures and PBM, MAS induced the synthesis of interleukin-1 alpha (IL-1 alpha) and IL-1 beta. Both interleukins were secreted faster and in higher amounts by PBM. IL-6 was also induced by MAS in PBM and human spleen cells. The amounts of IL-6 measured by ELISA were higher in PBM, whereas the biological activity of IL-6 was higher in spleen cell cultures. T-cell products such as IL-2, IL-4, and IFN-gamma were also induced by MAS in PBM and spleen cells. The kinetics of IFN-gamma and IL-4 induction were negatively correlated. In PBM we found low levels of IL-4 and high IFN-gamma induction, whereas in spleen cells high titers of IL-4 and low IFN-gamma titers were observed. Collectively, our results indicate that MAS induces different networks of cytokine interactions depending on the organ from which the cells are derived.

Antigens↗
PubMed1991

[Removal of a displaced nasopharyngeal tube from the esophagus using an inflated catheter].

A safe and easily employed method of removal of a blunt foreign body from the oesophagus is described. The present case was a newly born infant with Pierre Robin's syndrome and congenital heart disease. A nasal tube had become displaced and the clinical condition did not permit endoscopic removal. By means of an inflatable balloon catheter introduced through the tube to the stomach, the foreign body could be removed without difficulty.

Catheterization↗
PubMed1991

[Colorectal neoplasms. Study of the attitudes among Danish gastroenterologists].

The results of a questionnaire concerning colorectal neoplasms are discussed with reference to the relevant literature. Coloscopy is the examination of first choice in the diagnosis and follow-up of colorectal neoplasms but double-contrast barium enema (DCBE) is still justified, particularly in cases where coloscopy proves difficult. In the light of present knowledge, the replies to the questionnaire appear to attach too much importance to frequent early control examinations of patients with cancer and adenomata at the expense of more relevant long-term control. Before a control programme for colorectal neoplasm is commenced, a clean colon should be ensured. Patients attending control examinations should be informed about the symptoms of interval cancer.

Adenoma↗
PubMed1991

Increases of neuron-specific enolase, S-100 protein, creatine kinase and creatine kinase BB isoenzyme in CSF following intraventricular catheter implantation.

In 15 patients without acute brain injury the concentrations of Neuron-specific Enolase (NSE), S-100 Protein (S-100), Creatine Kinase (CK), and Creatine Kinase BB isoenzyme (CK-BB) in ventricular cerebrospinal fluid (CSF) were measured immediately after lateral ventricle cannulation for diagnostic or treatment purposes. From patients who were treated with a shunt another CSF sample was obtained one week after shunt implantation by puncture of the antechamber of the valve. The CSF concentrations of NSE, S-100, CK and CK-BB after cannulation were found to be of the same order as found in patients with severe head injury, stroke or subarachnoid haemorrhage. One week after shunt implantation the concentrations of S-100, CK and CK-BB had returned to normal levels in almost all patients, while the NSE concentrations remained elevated. These findings indicate that the sampling procedure may result in contamination of CSF with NSE, S-100, CK and CK-BB and they should be taken into account in the prognostic evaluation of enzyme concentrations after brain injury.

Brain Damage, Chronic↗
PubMed1991

Effect of cholecystectomy on the relationship between hydrostatic common bile duct pressure and sphincter of Oddi motility.

The sphincter of Oddi (SO) motility before and after an artificial elevation of the common bile duct pressure was studied by means of endoscopic manometry in nine female subjects, seven of whom had undergone previous cholecystectomy. An increase in the hydrostatic common bile duct pressure resulted in total inhibition of the phasic SO contractions in the two patients with gallbladders in situ, as well as in four of the cholecystectomized patients. The results thus indicate that the inhibitory effect of hydrostatic common bile duct pressure on the SO motility previously demonstrated in the cat is also present in man. On the other hand, as the inhibition of the phasic contractions failed to occur in three of the postcholecystectomy patients, the findings also suggest that cholecystectomy may result in altered regulation of SO motility in some patients. This mechanism could then contribute to development of pain in susceptible subjects postcholecystectomy. Finally, the results also showed that pain experienced by some patients upon contrast injection during ERCP bears no relationship to SO motility, but is due to an interindividually variable sensitivity of the bile duct wall to the intraluminal pressure variation.

Abdominal Pain↗
PubMed1991

In situ hybridization of interferon-gamma producing peripheral blood mononuclear cells.

Individual interferon-gamma (IFN-gamma) producing cells in activated human peripheral blood mononuclear cells (PBMC) were characterized by in situ hybridization using [35S]-labelled antisense RNA probes. The proportion of positive cells expressing IFN-gamma mRNA varied according to the substances used for stimulation. IFN-gamma mRNA expressed a relatively low percentage of 1-8% PBMC after a single stimulus with mitogens or OKT-3 antibody and 20-30% of the cells were identified to synthesize IFN-gamma mRNA after stimulation with PHA + P-MA + OKT-3 antibody. The expression of IFN-gamma mRNA and production of the lymphokine was dependent on accessory cells. If accessory cells were replaced by recombinant interleukin-1 (IL-1) plus interleukin-6 (IL-6), then T-cell proliferation to phytohaemagglutinin (PHA) could be partially restored and measurable amounts of IFN-gamma were detected. The addition of interleukin-2 (IL-2) or phorbol-12-myristate-13-acetate to T cells stimulated with PHA, IL-1 and IL-6 did not restore the production of IFN-gamma to an extent comparable to that produced by T cells stimulated in the presence of accessory cells. In further studies, depletion of T-cell subsets showed that CD3+, CD4+, CD8+, CD29+ and CD45RA+ cells were involved in IFN-gamma production after mitogenic stimulation. In conclusion, our data demonstrate that IFN-gamma production is dependent on signals from accessory cells and IFN-gamma is synthesized by only a small proportion of T cells, that did not belong to a unique population, characterized by conventional cellular surface antigens.

Blotting, Northern↗
PubMed1990

[Treatment of esophageal achalasia].

Achalasia is a motor disease of the oesophagus which can be treated surgically (myotomy), medically or by dilatation. After myotomy satisfactory results are obtained in 84%-95% of the patients. Unacceptable results are due primarily to gastro-oesophageal reflux, inadequate or healed myotomy. Dilatation provide good results in about 70% but generally repeated dilatation is required. The remaining 30% can usually be treated surgically. Dilatation is complicated by perforation in about 3% of the patients, but reflux is not as frequent as after myotomy. At present medical treatment is only indicated temporarily prior to dilatation or surgery. Surgical treatment is recommended for patients with contemporary delayed gastric emptying, hiatal hernia, vigorous achalasia, epiphrenic diverticula and for children with achalasia. For the remaining patients both methods can be used but after 2-3 dilatations myotomy is recommended.

Dilatation↗
PubMed1990

Histamine release from gut mast cells from patients with inflammatory bowel diseases.

Inflammatory mediators from intestinal mast cells may serve as initiators of acute and delayed inflammation. Mast cell histamine release was measured in 19 patients with inflammatory bowel diseases using gut mast cells from enzymatically dispersed endoscopic forceps biopsy specimens of macroscopically inflamed and normal tissue. Mast cells and corresponding basophils were challenged with anti-IgE, anti-IgG, subclass anti-IgG4, and formyl-methionyl-leucyl-phenylalanine (FMLP) and results were compared with those from nine patient control subjects. The mast cell count in patients with ulcerative colitis was increased compared with that in control subjects and patients with Crohn's disease, and the mast cell count obtained from inflamed tissue was greater than that of normal tissue. The study also shows the heterogeneity of the responsiveness of the histamine releasing cells to various secretagogues. Thus, mast cells released 0.4 (0.0-2.0) (median (range)) ng histamine per sample at anti-IgE challenge, and basophils were also anti-IgE responsive. In contrast, mast cells did not respond to FMLP but the corresponding basophils did. Gut mast cells released 0.3 (0.0-1.0) (median (range)) ng histamine per sample at anti-IgG4 challenge; however, the corresponding basophils did not respond to anti-IgG4. In addition, the anti-IgG4 mediated histamine release was primarily confined to patients with inflammatory bowel disease. This study substantiates previous histopathological findings that mast cells may play a functional role in the inflammatory process of inflammatory bowel diseases and provides evidence for a possible role of subclass IgG4 as a reaginic antibody.

Adolescent↗