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K Krüger

Publications and source records attributed to K Krüger.

At least 37 records · Page 2Linked to original sources
PubMed2002

[Psoriatic onycho-pachydermo- periostitis].

BACKGROUND: Psoriatic onycho-pachydermo-periostitis is a rare manifestation of psoriatic arthritis. It is characterized by the trias of psoriatic onychosis, tender soft tissue thickening, and osteoperiostitis of the distal phalanges in the absence of distal interphalangeal arthritis. Recommendations for the treatment of symptomatic POPP are not available. AIM OF THE STUDY: Treatment of a symptomatic 49-year old male. METHODS: Sulfasalazine 1000mg b.i.d., p.o. for 8 months followed by radiotherapy of both hands with 6x0.5 Gy. RESULTS: No clinical response was observed with either of the two treatments. CONCLUSIONS: The course of this single case does not support sulfasalazine treatment or radiotherapy in psoriatic onycho-pachydermo-periostitis.

Arthritis, Psoriatic↗
PubMed2002

[Endovascular gamma-irradiation for prevention or restenosis after angioplasty of femoropopliteal de-novo-stenoses-long-term results of a feasibility study].

OBJECTIVES: To evaluate the performance and efficacy of endovascular irradiation after percutaneous transluminal angioplasty (PTA) of de-novo femoropopliteal stenoses in a pilot study. METHODS: 6 patients received non-centered endovascular irradiation (12 Gray at surface of the vessel wall) immediately after angioplasty of de-novo femoropopliteal stenosis, 1 patient was given centered endovascular irradiation using 192-iridium (12 Gray at surface of the vessel wall) Centered irradiation was considered for two other patients. Duplex sonographies and interviews were performed the day before and after PTA and after 1, 3, 6, 9, 12, 18, 24 months up to 4 years. Intraarterial angiography was performed in symptomatic patients. RESULTS: Non-centered endovascular irradiation was possible in all patients without problems or complications. Centered irradiation was not possible in two patients with the cross-over approach. One thromboembolic complication occurred during centered irradiation. Both restenosis and new stenosis at the edge of irradiated distance occurred in 1/7 patients. No other side effects were observed during follow-up. CONCLUSIONS: In our pilot study endovascular irradiation after angioplasty of de-novo femoropopliteal stenosis was possible with low rates of complications and restenosis and taking vessel anatomy into account.

Adult↗
PubMed2002

[Comparison of flat-panel radiography and computed radiography in urography].

PURPOSE: To evaluate the diagnostic value of digital flat-panel radiography in uroradiology the i. v. urograms of patients who had been examined with computed radiography and digital flat-panel radiography were compared regarding image quality. METHODS: 50 patients who underwent clinically indicated i. v. urography were examined with digital flat-panel radiography and computed radiography. In order to avoid unnecessary double exposure to X-rays, patients were examined either by flat-panel or computed radiography before injection of contrast media. Each further clinically indicated exposure after administration of contrast media was done by alternating the other examination technique. The digital images were compared by 4 radiologists regarding image quality for the detection of defined anatomic structures. RESULTS: Digital flat-panel radiography showed an image quality of the liver, spleen and both kidneys that was similar to computed radiography. The urinary tract, lumbar spine, pelvis and psoas muscle were significantly better visible on flat-panel radiography images. CONCLUSIONS: Compared to computed radiography there is no loss of image information by using digital flat-panel radiography in uroradiology. On the contrary, some anatomic structures on abdominal survey images show better image quality. In conclusion, digital flat-panel radiography has the potential to replace computed radiography in uroradiologic examinations.

Contrast Media↗
PubMed2002

Relevance of magnetic resonance imaging for ventricular endoscopy.

OBJECTIVE: Endoscopic procedures may represent an alternative to microsurgery or shunt operations in intra- or paraventricular pathologies. However, the operative results mainly depend on the selection of suitable patients. In the present study of 30 patients with occlusive hydrocephalus, the relevance of differentiated magnetic resonance (MR) imaging for evaluation of the pathophysiological and anatomic prerequisites was investigated. PATIENTS AND METHODS: Apart from conventional axial T(2) -weighted turbo spin echo (TSE) sequences (TR/TE 2126/100 ms) and T(1) -weighted spin echo (SE) sequences (TR/TE 450/15 ms) with and without the administration of Gd-DTPA, the MR protocol included sagittal and coronal thin-sliced T(2) -weighted TSE sequences, cardiac-triggered (TR/TE > 2700/120 ms, slice thickness 3.0 mm) or in volume technique (TR/TE 4000/180 ms, slice thickness 1.4 mm). For the visualization of CSF flow, a sagittal and axial phase-contrast-multi-heart-phase (PCMHP) measurement with 16 phases per cardiac cycle and flow sensitivity in the cranio-caudal direction (TR/TE 18/9.5 ms and 14/9.5 ms) was performed. RESULTS: The combination of imaging and flow sequences provided most information about the extent and the etiology of hydrocephalus. An obstruction of CSF pathways could be detected by the absence of flow voids in T(2) -weighted TSE sequences or of flow signals in PCMHP sequences. The size of the foramen of Monro and of the third ventricle could be evaluated in thin-sliced T(2) -weighted TSE sequences, for the foramen of Monro in coronal and sagittal and for the third ventricle in coronal and axial slice direction, respectively. The basal structures of the third ventricle, including its floor, the infundibular recess, the mamillary bodies, and the basilar artery, could be best identified in sagittal thin-sliced T(2) -weighted TSE scans, cardiac-triggered or in volume technique. CONCLUSION: In occlusive hydrocephalus, a differentiated MR protocol with thin-sliced T(2) -weighted TSE sequences and phase-contrast sequences allows a very precise estimation of the pathophysiological and the anatomic prerequisites for endoscopic procedures. Furthermore, MR imaging can be used for the follow-up documentation of ventriculo-cisternostomies, -cytostomies, or openings of other membranes.

Adolescent↗
PubMed2002

[Intravascular ultrasound thrombolysis for recanalization of peripheral arteries: evaluation of an in vitro model and results of a pilot-study].

OBJECTIVES: To evaluate the effectiveness of ultrasound thrombolysis in vitro in comparison with thrombectomy, and in vivo as a pilot-study for the treatment of thrombotic occlusions of peripheral arteries. METHODS: Under standardized conditions, one-day-old and five-day-old thrombi of whole blood, thrombin-induced thrombi and old organized thrombi of human blood were treated with ultrasound thrombolysis and Amplatz thrombectomy device (ATD). Four patients with arterial occlusive disease of Fontaine stage IIb-III underwent intraarterial ultrasound-thrombolysis, applied to long segmental occlusions of the superficial femoral or iliac artery ranging in duration from three days to one year. RESULTS: The weight of the thrombi after ultrasound thrombolysis was 1.5 g +/- 0.53 (ATD: 0 g) compared to 3.65 g +/- 0.34 without treatment, with more weight reduction in five-day-old thrombi than in one-day-old thrombi. In vivo, partial recanalization was achieved in a three-day-old femoral occlusion. There was no effect in the other three patients. Urokinase thrombolysis with subsequent PTA and stenting resulted in complete recanalization in three patients. CONCLUSIONS: Ultrasound thrombolysis in vitro was significantly less effective than ATD. The results of ultrasound thrombolysis were influenced by the age of the thrombus and its in vitro formation. Intravascular ultrasound thrombolysis alone was insufficient to treat occluded peripheral arteries in vivo.

Aged↗
PubMed2001

Activated T lymphocytes bind in situ to stromal tissue of colon carcinoma but lack adhesion to tumor cells.

It is not entirely clear which adhesion molecules are responsible for the site-directed traffic of T cells within the tumor microenvironment. The present study investigated whether colon carcinoma tissue and normal colon differ in the expression of functionally relevant molecules. In addition, we identified adhesion molecules involved in the binding of activated T cells onto colon carcinoma in situ. Malignant colon epithelium expressed few adhesion receptors, i.e. CD44 (HERMES), CD49b (integrin alpha2) and CD162 (PSGL-1), whereas the stromal compartment within colon carcinoma was positive for numerous binding molecules, e.g. CD44, CD49a (integrin alpha1), CD49e (integrin alpha5), CD51 (integrin alpha(v)), CD54 (ICAM-1), CD99 (MIC2) and CD162. Lymphocytes infiltrating tumor stroma contrasted with lymphocytes within normal colon interstitium by lacking CD28, CD154 (CD40L), CD56 (NCAM) and CD98 (4F2). Normal activated T cells bound to the lymphocyte-rich areas within the stroma of colon carcinoma using CD44, CD50 (ICAM-3), CD99, CD102 (ICAM-2) and CD162 on the T lymphocytes. We conclude that lymphocytes within colon carcinoma stroma may lack several functionally crucial cell surface molecules. We present a panel of adhesion molecules that could mediate the migration of activated T lymphocytes into the stroma of colon carcinoma.

Antigens, CD↗
PubMed2001

[Comparison of digital selenium radiography with an analog screen-film system in the diagnostic process of pneumoconiosis according to ILO classification].

UNLABELLED: Comparison of digital selenium radiography with an analog screen-film system in the diagnostic process of pneumoconiosis according to ILO classification. PURPOSE: The aim of the study was to determine the diagnostic value of digital selenium radiography in patients with pneumoconiosis. For this purpose chest x-rays by digital selenium radiography and analog screen-film system were compared according to the ILO classification of pneumoconiosis. METHOD: After approval of the study by the local ethic commission and the Federal German Office for Radiation Protection 50 patients were subjected to x-rays by digital selenium radiography (Thoravision; Philips Medical Systems, Hamburg, Germany) and analog screen-film system of the same day within the scope of an industrial medicine preventive checkup. Four investigators rated the chest x-rays according to the ILO classification of pneumoconiosis. RESULTS: The findings demonstrated by chest x-rays according to ILO classification were rated similar by digital selenium radiography and analog screen film systems. Image quality of the digital pictures was rated significantly better. CONCLUSION: The use of digital selenium radiography in evaluating chest x-rays according to the ILO classification does not result in over- or underestimation of pulmonary pathologies. Hence, in the diagnosis of pneumoconiosis, digital selenium radiography can replace the tested analog screen-film system.

Adult↗
PubMed2000

Expression of the apoptosis-inducing ligands FasL and TRAIL in malignant and benign human breast tumors.

Apoptosis-inducing ligands such as Fas ligand (FasL) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) have been found to play an important role in cell regulation. Different malignant tumors show an altered expression of these ligands and their respective receptors compared to normal tissues. The purpose of this study was therefore to investigate expression of TRAIL, FasL, and its receptor Fas on protein and mRNA levels in breast carcinomas (n=40), fibroadenomas (n=7), and normal breast tissues (n=5). Immunohistochemical reaction demonstrated that FasL was strongly expressed in breast cancer tissues (34/40) while only one fibroadenoma and one normal breast tissue reacted weakly positive for FasL. All fibroadenomas and normal breast tissues as well as the majority of breast cancer tissues expressed Fas on protein level. Quantitative RT-PCR analysis detected high expression of FasL mRNA in breast cancer tissues and fibroadenomas, whereas fibroadenomas showed the highest Fas mRNA copy numbers, followed by breast cancer tissues and normal breast tissues (P<0.05). Compared to FasL expression, TRAIL could be detected in less breast cancer tissues on protein level (21/40) and was found in only one fibroadenoma and none of the normal breast tissues. Thus, it can be concluded that malignant breast tumors show an altered expression of the two apoptosis-inducing ligands FasL and TRAIL.

Apoptosis↗
PubMed2000

Avascular areas on nailfold capillary microscopy of patients with Wegener's granulomatosis.

Over the past 25 years, nailfold capillary microscopy (NCM) has gained diagnostic value in the field of rheumatology based on descriptive data from patients with distinct connective tissue diseases (CTD). We prospectively analysed NCM findings from 116 patients selected for NCM by one of the following indications: (1) suspected diffuse or limited scleroderma or dermatomyositis, (2) evaluation of Raynaud's phenomenon (RP) or (3) suspected small-vessel vasculitis. Nailfold haemorrhages, and enlarged and tortuous nailfold capillaries ('lupus pattern') were found to comparable degrees in patients with CTD and primary RP. Only giant loops, bushy capillaries and avascular areas indicated CTD; 92% of patients with Wegener's granulomatosis (WG) had avascular areas. From all nailfold capillary abnormalities, only bushy capillaries, giant loops and avascular areas support a suspected CTD. A lupus-like pattern is not diagnostic. Avascular areas are a typical abnormality in patients with WG, for which NCM findings have not been described previously.

Adult↗
PubMed2000

Modulation of vascular tone by nitric oxide and endothelin 1 in myometrial resistance arteries from pregnant women at term.

OBJECTIVE: We evaluated the role of endothelium-derived nitric oxide and endothelin 1 in the modulation of myogenic tone, norepinephrine-induced tone, and flow-mediated responses in resistance arteries from pregnant women at term. STUDY DESIGN: Arteries (approximately 200 microm at 50 mm Hg; n = 27) were dissected from myometrial biopsies obtained from women undergoing elective cesarean delivery at term and mounted in a pressure arteriograph. Responses to intraluminal flow, pressure, and norepinephrine were studied in the absence and presence of the nitric oxide synthase inhibitor Nomega-nitro-L-arginine and the endothelin-converting enzyme inhibitor phosphoramidon. RESULTS: Pressure-induced (80 mm Hg) myogenic tone was significantly enhanced after incubation with Nomega-nitro-L-arginine (33% +/- 8% vs 24% +/- 4%; P <.05), whereas phosphoramidon significantly reduced myogenic tone (24% +/- 5% vs 33% +/- 5%; P <.05). A combination of Nomega-nitro-L -arginine and phosphoramidon did not affect myogenic tone. Norepinephrine-induced tone was significantly enhanced after nitric oxide synthase inhibition (49% +/- 6% vs 41% +/- 5%; P <.05) but was not affected by phosphoramidon. Flow-mediated dilatation was increased in the presence of phosphoramidon compared with flow-induced dilatation in physiologic salt solution (maximum dilatation, 57% +/- 12% vs 30% +/- 5%; analysis of variance, P <.05), and all flow-induced dilatation was abolished by Nomega-nitro-L -arginine. CONCLUSIONS: Nitric oxide and endothelin 1 may play a significant role in modulation of myogenic tone and flow-mediated responses in the resistance vasculature of the uterine circulation in normal pregnancy.

Arteries↗
PubMed2000

Preeclampsia: evidence for impaired shear stress-mediated nitric oxide release in uterine circulation.

OBJECTIVE: We sought to compare flow-mediated dilatation and myogenic and norepinephrine-induced tone in myometrial resistance arteries from women with preeclampsia and healthy pregnant women and to evaluate the role that nitric oxide may play in these responses. STUDY DESIGN: Arteries (approximately 200 microm, at 50 mm Hg) were dissected from myometrial biopsy specimens from women undergoing emergency cesarean delivery because of preeclampsia (n = 6) and from healthy control subjects undergoing planned cesarean delivery (n = 9). Responses to intraluminal flow, pressure, and a constrictor agonist (norepinephrine, 10(-6) mol/L) were studied in the absence and presence of the nitric oxide synthase inhibitor N omeganitro-L -arginine (10(-4) mol/L). Myogenic and norepinephrine-induced tone were calculated after the determination of artery diameter in the absence of extracellular calcium and in the presence of papaverine (10(-4) mol/L). RESULTS: An increase in intraluminal flow led to dilatation of isolated myometrial arteries from healthy gravid women, whereas flow-mediated dilatation was absent in arteries from gravid patients with preeclampsia (increase in diameter at maximum flow rate of 204 microL/min, 28% +/- 5% in healthy gravid patients vs -15% +/- 6% in gravid women with preeclampsia; analysis of variance, P <.05). Addition of N omega-nitro-L -arginine had no significant effect on flow-mediated responses in arteries from women with preeclampsia, whereas flow-mediated dilatation was abolished after addition of N omega-nitro-L -arginine in arteries from healthy gravid women (increase in diameter at a maximum flow rate of 204 microL/min, 28% +/- 5% control vs -9% +/- 5% N omega-nitro-L -arginine; analysis of variance, P <.05). Arteries from women with preeclampsia developed pressure-induced myogenic and norepinephrine-induced tone, similar to that obtained in arteries from healthy gravid women. In arteries from gravid women with preeclampsia, inhibition of nitric oxide synthase enhanced myogenic-induced tone (25% +/- 4% control vs 35% +/- 5% N omega-nitro-L -arginine; P <.05) and norepinephrine-induced tone (36% +/- 4% control vs 46% +/- 6% N omega-nitro-L -arginine; P <.05), as in arteries from healthy gravid women. CONCLUSIONS: Nitric oxide may participate in modulation of pressure- and norepinephrine-induced tone even in preeclampsia, but the shear stress-mediated release of nitric oxide is absent. Failure of shear stress-mediated dilation in myometrial arteries from gravid women with preeclampsia might contribute to the impaired uteroplacental blood flow in this disease.

Adult↗
PubMed2000

Microemulsion formulation of cyclosporin (Sandimmun Neoral) vs Sandimmun: comparative safety, tolerability and efficacy in severe active rheumatoid arthritis. On behalf of the OLR 302 Study Group.

OBJECTIVE: To compare the safety, tolerability and efficacy of the new oral microemulsion formulation of cyclosporin A (CyA; Sandimmun Neoral) and the original CyA formulation (Sandimmun), in patients with severe active rheumatoid arthritis (RA), over a 12-month period. METHODS: In this double-blind, multicentre study, patients were randomized to treatment with Neoral or Sandimmun, starting with 2.5 mg/kg/day, with dose adjustments after 4 weeks. Primary efficacy criteria included patients' assessment of disease activity. Pharmacokinetic and safety assessments were performed at regular intervals. RESULTS: Compared with Sandimmun, Neoral showed a consistent trend towards greater clinical efficacy from week 12 onwards, including a significant difference in patients' assessment of disease activity at the study end-points. A significantly lower increase in dose from baseline was observed with Neoral at week 24. Pharmacokinetic assessments at week 24 showed increased absorption and decreased variability with Neoral. No differences in safety were found between treatment groups. CONCLUSION: These observations indicate that Neoral is as safe and at least as effective as Sandimmun and have important implications for patient management given the increasing role for CyA in the treatment of severe, active RA.

Antirheumatic Agents↗
PubMed2000

Birth defects and paternal occupational exposure. Hypotheses tested in a record linkage based dataset.

UNLABELLED: MAIN QUESTION: To test previously established hypotheses on associations of birth defects with paternal occupation on the basis of a Norwegian registry material. METHODS: The study comprised all births in Norway 1970 -1993 for which linkage with population censuses 1970, -80 and -90 on parents' job title could be obtained--about 1 million births (75% all births). The reference population was offspring of the group that did not belong to the actual occupation. RESULTS: Vehicle mechanics had an association with hypospadias--OR 5.19 (CI 1.31-14.24), painters had a non-significant association with spina bifida--OR 2.03 (CI 0.99-3.75) and printers with club foot--OR 1.61 (CI 0.89-2.90). Associations observed previously in off-spring of fathers in large occupational groups such as teachers, drivers, electricity related occupations, sales related occupations and agricultural workers were not confirmed in this dataset. CONCLUSIONS: The study gave further evidence of cause effect relationships in the confirmed positive associations, though without any clarification of possible mechanisms involved. Possible false negative findings might be caused by low statistical power due to small occupational groups or non-differential misclassification of exposure.

Adult↗
PubMed1999

[Acquired reactive perforating dermatosis. Successful treatment with allopurinol in 2 cases].

Perforating disorders represent a heterogenous group of dermatoses characterized by transepithelial elimination of dermal structures. Primary perforating disorders should be distinguished from secondary perforating disorders in which perforation with transepithelial elimination is a rare component of a variety of dermatoses. The primary perforating disorders are hyperkeratosis follicularis et parafollicularis in cutem penetrans (Kyrle's disease), elastosis perforans serpiginosa and perforating folliculitis. Acquired reactive perforating dermatosis (also known as acquired reactive perforating collagenosis) together with the hereditary variant of the reactive perforating collagenosis represent further examples of the primary perforating disorders. We report on 84 year old and 96 year old female patients with an acquired perforating dermatosis. Both of the patients additionally showed diabetes and hyperuricemia. Oral administration of allopurinol (100 mg daily) led to a healing of the disseminated skin lesions in 1-2 weeks. After a follow-up period of 6 months, both patients were in complete remission. On one hand, these results prove again the existence and the severity of this disease, and on the other hand suggest an immunomodulating or differentiation-promoting action in addition to the uricostatic effect of allopurinol.

Aged↗