Biomedical subjects
Publications and source records attributed to G Meyer.
Bovine herpesvirus 1 (BHV-1) induces apoptotic cell death in bovine peripheral blood mononuclear cells and B-lymphoma cells. Using a BHV-1 glycoprotein H null mutant, we have demonstrated that although penetration of BHV-1 is not required, attachment of BHV-1 viral particles is essential for the induction of apoptosis.
UNLABELLED: The purpose of our study was to compare the results of planar and SPECT scintimammography for the detection of breast carcinoma. In addition, our goal was to determine whether SPECT reconstructed with filtered backprojection (FBP) or with iterative algorithms (ISA) can improve the sensitivity and specificity of planar scintimammography (SMM). METHODS: One hundred thirteen patients with suspicious physical examinations and/or mammography underwent planar lateral and anterior breast imaging as well as SPECT imaging after injection of 99mTc-sestamibi. We used a blind evaluation, both separately and combined, for planar SMM, ISA-SPECT and FBP-SPECT. Scintigraphic findings were correlated with the final histopathological diagnoses. RESULTS: The sensitivity of planar SMM was 80% with a specificity of 83%. All ISA-SPECT studies were of diagnostic quality, while FBP-SPECT was considered nondiagnostic in 14 that were excluded for statistical calculation. Sensitivity of ISA-SPECT and FBP-SPECT were 71% and 69%, respectively. Specificity was 70% for ISA-SPECT and 66% for FBP-SPECT. Combined planar SMM plus ISA-SPECT sensitivity was 85% (81% for planar SMM plus FBP-SPECT) with a specificity of 72%. Three carcinomas indeterminate on planar SMM were correctly identified by combined planar SMM plus ISA-SPECT. ISA-SPECT and FBP-SPECT provided additional information to planar SMM with respect to localization of sestamibi uptake, tumor extent, improved diagnostic certainty and detection of axillary nodes in 40 and 14 patients, respectively. CONCLUSION: ISA reconstruction is the preferable approach to SPECT data. Combined with planar SMM, ISA-SPECT can improve sensitivity. SPECT is useful in cases of indeterminate and positive planar SMM.
For the creation of a gastrostomy percutaneous endoscopic technique should be the method of first choice. If impossible a laparoscopic procedure should be preferred to a conventional one. Laparoscopic Janeway-gastrostomy might have some advantages compared to Kader-Stamm-Fistulas. We present the results with this method which we have used since 1993 in 12 patients. The postoperative course of these patients with mainly malignant diseases of ENT (n = 4), esophagus (n = 3) and thyroid gland (n = 3) as well as two non-malignant underlying diseases is presented and discussed in the light of recent publications. The Janeway-gastrostomy is an effective, easily feasable and safe procedure that ensures a good palliation also due to easy handling and care.
UNLABELLED: Aim of the present study: Laparoscopy offers a novel surgical approach for splenectomy. This prospective study with 35 patients requiring splenectomy examines the surgical and hematologic as well as oncologic safety of this procedure. METHODS: In 35 patients (16 male, 19 female) hematologic, surgical and clinical data were obtained prospectively to evaluate the surgical and hematologic as well as oncologic safety of laparoscopic splenectomy. Long-term follow-up data are available for 23 patients at a median of 17 months postoperatively. RESULTS: Mean operation time was 130.0 +/- 8.5 minutes and despite of blood loss > or = 1000 ml (n = 5) no significant intraoperative complications were observed. Mean blood loss was 460.0 +/- 69.2 ml and blood transfusions were necessary in 3 cases (8.6%; 1 x autologous blood). Mean organ weight was 270.5 +/- 34.7 g. Mean hospital stay postoperatively was 4.3 +/- 0.3 days and 2 revisions were necessary (5.7%). A significant rise in platelet count from 114.8 +/- 14.6 G/l to 235.0 +/- 23.6 G/l was observed postoperatively which could be confirmed in long-term follow-up (213.4 +/- 32.0 G/l; p < 0.05). Thrombocytopenic patients also showed this significant rise in platelet count. The initially significant fall in hemoglobin from 13.5 +/- 0.4 g/dl to 10.9 +/- 0.3 g/dl returned to 14.0 +/- 0.4 g/dl at follow-up. Anemic patients showed a significant rise of hemoglobin at follow-up evaluation (p < 0.05). In this series of 35 consecutive patients to conversion was necessary, no mortality was observed, perioperative morbidity was 2.9% and hematologic success could be achieved in 20 (85.7%) patients available for follow-up evaluation. CONCLUSIONS: Laparoscopic splenectomy is a safe and successful surgical procedure in patients requiring splenectomy for benign hematologic diseases. This approach offers the advantages of minimal invasive surgery and should be considered in all patients requiring splenectomy.
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Proteins associated with lipid vesicles or mixed micelles of human gallbladder bile were separated by Sepharose-2B gel filtration chromatography followed by protein concentration and delipidation. After two-dimensional polyacrylamide gel electrophoresis and silver staining up to 59 and 471 polypeptide spots were counted in vesicular and micellar fractions, respectively. As major components the plasma proteins transferrin, albumin, alpha-fibrinogen, beta-fibrinogen, gamma-immunoglobulin G, immunoglobulin light chains, alpha-1 antitrypsin and haptoglobin alpha-2 chain were identified in the lipid vesicles by comparison with human protein reference maps. However, most biliary proteins including the anionic polypeptide fraction are associated with mixed micelles. The pathophysiological significance of these proteins associated with lipids needs to be investigated further.
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BACKGROUND: Herpes zoster is a common affliction in older patients, with up to 15% experiencing some residual pain in the distribution of the rash several months after healing. Despite numerous randomized clinical trials, the effect of treating herpes zoster with oral acyclovir in preventing postherpetic neuralgia remains uncertain because of conflicting results. METHODS: Meta-analysis of published randomized clinical trials on the use of acyclovir to prevent postherpetic neuralgia using the fixed-effects model of Peto. RESULTS: Thirty clinical trials of treatment with oral acyclovir in immunocompetent adults were identified. After excluding studies with duplicate data, suboptimal and topical dosing, non-placebo-controlled or nonrandomized designs, and those using intravenous acyclovir, 5 trials were found to be homogeneous and were combined for analysis. From these trials, the summary odds ratio for the incidence of "any pain" in the distribution of rash at 6 months in adults treated with acyclovir was 0.54 (95% confidence interval, 0.36-0.81). CONCLUSION: Treatment of herpes zoster with 800 mg/d of oral acyclovir within 72 hours of rash onset may reduce the incidence of residual pain at 6 months by 46% in immunocompetent adults.
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S-Carbocysteine-lysine salt monohydrate (S-CMC-Lys) has been shown to open a Cl- channel in the trachea, thus aiding fluid secretion. The aim of this study was to characterize the channel and the action mechanism on a culture line of human respiratory epithelial cells. The patch-clamp technique (in cell-attached or inside-out configuration) and conventional micro-electrodes were used. The activity and density of a cAMP-dependent Cl- channel, identical to the cystic fibrosis transmembrane regulator (CFTR) channel, proved to be maximally stimulated by 100 microM S-CMC-Lys present in the cAMP-free cell incubation medium for 240-290 min (cell-attached configuration). Subsequent addition of cAMP to the medium did not determine any further activation. S-CMC-Lys acted mostly indirectly as, when placed in direct contact with a membrane patch, activation of the CFTR channel was nil (cytoplasmic side) or limited (external side).
A cross-sectional study was performed on all of 10029 school-beginners in Munich in 1994 to investigate the vaccination status of measles, mumps and rubella immunisation. The objective of the study was to determine socio-demographic and psychological factors affecting the MMR vaccination rate. Data were received from 81.8% of all 10029 school-beginners. The vaccination rate was 86.1% for measles, 84.5% for mumps and 72.9% for rubella (missing values not included). Low overall vaccination rate was found in not first-born children, children of parents with non-german nationality, in children of parents with a low socio-economic status, in children accompanied by a working parent, and in children accompanied by a smoking parent. Children without any denomination also showed a lower vaccination rate. Girls had a higher vaccination rate for rubella than boys. A higher overall vaccination rate for MMR was associated with parents considering these infections to have a high impact for people's health. Vice versa children of parents considering adverse effects of vaccination against MMR as an important impact on health had significant lower vaccination rate. The results of a multiple logistic regression model showed two factors significantly affecting the MMR vaccination rate: Physician's recommendation and individual attitude towards medicine seem to have the most important influence on decision making for or against vaccination. In conclusion MMR vaccination strategies have to be improved. New ways such as, no vaccination--no school's should be considered for Germany.
In intact tissue, DAGO ([D-Ala2, MePhe4, Gly-ol5]enkephalin; 10(-5) M; mu-ligand; addition on the serosal side) stimulated D-glucose absorption and D-glucose-dependent variations in short-circuit current (delta Isc,glu); naloxone (10(-6) M) antagonized these effects. DADLE ([D-Ala2, D-Leu5]enkephalin, mainly a delta-ligand; 10(-5) M) and (pCl-Phe4)-DPDPE ([D-pen2, p-chloro-Phe4, D-Pen5]enkephalin, a more selective delta-ligand; 10(-5) M) did not significantly stimulate delta Isc,glu (addition on the serosal side). In the absence of the muscularis and myenteric plexus or using intact tissue treated with tetrodotoxin (TTX; 3 x 10(-7) M), DAGO was unable to increase delta Isc,glu. Addition of DAGO to the mucosal side did not induce any variations in delta Isc,glu. In conclusion, DAGO is able to increase D-glucose absorption by interacting with mu-receptors located in the myenteric plexus.
Since the introduction of antibiotics into clinical practice, purulent pericarditis has become a rare disease. The major complication of the standard management for this condition is constrictive pericarditis. We report two cases of purulent pericarditis in which intrapericardial fibrinolysis was performed in order to minimize this complication. The first case was a 38-year-old man admitted to our intensive care unit (ICU) for management of constrictive pericarditis complicating purulent pericarditis diagnosed 17 days previously. The patient was treated with four intrapericardial injections of streptokinase (250,000 IU each). Fluid drainage and cardiac output were improved. No change in clotting parameters was noted. Pericardiectomy and esophagectomy were then performed for a diagnosis of esophageal neoplasm. The postoperative course was uneventful. The second case was a 16-year-old boy admitted with loss of consciousness due to cardiac tamponade. Percutaneous pericardiocentesis drained 900 ml of cloudy fluid. Two intrapericardial injections were performed (day 1 and day 5) without any complication. Pericardial drainage was withdrawn on day 13 and the patient was discharged from ICU on the same day. Six months later, there was no evidence of constrictive pericarditis. Intrapericardial fibrinolysis appears to be safe and effective when prescribed rapidly in the course of purulent pericarditis.
This study evaluated and compared technetium-99m sestamibi scintimammography (SMM) and breast magnetic resonance imaging (MRI) results in patients with indeterminate mammograms to determine whether either technique can improve the sensitivity and specificity for the diagnosis of breast carcinoma. From 123 consecutive patients who underwent physical examination, mammography, SMM, and histopathologic confirmation, a subgroup of 82 patients presenting with indeterminate mammograms was studied. Sixty-eight patients underwent contrast-enhanced MRI. SMM results were scored on the basis of the intensity and pattern of sestamibi uptake. MRI images were scored on the basis of signal intensity increase after administration of contrast material as well as the enhancement pattern and speed of gadolinium uptake. The results obtained with the two techniques were compared and related to the final histopathologic diagnoses. Considering indeterminate findings as positive, the sensitivity of SMM was 79% and the specificity, 70%. MRI displayed a sensitivity of 84% and a specificity of 49%. When indeterminate results were considered negative, the sensitivity and specificity of SMM were 62% and 83%, respectively. MRI revealed a sensitivity and specificity of 56% and 79%, respectively. The calculated sensitivities and specificities demonstrate the diagnostic limitations of both SMM and MRI in the evaluation of patients with indeterminate mammographic findings. Due to the higher specificity, SMM may be the preferred modality in the evaluation of selected patients with breast abnormalities.
The nucleotide sequence of a 10.5 kb region (map position 0.332 to 0.410) of bovine herpesvirus type 1 (BHV-1) was determined. This region contained three open reading frames (ORFs) homologous to herpes simplex virus DNA polymerase catalytic subunit (DNApol, UL30), major DNA-binding protein (MDBP, UL29) and ICP18.5 assembly protein (ICP18.5, UL28). The BHV-1 DNApol. MDBP and ICP18.5 ORFs were 1246, 1203 and 826 amino acids long with a calculated molecular mass of 134.2 kDa, 124.4 kDa and 86.9 kDa, respectively. They showed a high homology with alphaherpesvirus homologs despite large differences in the G + C content of the UL30-UL28 segment ranging from 44.4% for varicella zoster virus to 71.5% for BHV-1. Particularly well conserved among Alphaherpesvirinae are the putative functional domains of the DNApol and MDBP proteins which are discussed. Phylogenetic analysis revealed that BHV-1 clustered in the Varicellovirus genus with the animal D-type viruses. In this group, the BHV-1 position was shown to vary according to the investigated genes. Indeed, pseudorabies virus clustered with BHV-1 in the DNApol tree but with equine herpesvirus 1 in the ICP18.5 tree.
BACKGROUND: Pulmonary embolism often occurs in elderly patients. However, clinical presentation and treatment of massive pulmonary embolism (PE) in the elderly have not been extensively investigated. We report the results of rt-PA bolus infusion in patients aged 75 years or more suffering from massive PE. METHODS: Fifty-four adult patients referred to our institution with symptoms suggestive of massive PE were included in a therapeutic trial of single-chain rt-PA. Patients with a Miller angiographic score of at least 20/34 were considered for entry into the study. Patients were divided into two groups according to their age. Clinical presentation at admission, resolution of scintigraphic vascular obstruction, death rate, hemorrhagic complications, recurrent pulmonary embolism and long-term follow-up were compared between both groups. RESULTS: Twenty-eight patients were less than 75 years old and 26 patients were aged 75 years or more. Clinical symptoms at admission were similar in both groups. The mean absolute improvement in the lung scan perfusion defect, the rate of major bleeding, and the long-term evolution were not statistically different between older and younger patients. CONCLUSION: Clinical presentation and tolerance of massive PE did not differ between elderly and non-elderly patients. Old age should not preclude thrombolytic therapy in massive PE, provided there are no other contraindications for thrombolytic treatment.
gamma delta T cells are implicated in autoimmune diseases but their precise function remains unclear. In multiple sclerosis (MS) brain tissue, gamma delta T cells co-localize with heat shock protein (hsp)65+ oligodendrocytes and are oligoclonally restricted in the V delta 2J delta 3 lineage. To investigate the homing properties and the degree of heterogeneity of V delta 2J delta 3+ gamma delta T cells in MS, peripheral blood lymphocytes (PBL) from 34 MS patients, 42 controls (14 autoimmune control patients, 28 healthy volunteers), and 11 lymphatic tissues of MS patients and controls were studied by RT-PCR and sequencing. V delta 2J delta 3 TCR rearrangement was detected in 27 out of 28 healthy controls, and was significantly less frequent in MS patients (24 out of 34) and autoimmune control patients (seven out of 14). It was present only in five out of 11 tissue specimens, none of them from MS patients. Direct sequencing and cloning/automated sequencing of the V delta 2J delta 3 PCR products indicated heterogeneity in healthy controls and oligoclonality in MS patients, but also in autoimmune control patients. Differences between MS patients and healthy controls were more accentuated in exacerbating hospitalized patients than in clinically stable outpatients participating in a clinical trial. Only one V delta 2J delta 3 sequence of a total of 85 different sequences obtained was shared between two MS patients. Taken together, evidence for clonal expansion of V delta 2J delta 3+ gamma delta T cells was found in PBL of MS patients. This T cell subset, previously shown to be present in 100% of chronic-active MS plaques, might home to the CNS in MS, resulting in its under-representation in the blood.
An unusual case of life-threatening visceral larva migrans (toxocariasis) is reported herein. The patient was admitted with acute dyspnea and bilateral pleural effusion; rapidly pericardial tamponade developed. Blood and body fluid eosinophilia were elevated. Extensive investigations revealed no malignant process or vasculitis, but Toxocara infection was confirmed by rising specific antibody titers. The high seroprevalence of Toxocara antibodies, particularly in children, suggests that a diagnosis of visceral larva migrans should be considered before a diagnosis of systemic hypereosinophilic syndrome even when clinical presentation is unusual. Prophylaxis against this widespread polymorphic zoonotic infection is desirable in view of the potentially dramatic consequences of infestation.