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Biomedical subjects

E Walter

Publications and source records attributed to E Walter.

At least 73 records · Page 4Linked to original sources
PubMed1993

[Trans-jugular intrahepatic portosystemic stent-shunt (TIPS) in a patient with Budd-Chiari syndrome].

The surgical modalities for the management of Budd-Chiari syndrome are associated with high morbidity and mortality. The clinical course of a patient with subacute Budd-Chiari syndrome and a myeloproliferative disorder is described in whom, to reduce the portal hypertension, a transjugular intrahepatic portosystemic stent-shunt (TIPS) was implanted. TIPS is a new, still experimental procedure for the treatment of patients with portal hypertension which is used mainly for patients with recurrent variceal bleeding. An intrahepatic metal wire stent connects a main branch of the portal vein with a large hepatic vein and reduces the portal venous pressure as a side-to-side portosystemic shunt. In the patient described here the implantation of a TIPS was followed by rapid reduction of ascites production and a continuing general improvement.

Adult↗
PubMed1993

In vivo inhibition of duck hepatitis B virus replication and gene expression by phosphorothioate modified antisense oligodeoxynucleotides.

Antisense oligodeoxynucleotide strategies have been employed in a variety of eukaryotic systems both to understand normal gene function and to block gene expression. Pharmacologically, 'code blockers' are ideal agents for antitumour and antimicrobial treatments because of their specific mode of action. Here we report the inhibition of duck hepatitis B virus (DHBV) by antisense oligodeoxynucleotides in primary duck hepatocyte cultures in vitro as well as in DHBV-infected Pekin ducks in vivo. The most effective antisense oligodeoxynucleotide was directed against the 5' region of the pre-S gene and resulted in a complete inhibition of viral replication and gene expression in vitro and in vivo. These results demonstrate the application of antisense oligodeoxynucleotides in vivo and exemplify their potential as human antiviral therapeutics.

Animals↗
PubMed1993

Identifying human immunodeficiency virus infection at birth: application of polymerase chain reaction to Guthrie cards.

Guthrie cards containing dried blood spots from 67 children now known to be infected with human immunodeficiency virus (HIV) and 63 children now classified as having had seroreversion were retrieved from the newborn infant archives from 1986 through 1991 to determine whether the polymerase chain reaction (PCR) could predict the infection at birth. The PCR assays operating at a sensitivity capable of detecting 2 to 10 copies of HIV proviral DNA per microgram were able to detect HIV proviral DNA in 52% (35/67) of the infected neonatal blood specimens. Longer storage times did not decrease PCR positivity rates, an advantage over assays for HIV antibody. Children whose clinical progression has been aggressive had high rates of PCR positivity in neonatal specimens, 50% (7/14) in those with low CD4 cell counts during the first year of life, 71% (10/14) in those with Pneumocystis pneumonia or disseminated cytomegalovirus infection by age 1 year, 62% (18/29) in those with onset of acquired immunodeficiency syndrome by 18 months, and 66% (14/21) in those who died of the disease by 36 months of age. No evidence of HIV proviral DNA was found in any of the 63 specimens from children with seroreversion. We conclude that PCR, using routinely available dried blood spots from neonates, has applications in early diagnosis and in epidemiologic projections going beyond current seroprevalence studies.

AIDS Serodiagnosis↗
PubMed1993

Transjugular intrahepatic portosystemic stent-shunt (TIPS) in the treatment of Budd-Chiari syndrome.

Budd-Chiari syndrome is characterized by splanchnic congestion due to obstruction of the hepatic venous outflow. A variety of treatment modalities have limited applicability due to their invasive nature, complications or low effectivity. The transjugular intrahepatic portosystemic stent-shunt (TIPS) offers a new treatment by creating an intraparenchymal duct between a main branch of the portal vein and hepatic vein i.e. the intrahepatic part of the inferior vena cava. This paper describes the treatment of two patients with fulminant and subacute Budd-Chiari syndrome treated 2 days and 2 months after the onset of clinical symptoms. It demonstrates that TIPS is a feasible treatment of Budd-Chiari syndrome that restores splanchnic blood flow, reduces collateral circulation and ascites and provides sufficient time to allow for elective liver transplantation, if indicated. Further studies are required to evaluate the effect of TIPS on liver function and survival.

Adult↗
PubMed1993

[The value of the AMBER system in demonstrating intrathoracic space-occupying lesions. A comparative ROC study of the AMBER and conventional technics for postero-anterior views of the thorax. Advanced Multiple Beam Equalization Radiography].

Since October 1991 the AMBER technique has been used for the diagnosis of chest diseases in about 4,000 patients. The ability of this technique, compared with conventional methods, for demonstrating intrathoracic masses on p.a. views has been assessed. Amongst the patients there were 43 with coin lesions, 18 with hilar and 33 with mediastinal masses. ROC analysis showed the AMBER technique to be superior in demonstrating coin lesions (AMBER 0.92, conventional 0.85) and mediastinal masses (AMBER 0.89, conventional 0.73). There was a small, statistically not significant, disadvantage in the AMBER technique for demonstrating hilar masses (AMBER 0.80, conventional 0.84).

Chi-Square Distribution↗
PubMed1993

Suramin prevents duck hepatitis B virus infection in vivo.

The effect of suramin on duck hepatitis B virus (DHBV) infection was investigated in vivo. Suramin pretreatment of Pekin ducklings completely prevented DHBV infection. In contrast, suramin given at the time of or after inoculation with DHBV did not inhibit viral infection, replication, or gene expression. These data indicate that suramin effectively blocks the early stages of DHBV infection in vivo.

Animals↗
PubMed1993

[Biliary fistula after concealed choledochal rupture in a polytraumatized patient].

This paper describes the case of a polytraumatised patient. Following primary care, a persistent fistulous wound developed. After initially good healing, the patient progressively deteriorated. Extensive diagnostic workup revealed a maximally elevated bilirubin concentration in the wound secretion. Five years previously, the patient had undergone a cholecystectomy. A leak in the common bile duct caused by the trauma was detected and was treated with a biliodigestive anastomosis with a Roux-Y loop, and bypass of the distal common bile duct.

Aged↗
PubMed1992

[Gallstones: etiology and risk factors].

Cholesterin is excreted into bile together with phospholipids and bile acids, which are essential for the formation of micelles. Cholesterin-supersaturation of the bile and a relative hyposecretion of bile acids, the presence resp. the lack of promotors and inhibitors of nucleation and a reduced gallbladder contractility are the most important factors in the formation of cholesterol stones. For the formation of pigment stones, however, an increase of bilirubin production and infection of the biliary tract are the causative factors.

Bile↗
PubMed1992

[Early diagnosis of hepatocellular carcinoma].

In every patient, in particular males of all ages presenting with chronically progressive diseases or cirrhosis of the liver, ultrasonography and an AFP test should be performed at intervals of six months. If hepatocellular carcinoma of the liver (HCC) is suspected (i.e. by increase of AFP or a positive result in ultrasonography), diagnosis should be confirmed by further investigations such as fine-needle biopsy guided by sonography, angiography and CT-scan. Adequate therapeutical measures such as resection of the tumor, chemotherapy, injection of alcohol or liver transplantation can thus be initiated in time. Besides efforts for early diagnosis of carcinoma of the liver, preventive measures (vaccination for hepatitis B, restrictive use of blood transfusion, reduction of alcoholism, thorough therapy of hemochromatosis, etc.) may contribute to the reduction of chronic diseases of the liver and of associated HCC.

Carcinoma, Hepatocellular↗
PubMed1992

[Hepatitis A to E: current diagnosis].

Diagnosis of viral hepatitis is based on epidemiologic data (information about travels, blood transfusions, contacts with persons suffering from hepatitis, etc.) and on results of physical examination and laboratory investigations. Usually, serologic and genomic analysis lead to the specific proof of the viral etiology: HAV, HBV/HDV, HCV and HEV. If these infections are not detected, nonviral causes of hepatopathy should be investigated (i.e. toxic, pharmaco-toxic, metabolic, immunologic, etc.).

Hepatitis Antibodies↗
PubMed1992

HIV-1 sensitivity to zidovudine and clinical outcome in children.

In adults with the acquired immunodeficiency syndrome, long-term monotherapy with zidovudine selects for human immunodeficiency virus type 1 (HIV-1) strains with substantially reduced in-vitro susceptibility to the drug. We have assessed the relation between in-vitro resistance to zidovudine and clinical outcome in children, in whom disease progression is more rapid than in adults. We studied 23 children with symptoms of HIV-1 disease during extended monotherapy with zidovudine. An in-vitro assay was used to determine the concentration of zidovudine required to inhibit by 50% the replication of viral isolates (IC50) obtained after 9 to 39 months of treatment. Viral stocks of high enough titre to yield reproducible results were obtained from 19 of the children. During the following 6 months of therapy, 9 children were stable, 7 deteriorated, and 3 died. There was a highly significant relation between decreased zidovudine susceptibility and poor clinical outcome (p less than 0.001) but no relation between IC50 and age at start of therapy or length of time on treatment. Age-adjusted CD4 lymphocyte counts were lower at the start of treatment (p = 0.02) and at the time of sampling (p = 0.01) in children whose viral isolates had an increased zidovudine IC50. Initial serum p24 antigen levels were not predictive of subsequent emergence of resistant virus, but at the time of sampling for viral sensitivity higher p24 antigen levels were associated with raised IC50 (p = 0.004). The findings suggest that most children who become unresponsive to monotherapy with zidovudine, as judged by clinical criteria, will have changes in in-vitro sensitivity to the drug. In these children, an alternative antiretroviral therapy should be considered.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Inhibition of duck hepatitis B virus infection by lysosomotropic agents.

The early phases of hepadnaviral infection were studied in primary duck hepatocyte cultures. Incubation of duck hepatocytes in vitro with duck hepatitis B virus (DHBV) resulted in infection with high levels of viral replication. The lysosomotropic agents ammonium chloride and chloroquine effectively inhibited viral infection, indicating that DHBV infection, similar to infection with other enveloped viruses, depends on receptor-mediated endocytosis and involves membrane fusion triggered by low pH.

Ammonium Chloride↗
PubMed1991

[Correspondence of mammographic and pathological-anatomical tumor extent in breast cancer].

Pre-operative mammograms and exact information on the pathological-anatomical extent of the tumour were available in 198 patients with carcinoma of the breast. The tumour as seen on the mammogram was measured and compared with the histological information. Five of the 198 carcinomas (2 1/2%) could not be seen on the mammogram. In 69.7% of cases, mammography was suspicious of a carcinoma and in 27.8% a lesion was found that required further investigation. In 67.7%, the mammographic and pathological tumour extent agreed within 3 mm. In 18.2% the tumour appeared more than 3 mm greater, and in 9.6% more than 3 mm smaller than real size; the error was greater than 30 mm in only 3.2%.

Adult↗
PubMed1991

Duck hepatitis B virus infection of non-hepatocytes.

One hundred and seventeen ducklings, 42 inoculated with duck hepatitis B virus (DHBV) 2 days after hatching and 55 connatally infected, were studied over a 6-month period in parallel with 20 ducklings without DHBV infection. Using immunohistochemical, in situ and blot hybridization analyses, the natural course of hepatic and extrahepatic infection was examined. DHBV infection started in the liver 2-4 days post-inoculation. There, DHBV was found not only in hepatocytes, but also in bile duct epithelial cells. Further, DHBV infection occurred in exocrine and endocrine pancreas (beginning 6-10 days and 20 days post-inoculation, respectively) and in germinal centers of the spleen (beginning 8 weeks post-inoculation). Occasionally viral DNA was also found in kidney glomeruli. Using strand-specific RNA probes, viral DNA in pancreas and spleen was clearly demonstrated to be replicating intermediates. Hepatic and extrahepatic infection with DHBV was not associated with histologic inflammation or pathologic changes in these tissues or the liver. These data indicate that DHBV can infect cells other than hepatocytes. The biological significance of non-hepatocyte infection for the life-cycle of the virus and its potential significance for viral persistence remain to be determined.

Animals↗
PubMed1991

Sulfated polyanions do not inhibit duck hepatitis B virus infection.

On the basis of the antiviral action of sulfated polyanions in human immunodeficiency virus and other viral infections, we studied the effect of dextran sulfate and heparin on duck hepatitis B virus infection. These agents do not affect viral uptake and replication in liver cells in vitro or in vivo. Sulfated polyanions, therefore, appear to have no potential for the treatment of hepadnavirus infections.

Animals↗