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Biomedical subjects

A Kurth

Publications and source records attributed to A Kurth.

17 recordsLinked to original sources
PubMed2005

Generation of recombinant norovirus-like particles (VLP) in the human endothelial kidney cell line 293T.

Noroviruses (NVs) are the major cause of non-bacterial outbreaks of gastroenteritis. Here we report a new alternative system to generate recombinant NV virus-like particles (rNV-VLP) in a human endothelial kidney cell line (HEK). Transfecting HEK-293T cells with an expression vector coding for the ORF-2 gene lead to the expression of the viral structural protein VP1 which spontaneously assembled into virus-like particles (VLP), as shown by electron microscopy. The transfected cells did not show a cytopathic effect and released rNV-VLP into the culture medium. The HEK-293T cell derived particles were morphologically indistinguishable to the rNV-VLP produced from baculovirus and the Venezuelan equine encephalitis virus (VEE)-replicon. The produced particles were stable for at least 2.5 months at 4 degrees C.

Cell Line↗
PubMed2002

[Effects of the intensity of a post partum examination on the fertility performance of high yielding dairy cows].

Two methods for a scheduled post partum examination were compared on a commercial dairy farm. In Group 1, all cows (n = 601) were examined by rectal palpation between day 20 and 26 post partum for signs of endometritis (vaginal discharge, enlarged uterus). In Group 2, all cows (n = 652) were examined by external inspection for vaginal discharge as a sign for endometritis. In both groups all cows with endometritis were treated twice with prostaglandin F2 alpha (25 mg of dinoprost) in a 14-day interval. The proportion of cows with signs of endometritis was 33.3% and 17.2% in Group 1 and Group 2, respectively (p < 0.05). In Group 1, the conception rate (39.0% vs 49.3%) and the proportion of cows pregnant (60.5% vs 72.6%) were lower for cows with endometritis than for cows without endometritis. In Group 2, no significant differences were found in reproductive performance for cows with and without signs of endometritis. No significant differences in reproductive performance were found for cows with endometritis between the two groups. Also, for cows without endometritis no significant differences in reproductive performance were found between the groups. It is concluded that the post partum examination by rectal palpation was more sensitive in finding cows with endometritis. However, with regard to the reproductive performance the more sensitive method was not more effective than the method based on systematic external inspection.

Animals↗
PubMed2001

Moving from apprehension to action: HIV counseling and testing preferences in three at-risk populations.

This study sought to identify factors influencing HIV testing decisions among clients at a sexually transmitted disease clinic, gay men, and injection drug users. Focus group and intensive interview data were collected from 100 individuals. The AIDS Risk Reduction Model was adapted to describe factors that affect test decisions. Testing barriers and facilitators were grouped as factors affected by "Individual" beliefs, "System" policies and programs, "Testing" technology, and "Counseling" options. Individual factors (fear of death and change), system factors (anonymous test availability, convenience), and counseling and testing factors (rapid results, counseling alternatives) interact to determine whether an individual does not test ("apprehension") or does test ("action"), and ultimately, tests routinely ("integration"). In conclusion, traditional HIV testing presents barriers to some populations at risk for HIV. These findings suggest several strategies to improve HIV test acceptance: acknowledge fears, address system barriers, utilize available test technologies, and expand counseling options.

AIDS Serodiagnosis↗
PubMed2000

Treatment of BK virus-associated hemorrhagic cystitis and simultaneous CMV reactivation with cidofovir.

Hemorrhagic cystitis (HC) is a common complication following high-dose chemotherapy and bone marrow transplantation, and the treatment of virus-associated HC remains to be optimized. This is the first report on the successful use of cidofovir in a patient with HC and polyoma viruria concomitant with CMV reactivation after allogeneic BMT. Treatment led to a significant decrease in viruria and to sustained suppression of CMV reactivation. Administered with probenecid and hydration, cidofovir was well tolerated, and there were no side-effects.

Antiviral Agents↗
PubMed1999

New chimaeric hepatitis B virus core particles carrying hantavirus (serotype Puumala) epitopes: immunogenicity and protection against virus challenge.

Virus-like particles generated by the heterologous expression of virus structural proteins are able to potentiate the immunogenicity of foreign epitopes presented on their surface. In recent years epitopes of various origin have been inserted into the core antigen of hepatitis B virus (HBV) allowing the formation of chimaeric HBV core particles. Chimaeric core particles carrying the 45 N-terminal amino acids of the Puumala hantavirus nucleocapsid protein induced protective immunity in bank voles, the natural host of this hantavirus. Particles applied in the absence of adjuvant are still immunogenic and partially protective in bank voles. Although a C-terminally truncated core antigen of HBV (HBcAg delta) tolerates the insertion of extended foreign sequences, for the construction of multivalent vaccines the limited insertion capacity is still a critical factor. Recently, we have described a new system for generating HBV 'mosaic particles' in an Escherichia coli suppressor strain based on a readthrough mechanism on a stop linker located in front of the insert. Those mosaic particles are built up by both HBcAg delta and the HBcAg delta/Puumala nucleocapsid readthrough protein. The particles formed presented the 114 amino acid (aa) long hantavirus sequence, at least in part, on their surface and induced antibodies against the hantavirus sequence in bank voles. Variants of the stop linker still allowed the formation of mosaic particles demonstrating that stop codon suppression alone is sufficient for the packaging of longer foreign sequences in mosaic particles. Another approach to increase the insertion capacity is based on the simultaneous insertion of different Puumala nucleocapsid protein sequences (aa 1-45 and aa 75-119) into two different positions (aa 78 and behind aa 144) of a single HBcAg molecule. The data presented are of high relevance for the generation of multivalent vaccines requiring a high insertion capacity for foreign sequences.

Amino Acid Sequence↗
PubMed1999

[Structural requirements of computer-based medical documentation in a hospital setting].

During the last years physicians are confronted with a significant increase of their duties in clinical documentation. By law the medical diagnoses and procedures were linked with the aspect of liquidation. In consequence it is very important that physicians work out a detailed list of options concerning the features of the medical database, which has to cover the complete clinical data input and deliver flexible utilities for detailed evaluation. Beside documentation the system has to perform as an essential tool of clinical organisation and quality control to optimize the medical and commercial efficiency of the hospital. An open interface technology should be postulated to avoid a stand alone system in the long run.

Databases as Topic↗
PubMed1999

Cauda equina compression due to a laminar hook: A late complication of posterior instrumentation in scoliosis surgery.

Whilst neurologic injury following correction of scoliosis with CD-instrumentation is generally known to be an early complication, any late occurrence of cauda compression secondary to employment of a laminar hook-rod construct is exceptional. We report on such a rare case of late occurrence of cauda equina syndrome, when a laminar hook at level L2 became symptomatic causing compression of the cauda equina almost a decade after spine surgery. This case demonstrates that one should not only be aware of a potential neural injury at intraoperative placement of laminar hooks, but also one is reminded that a laminar hook poses the threat of late neurologic injury years after successful osseous spinal fusion. The surgeon treating patients with scoliosis must be aware of the possible complication described in our patient in addition to those that have already been well documented.

Adult↗
PubMed1989

Agricultural development and nutritional status in Malawi.

A comparative anthropometric assessment involving 2175 measurements of 1533 children under the age of 5 was carried out in Malawi, both before and after the harvest seasons (February and May, 1985). Subjects were randomly drawn from socioeconomically similar rural environments within and outside a large-scale agricultural development project. Chronic malnutrition (height for age less than 90 per cent of the median) was found to be 36 per cent in February and 41 per cent in May. The prevalence of acute malnutrition (weight for height less than 80 per cent of the median) was 4 per cent and 5 per cent, respectively. Tests of significance found no statistical difference between the project and non-project children for a variety of nutritional status indices. It is postulated that such factors as increased female access to extension services and male access to nutrition education may have greater impact on morbidity than income increases alone, and should be part of agricultural development planning.

Agriculture↗
PubMedDate not supplied

A context for HIV testing in pregnancy.

The use of the human immunodeficiency virus (HIV) antibody test for women of childbearing age is discussed. Serological tests used to determine HIV status are reviewed. Practitioners should be aware of the legal and ethical issues involved in testing. Psychological responses to knowledge of test results are considered. The goal of the counseling session is to provide sufficient information for the woman to make an informed decision about reproductive choices. The format and content of pre- and post-test sessions are outlined, and checklists that may assist the practitioner in post-test counseling appear in the Appendixes.

AIDS Serodiagnosis↗
PubMedDate not supplied

Promoting sexual health in the age of HIV/AIDS.

Identifying, managing, and preventing HIV infection and other sexually transmitted diseases (STDs) are essential components of women's health care. Biological, sociocultural, and epidemiological risks, including STDs, increase the likelihood that a woman will become infected with HIV. Infection with a STD facilitates the likelihood of infection with HIV, and many of the same risk behaviors and interventions are relevant. Promoting sexual health in the age of HIV/AIDS necessitates the acknowledgement of behavioral and social aspects of sexuality, as well as clinical approaches and skills that support safer and satisfying sexual lives for women. This article reviews the use of sexual and substance use risk assessment, individualized counseling, and risk-reduction strategies for woman to improve sexual health.

Adolescent↗
PubMedDate not supplied

[Three-dimensional computer reconstruction of the pelvic and hip area in the preoperative planning of orthopedic interventions and surgical simulation].

RESEARCH QUESTION: Osteotomies are elective operations which require exact pre-operative planing. Computer assisted three-dimensional planning of orthopedic procedures requires a three-dimensional reconstruction of the region of interest. To be applicable, such a three-dimensional reconstruction must be an accurate mathematical description of the region of interest, and not only a 3-D-image. The purpose of this study was to create such an accurate 3-D reconstruction. METHODS: We describe a method to create an exact reconstruction from CT-data, from the data acquisition, contour determination by an algorithm, triangulation of the resulting data and reconstruction of the region of interest. CONCLUSION: The described method is a useful tool to obtain exact individual three-dimensional reconstructions of any skeletal region of interest. This makes pre-operative planning and simulation of the results of orthopedic procedures at the computer possible.

Computer Simulation↗
PubMedDate not supplied

[Computer-assisted analysis of the kinematics of the upper ankle joint].

Usually the upper ankle joint is described as a typical hinge though it had been often remarked that the axis of rotation moves considerably with regard to the angular adjustment between the tibia and the trochlea tali. In the present study the relation between the movements in the upper ankle joint and the geometry of the lateral ligaments was analysed. The contours and elected landmarks of 6 dissected ankle joints were measured using a digitizer which allowed the computerized scanning of motion x-rays. In addition the proximal and distal insertion planes of the lateral ligaments were registered. Mathematical procedures were applied on the experimental data to predict the kinematic principles. The model of an hinged joint could not reproduce the motion curve which was actually found. Using the model of a link chain with four pivots, which was determined by the course of the talofibular and the calcaneofibular ligament, a good correlation with the experimental results was evident. This model implies a rotary and gliding component in the movement of the tibia against the trochlea tali. Beside the correspondence with the data of the present study the model allows an easy explanation of many other well known morphologic phenomena of the upper ankle joint for which a stringent interpretation was not yet available.

Ankle Joint↗
PubMedDate not supplied

Critically sized osteo-periosteal femoral defects: a dog model.

A 21-mm defect was created in 1 femoral diaphysis each of 15 dogs. Periosteum as well as a cylinder of bone was removed, and the defect was stabilized with a bone plate. Twelve of the defects were filled with an equal volume of autogenous cancellous bone harvested from the ipsilateral ilium. Three defects were left untreated. Cranial to caudal radiographs were taken postoperatively and every 4 weeks for 16 weeks. The radiographs were evaluated for healing using two ordinal scales. At 16 weeks, the dogs were euthanized and the femurs harvested for biomechanical testing and histologic evaluation. Both operated and contralateral not operated femurs were mechanically tested to failure in torsion, and load at failure and stiffness were calculated. All dogs tolerated the procedure well, and were using the operated limb within 1 or 2 days postoperatively. There were no complications noted during the 16 weeks of the study. Unfilled defects did not heal and became atrophic nonunions. The defects filled with autogenous cancellous bone healed in a consistent pattern of consolidation, incorporation, and remodeling, with uniform increases of both ordinal scales used. The femoral cortex opposite the bone plate demonstrated most mature remodeling, evident both radiographically as well as histologically. Unoperated femurs failed at 13.61 +/- 3.88 N-m and grafted femurs failed at 2.96 +/- 1.3 N-m, which was 23% of the measurement of the unoperated femur. Relative stiffness of the unoperated femurs was 5974 +/- 4316 N-m2/radian, and grafted femurs had a relative stiffness of 642 +/- 561 N-m2/radian, which was 10.4% of the measurement of unoperated femur. This model proved to be a critically sized defect, which when left unfilled resulted in an atrophic nonunion, and when filled with cancellous bone resulted in a consistent healing pattern.

Animals↗
PubMedDate not supplied

Reproductive and sexual health benefits in private health insurance plans in Washington State.

CONTEXT: Although unintended pregnancy and sexually transmitted diseases (STDs) are considerable problems in the United States, private health insurance plans are inconsistent in their coverage of reproductive and sexual health services needed to address these problems. METHODS: A survey administered to a market-representative sample of 12 health insurance carriers in Washington State assessed benefit coverage for gynecologic services, maternity services, contraceptive services, pregnancy termination, infertility services, reproductive cancer screening, STD services, HIV and AIDS services, and sterilization, as well as for the existence of confidentiality policies. "Core" services in each category were defined based on U.S. Preventive Services Task Force and other recommendations. RESULTS: Of the 91 top-selling plans on which data were collected, 8% were indemnity plans, 14% were point-of-service plans, 21% were preferred-provider organization plans and 57% were health maintenance organization (HMO)-type products; they had a combined enrollment of 1.4 million individuals. Coverage of core services varied widely by type of plan. While a high proportion of plans covered core gynecologic, maternity, reproductive cancer screening, STD and HIV and AIDS services, nearly half of plans did not cover any kind of contraceptive method. Approximately 13% of female enrollees did not have core coverage for gyneco!ogic services, 19% for matemity services, 75% for contraception, 37% for sterilization and 53% for pregnancy termination; 98% of women and men were not covered for infertility treatment. Most carriers did not have specific policies for maintaining privacy of sensitive health information. Overall, benefit coverage was lower for indemnity, preferred-provider organization and HMO plans in Washington State than has previously been seen nationally. CONCLUSIONS: A sizable proportion of women and men in Washington State who rely on private-sector health insurance lack comprehensive coverage for key reproductive and sexual health services.

Family Planning Services↗