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Biomedical subjects

A Berger

Publications and source records attributed to A Berger.

At least 289 records · Page 16Linked to original sources
PubMed1996

Microalbuminuria screening by reagent strip predicts cardiovascular risk in hypertension.

OBJECTIVE: We tested the hypothesis that qualitative microalbuminuria (MAU) screening in a practice setting would identify non-diabetic hypertensive patients at high risk of developing cardiovascular disease. DESIGN: We enrolled general practitioners throughout Germany, who obtained histories, physical examinations, and routine laboratory values as clinically indicated on treated or non-treated hypertensive, non-diabetic patients. MAU was measured with a albumin-sensitive, immunoassay test strip. We studied 11 343 non-diabetic hypertensive patients. RESULTS: The patients' mean age was 57 years, 51% were men and mean hypertension duration was 69 months. Twenty-five per cent had coronary artery disease, 17% had left ventricular hypertrophy, 5% had had a stroke, and 6% had peripheral vascular disease. MAU was present in 32% of men and 28% of women (P < 0.05). In patients with MAU, 31% had coronary artery disease, 24% had left ventricular hypertrophy, 6% had had a stroke, and 7% had peripheral vascular disease. In patients without MAU, these rates were 22%, 14%, 4%, and 5% respectively: lower in every category (P < 0.001). Further, in patients with coronary artery disease, left ventricular hypertrophy, stroke, and peripheral vascular disease, MAU was significantly greater than in patients who did not have these complications (P < 0.001). MAU increased with age, severity of hypertension and duration of hypertension, was associated with higher plasma creatinine values, and was more common in patients with hyperlipidemia (P < 0.05). CONCLUSION: On the basis of our survey, we conclude that qualitative MAU determinations identify hypertensive patients with particular cardiovascular risk in a practice setting.

Aged↗
PubMed1996

Mental disorder and criminality. Male alcoholism.

This study investigated the lifetime prevalence of criminal behavior in a population of 360 Research Diagnostic Criteria alcoholics. The same number of control subjects were drawn from the general population of the same catchment area and matched with the patients with regard to sex, age, marital status, occupational level, and community size. The full account of conviction records in a criminal register was used as a measure of criminal behavior. Altogether, 68% of patients vs. 37% of controls had any criminal record. Higher rates were found for alcoholics than for controls for all types of crime; differences were especially pronounced in crimes against property and in violent crimes. We conclude that alcoholism contributes to criminal behavior to a considerable degree, independently of sociodemographic factors.

Adolescent↗
PubMed1996

A nuclear mutant of Arabidopsis with impaired stability on distinct transcripts of the plastid psbB, psbD/C, ndhH, and ndhC operons.

The high-chlorophyll fluorescence photosynthesis mutant hcf109 of Arabidopsis was characterized in detail to gain insights into the regulatory mechanism of RNA processing in higher plants. By using electron transport, chlorophyll fluorescence, and immunoblot studies, we assigned the mutational lesion to photosystems I and II and the plastid NAD(P)H dehydrogenase complex. The functional pleiotropy was reflected in RNA deficiencies. Although all nuclear-encoded photosynthetic RNAs analyzed revealed no difference in size or steady state level between mutant and wild type, the RNA patterns of the plastome-encoded psbB-psbT-psbH-petB-petD, psbD-psbC-ycf9, ndhC-ndhK-ndhJ, and ndhH-ndhA-ndhI-ndhG-ndhE-psaC-ndh D transcription units were severely disturbed. These operons encode subunits of photosystems I (psa) and II (psb), the cytochrome bGf complex (pet), the plastid NAD(P)H dehydrogenase (ndh), and the unidentified open reading frame ycf9. With the exception of the ndhC operon, the RNA deficiencies observed were specific and restricted to particular segments of the psbB, psbD/C, and ndhH operons, that is, the psbB-psbT, ycf9, and psaC regions. Run-on transcription studies with isolated chloroplasts showed that the failure of these transcripts to accumulate was due to RNA stability and not transcription. Other polycistronic transcription units analyzed were not affected by the mutation. This result indicates that the trans-regulatory factor encoded by the hcf109 gene is not a general RNA stability factor but that it specifically controls the stability of only these distinct transcripts. Because the hcf109 locus was mapped at a distance < 0.1 centimorgans from the phytochrome C gene, its molecular characterization by positional cloning is possible.

Arabidopsis↗
PubMed1996

Invasion of respiratory epithelial cells by Burkholderia (Pseudomonas) cepacia.

Pulmonary infections caused by Burkholderia (Pseudomonas) cepacia are an important cause of morbidity and mortality in cystic fibrosis (CF) patients. Several features suggestive of cellular invasion and intracellular sequestration of B. cepacia in CF are persistence of infection in the face of antibiotic therapy to which the organism demonstrates in vitro susceptibility and a propensity to cause bacteremic infections in patients with CF. Epithelial cell invasion was demonstrated in vitro in A549 cells by a modified gentamicin protection assay. The kinetics of invasion appear to be saturable. Electron microscopy of invaded monolayers showed intracytoplasmic bacteria enclosed by membrane-bound vacuoles. No lysosomal fusion with these vacuoles was observed. Intraepithelial cell replication was suggested by electron microscopy and confirmed by both a quantitative assay and a visual assay. Cytochalasin D, but not colchicine, inhibited invasion, suggesting a role for microfilaments but not microtubules. The invasion phenotype in B. cepacia may be an important virulence factor for CF infections.

Burkholderia Infections↗
PubMed1996

How accurate is serologic testing of plasma pools for hepatitis B virus surface antigen, anti-human immunodeficiency virus 1 and 2, and anti-hepatitis C virus?

OBJECTIVE: The European pharmacopeia prescribes that, during the manufacture of blood derivates, the first homogeneous pool of plasma (for example, after removal of cryoprecipitate) must be tested for hepatitis B virus surface antigen (HBsAg), for hepatitis C virus (HCV) antibodies and for human immunodeficiency virus (HIV) antibodies using test methods of suitable sensitivity and specificity, in order to reduce the residual risk of infection originating from blood products. The present study was performed to verify if commercially available immunoassays, which are licensed for the screening of single serum and plasma samples, are suitable for the determination of HBsAg, anti-HCV, and anti-HIV in plasma pools. DESIGN: Plasma tools originating from different countries were spiked with HBsAg- and anti-HCV-positive standards (National Institut für Biological Standards, Hertfordshire, UK) and anti-HIV-positive serum. For the determination of HBsAg with and without immune complex dissociation (ICD), anti-HCV and anti-HIV antibodies the Abbott (Delkenheim, Germany) IMx system was used. RESULTS: In contrast to the testing for anti-HIV and anti-HCV, the detection of HBsAg (0.125 IU/ml detection limit) was influenced by the presence of anti-HBs in plasma pools. Statistically significant differences could be observed between anti-HBs-positive plasma pools and anti-HBs-negative serum samples spiked with HBsAg. The kinetics of HBsAg-anti-HBs complex formation showed that in a plasma pool with a high anti-HBs (329.4 IU/ml) concentration HBsAg was not detectable after 5 h of incubation. After ICD, HBsAg was still detectable in the pool with high anti-HBs content. Anti-HIV antibodies could be detected up to a dilution of 1/480,000, anti-HCV up to a dilution of 1/80, both in a spiked negative serum. Overall, the divergences between spiked plasma and serum were relatively low for anti-HCV and anti-HIV detection. CONCLUSION: The Abbott IMx assay permits a highly sensitive detection of HBsAg (after ICD or immediately after thawing of anti-HBs-positive plasma pools), anti-HCV, and anti-HIV in plasma pools. However, in case of a contamination with donations originating from individuals with acute HBV, HIV, or HCV infection or with a poor humoral immune response, serologic testing for HBsAg, anti-HIV, and anti-HCV may fail to detect potentially infectious plasma pools.

AIDS Serodiagnosis↗
PubMed1996

[Bilateral biceps replacement-plasty by transposition of the latissimus dorsi muscle in arthrogryposis multiplex congenita. A case report].

The case of a four-year old girl with arthrogryposis multiplex congenita is reported. Primary clinical examination revealed bilateral passive elbow flexion only 0-20-70 without active elbow flexion. A two-stage operative procedure was chosen for both sides. At first an elbow arthrolysis was performed with subsequent intensive physiotherapy. In a second session we performed a bipolar transposition of the latissimus dorsi as a myocutaneous flap. The patient was first operated on the left and afterwards on the right side. By this procedure, the patient achieved a significant improvement of both passive and active elbow flexion mobility. The range of active motion was 0-30-90 and 0-40-90 degrees.

Arthrogryposis↗
PubMed1996

Structural requirements of sphingosylphosphocholine and sphingosine-1-phosphate for stimulation of activator protein-1 activity.

The sphingolipids sphingosine-1-phosphate (SPP) and sphingosylphosphocholine (SPC) stimulate mitogenesis in Swiss 3T3 fibroblasts and stimulate DNA binding activity of activator protein-1 (AP-1). We show that SPP and SPC were more potent agents than nonphosphorylated sphingosines and N-acyl-sphingolipids (ceramides) with respect to DNA synthesis, AP-1 DNA binding activity, and AP-1 trans-activation, illustrating the importance of the terminal phosphate group. The free 2-amino group and the 4E double bond of SPC and SPP were found to be important for these activities. Although the combination of decreasing the sphingoid backbone chain length of SPC by two carbons and hydrogenating the 4E bond only slightly reduced its effects, in contrast, the same modifications in SPP significantly decreased its mitogenic and AP-1 trans-activation effects. Furthermore, substitution of the 3-hydroxyl group in SPP with hydrogen decreased its ability to stimulate DNA synthesis and to stimulate AP-1 transcriptional activity. Thus, critical sphingolipid structural components for AP-1 activation and mitogenic stimulation include the free 2-amino group, the free 3-hydroxyl group, the 4,5-trans double bond, and terminal phosphorylation. These observations may be relevant for clinical uses of these compounds in applications such as wound healing and inhibition of metastasis.

3T3 Cells↗
PubMed1996

Effect of antihypertensive treatment on qualitative estimates of microalbuminuria.

We tested the utility of qualitative microalbuminuria (MAU) screening in an office practice setting, in assessing the response of MAU to drug treatment. We enrolled general practitioners throughout Germany, who obtained histories, physical examinations, and routine laboratory values as clinically indicated on > 6000 non-treated hypertensive, nondiabetic patients. MAU was measured with an albumin-sensitive, immunoassay test strip. The patients were then assigned to monotherapy by their physicians with carvedilol, angiotensin-converting enzyme (ACE) inhibitors, beta blockers, calcium channel blockers, diuretics, and other single regimens in an open-label fashion. The goal was diastolic pressure < 90 mm Hg or at least a 10 mm Hg decrease in systolic (S) and diastolic blood pressure (DBP). The patients' mean age was 57 years and 51% were men. The mean known hypertension duration was 69 months. MAU was present in 37% of men and 34% of women. All regimens lowered BP. All regimens caused large numbers of MAU patients to revert by 3 months. MAU reversal occurred in patients less than 65 years as well as in those 65 years or older. Multiple regression analysis indicated that systolic and DBP reduction, duration of hypertension, and body size were most associated with MAU reversal. Thus, MAU determinations reverted to negative with antihypertensive treatment in many patients. BP reduction was the single most important variable in reversing MAU. All drug regimens were effective. We conclude that qualitative MAU detection is useful not only for screening, but also for follow-up nondiabetic patients with hypertension in an office practice setting.

Aged↗
PubMed1996

[Time limited immunosuppression in allogenic nerve transplant in the rat].

A rejection response of peripheral nerve allografts eliminates the Schwann cells without destroying the tubular architecture and leads to a regeneration of inferior quality. Under immunosuppression this rejection is prevented, and allogenic Schwann cells persist in the grafts, leading to a better regeneration result. In adult rats of the strains DA and LEW.1W, a 2,5 cm segment of the sciatic nerve was grafted. Under Cyclosporin A regeneration was allowed to take place for 12 weeks. Thereafter, immunosuppression was discontinued in one group and gradually reduced in another. Regeneration quality was compared after an additional six weeks in comparison to an autologous control. Best regeneration was observed in the autologous control; no statistical differences were observed between the two experimental groups. Gradual reduction of immunosuppression did not result in an atraumatic replacement of donor derived Schwann cells by recipient derived ones. Allogenic nerve grafting needs continuous immunosuppression, which to date precludes it from clinical application.

Animals↗
PubMed1996

[Expression of various monoclonal antibodies in nodules and band stage in Dupuytren's disease].

In 42 seronegative patients (n = 6 normal fascia, n = 12 nodal stage of Dupuytren's contracture, n = 24 stage IV) we performed immunohistochemical examinations of specimens of four locations of the digitopalmar fascia by means of indirect immunofluorescence tests. We determined the expression of monoclonal antibodies against vimentin, leucocyte common antigen (LCA, CD 45), four macrophage-antigens (27E10, RM3/1, 25F9, CD68), PDGFR-beta subunit (platelet-derived growth factor receptor). In 12 specimens of nodal stage disease macrophage-antigens typical for late inflammatory phase was detected. Other macrophage phenotypes were found to a lesser degree. All of these antigens were negative in normal palmar fascia and only sporadically positive in stage IV disease. PDGFR, which has not been investigated in digitopalmar flexion contracture before, has been expressed in cells of Dupuytren's disease as well as in normal fascia to a minor degree. In nodal stage disease, PDGFR-expression was not generally increased, although the majority of these cases showed intensively dyed clusters. EGFR could neither be detected in nodal or cord-stage of Dupuytren's disease, nor in normal digitopalmar fascia.

Antibodies, Monoclonal↗
PubMed1996

[Surgical prevention of post-traumatic infection by immediate necrectomy of burn wounds].

Sepsis is the commonest cause of death following burn injuries. The main source of the bacteria which cause the onset of sepsis is the burn wound itself. We evaluated the question of whether immediate necrectomy versus early necrectomy leads to a decrease in septic complications, as well as posttraumatic lethality. We evaluated 66 patients, 33 of whom underwent immediate necrectomy (i.e., within the first 3 days posttraumatically, group 1); the remaining 33 patients underwent necrectomy in the early posttraumatic phase (from the fourth posttraumatic day, group 2). Following immediate necrectomy (group 1), septic complications developed in 12.1%, as compared to 33.3% in group 2 (p < 0.01). Lathality was significantly reduced in group 1 with 9.1% compared to 21.2% in group 2 (p < 0.01). In this study it was demonstrated that immediate necrectomy versus early necrectomy in young patients leads to a significant decrease of septic complications and lethality following burn injury.

Adult↗
PubMed1996

[What is the advantage of free microvascular tissue transfer after pelvic exenteration? A argument for delayed primary management].

Locoregional pelvic recurrences are amenable to re-resection even if musculoskeletal fixation is present. This report updates our experience with pelvic composite resections and microsurgical closure of the perineal cavity by nine latissimus dorsi flaps, one as a bilobed type combined with a scapula flap. All flaps survived. There was one rupture of the vascular pedicle following repositioning of the patient. Another flap healed completely, but presented a wound rupture with secondary healing in the area of the rima ani. Three major advantages to this method have been proven: (1) Healing and hospitalization could be reduced compared to conservative treatment; (2) The latissimus dorsi transfer allows stable perineal coverage and closure of dead space, preventing any pelvic herniation; (3) Performed as a delayed procedure the free tissue transfer is well tolerated by the patient.

Adult↗
PubMed1995

High levels of DNA adducts in human colon are associated with colorectal cancer.

Colon cancer is one of the most frequent causes of cancer death in western countries. Epidemiological studies suggest that colorectal cancer can be attributed, at least in part, to carcinogens and mutagens present in the diet and/or the environment. The covalent binding of these xenobiotics or their reactive metabolites to DNA is believed to initiate this chemical carcinogenesis. In the present study, using a 32P-postlabeling method, we investigated DNA adduct levels in control colons from patients without colorectal adenocarcinoma and in nontumoral and tumoral tissues from patients with colorectal adenocarcinoma. Our results show that the DNA adduct level is significantly higher (P < 0.001) in nontumoral than in control or tumoral colon samples. For the first time, we demonstrate in humans that the presence of numerous adducts in colonic mucosa is associated with colorectal cancer, a finding in agreement with the importance of chemical factors in causing this disease; therefore, after confirmation of the link between DNA adducts and colorectal cancer, the measurement of DNA adduct levels in colon samples could constitute a useful approach to the early detection of colorectal cancer.

Adenocarcinoma↗