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Biomedical subjects

M Klassen

Publications and source records attributed to M Klassen.

10 recordsLinked to original sources
PubMed2001

Effects of a mistletoe preparation with defined lectin content on chronic hepatitis C: an individually controlled cohort study.

Despite advances in the therapy of chronic hepatitis C for some hepatitis C virus (HCV) genotypes interferon and ribavirin combination therapy is effective in less than 50% of patients. Abnobaviscum Quercus (AQ) is a mistletoe preparation containing defined amounts of mistletoe lectins (ML). It has shown immunomodulatory properties in vitro and in vivo. In small clinical trials AQ resulted, within an anthroposophical treatment concept, in a biochemical or virological response in up to 40% of patients with chronic hepatitis C. In order to evaluate the effect of this preparation we conducted an individually controlled cohort study. 25 patients with chronic hepatitis C (mean duration 147 +/- 80 months) and elevated alanine aminotransferase (ALT) levels were included in the study. As control they were observed for 6 months pre-treatment. This pre-treatment period was followed by 6 months of active treatment in which the mistletoe preparation was subcutaneously injected three times a week. Main outcome parameters were normalization of ALT and viral load. Hepatitis C associated signs and symptoms like tiredness, fullness in the right upper abdomen and musculoskeletal pain were assessed monthly in a standardized questionnaire. All 25 patients completed the study and most of the patients wanted to continue treatment. Mean duration of treatment was 9.1 months. None of the patients had complete or partial normalization of ALT or HCV RNA levels during pre-treatment or treatment period. Mean ALT did not change during the study. Tiredness, fullness in the right upper abdomen and musculoskeletal pain were present in 18, 8 and 4 patients respectively. They significantly improved within two months of treatment. A significant eosinophilia (p=0.0001) occurred between month 2 and 6 during treatment. 9 month treatment with a ML containing mistletoe preparation has no effect on viral load or ALT as markers of activity in patients with chronic hepatitis C. However, frequency and intensity of clinical signs and symptoms in our patients decreased significantly, similar to reports of improved quality of life in tumour patients treated with such preparations. A significant eosinophilia suggests that ML containing mistletoe preparations induce a T-helper 2 immune response.

Adjuvants, Immunologic↗
PubMed1994

Splenic artery aneurysm and upper gastrointestinal bleeding in a nulliparous woman. A case history.

An eighty-three-year-old nulliparous woman hospitalized for orthopedic surgery developed postoperative upper gastrointestinal bleeding and hypotension resulting in her death. Postmortem examination revealed a ruptured splenic artery aneurysm. This is the second reported case of gastrointestinal bleeding due to ruptured splenic artery aneurysm in a nulliparous woman and the first such case resulting in death. The incidence, pathophysiology, clinical presentation, and diagnosis of splenic artery aneurysm are discussed.

Aged↗
PubMed1991

Clostridial bacteremia: implications for the surgeon.

Clostridial bacteremia is rare and has a variable presentation from asymptomatic to septic shock with disseminated intravascular coagulation (DIC), red cell hemolysis, and rapid death. In order to delineate the predisposing and prognostic factors in these patients, the authors reviewed 47 cases of clostridial bacteremia presenting over a seven year period at a major metropolitan teaching hospital. Predisposing factors included locally decreased oxidation reduction potential (Eh) in 43 per cent (including atherosclerosis, diabetes, and radiation therapy), systemic immunosuppression in 53 per cent (including alcohol abuse, chemotherapy, steroids, and malignancy), and a site of epithelial barrier disruption. The sites of clostridial invasion included: gastrointestinal tract (GI) (n = 22), pulmonary (n = 7), cutaneous (n = 7), undetermined (n = 7), and female genital tract (n = 4). Seven patients were found to have malignancy. Seventy-nine per cent of the blood culture isolates were histotoxic species (Clostridia perfringens and C. septicum). The overall mortality was 47 per cent. Significant differences between survivors and deaths included DIC, new onset renal failure, severe atherosclerotic disease, and age (P less than .05). The authors conclude that clostridial bacteremia is uncommon but highly lethal and may occur when decreased tissue Eh, systemic immunosuppression, and an epithelial barrier disruption are present. Poor outcome appears to be a reflection of advanced age, underlying illness, and presence of a histotoxic species.

Adult↗
PubMed1989

Total gastrectomy in the treatment of advanced gastric cancer.

To assess the role of total gastrectomy in the treatment of advanced gastric cancer, we reviewed the records of 27 patients who underwent the procedure from 1979 to 1988. Operative mortality was 4 percent (1 of 27), and postoperative morbidity occurred in 48 percent of the patients. Twenty-five of 26 patients were tolerating solid food at the time of discharge; 21 were able to maintain oral alimentation until just prior to their death. Median survival following the operation was 15 months (range: 2 to 110 months), with a 62 percent absolute 1-year survival rate and a 38 percent 2-year survival rate. On the basis of these results, we conclude that in patients with advanced gastric carcinoma, total gastrectomy with Roux-Y esophagojejunostomy can be performed with an acceptable morbidity and mortality, provides significant palliation by restoring the patient's ability to eat, and should be performed when technically feasible, even in the presence of gross residual disease.

Adult↗
PubMed1988

Regulation of human chorionic somatomammotropin gene expression in rat pituitary tumour cells.

A gene (hCS-1) coding for human chorionic somatomammotropin (hCS) was introduced stably into rat anterior pituitary tumour (GC) cells. These cells were treated with hormones, growth and other factors implicated in hCS production in the placenta. Levels of hCS-1 gene mRNA and hCS release were increased by thyroid hormone, dexamethasone, a cyclic adenosine monophosphate (cAMP) analogue (8-bromo-cAMP), and phorbol ester, phorbol-12-myristate-13-acetate (PMA). No significant response to insulin, medium glucose levels, epidermal growth factor or insulin-like growth factor II was observed. A hybrid gene containing the 5'-flanking sequences from the intact hCS-1 gene was also stably introduced into GC cells. These cells were tested to determine the contribution made by 5'-flanking DNA on the responses observed with the intact gene. Although expression of this hybrid gene was stimulated by thyroid hormone, no response to 8-bromo-cAMP or PMA was observed. These data suggest that sequences downstream of the transcription initiation site might play an important role in hCS gene expression and regulation.

8-Bromo Cyclic Adenosine Monophosphate↗