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Biomedical subjects

P Kempf

Publications and source records attributed to P Kempf.

At least 19 recordsLinked to original sources
PubMed1995

Human Kupffer cells secrete IL-10 in response to lipopolysaccharide (LPS) challenge.

BACKGROUND/AIMS: Kupffer cells are involved in local immunoregulation in the liver by secretion of cytokines and direct cellular contact. They are able to influence the function of other liver cells, i.e. sinusoidal endothelial cells, Ito cells and hepatocytes. The three known major functions of Kupffer cells are clearance of endotoxin from the portal circulation, release of soluble mediators and presentation of antigen. METHODS: Human Kupffer cells were isolated by collagenase perfusion followed by centrifugal elutriation and analyzed for cytokine secretion after 3 days in culture. RESULTS: We found that freshly isolated human Kupffer cells secreted the anti-inflammatory cytokine interleukin-10 in response to stimulation with lipopolysaccharide. The release of interleukin-10 was maximal 12-24 h after lipopolysaccharide challenge. Furthermore, we could show that exogenous interleukin-10 downregulated the release of the proinflammatory cytokines interleukin-6 and tumor necrosis factor alpha by Kupffer cells after lipopolysaccharide stimulation. The release of interleukin-6 was maximal 24 h after stimulation and interleukin-10 inhibited interleukin-6 release after 6 h. Tumor necrosis factor alpha showed maximal secretion 6 h after stimulation and exogenous interleukin-10 also downregulated the tumor necrosis factor alpha release after 6 h. CONCLUSIONS: Kupffer cells are exposed physiologically to lipopolysaccharide present in portal venous blood. Given the known anti-inflammatory effect of interleukin-10, our findings of secretion of interleukin-10 by Kupffer cells in response to lipopolysaccharide and suppression of interleukin-6 and tumor necrosis factor alpha release by Kupffer cells in vitro through exogenous interleukin-10 suggest an important role for interleukin-10 in the regulation of the local immune response in the liver sinusoid.

Cytokines↗
PubMed1991

[Ambulatory monitoring of frequency of apnea in patients with suspected sleep apnea syndrome. Comparative studies using a thermistor sensor].

To record and evaluate the number and duration of nocturnal apneas, and easy method is needed in an outpatient setting. New methods such as recording the tracheal sounds, heart frequency, and O2 saturation, are now available. Recording of thermal convection by Thermistor has not been performed on an outpatient basis so far. Hence, we developed a method by which a thermistor was placed on a mask to record the nasal and oral flow. A specially developed computer hardware evaluates date, time, period, number and mean values of the apneas. The parameters were compared with the conventional methods of recording apneas (thoracic and abdominal movement. O2 saturation, heart frequency and 3 thermistors at mouth and nose). 20 patients, mean age 53.1 +/- 1.6 years, were examined. In 12 patients the apnea frequency was between 0 and 50 apneas per night, in 8 between 50 and 550. Patients with an apnea frequency of more than 50 per night (polygraphy) could be identified with the thermistor method. Our results show that the method is sensitive in respect of the oral and nasal flow. The method seems valid to differentiate between normal persons and patients with increased risk of apnea syndrome.

Adult↗
PubMed1991

[Comparative studies on the effect of nasal CPAP, theophylline and oxygen in patients with sleep apnea syndrome].

In patients with sleep apnea-syndrome nasal CPAP-therapy is the method of choice. The apnea phases are practically completely eliminated. However some patients with SAS don't accept CPAP-therapy. In this group Theophylline or O2-therapy respectively is discussed. We examined therefore 21 patients (55.8 +/- 9 years) with sleep-apnea syndrome and an apnea-index of 39 +/- 19.9 during 4 consecutive nights (diagnosis, nCPAP-therapy, O2-therapy by 21/min, by nasal prongs and Theophylline 375-400 mg in the evening and calculated apnea-index, the longest apnea and the lowest O2-saturation. On CPAP the number of apneas was practically reduced to 0. On Theophylline there was a relevant reduction of the apnea frequency. On O2-therapy only few patients with non-compliance Theophylline-therapy can be of some benefit in patients with moderate sleep-apnea syndrome. However the apnea-index cannot be normalized.

Humans↗
PubMed1990

Monitoring at home.

To reduce time committment and expense in the diagnosis of sleep apnea it is necessary to develop simplified monitoring techniques. The monitoring systems to detect apneas should have high sensitivity, good reproducibility, be inexpensive and practical to use. The following methods have been suggested: inductance plethysmography, capnography, flow measurements by thermistors, tracheal sound recording, static charge sensitivity bed, oximetry, activity monitoring, detection of snoring. Some devices to registrate breathing have been combined with oximetry and other methods. The results have been validated by polysomnography and show rather good correlations. However, there exists no information on the time and cost savings of a step wise diagnosis of sleep apnea.

Adult↗
PubMed1988

Preoperative radiotherapy as adjuvant treatment in rectal cancer. Final results of a randomized study of the European Organization for Research and Treatment of Cancer (EORTC).

A randomized clinical trial was conducted by the European Organization for Research and Treatment for Cancer (EORTC) Gastrointestinal Cancer Cooperative Group to study the effectiveness of irradiation therapy administered in a dosage of 34.5 Gy, divided into 15 daily doses of 2.3 Gy each before radical surgery for rectal cancer (T2, T3, T4, NX, MO). Four hundred sixty-six patients were entered in the clinical trial between June 1976 and September 1981. Tolerance and side effects of preoperative irradiation were acceptable. The overall 5-year survival rates were similar in both groups. When considering only the 341 patients treated by surgery with a curative aim, the 5-year survival rates were 59.1% and 69.1% in the control group and in the combined modality group, respectively (p = 0.08). The local recurrence rates at 5 years were 30% and 15% in the control group and the adjuvant radiotherapy group, respectively (p = 0.003). Although this study did not show preoperative radiotherapy to have a statistically significant benefit on overall survival, it does have a clear effect on local control of rectal cancer. Therefore, before performing radical surgery, this adjuvant therapy should be administered to patients who have locally extended rectal cancer.

Adenocarcinoma↗
PubMed1988

[Distal radius fracture--indications for conservative, partial surgical and surgical therapy].

460 fractures of the distal radius including 91 which are treated surgically are investigated in a retrospective study. There were 260 fractures of the left and only 200 of the right radius. 66% of the patients were female, especially striking is the superior number of women older than 45 years. The evaluation of the final radiological results referring to anatomical joint angles and normal radius length shows a high correlation to the evaluation of the final functional results. 70% of the latter are valued as excellent or good, 19% as tolerable and 11% as poor. The classification according to Frykman shows a significantly better result for cases without violation of the distal ulna. The comparison between operative and non-operative treatment of dislocated fractures without infraction of the radiocarpal joint demonstrates good results of percutaneous wire fixation in those cases. The therapy of fractures with infraction of radiocarpal and radioulnar joint is difficult. In this group we could not find a superiority of operative against conservative treatment. Wire fixation lead to 19% poor results and cannot be recommended for all cases. Six patients treated by external fixation and five treated by osteosynthesis using metal plates had good or tolerable results. The indication for using these methods has to be considered.

Adult↗
PubMed1986

[Clinical incidence of subclavian thromboses following pacemaker implantation].

Although pacemaker (PM) implantation has developed into a standard therapy in appropriate rhythm disorders the procedure is not free of complications. One of the most common problems is thrombotic alteration in the region of the entry of the pacemaker electrode into the venous system. To obtain more details of the incidence and extent of these complications, we investigated a total of 97 patients in two groups, clinically, phlebographically and by Doppler-ultrasound technique. 56 (30 males, 26 females, mean age 73 years) were examined 1 week, and 41 (18 males, 23 females, mean age 72 years) 1 year after PM implantation. The thrombotic changes were quantified and correlated to various anamnestic and clinical parameters with the following results: 1 week after implantation 25% of patients show thrombi with collaterals, in 15% shorter than, and in 10% longer than 3 cm. One complete obturation of the implantation vessel was recognized. Thrombotic changes without collaterals were found in 36%, in 25% shorter than, and in 11% longer than 3 cm. One year after PM implantation there are organized thrombi in 71%, 41% of these patients show collaterals phlebographically. The others had no hemodynamic changes. Of all the anamnestic and clinical parameters, a significant correlation was found only between development of thrombi and material of electrodes. Polyurethane electrodes have a significantly higher rate of thrombosis than silicone electrodes (p less than or equal to 0.0066).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1984

[Preoperative radiotherapy in rectal cancer].

A combined therapy of the rectum carcinoma was performed from 1973 to 1980; a randomization was made between preoperative irradiation with 34.5 Gy and operation. The irradiation was performed with Co-60 with opposing fields, including the small pelvis as well as the para-aortal region of the 2nd lumbar vertebra. The evaluation of March 1983 showed a significantly higher number of deaths caused by the tumor in the only operated patients. With respect to side effects, there are no essential differences between the preirradiated and the only operated group.

Combined Modality Therapy↗
PubMed1983

Improved quality of life with an implantable pump for liver perfusion.

In spite of the current discussion on whether liver perfusion is effective (Grage et al. 1979; Ansfield et al. 1975), the implantable perfusion pump offers the possibility of combining the still questionable therapeutic success with a high quality of life during the time remaining to such patients.

Antineoplastic Agents↗
PubMed1982

[The value of computer tomography in the diagnosis of local recurrences of carcinoma of the rectum (author's transl)].

The tendency of rectal carcinomas to recur makes it necessary to reexamine these patients repeatedly. The tissues remaining following resection of the rectum can only be examined directly by computer tomography. The value of this procedure in the diagnosis of local recurrences has so far not been established. The results of computer tomography must therefore be correlated with already established methods, particularly clinical examination and CEA measurements.

Adenocarcinoma↗
PubMed1981

Comparison of ftorafur with 5-fluorouracil in combination chemotherapy of advanced gastrointestinal carcinoma.

The aim of the study was to compare the combination 5-FU-carmustine with ftorafur-carmustine in the treatment of advanced gastrointestinal cancer. To this end, a prospective, multicenter, randomized trial was initiated. Part I of this trial showed that similar response rates can be obtained with 5-FU-carmustine and ftorafur-carmustine in 109 patients (32.7% versus 26.3%). However, median survival was better in patients treated with 5-FU-carmustine (307 days versus 163 days). Part II of the trial revealed that neither a higher dosage of ftorafur (2 g/m2/day X 5 days) nor the addition of vincristine to both regimens changed the previously obtained results significantly. Again, median survival was found to be better in patients treated with 5-FU combination chemotherapy (304 days versus 144 days). Both the 5-FU and the ftorafur combination were tolerated reasonably well. The results suggest that combination chemotherapy including 5-FU is superior to ftorafur at the applied dosages in terms of survival.

Adult↗
PubMed1980

[Emergency endoscopy after operation of the upper gastro-intestinal tract: problems and risks (author's transl)].

Upper gastro-intestinal bleeding or other complications after operations on this tract can lead to grave additional risk for the patient, especially in the early postoperative phase. Because of its high degree of diagnostic accuracy, emergency endoscopy is in most cases of decisive importance in planning the type (conservative or surgical) and timing of any necessary treatment. Special investigative techniques as well as the early use of endoscopy in 97 patients achieved a high rate of success at a low risk to the patients. Indications, results and risks of emergency endoscopy of the upper gastro-intestinal tract in the late postoperative phase are similar to those for the non-operated patient.

Digestive System Surgical Procedures↗
PubMed1979

[Histological and histoautoradiographical examination of the interposed jejunum after total gastrectomy in dogs (author's transl)].

Total gastrectomy was performed on purebred beagle dogs and a 30--40 cm jejunal segment was grafted isoperistaltically between oesophagus and duodenum. Histological and histoautoradiographical examinations were carried out and the wall-thickness and the cell-transformation rate in the interponate determined. Despite the isoperistaltic substitute-stomach a muscular wall-hypertrophy of 140% of the interponated jejunum was found. The reason for this hypertrophy is thought to be the result of adhesions and the functional mechanical demands. Histoautoradiographical examinations confirmed that the regeneration time in the substitute-stomach decreased by 70% compared with the normal jejunum. The distinct reduction of cell regeneration in the regeneration in the interponated jejunum could be attributed to the considerable regression of the absorbent performance and to the increase in its mechanical exercises.

Animals↗
PubMed1977

[Preliminary results of preoperative radiotherapy in carcinoma of the rectum (author's transl)].

Preliminary results were evaluated in patients with carcinoma of the rectum of whom 33 had preoperative radiotherapy and 23 were treated by operation only. The tumour stage was T2-4 NX MO in all patients. There was no significant difference between the groups as to postoperative mortality, would healing, and postoperative admission time. However, the recurrence rate was significantly lower in pre-irradiated patients than in those treated by operation only. The combination of radiotherapy and radical operation appears to be a possible means of significantly improving the survival rate of patients with carcinoma of the rectum.

Adult↗