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Biomedical subjects

K Henning

Publications and source records attributed to K Henning.

At least 19 recordsLinked to original sources

Motor vehicle crash pedestrian deaths in New York City: the plight of the older pedestrian.

OBJECTIVE: To describe the epidemiology of pedestrian deaths due to motor vehicle crashes (MVCs) between age groups in New York City (NYC), with a comparison to national data. METHODS: Review of MVC pedestrian deaths in NYC and the US from 1998 to 2002. Data on deaths were obtained from the National Highway Traffic Safety Administration. RESULTS: Almost half (48%) of all MVC deaths in NYC were among pedestrians, compared with 12% nationally. Pedestrian death rates were highest among older age groups (> or =65 years). NYC's older pedestrians were more likely than US older pedestrians to be killed at an intersection, during daytime and on weekdays. CONCLUSION: Older people constitute a major proportion of MVC pedestrian deaths in NYC. Conditions (such as traffic exposure) surrounding pedestrian MVCs may differ by age group. The high burden of MVCs among older pedestrians in NYC highlights the importance of local-level analysis to guide public health planning.

Accidents, Traffic↗

[Zoonoses in working- and wild animals and their significance in Germany. An overview].

The control of infectious diseases transmitted from animals to humans (zoonoses) was recently put on a new basis in the European Union when a new Zoonoses Directive entered into force. Brucellosis, campylobacteriosis, echinococcosis, listeriosis, salmonellosis, trichinosis, and the respective causative agents, tuberculosis due to Mycobacterium bovis, and verotoxigenic Escherichia coli must be included in monitoring. Additional zoonoses and zoonotic agents are to be monitored according to the epidemiological situation. Against this background, the current knowledge on important zoonoses transmitted from livestock and some wildlife animals to humans as well as the epidemiological situation in Germany with regard to these diseases is summarized.

Animals↗

Laparoscopic partial adrenalectomy in patients with aldosterone-producing adenomas: indications, technique, and results.

OBJECTIVES: To report the indications, technique, and results in patients with primary hyperaldosteronism due to aldosterone-producing adrenal adenoma treated by laparoscopic partial adrenalectomy. Laparoscopy has become the technique of choice in adrenal surgery, but adrenalectomy is the standard procedure. Only a few studies have reported on partial adrenalectomy, and the indications and technique have not yet been clearly defined. METHODS: From June 1995 to December 2001, 13 patients presented with hyperaldosteronism and a single adrenal adenoma (Conn's syndrome) and were treated with laparoscopic partial adrenalectomy. The mean age was 60 years, and the average tumor size was 2.1 cm in diameter. A transperitoneal approach was used in all patients, tumors were resected with safety margins by endoshears, and hemostasis was achieved by bipolar coagulation and finally by sealing with fibrin glue. RESULTS: All procedures were finished laparoscopically, and no conversion was necessary. No major intraoperative or postoperative complication was observed. The histologic examination showed adenomas with negative surgical margins in all cases. Postoperative computed tomography revealed a normal blood supply for the remaining adrenal tissue. Blood pressure and aldosterone levels were unremarkable at follow-up, and no local recurrence was observed. CONCLUSIONS: Laparoscopic partial adrenalectomy for aldosterone-producing adenomas is a minimally invasive procedure with a low complication rate. It provides the benefit of retaining functional tissue on the side of the affected adrenal gland. Therefore, we recommend laparoscopic partial adrenalectomy for patients with small, potentially benign, tumors of the adrenal gland, even with a healthy contralateral adrenal gland.

Adrenal Gland Neoplasms↗

Neospora caninum and Waddlia chondrophila strain 2032/99 in a septic stillborn calf.

Characteristics of an intracellularly growing micro-organism isolated from an aborted bovine foetus are described. The organism replicated within cytoplasmic vacuoles, was resistant to penicillin and exhibited structural characteristics compatible with Waddlia chondrophila. An ELISA specific for Chlamydia spp., immunofluorescence tests using antibodies directed against Chlamydia spp. or Simkania negevensis, and PCR using Chlamydia-specific primers showed that the agent was distinct from Chlamydiae or S. negevensis. Determination of 16S and partial 23S ribosomal RNA gene sequences in combination with the PCR results and the morphological, antigenic and developmental characteristics provided evidence that the isolate 2032/99 can be classified as W. chondrophila or a closely related organism.

Abortion, Veterinary↗

Laparoscopic nephron-sparing surgery for renal tumors.

OBJECTIVES: To report our experience with laparoscopic nephron-sparing surgery. Because of the widespread use of ultrasonography and computed tomography, laparoscopy is becoming more and more important in the surgical management of solid renal masses. Although laparoscopic radical nephrectomy has gained wide acceptance, laparoscopic nephron-sparing surgery for renal tumors is still rarely done. METHODS: From June 1994 to December 2000, we treated 51 patients presenting with small exophytic solid renal masses by laparoscopic wedge resection in two Austrian centers. Depending on the center, the retroperitoneal approach was used in 32 cases and the transperitoneal approach was used in 19. The mean age was 59.8 years, and the average tumor size was 2 cm in diameter. Wedge resection was performed with the UltraCision device, and hemostasis was achieved by bipolar coagulation and fibrin glue-coated cellulose. RESULTS: All procedures were finished laparoscopically, and no conversion was necessary. The mean operating time was 132 minutes (range 70 to 300), mean blood loss 282 mL (range 20 to 800), mean postoperative hospital stay 5.8 days (range 3 to 12). The histologic findings were renal cell carcinoma in 38 patients (76%), benign disease in 12 patients (24%), and secondary tumor in 1 patient. Neither distant nor local recurrences were observed by the last follow-up date. Three cases of urinary leakage and one of postoperative bleeding occurred. CONCLUSIONS: Laparoscopic nephron-sparing surgery for renal tumors is a technically difficult procedure, but excellent tumor control can be achieved. Nevertheless, currently, this procedure should be concentrated in centers with a high experience in laparoscopic surgery.

Adult↗

Smoking cessation counseling practices: a survey of Alabama obstetrician-gynecologists.

BACKGROUND: Minimal interventions delivered by obstetrician-gynecologists (OB-GYNs) to their pregnant patients who smoke could result in a substantial decrease in smoking during pregnancy. We examined performance and motivation levels of Alabama OB-GYNs for engaging in clinical practices based on National Cancer Institute (NCI) guidelines. METHODS: Questionnaires assessing attitudes, intentions, and behaviors specified by the NCI's "4-A" model (ask, advise, assist, and arrange follow-up) were mailed to all OB-GYNs licensed in Alabama. RESULTS: A total of 130 physicians completed the questionnaire. Nearly all reported that they ask (93%) and advise (90%) their patients who smoke to quit; however, significantly fewer reported that they assist (28%) or arrange follow-up (24%) with their pregnant patients. CONCLUSIONS: Interventions are needed to motivate, support, and guide OB-GYN physicians to assist and follow-up with their pregnant patients who smoke.

Adult↗

Laparoscopic surgery for stage T1 renal cell carcinoma: radical nephrectomy and wedge resection.

OBJECTIVES: Renal cell carcinoma (RCC) is likely to become one of the most important indications for laparoscopic surgery. We herein report our experience. METHODS: From April 1994 until April 1999, 98 patients presenting with RCC were treated laparoscopically by either radical nephrectomy (RN; n = 73) or wedge resection (WR; n = 25). The mean age was 62.3 years. The mean tumour diameters were 3.8 cm (RN) and 1.9 cm (WR). All tumours were clinical stage T1 lesions. The transperitoneal approach was used for RN in all patients. For WR either the transperitoneal or the retroperitoneal approach was used. In 15 patients, the adrenal gland was removed simultaneously. The specimen was entrapped in an organ bag and removed intact through a small muscle-splitting incision in the lower abdominal wall. RESULTS: RN: The mean operating time was 142 (range 86-230) min, the mean blood loss was 170 (range 0-1,500) ml, and the mean postoperative hospital stay was 7.4 (range 3-32) days. Minor complications occurred in 4.0% of the patients, while major complications were seen in 8.0% of them. WR: The mean operating time was 163.5 (range 90-300) min, the mean blood loss was 287 (range 20-800) ml, and the postoperative hospital stay was 8.0 (range 3-8) days. Minor complications: 4%, major complications: 8%. Histology revealed RCC stage T1 in 77 patients, stage T3a in 7, and stage T3b in 3 patients, oncocytoma in 2 patients, angiomyolipoma in 2, renal adenoma in 1, renal metastasis in 1, multilocular cysts in 4, and renal abscess in 1 patient. Over mean follow-up periods of 13.3 and 22.2 months for RN and WR, respectively, neither local recurrences nor metastases have been observed among patients with histologically confirmed RCC. CONCLUSIONS: Laparoscopic surgery for clinical stage T1 RCC is safe and efficient. Excellent tumour control can be achieved. However, longer follow-up periods will be necessary to confirm these results.

Adult↗

Laparoscopic radical nephrectomy: a single-center experience of 51 cases.

A modified technique of laparoscopic radical nephrectomy for treatment of renal cell carcinoma makes surgery easier, faster, and safer in terms of tumor cell spillage. We report our experience with this procedure in 51 consecutive cases. A transperitoneal approach was used in all cases. The average patient age was 62 years. The solid renal mass diameter was between 2 and 9 cm. Extrafascial mobilization of the kidney included limited lymph node dissection. In six patients the adrenal gland was removed simultaneously. The specimen was removed intact through a small muscle-splitting incision in the lower abdominal wall. The procedure was successful without conversion to open surgery in all 51 patients. The average operating time was 125 minutes, and the average postoperative hospital stay was 7.2 days. Major complications were seen in 4% of patients. Neither local recurrences nor metastases were observed in the following 7.9 (1-19) months. In our experience, laparoscopic radical nephrectomy is safe and efficient. Removing the specimen intact through a small muscle-splitting incision reduces operating time, avoids tumor cell spillage, and allows exact pathological staging.

Carcinoma, Renal Cell↗

[Demonstration of Chlamydia from an equine abortion].

The isolation and identification of a chlamydial agent from an equine fetus is reported. The fetus was aborted by a mare with respiratory disease and fever in the 9th month of pregnancy. The serum of the mare was investigated by the compliment fixation test. Specific antibodies were detected for chlamydial antigen in a titer of > 1:40 and for equine herpes virus 1 antigen in a titer of 1:32. Pathological lesions were not found in the organs of the fetus. Chlamydiae were detected in the placenta by ELISA and subsequently isolated by cell culture. Using PCR technique the agent was identified as Chlamydophila psittaci.

Abortion, Veterinary↗

Loss of laminin-5 in the epithelium-stroma interface: an immunohistochemical marker of malignancy in epithelial lesions of the breast.

AIMS: To demonstrate immunohistochemically the alpha3 and gamma2 chain of laminin-5 in benign epithelial and malignant lesions of the human breast. METHODS AND RESULTS: The alpha3 chain was identified by the monoclonal antibody BM165 and the gamma2 chain by GB3 in shock frozen samples using APAAP (alkaline phosphatase monoclonal anti-alkaline phosphatase) technique. The pre-existing breast epithelium, the 12 benign ductal and lobular proliferations and the three fibroadenomas showed a continuous immunostaining in the basement membrane region. In contrast to benign epithelial lesions, the 44 cases of invasive breast carcinoma showed a loss of the laminin-5 chains in more than 50% of the carcinoma stroma interface. Twenty-four out of the 44 invasive carcinomas revealed a complete loss of laminin-5 immunostaining. Focal defects of the laminin-5 immunostaining were also found in ductal carcinoma in situ in its pure form. CONCLUSIONS: As recently described, the malignant transformation of breast epithelium with expression of an invasive phenotype is associated with a decrease of hemidesmosomes. The reduced immunostaining of laminin-5 is in line with this finding because laminin-5 represents the major component of the anchoring filaments attaching hemidesmosomes to the basement membrane. We feel that immunohistochemical demonstration of laminin-5 may serve as a marker of benignity in epithelial breast lesions. While other carcinoma types exhibit an increased laminin-5 deposition, which has been suggested as an invasion promoting factor, the loss of laminin-5 in breast cancer supports the view that breast carcinomas do not utilize laminin-5 for invasion.

Breast Neoplasms↗

Human immunodeficiency virus type 1 in the semen of men receiving highly active antiretroviral therapy.

BACKGROUND: Highly active antiretroviral therapy can effectively decrease the levels of human immunodeficiency virus type 1 (HIV-1) virions in peripheral plasma and seminal fluid of infected men. Whether the genital tract of HIV-1-infected men who are receiving highly active antiretroviral therapy and who have no detectable virus in the peripheral plasma harbors replication-competent virus is not known. METHODS: We collected peripheral-blood and semen samples from seven men with HIV-1 infections who were receiving highly active antiretroviral therapy and who had no detectable viral RNA (fewer than 50 copies per milliliter) in plasma and analyzed the samples for cell-associated proviral DNA using a quantitative polymerase-chain-reaction assay. Replication-competent viruses were evaluated by cell-coculture assays. Proviral DNA and replication-competent virus obtained from peripheral-blood and seminal cells were also analyzed by sequencing relevant viral genes. RESULTS: Despite the long-term suppression of HIV-1 RNA in the plasma of the seven men, proviral DNA was detected in seminal cells in four. Replication-competent viruses were recovered from peripheral-blood cells in three men and from the seminal cells in two of these three men. The viruses recovered from the seminal cells had no genotypic mutations suggestive of resistance to antiretroviral drugs and were macrophage-tropic, a feature that is characteristic of HIV-1 strains that are capable of being sexually transmitted. CONCLUSIONS: In HIV-1-infected men who are receiving highly active antiretroviral therapy and who have no detectable levels of viral RNA in plasma the virus may be present in seminal cells and therefore may be capable of being transmitted sexually.

Amino Acid Sequence↗

Perfectionism, the imposter phenomenon and psychological adjustment in medical, dental, nursing and pharmacy students.

Extensive attention has been paid over the past three decades to the stressors involved in training in the health professions. Although empirical studies have identified demographic subgroups of students most likely to become distressed during training, less research has been carried out to evaluate the impact of students' personality characteristics on their adjustment. Severe perfectionism is one such personality trait that has been shown to increase the risk for anxiety and depressive disorders in other populations. Another set of personality traits linked to increased psychological problems has been labelled the 'impostor phenomenon', which occurs when high achieving individuals chronically question their abilities and fear that others will discover them to be intellectual frauds. Both perfectionism and the impostor phenomenon would seem to be pertinent factors in the adjustment of health professional students; however, these character traits have not been empirically examined in this population. In the present study psychological distress, perfectionism and impostor feelings were assessed in 477 medical, dental, nursing and pharmacy students. Consistent with previous reports, the results showed that a higher than expected percentage of students (27.5%) were currently experiencing psychiatric levels of distress. Strong associations were found between current psychological distress, perfectionism and impostor feelings within each programme and these character traits were stronger predictors of psychological adjustment than most of the demographic variables associated previously with distress in health professional students. Implications for future research, limitations of this study and clinical recommendations are discussed.

Adaptation, Psychological↗

Long-term psychological adjustment to witnessing interparental physical conflict during childhood.

A retrospective survey of undergraduate students was used to examine the long-term psychological impact of witnessing interparental physical aggression during childhood. Two hundred and three of 1,452 young adults surveyed (14%) reported witnessing as children at least one incident of physical aggression between their parents. Both men and women who witnessed interparental physical conflict reported higher levels of current psychological distress than a comparison group of young adults who never observed physical aggression between their parents. This group difference remained even after controlling for parental divorce, parental SES, physical abuse of the child, parental alcoholism, and nonphysical discord witnessed between parents. Additional analyses found that the negative effect of witnessing interparental aggression was intensified when the aggression was serious enough to warrant some type of outside assistance for the victim and when the parent of the same-sex was seen being victimized. Although these findings provided support for the theory that witnessing interparental physical aggression is a traumatic experience that may have long-term psychological ramifications, we also found that a substantial proportion of the variance accounted for in adult adjustment by interparental physical conflict was mediated through decreased parental caring and warmth during childhood. Implications for these results, limitations of the present study, and directions for further research are discussed.

Adolescent↗