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Biomedical subjects

G Enders

Publications and source records attributed to G Enders.

159 records · Page 9Linked to original sources
PubMedDate not supplied

Detection of human cytomegalovirus in urine samples by cell culture, early antigen assay and polymerase chain reaction.

With the advent of effective therapy rapid, sensitive and reliable assays for diagnosis of human cytomegalovirus (HCMV) infections are required. In a total of 1,928 urine samples, detection of HCMV-immediate early antigen in a spin amplified microplate culture by a monoclonal antibody and immunoperoxidase staining (EA-assay) was compared with virus isolation in cell culture. Sensitivity of the EA assay was 85.5% and specificity was 99.5% compared with virus isolation. Overall agreement of both assays was 97.8%. In addition, in 235/1,928 urine samples amplification of HCMV-DNA was performed by means of polymerase chain reaction (PCR) using primers from the immediate early (IE1) gene region and 141/1,928 using primers from the late region (LA). The sensitivity of PCR compared with virus isolation was 67.8% for IE1 primers and 94.1% for LA primers (statistical significance: p < 0.01, Chi-square-test). Overall agreement between virus isolation and PCR was 88.5% for IE1-PCR and 84.4% for LA-PCR. Discordant results were more often found in adults with acute infection and immunocompromised patients than in infants.

Adolescent↗
PubMedDate not supplied

Parvovirus B19 diagnosis in pregnant women--quantification of IgG antibody levels (IU/ml) with reference to the international parvovirus B19 standard serum.

On the basis of the results of a collaborative study the Expert Committee on Biological Standardisation of the World Health Organisation has issued an international standard (IS) serum for parvovirus B19 IgG antibody (NIBSC 93/724). In this study this IS was used to calibrate an in-house standard serum for reporting the results of parvovirus B19 IgG testing in IU/ml. The IgG titre distribution in 939 pregnant women was determined. These samples were sent to the laboratory for determining the immune status to parvovirus B19 following contact with parvovirus B19 infected individuals or for detecting acute infection in patients with symptoms suggestive of parvovirus B19 infection.

Adult↗
PubMedDate not supplied

Acute parvovirus B19 infection in pregnant women--an analysis of serial samples by serological and semi-quantitative PCR techniques.

The serological and virological course of parvovirus B19 infection was followed in 14 women who suffered symptomatic or subclinical acute infection during pregnancy. Serial serum samples from the patients were tested for IgG and IgM antibodies and the levels of parvovirus B19 DNA were monitored using a semi-quantitative PCR assay. In addition, the outcome of the pregnancies was documented by clinical information and by testing cord blood for parvovirus B19 specific antibodies as well as for parvovirus B19 DNA by PCR. Levels of IgG antibodies rose steadily within 2 months of infection and in some cases began to decline at the end of pregnancy. IgM antibodies were usually detected for at least 2 months and persisted for as long as 9 months in one case. Viral DNA was detectable for at least 8 weeks following infection and semi-quantitative analysis revealed a gradual reduction in virus load during the viraemic phase of infection. There were no apparent differences in the course of antibody development and duration of viraemia in symptomatic versus subclinical infections.

Antibodies, Viral↗
PubMedDate not supplied

Fast and type-specific analysis of herpes simplex virus types 1 and 2 by rapid PCR and fluorescence melting-curve-analysis.

Diagnosis of central nervous system (CNS) infection with herpes simplex virus (HSV) requires sensitive and rapid techniques. PCR therefore is considered to be the diagnostic gold standard in these cases. However, current PCR protocols are time-consuming and labor-intensive. In addition, the need for post-amplification manipulations increases the risk of laboratory contaminations with amplified products. In order to improve conventional PCR techniques we compared our current semiautomated HSV-PCR-ELISA assay with a new micro-volume rapid-cycle PCR system that combines real-time monitoring and fluorescence melting-curve analysis without the need for post-amplification sample manipulations. Spiking experiments with supernatants of tissue culture-grown HSV type 1 (HSV-1) and type 2 (HSV-2) in HSV-negative control cerebrospinal fluid (CSF) and sterile water revealed that the new rapid cycle PCR protocol is as sensitive and specific as the PCR-ELISA. Furthermore, a mismatch (G:T) within the probe-targeted region of the HSV-2 glycoprotein B gene decreases the probe/product melting temperature (Tm) from 69 degrees C for HSV-1 to 64 degrees C for HSV-2, enabling the simultaneous identification of the two HSV genotypes by melting-curve analysis within one run. This type specificity of the system was confirmed with 30 genital swabs previously analyzed for the presence of HSV-1/2 in cell culture. While our current PCR-ELISA method needs up to 1 day from sample preparation to result generation, the new procedure takes only 1 h. We consider this system as a promising new tool for the analysis of HSV DNA in CSF and in other human body fluids as well as for the diagnosis of other infectious agents where rapid diagnosis, high sensitivity and specificity are required.

Central Nervous System Infections↗
PubMedDate not supplied

[Intrauterine herpes simplex virus infection].

BACKGROUND: Early fetal herpes simplex virus (HSV) infection is rarely documented. Only the minority of affected fetuses survive this condition. PATIENT AND METHODS: At 19 weeks of gestation the first episode of a genital HSV-infection of a pregnant woman was treated with local interferon beta. At 34 weeks of gestation hydrocephalus with secondary microcephaly and microphthalmia of both eyes was detected by ultrasonography. In the amniotic fluid HSV type 2 (HSV-2) was isolated and HSV-2-DNA was detected by PCR. The serum of the mother proved positive for HSV-2 (glycoprotein G2)-specific IgG-antibodies. No other infectious causes were apparent on further testing. At 35 + 4 weeks gestation a small-for-gestational-age neonate (2130 g) with microcephaly (29 cm head circumference) was born by spontaneous vaginal delivery. Scarce ulcerative skin lesions and vesicles, hepatosplenomegaly and microphthalmia were diagnosed. Furthermore, encephalomalacia with parenchymal destruction, cataract of both eyes and aplasia of the maculae and papillae were found. HSV-2-PCR was tested positive in chorionic cells and an umbilical segment of the placenta as well as in swabs from both eyes, throat, and a herpetic skin lesion collected during the first 5 days of life. HSV-IgM-antibodies were found in the umbilical cord blood. Local and intravenous treatment with aciclovir was started. The infant exhibited signs of a severely malfunctioning central nervous system. At the age of 4 months the boy suffered from generalised cerebral seizures. He died at the age of 9 months as a consequence of respiratory insufficiency with consecutive circulation failure. RESULTS: The case of an intrauterine HSV-2-infection is presented. The time of onset of fetal infection was most probably at the time of the maternal disease (19 weeks of gestation). Inspite of the very early infection the fetus did not die in utero. CONCLUSIONS: Especially, if a primary genital HSV-2-infection of a pregnant woman is suspected, which can be proven by serological means only several weeks after infection, systemic therapy of the mother with aciclovir should be considered since materno-fetal transmission may occur due to the risk of maternal viraemia.

Abnormalities, Multiple↗
PubMedDate not supplied

[Diagnostic and therapy of a severe fetal parvovirus-B19-infection with persistence of viral DNA in the mothers blood but inconspicuous serological tests. Case report].

In the 24th week of gestation we diagnosed a severe hydrops fetalis in a 25 year old VI gravid III para, who had contact to parvovirus B19 in the 14th week of gestation. Because of the severe anaemia of the fetus and the massively increased bilirubinoides in the amniotic fluid we decided at the same day to apply the first of four intrauterine transfusions. The serological patterns of maternal blood with highly positive parvovirus-B19-IgG and negative IgM suggested that an infection had occurred. Parvoviral DNA was found in maternal and fetal blood confirming the diagnosis of an acute intrauterine parvovirus-B19 infection. No viral DNA was detected in fetal ascites. IgM in fetal blood was negative. By means of four transfusions, the pregnancy could be prolonged until the 32 + 5th week of gestation while the ascites was declining. When rupture of membranes occurred, a cesarean section had to be performed due to contractions and presentation of the feet. The newborn's blood count exhibited a thrombocytopenia with normal haemoglobin and haematocrit. Five days after delivery, a blood exchange had to be done because of a hyperbilirubinaemia. After seven weeks, the child could be dismissed from hospital in good general status, with decreasing ascites, normal liver function and normal neurological status. The blood of the newborn was tested to be positive for IgG, while IgM-antibodies and parvovirus-B19-DNA were negative. The diagnosis of a parvovirus-B19 infection of a fetus with severe hydrops and anaemia could be verified by a positive proof for DNA in maternal blood, with negative IgM and highly positive parvovirus-B19-IgG and on the other hand highly positive viral DNA in fetal blood and in the amniotic fluid. 10 weeks after contact to parvovirus B19, i. e. in the 24th week of gestation, positive IgG- and negative IgM-antibodies were found in the mother's blood, whereas fetal complications were noticed. These data demonstrate that following an acute parvovirus-B19-infection of the mother IgM-antibodies can be proofed for 6 - 8 (- 10) weeks. On the other side parvovirus-B19-DNA in the mothers blood is detectable by means of PCR for 8 - 10 weeks and in some cases even more than 15 weeks.

Adult↗
PubMedDate not supplied

Rubella antibody titers in vaccinated and nonvaccinated women and results of vaccination during pregnancy.

In the Federal Republic of Germany (FRG), the selective rubella vaccination strategy used in the United Kingdom was followed until 1980, when vaccination of children was introduced. According to surveys in the Stuttgart area, so far no significant reduction in the rate of seronegativity (10%) among postpubertal women has occurred. However, among women with a history of vaccination, the rate of seronegativity has decreased to 2.4%. For the vaccinated group the percentage of women with low levels of rubella antibody (23%) is significantly higher than for women without a history of vaccination (9.5%). In the study of the outcome of accidental vaccination during pregnancy or shortly before conception, which has followed up 365 women so far, 194 infants have been born without signs of congenital rubella syndrome (CRS). Also no cases of CRS were noted in 98 infants born to women known to be susceptible to rubella at the time of vaccination. When the data obtained in the United States and Stuttgart on the outcome of accidental vaccination are combined, the theoretical maximum risk of CRS calculated is as low as 1.2%.

Adolescent↗
PubMedDate not supplied

Serologic test combinations for safe detection of rubella infections.

Today a great number of serologic tests, including commercial kits, are available for rubella antibody testing. The performance and quality of various commercial tests (ELISA Enzygnost [Behring], Rubazyme [Abbott], Rubenz M [Northumbria/Biosigma], single radial hemolysis [e.g., Koch & Merk]) with a great number of selected sera were compared with those of conventional methods (hemagglutination-inhibition test, sucrose density gradient ultracentrifugation), and certain test combinations were selected. These proved useful for safe and rapid diagnosis of the stage of natural, vaccinal, and congenital rubella infection and for the determination of the immune status in pregnant women.

Antibodies, Viral↗
PubMedDate not supplied

Can we continue research in splenectomized dogs? Mycoplasma haemocanis: old problem--new insight.

We report the appearance of a Mycoplasma haemocanis infection in laboratory dogs, which has been reported previously, yet, never before in Europe. Outbreak of the disease was triggered by a splenectomy intended to prepare the dogs for a hemorrhagic shock study. The clinical course of the dogs was dramatic including anorexia and hemolytic anemia. Treatment included allogeneic transfusion, prednisone, and oxytetracycline. Systematic follow-up (n = 12, blood smears, antibody testing and specific polymerase chain reaction) gives clear evidence that persistent eradication of M. haemocanis is unlikely. We, therefore, had to abandon the intended shock study. In the absence of effective surveillance and screening for M. haemocanis, the question arises whether it is prudent to continue shock research in splenectomized dogs.

Animals↗
PubMedDate not supplied

Late onset of hydrops fetalis following intrauterine parvovirus B19 infection.

We present a case of intrauterine parvovirus B19 infection, diagnosed by detection of B19 DNA in the amniotic fluid obtained at 15 weeks of gestation for chromosome analysis in an asymptomatic pregnancy, causing hydrops fetalis 7 weeks later. Following intrauterine transfusion, rapid resolution of hydrops could be observed and a healthy boy was born at 38 weeks of gestation. The respective laboratory data obtained from the examination of the amniotic fluid and maternal, fetal, and neonatal blood offer interesting insights into the dynamics of maternal-fetal parvovirus B19 infection.

Adult↗
PubMedDate not supplied

[Virus and other infections in pregnancy: diagnosis and prevention. 2].

The various viral and other microbial infections represent only a small proportion (5-10%) of the noxae which threaten pregnancy and the fetus. However, interest is centered on them because methods of controlling them are now available. These include preventive measures, e.g., active immunization prior to pregnancy for measles, mumps, and rubella; passive prophylaxis with immunoglobulins when the pregnant women comes into contact with, e.g., rubella and varicella, and passive-active prophylaxis with hyperimmunoglobulin and simultaneous active immunization of the newborns from HBsAg and HBeAg-positive resp. anti-HBe-negative mothers and early therapy. The latter is possible for acute herpes simplex and toxoplasmosis infection; it is effective for lues and infections with gonococci, listeriae, beta-hemolytic streptococci, chlamydiae and mycoplasmas. In cases of acute rubella during the first 17 weeks of pregnancy termination of pregnancy must also be considered a prophylactic measure. Laboratory diagnosis today includes, in addition to the conventional tests for antibodies and pathogens, determination of IgG (permanent) and IgM (early) antibodies as well as demonstration of antigens. Depending on the type of pathogen and the diagnostic problem, several types of serologic tests must be combined for rapid determination of the immune status on contact or for detection of acute infections in pregnancy; necessitating in some instances also the isolation of the pathogen. Diagnostic procedures are similar for identifying prenatal and perinatal infection with and without abnormalities in the neonate. Modern laboratory diagnosis is therefore very important for prophylactic and therapeutic measures in pregnancy as well as for further management and supportive care of congenitally infected infants.

Adolescent↗
PubMedDate not supplied

Clinical approaches to male infertility with a case report of possible nifedipine-induced sperm dysfunction.

BACKGROUND: Male infertility has many causes, and recently it has been suggested that calcium channel blockers might contribute to male infertility. METHODS: A case consistent with nifedipine-induced male infertility is described. MEDLINE was searched for articles on the effect of calcium channel blockers and the general causes of infertility, with an emphasis on male infertility, using the key words "nifedipine," "male infertility," "sperm," and "calcium channel blockers." RESULTS AND CONCLUSIONS: Male infertility induced by calcium channel blockers should be included in the differential diagnosis of infertile couples in appropriate cases. Whether a calcium channel blocker could be developed as a male contraceptive remains to be determined. Further studies are needed to determine the prevalence of infertility among men taking calcium channel blockers.

Adult↗