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T Krause

Publications and source records attributed to T Krause.

At least 91 records · Page 5Linked to original sources
PubMed1991

Life-threatening fluid extravasation of central venous catheters.

The majority of life-threatening injuries secondary to the placement of central venous catheters, such as bleeding and pneumothorax, occur at the time of initial insertion. When a catheter extravasates in the neck, edema of the neck wall or chest is usually seen, and the pump indicates occlusion. We present four cases in which an uneventful, successful placement of four central lines (three superior vena cava, one inferior vena cava) were followed at greater than 48 hours by either hydrothorax or hydroperitoneum, which resulted in either cardiorespiratory collapse or intraabdominal sepsis. In reviewing these cases, all showed both a change in catheter location on a subsequent x-ray and poor or no blood return on aspiration; paradoxically, the infusion pump in each case did not sense a catheter malposition or occlusion. We conclude that, although the success of central line placement may be documented on insertion, a continual reappraisal of both the function and location of the line is necessary.

Catheterization, Central Venous↗
PubMed1991

Differences in DNA adduct formation between monocytes and lymphocytes after in vivo incubation with benzo[a]pyrene.

It was the aim of this study to compare the formation of DNA adducts in different human white blood cells. Lymphocytes and monocytes were isolated from peripheral blood by density centrifugation and by a monocyte-specific antibody linked to magnetic beads. DNA adducts were determined by 32P-postlabelling. After in vitro incubation with benzo[a]-pyrene (B[a]P) we found DNA adducts in monocytes, but not in unstimulated blood lymphocytes. Only after growth stimulation by phytohaemagglutinin did lymphocytes show an adduct pattern similar to monocytes. In contrast, B[a]P-7,8-dihydro-9,10-diolepoxide, an activated intermediate of B[a]P metabolism leads to similar DNA adducts in both cell types. When lymphocytes were incubated in the presence of B[a]P together with monocytes, then after subsequent separation lymphocytes exhibited most of the adducts found in monocytes, though to a lower extent. Our results suggest that unstimulated blood lymphocytes--which are unable to activate metabolically promutagens like B[a]P--receive the genotoxic material to form DNA adducts from other blood cells or from cells in the vessel lining. We conclude that the amount and the pattern of DNA adducts formed in whole white blood cells may be influenced considerably by a variable proportion of monocytes.

7,8-Dihydro-7,8-dihydroxybenzo(a)pyrene 9,10-oxide↗
PubMed1991

[The visualization of heart wall motion using MR-interferography].

MR interferography provides a method for noninvasive measurement of heart wall motion. An interferographic pattern is projected on short axis views of the left ventricle, characterising local motion of the myocardium. In contrast to tagging methods, interferography images the direction and velocity of local wall motion at the moment of acquisition directly. Ten healthy volunteers and 8 patients with myocardial infarction were studied. Contraction, relaxation velocity of the ventricular wall, and rotation (twist) of the left ventricle were recorded. Myocardial scars were identified by abnormal pattern of segmental wall motion. MR interferography represents a promising tool for assessment of the transmural distribution of thickening and of other components of motion within the wall.

Adult↗
PubMed1990

32P-postlabelling analysis of DNA adducts in monocytes of smokers and passive smokers.

In a controlled study, ten male volunteers were subjected to different smoking and passive smoking conditions. After 60 h of strictly controlled nonsmoking, five smokers were exposed to mainstream smoke only, while five nonsmokers were exposed to the gas phase of environmental tobacco smoke (ETS). In a second experiment smokers were mainstream and ETS exposed, while nonsmokers were exposed to complete ETS. Blood was drawn before and after smoking and DNA adducts were analysed from blood monocytes by the 32P-postlabelling assay, using the nuclease P1 enhancement method. We detected DNA adducts in monocytes of all probands. These adducts unrelated to smoking showed interindividual differences but only minor intraindividual changes in four samples of the same donor. After smoking interindividually variable additional adducts were visible in active smokers only. These smoking-related adducts had disappeared after 40 h of nonsmoking and reappeared again in three out of five smokers after the second smoking period. We conclude that smoking causes an interindividually variable pattern of DNA adducts in active smokers. These adducts disappear in less than 2 d, owing to the fast turnover of monocytes in the intravascular system. The effects described could not be observed in heavily exposed passive smokers.

Adult↗
PubMed1990

Detection of traumatic myocardial injury by means of simultaneous Tl-201/Tc-99m pyrophosphate tomography--report of three cases.

Trauma to the chest can result in cardiac damage, which may be missed by clinical examination because of associated injuries. Routinely performed non-invasive tests may also be non-diagnostic. Tc-99m pyrophosphate (PPi) tomography, in this study combined with Tl-201, is a promising addition to non-invasive evaluation. In three patients with cardiac injury, this technique successfully detected and localized myocardial necrosis.

Adult↗
PubMed1990

Acute myocardial infarction delineated by noninvasive thallium-201/technetium-99m pyrophosphate tomography.

The purpose of this study was to validate different scintigraphic approaches for assessing acute myocardial infarctions. 201Tl, 99Tcm pyrophosphate (PPi) and combined 201Tl/99Tcm PPi tomograms were evaluated in 115 consecutive patients, in 85 of whom clinical examination revealed acute myocardial infarction. The overall sensitivity and specificity for infarct detection was 80% versus 56% for 201Tl alone, 61% versus 97% for 99Tcm PPi alone, and 100% each for the combined 201Tl/99Tcm PPi imaging. The sensitivity for nontransmural infarcts was 57% for 201Tl, 37% for 99Tcm PPi and 100% for combined imaging. The overlay of 201Tl and 99Tcm PPi images increases the observer's confidence in the diagnosis and provides better localization of the infarction. 201Tl alone could localize the infarction in 80%, 99Tcm PPi alone in 49% and 201Tl/99Tcm PPi in 100% of the cases. ECG and 201Tl/99Tcm PPi tomography concurred upon infarct localization in 98% of the patients. Based on the 201Tl/99Tcm accumulation pattern, 94% of the Q-wave infarctions were judged to be transmural and 83% of the non-Q-wave infarctions were judged to be nontransmural. It is concluded that combined 201Tl/99Tcm PPi tomography is highly accurate for determining the presence and location of acute myocardial infarction. This technique appears to be superior to studies where only one radioisotope is used.

Adult↗
PubMed1990

[Experiences in the diagnosis and treatment of polyneuropathies in patients with malignant monoclonal gammopathy].

4 patients are reported having monoclonal gammopathies, who clinically exhibited a sensomotoric polyneuropathy being progressive during some years. The EMG showed axional failure and secondary demyelisation. In two of the patients an IgG-type multiple myeloma has been revealed, while in the other two ohnes an increase of abnormal IgM-mIg could be demonstrated. In all patients the liquor protein was found increased and the appropriate mIg has been found in the liquor. Immunohistochemically the appropriate immunoglobulins could be demonstrated on the peripheral nerve by means of immunofluorescence method. Electron microscopical studies of nerval biopsies supported the diagnosis of mIg-associated polyneuropathy. References to diagnostics and treatment of mIg-associated polyneuropathy are done.

Aged↗
PubMed1990

[Scintigraphy using 111In-labeled antimyosin in Churg-Strauss vasculitis with myocardial involvement].

A case of Churg-Strauss vasculitis in a young woman is reported. Diagnosis was confirmed by muscle biopsy. Affection of lungs, kidneys and skin was evident. In addition, myocarditis was suspected on clinical evidence. A highly positive scintigraphy with 111In-antimyosin enabled diagnosis and assessment of damage to the myocytes. With a heart-to-lung ratio of 3.0 the accumulated activity in the myocardium was higher than usually found in myocarditis. This finding supports the hypothesis of an additional ischemic necrosis.

Adult↗
PubMed1989

Reduced O6-methylguanine repair in fibroblast cultures from patients with lung cancer.

The activity of O6-methylguanine-DNA methyltransferase was determined in fibroblast cultures from 45 patients with lung cancer, 39 patients with cutaneous malignant melanoma, and 29 healthy controls. This enzyme is a critical parameter for the capacity to repair O6-methylguanine (O6-mGua) adducts in DNA, and a decreased activity might therefore be responsible for an enhanced susceptibility to cancer. The assay was performed with 8 x 10(6) fibroblasts which were homogenized and incubated with a known amount of O6-mGua containing DNA. The remaining substrate was determined fluorimetrically after high performance liquid chromatographic separation. O6-mGua repair was significantly reduced in lung cancer patients [6.64 +/- 4.32 (SD) pmol O6-methylguanine repaired/8 x 10(6) cells] as compared to healthy controls [10.35 +/- 5.42, P less than 0.0022] or patients with cutaneous malignant melanoma [10.83 +/- 6.66]. The lowest mean values were detected in a subgroup of 16 lung cancer patients with a tumor manifestation below 46 years of age (5.06 +/- 3.89). Fibroblasts from 4 patients with lung cancer had no detectable repair. We conclude that a reduced capacity to remove O6-mGua adducts may represent a further mechanism of individually enhanced lung cancer risk.

Adult↗
PubMed1989

Characterization of some previously unclassified Pasteurellaceae isolated from hamsters.

Bacteria isolated from purulent processes on the jaws of European hamsters (Cricetus cricetus) and from intestinal inflammatory processes in Syrian hamsters (Mesocricetus auratus), bred as laboratory animals have been shown to be phenotypically similar but not identical with Pasteurella pneumotropica. Deoxyribonucleic acid (DNA)-DNA hybridization studies indicate that with one exception, the strains represent two new species of the family Pasteurellaceae. In the absence of a close genomic relatedness to members of the genera Actinobacillus or Pasteurella or allied organisms, however, the two new taxa are described without any formal designation. The one exception was identified as Actinobacillus capsulatus, a species not previously isolated from hamsters.

Actinobacillus↗
PubMed1989

[Improved detection of acute myocardial infarct with combined simultaneous thallium-201/technetium-99m-PPi tomography in comparison with planar infarct scintigraphy].

UNLABELLED: The combined TI-201/Tc-99mPPi tomography was compared to planar Tc-99m-PPi scintigraphy in terms of diagnosis and localization of the infarction. In 32 consecutive patients with recent myocardial infarctions, the necrosis could be detected by means of planar imaging in 17 out of 22 patients with transmural and in three out of 10 patients with intramural infarctions. Six out of seven patients without recent myocardial infarctions were accurately diagnosed. Double radionuclide tomography made possible accurate diagnoses in all patients. Artefacts resulting from residual radioactivity within the cardiac blood pool and uptake of tracer in bones that overlie the heart were only observed with planar imaging. CONCLUSION: double radionuclide tomography is superior to planar imaging in the diagnosis of acute myocardial infarction.

Adult↗