PubMed Health⌕ Search

Biomedical subjects

R Kästner

Publications and source records attributed to R Kästner.

At least 19 recordsLinked to original sources
PubMed2003

Impact of medical and demographic factors on long-term quality of life and body image of breast cancer patients.

BACKGROUND: The impact of various medical and demographic factors on the quality of life (QoL) of breast cancer patients has been discussed controversially. We investigated the influence of six different factors on long-term QoL and body image of women with primary breast cancer. PATIENTS AND METHODS: Two-hundred and seventy-four breast cancer patients were administered the QoL questionnaire following a mean interval of 4.2 years after primary diagnosis. All women had been primarily treated for stage I to III breast cancer without evidence of distant metastases. QoL was evaluated by using the QLQ-C30 questionnaire Version 2.0. Supplementary scales included body image, satisfaction with surgical treatment, cosmetic result and fear of recurrence. We analyzed the impact of tumor stage, surgical treatment, adjuvant radiotherapy, adjuvant cytotoxic therapy, age and length of follow-up period on the examined outcome parameters. RESULTS: At the time of the follow-up examination, patients showed minor impairment of QoL (mean 67.8) and body image (mean 24.8), but more fear of recurrence (mean 60.7). None of the studied factors had a significant impact on overall QoL (P >0.05) according to the QLQ-C30 questionnaire. In contrast, with the exception of the factors 'cytotoxic therapy' and 'radiotherapy' all investigated variables influenced at least one of the additional psychological scales (P <0.05). The primary surgical treatment modality had the strongest impact and affected all four scales. Patients treated with breast conservation reported a more favorable body image, compared to those treated with mastectomy (17.2 versus 37.5, P <0.01), more satisfaction with surgical treatment (4.0 versus 10.7, P = 0.01), rated a better cosmetic result (75.5 versus 57.1, P <0.01), but presented more fear of recurrence (63.9 versus 55.3, P = 0.04). CONCLUSION: Current QoL questionnaires do not sufficiently cover all relevant aspects of QoL, but might be complemented by breast cancer specific aspects such as body image and fear.

Adult↗
PubMed2001

[Specific concepts of care for pregnant women with drug addiction or HIV infection].

In the last 10 years about 130 women with a drug addiction and more than 100 HIV-positive pregnant women were treated at the 1. University Hospital of Obstetrics and Gynaecology in Munich. Besides a specialized medical treatment both groups required intensive psychosocial care. HIV-infected people are still isolated and suffer from the social stigmata. Their essential needs for sexuality and children of their own are often ignored or even condemned because of irrational fears about HIV, which continue despite rapid medical improvements. The life-expectancy for example has increased since the inauguration of protease inhibitors. Vertical transmission of HIV is below 2% through medical treatment in pregnancy, elective cesarean section and renunciation of breastfeeding. Drug addicted pregnant women are given the opportunity to change their life in order to care for their children appropriately. The basis for this is a substitution with levomethadone and elimination of the use of other drugs. The addicted women often can reduce the dosage of levomethadone during the course of their pregnancy and sometimes can cease totally. Normally they are highly motivated and thus can ease the withdrawal symptoms of their newborns following delivery. By establishing a reliable social net during pregnancy mothers learn to recognize the demands of their children after birth and thus emotional and cognitive deficits can be prevented.

Female↗
PubMed2000

Analysis of point mutation in exon 2 of CYP2E1 gene in renal cell/urothelial cancer patients in comparison with control population.

OBJECTIVE: Genetic polymorphisms of human cytochrome P450s have been implicated to be of importance for susceptibility to different cancers. Recently, a point mutation was found in the exon 2 of the CYP2E1 gene (CYP2E1*2) [Hu et al. 1997]. In order to evaluate a possible link between the point mutation in exon 2 of the CYP2E1 gene and the susceptibility to renal cell/urothelial cancer, we developed a screening method based on the polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). MATERIAL: DNA of peripheral white blood cells was isolated from 158 renal cell/urothelial cancer patients as well as from 150 controls. METHOD: Primers for PCR were designed by the Primer 3 release 0.1 program. The PCR yield a product of 215 base pairs (bp), which was digested with the restriction enzyme Hha I. The DNA fragments were separated on a 3% agarose gel stained with ethidium bromide. Restriction enzyme digestion of the PCR product obtained from the wild-type DNA resulted in the appearance of a 66 bp, a 43 bp, a 40 bp, a 39 bp and a 28 bp DNA fragment. In contrast to the wild-type, the digestion of the PCR product from DNA carrying the point mutation resulted in the loss of the 39 bp and 40 bp fragments and the appearance of an additional 79 bp fragment. Therefore, the loss of one Hha I restriction site caused by a single nucleotide exchange is suitable for the identification of the point mutation in exon 2 of CYP2E1 gene. RESULTS: However, we could not detect any point mutation in any of the 158 renal cell/urothelial cancer patients or the 150 controls. The distribution of the point mutation in exon 2 of CYP2E1 gene did not show any difference in renal cell/urothelial cancer patients and controls. CONCLUSION: This might indicate a lack of association between this CYP2E polymorphism (CYP2E1*2) and renal cell/urothelial cancer.

Base Sequence↗
PubMed1998

CYP2E1 genotyping in renal cell/urothelial cancer patients in comparison with control populations.

OBJECTIVE: Genetic polymorphisms in enzymes involved in carcinogen metabolism have been found to influence susceptibility to cancer. Ethanol-inducible CYP2E1 is an enzyme of major toxicological interest because it metabolizes several drugs, precarcinogens, and solvents to reactive metabolites. In the present investigation, we studied the cytochrome P450 2E1 genetic polymorphism in renal cell/urothelial cancer patients in comparison with healthy control populations in the regions of Jena and Halle in Germany. PATIENTS AND MATERIAL: DNA of peripheral white blood cells was isolated both from 273 renal cell/urothelial cancer patients and 298 controls from the regions of Jena and Halle. METHOD: We focused on polymorphisms in the promoter region and intron 6 of the CYP2E1 gene. The polymorphims were identified as restriction fragment length polymorphisms (RFLPs) by polymerase chain reaction (PCR) and subsequently applying the restriction enzymes PstI/RsaI and DraI. RESULTS: In the region of Jena as well as of Halle, the frequency distributions of the PstI/RsaI, DraI, and combined DraI + PstI/RsaI genotypes showed no significant differences between controls and renal cell/urothelial cancer patients. We did not find significant differences between Jena and Halle. 86.7% of all subjects with a homozygote PstI/RsaI genotype also carried a homozygote DraI genotype, whereas 5.2% of all subjects with a heterozygote PstI/RsaI genotype also carried a heterozygote DraI genotype. The heterozygote genotype of PstI/RsaI polymorphism always determines the heterozygote genotype of DraI polymorphism. Our results failed to demonstrate any differences in the distribution of CYP2E1 polymorphisms between renal cell/urothelial cancer patients and controls. CONCLUSION: Summing up, our results show that CYP2E1 genotype cannot predict risk for renal cell/urothelial cancer in the population from 2 different regions in Germany. The results demonstrate a lack of association between CYP2E1 genetic polymorphism and renal cell cancer/urothelial cancer.

Carcinoma, Renal Cell↗
PubMed1997

Release of a stable cardiodepressant mediator after myocardial ischaemia during reperfusion.

OBJECTIVE: The aim of this study was to investigate whether cardiodepressant mediators are released after myocardial ischaemia during reperfusion. METHODS: Using a double heart model, the effect of the reoxygenated coronary effluent of an isolated guinea pig heart on a sequentially perfused second heart was studied under control conditions and after 10 min ischaemia of the first heart. Investigation of the modulating role of known autacoids took place by using free radical scavengers, an NO synthase inhibitor and adenosine receptor antagonists. In order to identify the chemical nature of cardiac metabolites, the coronary effluent was also subjected to different chemical treatment modes. RESULTS: No haemodynamic changes were observed during sequential perfusion under control conditions. After 10 min of global ischaemia in heart I, a marked decrease in LVP (-22%), LVdP/dtmax (-43%), LVdP/dtmin (-41%) and coronary perfusion pressure (-25%) was measured in heart II during sequential perfusion. The negative inotropic effect was rapid in onset and reversible within 5 min; free radicals, nitric oxide and adenosine were not involved. Storage of the coronary effluent of the first heart up to 24 h, heating, or protease treatment did not modify its cardiodepressant effects on the second sequentially perfused heart. CONCLUSIONS: These results suggest the release--from an isolated heart after ischaemia during reperfusion--of a cardiodepressant mediator which induces a potent reversible negative inotropic effect on a sequentially perfused heart. The mediator is stable and in all probability not a protein.

Adenosine Deaminase↗
PubMed1997

Cardiodepressive mediators are released after ischemia from an isolated heart: role of coronary endothelial cells.

OBJECTIVES: This study was designed to ascertain whether cardiodepressive mediators released after ischemia originate from coronary endothelial cells. BACKGROUND: Endothelial cells modulate myocardial contractility under physiologic conditions. Few data are available describing the role of coronary endothelial cells on myocardial function after ischemia. METHODS: Using a model of sequential perfusion of two isolated rat hearts, the effect of the reoxygenated coronary effluent of heart I was investigated on myocardial contractility of heart II. After 40 min of separate perfusion at constant flow (10 ml/min), the two hearts were perfused sequentially with (group I) or without (control group) preceding ischemia (10 min) of heart I. In groups II and III, the coronary endothelium of heart I was functionally removed by Triton X-100 or hyperkalemic infusion before global ischemia. Endothelial damage was confirmed by functional tests and electron microscopy. RESULTS: Under control conditions no changes were observed in heart II during sequential perfusion. In contrast, after 10 min of ischemia in heart I, a marked reversible decrease in left ventricular pressure, left ventricular dP/dtmax and left ventricular dP/dtmin (-55%, -66% and -70%, respectively) was observed in heart II. Heart rate and coronary perfusion pressure did not change significantly. Selective endothelial damage of heart I before ischemia did not modify the negative inotropic effect observed in heart II. CONCLUSIONS: Cardiodepressive mediators are released after ischemia during reperfusion from an isolated heart and induce a reversible negative inotropic effect in a sequentially perfused heart. It is unlikely that these agents are derived from the coronary endothelium.

Animals↗
PubMed1992

[Clinical application of quantitative evaluation of horizontal pursuit movements of the eye].

Horizontal smooth pursuit eye movements were quantitatively evaluated in forty patients with various neurological diseases (chronic alcoholism, acusticusneurinom and multiple sclerosis) as well as in twenty-four healthy subjects. Different frequency sinusoidal targets with an amplitude of 20 degrees were used. The quantitative analysis was possible after calculating the pursuit value as the difference between the saccadic part and the maximal amplitude of the recorded eye movement. Maximal and minimal P-values of 0.5, 0.7 and 0.9 Hz were chosen in the discriminant analyses. It is suggested that these parameters are very helpful in distinguishing between the groups of patients and the group of subjects.

Adult↗
PubMed1991

[Effect of pressure-induced ischemia on oxygen supply in the retinal capillary area. Results of a mathematical model].

This paper attempts to obtain a better understanding of the oxygen supply to tissue cells of the optic nerve head by describing all phases of the release, diffusion and consumption process by means of a mathematical model. As a result the oxygen partial pressure reduction induced by intraocular pressure elevation--as it occurs in glaucoma--seems to be mainly influenced by a pressure-induced lowering of the average blood velocity in the retinal capillaries. A reduction of this velocity to a fourth of its normal value even makes the oxygen partial pressure at the venous capillary wall drop below the critical level necessary for maintaining cell activity. Furthermore our calculations allow us to conclude that an involvement of the retinal capillary network supplied by the central retinal artery should not be neglected in glaucoma.

Blood Flow Velocity↗
PubMed1991

[Saccadic eye movements: methodologic aspects and possibilities of clinical use].

Saccades are fast eye movements that occur when the eye makes a refixation movement. Initially clinically relevant physiological and anatomical data are given. The two most frequently used oculographic methods are presented briefly. For clinical use it is particularly important that ocular motor disorders and effects of various drugs are compensated partially by plastic adaptation of central mechanisms. The main diagnostic fields are disorders of brain stem, cerebellum or peripheral oculomotor apparatus. Examination of horizontal and vertical saccades is a useful help in diagnosis of subclinical ocular motor disorders in encephalomyelitis disseminata.

Brain Diseases↗
PubMed1987

Developmental patterns of thyroid hormones and testosterone in ferrets.

Plasma levels of thyroxine (T4) and triiodothyronine (T3) were measured in male and female ferrets at regular intervals between postnatal day 20 and 150 as well as in adult animals. In addition, testosterone level in male ferrets was measured. All hormones showed characteristic developmental patterns. There is a T4 maximum prior to a T3 maximum in subadult animals which in both cases surpasses adult levels. Testosterone level shows a different developmental pattern. There is an outstanding peak in subadult males around day 60-80, which, however, is surpassed by adult levels during the mating season.

Animals↗
PubMed1987

[Effect of carbamazepine on the velocity of saccades].

In 5 female patients suffering from focal epilepsies, the maximal velocity of saccades was determined before and during carbamazepinE therapy. A decrease in the velocity of saccades was followed by an increase at the same serum level.

Adult↗
PubMed1987

Comparative studies on the astrocytic reaction in the lesioned central nervous system of different vertebrates.

UNLABELLED: The morphology of the optic nerve of fish, amphibians, reptiles, birds and mammals, with special reference to the membrane architecture of the astrocytes, is described by means of ultrathin sections and freeze-fracture replicas. The reaction patterns of the astrocytes in response lesions of the optic nerve are discussed with respect to the regenerative capacity of the central nervous system (CNS). Astrocytic membranes in the optic nerve of the goldfish and Rana esculenta do not reveal orthogonal arrays of particles (OAP), in contrast to those of the optic nerve of the turtle, lizard, chicken, pigeon and rat. Reactive astrocytes in the crushed optic nerve of goldfish establish tunnel-like structures that are in close contact with the regenerating axons. During the regeneration period the distribution of intramembranous particles (IMP) in the astrocytic membrane is not uniform, in contrast to the situation found after complete regeneration and in the untreated optic nerve. Reactive astrocytes in degenerating optic nerves of chicken and rat form a glial scar. The density of the OAP decreases in reactive astrocytes of adult chicken and rats, whereas the density increases during the degeneration period in the optic nerve of the postnatal rat. HYPOTHESIS: Astrocytes devoid of OAP are only found in regions of the vertebrate CNS capable of regeneration. In contrast, the inability to regenerate coincides with the appearance of OAP. Therefore, it is suspected that the presence of OAP in astrocytic membranes is at least one of several factors involved in the abortive regeneration of nerve fibers.

Animals↗
PubMed1986

[Direct myocardial anti-ischemic effect of diltiazem in the human].

In a randomized double blind placebo-controlled study in 20 patients the influence of the calcium antagonist diltiazem (1.0 mg administered intracoronarily, distal from the stenosis) on the severity of myocardial ischemia during therapeutic coronary occlusion (transluminal coronary angioplasty) of the left anterior descending coronary artery was investigated. The severity and time of onset of ischemic ST and T wave changes as well as anginal pain were significantly reduced 3 and 8 minutes after diltiazem, whereas there was no definite change in the controls. Heart rate and blood pressure were not influenced by diltiazem or placebo. The results indicate a direct antiischemic effect of diltiazem on myocardial cells. The findings can neither be explained by an influence on cardiac afterload nor by coronary vessel reactions, nor a reduction of myocardial contractility. The findings do not permit conclusions in terms of the duration of this direct antiischemic mode of action.

Adult↗
PubMed1985

[Neoplastic meningosis in immature cell leukemias and malignant lymphomas].

162 patients with acute leukemias or malignant non-Hodgkin lymphomas were examined for meningeal and cerebral manifestations of their disease. A clinically manifest disease could be found in 13 patients, meningosis was additionally detected by autopsy in 32 patients. The highest frequency was found in acute lymphatic leukemia followed by lymphoblastic lymphomas and acute myeloic leukemias. Less frequently there was a meningeal involvement in low-grade malignant lymphomas which becomes clinically manifest only in some rare cases. In this respect, non-lymphoblastic, high grade-malignant lymphomas take an intermediate position. On principle, meningosis prophylaxis is imperative for acute lymphoblastic leukemias and advanced lymphoblastic lymphomas.

Autopsy↗