Biomedical subjects
Publications and source records attributed to G Hein.
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A rat interleukin 4 receptor (IL-4R) cDNA was cloned by polymerase chain reaction (PCR) using RNA of Con A activated T cells and primers deduced from mouse and human IL-4R sequences. Sequence analysis revealed an open reading frame for a putative membrane protein of 800 amino acids in length. It comprises an overall identity of 52 and 78% to its human and mouse homologues, respectively. The extracellular part of the rat IL-4R contains a number of residues including cysteines and a WSXWS motif typical for the cytokine receptor superfamily. Analysis of amino acid exchanges between rat and mouse IL-4 receptors deciphered for replacement (R) or silent (S) mutations suggested different types of selective pressure acting on the extracellular and intracellular domains. A high R/S value that indicates selective pressure for amino acid exchanges was found for the extracellular domain and a low R/S value for the intracellular part of the IL-4R. Since we previously found a similar high R/S value in the rat IL-4 gene encoding the ligand for the IL-4R, the high amino acid exchange rate can best be explained by coevolution between IL-4 and the ligand binding domain of the IL-4R to improve or retain affinity.
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Expression of cytokines in tumor cells provides a sensitive modality to analyze the consequences of local cytokines in vivo on tumor infiltrating cells and tumorigenicity. We have transfected Chinese hamster ovary (CHO) cells with an interleukin 10 (IL-10) expression vector. CHO-IL10 cells although unaltered with respect to their in vitro growth lost tumorigenicity, both in nude and in SCID mice and in an IL-10 dose dependent manner. In addition, CHO-IL10 cells suppressed the growth of equal numbers of coinjected but not of contralaterally injected CHO cells. Immunohistology with anti-CR3/Mac-1 and anti-Mac-3 monoclonal antibodies revealed that CHO tumors were substantially infiltrated by macrophages. However, in CHO-IL10 tumors macrophages were virtually absent within the tumor tissue. Our results suggest that IL-10 indirectly suppresses tumor growth of certain tumors by inhibiting infiltration of macrophages which may provide tumor growth promoting activity.
Sera from 80 patients suffering from rheumatoid arthritis--30 of them with extraarticular manifestations (EAM)--were analyzed for the presence of IgE rheumatoid factors (IgE RF), IgM RF, and immune complexes. Despite of a close correlation between IgM RF and IgE RF, IgE RF allow a better discrimination between patients with and without EAM (73.3 and 38.0%) compared to IgM RF (86.7 and 78.0%). IgE RF could be found in 5% of patients suffering from bronchial asthma, but up to now not in nonrheumatic joint diseases.
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Leg lengthening procedures have developed rapidly in the last 20 years, especially distraction epiphyseolysis and corticotomy. We have used both methods since 1977 and carried out 22 distraction epiphyseolyses (20 patients) and 33 corticotomies (28 patients). The average lengthening distance was 8.25 cm and 7.8 cm respectively (minimum 4 cm, maximum 18 cm). The time per cm lengthening (lengthening index) was 45.8 days/cm for epiphyseolysis and 52.2 days/cm for corticotomy. The complication rates were similar in both methods (1.18 and 1.21 pro lengthening procedure). Both techniques are preferably performed by a well trained team of physicians, nurses and physiotherapists for correction of leg length discrepancies.
To demonstrate an as yet merely postulated generalized osteopathy in psoriatics, the serum calcium level, the alkaline phosphatase in the serum and the urinary excretion of hydroxyproline were evaluated in 24 patients with Ps and 24 patients with PA. Moreover, the bone bioptates from 25 patients with PA and 10 patients with Ps were examined histologically and measured morphometrically. The investigations provide evidence for the existence of a generalized "latent" osteopathy in terms of an elevated bone turnover rate without loss of bone volume (high turnover remodelling) in both patients with PA as well as those with Ps without arthritis. As a pathogenetically essential factor shared by dermatosis and "osteopathy", latent vitamin D deficiency and/or D hormone resistance is discussed.
The sera of 80 patients suffering from rheumatoid arthritis (RA)--30 of them with extraarticular manifestations (EAM) and 50 patients with articular disease only--of 25 patients with other joint diseases and of 30 normal healthy subjects, were analyzed for the presence of 1) IgE rheumatoid factors (IgE RF) by means of a solid phase radioimmunoassay and an ELISA, 2) IgM rheumatoid factors by using solid phase radioimmune techniques, and 3) circulating immune complexes (CIC) with the C1q binding test (C1q BT) and the solid phase conglutinin binding test (SPCBT). The best technique to discriminate RA patients with EAM from RA patients without EAM and patients with other articular diseases was the determination of IgE RF (73.3%, 38.0%, 0%, resp.) compared to IgM RF (86.7%, 78.0%, and 56.0%) and CIC (C1q BT: 80.0%, 66.0% and 45.0%; SPCBT: 46.7%, 22.0%, and 20.0%). The results suggest a certain role of IgE RF for diagnosis and a possible development of extraarticular manifestations in rheumatoid arthritis.
We have used Ilazorov's method of distraction epiphyseolysis for leg lengthening since 1977 and his new method of corticotomy or compactotomy since 1983. The first method was carried out in 22 lower limbs with an average lengthening of 8.25 cm (range 4 to 18 cm); included in this group are 2 patients with achondroplasia in whom both legs were lengthened 12 cm. In the second method, a corticotomy is carried out at the metaphyseal-diaphyseal junction followed by distraction in Ilazorov's apparatus (4 x 0.25 mm a day). We lengthened 30 legs; included are 5 patients who had both legs lengthened from between 8 and 12 cm. In the remainder an average of 7.9 cm of lengthening was achieved (range from 4 to 15 cm). The index for the treatment time per cm achieved (time from operation until full weight-bearing per cm of lengthening) was shorter after distraction epiphyseolysis than after corticotomy. Complications were also a little less after the latter procedure. Distraction epiphyseolysis has to be limited to children from aged 12 years until growth ceases. The advantage with corticotomy is that it can be done at any age from 5 to 30 years. Care is needed in both cases to avoid complications.
Treatment of relapsed or neglected clubfeet between the age of 8-15 years is at present unsatisfactory. Correction by triple arthrodesis with wedge osteotomies is not possible before the end of skeletal maturation. This caused us to use Ilizarov's external fixator, which made it possible to correct all components of clubfoot simultaneously by continuous guided distraction. Thirteen feet in 12 children were treated. A plantigrade foot was achieved in all cases. All patients were able to wear ready-made shoes. Complications were some slight and two severe pin track infections, temporary edema, and two relapses successfully treated by means of second procedures.
In 23 patients with psoriatic arthritis and 9 patients with psoriasis without joint involvement, we took bone biopsies from the iliac crest. Histomorphometrical investigations showed that the volume density of the bone was not decreased in either group of patients, but we found a high rate of turnover remodelling. An elevated rate of bone turnover is regarded as the characteristic principle of "psoriatic osteopathy", which--more exactly--should be called "latent osteopathy". Deficiency of vitamin D is discussed as a possible etiological factor.
In the morning urine of 24 patients with psoriasis and that of 24 patients with psoriatic arthritis, we determined the excretion of hydroxyproline (mg HP/mumol crea), after preceding diet low in collagen. Surprisingly, psoriatic patients without articular involvement showed a significantly higher excretion of HP than those with psoriatic arthritis. Further differentiation revealed that there were no clear-cut correlations between the amount of HP excretion and the activity of the articular process; we proved, however, that the amount of HP excretion was definitely related to the activity of the skin eruptions in both groups of patients. We discuss whether an osteopathy pathogenetically associated with the skin disease (irrespective of synovitis in psoriatic arthritis) may possibly be responsible for these results.
In order to make evident an up to now only postulated generalized osteopathy in psoriatics in 24 patients with psoriasis and 24 patients with psoriatic arthritis the serum-calcium levels, the alkaline phosphatase in the serum and the excretion of hydroxyprolin in the urine were determined. Moreover, the bone bioptates of 25 patients with psoriatic arthritis and 10 patients with psoriasis were histologically examined and morphometrically measured, respectively. The examinations give evidence for the presence of a generalized "latent" osteopathy in the sense of an increased bone turnover rate without loss of bone volume (high turnover remodeling) in patients with psoriatic arthritis as well as in those with psoriasis without arthritis. As a common pathogenetically significant factor for dermatosis and osteopathy a latent vitamin D deficiency and a D-hormone resistance is discussed.
The early diagnosis and treatment of congenital dislocation of the hip cannot prevent the manifestation of luxation in every case. The following operative treatment should include not only the open reposition, but also all deformities of the upper femur and the acetabulum. This combined procedure is already possible in the infancy starting from the 6th month. The correction of increased antetorsion and CCD-angle alone respectively the increased acetabular angle is not indicated. The spontaneous normalization of the not operated part of the hip can be find only in a minimal part of cases. The stabilization of bone defect in the acetabuloplastic by Dega is performed by allogenic deep frozen cortico-cancellous bone grafts successfully.
Five alk(en)ylsulfinothioic acid alk(en)yl-esters isolated from onions and four synthetic thiosulfinates inhibited 5-lipoxygenase of porcine leucocytes, histamine release and leukotriene B4 and C4 biosynthesis of human polymorphonuclear leucocytes, thromboxane B2 biosynthesis by human platelets and allergen- and PAF-induced bronchial obstruction of guinea-pigs. The anti-asthmatic and anti-inflammatory effects of onions depend in part on the thiosulfinate moiety: (Formula: see text).
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