Biomedical subjects

E Kruse

Publications and source records attributed to E Kruse.

At least 19 recordsLinked to original sources

PubMed2000

[Acceptance of wearing a hearing aid by children].

BACKGROUND: Having one or 2 hearing aids is not a guarantee that a child will wear the instruments constantly. The purpose of this study was to evaluate the hearing aid acceptance by children (assessed using the daily wearing time). PATIENTS AND METHODS: A total of 116 parents of a patient population of persistent hearing-impaired children with a need for a hearing aid (average age 51.1 +/- 30.1 months) rated the wearing acceptance of their children on a 5-point-Likert-scale. This assessment was made after the child had received its individual hearing aid for its specific disorder (on average after 5 months). Hearing levels ranged from mild to profound. RESULTS: 58.6% of the children accepted their electroacoustic aids amplier "excellent" or "good", 18.1% did it "average", 23.3% "bad" to "miserable" or even "not at all". There was no significant difference between girls and boys. The wearing acceptance from children with unilateral hearing impairments was reduced, especially from those with chronic conductive disorders by malformations of the ears. Very young children (prelingual hearing impairments), mainly those with additional handicaps and/or not German speaking homes demonstrated a "bad" to missing wearing behaviour. Hearing acceptance did not correlate with the severity of the disorder. CONCLUSION: The wearing acceptance as one aspect of compliance should be rated before each regular hearing aid control. Finally it is an efficient and sensitive mean to detect faulty amplification and changed diagnosis.

Child↗

PubMed2000

Foix-Chavany-Marie (anterior operculum) syndrome in childhood: a reappraisal of Worster-Drought syndrome.

Foix-Chavany-Marie syndrome (FCMS) is a distinct clinical picture of suprabulbar (pseudobulbar) palsy due to bilateral anterior opercular lesions. Symptoms include anarthria/severe dysarthria and loss of voluntary muscular functions of the face and tongue, and problems with mastication and swallowing with preservation of reflex and autonomic functions. FCMS may be congenital or acquired as well as persistent or intermittent. The aetiology is heterogeneous; vascular events in adulthood, nearly exclusively affecting adults who experience multiple subsequent strokes; CNS infections; bilateral dysgenesis of the perisylvian region; and epileptic disorders. Of the six cases reported here, three children had FCMS as the result of meningoencephalitis, two children had FCMS due to a congenital bilateral perisylvian syndrome, and one child had intermittent FCMS due to an atypical benign partial epilepsy with partial status epilepticus. The congenital dysgenetic type of FCMS and its functional epileptogenic variant share clinical and EEG features suggesting a common pathogenesis. Consequently, an increased vulnerability of the perisylvian region to adverse events in utero is discussed. In honour of Worster-Drought, who described the clinical entity in children 40 years ago, the term Worster-Drought syndrome is proposed for this unique disorder in children.

Adolescent↗

PubMed2000

Acoustic voice analysis by means of the hoarseness diagram.

The hoarseness diagram (Michaelis, Fröhlich, & Strube, 1998a) has been proposed as a new approach to describe different acoustic properties of voices. To test its performance in the analysis of pathologically disturbed and normal voices five requirements are suggested that should be met by any acoustic voice-analysis protocol to be used in voice research and clinical practice. The hoarseness diagram is then tested with regard to these requirements. Individual voices are found to show a satisfactory localization in the diagram. Aspects of stationarity are discussed in the context of four case studies. The different cases illustrate that changes in the acoustic analysis results are observed if the voice-generation conditions change, whereas results are stationary if phonation conditions do not change. Different pathological voice groups defined on grounds of the specific phonation mechanism are found to map to specific regions of the hoarseness diagram, with differences between group locations being significant. All results can be interpreted without exceptions if the two hoarseness diagram coordinates are taken to reflect the vibrational irregularity of the voice-generation mechanisms on the one side and the degree of closure of the vibrating structures on the other side. The hoarseness diagram and its underlying algorithms are thus shown to constitute a useful approach to acoustic voice analysis in research and clinical practice. The tests themselves demonstrate several application possibilities, including the quantitative monitoring of individual voices.

Adolescent↗

PubMed2000

Role of magnesium chelatase activity in the early steps of the tetrapyrrole biosynthetic pathway.

Magnesium-protoporphyrin IX chelatase (Mg-chelatase) is located at the branchpoint of tetrapyrrole biosynthesis, at which point protoporphyrin IX is distributed for the synthesis of chlorophyll and heme. We investigated the regulatory contribution of Mg-chelatase to the flow of metabolites. In plants, the enzyme complex consists of three subunits, designated CHL D, CHL I, and CHL H. Transgenic tobacco (Nicotiana tabacum) plants expressing antisense RNA for the Mg-chelatase subunit CHL H were analyzed to elucidate further the role of Mg-chelatase in the distribution of protoporphyrin IX into the branched tetrapyrrolic pathway. The transgenic plants displayed a reduced growth rate and chlorophyll deficiency. Both phenotypical properties were correlated with lower Mg-chelatase activity. Unexpectedly, less protoporphyrin IX and heme accumulated, and a decrease in 5-aminolevulinate (ALA)-synthesizing capacity and ALA dehydratase activity paralleled the progressive reduction in Mg-chelatase activity in the transformants compared with control plants. The reduced activities of the early enzymatic steps corresponded with lower levels of transcripts encoding glutamyl-tRNA reductase and ALA-dehydratase. The decreased expression and activities of early enzymes in the pathway could be explained by a feedback-controlled mechanism in response to lower Mg-chelatase activity. We discuss intercompartmental signaling that synchronizes the activities of the first steps in tetrapyrrolic metabolism with the late steps for the synthesis of end products.

Lyases↗

PubMed1999

Effects on vocal function and incidence of laryngeal disorder when using a laryngeal mask airway in comparison with an endotracheal tube.

A study of 56 patients was undertaken to determine whether there is a difference in the effect of the laryngeal mask airway and the endotracheal tube on the vocal tract after short-duration anaesthesia. All the patients were interviewed pre- and post-operatively. In 43 patients, it was possible to assess the larynx using videoendoscopy and videostrobolaryngoscopy both pre- and post-operatively. Selected acoustic characteristics were investigated in 51 patients pre- and 18-24 h post-operatively. Thirty-four patients that did not have anaesthesia were used as an age-matched control. The interview showed, that patients in the LMA group complained less frequently of having post-operative laryngeal discomfort. The videostrobolaryngoscopy demonstrated minor lesions of the vocal tract in six patients in the ETT group and in one patient in the LMA group. Of the 12 voice variables evaluated, there was no significant difference in any parameter between the two groups. Both groups had a higher fundamental frequency post-operatively.

Adolescent↗

PubMed1999

Reduced activity of geranylgeranyl reductase leads to loss of chlorophyll and tocopherol and to partially geranylgeranylated chlorophyll in transgenic tobacco plants expressing antisense RNA for geranylgeranyl reductase

The enzyme geranylgeranyl reductase (CHL P) catalyzes the reduction of geranylgeranyl diphosphate to phytyl diphosphate. We identified a tobacco (Nicotiana tabacum) cDNA sequence encoding a 52-kD precursor protein homologous to the Arabidopsis and bacterial CHL P. The effects of deficient CHL P activity on chlorophyll (Chl) and tocopherol contents were studied in transgenic plants expressing antisense CHL P RNA. Transformants with gradually reduced Chl P expression showed a delayed growth rate and a pale or variegated phenotype. Transformants grown in high (500 &mgr;mol m-2 s-1; HL) and low (70 &mgr;mol photon m-2 s-1; LL) light displayed a similar degree of reduced tocopherol content during leaf development, although growth of wild-type plants in HL conditions led to up to a 2-fold increase in tocopherol content. The total Chl content was more rapidly reduced during HL than LL conditions. Up to 58% of the Chl content was esterified with geranylgeraniol instead of phytol under LL conditions. Our results indicate that CHL P provides phytol for both tocopherol and Chl synthesis. The transformants are a valuable model with which to investigate the adaptation of plants with modified tocopherol levels against deleterious environmental conditions.

Journal Article↗

PubMed1998

[Objective description of voice quality using the hoarseness diagram].

The need for an objective assessment of voice quality can be seen in the increasing use of acoustic analysis methods for clinical diagnosis and research. The hoarseness diagram allows clinicians to objectively describe even highly disturbed or aphonic votes. Its application possibilities are illustrated in three case studies in which changes in voice quality were monitored during voice rehabilitation. The distributions of voice groups that were defined on the basis of specific pathophysiological phonation conditions were then compared for their acoustic differences. The groups comprised various phonation conditions after the resection of laryngeal tumors and different types of laryngeal paralyses. Interpretation of the results suggests a direct correspondence of the hoarseness diagram coordinates and the irregularity of vibration on the one side and the degree of glottal closure on the other. This illustrates the potential usefulness of the hoarseness diagram in a clinical context.

Adult↗

PubMed1998

Psychological profiles of patients with laryngeal contact granulomas.

The association between laryngeal contact granuloma and demographic/psychological variables was examined by using a psychosomatic approach to health research. A stepwise procedure of logistic regression analyses was utilized to get a final multivariate model of variables associated with the clinical finding of a laryngeal contact granuloma. The subjects consisted of 47 patients with contact granulomas and 110 patients with voice disorders due to other causes. Our analysis of 22 variables uncovered the following statistically significant factors for developing a contact granuloma: male gender (P = 0.0001), low achievement orientation (P = 0.0007), fear of physical lesions (P = 0.0038), impulsiveness (P = 0.0016), age > 60 years (P = 0.0012), low extraversion (P = 0.004), high achievement orientation (P = 0.0079), fear of appearing in public (P = 0.0216) and strain (P = 0.03). These results show that a variety of variables are important for predicting the development of a laryngeal contact granuloma. The usefulness of this set of risk variables for predicting a contact granuloma remains to be proved in a prospective study. It is possible that not only the nature but the number of risk factors are the prime determinants of outcome.

Achievement↗

PubMed1998

[Higher touch and kinesthetic functions in children with former speech/language development disorders: a neuropsychological study].

Two groups of children took part in this study to test the hypothesis that children diagnosed in infancy as specific speech/language-impaired have deficits in tactile-kinesthetic functions: A formerly clinical group of 25 German-speaking pupils with a mean age of 8;7 years (SD 7.1 months) who have previously been identified as specific speech/language-impaired (on average at 4;11 years, SD 10.6 months) and a control group of 25 normal pupils in elementary school without a former or actual speech/language disorder (mean age: 9;2 years, SD 8.3 months). The control group was matched with the formerly clinical group for gender and age. Performance scores of both groups on a nonverbal intelligence test (the Raven's Matrices), on a tactile-kinesthetic subtest (Berliner-Luria-Neuropsychologisches Verfahren f¿r Kinder), and on a developmental language test (Heidelberger Sprachentwick- lungstest) were compared. There was a significant difference (p < 0.05) in the mean tactile-kinesthetic performance of both groups (3.1 vs. 4.0) who present a nearly identical nonverbal intelligence. Thirty-two percent of the formerly clinical group demonstrated a performance below the norm. Analysis of the laterality did not reveal significant differences in performance between left and right hand, neither in right-handers nor in left-handers of both groups. Nevertheless right-handers demonstrated on average a better somatosensory performance with their left hand. Mean language and tactile-kinesthetic performance correlate significantly in the formerly clinical group (r = 0.45, p < 0.05), but not in the control group (r = 0.08). The formerly clinical group was inferior in performance to the normal subjects especially in complex functions as in the tactile discrimination of sharp/blunt and in topognosia.

Child↗

PubMed1998

Evaluation of side effects after nicotine nasal spray in patients with chronic rhinitis.

Thirty-three subjects with chronic rhinitis used nicotine nasal spray in an open study as an aid in smoking cessation. Thirty-eight percent of them were completely abstinent at 12 weeks, whereas 35% were completely abstinent at 20 weeks. The nasal spray was associated with irritant nasal side effects, which occurred most often in the early stages of treatment. Clinical nasal examinations could not observe any significant impairment in nasal conditions following spray use. In conclusion, this study confirms the short-term safety of the nicotine nasal spray as an aid in smoking cessation.

Administration, Intranasal↗

PubMed1997

Cloning and characterization of a plastidal and a mitochondrial isoform of tobacco protoporphyrinogen IX oxidase.

Protoporphyrinogen IX oxidase is the last enzyme in the common pathway of heme and chlorophyll synthesis and provides precursor for the mitochondrial and plastidic heme synthesis and the predominant chlorophyll synthesis in plastids. We cloned two different, full-length tobacco cDNA sequences by complementation of the protoporphyrin-IX-accumulating Escherichia coli hemG mutant from heme auxotrophy. The two sequences show similarity to the recently published Arabidopsis PPOX, Bacillus subtilis hemY, and to mammalian sequences encoding protoporphyrinogen IX oxidase. One cDNA sequence encodes a 548-amino acid residues protein with a putative transit sequence of 50 amino acid residues, and the second cDNA encodes a protein of 504 amino acid residues. Both deduced protein sequences share 27.2% identical amino acid residues. The first in vitro translated protoporphyrinogen IX oxidase could be translocated to plastids, and the approximately 53-kDa mature protein was detected in stroma and membrane fraction. The second enzyme was targeted to mitochondria without any detectable reduction in size. Localization of both enzymes in subcellular fractions was immunologically confirmed. Steady-state RNA analysis indicates an almost synchronous expression of both genes during tobacco plant development, greening of young seedlings, and diurnal and circadian growth. The mature plastidal and the mitochondrial isoenzyme were overexpressed in E. coli. Bacterial extracts containing the recombinant mitochondrial enzyme exhibit high protoporphyrinogen IX oxidase activity relative to control strains, whereas the plastidal enzyme could only be expressed as an inactive peptide. The data presented confirm a compartmentalized pathway of tetrapyrrole synthesis with protoporphyrinogen IX oxidase in plastids and mitochondria.

Amino Acid Sequence↗

PubMed1997

Spasmodic laryngeal dyspnea: a rare manifestation of laryngeal dystonia.

We describe clinical experiences in the management of three patients with laryngopharyngeal dystonia causing severe breathing problems. In contrast to spasmodic dysphonia, which presents with action-induced involuntary spasm of laryngeal muscles during speaking, all three patients showed laryngopharyngeal spasms primarily during respiration. In analogy to spasmodic dysphonia we propose the term spasmodic laryngeal dyspnea for this rare condition. Localized unilateral botulinum toxin injected into the thyroarytenoid muscle and/or ventricular folds reduced the quantity and quality of spasms and led to a pronounced improvement of breathing problems.

Aged↗

PubMed1997

Identification and diagnostic evaluation of hearing impairments in early childhood in German-speaking infants.

The present study was devised to gather epidemiological information to aid in understanding the etiology, identification, and management of children with permanent hearing losses in Lower Saxony as a defined geographical area of Germany. All infants and preschool children were identified in the Department of Phoniatrics and Pediatric Audiology during a 1-year period (October 1994 until October 1995). Forty-four hearing-impaired children were identified, of whom 41 (93%) had sensorineural losses and 3 had pure conductive losses. Thirty-two children (73%) had bilateral hearing impairments. The causes of hearing loss were unknown in 17 children (39%). The median age of identification for the study group was 32 months, with a median age of 35.5 months when fitting hearing aids. Severity of hearing loss was inversely associated with age of identification. Prelingually deaf children had the worst comprehension levels of all children tested psychologically. Results were tabulated and special references to other studies were discussed. Our findings show again that the successful out-come of speech and language development depends on early identification and management of the hearing loss, and on continued assessment of the progress of habilitation. These require a basic assessment of the stage of language development (in perception and expression) as relevant rehabilitation measures. The next step is the treatment of existing linguistic deficits followed by retests at regular intervals.

Child, Preschool↗

PubMed1997

[Quality control in pediatric hearing aid fitting].

Specific hearing aid selection and careful fitting are essential for successful rehabilitation of hearing-impaired children. For this reason the different hearing aid types prescribed, the type and frequency of hearing aid insufficiencies reported and the effectiveness and regularity of our follow-ups were studied evaluating 253 followup exams in 39 children (71 ears) suffering of a sensorineural hearing loss, including all degrees, supplied with a behind-the-ear hearing aid. Most of the devices had been prescribed outside our department on an initial trial basis. After critical evaluation, the number of hearing aid types was reduced from 33 to 23 when corresponding devices failed to match well with the degrees and types of hearing losses present. A further decrease in hearing aid types could not be achieved as a consequence of many being already end-prescribed. Insufficiencies (n = 222) were found in 60% of the hearing aid evaluations: 59% involved dynamic hearing aid adjustments requiring better amplification (37%), distortion (18%) and dynamics (4%). Additionally, 16% affected hearing aid function and another 16% form (9%) and material (4%) of the otoplasty and the tube (3%). The last 9% of the deficiencies concerned the potentiometer cap: it hadn't been fitted in about half of the cases and had been lost in the other half despite being needed. Routine followup evaluations of the hearing aids occurred regularly in 76% of the cases with an effectiveness of 73%. Our results confirm the importance and necessity for pedaudiologic qualitative hearing aid controls in children.

Audiometry, Evoked Response↗

PubMed1997

[Follow-up of patients with laryngeal contact granuloma].

A conservative approach (vocal rest, voice therapy, antibiotic treatment of infections and/or management of esophageal reflux) and microsurgery have been used to heal laryngeal contact granulomas. Unfortunately, recurrences have been found in most cases. In the present study we followed 45 patients after an initial diagnosis of a contact granuloma was made based on laryngoscopy and stroboscopy with video-documentation. All studies were conducted in the Department of Phoniatrics (University of Göttingen) during the past four years, with follow-ups made at 3 month-intervals up to 12 months after diagnosis. All patients were counselled using a focal psychosomatic approach. Follow-up was possible for 41 patients. Findings showed that 19 patients lost their contact granulomas completely without therapy, 12 of which occurred over a period to 13 months after diagnosis. Seven patients underwent microsurgery at their own requests, with 5 developing recurrences when compared with the first diagnosis, 15 patients still had a contact granuloma. Emotional strain in connection with specific personality traits seemed to operate as a significant variable in the remission of contact granulomas.

Adult↗

PubMed1997

[Functional voice quality assessment in curative microsurgery of laryngeal malignancies. Postoperative voice rehabilitation based on the "laryngeal double valve function"].

According to Negus and Pressman the sphincter systems of the vocal folds and the ventricular folds form a respiratory "laryngeal double valve function". Correspondingly, we found a physiological phonation system of the glottis and a pathological-compensatory one of the supraglottis. They appear to be regulated through an automatic phonatory control system with the glottal phonatory function evidently acting as sensor level. In order to confirm this hypothesis, objective voice analyses with glottal-relevant parameters of 26 voice-rehabilitated patients after minimally invasive laser surgery of glottal carcinomas are presented and integrated into a "hoarseness diagram" with the coordinates roughness and breathiness. Using statistically deliminated acoustic dusters, our data show a qualitative hierarchy of different postoperative phonation mechanisms. They demonstrate the influence of the vibratory capacity of glottal and supraglottal structures on the quality of the vibratory closure. Both functional parameters evidently determine the resulting voice quality in the sense of our hypothesis.

Female↗

PubMed1997

Isolation and characterisation of tobacco (Nicotiana tabacum) cDNA clones encoding proteins involved in magnesium chelation into protoporphyrin IX.

We have identified cDNA clones encoding the two Mg chelatase subunits CHL I and CHL H from tobacco (Nicotiana tabacum) by screening a cDNA library with homologous cDNA fragments from Arabidopsis thaliana. A full-length Chl I cDNA clone encodes a peptide with 426 amino acids. The entire cDNA sequence encoding 1382 amino acid long CHL H was obtained by extension of a truncated cDNA fragment using the 'rapid amplification of cDNA ends' (RACE) method. Both genes Chl I and Chl H were strongly expressed in young leaves and to a lesser extent in mature leaves. Only traces of both transcripts were found in flowering organs. Southern blot analysis suggests that CHL I is encoded by a single gene and CHL H most likely by several genes.

Blotting, Northern↗

PubMed1997

Mg-chelatase of tobacco: identification of a Chl D cDNA sequence encoding a third subunit, analysis of the interaction of the three subunits with the yeast two-hybrid system, and reconstitution of the enzyme activity by co-expression of recombinant CHL D, CHL H and CHL I.

Mg-protoporphyrin IX chelatase catalyzes insertion of the magnesium ion into protoporphyrin IX, the last common intermediate precursor in chlorophyll and heme biosynthesis, to form Mg-protoporphyrin IX. In Rhodobacter sphaeroides, and Synechocystis, the three open reading frames bchD/chID, bchH/chIH and bchI/chII encode proteins which are required for in vitro Mg-chelatase activity. In higher plants also, three proteins are necessary for the Mg chelation, and genes homologous to bchH and bchI have been isolated previously. In this study, a novel tobacco cDNA sequence homologous to bchD is isolated and initially characterized. Together with the tobacco clones encoding the other two subunits, full-length cDNAs are now available for the first time for all three subunits of one plant species. The CHL D polypeptide deduced from the open reading frame encodes a protein of 758 aa (82.9 kDa) with an amino terminal extension that resembles a plastid transit peptide. Sequence comparison of tobacco CHL D revealed similarities to the D subunit of Rhodobacter and Synechocystis of 44% and 75%. The amino terminal half of CHL D shows significant similarity (46%) to the entire CHL I peptide sequence, indicating a gene duplication from an ancestral gene. The carboxy terminal half seemed to be unique. Both parts of CHL D are linked with a glutamine/asparagine/proline-rich region flanked by a highly acid-rich segment. Protein-protein interaction among the three subunits CHL D, H and I was studied using the yeast two-hybrid system. Physical interaction was demonstrated between CHL D and CHL I indicating that CHL D is part of the Mg-chelatase. Heterodimer formation of CHL H with CHL I or CHL D could not be demonstrated by transactivation of the lacZ reporter gene. Homodimerization of the CHL D subunit was indicated in the more sensitive assay on X-Gal-containing agar plates. In vitro Mg2+ insertion into protoporphyrin IX was demonstrated in protein extracts of yeast strains expressing the three subunits of tobacco Mg-chelatase. The reconstitution of the recombinant enzyme activity required additional ATP.

Amino Acid Sequence↗