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Biomedical subjects

L Köhler

Publications and source records attributed to L Köhler.

At least 109 records · Page 6Linked to original sources
PubMed1990

[Relevant "end points" for evaluation of the colon pouch after deep rectum resection].

After low colo-rectal 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↗
PubMed1990

Differentiation and retrodifferentiation of U937 cells: reversible induction and suppression of intermediate filament protein synthesis.

Significant morphological and functional changes were observed when human monoblastoid U937 tumor cells growing in suspension were induced by the phorbol ester 12-O-tetradecanoylphorbol-13-acetate (TPA) for 72 h to differentiate along the monocyte/macrophage pathway. These include adherence of the cells to each other and to the substratum, alterations in cell-surface antigen expression and cessation of autonomous proliferation. In this study, we show by both, hybridization analysis of RNA and immunoblotting that an enhanced expression of the intermediate filament (IF) subunit proteins vimentin, lamin A and lamin C accompanied the TPA-induced differentiation process. After long-term culture of differentiated U937 cells in the absence of TPA (more than 28 days), however, the adherent cells retracted their pseudopodia, detached and started again to proliferate. This "retrodifferentiation" process, not previously described was paralleled by a rapid down-regulation of both, IF mRNA and protein synthesis back to the level of undifferentiated U937 control cells. These data suggest a functional relationship between the expression of vimentin and lamins A and C and the differentiation process taking place in these cells.

Cell Differentiation↗
PubMed1990

[Analysis of the effectiveness of the public health system with special reference to the health of children].

A well structured, efficient health service is an important component of the welfare state, in Sweden for example. But its significance for the state of the nation's health is limited and will be affected, inter alia, by life styles and the environment. A progressive health policy must be based on cooperation between various sectors of society, and here the health service plays a central part. Therefore social policy must be well documented and subjected to continuous review. This is an important prerequisite for planning and correction at different levels. The analysis must take account of society as a whole, organization, and the individual! In so doing, greater significance should be attributed to the effectiveness and quality of the health service than to structures, capacity and statistics. With reference to the health of children in the Nordic countries, it is encouraging to see that this conception of evaluation has also gained greater acceptance in preventive care, firstly in the field of paediatric health care and more recently in the school health service as well.

Child↗
PubMed1989

[Quality of life as a justification for high risk therapeutic concepts--pouch or simple reconstruction].

The classic endpoints of mortality and morbidity are no longer sufficient to evaluate new therapeutic concepts. Since significant differences are rarely found between the different patient groups, e.g. pouch vs simple reconstructions in the intestinal tract. Patients undergoing total gastrectomy have a better quality of life after receiving a Hunt-Lawrence-Rodino-pouch than after simple esophagojejunostomy. Similarly ileoanal pouch reconstruction in the pelvis after total colectomy impairs a patient's well-being less than classic enterostomas. Colonic pouch after following very low anterior resections could provide a new approach by substituting for rectum capacity.

Activities of Daily Living↗
PubMed1989

[Pouch formation in resection of deep rectal cancer: a recommendable method?].

A degree of urgency and increased bowel movements are experienced by 25% of patients who have a low colorectal or coloanal anastomosis. The construction of a J-shaped colonic pouch seems a reasonable way to improve reservoire continence. We used this new technique in five patients and worked up the preliminary results in connection with a survey of the literature. Increased bowel movements and urgency were reduced postoperatively, but some patients reported pouch evacuation problems, having to use enemas or suppositories to empty their reservoirs. To estimate the value of this new technique, innovative endpoints such as overall well-being and quality of life, might be more important than conventional endpoints which measure only functional results.

Aged↗
PubMed1989

TPA-induced differentiation and adhesion of U937 cells: changes in ultrastructure, cytoskeletal organization and expression of cell surface antigens.

Incubation of the human promonocytic cell line U937 with 12-O-tetradecanoylphorbol-13-acetate (TPA) for 72 h resulted in differentiation into immature macrophage-like cells and was accompanied by marked morphological and functional changes. U937 cells which normally grow in suspension and show a smooth surface, extended pseudopodia and became adherent to each other and to the surface of the culture vessel. Concomitant with the TPA-induced adherence U937 cells ceased to proliferate. Our results show that phorbol ester-treated U937 cells exhibited markedly increased levels of fibronectin and of the cytoskeletal proteins actin, myosin and vimentin including a reorganization of actin and vimentin filaments. The induction of both cellular adherence and growth inhibition were accompanied by a significantly reduced level of cells expressing transferrin receptors and changes in cell surface antigen expression. Here, the expression of the leukocytefunction antigens (LFA-1), including CD11 and CD18 was markedly enhanced during phorbol ester-induced differentiation. TPA-treatment, however, failed to enhance the small amount of U937 cells expressing the monocyte/macrophage-specific CD14 antigen or expressing MHC class-II antigens. A detailed analysis of the CD14 cluster by 7 differential antibodies resulted in an induction of TM1, UCHM1, MEM15, My4, and 3C10, whereas the epitopes recognized by TM2 and Mo2 remained unaltered. Neither indomethacin nor interferon-gamma were capable of inducing a marked expression of these antigen epitopes in TPA-treated cells. Although these data demonstrate that during phorbol ester-induced differentiation U937 cells acquire many properties typically associated with macrophages, the failure to express marked levels of macrophage-specific cell surface antigens suggests a transition of U937 cells from a promonocytic to an immature macrophage intermediate state rather than into mature macrophage-like cells.

Antigens, Surface↗
PubMed1987

[Long-term results following resection arthroplasty and prosthesis implantation in idiopathic saddle joint arthrosis].

Thirty-six patients with arthrosis of the carpometacarpal joint of the thumb were treated, 19 patients by resecting the trapezium and interposing a tendon, 17 patients by replacing the resected trapezium with silastic prosthesis (Swanson). The follow-up time was in average 22 respectively 44 months; both groups were comparable. The patients treated by resection of the trapezium and tendon interposition were more satisfied and had less pain than those treated by implantation of a Swanson prosthesis. There was no difference in mobility and strength of pinch between the two groups. After resection of the trapezium and tendon interposition the authors found a proximal translocation averaging 7 mm (6 to 14), however these patients had a good functional result and no pain. Five patients had a luxation of the Swanson prosthesis, and four required a second operation.

Arthritis↗
PubMed1986

Reconstruction of heel and sole defects by free flaps.

One latissimus dorsi musculocutaneous flap and five radial forearm flaps were used in reconstruction of weight-bearing parts of the heel and sole, the follow-up period being 7 to 38 months. Additional injuries such as forefoot amputations or amputations of the other leg were present in four patients. There was no flap loss. The latissimus dorsi flap proved to be too bulky and showed recurrent ulcerations, several reoperations were necessary, and definite healing has not occurred. The five forearm flaps gave good results, with a walking range from 2 hours to unimpeded walking. Complications included fissuring at the edges of one large flap and a local infection which was successfully treated. Cutaneous sensation returned in all but one flap, where it was reduced preoperatively due to a meningomyelocele. The results indicate that the fasciocutaneous radial forearm flap should be taken into consideration for reconstruction of weight-bearing areas of the heel and sole. Shortcomings of this flap include an unsightly donor defect and possible hair growth on the flap.

Adolescent↗
PubMed1985

Functional role of lipid metabolism in activated T-lymphocytes.

Exogenous long-chain fatty acids are readily taken up by unstimulated lymphocytes derived from the thymus of calves or rabbits and esterified to complex lipids, primarily phospholipids and triacylglycerols. Compared to saturated fatty acids, unsaturated fatty acids are incorporated preferentially. Furthermore, unsaturated fatty acids are transferred from triacylglycerols to phospholipids. The transfer cannot be observed with palmitic acid. With regard to individual phospholipid species, oleic acid and linoleic acid are found primarily in phosphatidylcholine. Arachidonic acid, however, is transferred to phosphatidylethanolamine and phosphatidylinositol as well. This suggests an arachidonic-specific transfer between individual phospholipids. Stimulation of the cells with the mitogen concanavalin A results in an enhanced incorporation of the fatty acids and an enhanced transfer from triacylglycerols to phospholipids. Triacylglycerols may thus be regarded as a labile intracellular storage pool that may be activated upon mitogenic stimulation.

Animals↗
PubMed1985

Technical aspects in ultra-large corneal grafts.

The larger the corneal graft, the more difficult is the excision of the button and especially suturing of the graft. The instruments and microsurgical unit are adapted to size and dimensions of animal surgery. The mathematical correlation between the diameter of the graft, the thickness of the cornea, and the length of the wound edges and suturing material can be calculated.

Animals↗
PubMed1985

[Treatment of ovarian cancer with combined operative, radiologic and cytostatic therapy].

It is reported about significant superior results of two years of the combined ovarian cancer treatment in contrast to operation and chemotherapy. Our therapy is the combination of operation, great field radiation technique, chemotherapy and second-look-operation. The remission of two years: Stage I: 64%, stage II: 50%, stage III: 45% and stage IV: -Only in stage IV no improvement can be achieved by addition of the radiation therapy.

Adult↗
PubMed1984

Food intake and growth of infants between six and twenty-six weeks of age on breast milk, cow's milk formula, or soy formula.

In 59 normal infants attending well-baby clinics, food consumption was registered until 26 and growth until 52 weeks of age. They were either breast-fed or formula-fed with a cow's milk product or a soy protein product. The average consumption of breastmilk was 746, 796, 722 ans 689 g/day at 6, 14, 22 and 26 weeks respectively. Bottle-fed infants received larger volumes, and at 6 and 14 weeks were the calculated total energy intakes significantly higher than in breast-fed infants. No differences were seen between the feeding groups with respect to length and the sum of four skin folds. The soy formula-fed children, who happened to be 200 g heavier at birth, had lower weight gains during the first 6 weeks than the other two groups. Thereafter, the average weights of the soy formula group did not differ from the other groups. At 3 months, the soy formula-fed children displayed a slower mineralisation and maturation of bone, but the difference was no longer significant when re-examined at 6 months. Formulas based on soy protein isolates seem to be acceptable as substitutes for cow's milk formulas in feeding normal infants.

Animals↗