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Biomedical subjects

M Kunz

Publications and source records attributed to M Kunz.

67 records · Page 4Linked to original sources
PubMed1993

[Thrombopenia after liver transplantation].

Thrombocytopenia (TP) is a common finding after liver transplantation and is often multifactorially induced. In 31 of 33 liver transplant recipients (operated between 1986 and 1991 at our institution) TP was observed but only in 4 the nadir of the platelet count was less than 20,000/mm3. Highly significant influence in the severity of postoperative TP as well as on the recovery time (defined as the first day with a platelet count higher than 100,000/mm3) was found for a preexisting TP and for the intraoperative need for blood transfusions. 8/33 patients had a concomitant splenectomy but no effect on platelet nadir nor on the recovery time could be detected. In our series we could not find any platelet related factor with a significant impact on patient survival. In one patient severe TP was induced by a CMV-related hematophagic histiocytosis fully regredient with antiviral therapy. Another patient with AB0 incompatible graft had a severe TP induced by graft versus host disease.

Adult↗
PubMed1992

[Evaluation of TSH suppression using a 3d-generation TSH assay: diagnostic and therapeutic consequences].

UNLABELLED: We measured basal and TRH-stimulated TSH values with a 3rd generation assay in patients under suppressive thyroxine (T4) therapy for thyroid carcinoma or goiter and in patients with overt hyperthyroidism. All hyperthyroid patients had undetectable basal TSH levels (< 0.01 mU/l). In patients on suppressive T4 treatment basal TSH values were undetectable in 37.5% (= group A) and measurable in the intermediate range of 0.01-0.05 mU/l in 62.5% (= group B). After TRH administration there was no TSH increase in the hyperthyroid patients (< 0.01 mU/l in 100%). T4-treated patients of group A showed no relevant TSH stimulation in 58% (peak < or = 0.05 mU/l = total TSH suppression). An increase of > 0.05 mU/l could be measured in 42% of group A and 100% of group B (= subtotal TSH suppression). Many of these TSH values measured by a 3rd generation assay are in the undetectable range for most of the commercially available 2nd generation assays (< 0.10 mU/l). CONCLUSION: TSH assay of the 3rd generation decisively improves the diagnosis of hyperthyroidism and probably also borderline hyperthyroidism. Against the background of increased risk of osteoporosis and cardiac function disorders as a result of suppressive T4 treatment, our results suggest the following practical therapeutic guidelines: total TSH suppression with the risk of iatrogenic hyperthyroidism should be confined to high risk patients (eg with metastatic thyroid cancer). Where the risk is low, however (thyroid cancer with favourable prognosis, goiter, goiter prophylaxis), only subtotal TSH suppression is indicated.

Adult↗
PubMed1992

[Does isolated TSH elevation need treatment? Study of risk factors for the development of manifest hypothyroidism].

Isolated elevations of basal TSH levels are frequently observed in the general population. In a prospective study we analyzed the spontaneous evolution of thyroid function over time in such patients. The mean observation period was 5.4 (0.5-12) years. During the follow-up period 20% of these patients developed overt hypothyroidism. The risk of developing hypothyroidism was determined primarily by the initial TSH value and an additive effect was found for the thyroid antibodies and the thyroidal reserve (delta-T3) after TRH stimulation (Cox proportional hazard model). The cumulative risk for overt hypothyroidism after 10 years was only 22% for a mean TSH level of 12 mU/l for patients with negative thyroid antibodies and a good thyroidal reserve (low-risk), but increased to 63% for patients with positive antibodies and impaired T3 reserve (high-risk). Therefore, patients with isolated elevation of TSH can be divided into two subgroups according to the results of TSH, antibody status and T3 reserve: (1) In the "low-risk group" with good prognostic factors the patients should be followed up by periodic laboratory testing only (TSH, FT4, every 2-3 years). (2) In the "high-risk group" with clearly abnormal parameters, however, frequent controls are mandatory (every 6-12 months) or treatment with thyroxine may be indicated.

Adult↗
PubMed1992

Epidermal expression of the calcium binding surface antigen 27E10 in inflammatory skin diseases.

The expression of the heterodimeric complex of the calcium-binding proteins MRP-8 and MRP-14 was investigated in various inflammatory dermatoses using immunohistochemical staining with the monoclonal antibody 27E10. In addition to the inflammatory infiltrate, a positive staining was repeatedly found in the involved epidermis from patients with lichen planus, lupus erythematosus and psoriasis vulgaris, but not in normal skin epidermis and/or in epidermis from leucocytoclastic vasculitis patients. The keratinocytic expression of the 27E10 antigen was dissimilar to that of the MHC class-II molecules and the adhesion molecule ICAM-1. These data indicate that the 27E10 antigen is a distinct activation marker of inflammatory keratinocytes and may have proinflammatory properties.

Antigens, Surface↗
PubMed1992

[Injuries of the cruciate ligament in children caused by sports accidents].

From 1982 to 1990, 87 knee arthroscopies were performed on children aged 13 years and younger, following post-traumatic haemarthrosis. Damage to anterior and posterior cruciate ligaments was found in more than 1/3 of these cases. The injury to the actual anterior cruciate ligament occurred more often than the injury associated with avulsion fracture of the tibial eminences. It was found that almost all of the ruptures to the actual anterior and posterior cruciate ligaments occurred proximally. Hence, if haemarthrosis occurs in children, arthroscopy should be performed as a diagnostic and therapeutic measure. Surgery must follow the complete rupture of the actual ligaments and dislocated fracture of the bony insertions. The outcome of these operations on children is very satisfactory.

Anterior Cruciate Ligament↗
PubMed1990

[Typical nosocomial infection with an unusual cause: Hafnia alvei. Report of 2 cases and literature review].

The route of infection and the course of two typical nosocomial infections are described in two patients infected with a rare gram-negative bacterium. Both patients underwent cardiovascular surgery. They were placed close to each other in the intensive care unit for several days and suffered from pneumonia and from wound infection respectively. In both patients bacterial culture grew Hafnia alvei. Successful antibiotic treatment was achieved with Netilmicin and Imipenem. Urinary tract, respiratory tract and wound infections are the most frequent nosocomial infections according to the literature. Risk factors are duration of stay in the intensive care unit, shock, poor general condition and advanced age.

Aged↗
PubMed1982

Studies on a highly active anticoagulant fraction of high molecular weight isolated from porcine sodium heparin.

We have studied heparin fractionation using gel filtration and ion-exchange chromatographic methods. The starting material was commercial grade porcine mucosal sodium heparin (PSH). The fractionation was monitored employing synthetic substrates for assaying both antithrombin (with H-D-Phe-Pip-Arg-pNA ; S-2238) and anti-FXa (with Bz-Ileu-Glu-Gly-Arg-pNA ; S-2222) activities. The resulting fractions were evaluated in different amidolytic and coagulation methods used to determine heparin potency by comparison with PSH. By gel filtration of PSH on Ultrogel Aca 54, both strong anti-FXa and antithrombin activities were associated with the fractions eluted in the high molecular weight range (MW congruent to 20 x 10(3)). These fractions also had potent anticoagulant action when assayed by conventional clotting methods. PSH was also subjected to fractionation by an ion-exchange technique (DEAE-Sephacel) with increasing salt molarity. The patterns for antithrombin and anti-FXa activities were again closely related, if not identical. Four fractions were usually distinguished, with respectively negligible, intermediate, high and very high activities when compared to PSH. The very highly active fraction (HAF), approximately 15% by weight, was eluted at high salt molarity (greater than 0.8 M NaCl). On a weight basis its anticoagulant activity was congruent to 2-3 times that of PSH as determined by amidolytic as well as clotting methods. Intravenous injection of HAF to rabbits and dogs (1.0 and 2.5 mg/kg) produced a much stronger anticoagulant response than PSH, also showing an effect which persisted for a longer duration.

Animals↗
PubMed1982

Insertion tendopathy in athletes. A light microscopic, histochemical and electron microscopic examination.

Tendon tissue of eleven athletes suffering from insertion tendopathy and of two controls was examined. Part of the tissue was prepared for routine light microscopy, a part for enzyme histochemical staining of Nicotinamide-adenine-dinudeotide-diaphorase (NADP-diaphorase), lactate dehydrogenase (LDH), beta-glucuronidase and alkaline phosphatase. Small pieces of tissue were also prepared for electron microscopic examination. The removed tissue was edematous and mushy. The normally densely packed parallel or interwoven collagen bundles were loosened by edema, focal necrosis or hemorrhage. Infiltration of fatty tissue and granulation tissue was also present. The amount of acid mucopolysaccharides was markedly increased. The histochemical studies showed strong enzyme activity of NADP-diaphorase and LDH in normal tendon tissue as well as around areas of degeneration and in granulation tissue. beta-Glucuronidase and alkaline phosphatase was present, but in general with lesser activity than the above enzymes. The electron microscopic examination revealed marked degeneration of the fiber systems, focal necrosis, deposit of amorphous masses and mucopolysaccharides and focal mineralisation. The reparative zones showed proliferating capillaries, often with a collapsed lumen and prominent endothelial cells and basement membranes.

Adult↗
PubMedDate not supplied

Distributions of distances in information strings.

Distances between identical symbols in information strings (biological, language, computer programs (*.exe files) are described with a different precision with four distributions: exponential, Weibull, log-normal and negative binomial. The correlations are sometimes highly significant.

Amino Acid Sequence↗
PubMedDate not supplied

[Operative treatment of ruptures of distal tendon of biceps muscle with a minimally invasive technique using suture anchors--clinical results].

AIM: Ruptures of the distal tendon of the biceps muscle should be treated operatively. A minimally invasive technique and the use of suture anchors may decrease the intraoperative risks. But can satisfactory clinical results be achieved? METHOD: We present the results of a clinical study. Between 1999 and 2005 nine patients were operated for distal biceps tendon avulsion. A minimally invasive operating technique using a suture anchor was established and the technique is described. Rantanen and Orava's score was used to compare clinical and radiological findings. RESULTS: Clinical follow-up was performed at 6 months after operation. In six patients excellent results according to Rantanen and Orava were achieved. No loss of strength was noticed in 6 of 9 cases. Range of motion was unlimited in six patients. In two cases we found heterotopic ossifications. CONCLUSION: On the basis of our results we suggest that minimally invasive surgery using a suture anchor should be performed more often. The technique described leads to results that are comparable to those found in the literature.

Accidents, Occupational↗
PubMedDate not supplied

Tumour necrosis factor-alpha promoter polymorphism in erythema nodosum.

Erythema nodosum is a common skin disease characterized by erythematous, tender subcutaneous nodules, mostly located on the lower extremities. Little is known about its pathogenesis, although a wide variety of aetiological factors (e.g. bacterial and viral infections, neoplastic diseases and drugs) have been described. Sarcoidosis, a typical granulomatous disease, often occurs in association with erythema nodosum (Loefgren syndrome). Since granulomatous diseases have been closely linked to a deregulated tumour necrosis factor (TNF)-alpha production, it was tempting to speculate whether TNF-alpha might play a role in the pathogenesis of erythema nodosum, at least in cases associated with sarcoidosis. A previously described nucleotide exchange, (G-A) at position -308 in the human TNF-alpha gene promoter, has been shown to be a major cause for enhanced TNF-alpha production. In the present report, we investigated the genomic TNF-alpha promoter region in patients suffering from EN with and without underlying sarcoidosis. Our results showed a strong correlation between the uncommon TNF A II allele and sarcoidosis-associated erythema nodosum. Patients with erythema nodosum without underlying sarcoidosis displayed a similar allele frequency compared with controls. Taken together, we provide evidence that erythema nodosum in association with sarcoidosis might be pathogenically linked to altered TNF-alpha production due to a genetic promoter polymorphism.

Base Sequence↗