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Biomedical subjects

U Wolf

Publications and source records attributed to U Wolf.

At least 19 recordsLinked to original sources
PubMed2006

[Fear Avoidance Beliefs and physical function in elderly individuals with chronic low back pain].

Fear Avoidance Beliefs and physical function in elderly individuals with chronic low back pain This analysis assessed how fear avoidance beliefs (FABs) affected subjective and objective functional parameters as well as pain in elderly individuals. The study comprised 152 elderly patients with low back pain, which was attributed to spondylosis in almost half of the cases. Their average age was 70.1 years (SD=4.3, range 65-84). All of the patients participated in a physiotherapeutic program including data acquisition before treatment (t1), immediately after its completion (t2), and 6 months later (t3). FABs were assessed by a five-item scale with satisfying psychometric properties. The primary outcome criterion was function, which was evaluated as a subjective measure using the Hannover functional disability scale and as an objective measure based on the anteflexion determined by ultrasound topometry. Secondary outcome criteria were pain parameters. At the time o the first measurement (t1), the patients were classified into three groups with strong, intermediate, or weak FABs. Analyses of variance reveal an improvement of subjective functional capacity in every FAB group between t1 and t2. At t3, there is a decline of these values only in the group of the high fear avoiders. High fear avoiders also show lower values in the objective measure at all three measurement points. No influence of the FABs on the pain parameters could be determined. It would be expected that the efficacy of physiotherapy could be improved if the patients' FABs are taken into consideration when planning the treatment regimen.

Activities of Daily Living↗
PubMed2006

[Cross-border cooperation in Europe: what are Euregios?].

In cross-border cooperation, much importance has been attributed to the so-called "Euregios", synonymously also called "Euroregions". These are cross-border structures in which, above all, local and regional authorities have joined together across one or several national borders. As early as 1958, the first Euregio was established along the German-Dutch border. Meanwhile many other Euregios have been set up. Euregios provide the testing ground for pilot projects to examine practical solutions of cooperation. Euregios are therefore also called "laboratories of Europe" or "testing laboratories of European integration". Also in the health sector, several cross-border projects are being and have already been carried out. According to what has been found out so far, above all Euregios with long years of experience in cross-border cooperation seem to commit themselves to the health issue. A huge number of the projects is co-financed by the European Union. Compared to other thematic areas, in some border regions the health issue has, on the whole been, underrepresented in cross-border cooperation. In this respect, there is potential for development. Information on existing projects as well as their experiences can facilitate the successful implementation of health-relevant cross-border projects also in those regions which have up to now not carried out any or only a few projects of this kind. The EU-funded Euregio project, carried out by lögd NRW, is the first project in which a systematic inventory analysis of cross-border health care projects will be drawn up.

Community Networks↗
PubMed2005

[Monitoring multiple cardiovascular paramaters using telemedicine in patients with chronic heart failure].

Progression of chronic heart failure depends on various additional pathophysiologic factors like blood pressure, arrhythmias, congestion. Early detection of any alteration using telemonitoring of multiple vital parameters may avoid severe decompensation requiring hospital admission. The feasibility and the clinical outcome using a new telemonitoring device for recording multiple vital parameters and allowing communication on individual state of health is investigated. Twenty-four patients with chronic heart failure (mean age 65 years, mean LV ejection fraction 35%) requiring at least one hospital admission during the past year were investigated. Twice a day, the vital-parameters were measured (weight, blood pressure, heart rate and rhythm, oxygen saturation, respiration rate) and patients information on well being, shortness of breath, medication, and request for contact were received. Intra-individual comparison was carried out between the 12 month before inclusion in this study and 12 month under telemonitoring surveillance (extrapolated, if necessary). Performing over 10 500 measurements during 5751 patient days, critical events were diagnosed for 55 events concerning relative weight gain (43 episodes), blood pressure (6), decrease in oxygen saturation (3), new onset of atrial fibrillation with tachyarrhymia (3). Of these, 45 events were controlled on an outpatient basis by changing medication or external cardioversion. Only 10 patients required re-admission. Thus, the number of admission to the hospital could be reduced by 62%, those of days spent in hospital by 69%. Non-invasive telemonitoring of multiple vital parameters combined with patients statements on their health condition and out-patient treatment on the basis of these findings is found to be an effective and reliable approach to avoid hospital readmission for patients with chronic heart failure.

Adult↗
PubMed2004

Detection of fast neuronal signals in the motor cortex from functional near infrared spectroscopy measurements using independent component analysis.

Fast changes, in the range of milliseconds, in the optical properties of cerebral tissue are associated with brain activity and can be detected using non-invasive near-infrared spectroscopy (NIRS). These changes are assumed to be caused by changes in the light scattering properties of the neuronal tissue. The aim of this study was to develop highly sensitive data analysis algorithms to detect this fast signal, which is small compared with other physiological signals. A frequency-domain tissue oximeter, whose laser diodes were intensity modulated at 110 MHz, was used. The amplitude, mean intensity and phase of the modulated optical signal were measured at a sample rate of 96 Hz. The probe, consisting of four crossed source detector pairs was placed above the motor cortex, contralateral to the hand performing a tapping exercise consisting of alternating rest and tapping periods of 20 s each. An adaptive filter was used to remove the arterial pulsatility from the optical signals. Independent component analysis allowed further separation of a signal component containing the fast signal. In nine out of 14 subjects, a significant fast neuronal signal related to the finger tapping was found in the intensity signals. In the phase signals, indications of the fast signal were found in only two subjects.

Adult↗
PubMed2004

[German Environmental Survey for Children (GerES IV). Environmental module of KiGGS. Part 2: The first year of field work].

The field work of the German Environmental Survey for Children (GerES IV) was started nationwide in May 2003. The survey is a module of the National Health Interview and Examination Survey for Children and Adolescents (KiGGS). This environmental survey includes a representative subsample of 1800 children from the 18,000 participants of the KiGGS who are being examined regarding health-relevant environmental exposure. The investigational programme of the survey was tested successfully in a pilot study (pretest) the results of which contributed to the optimisation of the main study. The field work is essentially done by the environmental interviewer of the three teams of the KiGGS. Preparation, organization and accompaniment of the work is done by the coordination centre of the Robert Koch Institute on Federal Environmental Agency (UBA) instructions. Funding agencies are the Federal Ministry of Education and Research (BMBF) and the Federal Ministry for the Environment, Nature Conservation and Nuclear Safety (BMU). Both the KiGGS and the environmental module are evaluated by internal and external quality assurance during the whole study period (May 2003-May 2006). Up to now the established teams have done their field work very well and the coordination of the overall project by the Robert Koch Institute works well, too. A total of 722 subjects had taken part in the GerES IV by July 2004.

Adolescent↗
PubMed2001

Depth dose-equivalent and effective energies of photoneutrons generated by 6-18 MV X-ray beams for radiotherapy.

Photoneutron production was investigated on Siemens KD 2 and Varian Clinac accelerators operating in the 6-18 MV range. Neutron dose equivalent rates were measured on the surface of a water phantom at the isocenter of the accelerators and also inside the phantom at depths of 1, 5, and 10 cm and off-axis distances of 0, 20, and 50 cm. Superheated drop detectors based on dichlorofluoromethane and etched-track detectors with boronated converters were employed in this study. The energy response of these detectors permits a direct measurement of dose equivalent without prior knowledge of the neutron energy spectra. Dose equivalent rates were assessed using the Q(L) relationship from ICRP publication 60, as well as using earlier data from ICRP publication 21. This permitted both a comparison with previously published data and an assessment of the impact of the recent ICRP recommendations--which were found to increase the dose equivalent levels by about 30%. In addition, the depth corresponding to 50% of maximum dose equivalent, dH50, was determined along the central axis of the beams and at 50 cm off-axis. Monte Carlo neutron transport calculations were performed to determine the depth-dose equivalent distributions in a phantom irradiated with monoenergetic neutrons. Effective energies of the photoneutron spectra were then estimated by comparing our measured dH50 values to those calculated for monoenergetic neutrons. It was found that the effective photoneutron energy is 1.8-2.1 MeV within the 10-18 MV x-ray beams, and it is 0.5-0.8 MeV for photoneutrons transmitted through the accelerator head. Data from this work cover most of the x-ray beam energies in clinical use and permit an assessment of integral dose values as well as specific organ doses to a radiotherapy patient.

Humans↗
PubMed2000

Thoracic disc herniation: a diagnostic challenge.

An unusual case of lower thoracic disc herniation combined with shoulder pain is presented in this case report, A literature search showed that shoulder pain associated with a lower thoracic disc herniation has not yet been reported. An acromioplasty for chronic impingement syndrome was performed to relieve the patient's shoulder symptoms. An unsatisfactory outcome plus a progressive but incomplete paraplegia, prompted further investigation and this revealed a low thoracic herniation. The nucleotomy which followed afterwards lead to a rapid improvement of both the shoulder symptoms and the incomplete paraplegia. This case report shows that chronic shoulder pain may be caused or exacerbated by a thoracic disc herniation in the low thoracic spine. Therefore, prior to performing surgery for peripheral joint symptomatology, the possibility of a central sensitising trigger should be excluded by physical examination of neural tissue dynamics as well as any other necessary confirmatory investigations.

Adult↗
PubMed2000

Effects of low dose radiation therapy on adjuvant induced arthritis in rats.

PURPOSE: Substantial clinical evidence shows the efficacy of low dose radiotherapy (RT) in the treatment of painful osteoarthritis. Experimental investigations into these empirically clinical observations remain scarce. This study investigated in vivo the effects of daily 5 x 1.0 Gy versus 5 x 0.5 Gy on adjuvant induced arthritis in rats in order to explore whether there is a dose dependence of anti-inflammatory efficacy. MATERIALS AND METHODS: Adjuvant arthritis in female Lewis rats was induced by intradermal injection of heat inactivated Mycobacterium tuberculosis on day 0. Both hind paws were X-irradiated daily from days 15 to 19 after induction according to four protocols (15 animals/group): group 1, 5 x 1.0 Gy (non-arthritic animals); group 2, sham-irradiated control; group 3, 5 x 1.0 Gy; group 4, 5 x 0.5 Gy. The clinical parameters arthritis score (AS), hind paw volume (HPV), body weight, and erythrocyte sedimentation rate (ESR) were determined. On days 21 and 30 histological sections of at least 12 ankle joints per group were analysed semi-quantitatively. RESULTS: Local irradiation of non-arthritic rats (group 1) with 5 x 1 Gy did not induce any arthritic signs. Sham-irradiated arthritic rats (group 2) showed a full-blown arthritic syndrome. Treatment of arthritic rats with 5 x 1 Gy (group 3) or 5 x 0.5 Gy (group 4) led to a reduction of mean AS from day 21 to 29 compared with group 2 (days 27-29--group 3: p=0.037; group 4: p=0.034), with no differences in efficacy between groups 3 and 4. Concurrently, following radiation treatment there was no further increase in HPV. At the end of the observation period, this effect demonstrated a dose-dependent level of significance (days 27-29--group 3: p=0.0036; group 4: p=0.039). A significant decrease in the ESR was noted in both irradiated arthritic groups on day 21 (group 3: p=0.015; group 4: p=0.006). The histopathological analysis revealed a highly significant reduction of cartilage and bone destruction on day 30 in both irradiated groups. CONCLUSIONS: This study confirms by objective criteria the anti-inflammatory efficacy of low dose RT and gives some indication for a dose dependence of its efficacy.

Animals↗
PubMed1999

Reorganization of the sex-determining pathway with the evolution of placentation.

In mammals, the sex determination system has already been unraveled in considerable detail, and the genes involved are increasingly used to investigate this system in non-mammalian vertebrates. Data available so far indicate that many of the genes identified are involved in this pathway throughout the vertebrate phylum, suggesting that the mechanism of sex determination was essentially conserved in this taxonomic category. However, a rather fundamental difference between mammals and non-mammalian vertebrates is the role of steroid sex hormones which are critical for gonadal differentiation in the latter, while during mammalian evolution an innovation occurred, whereby genes that superseded steroids as factors acting in early gonadogenesis were co-opted to the pathway. An intermediate stage of this evolutionary switch may still be represented by extant marsupials. Referring to the central role of aromatase in steroid-mediated, and of SRY in eutherian gonadal determination/differentiation, it is argued here that the "aromatase system" was replaced by the "SRY system" as a prerequisite for the evolution of placentation. It is proposed that in co-evolution with placentation, new specificities and extensions of the pleiotropic spectrum of sex-determining genes have appeared. The evolutionary innovation of placentation may thus have been materialized by reorganization of the sex-determining system whereby genes were recruited at the top of the pathway and genes at the bottom remained rather conservative but became increasingly pleiotropic.

Animals↗
PubMed1999

Verification of electron field positioning.

The difficulties in verification of electron fields are due to the limited range of electrons within the human body. Modern linacs provide a special mode of operation (film mode), so that electron fields can be irradiated with a small photon dose. Thus, the images obtained can be used for comparison with the corresponding simulator images or DRRs to determine the electron field position and to detect positioning errors.

Breast Neoplasms↗
PubMed1999

[Environmental noise and satisfaction with area of residence].

In the German National Health Interview and Examination Survey, more than one third, i.e. 36.2% of persons interviewed on the matter of noise nuisance in their homes attributed to outdoor noise confirmed the occurrence of noise. Regarding this result only small and statistically insignificant differences have been assessed in East and West Germany. The frequency of affirmative answers given by German women, ages 20-39, was significantly higher as compared to men in the same ages bracket. Regarding the dominant noise effects in their home, 87% of persons affected mentioned traffic noise as a source. In the second place neighbour noise has been reported by 32%. Aircraft and railway noises percepted by 20%, are in the third and fourth place. Particularly severe indoor noise effects, i.e. persisting noise during the night, are accompanied with clearly increased discontent regarding the home and living area.

Adolescent↗
PubMed1998

Comparison of absolute cerebral haemoglobin concentration in neonates measured directly and by the oxygen swing method both based on near infrared spectrophotometry.

The total cerebral haemoglobin concentration (tHb in mumol/l) as a major indicator of the oxygen transport capacity is investigated in neonates. Two methods to determine tHb by near infrared spectrophotometry (NIRS) have evolved so far: The first method requires a slow oxygenation change with reference to arterial oxygen saturation (tHbo-method). The second method is based on a geometrical principle and a two channel NIRS instrument (tHbg-method). The aim of this study was to compare both methods quantitatively. 15 clinically stable preterm infants needing supplemental oxygen were included in this study. For each method the measurements of three infants were excluded due to unsatisfactory measurement quality. The remaining 9 neonates had a mean gestational age of 29 (range 25.1 to 31.4) weeks, birthweight of 1272 (740 to 1690) g and a postnatal age of 2.6 (0.5 to 5) days. In each infant 6 tHbo measurements were carried out. During each tHbo measurement the mean of the continuously available tHbg (Cerebral Redox Monitor 2020, Johnson & Johnson Medical) was calculated. The mean of all successful tHbo and corresponding tHbg was determined for each infant. The mean tHbg was 151 mumol/l (range 62 to 223 mumol/l) and the mean tHbo was 59 mumol/l (27 to 113 mumol/l). The regression line between the two methods was tHbg = 1.34 x tHbo + 72 mumol/l. The r was 83.6%. The correlation suggests, that both methods can be applied to measure tHb. However, it has to be taken into account that the tHbg-method returns significantly higher values than the tHbo-method.

Birth Weight↗
PubMed1998

Susumu Ohno.

Explore the source record for details and available documents.

Animals↗
PubMed1998

The serologically detected H-Y antigen revisited.

H-Y antigen has been defined by various immunological methods including graft rejection, T-cell mediated cytolysis, and antiserum cytotoxicity. The H-Y phenotype is normally associated with the male sex in mammals. Using specific T-cell clones, two Y-linked genes coding for H-Y epitopes have been identified in the mouse, Smcy and Uty, and one of these genes, SMCY, is also present on the human Y chromosome. Anti-H-Y antisera detect a membrane bound antigen associated with beta2-microglobulin, and a soluble protein secreted by testicular Sertoli cells. The membrane bound antigen appears to be different from the peptides detected by cytotoxic T-cells, and for the soluble antigen evidence was provided that, in mammals it may be identical with anti-Müllerian hormone. In non-mammalian vertebrates, serological H-Y antigen is associated with the heterogametic sex, and sex-reversal of the homogametic sex results in the occurrence of H-Y antigen. Originally, H-Y antigen was believed to be responsible for sex determination, thus representing the testis-determining factor (TDF) in mammals, but this hypothesis has been disproved by showing that male gonadal differentiation can also occur (in the mouse) in the absence of H-Y antigen. In the meantime, SRY is considered to be TDF. Although it was revealed that the H-Y antigens as detected by different assays are genetically heterogeneous, they are probably involved in male-specific functions in mammals, and possibly in the differentiation of the heterogametic sex in non-mammalian vertebrates.

Animals↗
PubMed1997

Identical mutations and phenotypic variation.

The relationship between pathogenetic mutations and disease phenotype is becoming increasingly complex. Well-delineated clinical entities can be genetically heterogeneous, and mutations in a particular gene may result in fundamental clinical differences. Genetic heterogeneity includes mutations at different gene loci or allelic mutations within a single gene, resulting in a similar phenotype. However, one and the same mutation is expected to be associated with a uniform clinical picture. In the present article, evidence is presented that this is not necessarily the case, and examples of identical mutations resulting in highly variable combinations of clinical features are discussed. Although the number of examples of this puzzling phenomenon is rapidly increasing, the underlying mechanisms are as yet poorly understood. In some cases, interacting genetic alterations can be held responsible for the phenotypic heterogeneity; in others, epigenetic phenomena provide a plausible explanation. These and other mechanisms under discussion are considered here. The Mendelian concept of monofactorial disease causation appears to be increasingly untenable for a growing number of developmental errors.

Genetic Diseases, Inborn↗
PubMed1995

The molecular genetics of human sex determination.

The classical conception of the chromosomal mechanism of sex determination presumes a chromosome unique for and determining the heterogametic sex. On the basis of recent evidence, however, this picture is becoming increasingly complex, with a multitude of genes appearing to interact simultaneously or successively to bring about the gonadal phenotype. The genes identified so far that are thought to be involved in the process of human sex determination are distributed on various chromosomes, but the consecution of their function remains to be elucidated. To the Y chromosome only a relative role can be ascribed, and it has not yet been established which gene is on top of the cascade. All of the genes under discussion are involved in transcriptional control, and at least the majority of them appear to exert pleiotropic effects. The regulation of their expression must still be defined, and it will be a long way before a link to gonadal morphogenesis is ultimately found.

Genes↗