Biomedical subjects
Publications and source records attributed to D Teichmann.
RT-PCR was used to diagnose dengue virus infections confirmed serologically in 26 returning travellers. RT-PCR was positive for three (75%) of four samples taken on or before day 3 of the illness, for 15 (78.9%) of 19 samples taken between days 4 and 7, and for none of three samples tested on or after day 8 (p 0.0337). When applied early, RT-PCR seems to be a useful tool for the diagnosis of dengue fever.
Resurgence in the incidence of HIV and syphilis infections has been reported from all Western European Countries and the USA during the past years, the majority of them in men who have sex with men. The attitude among HIV-positive patients towards the application of preventive measures is changing in comparison to the time immediately after the detection of the HIV. Furthermore, HIV care providers do not always talk in an open manner about safer sex and disclosure, with the result that a large group of patients regards oral sex as harmless with respect to the transmission of sexually transmitted diseases (STDs). We illustrate this context by the case presented. Since both HIV and syphilis represent risk factors for the transmission of further STDs, their interdependency must be interrupted by promotion of early and effective STD-related health-care behaviours.
Dengue fever is recognized as one of the most frequent imported acute febrile illnesses affecting European tourists returning from the tropics. In order to assess the value of virus isolation for the diagnosis of dengue fever, 70 cases of dengue fever confirmed in German travelers during the period 1993-2001 were analyzed retrospectively. In 26 patients who had developed acute febrile illness within 2 weeks following their return from a trip to a dengue-endemic area, 9 of 13 attempts to isolate the virus were successful in sera drawn 1-5 days and 2 of 13 sera drawn 6-10 days after the onset of illness. DEN-1 was the most frequent serotype isolated. If performed early, virus isolation is a reliable tool for detecting dengue virus in returning travelers.
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A woman from Bangladesh who had lived in Germany for more than 2 years presented with migratory, painful swellings on her left hand and arm of 5 months duration. Laboratory examinations yielded a marked eosinophilia and a grossly elevated IgE level in combination with an inflammatory reaction restricted to the subcutaneous tissues. A preliminary diagnosis of gnathostomiasis was established and confirmed by a positive gnathostoma serology by enzyme immunoassay (EIA). Treatment was initiated with albendazole, leading to the outward migration of a larva and complete resolution of clinical disease. Currently, there is no definitive therapy that has been proved to be both safe and highly effective. A wide range of potential agents has been used in clinical studies, but only albendazole has proved to be reliably effective to date, stimulating the outward migration of larvae in a proportion of cases of cutaneous disease, as observed in the present case.
Human fascioliasis is distributed worldwide with several foci of high endemicity. Being a rare disease in Europe, we describe here a case in the initial hepatic phase of the disease. Therapeutic and, with reference to the 2 distinct stages of disease, diagnostic standards are discussed.
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Lac repressor, lambda cro protein and their operator complexes are structurally, biochemically and genetically well analysed. Both proteins contain a helix-turn-helix (HTH) motif which they use to bind specifically to their operators. The DNA sequences 5'-GTGA-3' and 5'-TCAC-3' recognized in palindromic lac operator are the same as in lambda operator but their order is inverted form head to head to tail to tail. Different modes of aggregation of the monomers of the two proteins determine the different arrangements of the HTH motifs. Here we show that the HTH motif of lambda cro protein can replace the HTH motif of Lac repressor without changing its specificity. Such hybrid Lac repressor is unstable. It binds in vitro more weakly than Lac repressor but with the same specificity to ideal lac operator. It does not bind to consensus lambda operator.
The relationship between left ventricular filling pressure and Doppler echocardiographic parameters of diastolic mitral flow (MF) was evaluated in patients with ischemic heart disease during acute ischemia induced by percutaneous transluminal coronary angioplasty (PTCA) of the left anterior descending artery. Thirty-two patients were examined by simultaneous recordings of the Doppler MF signal and the mean pulmonary capillary wedge pressure (PCm) as an approximation of left ventricular filling pressure. At rest PCm was correlated with the early/late velocity integral ratio (Ei/Ai: r = 0.62: p less than 0.0001; n = 32). In 25 of 32 patients the recordings during PTCA could be evaluated. At the end of the inflation (duration: 69 +/- 24 seconds) PCm increased from 11.2 +/- 5.5 to 17.2 +/- 7.2 mm Hg (p less than 0.001), and total MF integral as an index of systolic ventricular function decreased by 14.9 +/- 12.8% (p less than 0.001). Inasmuch as both early and late velocity integrals were reduced during PTCA, the Ei/Ai ratio did not change significantly (1.41 +/- 0.51 to 1.34 +/- 0.60; NS). In a subgroup of inflations without ECG signs of ischemia, Ei was decreased without a concomitant decrease in Ai, thus leading to a decrease in the Ei/Ai ratio (1.36 +/- 0.43 to 1.17 +/- 0.31; p less than 0.05). Summarizing the events during PTCA, a steady increase in PCm was observed, whereas the Ei/Ai ratio was slightly decreased. Thus the observation at rest that an elevated PCm was associated with an elevated Ei/Ai was no longer valid during PTCA (Ei/Ai: r = 0.28; NS). A significant correlation was found between parameters of Doppler MF and PCm in patients with ischemic heart disease at rest. During PTCA this relationship was attenuated. Therefore noninvasive assessment of left ventricular filling pressures during acute ischemia by Doppler echocardiography does not seem feasible.
A close relation between the Doppler-echocardiographic transmitral flow signal (TMF) and the left ventricular filling pressure in patients with coronary heart disease (CHD) was described in several reports. The present study investigated the validity of this relation during an episode of acute ischemia induced by coronary angioplasty (PTCA) by simultaneous recording of TMF and mean pulmonary capillary wedge pressure (PCm). Thirty-nine patients were examined at rest, and 33 of them were further studied during a subsequent PTCA of the left anterior descending artery (n = 22) or the right coronary artery (n = 11). The onset of ischemia was evaluated by electrocardiography. The Doppler-echocardiographic parameters of diastolic ventricular function were correlated with PCm; the closest correlation was obtained for the relation between PCm and the ratio of the early/atrial velocity integral (Ei/Ai: r = 0.59; p less than 0.0001), and between PCm and the relative share of the early diastolic velocity integral (Ei%: r = 0.58; p less than 0.0001). A wide confidence interval of individual values did not allow a calculation of PCm from Ei/Ai. By a semiquantitative approach an elevated PCm could be estimated from Ei/Ai greater than 1.5 with a high sensitivity (86%) and specificity (81%). During PTCA an increase of PCm was observed (start: 10.2 +/- 4.8; end: 15.0 +/- 6.5; p less than 0.0001), while Ei/Ai decreased slightly (start: 1.37 +/- 0.41; end: 1.27 +/- 0.51; p = 0.32). With increasing duration of inflation, the correlation between PCm and Doppler-echocardiographic parameters was attenuated.(ABSTRACT TRUNCATED AT 250 WORDS)
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