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Biomedical subjects

C Karl

Publications and source records attributed to C Karl.

At least 19 recordsLinked to original sources

Frequency data for the STR loci HumFibra (FGA) and HumACTBP2 (SE33) in a population of Germans and Turks from South-West Germany.

Population studies were carried out on German and Turkish individuals from South-West Germany using the short tandem repeat (STR) systems HumFibra (n = 138 Turkish and 1161 German individuals) and HumACTBP2 (n = 202 Turkish and 1338 German individuals). After electrophoresis 19 alleles could be identified for HumFibra and 55 for HumACTBP2. No significant deviations from Hardy-Weinberg equilibrium were observed.

Alleles↗

Tumour necrosis factor-alpha (TNF-alpha) in human endometrium and uterine secretion: an evaluation by immunohistochemistry, ELISA and semiquantitative RT-PCR.

Tumour necrosis factor-alpha (TNF-alpha is a pleiotropic cytokine synthesized throughout the female reproductive tract. Even though evidence has accumulated that supports its role in autocrine and paracrine processes, its expression and function in the human endometrium are still not completely understood. To gain a better understanding of the synthesis and release of TNF-alpha in the endometrium and how this relates to concentrations in uterine secretion, its expression throughout the menstrual cycle was investigated by three different techniques. Samples of endometrial tissue and uterine secretions were collected from patients undergoing abdominal and vaginal hysterectomy for benign reasons. The mRNA expression of TNF-alpha was investigated in homogenized endometrial tissue by semiquantitative reverse transcription-polymerase chain reaction (RT-PCR) (n = 18). An assessment of the cellular TNF-alpha protein localization in the endometrial glands was performed immunohistochemically (n = 39). The concentrations of the secreted TNF-alpha protein in endometrial secretion were determined by enzyme-linked immunosorbent analysis (n = 30). All three methods gave similar results on the temporal expression of TNF-alpha mRNA and TNF-alpha protein during the cycle. Concentrations of endometrial TNF-alpha mRNA in tissue samples and TNF-alpha protein in uterine secretion were quite low at the beginning of the cycle, rose sharply in the mid- to late proliferative phase and decreased towards the end of the cycle. The concentrations of TNF-alpha protein in the endometrial glands, as shown by immunohistochemical investigation, stayed high throughout the secretory phase at values slightly below those of the late proliferative phase.

Endometrium↗

Characterization of a newly established endometrial stromal sarcoma cell line.

We describe a newly established human sarcoma cell line derived from an endometrial stromal sarcoma (ESS). The cell line has been maintained in long-term cell culture for more than 2 years. It has been repeatedly analyzed in terms of morphology, immunocytochemical features, ultrastructure and karyotypic characteristics. In contrast to uniform endometrial stromal differentiation in vivo, the tumor cells were shown to display distinct phenotypical heterogeneity in vitro. In addition to the predominant cell type, which retained sarcomatous differentiation, foci of epithelial-like cells were observed in the cell culture. Immunocytochemical and ultrastructural analysis demonstrated a mainly mesenchymal phenotype with signs of epithelial characteristics, such as expression of cytokeratins, and the presence of desmosomes and kinetocilia, respectively. Cytogenetic analyses in early and late passages revealed unbalanced translocations between chromosomes 3 and 6 and an additional i(19)(q10), as common karyotypic changes in all tumor cells, indicating a monoclonal origin. Our new cell line can be used as an in vitro model to study the mechanisms of heterogeneous differentiation patterns in ESS.

Aged↗

Cloning and functional expression of a mammalian gene for a peroxisomal sarcosine oxidase.

Sarcosine oxidation in mammals occurs via a mitochondrial dehydrogenase closely linked to the electron transport chain. An additional H2O2-producing sarcosine oxidase has now been purified from rabbit kidney. A corresponding cDNA was cloned from rabbit liver and the gene designated sox. This rabbit sox gene encodes a protein of 390 amino acids and a molecular mass of 44 kDa identical to the molecular mass estimated for the purified enzyme. Sequence analysis revealed an N-terminal ADP-betaalphabeta-binding fold, a motif highly conserved in tightly bound flavoproteins, and a C-terminal peroxisomal targeting signal 1. Sarcosine oxidase from rabbit liver exhibits high sequence homology (25-28% identity) to monomeric bacterial sarcosine oxidases. Both purified sarcosine oxidase and a recombinant fusion protein synthesized in Escherichia coli contain a covalently bound flavin, metabolize sarcosine, L-pipecolic acid, and L-proline, and cross-react with antibodies raised against L-pipecolic acid oxidase from monkey liver. Subcellular fractionation demonstrated that sarcosine oxidase is a peroxisomal enzyme in rabbit kidney. Transfection of human fibroblast cell lines and CV-1 cells (monkey kidney epithelial cells) with the sox cDNA resulted in a peroxisomal localization of sarcosine oxidase and revealed that the import into the peroxisomes is mediated by the peroxisomal targeting signal 1 pathway.

Amino Acid Sequence↗

Randomized comparison between antibiotics alone and antibiotics plus granulocyte-macrophage colony-stimulating factor (Escherichia coli-derived in cancer patients with fever and neutropenia.

PURPOSE: A prospective, randomized study was conducted to determine if recombinant human granulocyte-macrophage colony-stimulating factor (rh-GMCSF) (Escherichia coli-derived) could improve response rates to antibiotic therapy and shorten the duration of neutropenia in cancer patients. PATIENTS AND METHODS: A total of 107 febrile neutropenic cancer patients were randomly assigned to empiric therapy with ticarcillin-clavulanate (4 g ticarcillin + 0.1 g clavulanate i.v. every 4 hours) plus netilmicin (2 mg/kg i.v. every 8 hours) with or without rh-GMCSF (3 micrograms/kg per day i.v.). Clinical improvement, duration of neutropenia, and toxicity were monitored. RESULTS: Addition of rh-GMCSF to the antibiotics significantly improved the response rate (96% versus 82%, P = 0.03), but not the survival rate (93% versus 93%), in the evaluable patients. This difference in response rate was not significant when considering all patients in an intent-to-treat analysis. The number of patients who recovered from severe neutropenia ( < 100 cells/microliter) during the period of observation in the study was significantly greater among patients receiving the colony-stimulating factor, although the median duration of neutropenia was not affected. Superinfections and subsequent infections were not significantly different among the two treatment regimens. Side effects were more common among patients treated with the colony-stimulating factor. CONCLUSIONS: Our data do not support the routine administration of rh-GMCSF with antibiotics for patients with fever and neutropenia. Further studies should be conducted to identify those patients most likely to benefit from rh-GMCSF therapy, such as patients with persistent profound neutropenia and refractory infections.

Adolescent↗

Safety, plasma concentrations, and efficacy of high-dose fluconazole in invasive mold infections.

A trial of the antifungal triazole fluconazole was conducted in cancer patients with presumed or proven mold infection. Groups of patients received fluconazole at four dosages (800, 1200, 1600, or 2000 mg/day). Adverse events, plasma levels, and clinical response were examined. Thirty-nine patients were enrolled. The 28 evaluable patients had presumed (13 patients) or proven (15) mold infection with Aspergillus (4) and Fusarium (3) species, Zygomycetes organisms (1), or nonspeciated mold (7). Adverse effects included elevated liver function test results (8 patients), nausea and vomiting (2), and erythema multiforme (1). Neurologic toxicity occurred in 3 patients receiving 2000 mg/day. Average steady-state peak plasma concentrations were 51.8, 74.4, and 91.8 mg/L for dosages 1200, 1600, and 2000 mg/day, respectively. Seven of 28 evaluable patients responded. Response did not appear to be related to dose. Fluconazole is well tolerated at total daily doses up to 1600 mg. The data suggest a linear plasma concentration-dose relationship. The activity of fluconazole in refractory mold infections seems to be limited.

Adolescent↗

[Cerebrovascular abnormalities in pregnancy].

A 37-year-old pregnant woman without neurological history was admitted in the 21st week of pregnancy for multiple seizures. Angiography confirmed the diagnosis of cerebral angioma. The patient decided to continue with her pregnancy; caesarean section under regional anesthesia via an epidural catheter was uneventful. Five weeks later the angioma was resected after sudden recurrence of seizures and neurological deterioration. In this report, the therapeutic options for elective neurosurgical intervention after possible termination of pregnancy, during pregnancy, or after delivery are discussed including anesthesiological management during delivery.

Adult↗

Effectiveness of an oral triazole for opportunistic mold infections in patients with cancer: experience with SCH 39304.

Fungal infections are the most common infectious cause of death among patients with hematologic malignancies. Conventional antifungal agents have limited activity and a narrow therapeutic index. In an open-label study we assessed the activity of an oral triazole, SCH 39304, in the treatment of refractory life-threatening mold infections in 50 patients with cancer, most of whom had previously received amphotericin B and/or fluconazole. SCH 39304 was given at a daily dose of 200-400 mg for a median of 8 weeks. The overall rate of response was 79% among 34 evaluable patients, with a complete response in 22 instances and a partial response in 5. Some patients responded despite persistent, profound immunosuppression. Three patients developed relapses, and two developed fungal superinfections. SCH 39304 was well tolerated. We conclude that oral triazoles such as SCH 39304 may represent effective and safe treatment of mold infections in immunosuppressed patients, at least after standard antifungal chemotherapy. Unfortunately, the carcinogenic potential of SCH 39304 in animals has precluded its development. Our hope is that analogues with similar efficacy but without carcinogenic potential can be developed.

Administration, Oral↗

[Peridural morphine administration for postoperative analgesia on the general medical unit].

With the present study the risk of postoperative peridural analgesia with morphine on ordinary wards should be estimated. 50 patients undergoing gynecological laparotomies received 3 mg morphine by a peridural catheter for postoperative pain relief. The degree of postoperative pain was objectivated by a visual analogue scoring system (1-10). Mean duration of analgesia was 11 hours. The pain score ranged between 1 and 3. The acceptance was very well. Heart rate and mean arterial pressure remained stable. Blood gas analyses showed a slight increase of the pCO2 with no clinical importance. The advantages of epidural morphine are: low dose, long duration, lack of sedation and the discharge of nurses. Experienced anesthesiologists visited all patients once a day. The nurses are educated to recognize complications.

Adult↗

[Effect of parity on the venous system of the leg].

Pregnancy is known to be an important aetiological factor of varicose veins. How much this can be attributed to gestation is still controversially discussed. This problem was investigated using three non-invasive methods--Ultrasonography, Venous-Occlusion Plethysmography (VOP) and Light-Reflexion-Rheography (LPR). We found no significant differences between the group of primipara and multipara with relation to the venous morphology and the venous function in the legs. Only the distensibility of the venous wall of the multipara group was slightly increased in comparison to the group of the primipara. These results were found by VOP and LRR simultaneously. Varicosis is therefore caused mainly by the first pregnancy, whereas the subsequent pregnancies do not show remarkable changes of the status quo. Concerning the sensitivity of the methods mentioned above, ultrasonography alone can give easy and quick information. In the case of pathological findings, the indication for more complex investigations (VOP and LRR) can be established.

Female↗

[Sonography as a screening examination method of the venous system in pregnancy. Comparative studies of the arm and leg vein system].

Comparative studies were conducted during the third trimenon of pregnancy between the 36th and 40th weeks of gestation and on the seventh day after delivery, at the venous system of the legs (vena iliaca, v. femoralis and v. poplitea) and at the venous system of the arms (v. brachialis). A marked reduction of the venous diameters was seen on the legs, whereas no difference was found in the venous system of the arms between both times of measurement. This points to the haemodynamic effect of the pregnant uterus, providing an obstacle to the flow of blood from the venous system of the legs. After delivery there is a relatively higher extensibility of the veins of the leg compared with the measurements in the third trimenon. This may be due on the one hand to the long-lasting overextension during pregnancy, and on the other hand also to the hormonal and enzymochemical changes that take place even during the puerperium. Doppler sonography of the v. femoralis showed clearly that the foetus obstructs blood flow from the venous system of the legs. Sonography seems to be able to visualise direct the changed morphology of the veins during pregnancy and to indirectly yield information on the extensibility of the venous system eg during standing, thus demonstrating in what way the venous system functions in a particular condition. Hence, sonography of the venous system of the legs during pregnancy should be used as a screening method wherever it is essential to discover extreme venous dilatations well in time and to initiate compression treatment.

Arm↗

[Non-invasive diagnosis of the venous system of the leg in pregnancy].

During pregnancy one should largely avoid invasive and radiological diagnostic methods. However, real-time sonography and venous occlusion plethysmography yield non-hazardous information on venous morphology and venous function. It became possible to demonstrate by means of these examination methods that the diameters of the veins are enlarged in pregnancy compared to the situation post partum. The difference in significant. Venous occlusion plethysmography points to a deterioration of venous function post partum, since the difference to the values in the third trimenon is not significant. Venous function measurement often pointed to the existence of an obstacle to flow during pregnancy, whereas sonographically a dilatation of the veins was revealed the existence of an obstacle to flow represented by the pregnant uterus. Hence, it appears meaningful to combine both investigation methods to confirm the occurrence of venous changes during pregnancy.

Blood Flow Velocity↗

Uroflow measurements: their information yield in a long-term investigation of pre- and postoperative measurements.

This investigation shows that the reproducibility of uroflow measurements is limited. For their evaluation, anamnesis and the measured results have to be taken into account equally. We found correspondence of both parameters in about 50% only. One single measurement cannot provide precise information, as psychogenic, social, and other factors influence the measurement. In our study 3 subjects had their micturitions registered over a period of 2 months. We found an increase of the maximum flow with increasing bladder volume. The maximum bladder volume was reached in only four micturitions. Normal values range at about 25% of the maximum bladder volume. Analyzing the micturitions in regard to the time of day, we found maximum flow rates in the morning hours. Under clinical conditions the altered surroundings lead to a measured result which is psychogenically influenced and can only be balanced after repeated measurements. The curves of all 3 patients were equal and inconspicuous. In cases of infravesical obstruction, surgical success could be documented by comparing the pre- and postoperative uroflows. In all cases of neurogenic bladder disorders and unclear findings, uroflow measurements are, however, not sufficient, and diagnosis is accomplished by a complete urodynamic examination. In spite of certain restrictions, uroflowmetry yields a high level of information, besides being a simple, at any time reproducible, and noninvasive procedure. Due to its low costs, it should be the primary step in diagnostics in the clinic as well as for practitioners.

Adult↗

[Stomatologic studies in schizophrenic patients--contributions to the problem of medical and social integration of psychiatric patients].

Stomatological examination was carried out on 173 patients with schizophrenia (IKK-Nr. 295). It was observed that this group of patients showed a diminished dental and oral care in comparison to the average population of the same region. The close cooperation of dentists with the institutions for chronic patients will be as prophylactic measure in favour of the patients encouraged.

DMF Index↗

[Late results in fallopian tubes studies on the Bleier clip].

We report on 243 patients with sterilisation by the Bleier Clip. 234 patients were operated by coeliotomia posterior. 9 cases were sterilized in combination with Caesarean section. In 4 of 243 women we observed pregnancies during the follow-up period (failure rate = 16%). The mean time of the 4 conceptions after operation was 43 months. This result shows that the primary cause was not the operation technique but the systemic failure of the Bleier Clip. In cases with controls by hysterosalpingography all Fallopian tubes were occluded, 84% together with a sactosalpinx.

Cesarean Section↗

[History and urodynamic findings in incontinent women].

The history and urodynamic findings correlate with each other in only 52% of the cases. The best correlation was in cases of stress incontinence. The least correlation occurred in cases of mixed incontinence. The best choice for the surgical and pharmacological management of urinary incontinence in women is based on a review of all collected findings and on knowledge of the physiology and anatomy of urinary incontinence.

Adult↗

[Abdominal decompression - should this obstetric method be employed in future too? (author's transl)].

Heyns developed a method to produce decompression in the abdomen of pregnant women. He stated that the method was recommended to promote analgesia during the period of dilatation and to shorten the delivery period. Since enhanced blood supply of the placenta was expected also, the method was stated to be useful in gestosis patients. Regular application during the last three months of pregnancy were said to enhance the intelligence of the foetus. The examinations quoted in this article show insufficient analgesia and lack of shortening of the delivery period. No clear evidence of increased placental blood supply was seen. On account of the uncomfortable mode of application and the hypovolaemic sequential condition this method has not been accepted as obstetric practice.

Blood Pressure↗