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Biomedical subjects

H Ebner

Publications and source records attributed to H Ebner.

At least 37 records · Page 2Linked to original sources

[Comparative studies of the effectiveness of specific immunotherapy in house dust mite allergy].

In a prospective study, 60 patients with allergic rhinoconjunctivitis and/or asthma due to house dust mites were chosen for hyposensitization treatment with Migen (M) or Pharmalgen (P). Immunotherapy stretched over a whole year and every 3 months clinical results were evaluated by the patient's symptom score, by results of skin prick and conjunctival provocation tests, as well as by RIA and ELISA regarding the total and specific IgE and also specific IgG and IgG4 levels. Out of 30 patients of the M group, 15 were followed up over the whole therapeutic regimen, 4 of whom showed a very good, 7 a good to moderate clinical outcome and 4 showed no improvement at all. In the P group, 17 out of 30 patients were followed up whereby 9 showed a very good and 8 a good to moderate response. In both groups of patients a statistically significant decrease in skin and conjunctival sensitivity to mite allergens was observed after 12 months of therapy. However, there was no correlation between this observation and the failure or success of immunotherapy. Furthermore, in both groups there was significant increase in total and specific IgE (with a slight decrease after 6 to 12 months) and also in specific IgG and IgG4 (especially in the P group), but again these changes in antibody levels gave no indication of a good or bad clinical outcome. Hence, we believe other reasons than the usually presented thesis of inducing "blocking antibodies" by immunotherapy to be responsible for the well-known effects of hyposensitization.

Adult

The mechanism of angioplasty--endoscopic and morphometric investigations in an experimental model.

The effect of angioplasty using two different sizes of balloon catheter were examined by angiography and angioscopy before and after dilatation. A significant increase in the outer and inner diameters was seen accompanied by a decrease in the cross sectional area of the stenoses as well as the thickness of the vascular wall. Angioscopy revealed typical longitudinal tears of the plaque edges which are pressed during flow against the vessel wall. Turbidity of saline could be seen after dilatation indicating possible rupture of the atheromatous plaque. These findings are discussed in the light of the mechanisms of angioplasty and the possible reasons for the good early and long-term results.

Angioplasty, Balloon

Characterization of Micropolyspora faeni antigens by human antibodies and immunoblot analysis.

IgG, IgM and IgA antibody responses against Micropolyspora faeni (Mf) antigens were studied by means of immunoblotting experiments using 70 sera derived from three groups of farmers, namely patients with extrinsic allergic alveolitis (EAA) due to thermophilic actinomycetes (n = 25), patients without EAA but with hay exposure (n = 14), and patients suspected to have EAA (n = 31), and 27 sera from two groups of control persons (healthy laboratory workers, n = 13; healthy farmers, n = 14). Patients with EAA showed IgG, IgM and IgA antibody responses mainly against the antigens with molecular weights (MW) of 11, 12, 25, 35 and 60 kD ("major antigens"), and in addition, but less often, against six antigens with MW in the range of 15 to 62.5 kD ("minor antigens"). The other two groups of patients and also the exposed control persons showed very similar results; however, the antibody response in healthy farmers was substantially weaker in comparison to the three groups of patients and was almost limited to the major antigens with MW 11, 25 and 60 kD. Although patients with proven EAA had higher amounts of antibodies, there was no correlation between this antibody response and the onset of disease. The results indicate the necessity of including at least the major antigens with MW of 11, 25 and 60 kD in all extracts used for in vitro diagnosis of Mf-induced EAA.

Adult

IgE and IgG antibodies of patients with allergy to birch pollen as tools to define the allergen profile of Betula verrucosa.

IgE and IgG antibody response to birch pollen antigens were studied by means of immunoblotting experiments testing 58 sera from patients with Type I allergy to birch pollen. 56/58 patients showed IgE antibodies reactive with Bet v I, a 17 kilodalton (kD) pollen protein. 2D-electrophoresis/immunoblot revealed a heterogeneity of that protein. Ten spots (pH 4.9-5.9) could be detected, presumably representing differentially glycosylated isoallergens. In 33/58 patients, there was no evidence of IgE antibodies directed against allergens other than Bet v I. However, in 25/58 of patients' sera, 11 minor allergens (13, 15, 18, 27, 29, 32, 39, 44, 57, and 68 kD) with individual incidences from 1.7% to 17.2% were identified. All proteins were also recognized by the patients' IgG antibodies: in the case of Bet v I recognition was weak, whereas the IgG response to the minor allergens was pronounced. Sera from healthy individuals showed similar IgG antibody responses, but no IgG to the 15, 27, and 29 kD proteins. Our results suggest that IgG directed against minor allergens may function as trapping antibodies in healthy individuals. Too low or lacking amounts of anti-Bet v I IgG may facilitate an allergic reaction.

Adolescent

Specificities of IgE and IgG antibodies in patients with birch pollen allergy.

58 sera from patients with established birch pollen allergy showed characteristic antibody-binding patterns in immunoblotting experiments. Regarding IgE, 56/58 patients recognized a protein of molecular weight (MW) 17 kilodaltons (kD), previously defined as Bet v I. 23/58 patients in addition reacted with a variety of 11 minor allergens with MWs ranging from 13 to 68 kD. A 13-kD protein was proved to represent an independent minor allergen. IgG binding in patients and healthy individuals was more pronounced on the minor allergens than on Bet v I. 3 different allergens were not detected by IgG of healthy individuals. In two-dimensional electrophoresis/immunoblot, a monoclonal antibody and human IgE (in both cases directed against Bet v I) detected a very similar cluster of spots, probably representing isoallergens of Bet v I.

Allergens

[Wild silk-induced asthma. A contribution to the knowledge of inhalation allergies caused by wild and tussah silk-filled bed quilts].

In the silk industry occupational IgE-mediated hypersensitivities to different allergens are well known. Since the use of silk waste for the filling of bed quilts a great number of patients suffering especially from silk-asthma could be observed. Immunological investigations showed clearly that in this context sericin and also antigens from an insect of the genus anthrenus in the silk material are of allergenic importance. On the basis of typical case histories from the occupational and private scene the diagnostic difficulties of silk allergy are discussed.

Adult

Selection and preoperative treatment of over-seventy-year-old patients undergoing thoracotomy.

The thoracic surgeon is confronted with the question of the operability of patients over 70 years old more and more frequently. Not only the advanced age, but also probable functional impairments are decisive for the outcome of an operation in this often polymorbid age group. Fifty-three patients over 70 years old underwent 58 thoracotomies. The hospital lethality was 7.5%, the complication rate 17%. These results could be obtained by a specific selection of patients, based on functional parameters, intensive preoperative medical and physiotherapeutic treatment in terms of improvement of possible functional deficits and the usual postoperative intensive care. In our long-term observations we could record a 5-year survival rate of 100% in patients with benign diseases and of 46% in cases of bronchial carcinoma. These results confirm our attitude that the age 70 years and older should not be considered as contraindication for thoracic surgery.

Aged

Spaetlese lung.

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Agricultural Workers' Diseases

[Reactions to vaccinations against tetanus and tick-borne encephalitis caused by merthiolate (thiomersal)].

Thirty patients with suspected adverse reactions to tetanus- or tick-borne encephalitis-vaccines were subjected to allergy tests. In 8 of 30 patients epicutaneous and/or intracutaneous tests with merthiolate were positive. Testing anorganic mercury, formaldehyde, aluminium hydroxide, gentamycin and egg white (i.c. and RAST), no positive reactions were found. After vaccination - prior to testing - merthiolate - positive patients had suffered from local inflammatory reactions at the injection site, fever and lymphadenopathy (four patients), urticarial (three patients) or lichenoid exanthemas (one patient). Reviewing the literature it is suggested that alternatively merthiolate-free vaccines be provided for sensitized individuals.

Adolescent

[Extrinsic allergic alveolitis: comparison of 2 methods (Ouchterlony gel precipitation and ELISA) for antibody detection in routine diagnosis].

Sera from 58 patients with suspected extrinsic allergic alveolitis (EAA) were tested in parallel by the double diffusion test and the "enzyme-linked immunosorbent assay (ELISA)" using 10 different antigen solutions (extracts from thermophilic actinomycetes, various mycetes, pigeon serum, pigeon droppings and the wheat weevil sitophilus granarius). The ELISA technique was more sensitive than the double diffusion test in detecting antibodies to the panel of antigens used. However, by using several antigen dilutions the number of sera positive sera with the double diffusion test increased and an overall correlation of 93.1% with the ELISA was achieved. The results of the study are discussed with regard to the advantages and disadvantages of both test systems for the in vitro diagnosis of EAA.

Adult

Functional surgery of bullous emphysema.

Multiple large and small emphysematous bullae were resected in 27 patients with chronic obstructive lung disease (COLD). Twenty-two patients were operated on one side, and 5 patients underwent bilateral consecutive operations. Twenty-five patients were male, 2 female, and they were between 22 and 67 years old (mean 49.5 years). All patients had a follow-up examination between 3 and 48 months postoperatively. As operative techniques, resection by means of a clamp, plication of cysts according to Nissen, resection with homologous dura plasty (7 patients) and pericardial plasty (7 patients) were used. In 19 patients preoperative and postoperative pulmonary function was compared. Functional improvement occurred in 17 patients - including all of the 5 bilateral procedures. Postoperative improvement was more pronounced with decreasing preoperative pulmonary function, measured as VC, RV, IGV and Raw. Partial pulmonary insufficiency could be improved in 9 patients and global pulmonary insufficiency was improved in 5. In 16 cases physical work capacity was increased. The hemodynamics of the pulmonary circulation were improved in all patients with increased preoperative pulmonary artery pressure (latent pulmonary hypertension in 7 patients, overt pulmonary hypertension in 5). FEV1 was least influenced by surgery, especially in patients more than 50 years old. The long-term prognosis, thus has to be judged cautiously. One patient died postoperatively (mortality 4%). The technique of dura and pericardial plasty, aiming at functional adaptation, is described. Sutures inverting or folding pulmonary tissue are avoided. The aspect of at least temporary (up to 3 years) functional improvement leads us to advocate the use of extended criteria of operability.

Adult

Chlamydia trachomatis in 'abacterial' prostatitis: microbiological, cytological and serological studies.

Chlamydia trachomatis was isolated from urethral swabs after prostatic massage in patients with 'abacterial' prostatitis. After exclusion of prostatic infections by gram-negative bacteria, enterococci and ureaplasmas, in 20 of 43 patients with apparent monoinfection by C. trachomatis, a leucocytal reaction was demonstrated in prostatic secretions. By microimmunofluorescence test, antibody titers greater than or equal to 1:8 against various types of C. trachomatis were detected in these patients, whereas serology was negative in chlamydia-positive patients without increased leucocyte counts (prostatodynia).

Adolescent

Significance of Chlamydia trachomatis in "abacterial" prostatitis.

Chlamydia (C.) trachomatis was isolated in McCoy cell cultures from urethral swabs after prostatic massage, of 43 out of 233 patients (18.5%) with symptoms of "abacterial" prostatitis, but also from 5 out of 65 control persons (7.7%). Numbers of granulocytes in sediments of cytocentrifuged urine voided after prostatic massage were normal (less than or equal to 2, magn. 400 X) in all 65 control persons, but were increased in 26 out of 43 patients with symptoms of "abacterial" prostatitis (greater than or equal to 4, magn. 400 X). Using an (H + L) chain specific anti-IgG FITC conjugate, microimmunofluorescence tests for detection of antibodies against C. trachomatis could be performed with the sera of all 65 control persons and with those of 37 out of the 43 patients. All control persons, even those five with positive C. trachomatis culture, were serologically negative (titer less than 1:8), while in 13 out of 15 C. trachomatis positive patients with a definitive diagnosis of "abacterial" prostatitis, humoral antibodies with titers of greater than or equal to 1:8, predominantly against serotypes I, J, E, and G, were detected. Serological results correlated well with granulocyte counts in urines after prostatic massage. Patients with symptoms of "abacterial" prostatitis with normal granulocyte counts (less than or equal to 2) and negative serology (titer less than 1:8) were considered suffering from "prostatodynia".

Adolescent

[Results of electrophysiologically guided surgery in ventricular tachycardia].

We report on 33 patients (pts) with medically refractory ventricular tachycardia (VT) after myocardial infarction in whom electrophysiologically guided surgery was performed. In 18 pts the origin of the VT was identified preoperatively by endocardial catheter mapping. Intraoperative endocardial mapping was performed in 32 pts. The origin of the VT was detected in 24 pts, whereas in 8 pts the surgical procedure was guided by the results of intraoperative mapping during sinus rhythm. In one patient no intraoperative mapping was performed and surgery was guided only according to the results of endocardial catheter mapping. A deep endomyocardial incision was performed in 14 pts, whereas local endocardial resection was done in 19 pts. Six pts (18%) died postoperatively still being in the hospital, 27 pts (82%) were discharged. There were 4 late deaths during mean follow up period of 18 months. One patient had a spontaneous recurrence of VT. 8 pts remained on antiarrhythmic medication due to complex ventricular arrhythmias. We conclude that in case of medically refractory VT in coronary artery disease, surgical therapy becomes an acceptable alternative when guided by pre- and intraoperative electrophysiological mapping.

Adult