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Biomedical subjects

J Kühr

Publications and source records attributed to J Kühr.

At least 37 records · Page 2Linked to original sources
PubMed1992

[Urinary N-methylhistamine excretion. Following exogenous histamine administration and allergy/exercise-induced bronchoconstriction].

Histamine is partly metabolized to a stabile metabolite N-methyl-histamine and excreted in the urine. We analysed the degradation of infused histamine and the N-methyl-histamine-excretion in atopic and normal individuals as in patients with a bronchoconstriction due to allergen/exercise challenge. N-methyl-histamine was determined by a newly developed radioimmunoassay. 60 controls and 38 atopic individuals were investigated. There is a proportional increase of N-methyl-histamine in the urine in young children. However, no significant difference between allergic and non-allergic individuals was found. After parenteral administration of a standardized amount of histamine 12% of the applied amount was secreted in the urine as N-methylhistamine. The most significant increase of N-methylhistamine-excretion was observed in the first hour after application. Only an 0.1% rise of N-methyl-histamine was observed following an oral administration of histamine. Neither bronchial challenge with specific allergen nor physical exercise elicited significant changes of N-methylhistamine excretion. The secretion of N-methyl-histamine demonstrates the degradation of histamine in the circulation, the measurement oft this metabolite in the urine should be considered when analysing the cause of severe systemic allergic reaction as anaphylaxis but not asthma or atopic disposition.

Adolescent↗
PubMed1991

[Air pollutant burden and bronchial asthma in school children].

To examine the possibility of an effect of indoor and outdoor exposures on the prevalence of asthma in childhood we conducted a cross-sectional study in the area of Freiburg city and two communities in the Black Forest. The study group consists of 704 children aged 7 to 16 years. The children and their mothers took part in a standardized interview and a medical examination. Indoor exposures were assessed from information gathered in the interview by two different indices: (a) heating system and single room heating, and (b) the amount of indoor ventilation. The measurement of outdoor pollutants took into account weekly estimations of NO2 and combustion particles. The presence of asthma was recorded according to a previous medical diagnosis. Confounders were assessed during the interview (passive smoking, genetic predisposition to asthma etc.) or during the medical examination (cutaneous sensitization with a skin prick test). For the analysis of the data we applied logistic regression models and estimated odds-ratios. Only one of the four hypothesis variables displays a significant effect on the prevalence of asthma: Stoves as heating device carry a 4.8-fold relative risk for asthma compared to other types of heating. Among the confounding variables controlled for in the explanatory model, cutaneous reactions showed a relative risk of eight.

Adolescent↗
PubMed1991

[Clinical and epidemiological application of carbachol for the testing of bronchial hyperreactivity in school-age].

Airway reactivity was investigated by inhalation of the cholinergic agent carbachol. A standardized Carbachol challenge test (CCT) was carried out in a cumulative manner in 59 school-aged children as well as 10 not asthmatic individuals. The carbachol aerosol was delivered by jet nebulization. It was administered by inhalation of stepwise twofold increasing cumulative doses from a balloon taking tidal breaths. The inhalation was finished at the dose step eliciting a 100% increase in R(aw). Bronchial reactivity was derived by linear regression from the dose-response function. Bronchial sensitivity was registered by the threshold dose. Calculated on the bronchial reactivity of 57 asthmatics the asthma-related sensitivity of the CCT was 83%. The specificity was 90%. In 7 children the week-to-week reproducibility was tested: 6 children showed discrepancies of the threshold dose of less than two steps, in one case a shift of two steps was observed. In none of the probands a severe systemic side effect occurred. The carbachol challenge test is an appropriate method to distinguish asthmatic children from the normal population. The validity and good reproducibility as well as the feasibility in children makes the procedure valuable for pediatric investigations of bronchial hyperreactivity as a common feature in asthma.

Bronchial Hyperreactivity↗
PubMed1990

[The immunogenicity and allergenicity of an experimental cow's milk protein hydrolysate].

Recently hydrolyzed cow milk proteins have been introduced for the production of infant formulas and are available as hypoallergenic infant formulas. To achieve a decrease in antigenicity and allergenicity a protein hydrolysis (mostly enzymatic) is performed. Sera of different groups were tested for IgG and IgE antibody-binding: 31 controls, 36 atopic children, and 20 children with cow milk protein allergy. Histamine release from basophil leucocytes after incubation with the cow milk proteins beta-lactoglobuline and casein, as with the cow milk protein hydrolysate, was determined additionally for five control, 10 atopic, and five cow milk allergic children. IgG binding to cow milk protein and to the hydrolysate was found in the majority of the sera tested. IgE binding was detectable in sera of only five of the 10 cow milk allergic children, despite detection of specific IgE-antibodies against cow milk proteins in all sera. Histamine release by the cow milk hydrolysate was observed for five atopic and two cow milk allergic children. The cow milk hydrolysate demonstrated a decreased but partially conserved antigenic/allergenic potency compared with cow milk proteins.

Adolescent↗
PubMed1990

Determination of N-methylhistamine in urine as an indicator of histamine release in immediate allergic reactions.

The use of the urine histamine metabolite, N-methylhistamine (N-MH), as a parameter of histamine release in immediate allergic reactions was investigated. Baseline levels were determined in 34 normal control subjects and 29 atopic patients. Increases of urine N-MH values were measured during histamine infusions and in venom-allergic patients receiving bee-sting challenges. N-MH was determined by a newly developed radioimmunoassay. Baseline levels in control subjects and atopic patients demonstrated no significant differences. With regard to challenge tests, fluctuation of N-MH levels during a 6-hour period was measured. Random 6-hour increases in healthy and atopic subjects ranged from 5% to 41%. Before infusion of histamine (0.25 micrograms/kg/min for 30 minutes), baseline values were 137 +/- 11.4 micrograms N-MH per gram of creatinine and 9 +/- 1.1 micrograms N-MH per hour (n = 9). Levels peaked 1 hour after infusion at 275 +/- 45 micrograms/gm of creatinine and 44 +/- 5.6 micrograms/hr and decreased to resting levels after 2 hours. Metabolization by N-MH accounted for 9.5% +/- 4.9% (range, 2.4% to 18.4%) of infused histamine in the urine of the nine subjects. Bee-sting challenges were performed in 12 patients and three control subjects. Only in three patients experiencing generalized urticaria, nausea, dyspnea, and hypotension were significant increases of urine N-MH levels (138%, 144%, and 238%) observed. All other patients and three normal control subjects demonstrated normal local reactions without increase of N-MH values.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

[Sensitization to 10 important air-borne allergens in school children].

Sensitization patterns and frequencies for 10 important aeroallergens were tested in a cross-sectional study with 704 schoolchildren (7-16 years) using a standardized skin prick-test method and highly purified immunochemically characterized test-solutions. A ratio of allergen and histamine wheal diameter of 0.5 or more was classified as a positive skin test result. We found a positive skin prick-test to at least one of the aeroallergens in 242 (34.4%) of the children. Among these 39.6% showed monosensitization and 9.8% polysensitization to at least 6 allergens. The most common allergens were grasspollen (19.2%), birchpollen (14.8%), house-dust mite (13.4%), catdander (10.5%) and hazelpollen (9.7%). Monosensitized children reacted mainly to grasspollen and house-dust mite, whereas positive reactions to animal dander and moulds only occurred in polysensitized children more frequently. Reactivity of the tested allergens, measured by the wheal size, was strongest for grasspollen and house-dust mite and the weakest for cladosporium and alternaria. The high prevalence of sensitization to inhalant allergens is an important risk-factor for allergic disease in childhood.

Adolescent↗
PubMed1990

[Thoracic injuries in traffic accidents and non-traffic accidents].

Traffic accidents differ from non-traffic accidents where the injuries are concerned. With the males two thirds of the thoracic injuries happened in non-traffic accidents and one third in road accidents; with the females, the relation was reversed. In thirteen per cent of the traffic accidents and in twenty-five per cent of the non-traffic accidents there were only thoracic injuries, in the other cases there were multiple injuries. Blunt damages of the thorax occurred in the majority of both kinds of accidents, penetrating injuries were less common. Closed rib fractures happened twice as often in traffic accidents as in accidents at work. Compound fractures of the ribs were three times as frequent in non-traffic accidents as in traffic accidents. In thirty-five per cent of road accidents and in twenty-two per cent of non-traffic accidents the injuries were of an intrathoracal kind. Of all the three hundred and thirty thorax injured patients thirty-four did not survive their injuries, twenty-nine due to traffic accidents, and five due to non-traffic accidents.

Accidents, Occupational↗
PubMed1990

[Accident and injuries situations in accidents at school and on the way to and from school].

In the Federal Republic of Germany, where accidents to schoolchildren are covered by the statutory accident insurance, a total of 991,947 accidents of this kind occurred in 1987, 133 of which were fatal. In this study, the accidents and injuries sustained by 1059 schoolboys and schoolgirls who received medical treatment in our clinics are analysed. We are concerned here with 887 accidents actually at school and 172 accidents on the way to or from school. In the case of accidents at school, the proportion of 6-, 7- and 8-year-olds affected was below 3% for each of these age groups. The percentage of children involved in accidents at school increased steeply with increasing age, reaching a peak in girls at 12 years of age, with 15.4%, and in boys at 13 years, with 14.5%. After this, the proportion in each individual age group lay between 10% and 12% up to 17 years of age and decreased to 7% in 19-year-olds. The proportion of accidents among 20- and 21-year-olds was less than 2%. Of the 887 accidents at school, 53% occurred during sports lessons, 28% during break times, 11% in the course of the general coming and going involved in attendance on the school premises, 3% during instruction in academic subjects and 3% during extracurricular activities, e.g. school outings. Each of these accident areas has its typical accident risks, and often its characteristic accident pattern in addition. Furthermore, there are age-specific and sex-specific features. The frequency of injuries to the upper extremities, including the hand, was 11% higher in girls than in boys.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents↗
PubMed1989

Relevance of basophil histamine release changes during venom immunotherapy.

We investigated the effect of rush and long-term venom immunotherapy on histamine release parameters in bee venom allergic patients. Ten patients received rush venom immunotherapy, and histamine release data were obtained immediately before and after treatment. 17 patients were assessed by histamine release 24 to 63 months after termination of long-term venom immunotherapy. A control group of 10 non-allergic subjects was included in this study. Histamine released from whole blood was determined in a sensitive radio-enzymatic assay using a single isotope technique. Bee venom phospholipase A-induced histamine release from whole blood proved to be a test procedure of high specificity and sensitivity. Eight of 10 untreated patients and no control subject showed significant antigen-induced histamine release. Results obtained from patients immediately after successful rush venom immunotherapy showed an important decrease (mean 45.9%) of total histamine content of basophil leukocytes in all patients. Antigen-induced maximum histamine release was found to be increased in one, decreased in two and unchanged in seven patients. In patients who received long-term immunotherapy cell sensitivity to phospholipase A was significantly lower than in a group of untreated patients (P less than or equal to 0.002). These results suggest that even years after discontinuation of immunotherapy, histamine release parameters reflect patients' protection from systemic sting reactions as assessed by sting challenges. Histamine depletion of basophils induced by rush immunotherapy may play an important role in patients' protection immediately after termination of the rush regimen.

Adolescent↗
PubMed1989

Anti-IgE- and complement-induced histamine release from peripheral leukocytes in normals and atopics.

Anti-IgE- and complement-induced histamine release from isolated basophils was compared in normal and atopic subjects. Activated complement was generated by incubation of a serum pool from normal donors with zymosan. Histamine was measured by a single-isotope radioenzymatic assay. In atopics, the mean histamine release induced by heterologous complement was significantly higher than in normals (p less than or equal to 0.01). Anti-IgE-mediated histamine release showed no differences between atopics and normals. Regarding the histamine release as a function of the age of the donor, we observed significantly higher complement-induced release values in normal children aged 1-10 years compared to those aged 10-20 and greater than 20 years (p less than or equal to 0.05). Anti-IgE-induced histamine release showed no age-related differences in normals or atopic patients. As a high complement-mediated leukocytic histamine release was more commonly found in atopics with heterologous complement, this phenomenon appears not to be due to a higher rate of complement activation in the serum of atopics, but rather to an intrinsic cell abnormality. Moreover, these results suggest that age-related releasability patterns might be considered when studying complement-induced histamine release. Differences between IgE- and complement-mediated histamine release indicated that parameters of releasability must be defined with respect to each stimulus.

Age Factors↗
PubMed1989

[Epidemiologic recording of bronchial asthma in the school child].

Bronchial asthma is the most frequent chronic disease in childhood. Nevertheless, no definition of the disease is known that would enable a satisfactory epidemiological recording of asthma. In 704 schoolchildren, typical signs and symptoms of asthma were recorded within the framework of a standardized interview. The occurrence of asthmatic symptoms was quantified by means of a symptom score. In 555 of the probands, bronchial reactivity was tested by means of an inhalative challenge with carbachol. The information gathered from the interview and the carbachol challenge test was placed in relationship to the family doctor's diagnosis of "bronchial asthma". Lifetime prevalence of asthma diagnosed by the family doctors is 4.97% with a clear male predominance. The asthmatic symptoms showed varying frequencies and validity compared with the family doctor's diagnosis. The occurrence of dyspnoea appears to be particularly sensitive (77%). Dyspnoea coincident with exercise is highly specific (99%). The sensitivity of the combination of carbachol test and symptom score is 92% and the specificity is 75%. The instruments described above offer a reliable possibility for epidemiological field research to record the prevalence of bronchial asthma in schoolchildren.

Adolescent↗
PubMed1989

[Bronchial asthma and bronchial hyperreactivity].

Bronchial hyperreactivity to allergens and non-allergic stimuli is a feature of most patients with asthma as measured by the response to inhalants as pharmacological agents and physical stimuli. In contrast to adults there is an obvious relation of asthmatic episodes to allergen exposure in childhood. However, the development and persistence of bronchial hyperreactivity is well described by interaction of inflammation cells and their mediators. Not only the severity of asthma is related to the severity of bronchial hyperresponsiveness but also the therapeutic strategies.

Asthma↗
PubMed1983

[Modification of osteomyelitis with free musculocutaneous transplants].

Twenty two latissimus dorsi free flaps transplanted with microsurgical techniques in infected regions are presented. The guarants of success are the end-end anastomosis, the venous drainage over the deep veins, the muscle with its skin coverage. The indications are: soft tissue infections, early infections after fractures, and the chronic osteitis. The economic, social and psychological effects of microsurgical tissue transfer elevate this technique to the procedure of choice.

Adult↗
PubMed1982

[Angiomatous dysplasia (Weber type) (author's transl)].

A rare form of angiomatous dysplasia with hypotrophy of the left arm is described. Numerous haemodynamically significant arterio-venous fistulae could be demonstrated in the soft tissues and in bone. The venous and lymphatic systems were normal. The lacunar reticular-cystic changes in the spongiosa of the phalanges are pathognomonic of arterial angiodysplasia of the Weber type. In most cases this is associated with bone hypertrophy.

Adolescent↗
PubMed1982

[The effect of immobilization on the number and function of osteoblasts].

The influence of immobilisation on the number and function of osteoblasts was determined by morphological examination of normal rabbit bone and that that had been inactivated through surgery. Contrary to earlier supposition, after inactivation not only the osteoclasts but also the osteoblasts increase distinctly. Even retardation of the parathyroid gland by magnesium does not lead to decrease of the osseous structure. Therefore, it can be concluded that disuse osteoporosis is normally produced in its first weeks by a considerable activity decrease of even more osteoblasts and less by increased function of osteoclasts. The increase in number of osteoblasts and their decreased activity after immobilisation indicate that the mechanical stimulus gives the essential impulse for full osteoblast function.

Animals↗
PubMed1981

[CT diagnosis of chronic osteomyelitis (author's transl)].

The CT findings in 20 patients with chronic osteomyelitis, mostly of post-traumatic origin, were compared with conventional radiographs and operative findings. CT diagnosed rather more sequestra than the conventional method. An important advantage of CT is the ability to demonstrate lesions in the medulla and infections in the soft tissues, eg. abscesses. CT should be reserved for cases where conventional methods with tomography leave unsolved problems, and in the present of fistulae.

Adult↗