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Biomedical subjects

L Köhler

Publications and source records attributed to L Köhler.

At least 91 records · Page 5Linked to original sources
PubMed1995

[Dynamic gracilis muscle-plasty--a case report].

The feasibility of anal dynamic graciloplasty (transposition of the gracilis muscle and subsequent implantation of a stimulation device) to restore continence, was assessed in a 71 year old patient. Anal dynamic graciloplasty was capable to achieve continence by increasing the sphincter tone from 35 mm Hg without stimulation to 110 mm Hg with stimulation. The clinical results and anal manometry data are described and the pros and cons of the procedure are discussed.

Adenoma, Villous↗
PubMed1995

[Laparoscopic surgery of ileus--miscarriage or training problem?].

The first results of laparoscopic surgery for mechanical ileus were analysed according to 3 classification systems of adverse perioperative events (complications). In our series 11 out of 14 patients were unsuitable for laparoscopic surgery mainly due to intraoperative mechanical problems. In 3 patients relevant and potentially hazardous events occurred which induced immediate conversion to laparotomy. Due to the impossibility and inability to completely explore the abdominal cavity, the laparoscopic approach cannot yet be recommended.

Adult↗
PubMed1993

Child health promotion: a task for social pediatrics.

Health implies broad and positive aspects of life, well beyond disease and medical care. It is clearly expressed in the constitution of the WHO, and has been clarified in the Health for All strategy, emphasizing health promotion as a basic means to enable people to increase control over their health. The study of the broad and complex issues of population health is called public health; it naturally also includes children and their special needs. The ideology of Health for All, the science of public health and the imperatives of children's health are integrated in Social Pediatrics. Its task is to place the health of children in a full social, economic and political context, using inter-disciplinary, interprofessional and inter-sector cooperation with the children and their parents as the basis for all activities. After relating a few successes of socio-pediatric actions on a national level, the focus is directed towards health promotion issues that are especially significant for children and young persons, i.e. fundamental, academic and practical issues. The way ahead for children's health promotion and for Social Pediatrics lies in the readiness to anticipate change and to adapt to new societal needs.

Child↗
PubMed1993

Nordic children with myelomeningocele. Parents' assessments of the handicap and physicians' classifications of the disabilities.

The differences between parents' assessments of their child's handicap and professionals' assessment of disabilities were studied in 486 Nordic children with myelomeningocele aged 4-18 years. Although disability and handicap are conceptually different, agreement between the parents' assessments of the handicap and the degree of disability according to Lorber's classification was found in 51% of cases. The parents' assessments showed close agreement with overall disability according to Lagergren's method in 45% of cases. The factors most strongly associated with parental assessment of the handicap were the child's motor disability, intellectual functioning, faecal and urinary incontinence and the parents' inclination to feel inadequate with respect to the child's needs. Data from professional assessment of disabilities alone are of limited value in understanding the impact of disabilities on the daily life of a child.

Adolescent↗
PubMed1993

Children with and without disabilities in the Nordic countries. A Nordic project.

A socio-pediatric study of children's health and well-being has been carried out, based on questionnaires from 2000 children with long-term illnesses and disabilities and from a representative sample of 10,000 children from the five Nordic countries. The overall results confirm that Nordic children enjoy a high standard of living, and that they are healthy, both physically, mentally and socially. They frequently use the health services but mainly for minor complaints and their hospital stays are short. Disabled children and their families have the same material standard of living and a similar social network as the others. Their leisure time activities, however, are reduced and the children's peer acceptance and self-esteem are lower and they have more psychosomatic symptoms. It is mainly the mothers who have to interrupt their career to take care of the disabled children. Most families, both disabled and others, are quite satisfied with the children's medical care, especially where continuity and specialist services are provided.

Adolescent↗
PubMed1992

[Functional disorders after deep rectum resection: is pouch formation recommended?].

After low colo-rectal or colo-anal anastomosis there is in 25% a degree of urgency and increased bowel movements. In order to improve the reservoir continence the construction of a J-shaped colonic pouch seems reasonable. We have operated 5 patients with the new technique and worked up our preliminary results in connection with a literature overview. Increased bowel movements and urgency are reduced postoperatively but some patients report pouch evacuation problems, using enemas or suppositories to empty their reservoirs. To estimate the value of this new technique innovative endpoints as overall well-being and quality of life might be more important than conventional endpoints measuring only functional results.

Aged↗
PubMed1991

Regulation of TNF-alpha, IL-1 and IL-6 synthesis in differentiating human monoblastoid leukemic U937 cells.

The human monoblastoid tumor cell line U937 was induced to differentiate along the monocyte/macrophage lineage by treatment with 5 x 10(-9) M 12-O-tetradecanoyl phorbol-13-acetate (TPA). Between 2 h and 4 h following TPA-treatment U937 cells started to release significant amounts of TNF-alpha which remained detectable until 8-10 days. A significant IL-1 beta release was measured 24 h-48 h post stimulation and increased levels of IL-1 beta persisted until 20-22 days of culture. In contrast no release of either IL-1 alpha or IL-6 could be detected with 5 x 10(-9) M TPA during the whole time course of the experiments. The sequential induction of TNF-alpha and IL-1 beta appeared to be independently regulated since TNF-alpha release was not required for the onset of IL-1 beta production. Northern-blot analysis confirmed the sequential induction and the long term expression of TNF-alpha and IL-1 beta mRNAs. Western-blot analysis predominantly showed a high molecular weight IL-1 beta protein of about 35 kD. Further investigations on the regulation of cytokine production and release by TPA-differentiated U937 cells revealed that TNF-alpha and IL-1 beta synthesis was not influenced by exogenously added rhTNF-alpha or PGE2, whereas rh gamma-IFN specifically enhanced the IL-1 beta production. Thus, the regulation and intracellular processing of cytokines generated by differentiating U937 cells shows some differences when compared to mature monocytes/macrophages which may be related to the tumorigenic origin of U937 cells or to an incomplete differentiation.

Blotting, Northern↗
PubMed1991

Parental perceptions of health care for children with chronic illness--a population-based study in a Swedish primary care district.

The division of responsibilities between specialized and primary health care for children with chronic illness is unclear. The utilization and perceptions of primary and specialized care were examined by means of a questionnaire mailed to the parents of all chronically ill children and a randomly selected control group. No difference in sociodemographic variables of responders (70%) and nonresponders was found. The study comprised 98 index and 168 control children. The index children utilized both primary and specialized care more than controls. The overall satisfaction with health care was high, but primary care did not come up to the expectations of many chronically ill children's parents. Satisfaction with specialized care but not with primary care had improved during the previous 15 years. Recognition in primary care of childhood chronic illnesses and their psychosocial consequences is important. In co-operation, the two health care levels together could enable a comprehensive, well-coordinated, and continuous care for these children.

Adult↗
PubMed1991

Youth, disability and quality of life.

When broader aspects of health are considered especially when assessing the life of the disabled it becomes necessary to reach beyond physical measurements to more dynamic aspects including the individual's other resources and demands. In such a context issues of quality of life are important. Quality of life is here defined as a term describing the total existence of an individual or a group and is operationalized in three life spheres: external conditions, interpersonal conditions and personal psychological conditions. National samples of youths aged 12-18 years with cystic fibrosis and myelomeningocele are compared to a reference group of normal youths in the five Nordic countries. The study was based on a mailed questionnaire. The results show that the disabled groups had equal external conditions as their peers while they rated lower on the interpersonal and personal levels. This indicates that the Nordic countries have succeeded in providing a good material support for families with handicapped youths. The fact that these families are also more satisfied with the different life spheres means that both objective and subjective needs are met. The social networks and personal psychological conditions, though, proved to be less sufficient and there is still a lot to be done to give handicapped youngsters a full life.

Adolescent↗
PubMed1990

Alterations in glycosylation and lectin pattern during phorbol ester-induced differentiation of U937 cells.

Incubation of the human monoblastoid tumor cell line U937 with 5 x 10(-9) M 12-O-tetradecanoylphorbol-13-acetate (TPA) for 3 days was associated with marked morphological and functional changes including adherence of the cells and cessation of proliferation. While growth arrest and the viability of the cells were not influenced, the TPA-induced adherence of U937 cells could be totally blocked by incubation with tunicamycin, suggesting an involvement of N-linked carbohydrates in these cell attachment processes. The isolation and characterization of endogenous lectins with specificities for lactose, L-fucose, and D-mannose from U937 controls and TPA-differentiated U937 cells demonstrated marked differences in either the pattern and the distribution of these sugar-specific carbohydrate-binding proteins. Our results indicate that alterations in cell-surface carbohydrates are of central importance for the attachment of the differentiating U937 tumor cells.

Cell Adhesion↗
PubMed1990

Whole gut irrigation and Prepacol laxative preparation for colonoscopy: a comparison.

Two techniques for preparation of the colon for colonoscopy were compared in a controlled trial. Fifty patients given a low residue diet and the laxative Prepacol were compared with 50 patients given whole gut irrigation. Significantly more patients suffered from vomiting (P = 0.0005), shivering (P = 0.0062) and nausea (P = 0.031) following irrigation; in two cases the procedure had to be abandoned because of profuse vomiting. Irrigation was less well tolerated by the patients (P = 0.00002) than preparation with Prepacol. On the other hand, the quality of bowel preparation was found to be better (P = 0.0005) after irrigation. On two occasions colonoscopy was not possible following Prepacol preparation because of faecal residue. Patients with a previous colorectal resection showed a similar quality of cleansing to those patients prepared with irrigation. We conclude that Prepacol is as efficient as irrigation for patients who have had a previous colorectal resection because the quality of bowel preparation is as good and the associated patient discomfort is small.

Adolescent↗