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Biomedical subjects

A Krause

Publications and source records attributed to A Krause.

At least 163 records · Page 9Linked to original sources
PubMed1993

Persistence of Borrelia burgdorferi in ligamentous tissue from a patient with chronic Lyme borreliosis.

OBJECTIVE: To document the persistence of Borrelia burgdorferi in ligamentous tissue samples obtained from a woman with chronic Lyme borreliosis. METHODS: Spirochetes were isolated from samples of ligamentous tissue, and the spirochetes were characterized antigenetically and by molecular biology techniques. The ligamentous tissue was examined by electron microscopy. Humoral and cellular immune responses were analyzed. RESULTS: Choroiditis was the first recognized manifestation of Lyme disease in this patient. Despite antibiotic therapy, there was progression to a chronic stage, with multisystem manifestations. The initially significant immune system activation was followed by a loss of the specific humoral immune response and a decrease in the cellular immune response to B burgdorferi over the course of the disease. "Trigger finger" developed, and a portion of the flexor retinaculum obtained at surgery was cultured. Viable spirochetes were identified. Ultramorphologically, the spirochetes were situated between collagen fibers and along fibroblasts, some of which were deeply invaginated by these organisms. The cultured bacteria were identified as B burgdorferi by reactions with specific immune sera and monoclonal antibodies, and by polymerase chain reaction amplification and Southern blot hybridization techniques. CONCLUSION: To our knowledge, this is the first report of the isolation of B burgdorferi from ligamentous tissue. This suggests that tendon tissues serve as a specific site of spirochete residence in human hosts.

Base Sequence↗
PubMed1993

[Granular cell tumor of the breast].

Report about a 46 year old women with granular cell tumor of the breast. Clinical features, mammography and sonography has appearances highly suspicious for breast cancer. Tumorectomy and axillary lymphonodectomy were performed. Estrogen and progesterone receptor both were histochemically and biochemically negative. Estradiol and prolactin levels in serum were normal. Cathepsin D in cytosol was slightly elevated, DNA-flow-cytometry revealed no signs of malignancy. Evident was the high content of protein S100 in cytosol of tumor cells.

Adipose Tissue↗
PubMed1993

[Our gynecologic heritage. The activities of scientific gynecologic societies in Northeast Germany after the World War II].

During the Second World War and especially since 1943 the activities of medical societies decreased more and more. The first gynecological meeting in the of Soviets occupied part of Germany happened October 5th till 6th 1946 in Jena. The Chairman was Gustav Döderlein. In May 1947 the Soviet Military Administration commanded the order Nr. 124 about foundation of medical societies. The Society of Gynecology at the University of Rostock was founded November 1947. In year 1948 was the unification with the Gynecological Society of Greifswald. The unified society organized till 1989 more than 40 meetings in the Northern towns of East Germany. 1991 the unification with the Northwestern Society of Gynecology and Obstetrics took place. The Society has now the name "North-German Society of Obstetrics and Gynecology".

Female↗
PubMed1993

[Clinical course and treatment of angiomatosis of the retina].

Basing on 11 cases of angiomatosis retinae, diagnosed and treated in the last 30 years in the Ophthalmological Clinic in Halle, the authors discussed the problems concerning this rare disease. Their observations confirmed the opinion that photocoagulation is the method of choice in the treatment of angiomatosis retinae and that it is successful in small, less than 2 disc diameter angiomas. The further possible therapeutical methods are cryocoagulation, radioactive-isotopes and vitrectomy. As the treatment should be repeated and the long-lasting follow-up is necessary, the efficient cooperation with the patients is very important.

Adolescent↗
PubMed1992

Nuclear factor I (NF I) binds to an NF I-type site but not to the CCAAT site in the human alpha-globin gene promoter.

Methylation interference and missing contact analyses demonstrate that nuclear factor I (NF I) recognizes an NF I-like site (5'-GGG(N)6GCCAG-3') within the alpha-globin promoter rather than the adjacent CCAAT box. Consistent with this, mutations within the CCAAT box do not alter significantly the affinity and specificity of the interaction whereas elimination of the 5'-GGG-3' half-site of the recognition sequence reduces the DNA binding strength of NF I by 2 orders of magnitude down to the range of unspecific interaction. On the other hand, the mutated alpha-globin promoter sequence that is no longer bound by NF I, although it retains an intact CCAAT box, interacts specifically with a protein component from nuclear extracts of HeLa cells. From these results we conclude that NF I is not the factor that interacts with the CCAAT box and that the second half of the canonical 5'-TGG(N)6GCCAA-3' NF I binding site cannot be regarded as identical with the CCAAT promoter element, as suggested previously.

Autoradiography↗
PubMed1992

Coiling phagocytosis is the preferential phagocytic mechanism for Borrelia burgdorferi.

The uptake mechanism for the spirochete Borrelia burgdorferi, the causative agent of Lyme disease, was investigated by electron microscopy for human and murine phagocytes. Spirochetes of both a low- and a high-passage strain were preferentially internalized by coiling rather than by conventional phagocytosis. The spirochetes engulfed by coiling phagocytosis were found to disintegrate in an organelle exclusion zone without evident participation of lysosomes. Preincubation of B. burgdorferi with monoclonal antibody to the spirochetal OspA enhanced phagocytosis in general but did not consistently influence the uptake mechanism. Quantitative and kinetic differences concerning the phagocytic rate and mechanism were evident between cells from different lineages, different human individuals, and mice and humans. In general, when few phagocytes participated in spirochete uptake, the active cells displayed a high ratio of coiling versus conventional phagocytosis. These results suggest that coiling phagocytosis of B. burgdorferi plays a critical role in the control of spirochetal infection. More detailed studies on the molecular basis of this phagocytic mechanism may lead to new insights into the pathogenesis of Lyme borreliosis, a disease which is frequently characterized by the host's inability to eliminate the pathogenic spirochete.

Adult↗
PubMed1992

Cellular immune reactivity to recombinant OspA and flagellin from Borrelia burgdorferi in patients with Lyme borreliosis. Complexity of humoral and cellular immune responses.

Patients with Lyme borreliosis (LB) usually develop a vigorous T cell response against the causative pathogen Borrelia burgdorferi, but little is known about the antigens recognized in the cellular response. Therefore, T cell reactivities against whole bacteria, recombinant 31-kD (outer surface protein A, [OspA]), and 41-kD proteins (flagellin) from B. burgdorferi were studied in patients with LB, non-LB patients, and healthy donors. In parallel, specific antibodies were determined by Western blot analysis. Virtually all patients with LB exhibited marked cellular responses to whole B. burgdorferi, which were significantly elevated compared with the control groups in both early and late disease stages. However, analyses using the purified antigens OspA and flagellin revealed considerable heterogeneity in the cellular reactivities among individuals as well as variations during the course of infection. T cell responses to OspA were significantly increased in patients with early LB compared with both control groups whereas in late-stage disease responses only exceeded those of non-LB patients and were not different from normal donors. Cellular immune reactivities to flagellin were significantly higher only in early LB compared with both control groups. Reciprocally, several control subjects demonstrated marked cellular responses to OspA and flagellin, suggesting that reactions to these proteins may not always be related to LB. T cell reactivity did not correlate well with the presence of specific antibodies. Almost all seropositive patients in both early and late stage LB had serum antibodies against flagellin, but antibodies to OspA were detectable only in a subset of late LB sera. These data demonstrate the complexity of the humoral and the cellular immune responses to components of B. burgdorferi.

Adolescent↗
PubMed1992

Decreased density of beta-adrenergic receptors on peripheral blood mononuclear cells in patients with rheumatoid arthritis.

There is growing evidence that the autonomic nervous system influences the immune response by activation and modulation of beta 2-adrenergic receptors (beta 2R) on immunocompetent cells. However, little is known about its pathogenetic role in autoimmune disease. Therefore, the number and the dissociation constants (beta 2R-KKD) of beta 2R on peripheral blood mononuclear cells (PBMNC) were determined in 21 patients with rheumatoid arthritis (RA) and 9 healthy age and sex matched controls [healthy donors (HD)] by a radioligand binding assay with [125I]iodocyanopindolol. The density of beta 2R (x +/- SEM = 2,120 +/- 103 binding sites/cell) and the beta 2R-KD (x +/- SEM = 6.8 +/- 0.8 pM) were significantly decreased in patients with RA compared to HD (number of beta 2R: 3,960 +/- 372, beta 2R-KD: 16.7 +/- 3.6, p less than 0.01). In RA, the number of beta 2R was significantly lower in patients with high systemic disease activity (n = 11, number of beta 2R: 1,850 +/- 134) than in patients with low inflammatory activity (n = 10, number of beta 2R: 2,418 +/- 95, p less than 0.004). In addition, there were significant negative correlations between the beta 2R density and an arbitrary systemic activity score (r = -0.74, p less than 0.001), the Ritchie index (r = 0.77, p less than 0.001), and various variables of disease activity (r = 0.59 to -0.78, p less than 0.005), respectively. Our data demonstrate the close interplay between the systemic inflammatory activity and the beta 2R characteristics in patients with RA. Our results provide further evidence that the immune response may be influenced by the sympathetic nervous system.

Aged↗
PubMed1992

Beta 2-adrenergic receptors on peripheral blood mononuclear cells in patients with rheumatic diseases.

In order to investigate the influence of the autonomic nervous system on the immune response in rheumatic diseases such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), we determined the number and the dissociation constants of beta 2-adrenergic receptors (beta 2R) on peripheral blood mononuclear cells (PBMC) in patients with RA characterized by either low or high disease activity, patients with SLE, and healthy age-matched controls by means of a radioligand binding assay with [125I]iodocyanopindolol. The number of beta 2R was significantly decreased in all three patient groups as compared with the healthy controls. In SLE patients, a significant negative correlation between beta 2R and the anti-ds-DNA antibody titre was observed (r = -0.57, P < 0.01). These data demonstrate the close correlation between the number of beta 2R on PBMC and the extent of disease activity in patients with RA and SLE and suggest an involvement of the autonomic nervous system in the pathogenesis of rheumatic disorders.

Aged↗
PubMed1992

Correlation between density of beta 2-adrenergic receptors on peripheral blood mononuclear cells and serum levels of soluble interleukin-2 receptors in patients with chronic inflammatory diseases.

In order to study the influence of the autonomic nervous system on the immune response, we evaluated the density and the equilibrium dissociation constants (KD) of beta 2-adrenergic receptors (beta 2R) on peripheral blood mononuclear cells (PBMC) in patients with rheumatoid arthritis (RA), Crohn's disease (CD), and in controls. Results were correlated with the serum concentrations of soluble interleukin-2 receptors (sIL-2R) as a marker for T-cell activation in vivo. The density of beta 2R was significantly decreased in patients with RA (P < 0.05) and CD (P < 0.05) as compared with controls. The number of beta 2R in patients with RA was significantly lower than in CD patients (P < 0.05). KD values of beta 2R were markedly but not significantly decreased in both patient groups as compared with control values. Serum concentrations of sIL-2R were significantly elevated in RA patients as compared with those in CD patients (P < 0.05) and controls (P < 0.05), while there was no difference between the latter two groups. In patients with RA, a significant negative correlation between beta 2R density and serum IL-2R levels (r = -0.66, P < 0.02) was observed. These results demonstrate the close correlation between the modulation of beta 2R on PBMC and the activation of the immune response. However, the role of beta 2R stimulation in the pathogenesis of immunologically mediated diseases remains to be clarified.

Adult↗
PubMed1992

Documentation of experience: preventive medicine for family physicians. The AAFP Commission on Quality and Scope of Practice.

The AAFP, the American Medical Association and the Joint Commission on Accreditation of Healthcare Organizations clearly agree on the principle that privileges should be based on documented evidence of training, experience and demonstrated current competence. Because of the broad nature of the specialty, family physicians will often be required to provide evidence of competence when requesting hospital privileges. The best defense against difficulties in credentialing and our best hope to continue providing the services to our patients for which we are trained are to create and keep current a strong documentation system of personal training and experience.

Accreditation↗
PubMed1991

T cell proliferation induced by Borrelia burgdorferi in patients with Lyme borreliosis. Autologous serum required for optimum stimulation.

The cellular immune response to Borrelia burgdorferi was studied in 24 patients with seropositive and seronegative Lyme borreliosis, 30 patients with arthritides of different origin (non-Lyme arthritides), and 20 normal blood donors. By far, the strongest T cell stimulation was induced by incubation with autologous serum; there was a significantly lower response or no response after incubation with allogeneic or heterologous sera. In patients with Lyme borreliosis, including seronegative patients, there was a strikingly elevated proliferation in response to whole B burgdorferi bacteria (mean 64,750 dpm) compared with that of normal donors (mean 19,700 dpm; P less than 0.0001) and especially that of non-Lyme arthritis patients (mean 11,600 dpm; P less than 0.0001). Levels of proliferation declined significantly in patients with Lyme borreliosis after successful antibiotic treatment. Parallel cultures using B burgdorferi and Treponema phagedenis as antigens showed that cells from patients with Lyme borreliosis responded significantly more to B burgdorferi than to T phagedenis, but this did not occur with cells from individuals with non-Lyme arthritides. There was no correlation between disease stages and proliferation values. These data indicate that lymphocyte proliferation assays may provide an important tool for the diagnosis of Lyme borreliosis, most notably in patients with arthritides and in those who are seronegative. Conversely, the lack of reactivity appears to be a strong indicator of the absence of active Lyme disease. It seems to be crucial, however, to use autologous sera in these assays.

Adolescent↗