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Biomedical subjects

M Kopp

Publications and source records attributed to M Kopp.

At least 19 recordsLinked to original sources
PubMed2001

Quality of life measurement in oncology--a matter of the assessment instrument?

Two widely used quality of life questionnaires, European Organization for Research and Treatment of Cancer Core (EORTC QLQ-C30) & Functional Assessment of Cancer Therapy-General (FACT-G), were examined for their comparability using four different groups of cancer patients. During a follow-up investigation, 418 cancer patients (Hodgkin's disease, breast cancer, bone marrow transplantation (BMT), chronic lymphatic leukaemia (CLL)) completed both the EORTC QLC-C30 and the FACT-G during the same session. For an illustration of the differences between the two Quality of Life (QoL) instruments, pairs of diagnostic groups were formed and their QoL scores using the EORTC QLQ-C30 and FACT-G compared. The corresponding subscales of the EORTC-QLC-C30 and the FACT-G show only low to moderate intercorrelations across all four groups of cancer patients studied. In particular, a comparison of pairs, namely Hodgkin's disease versus breast cancer patients and BMT versus CLL patients, highlights substantial differences in the corresponding subscales of the EORTC QLQ-C30 and the FACT-G. The results of the QoL investigations should not be interpreted independently of the instrument used and an interpretation of results must be based on the contents of items of the respective questionnaires.

Adult↗
PubMed2001

Successful management of claustrophobia and depression during allogeneic SCT.

As psychological problems are frequent in SCT patients we report on a patient with chronic myeloid leukemia, claustrophobia and depression. The successful allogeneic stem cell transplant of this patient in a reverse isolation setting required intensive interdisciplinary hematological, psychological and psychiatric collaboration. Psychopharmacologically the patient was treated with lorazepam 1 mg at 10 a.m. and 8 p.m. and after crisis on day +6, and 2.5 mg twice daily i.v. until one day before discharge (total 20 doses). Psychological counseling followed a cognitive-behavioural approach including progressive muscle relaxation and cognitive techniques focusing on the actual coping processes.

Adult↗
PubMed2001

Preoperative expectations and postoperative quality of life in liver transplant survivors.

OBJECTIVE: To assess normalization in the lives of liver transplant patients and the impact of preoperative expectations on postoperative quality of life (QOL). DESIGN: A semistructured interview, 2 QOL questionnaires, and chart reviews of medical histories. SETTING: Internal medicine department at Innsbruck university hospital, Austria. PARTICIPANTS: Fifty-five patients (32 men, 23 women) with liver transplants. INTERVENTIONS: The Sickness Impact Profile (SIP) and Functional Assessment of Cancer Therapy-General. RESULTS: Patients' preoperative expectations of a normal life style posttransplantation were predominantly optimistic (60%), but postoperatively only 40% thought that their expectations had been realized. The patients' SIP values showed significant impairments in nearly every area of life when compared with the values of a healthy control group. Only "complications during the hospitalized phase" had a statistically significant impact among the sociodemographic and clinical parameters on postoperative QOL. The lowest QOL scores were found among patients whose expectations of a return to normal life style had not been realized. CONCLUSION: Unmet life-style expectations after liver transplantation may lead to increased stress, which affects QOL long term. This finding is of clinical relevance; therapeutic measures, particularly professional pretransplant counseling, are indicated.

Analysis of Variance↗
PubMed2001

[Dealing with bacterial hypodermal infection in general practice: an inquiry and a prospective study].

OBJECTIVE: The author had for aim to collect data on how general practitioners deal with bacterial hypodermal inflammation. MATERIAL AND METHODS: An enquiry on practice and a prospective study were carried out over 3 months. RESULTS: The mean number of cases reached 0.54 per physician over the 3-month period, for a total of 103 cases of bacterial hypodermal infection. The patients'mean age was slightly superior to 60 years, with a high female predominance and a preferential site of infection located in the lower limbs (89.6 p. 100 of the cases). 20 p. 100 of the patients were immediately sent to hospital, mainly because of the importance of local and/or general symptoms, and of the underlying conditions. In home care, antibiotic therapy was almost always oral and consisted in courses of group A penicillin or pristinamycin in over half of the cases, for a mean duration of 12.4 days for erysipelas, and 9.1 days for cases classified as "other type of bacterial hypodermal infection". An anticoagulant treatment was associated in close to 30 p. 100 of the cases, and anti-inflammatory or corticoids agents were prescribed in 17.9 p. 100 of the cases. The cure rate among home care patients reached 89.3 p. 100 and only 3 patients were hospitalized after the initial treatment; these 3 patients had all been given non-steroidal anti-inflammatory agents.

Family Practice↗
PubMed2001

[Smoking and alcohol abuse in the Hungarian population].

The mortality rate of middle-aged (55-64 years old) men in Hungary today is higher--even in absolute terms--than it was in the 1930s. Within this age-group the death rate is extremely high among the lower socio-economic classes. The odds ratio of the incidence of death is 1.8 times higher among males aged up to 74 years with no high-school education than the same age groups with higher education. Some 40% of these differences can be accounted to the self destructive behavioral risk factors (alcoholism, tobacco smoking) being more prevalent in the lower socio-economic groups. According to the results of the presented national representative survey counted in Hungary among 12.640 subjects in 1995, 45% of the males and 26.6% of the females smoked. Among the male and female cohorts under 45 years of age, 47.9% and 31.9% smoked respectively. Among the males the number of daily cigarette consumption and the volume of daily alcohol intake was inversely related to the educational level. This negative correlation was not so clear among the female probands. The health promotion programs can only achieve their goals if they are to target the psychological and motivational background of the self destructive behavioral risk factors.

Adult↗
PubMed2000

EORTC QLQ-C30 and FACT-BMT for the measurement of quality of life in bone marrow transplant recipients: a comparison.

The purpose of the study was to compare two different quality-of-life self-rating instruments, namely the EORTC QLQ-C30, developed by the quality-of-life study group of the European Organisation for Research and Treatment of Cancer, and the FACT-BMT (version 3), the Functional Assessment of Cancer Therapy - Bone Marrow Transplantation scale, which is the FACT-G(eneral measure) in combination with a module developed specifically for evaluating quality of life of bone marrow transplant (BMT) patients. Fifty-six BMT recipients completed both the EORTC QLQ-C30 and the FACT-BMT (German language version) during the same session. Questionnaire data were analyzed on a subscale basis using correlation analysis and multiple linear regression. Correlations between corresponding subscales of EORTC QLQ-C30 and the FACT-BMT ranged from r=0.30 for the emotional domain (poor agreement) to r=0.77 for global QOL (good agreement). This suggests that the instruments, despite considerable overlap, possibly focus on different aspects of QOL, in particular in addressing emotional and social issues of BMT patients. It appears that the FACT-BMT gives a more comprehensive overview regarding the multidimensional construct of quality of life. The EORTC QLQ-C30 gives more insight into the physical aspects of quality of life and helps to identify symptoms which effectively decrease quality of life from the patient's perspective. The QLQ-C30 might be improved by the incorporation of a BMT-specific module currently under development. We therefore conclude that neither of the two instruments can be replaced by the other in the assessment of QOL of BMT patients and that a direct comparison of results obtained with the two instruments is likely to be misleading.

Adolescent↗
PubMed2000

Linear beta-1,3 glucans are elicitors of defense responses in tobacco.

Laminarin, a linear beta-1,3 glucan (mean degree of polymerization of 33) was extracted and purified from the brown alga Laminaria digitata. Its elicitor activity on tobacco (Nicotiana tabacum) was compared to that of oligogalacturonides with a mean degree of polymerization of 10. The two oligosaccharides were perceived by suspension-cultured cells as distinct chemical stimuli but triggered a similar and broad spectrum of defense responses. A dose of 200 microg mL(-1) laminarin or oligogalacturonides induced within a few minutes a 1.9-pH-units alkalinization of the extracellular medium and a transient release of H(2)O(2). After a few hours, a strong stimulation of Phe ammonia-lyase, caffeic acid O-methyltransferase, and lipoxygenase activities occurred, as well as accumulation of salicylic acid. Neither of the two oligosaccharides induced tissue damage or cell death nor did they induce accumulation of the typical tobacco phytoalexin capsidiol, in contrast with the effects of the proteinaceous elicitor beta-megaspermin. Structure activity studies with laminarin, laminarin oligomers, high molecular weight beta-1, 3-1,6 glucans from fungal cell walls, and the beta-1,6-1,3 heptaglucan showed that the elicitor effects observed in tobacco with beta-glucans are specific to linear beta-1,3 linkages, with laminaripentaose being the smallest elicitor-active structure. In accordance with its strong stimulating effect on defense responses in tobacco cells, infiltration of 200 microg mL(-1) laminarin in tobacco leaves triggered accumulation within 48 h of the four families of antimicrobial pathogenesis-related proteins investigated. Challenge of the laminarin-infiltrated leaves 5 d after treatment with the soft rot pathogen Erwinia carotovora subsp. carotovora resulted in a strong reduction of the infection when compared with water-treated leaves.

Cells, Cultured↗
PubMed1999

[The role of behavioral medicine and its place in medical practice].

Behavioral medicine is a rapidly developing interdisciplinary field that integrates the biological and psychosocial perspectives of human behavior and apply them to practice of medicine. The aim of behavioral medicine is to analyse, prevent and treat reversible, non-adaptive behavioral patterns, reactions and symptoms. In the early stages of chronic non-infectious illnesses of great epidemiological significance reversible regulation disturbances, non-adaptive behavioral factors (such as smoking, alcohol abuse, etc.) are the most important risk factors, which are closely connected with emotional disturbances, anxiety, depressive symptomatology, hopelessness and learned pathological reactions. Behavioral medicine deals with the recognition, effective treatment and scientific model of these behavioral and psychological problems on different fields of medical practice.

Anxiety↗
PubMed1999

Retrospective assessment of quality of life and treatment outcome in patients with Hodgkin's disease from 1969 to 1994.

We determined the current quality of life (QoL) of patients with Hodgkin's disease treated at the Innsbruck University Hospital between 1969 and 1994 at a mean time of 9.1 +/- 7.0 years after their initial treatment. Further aims of our study were to assess potential differences in objective treatment outcome and QoL between patients treated with chemo-, radio- or combined modality therapy and those enrolled in randomised clinical trials or treated according to standard procedures. The QLQ-C30, a health-related and validated self-report questionnaire developed by the Study Group on Quality of Life of the European Organization for Research and Treatment of Cancer (EORTC) was mailed to a cohort of 194 survivors out of a total of 225 patients with Hodgkin's disease; 126 of them (64.9%) returned the completed questionnaire. The 5- and 10-year overall survival rates for the total group of 225 patients were 94.3% and 84.9%, respectively. Irrespective of stage, higher relapse-free survival rates were observed in patients receiving combined modality treatment (P = 0.025). Five-year relapse-free survival rates were 96.6% for patients enrolled in clinical trials and 82.8% for patients treated outside of randomised studies (P = 0.037 in univariate and P = 0.064 in multivariate analysis). Patients treated with combined modality regimens had reduced QoL scores in comparison with those treated with either radiation or chemotherapy alone, but QoL parameters did not differ between patients enrolled in clinical trials and those treated according to standard procedures. Patients with Hodgkin's disease had an excellent long-term prognosis and very high QoL scores a mean of 9.1 years after treatment of their disease. The improved relapse-free survival rates achieved by combined modality regimens must be carefully weighed against the accompanying reduced QoL, since lower relapse rates did not translate into a survival advantage.

Adolescent↗
PubMed1999

Circadian variation of urinary eosinophil protein X in asthmatic and healthy children.

BACKGROUND: It is suggested that urinary eosinophil protein X (EPX) is a noninvasive tool to monitor bronchial inflammation in asthmatic children. However, circadian variation of the number and activation of eosinophils might possibly influence urinary EPX excretion. OBJECTIVE: Measurements of urinary EPX (radioimmunoassay) were used to investigate circadian variation of eosinophilic activation and to monitor bronchial inflammation in children with asthma before and after treatment with corticosteroids. METHODS: Urinary EPX excretion (microg/mmol creatinine) was measured in the morning and afternoon in 22 stable asthmatics and in 16 nonatopic, nonasthmatic controls to investigate circadian variation. Additionally, EPX excretion in the afternoon was analysed in 21 children with chronic asthma before and after 6 weeks of treatment with inhaled corticosteroids, and in seven children within 24 h of admission due to an asthma exacerbation and again 3 months after discharge. RESULTS: EPX excretion in the first morning urine sample of the day compared with the afternoon urine sample was significantly higher both in children with asthma (n = 22; mean +/- standard deviation: 179.7 +/- 97.3 vs 60.9 +/- 40.7 microg/mmol creatinine, P = 0.0001) and in nonatopic nonasthmatic controls (n = 16; 114.5 +/- 57.1 vs 53.4 +/- 29.0 microg/mmol creatinine, P = 0.0001). EPX excretion decreased significantly after 6 weeks of anti-inflammatory treatment in the group of children with chronic asthma (n = 21; 124.7 +/- 84.6 vs 87. 5 +/- 61.9 microg/mmol creatinine, P = 0.02) and in the group of children with an acute asthma exacerbation 3 months after discharge (n = 7; 233.2 +/- 174.5 vs 75.8 +/- 59.5 microg/mmol creatinine, P = 0.02). CONCLUSION: This study suggests a circadian variation of EPX excretion in children with asthma and in nonatopic, nonasthmatic controls. Measurement of EPX excretion is helpful monitoring therapy in asthmatic children if circadian variation is considered.

Adolescent↗
PubMed1999

Hydrogen peroxide from the oxidative burst is neither necessary nor sufficient for hypersensitive cell death induction, phenylalanine ammonia lyase stimulation, salicylic acid accumulation, or scopoletin consumption in cultured tobacco cells treated with elicitin.

H(2)O(2) from the oxidative burst, cell death, and defense responses such as the production of phenylalanine ammonia lyase (PAL), salicylic acid (SA), and scopoletin were analyzed in cultured tobacco (Nicotiana tabacum) cells treated with three proteinaceous elicitors: two elicitins (alpha-megaspermin and beta-megaspermin) and one glycoprotein. These three proteins have been isolated from Phytophthora megasperma H20 and have been previously shown to be equally efficient in inducing a hypersensitive response (HR) upon infiltration into tobacco leaves. However, in cultured tobacco cells these elicitors exhibited strikingly different biological activities. beta-Megaspermin was the only elicitor that caused cell death and induced a strong, biphasic H(2)O(2) burst. Both elicitins stimulated PAL activity similarly and strongly, while the glycoprotein caused only a slight increase. Only elicitins induced SA accumulation and scopoletin consumption, and beta-megaspermin was more efficient. To assess the role of H(2)O(2) in HR cell death and defense response expression in elicitin-treated cells, a gain and loss of function strategy was used. Our results indicated that H(2)O(2) was neither necessary nor sufficient for HR cell death, PAL activation, or SA accumulation, and that extracellular H(2)O(2) was not a direct cause of intracellular scopoletin consumption.

Algal Proteins↗
PubMed1999

Comparison of two quality-of-life instruments for cancer patients: the functional assessment of cancer therapy-general and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30.

PURPOSE: To compare two quality-of-life (QOL) questionnaires for cancer patients, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) and the Functional Assessment of Cancer Therapy-General (Fact-G), on the basis of empirical data. PATIENTS AND METHODS: Two hundred forty-four patients with a diagnosis of breast cancer or Hodgkin's disease completed both the EORTC QLQ-C30 and the FACT-G (German language version) during the same session. Questionnaire data were analyzed on a subscale basis using correlation analysis, canonical correlation, and multiple linear regression. RESULTS: Correlations between corresponding subscales of the FACT-G and the EORTC QLQ-C30 ranged from r =.14 for the social domain (very poor agreement) to r =.66 for the physical domain (good agreement), with r values for the other domains lying between these extremes. Canonical correlation analysis for the two sets of subscales revealed that overall agreement between the two instruments was only moderate (first canonical correlation coefficient r =.85, but overall redundancy less than 40%). Of the five FACT-G subscales, only one, physical well-being, was well represented by the EORTC QLQ-C30 subscales (multiple linear regression, R(2) =.67). Only three of eight EORTC QLQ-C30 subscales (physical functioning, global QOL, general symptoms) were represented fairly well by FACT-G subscales (R(2) =.43 to.60). The lowest R(2) values (<.15; ie, virtually no representation by the other instrument) were found for the FACT-G social well-being and relation with doctors and EORTC QLQ-C30 cognitive functioning subscales. CONCLUSION: For the sample investigated, the EORTC QLQ-C30 and the FACT-G were found to measure markedly different aspects of QOL, despite considerable overlap. Replicability provided, this implies that neither of the two QOL instruments can be replaced by the other and that a direct comparison of results obtained with the two instruments is not possible.

Adult↗
PubMed1999

Behavioural medicine in health promotion.

Behavioural medicine is a rapidly developing interdisciplinary field that integrates the physiological and psychosocial aspects of human behaviour and applies them to prevention. In the early stage of chronic non-infectious illnesses of great epidemiological significance the most important risk factors are the reversible psychophysiological regulation disturbances. According to the behavioural medicine model depressive symptomatology, hopelessness, anxiety, non-adaptive ways of coping, dysfunctional attitudes are common risk factors in the background of self-destructive behavioural disturbances, such as smoking, alcohol and drug abuse and suicidal behaviour. The basic link between physiological and psychological phenomena is the decision making process, the cognitive appraisal, evaluation of the given situation, which is very subjective and depends on the socialization process. The modern civilised way of life continuously creates situations in which we experience loss of control, and therefore the psychological and physiological balance can only be obtained with great difficulty. Especially under conditions of sudden cultural and socioeconomic transition strengthening adaptive ways of coping and preventing emotional disturbances are fundamental in health promotion.

Behavioral Medicine↗
PubMed1997

The pituitary adenylate cyclase-activating polypeptide-induced phosphorylation of the transcription factor CREB (cAMP response element binding protein) in the rat suprachiasmatic nucleus is inhibited by melatonin.

The mammalian hypothalamic suprachiasmatic nucleus (SCN) is an endogenous pacemaker generating circadian rhythms. SCN activity is synchronized with environmental light/dark cycles by photic information primarily transmitted via the retinohypothalamic tract (RHT). The SCN controls synthesis and release of melatonin, the hormone of the pineal gland. Melatonin itself feeds back to the SCN. Using brain slice technique and immunocytochemistry we demonstrate that (1) pituitary adenylate cyclase-activating polypeptide (PACAP) induces the phosphorylation of the transcription factor cAMP response element binding protein (CREB) in the SCN during late subjective day and (2) melatonin inhibits this PACAP-induced phosphorylation. Our data suggest that PACAP is a neurotransmitter which affects gene expression in the SCN probably via the cAMP signaling pathway and that the antagonistic effect of melatonin mirrors a feed-back loop within the circadian system.

Animals↗
PubMed1997

Effects of ambient ozone exposures during the spring and summer of 1994 on pulmonary function of schoolchildren.

To investigate the effect of natural exposure to ambient ozone over time, a follow-up study of school-aged children was performed in two small towns in southwestern Germany (Freudenstadt and Villingen) between March and October of 1994. Ozone half-hour mean concentrations were measured continuously and pulmonary function was tested in each child on four occasions (April, June, August, and September). To obtain an average short-term ozone effect, we first analyzed the data from the four time points separately and then constructed a model that included all information. During the study period the median (5th to 95th percentile) of all half-hour values of the ozone concentration was 101 micrograms/m3 or 50.6 ppb (45-179 micrograms/m3 or 22.5-89.8 ppb) in Freudenstadt and 64 micrograms/m3 or 32.1 ppb (1 to 140 micrograms/m3 or 0.5-70.1 ppb) in Villingen. To assess the effects of an individual ozone exposure we related the highest ozone concentration in the respective 24 hours before lung function testing to the results of the subconcentration in the respective 24 hours before lung function testing to the results of the subsequent pulmonary function tests. In the lung function test following the highest ozone exposure, the results of our cross-sectional linear regression analysis showed a significant negative correlation (P = 0.0181) between ozone exposure and forced vital capacity (FVC). In the longitudinal linear regression model we observed a negative statistical correlation between ozone exposure and lung function for the subpopulation living in the town with the high ozone levels (Freudenstadt). The association was more pronounced in boys than girls. For the children in Freudenstadt the decrement of FVC was -12.31 ml/10 micrograms/m3 ozone and the decrease in the forced expiratory volume in 1 second (FEV1) was -11.29 ml/10 micrograms/m3 ozone.

Air Pollutants↗
PubMed1997

Possible role of sweating in the pathophysiology of panic attacks.

In recent years the role of hyperventilation in the generation of panic attacks has attracted a considerable amount of interest. According to these studies hyperventilation can elicit the somatic symptoms of panic due to systemic alkalosis. We suggest that since in the case of panic, sweating might cause alkalosis, it could also contribute to the generation of panic attacks. In light of this hypothesis we made a statistical analysis of the panic symptoms of 111 panic patients diagnosed according to DSM-III criteria. The analysis revealed that: (1) there was a well identified group of panic patients who had minor breathing difficulties with heavy sweating; and (2) that all the patients sampled had either severe breathing, or sweating symptoms, or both. We conclude that in the absence of the intensive physical activity of the 'flight or fight' reaction, sweating as well as hyperventilation can cause alkalosis, which in turn might generate panic attacks.

Alkalosis, Respiratory↗