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Biomedical subjects

G Fischer

Publications and source records attributed to G Fischer.

At least 307 records · Page 17Linked to original sources

[The artery of the thumb metacarpophalangeal joint].

As a rule, a small artery passing through the palmar plate runs into the thumb metacarpophalangeal joint. Frequently, the joint vessel arises from the arteria princeps pollicis, and rarely from the arteria metacarpalis dorsalis I or from muscle branches of the arteria princeps pollicis. In 30% of our specimens we could find a third larger palmar thumb artery. To our knowledge, this vessel was not described up to now precisely. Frequently arising from the arteria princeps pollicis, it passes the whole region of the metacarpophalangeal joint of the thumb. Distally, the artery runs within the floor of the flexor pollicis longus tendon sheath. After a mean distance of 19.7 mm, the vessel passes through the wall of the tendon sheath between the A 1-pulley and the oblique pulley. This vessel anastomoses with the arteria radiopalmaris pollicis proximal to the junction of the digitopalmar arch. According to the nomenclature of anatomic variations in the forearm, we suggest to name the additional thumb vessel "Arteria mediana pollicis".

Adult↗

[Occupational risk factors for pharyngeal cancer. Results of the Heidelberg Pharyngeal Cancer Study].

We carried out a case-control study on the role of occupational factors on the risk of pharyngeal cancer. The study was performed at the Department of Otorhinolaryngology/Head and Neck Surgery of the University of Heidelberg and comprised 105 male patients with squamous cell carcinoma of the oropharynx and/or hypopharynx and 420 randomly selected control subjects who were matched for age, sex and residential area (1:4 matching design). The study showed that 34.3% of the cancer patients and 10.1% of the control subjects worked in the construction industry. As construction workers were 26.7% of the cancer patients and 7.1% of the control subjects employed, the relative risk of pharyngeal cancer in construction workers was estimated to be 2.5 (C.I. 1.1-5.5, adjusted for alcohol and tobacco consumption). After further adjustment for alcohol and tobacco consumption, an increased risk of pharyngeal cancer was found for workers exposed to cutting oils (RR = 3.7; C.I. 1.2-11.8), iron dust (RR = 2.7; C.I. 1.0-7.0) asbestos cement (RR = 2.5; C.I. 1.0-6.1), cement (RR = 2.2; C.I. 0.9-5.2) and coal/tar products (RR = 3.6; C.I. 0.8-17.3).

Adult↗

Performance of indirect embolectomy aided by a new developed flush-suction catheter system. Forty-seven experimental embolectomy procedures in test animals.

Embolectomy by means of the Fogarty catheter is the therapy of choice in the event of acute occlusions of limb arteries. However, less invasive catheter procedures have become established means to perform embolectomies lately. In order to improve the results after using the above mentioned methods, we have developed a new embolectomy procedure. The system applied consists of a flush-suction catheter as well as a high pressure pump. There is a jet-suction unit on the head of the tubular two-lumen catheter to gather thromboembolic material from the circumference of the head, to erode the collected material and evacuate it. The flushing pressure is generated by the pump. For the experimental testing of the system, the flush-suction embolectomy has been performed in 19 pigs after 47 artificial produced extremities embolism. Angiographically and angioscopically it could be proved that even older thrombotic material could be removed completely and without significant trauma of the vessel. At the pathologic investigation of the vessel in which embolectomy had been performed in no case an essential vessel-wall damage could be found. In almost each case the embolic material was removed completely. Only in 5 cases (10.6%) we have distal microembolism. Due to the experimental tests, the system turns out to be reliable as far as the technique is concerned. In addition, in the event of clinical application, the system allows the expectation of a reduction of the time interval between diagnosis and therapy, as well as a percutaneous application.

Angiography↗

Use of surface markers for MR radiotherapy planning.

PURPOSE: For the precise planning of radiotherapy treatment ports, the delineation and control of their borders has to be performed with X-ray and other imaging procedures before and during the therapy. MATERIALS AND METHODS: Conventional planned therapy ports are checked with the help of MR-imaging with new gel-markers, as a further development to formerly used fluid filled tubes, on the skin of the patient in different regions. We describe the essentials of these gels and report about their first practical use. RESULTS: Principal considerations to the technique and practical applications are given with imaging examples. The essential physical qualities of the gels are introduced with separate NMR experiments. It turns out, that multiplanar MR-imaging in combination with field markers on the skin is a fast simple and useful help for the control and the improvement of treatment planning. CONCLUSION: MR-imaging with gel-markers on the skin in many cases can show the tumor and the field-ports in one picture. Thus the therapy planning is refined with simple means. On the one hand the target volume can be seized completely and on the other hand sensitive organs can better be protected.

Humans↗

Differential effects of DNA-binding proteins on bidirectional transcription from the common promoter region of human collagen type IV genes COL4A1 and COL4A2.

Expression of the heterotrimeric collagen IV (alpha 1(IV))2 alpha 2(IV) is essential for the structural integrity and functional properties of basement membranes. The genes COL4A1 and COL4A2 coding for both subunits are located close to each other on the same chromosome and are transcribed from a common bidirectional promoter element. Binding of at least three different nuclear proteins could be detected within this promoter, a CCAAT-binding protein, Sp1 and a newly identified factor, designated 'CTCBF'. Mutagenesis of binding sites proved that these factors are essential for the efficient transcription of both genes, but revealed differential gene-specific effects. Therefore, the common promoter region of collagen IV does not represent an equally functional bidirectional element, but may be better understood as two overlapping gene-specific promoters with shared elements.

Base Sequence↗

Identification of a novel sequence element in the common promoter region of human collagen type IV genes, involved in the regulation of divergent transcription.

The expression of the heterotrimeric collagen IV molecule alpha 1(IV)2 alpha 2(IV) is essential for the structural integrity and functional properties of all basement membranes. The two genes COL4A1 and COL4A2 that code for the subunits are found closely linked on chromosome 13 in a head-to-head arrangement and are transcribed in divergent directions. We have identified a novel trans-acting factor that binds in vitro to a unique homopyrimidine/homopurine stretch within the shared promoter region of the two collagen IV genes. Additional binding sites have been identified within the first introns of both genes and the consensus sequence CCCTYCCCC for efficient binding has been deduced; the factor was named therefore 'CTC-binding factor' or 'CTCBF'. Mutations in the binding site of CTC-binding factor within the promoter inhibited binding in vitro and resulted in reduced transcription from both genes. The effect of mutations on the transcription of COL4A2 is more pronounced than on the transcription of COL4A1. CTC-binding factor is a nuclear factor that binds dominantly in vitro to the collagen IV promoter and is involved in regulating the expression of both collagen IV genes.

Base Sequence↗

The cis/trans interconversion of the calcium regulating hormone calcitonin is catalyzed by cyclophilin.

The cytosolic peptidyl-prolyl cis/trans isomerase cyclophilin from pig kidney can accelerate catalytically the cis/trans isomerization of prolyl peptide bonds. One- and two-dimensional 1H NMR spectroscopy was used to prove that the polypeptide hormone calcitonin is a substrate for cyclophilin. Isomerization of only one of the two prolyl peptide bonds is catalyzed significantly. The efficiency of catalysis was calculated by lineshape analysis and NOESY spectroscopy. Cyclosporin A completely blocks the effect of the enzyme on the conformational dynamics of the polypeptide.

Amino Acid Isomerases↗

Epiphysial ossification centres in iliosacral joints: anatomy and computed tomography.

Bilateral apparently bony structures of different forms and sizes located in the inferior and superior ventral parts of the sacroiliac joints were observed on axial CT images of the pelvic region of juvenile patients. No other pathological changes were noted in the sacroiliac joints of these individuals. In one patient the bony structures could also be seen on a conventional plain radiograph. We also examined 3 juvenile autopsy specimens of this joint using radiology, CT, macroscopical evaluation and histology. In two of them, structures could be detected on the CT scans which were similar to those observed in the young patients. Macroscopic investigations revealed the structures to be secondary ossification centres located in the articular cartilage of the lateral part of the os sacrum at the levels of the first and third sacral segments. According to older anatomical literature, these epiphysial ossification centres contribute to the auricular surface of the lateral part of the os sacrum and the free lateral surface of the inferior sacral parts. They can be observed between the ages of 12 and 25 years and begin to synostose with the lateral part around the age of 18 years. In macerated juvenile specimens of the bony pelvis, free ossicles were not detectable in the region of the sacroiliac joints. Histological peculiarities of the ossification process observed are discussed. These physiologically occurring ossification centres are to be differentiated from pathological alterations appearing as bony or bone-like structures on CT scans.

Adolescent↗

No proof of linkage between schizophrenia-related disorders including schizophrenia and chromosome 2q21 region.

We examined linkage between schizophrenia and schizophrenia-related disorders and five genetic markers on chromosome 2 in fourteen families ascertained through affected probands in St. Louis and Vienna. The chromosomal region 2q21 was considered a candidate locus for schizophrenia because of a report of a balanced translocation 2;18 (q21;q23) in a schizophrenia family. Linkage analyses were conducted for three disease models: a narrow model including schizophrenia only; an intermediate model including a spectrum of schizophrenia-related disorders; and a broad model including major affective disorders. Multipoint linkage analyses excluded linkage across the region (about 50 cM) for the intermediate disease model. The same was generally true for the broad affection status model. None of the two-point and multipoint analyses showed definite linkage of schizophrenia to any marker. The most prominent positive association was between D2S44 and a broad affection status model, giving a two-point lod score of 1.71 at 0.20 recombination fraction.

Adult↗

Manometry of esophageal varices: comparison of an endoscopic balloon technique with needle puncture.

BACKGROUND: A noninvasive technique of pressure measurement in esophageal varices using an endoscopic balloon has been shown to be reliable in vitro. In the present study, this method was tested in vivo. METHODS: Thirty-seven pressure measurements in esophageal varices were performed in 34 patients by two independent operators (A and B) using an endoscopic balloon and compared with measurements performed by needle puncture by a third operator (C). RESULTS: Three measurements performed with the endoscopic balloon were rejected because they were noninterpretable. Measurements performed by A and B correlated well (correlation coefficient, 0.90); interobserver variability (r) was 0.88. Of 37 punctures performed for pressure measurements, 4 resulted in bleeding and 8 measurements were rejected as uninterpretable. Regression analysis showed a good correlation between the needle puncture and balloon techniques for pressure measurements performed by both operators (y = 5.3 + 1.0x, r = 0.8; y = 6.2 + 0.9x, r = 0.8), and analysis of variability showed a measurement bias of -5.3 +/- 4.1 and -4.1 +/- 3.5 cm H2O. No significant difference in variceal size measured with the endoscopic balloon or endoscopic forceps was found. CONCLUSIONS: The endoscopic balloon allows measurement of pressure in esophageal varices without hazard to the patient; in addition, it may be used to assess the varix size.

Adult↗

Tubulo-papillary adenoma (so-called nephrogenic adenoma) arising in the renal pelvis. Report of a case with a critical consideration of histogenesis and terminology.

This is the first detailed clinical and histopathologic report of a tubulo-papillary adenoma (so-called nephrogenic adenoma) arising in the renal pelvis of a 35-year-old woman. The tumor showed a polypoid exophytic growth and consisted of closely packed tubular formations lined by cuboidal to low columnar cells with an admixture of delicate papillary structures. Its benign nature was indicated by the lack of cellular atypias, the extremely low proliferative activity and the absence of invasiveness. We favor the metaplastic theory of origin rather than an embryologic (dysontogenetic) derivation from mesonephric remnants as the underlying histogenetic principle. The descriptive term "tubulo-papillary adenoma" seems more appropriate than the designation "nephrogenic adenoma". True tumors of this type should clearly be distinguished from metaplastic tubular, papillary or tubulo-papillary cuboidal hyperplasias of the urothelium (so-called nephrogenic metaplasia) which are considered preneoplastic and assumed to be immediate precursors of adenomas of the lower urinary tract.

Adenoma↗

Analysis of virulence factors of Legionella pneumophila.

Legionella pneumophila, the causative agent of Legionnaires' disease is a facultative intracellular bacterium, which in the course of human infection multiplies in lung macrophages predominantly manifesting as pneumonia. The natural habitat of Legionella is found in sweet water reservoirs and man-made water systems. Virulent L. pneumophila spontaneously convert to an avirulent status at a high frequency. Genetic approaches have led to the identification of various L. pneumophila genes. The mip (macrophage infectivity potentiator) determinant remains at present the sole established virulence factor. The Mip protein exhibits activity of a peptidyl prolyl cis trans isomerase (PPIase), an enzyme which is able to bind the immunosuppressant FK506 and is involved in protein folding. The recently cloned major outer membrane protein (MOMP) could play a role in the uptake of legionellae by macrophages. Cellular models are useful in studying the intracellular replication of legionellae in eukaryotic cells. Human cell lines and protozoan models are appropriate for this purpose. By using U 937 macrophage-like cells and Acanthamoeba castellanii as hosts, we could discriminate virulent and avirulent L. pneumophila variants since only the virulent strain was capable of intracellular growth at 37 degrees C. By using these systems we further demonstrated that a hemolytic factor cloned and characterized in our laboratory, legiolysin (lly), had no influence on the intracellular growth of L. pneumophila.

Bacterial Outer Membrane Proteins↗

DNA HLA-DR typing results of 4000 kidney transplants.

Recipients (4076) and donors (3325) of kidney transplants performed at 110 transplant centers were typed for HLA-DRB by the DNA RFLP method. The discrepancy rate of replicate samples distributed among 8 participating laboratories was a low 2.6%. The discrepancy rate between RFLP-DRB and serological HLA-DR typings was 25.0% for organ donors and 27.6% for kidney recipients. Discrepancy rates at the different transplant centers ranged from 9.7% to 86.7%. The discrepancies consisted of antigens being incorrectly interpreted by serology (16.8%), and of serological "blanks" turning out to be definable alleles by the DNA method (10.8%). The alleles that were mainly affected by discrepancies were DR1, DR8, DR10, DR12, DR13, DR14, DR16, DR17.2, and DR18.

Alleles↗

Accumulation of gamma delta T cells in chronic cutaneous lupus erythematosus.

Monoclonal antibodies (moAbs) that recognize common or variable determinants of the gamma delta T-cell receptor (TcR) were used to assess gamma delta T-cell distribution on biopsy specimens and/or peripheral blood leukocytes (PBL) from 30 patients suffering from chronic cutaneous lupus erythematosus (CCLE). CD3+/gamma delta TcR + T cells were evaluated in 15 biopsies from patients with CCLE lesions, their numbers varying from 0.5 to 15.0% of all intralesional CD3 +T cells present. In all specimens from lesional skin gamma delta TCR+T cells were BB3 + and/or Ti gamma A +, indicating predominant use of the V gamma 2/V delta 2 phenotype. In the CCLE lesions the intraepidermal V gamma 2/V delta +T cells were observed in close vicinity to the damaged basal keratinocyte (KC) layer, and also randomly scattered among the densely packed inflammatory infiltrate in the dermis. In contrast to the immunohistologic findings, no numerical increase of gamma delta TcR+T cells could be observed among PBL from 28 of 30 CCLE patients. Only one CCLE patient being treated with hydroxychloroquine for two months had 15% CD3 +/gamma delta TcR+T cells among the PBL. Based on the immunohistologic findings one may infer that in CCLE, a skin-restricted form of LE, V gamma 2/V delta 2 +T cells expand extrathymically to an as yet unknown stimulus. One may also propose that these gamma delta T cells--based on their cytotoxic capacity--may contribute to the epidermal damage. It remains to be determined whether the extrathymic expansion of V gamma 2/V delta 2 +Tells occurs within lesional skin or in the periphery within subsequent recruitment into skin lesions. The results obtained by fluorescence-activated cell sorter analysis favor the first possibility.

Alleles↗

Immunophilins: structure-function relationship and possible role in microbial pathogenicity.

Immunophilins are housekeeping proteins present in a wide variety of organisms. Members of two protein superfamilies, cyclophilins (Cyps) and FK506-binding proteins (FKBPs) belong to this class of immunophilins. Despite the fact that the amino acid sequences of Cyp and FKBPs do not exhibit noticeable homology to each other, proteins of both classes are able to ligate immunosuppressive peptide derivatives. Cyps form complexes with the cyclic undercapeptide cyclosporin A and FKBPs are able to bind FK506 as well as rapamycin, both of which have a pipecolyl bond within their structure. In a ligand-bound form, immunophilins interfere with signal transduction in T cells. In addition, immunophilins have peptidyl prolyl cis-trans isomerase (PPlase) activity and are able to accelerate the rate of conformational events in proline-containing polypeptides. Microorganisms produce proteins that exhibit extensive sequence homologies to cyclophilins and FKBPs of higher organisms and which have considerable PPlase catalytic activity. While cyclophilins seem to be present in most if not all microbial species investigated, FKBPs are produced by yeasts as well as by a number of pathogenic bacteria, such as Legionella pneumophila, Chlamydia trachomatis and Neisseria meningitidis. The Mip protein of L. pneumophila is a virulence factor that plays an essential role in the ability of the bacteria to survive and multiply in phagocytic cells. Some results are summarized on the structure and putative functions of immunophilins and place special emphasis on the contribution of these polypeptides to the virulence of pathogenic microorganisms.

Amino Acid Isomerases↗

Natural distribution of 5 bacteria associated with periodontal disease.

The purpose of this study was to determine the prevalence and distribution of 5 bacterial pathogens in subgingival plaque, their relationship with each other and probing depth. Plaque was collected from 6905 sites in 938 subjects. A bacterial concentration fluorescence immunoassay and bacterial specific monoclonal antibodies were used to determine the presence and level of P. gingivalis (Pg), A. actinomycetemcomitans (Aa), P. intermedia (Pi), E. corrodens (Ec) and F. nucleatum (Fn) in each plaque sample. The prevalence in subjects was lowest for Pg (32%) and highest for Ec (49%). The site-based frequency distribution of these bacterial species ranged from 10.3% for Pg to 18.7% for Ec. Pi and Ec were the bacterial combination most often found together in a subject (27.2%). While 64.0% of the sites were without any of the 5 bacterial species evaluated, 20.2% had only 1 of the 5 bacterial species evaluated. The remaining 15.8% of sites had at least 2 bacteria species present. There was a general linear association of the detection level of bacterial species and probing depth. The odds ratios were 3.9 (Pg), 3.0 (Aa), 4.0 (Pi), 2.7 (Ec) and 2.8 (Fn) of finding high levels of these bacterial pathogens at > 5 mm probing depth (p < or = 0.01). Mean probing depth at molar sites without a specific bacteria was greater (p < or = 0.01) in subjects with a specific bacterium compared to molar sites in subjects without the bacteria.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Analysis of HLA-DR matching in DNA-typed cadaver kidney transplants.

The effect of matching for HLA-DR antigens was analyzed retrospectively in 3455 cadaver kidney transplants that were typed by the DNA-RFLP method. HLA-DR matching improved the one-year graft survival rate significantly (P < 0.01). Importantly, in 718 first transplants in which the number of mismatches assigned by serological typing was different from that assigned by DNA typing, only the DNA results showed a significant impact of matching on graft outcome (P = 0.03). These results demonstrate that DNA typing is clinically relevant. We were unable to confirm that the HLA-DR6 specificity or the DR6-split DRB1*1302 are associated with poor graft survival.

Cadaver↗