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Biomedical subjects

G Hildebrandt

Publications and source records attributed to G Hildebrandt.

At least 37 records · Page 2Linked to original sources
PubMed2000

Lymphocytic adenohypophysitis mimicking a pituitary macroadenoma.

A 24-year-old woman developed headache and rapidly progressive visual disturbances during the last trimester of her first pregnancy. Magnetic resonance tomography (MRI) of the brain documented an intra- and suprasellar mass lesion. For preservation of vision, transsphenoidal microsurgical decompression was performed. Immediately postoperatively, visual acuity improved and hemianopia resolved. Histological examination yielded the diagnosis of primary lymphocytic adenohypophysitis. This is a rare inflammatory pituitary disease. There are no typical clinical, laboratory, or radiological findings that allow precise preoperative diagnosis. Even though this autoimmune disorder is principally steroid-responsive, an improvement of visual disturbances under steroid therapy cannot be predicted. Therefore, surgery is justified not only to establish the diagnosis, but also to restore vision by decompression of the optic nerves and the chiasm.

Adenoma↗
PubMed2000

Acute deterioration of Charcot-Marie-Tooth disease IA (CMT IA) following 2 mg of vincristine chemotherapy.

BACKGROUND: Severe up to life-threatening neuropathy has been observed in patients with hereditary neuropathies receiving vincristine. CASE REPORT: A 52-year-old female painter suffering from high-grade non-Hodgkin's lymphoma (stage IVB) was treated with a total of 4 mg of vincristine during two courses of CHOP chemotherapy (cyclophosphamide, vincristine, adriamycin, prednisone). At onset of treatment no neurological problems were reported. There was good lymphoma response to chemotherapy. At the same time, however, the patient gradually developed dysphagia, dysarthria, muscular weakness of both lower and upper extremities, areflexia, paraesthesia of the fingertips and bilateral sensory impairment of feet and lower legs. These symptoms continually worsened over a period of seven weeks until she was unable to walk or to perform her work. Electrophysiological studies showed peripheral axonal and demyelinative sensorimotor neuropathy in correlation to histological findings. Molecular analysis revealed 17p11.2 duplication typical for Charcot-Marie-Tooth disease IA. While continuing chemotherapy without the use of vincristine the patient's neurologic symptoms slowly recovered within six months. CONCLUSION: Prior to administration of vincristine family and patient history as well as physical examination should be performed carefully to look for underlying hereditary neuropathy. For those patients with a clinical history or symptoms suggestive for CMT nerve conduction velocity studies and on an individual base even molecular genetic analysis are necessary to prevent serious neurologic complications. worsened significantly resulting in dependency on a wheelchair and inability to perform her work as a painter. Finally she consulted a neurologist and was admitted to hospital for further diagnostic studies and continuation of treatment for her lymphoma in March 1998 with a provisional diagnosis of severe vincristine-induced neuropathy. Medical history at time of admission included hyperthyroidism, that was currently treated with propylthiouracil, a MALT lymphoma 1983, that was treated surgically only, and a meningoencephalitis in 1968. No further medication was taken. In addition she had a history of Lyme disease since 1993 with positive IgM-titer until December 1997, when antibiotic therapy with doxycycline and ceftriaxone was administered successfully. Family history obtained on admission revealed that her mother had non-specific neuropathic symptoms as well as a poorly defined foot deformities of the mother's father. The patient's brother does not show any neurologic impairment and is in good physical health.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2000

Effects of low dose radiation therapy on adjuvant induced arthritis in rats.

PURPOSE: Substantial clinical evidence shows the efficacy of low dose radiotherapy (RT) in the treatment of painful osteoarthritis. Experimental investigations into these empirically clinical observations remain scarce. This study investigated in vivo the effects of daily 5 x 1.0 Gy versus 5 x 0.5 Gy on adjuvant induced arthritis in rats in order to explore whether there is a dose dependence of anti-inflammatory efficacy. MATERIALS AND METHODS: Adjuvant arthritis in female Lewis rats was induced by intradermal injection of heat inactivated Mycobacterium tuberculosis on day 0. Both hind paws were X-irradiated daily from days 15 to 19 after induction according to four protocols (15 animals/group): group 1, 5 x 1.0 Gy (non-arthritic animals); group 2, sham-irradiated control; group 3, 5 x 1.0 Gy; group 4, 5 x 0.5 Gy. The clinical parameters arthritis score (AS), hind paw volume (HPV), body weight, and erythrocyte sedimentation rate (ESR) were determined. On days 21 and 30 histological sections of at least 12 ankle joints per group were analysed semi-quantitatively. RESULTS: Local irradiation of non-arthritic rats (group 1) with 5 x 1 Gy did not induce any arthritic signs. Sham-irradiated arthritic rats (group 2) showed a full-blown arthritic syndrome. Treatment of arthritic rats with 5 x 1 Gy (group 3) or 5 x 0.5 Gy (group 4) led to a reduction of mean AS from day 21 to 29 compared with group 2 (days 27-29--group 3: p=0.037; group 4: p=0.034), with no differences in efficacy between groups 3 and 4. Concurrently, following radiation treatment there was no further increase in HPV. At the end of the observation period, this effect demonstrated a dose-dependent level of significance (days 27-29--group 3: p=0.0036; group 4: p=0.039). A significant decrease in the ESR was noted in both irradiated arthritic groups on day 21 (group 3: p=0.015; group 4: p=0.006). The histopathological analysis revealed a highly significant reduction of cartilage and bone destruction on day 30 in both irradiated groups. CONCLUSIONS: This study confirms by objective criteria the anti-inflammatory efficacy of low dose RT and gives some indication for a dose dependence of its efficacy.

Animals↗
PubMed2000

Extracranial vertebral artery dissection causing cervical root lesion.

The authors report an unusual manifestation of extracranial vertebral artery dissection (VAD), presenting with a predominantly motor radicular manifestation. Cervical magnetic resonance imaging (MRI) revealed the intramural hematoma in the dissected vessel wall, compressing mainly the segmental motor root and, to a lesser degree, the sensory ganglion. In the digital subtraction angiography (DSA), a circumscribed narrowing of the incriminated vessel was demonstrated. Color-coded Duplex imaging (CDDI) revealed complete recanalization after a few days of anticoagulation treatment. Complete neurologic recovery was seen after 3 months. Considering the MRI data, the likely pathogenetic mechanism was compression of the nerve root by the intramural hematoma. The synopsis with similar cases in the literature points to the characteristic features, i.e., the association of neck pain with radicular motor deficit and the absence of degenerative disk disease. The respective syndrome should raise the suspicion of vertebral artery dissection, especially in young individuals.

Adult↗
PubMed2000

[Results of the German investigation on the EU project "Salmonella in Pork (Salinpork)"--1. Investigations in the farms].

Reports of human salmonellosis caused by the consumption of pork and the introduction of control and surveillance programmes in different countries of the European Union were the reason for carrying out an international study under the title "Salmonella in Pork (Salinpork)": Six different EU-countries were involved in this study, which was supported by the Commission of the European Community and which was carried out over a period of April 1996 to April 1999. The aim of the investigation presented was to determine the prevalence of Salmonella in fattening, breeding and farrow-to-feeder herds as well as the determination of risk factors for the introduction of Salmonella into the farm (Part 1). In addition, sources of contamination of pork should be detected by taking samples of the product and the environment in the slaughterhouse (Part 2). In Germany, the investigation into Salmonella infections of 60 fattening, 20 breeding and 20 farrow-to-feeder herds were carried out in Schleswig-Holstein. The investigation included bacteriological examinations of feed and faecal samples for sero- and phagetyping and serological examinations by using the Danish Mix-ELISA. From 2,947 serological investigated fattening pigs were 7.3% (n = 213) positive, from 797 breeding sows 9.2% (n = 73) were serological positive and 4.5% (n = 18) of the investigated sows (N = 399) in farrow-to-feeder herds were serological positive. Altogether, 28.3% of the fattening, 50.0% of the breeding and 15.0% of the farrow-to-feeder herds were serological positive. A questionnaire was used to capture data about management, hygiene measures, feeding systems and the occurrence of diseases in the herd. After statistical analysis the common risk factor of fattening herds and sow herds was the use of pelleted feed. But in a control study with 17 different fattening herds the result could not be proven. Other factors which can influence the occurrence of Salmonella infections were discussed.

Animal Husbandry↗
PubMed2000

[Results of the German investigation in the EU Project "Salmonella in Pork (Salinpork)"--2. Investigations in a slaughterhouse].

In 1997 bacteriological examinations for the distribution of Salmonella in slaughterhouses were carried out in Germany within the framework of an international study "Salmonella in Pork (Salinpork)". During 6 days, 1,200 swab and water samples from slaughtered pigs and the environment were taken. 4.4% of the samples (n = 53) were Salmonella positive. S. typhimurium was isolated mainly (69.8%; n = 37), and 6 phagetypes were differentiated. In addition, S. derby and S. panama could be demonstrated. The resistance pattern of the different isolated S. typhimurium-phagetypes are presented. The phagetype DT 104 was multiresistant to ampicillin, spectinomycin, streptomycin, sulphonamide and tetracycline. In comparison with the serological prevalence of 7.3% of the fattening pigs in the farms (Part 1), only 1.0% of the samples taken from the surface of the carcass were Salmonella-positive. Swabs taken from the liver were in 2.7% positive and samples from the tongue gave in 5.3% of the cases Salmonella-positive results. In the examination of the environment Salmonella was demonstrated mainly from the water outlets, whereas Salmonella could not be isolated from water of the scalding tank. There was only one case (0.7%) in which Salmonella could be isolated from the hands of the personnel, and also only one swab of the polishing machine was positive (1.1%). But 6.7% samples of the saw were Salmonella-positive. A comparison of repeated, at intervals taken samples showed that the number of Salmonella-positive samples was higher in the last examination round of the particular slaughter days. The reason is suspected in the increasing number of slaughtered pigs and supplying farms, which may increase the probability of bringing in Salmonella.

Abattoirs↗
PubMed1999

Influence of age on the parasympatholytic property of tricyclic antidepressants.

Clinical evidence indicates that parasympatholytic effects of tricyclic antidepressants increase with age. The aim of the present study was to determine the possible physiological reason for this phenomenon. Subjects included 23 patients (14 female) with major depression, melancholic type, and 23 age- and sex-matched healthy control subjects. Cardiac vagal tone was measured at rest using both spectral analysis and a time domain beat-to-beat method. Results of the spectral and time domain methods for the estimation of vagal tone used in this study were highly correlated in control subjects as well as in medicated depressed subjects. Both patients and control subjects showed an age-related decline in cardiac vagal tone. Tricyclic antidepressants decreased vagal tone significantly by 25-49% depending on age (20-60 years), although the age difference was not significant. The greater effect of tricyclic antidepressants on parasympathetic activity typically seen in older age groups may reflect the fact that predrug levels of vagal tone are already low in older patients. Measurement of vagal tone prior to drug administration may therefore be of prognostic value for anticholinergic side effects.

Adult↗
PubMed1999

Brain death and organ donation in Germany: analysis of procurement in a neurosurgical unit and review of press reports.

OBJECTIVE: A prospective study was undertaken to determine the number of potential organ donors in a neurosurgical intensive care unit and to record the actual number of organ donations. The reasons for refusal of organ donations were analysed with respect to the controversial public discussion of the brain death concept and the transplantation law in Germany. METHODS: From 1994 to 1997, the number of cases of brain death, and the number of cases in which relatives consented or refused to organ donation as well as the number of actual organ explantations was recorded. Over the same period, press reports of 5 German language newspapers were analysed with regard to the authors' position on brain death and transplantation law, their qualification, intention, and mode of presentation. RESULTS: Annually, about 70 deaths occurred on the department's intensive care unit of which almost 30% of the patients were determined to have suffered brain death without any obvious contraindications against organ donation. The refusal rate of relatives rose from 56% up to 78%, and the rate of organ donors thus decreased from 5% in 1994 to 4% presently in the department. About 100 reports were published each year in the analysed newspapers, of which about 90% voiced approval of organ transplantation. During the review period, the depiction became more objective (57% in 1994 to 82% in 1997) and the suspicious attitude toward the technique of brain death diagnosis declined. Whereas 50% of the articles rejected the brain death concept in 1994, this figure decreased to 39% in 1997 and conversely the concept of consent rose from 33% in 1994 to 56% in 1997. CONCLUSION: In Germany, the relatives refusal rate in organ donation is continuously high, presumable due to a depressing 39% of press reports rejecting the brain death concept, and resulting in a very low number of organ donations. There is hope that the transplantation law which has finally passed German parliament in 1997, confirming the brain death concept as well as the legal principle of prior consent by the donor or consent by the relatives will eventually result in an increase of organ donation especially when supported by an educational campaign which is embodied in the transplantation law.

Adult↗
PubMed1999

Verification of electron field positioning.

The difficulties in verification of electron fields are due to the limited range of electrons within the human body. Modern linacs provide a special mode of operation (film mode), so that electron fields can be irradiated with a small photon dose. Thus, the images obtained can be used for comparison with the corresponding simulator images or DRRs to determine the electron field position and to detect positioning errors.

Breast Neoplasms↗
PubMed1999

Simplified preparation of a specific S. enteritidis antigen for ELISA and other immunological techniques.

This study was conducted to prepare a specific S. enteritidis antigen (FG-Antigen) for the serological detection of S. enteritidis infections in chicken flocks. This antigen (FG-Antigen) consistent mainly of the flagellar fraction H:g and partly of the fimbrial fraction SEF14 from a S. enteritidis-phage type 4 strain. The initial steps followed in the preparation of this antigen were conducted based on a previously described procedure, which involved the application of heat at 60 degrees C. The purification process (filtration and concentration) enabled the exclusion of the cross-reaction causing LPS antigens from the preparation and allowed the retention of S. enteritidis-specific antigens composed of fimbria and H:g fractions. As a result, no cross-reaction with S. typhimurium nor with S. gallinarum was exhibited by the prepared FG-antigen. To characterize and determine its specificity, the following laboratory tests were conducted: indirect ELISA, immunoblotting and a SEF14 agglutination test. In these examinations, rabbit and chicken reference sera as well as chicken field sera and absorbed hyperimmune sera against H:g-carrying serovars were used.

Agglutination Tests↗
PubMed1999

Detection of antibodies to S. enteritidis in broilers by means of indirect ELISA and chemiluminescent immunoassay (CLIA).

This study was conducted to develop a serological detection system for the monitoring of broiler flocks for Salmonella enteritidis infections. A specific S. enteritidis antigen (FG-Antigen) was used to compare the sensitivity and the specificity of the chemiluminescent immunoassay (CLIA) with those of the indirect ELISA. This comparison was performed using a total of 578 sera, which, depending on the microbiological and vaccination history, were categorized into groups. Most of the serum samples which were classified as positive showed higher titers in CLIA than in ELISA. Using the prevalence of positive reactors, significant differences between Groups were additionally demonstrated. The absorbance values of the passively immunized group showed the highest and those of the Salmonella-negative group the lowest correlation-coefficient. Using the mean net absorbance of the prevalence group, the ELISA system exhibited a sensitivity of 100% and a specificity of 96.2%, while CLIA had a sensitivity and a specificity of 85.7% and 96.2%, respectively. ELISA and CLIA can be used in the examination of non vaccinated flocks for S. enteritidis-infections as alternative to the bacteriological culture method. CLIA is distinguished for its fast and convenient procedure as well as for its wider measurement spectrum, while the indirect ELISA is almost as efficient as CLIA and requires less investment.

Animals↗
PubMed1999

Differentiation of alveolitis and pulmonary fibrosis in rabbits with magnetic resonance imaging after intrabronchial administration of bleomycin.

RATIONALE AND OBJECTIVES: The authors investigate the ability of magnetic resonance imaging to differentiate alveolitis and pulmonary fibrosis by correlating magnetic resonance and pathologic findings. METHODS: Lung damage was induced in 52 rabbits by instillation of 5 mL bleomycin sulfate (10 mg/kg) into a lower-lobe bronchus using a balloon catheter. Magnetic resonance examinations were performed in a group of 7 animals 3 hours after the initial damage, and in groups of 8 animals 24 hours and 8, 14, 30, and 80 days after the initial damage. Control animals were examined 3 hours (n = 5), 24 hours, and 8 days (n = 3 for each), respectively, after the instillation of 5 mL 0.9% sodium chloride. Magnetic resonance imaging at 1.5 T included conventional T1-weighted sequences before and after injection of gadolinium-DTPA (0.1 mmol/kg), and T2-weighted fast spin echo sequences. The signal intensity and contrast enhancement of injured lung were evaluated and compared with the contralateral healthy lung and with the lungs of control animals. All animals were killed immediately after the magnetic resonance examination, and the lungs were removed and fixed before sectioning and staining. RESULTS: There was good correlation between signal intensity and contrast enhancement with magnetic resonance imaging and histologic examination. The early phase of acute alveolitis showed lesions with high signal intensity on both T1- and T2-weighted images and marked contrast enhancement after gadolinium-DTPA administration, whereas in the late fibrotic stage the lesions displayed significantly lower signal intensity and contrast enhancement. CONCLUSION: Magnetic resonance imaging can differentiate between alveolitis and fibrosis by means of signal intensity and contrast enhancement after gadolinium-DTPA administration.

Animals↗
PubMed1999

A new technique for oral endotracheal airway access in rabbits under fluoroscopic control: An easy way for drug administration in chronic experiments.

Endotracheal drug administration plays an important role in rabbit models of pulmonary injury and lung disease. However, anatomical features of the oral fissure and pharynx of rabbits make orotracheal intubation a difficult task with a high failure rate. We developed a new technique for airway access in rabbits under fluoroscopic control using a balloon catheter. The procedure consists of four major steps: (1) a shortened 5-french vertebralis catheter is placed into the mesopharynx just above the epiglottic valve, (2) through the catheter lumen a guidewire is carefully moved across the epiglottis and inserted into the trachea, (3) the vertebralis catheter is replaced by a balloon catheter that subsequently is introduced into the tracheal tree over the guidewire, and (4) with the balloon catheter in the right position the guidewire is removed and the balloon is inflated so that finally the drug can be delivered. This procedure was performed in 55 New Zealand White rabbits under general anesthesia with ketamine/xylazine. In all 55 cases the procedure was performed successfully without any major complications and within a reasonably short time period. Removal of the catheter and awakening of the animals were uneventful. The described technique is a simple and safe method for airway access in rabbits and can be useful in chronic experiments for endotracheal drug administration.

Animals↗
PubMed1999

[Coupling of immunomagnetic separation and polymerase chain reaction for the rapid detection of salmonellae in minced meat and chicken giblets].

Coupling of immunomagnetic separation and polymerase chain reaction was used after preenrichment for the rapid detection of salmonellae in minced meat and chicken giblets. The primers used are specific to the origin of DNA replication (oriC) on the Salmonella chromosome and produce a 163 bp DNA fragment. The method allowed a screening of Salmonella free samples within 24 hours. It detected 5 serovars when inoculated in minced meat at a contamination level of 1 to 4 cfu/g. Compared with the method L 00.00-20 of the Official Collection of Methods of Analysis according to section 35 of the German Law on Food and Commodities it showed a sensitivity of 94% and a specificity of 87.5% for the examination of chicken giblets (n = 45) and a specificity of 100% for the examination of minced meat (n = 63).

Animals↗
PubMed1999

Straussenhaltung in Deutschland / Straussenfleisch aus Namibia--ein Fallbeispiel. [Ostrich husbandry in Germany / ostrich meat from Namibia - a case study].

Within the European Union, academic professions themselves are expected to reach a comparable level of professionalism, a fact that veterinary medicine as well should not ignore. At present, a working group is developing a concept of a teaching module for the Socrates programme "Education in Veterinary Public Health (VPH)", enabling the students by "case studies" to be induced to an integrated approach of tackling problems. In an attempt to demonstrate the didactic procedure, a study of ostrich meat as food for human consumption is presented as a concrete example. In the detailed teacher's guide, informations are given about ostrich husbandry, slaughter procedure and meat inspection, as well as detailed explanations how the health of human consumer can be safeguarded by the introduction of the HACCP system.

Animal Husbandry↗
PubMed1999

Management of vein of Galen malformations. A review based on five neurosurgically treated cases and literature reports.

The high morbidity and mortality associated with the management of vein of Galen aneurysmal malformations (VGAM) continues to pose a tremendous challenge to the neurosurgeon as well as to the attending interventional radiologist. Since 1985, five patients with VGAM have been referred to the neurosurgical unit of the University of Cologne, two neonates, one infant and two adults. Four patients underwent direct operation and two patients received a shunt. The treatment was performed without mortality. A review of the literature reflects no substantial difference between neurosurgical treatment during the last 15 years (mortality 10%) and endovascular treatment (best series mortality 6%).

Adult↗