Biomedical subjects
Publications and source records attributed to A Meyer.
A 74-year-old woman consulted for bloody tears. The etiology was a large conjunctival nodular melanoma hidden in the left superior fornix that had developed quietly on an unknown primary acquired melanosis. In this report the clinical and histological features as well as the treatment are presented. A decisional tree summarizes the treatment for conjunctival melanosis.
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INTRODUCTION: Since its first description in 1939 not more than approximately 80 cases of ureteroiliac artery fistulas have been reported. The incidence seems to increase with the number of endo-vascular and endo-urological interventions. Risk factors include pelvic vascular surgery and surgery for malignancy, irradiation and ureteral stenting. Due to the intermittent symptomatology, the preoperative diagnosis and planning of the therapeutic approach are often difficult. CASE REPORT: We report the case of an ureteroiliac artery fistula caused by an iliac artery aneurysm following vascular surgery, and review the literature. CONCLUSIONS: In case of preoperative diagnosis it is of great importance to coordinate the cooperation of urologists, vascular surgeons and radiologists in order to achieve the best treatment for the patient.
BACKGROUND: Although deficiencies in the early components of the complement system were among the first identified genetic risk factors for systemic lupus erythematosus (SLE), only a few studies addressed their significance in patients with cutaneous LE (CLE). Among environmental factors, it was postulated that cigarette smoking might intervene in the pathogenesis of LE. OBJECTIVES: To describe the clinical and biological features of patients with CLE and a complement deficiency. A secondary objective was to assess cigarette smoking in patients with CLE. PATIENTS AND METHODS: A retrospective study including all patients diagnosed as having LE between 1995 and 2003 in the Dermatology Department of Strasbourg University Hospital. Patient charts were reviewed and those patients in whom a C4 and/or C2 deficiency was diagnosed were included. Two patients with a combined C2/C4 deficiency were analysed in detail. RESULTS: There were 48 females and 37 males (F/M ratio = 1.3), with a mean age of 41 years at diagnosis; 73% of the patients had chronic LE and 27% subacute CLE. Among 32 screened patients, 24 patients with a mean age of 36 years had a complement deficiency; 17 had a C4A deficiency, five a C4B deficiency and two a combined C4A/C2 deficiency. A high proportion (58%) of these patients was male; 82% of the patients were smokers. This was especially true in males: 94% were smokers compared with 69% of females. CONCLUSIONS: Partial deficiency of C4, C2 or C4 and C2 is a common finding in patients with CLE. Most male patients with CLE are smokers. It is thus suggested that the combination of cigarette smoking and complement deficiency could be a risk factor for LE in men.
AIM: The aim of this study was to investigate the effect of long-term treatment with the dipeptidyl peptidase inhibitor P32/98 and its combination with rosiglitazone on blood glucose control and islet of Langerhans histology in male Zucker diabetic fatty (ZDF) rats, when treatment begins before or after the development of overt diabetes. METHODS: ZDF rats were treated with P32/98 from the age of 9, 12 or 15 weeks. Rosiglitazone maleate was given to a separate group from the age of 13 weeks. P32/98 was given to all of these rosiglitazone-treated rats from 16 weeks of age. Rosiglitazone maleate was also given from 16 weeks of age to half the rats that were given P32/98 from 9 weeks of age. The compounds were given by oral gavage until the rats were 14 weeks old and then in the diet. The experiment was terminated at the age of 20-21 weeks. Blood glucose, plasma insulin and oral glucose tolerance were measured at intervals; islet histology was assessed terminally. RESULTS: P32/98 improved glucose tolerance after both single and multiple doses when treatment started at 9 weeks of age, also after the third week of treatment when treatment began at 12 or 15 weeks of age. P32/98 reduced daytime blood glucose when treatment began at 12 weeks. Treatment with rosiglitazone increased food intake and body weight, and after 2 weeks, reduced daytime blood glucose, water intake and the area under the glucose tolerance curve. A single dose of P32/98 markedly improved glucose tolerance in rosiglitazone-treated rats. When treatment had begun at 9 weeks of age, P32/98 stimulated insulin secretion in some glucose tolerance tests. Neither P32/98 nor rosiglitazone affected pancreatic insulin content, nor did they have clear effects on islet histology. CONCLUSION: P32/98 elicited a sustained improvement in glucose tolerance in both prediabetic and diabetic ZDF rats. The effects of P32/98 on glucose and insulin were similar to those of rosiglitazone, and in contrast to rosiglitazone, P32/98 did not increase food intake or body weight. However, neither compound was especially effective at improving diabetes in ZDF rats when treatment began at 9, 12 or 15 (P32/98) or 13 (rosiglitazone) weeks of age.
The epidemiology of hepatitis A virus (HAV) infection is shifting from high to intermediate endemicity in Brazil, resulting in increased numbers of susceptible individuals and a greater potential for the emergence of outbreaks. Universal vaccination against HAV has been recommended for children, but updated sero-epidemiological data are necessary to analyze the level of natural immunity and to identify candidates for preventive measures. In addition, more molecular studies are necessary to characterize the genotypes involved in HAV infections and outbreaks. Sera from 299 school children (5-15 years old) and 25 school staff members, collected during an outbreak of HAV at a rural public school in June 2000, were tested for IgM and total anti-HAV antibodies (ELISA). Viral RNA was amplified by RT-PCR from anti-HAV IgM-positive sera and from 19 fecal samples. Direct nucleotide sequencing of the VP1/2A region was carried out on 18 PCR-positive samples. Acute HAV infection was detected by anti-HAV IgM in 93/299 children and in 3/25 adult staff members. The prevalence of total anti-HAV antibodies in IgM-negative children under 5 years of age was only 10.5%. HAV-RNA was detected in 46% IgM-positive serum samples and in 16% stool samples. Sequence analysis showed that half the isolates belonged to subgenotype IA and the other half to IB. On the basis of these data, mass vaccination against HAV is recommended without prevaccination screening, especially for children before they enter school, since nearly 90% of the children under 5 years were susceptible. Molecular characterization indicated the endemic circulation of specific HAV strains belonging to subgenotypes IA and IB.
We use inelastic neutron scattering and molecular dynamics simulation to investigate the interplay between the structure and the fast sodium ion diffusion in various sodium silicates. With increasing temperature and decreasing density the structure factors exhibit an emerging prepeak around 0.9 A(-1). We show that this prepeak has its origin in the formation of sodium rich channels in the static structure. The channels serve as preferential ion conducting pathways in the relative immobile Si-O matrix. On cooling below the glass transition this intermediate range order is frozen in.
Retinoic acid (RA) has been identified as a key signal involved in the posteriorization of vertebrate neural ectoderm. The main biosynthetic enzyme responsible for RA signaling in the hindbrain and spinal cord is Raldh2. However, neckless/raldh2-mutant (nls) zebrafish exhibit only mild degrees of anteriorization in the neural ectoderm, compared to full vitamin A deficiency in amniotes and the Raldh2-/- mouse. Here we investigated the role of RA during neuronal development in the zebrafish hindbrain and anterior spinal cord using DEAB, an inhibitor of retinaldehyde dehydrogenases. We show that the nls hindbrain and spinal cord are not fully devoid of RA, since blocking Raldh-mediated RA signaling leads to a more severe hindbrain phenotype than in nls. The anteroposterior distribution of branchiomotor neurons in the facial and more posterior nuclei depends on full RA signaling throughout early and late gastrula stages. In contrast, inhibition of RA synthesis after gastrulation reduces the number of branchiomotor neurons in the vagal nucleus, but has no effect on anteroposterior cell fates. In addition, blockage of RA-mediated signaling not only interferes with the differentiation of branchiomotor neurons and their axons in the hindbrain, but also affects the development of the posterior lateral line nerve.
UNLABELLED: We report on a series of 20 consecutive patients (10 males, 10 females) with adrenal cortical carcinoma (ACC) who were treated by surgery between 1987 and 2001. AIM: The aim of this study was to evaluate the outcome and the role of surgery in the management of this tumour. RESULT: One patient was at stage I, five patients at stage II, five patients at stage III and nine patients at stage IV of disease. Ten patients suffered from a functioning tumour, whilst ten patients revealed non-functioning tumours. In all patients a transabdominal approach was performed for the complete resection of the tumour, adjacent organs or metastases. The medium survival after surgical resection, calculated by the Kaplan-Meier method, was 45 months for the overall group, 65 months for patients at stage I or II, 38 months for patients at stage III and 19 months for patients at stage IV of disease. The 5-year survival rate for all patients was 23%, for patients at stage I or II 33%, for patients at stage III 20%, and for patients at stage IV around zero. CONCLUSION: Radical surgery with a complete resection of the tumour, adjacent organs, solitary metastases and loco-regional recurrence wherever possible improves survival, even at advanced stages of disease.
CA 19-9 is a tumor marker of pancreatic and gastrointestinal cancer. Elevation in nonmalignant disease is rare. The case of a patient with a partial staghorn calculus, giant hydronephrosis, and elevated CA 19-9 serum levels is presented. Open transperitoneal right-sided nephrectomy was performed. In immunohistochemical analysis, CA 19-9 was expressed in the renal tubular epithelium and the renal pelvis. During postoperative follow-up, the CA 19-9 levels returned to normal. Hydronephrosis might cause false-positive results when CA 19-9 measurement is used to screen for malignant disease. Posttreatment CA 19-9 levels of patients with hydronephrosis have to be monitored closely to safely exclude malignant disease.
A 3-year-old girl had a tumor growing for a month on the superior right eyelid, attached on the free margin of the eyelid and partially necrotic. A surgical excision was performed under general anesthesia. The histopathological study found an inflammatory lesion with epithelioid and giant cells, evidence of a granuloma, suggesting the diagnosis of chalazion. This case shows the various clinical presentations of this common and benign disease of the eyelid.
A 6-year-old girl had a single molluscum contagiosum of the lower eyelid. Clinically, the tumor had grown slowly since it had been discovered 8 months before the child was seen at our consultation. It appeared as a nodular lesion on the middle part of the eyelid. Its surface was irregular and its color was the same as the epidermis. It was surgically excised, using the shaving biopsy technique. Its histopathological study showed a papillomatous lesion with the typical features of a molluscum contagiosum. The patient was lost to follow-up soon after the surgery.
A 56-year-old female patient displayed an increased volume of her left lacrimal gland with pain and inflammation. On CT scan, a hyperdense lacrimal mass was found in the left lacrimal fossa. Observation was the first course, for no steroid therapy could be applied because of evolving digestive ulcers. After 9 months of observation, the gland was surgically removed en bloc through a wide anterolateral approach. Pathological analysis of the gland showed a pleomorphic adenoma. This case illustrates the advantage of a wide surgical approach in treating lacrimal gland tumors, in order to avoid or limit the risk of recurrence.
Mycoplasma pneumoniae is a common respiratory pathogen in community acquired pneumonia. In severe cases extrapulmonary manifestations of the disease may be prominent. Proof of infection is found, though usually delayed, through serologic methods. A calculated therapy of community acquired pneumonia, especially in younger patients with interstitial infiltrates, should therefore include effective treatment for Mycoplasma pneumoniae. Macrolide antibiotics are the most commonly used antibiotics in the treatment of mycoplasma infection, alternatives include ketolides, quinolones and tetracyclines.
INTRODUCTION: Appendectomy is one of the most commonly performed surgical procedures in general surgery and laparoscopic appendectomy represents the beginning of minimal invasive era in visceral surgery. But until yet, laparoscopic appendectomy is not the standard method for removal of the appendix and the discussion about the value and the advantages of laparoscopic appendectomy is still going on between the opponents and advocates of this method. In this article we present the transumbilical laparoscopic assisted "one-trocar" appendectomy (TULAA) as an alternative procedure for appendectomy and our experiences with this technique, which is up to now not very well known in Germany. METHOD: From November 1, 2000 to December 31, 2002, we performed appendectomy in 350 patients. 163 patients (46.6 %) underwent TULAA in the technique of Begin. All of them were examined two weeks and three months after surgery. RESULTS: In 94.5 % the "one-trocar" appendectomy was successful and there were no intraoperative complications. The mortality was 0 %. Conversion to the open procedure was necessary in 3 patients (1.8 %), respectively introduction of accessory trocars was necessary in 6 patients (3.7 %). In 111 from 163 patients (68.1 %) appendectomy was performed because of acute appendicitis. In 14.1 % we detected additional secondary findings during the laparoscopy. The postoperative complication rate was 3.6 %. CONCLUSION: The transumbilical laparoscopic assisted "one-trocar" appendectomy complements the minimal invasive procedures in visceral surgery. The operating technique combines the simplicity and the safety of conventional appendectomy with the survey of laparoscopic appendectomy. It minimizes the trauma of surgery and shows a perfect cosmetic result.
Malagasy poison frogs of the genus Mantella are diurnal and toxic amphibians of highly variable and largely aposematic coloration. Previous studies provided evidence for several instances of homoplastic colour evolution in this genus but were unable to sufficiently resolve relationships among major species groups or to clarify the phylogenetic position of several crucial taxa. Here, we provide cytochrome b data for 143 individuals of three species in the Mantella madagascariensis group, including four newly discovered populations. Three of these new populations are characterized by highly variable coloration and patterns but showed no conspicuous increase of haplotype diversity which would be expected under a scenario of secondary hybridization or admixture of chromatically uniform populations. Several populations of these variable forms and of M. crocea were geographically interspersed between the distribution areas of Mantella aurantiaca and Mantella milotympanum. This provides further support for the hypothesis that the largely similar uniformly orange colour of the last two species evolved in parallel. Phylogenies based on over 2000 bp of two nuclear genes (Rag-1 and Rag-2) identified reliably a clade of the Mantella betsileo and Mantella laevigata groups as sister lineage to the M. madagascariensis group, but did not support species within the latter group as monophyletic. The evolutionary history of these frogs might have been characterized by fast and recurrent evolution of colour patterns, possibly triggered by strong selection pressures and mimicry effects, being too complex to be represented by simple bifurcating models of phylogenetic reconstruction.
Different classification systems for therapeutic agents exist. The most commonly used one is the ATC Code (ATC: Anatomy, Therapeutic properties, Chemical, pharmacological properties). Here, an alternative classification system (TCAT: Target-Chemistry-Anatomy-Therapy) is proposed which refers to the molecular mechanism of action or rather, target. The main subgroups of targets are: enzymes; substrates, metabolies, proteins; receptors; ion channels; transporter molecules and systems; nucleic acids, ribosomes; physicochemical mechanisms; antigen-antibody reactions; unknown targets. This target-oriented approach may be particularly useful in teaching advanced medicinal chemistry.
In order to reduce the time to detection of nitrate reductase activity, which is arguably the most widely used phenotypic trait to differentiate between Mycobacterium tuberculosis, Mycobacterium bovis and Mycobacterium bovis BCG, the following study was conducted using cultures grown in an automated system. Automated culture systems, which are typically based on liquid medium, have greatly reduced the time-to-recovery of mycobacteria. Yet subsequent testing of isolates for nitrate reductase activity may take several weeks, because culture on solid media is required. Presented here is a procedure to obtain a final result within 24 h for nitrate reductase activity of cultures grown in an automated culture system. Using this procedure, Mycobacterium tuberculosis was rapidly differentiated from Mycobacterium bovis and Mycobacterium bovis BCG.