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Biomedical subjects

U Koch

Publications and source records attributed to U Koch.

At least 19 recordsLinked to original sources

Determination of the relative configuration of 5,6,7,8-tetrahydromethanopterin by two-dimensional NMR spectroscopy.

The relative configuration of the pterin moiety of 5,6,7,8-tetrahydromethanopterin 1, a coenzyme isolated from methanogenic archaea, has been determined by two-dimensional NMR spectroscopy of N5,N10-methenyl-5,6,7,8-tetrahydromethanopterin 2 to be rel-(6R; 7S; 11R). The complete proton resonance assignment of the pterin moiety of N5,N10-methylene-5,6,7,8-tetrahydromethanopterin 3 is described including the relative stereospecific assignment of the C(14a) methylene protons.

Magnetic Resonance Spectroscopy

[Changes in occupational status following cancer. An empirical study on occupational rehabilitation].

The importance of vocational integration has increased during the last years, whereas an analysis of the literature shows, that research in this field has been neglected especially in german speaking countries. This study investigates the situation and the problems of vocational integration after cancer. 380 former patients with different diagnoses treated in a university medical center have been asked by a self developed questionnaire for their experiences in treatment and medical rehabilitation, their actual impairment in physical and vocational functioning, their estimation of rehabilitation success, their actual employment problems and the changes of job conditions due to cancer. As the results show, more than one third of the sample returned to work often reducing working time or changing their job. Especially older patients with worse prognoses have been retired early. Special programs of vocational rehabilitation are not used by patients we examined, whereas programs of medical rehabilitation are used showing great differences between diagnostic groups. The return to work is influenced by age, tumor localisation, prognosis and the former status in job. The results are discussed with regard to the problems of psychosocial rehabilitation of cancer patients.

Adaptation, Psychological

Pharmacokinetics of azosemide in patients with T-drain after cholecystectomy.

In an open clinical trial the pharmacokinetics of orally administered azosemide (2-Chloro-5-(1H-tetrazol-5-yl)-4-[(2- thienylmethyl)amino] benzene sulfonamide. Luret, CAS 27589-33-9) was surveyed in a group of 10 patients with T-drain after cholecystectomy. The mean peak concentration was reached after 2.35 h (SE: 0.25 h) and was 474 ng/ml (142 ng/ml). The plasma elimination half-life was estimated to be 6.37 h (1.7 h). In 24 h 5.4% of the dose was excreted unchanged via urine and bile. Only a small fraction of the dose (0.53%) was recovered as glucuronide from urine and bile. Approximately 2% (0.74%) of the dose was excreted unchanged via bile. No other metabolites were detected. Plasma AUCO-24h was 3113 micrograms.h/l. The renal clearance of 27 ml/min (8.8 ml/min) was 3 times higher than the biliary clearance of 10 ml/min (2.4 ml/min). Azosemide is rapidly but incompletely absorbed and shows a longer half-life when compared with other loop diuretics. Enterohepatical circulation and first-pass effect seem to be less significant because low amount of azosemide is excreted via bile.

Adult

[Cancer rehabilitation in the Federal Republic of Germany--a critical review from the perspective of rehabilitation psychology].

Against the background of a common criticism of the rehabilitation system, the situation of rehabilitation research and practice in oncology is reviewed. A lack of efforts aimed at vocational rehabilitation as well as the main emphasis in inpatient services is criticized. Till now, outpatient services as well as psychosocial rehabilitation care are not as well established, as they should be with regard to provide assistance in coping with the disease and in adapting to the various disabilities may be followed by cancer. As rehabilitation research in oncology is still at its very beginning, we know little about the acceptance of rehabilitation measures as well as the rehabilitation process in its correlation between outcome criteria. Our own pilot study provides first results concerning vocational rehabilitation and acceptance of medical rehabilitation services. As conclusion, we need more elaborated research in oncological rehabilitation for optimizing and further developing rehabilitation care system especially with respect to outpatient and psychosocial services.

Ambulatory Care

[Psychosocial stresses after hospital admission--a comparison of internal medicine and surgical patients].

56 patients have been interviewed about their psychosocial situation at the beginning of their treatment in a medical department, 62 patients in a surgical department of a General Hospital. The "medical" patients were severely disturbed by their illness and by the different diagnostic and therapeutic procedures, even by routine investigations. The "surgical" patients, who just had been operated, concentrated with their feelings on the surgical operation. The clinical atmosphere and the relation and communication to the hospital staff had similar effects on both groups. Further investigations concerning the illness and the treatment should be specified in the different clinical disciplines, while disturbances by the hospital surrounding can be asked at all patients in the same way.

Adaptation, Psychological

Prevalence of Campylobacter pylori as demonstrated by histology or CLO-test in different types of gastritis. A study in 5 clinically predefined groups of patients.

The prevalence of Campylobacter pylori infection as detected by histology was studied in 5 predefined groups of patients. The associated histologic and endoscopic findings were registered. Validity of CLO-test was tested against the histologic detection. The following groups of patients were studied: A) Non-ulcer dyspepsia (defined by one or all of three symptoms: heartburn, nausea/inappetence, halitosis/belching) B) control group (no specific symptoms, no ulcer, no history of gastric surgery) C) Duodenal ulcer D) Gastric ulcer E) Billroth I or II resection of the stomach. 200 patients were recruited for group A-C, in group D 134 patients and in group E 113 patients were studied. A mean prevalence of 60% was observed. Prevalence was highest in patients with duodenal ulcer (86%). In group D a prevalence of 65%, in A and E a prevalence of 54%, and in B of 40% were seen. The overall test sensitivity of the CLO-test compared against the histologic detection rate was 75%, the specificity 81%. Sensitivity was reduced in group A (69%) and E (53%) and in patients with inactive chronic gastritis (67%). In all groups patients with active forms of gastritis showed the highest prevalence of C. pylori infection. The specificity of the CLO-test was reduced in patients with duodenal ulcer (46%) and gastric ulcer (48%). Decreased specificity observed after therapy with histamin receptor (H2) blockers may explain this finding. The relationship of C. pylori infection with active types of gastritis or gastro-duodenal ulcer hints at a causal relation but is no definite proof of its etiologic role. The validity of the CLO-test seems questionable in patients with gastroduodenal ulcer or operated stomach.

Antacids

[Changes in blood flow velocity in the basal cerebral arteries following neck dissection].

Cerebral blood-flow velocities (cm/s) and pulse index (PI) were studied pre- and postoperatively in a total of 15 male patients following bilateral radical/functional (group A; n = 10) or unilateral radical neck dissection (group B; n = 5) using a 2 MHz-pulsed transcranial Doppler ultrasonographical system (TCD), with a transtemporal approach to the middle cerebral artery. Systolic and mean flow velocities were significant reduced with subsequent increases in PI during the first postoperative sonography in group A-patients while no significant differences in TCD date developed in group B. Blood-flow velocities and PI reached control values within three days. General hemodynamic and respiratory parameters did not influence the changes in TCD flow profiles with the exception of moderate increases in arterial CO2 during the early postoperative period. It is concluded that the reductions in blood-flow velocities and concomitant increases in PI reflect a heightened resistance to flow in the arterial cerebral vasculature. The decrease in cerebral vascular compliance suggests increases in the cerebral venous outflow following the resection of essential drainage pathways. However, TCD does not provide any information about the adequacy of cerebral blood flow.

Adult

Histamine release from basophils after in vivo application of recombinant human interleukin-3 in man.

Interleukin 3 (IL3) is known to stimulate progenitor cell proliferation and maturation as well as differentiated cell functions, e.g. direct or anti-IgE-mediated histamine release (HR). We investigated 14 patients with malignant diseases being treated with recombinant human IL3 (rhuIL3) as a daily subcutaneous bolus injection for 15 days. For analysis, patients were combined in a 'low-dose' [30 (n = 1), 60 (n = 3) and 125 (n = 2) micrograms/m2/day] and a 'high-dose' [250 (n = 6) and 500 (n = 2) micrograms/m2/day] therapy group. In the high-dose group there was a 2-fold increase in total leukocytes, and 8-fold increase in basophils, and a 23-fold increase in eosinophils. Histamine content per basophil decreased rapidly after rhuIL3 administration. Anti-IgE-induced HR increased in a dose-dependent manner after rhuIL3 therapy (low-dose group: HRmax 47.5 vs. 53.3%; high-dose group: HRmax 57.8 vs. 75.4%, p less than 0.05). In contrast to anti-IgE-induced HR, HR with ionophore (78.0 vs. 50.3%, p less than 0.05), FMLP (32.3 vs. 11.4%, p less than 0.05), sodium chloride (31.8 vs. 22.6%, n.s.) and mannitol (56.3 vs. 47.8%, n.s.) decreased. There was no histamine release from basophils upon in vitro stimulation with rhuIL3 alone. The kinetics of the increase in anti-IgE-induced histamine release did not parallel the rapid histamine depletion of cells. We conclude that rhuIL3 therapy may cause a rapid HR from basophils which cannot be observed after stimulation of cells in vitro. The clinical importance of this HR remains unclear as side effects could not be correlated with HR.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged

PEEP-masks in patients with severe obstructive pulmonary disease: a negative report.

Positive pressure during expiration by face masks applied by the patient has gained wide acceptance in the treatment of chronic bronchitis, but the efficacy is still unproven. The effect of 6 months of treatment with PEEP-masks (positive end-expiratory pressure) was therefore studied in 47 patients with severe irreversible obstructive pulmonary disease (forced expiratory volume in one second (FEV1) about 1 l), and mucus hypersecretion. Patients were double-blindly randomized to at least 45 min daily treatment with PEEP-masks with either 10 or 0 cm water pressure. After 6 months of treatment, no statistical difference was found between the two groups in change of median values (month 6 - month 0) of FEV1, forced vital capacity (FVC), arterial oxygen tension (PaO2), amount of sputum or dyspnoea. Median values of arterial carbon dioxide tension (PaCO2) decreased significantly (0.03 kPa) in the placebo group. Cough intensity and dyspnoea during walking on staircases improved significantly in the placebo group. No difference among groups was found in number of days bedridden, hospitalized, number of exacerbations or antibiotic consumption. We conclude, that the use of PEEP-masks in these patients is without clinical documentation and cannot be recommended.

Adult

[Determination of lithium in serum and saliva of patients with manic-depressive disorder].

The slight therapeutic breadth involved means that manic depressive lithium prophylaxis may call for life-long routine management. The lithium/serum-level checks required hitherto are here compared with a non-invasive method, that of determining the lithium level from a mixture of the patient's saliva, a method involving no danger that will eventually assume considerable importance.

Adult

Communicative skills in chronic and severe nonfluent aphasia.

A diagnostic tool was developed for the investigation of communicative skills in nonfluent aphasic patients suffering from moderate or severe language deficits. Communicative skills and neurolinguistic deficits were assessed in 20 patients suffering from Broca's or global aphasia. Comparative data analysis revealed remarkably low correlations between communicative and neurolinguistic deficits. In nonfluent aphasic patients with severe linguistic impairment communicative abilities and non- and paralinguistic compensatory efforts and skills accounted for their efficient performance.

Adult

[Initial experiences with the dentin-ossicle prosthesis].

The results of 73 implantations performed from 1.7.1986-30.6.1988 are reported in a first follow-up study. 82% reached an air-bone gap of less than 30 dB, 55% of less than 20 dB. In comparison with other materials recently reported the functional results are a little less favourable due to the high percentage of revision surgery in our patients. Only few complications had to be noticed: no single extrusion was observed, but in one case a nearly complete resorption of the DOP was seen. Two DOPs, removed by revision surgery, were examined histologically. Beside resorptive processes, bony changes as a sign of biointegration into the middle ear were found. On account of our first results, DOP seems very suitable for the reconstruction of a destroyed ossicular chain, especially in cases where the autologous ossicles are not available.

Adolescent

[The psychosocial position of internal medicine patients following admission to the hospital--an empirical study].

56 patients with an average age of 55 years have been interviewed about their psychosocial situation at the 3rd till 5th day of treatment in a medical department of a hospital. They were more disturbed by their illness than by the medical therapy, although some were even stressed hardly by routine investigations like taking blood or sonographies. The hospital atmosphere was also found to be a source of disturbances (tying away from home, immobilisation). Especially patients older than 60 years, patients who were ill for the first time and those, who were not sufficiently informed had difficulties in adaptation. Female patients had more problems than male patients to cope with the changes. In further studies the different distressing factors and the strategies of coping of the ill should be investigated more exactly during the whole stay in hospital, to develop specific offers to help the patients.

Adaptation, Psychological

Characteristics of purified cows' milk xanthine oxidase and its submolecular characteristics.

Xanthine oxidase (EC 1.2.3.2) was purified from fresh cows' milk by differential centrifugation and hydroxylapatite chromatography in the absence of reducing agents and proteases. The purified isolate possessed an absorbance at 280 nm:absorbance at 450 nm ratio of 4.84; an absorbance (1 cm at 280 nm 1%) of 11.9; an activity:absorbance at 450 nm of 141, a specific activity of 3.59 units/mg; and detectable dehydrogenase activity. The enzyme preparation was obtained in a reversible oxidase form that could be partially converted to xanthine dehydrogenase in the presence of 10mM dithiothreitol or 1% mercaptoethanol. Amino acid analyses revealed that the enzyme was hydrophobic in nature and that lysine constituted its N-terminal residue. The protein contained 22 disulfide and 38 sulfhydryl groups, four of which were detectable in the undenatured protein complex. Discontinuous PAGE in the presence of selected dissociation agents did not result in further resolution. Sodium dodecyl sulfate-PAGE of the purified enzyme revealed a sharp zone with a molecular weight of 151,000 +/- 4000 (i.e., monomer). The purified enzyme exhibited oxidase activity in the presence of 6 M urea and following limited proteolysis by trypsin, chymotrypsin, plasmin, pancreatin, pepsin, and papain. Proteolyzed xanthine oxidase migrated as a single zone in polyacrylamide gels in the presence and absence of dissociating agents such as 1% mercaptoethanol and 6 M urea. Restricted digestion of xanthine oxidase by proteases was indicated by the presence of three major zones with molecular weights ranging from 85,000 to 100,000, 30,000 to 35,000, and 18,000 to 20,000 commonly observed in SDS gels. Amino acid profiles of the principal peptidyl fragments of trypsin-cleaved xanthine oxidase indicated their hydrophobic nature and lysine as the N-terminal residue for all fragments.

Amino Acids