[Symptoms and diagnosis of Lyme borreliosis].
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Bacteriological Techniques↗
Biomedical subjects
H Hofmann
Publications and source records attributed to H Hofmann.
Association of hepatitis C virus infection with chronic liver disease in paediatric cancer patients.
A total of 203 paediatric cancer treatment survivors were tested for serum antibodies against hepatitis-C virus (anti-HCV). Anti-HCV was detected in 41 patients (20.2%) with first generation anti-HCV ELISA. Positive results were confirmed in all samples retested with a second generation ELISA (n = 35) and in all but two cases re-analysed by immunoblotting (n = 23). Anti-HCV positive children had received significantly more blood product transfusions compared to seronegative patients. In 75 children (32%) chronic liver disease was found. It was defined as an elevation of serum alanine aminotransferase values to a least 2.5 times the upper limit of normal persisting for 6 months or longer. Hepatitis A was never detected, and in 58 children the chronic hepatopathy was unexplained by hepatitis B (non-A non-B chronic liver disease). Of these patients 29 (50%) were seropositive for anti-HCV. Surprisingly, non-A/non-B chronic liver disease was associated with anti-HCV in 14 of 19 solid tumour patients (78.9%), but in no more than 14 of 39 leukaemia and lymphoma patients (35.9%). This phenomenon was not explained by different rates of cytomegalovirus disease and drug toxicity related hepatopathies between the two groups. It may be related to differences of leukaemia/lymphoma compared to solid tumour therapy schedules (differential immunosuppression and liver toxicity).
Child↗
Molecular and immunological characterization of a novel polymorphic lipoprotein of Borrelia burgdorferi.
We describe the cloning, expression, and molecular characterization of a novel polymorphic Borrelia burgdorferi lipoprotein recognized by monoclonal antibody LA7. Sequence analysis revealed an open reading frame encoding a 21,866-Da polypeptide (IpLA7). Comparison with other known proteins indicated sequence similarity between IpLA7 signal peptides and those of other prokaryotic lipoproteins, including the immunodominant B. burgdorferi outer surface proteins OspA, OspB, pC, and OspD. Both natural IpLA-7 and recombinant IpLA-7 could be biosynthetically labeled with [3H]palmitate. Upon solubilization of intact B. burgdorferi with the nonionic detergent Triton X-114, IpLA7 was extracted together with other lipoproteins into the detergent phase. Indirect immunolabeling studies indicated that the epitope recognized by monoclonal antibody LA7 is mainly located in the periplasmic space. Two-dimensional gel electrophoresis and immunoblotting confirmed the calculated acidic pI of 5.7 for IpLA-7. The LA7 gene was shown to be species specific and to be located on the linear chromosome of B. burgdorferi. The analysis of 40 individual spirochetal isolates on the basis of restriction fragment length polymorphisms revealed considerable genotypic heterogeneity of LA7 corresponding to that previously found for ospA. Native IpLA-7 and recombinant IpLA-7 were recognized by immune sera from infected mice as well as some human sera derived from infected but healthy donors and may thus prove useful as an additional marker for the serodiagnosis of Lyme disease.
Amino Acid Sequence↗
[Algorithm for calibrating eye movements].
A mathematical model and the corresponding computer program based on an algorithm for calibration of eye movements are described. The latter is used to represent and analyse eye movements on a monitor screen using the EYE/HAND software, with the aid of which movements of eye and hand can be represented either simultaneously or separately. Demands on the rate of data acquisition and representation of the curves (real-time monitoring) are satisfied. Calibration is based on vector transformation of the digitised analog values to monitor coordinates. The parameters of the transformation algorithm are determined by fixation of the eye movements to freely selectable monitor screen markers.
Calibration↗
Effects of ribose on exercise-induced ischaemia in stable coronary artery disease.
There is no established treatment specifically aimed at protecting or restoring cardiac energy metabolism, which is greatly impaired by ischaemia. Even after reperfusion, myocardial content of ATP remains low for more than 72 h. Long-term post-ischaemic dysfunction and irreversibility of ischaemic damage have been associated with low ATP content. Evidence that the pentose sugar ribose stimulates ATP synthesis and improves cardiac function led us to test the possibility that ribose increases tolerance to myocardial ischaemia in patients with coronary artery disease (CAD). 20 men with documented severe CAD underwent two symptom-limited treadmill exercise tests on 2 consecutive days; we postulated that the ischaemia induced might bring about changes in ATP metabolism lasting for several days. Patients whose baseline tests showed reproducibility were randomly allocated 3 days of treatment with placebo or ribose 60 g daily in four doses by mouth. Exercise testing was repeated after treatment on day 5. At that time mean (95% confidence interval) treadmill walking time until 1 mm ST-segment depression was significantly greater in the ribose than in the placebo group (276 [220-331] vs 223 [188-259] s; p = 0.002). The groups did not differ significantly in time to moderate angina. In the ribose-treated group the changes from baseline to day 5 in both time to ST depression and time to moderate angina were significant (p less than 0.005), but these changes were not significant in the placebo group. In patients with CAD, administration of ribose by mouth for 3 days improved the heart's tolerance to ischaemia. The presumed effects on cardiac energy metabolism offer new possibilities for adjunctive medical treatment of myocardial ischaemia.
Aged↗
Prevalence of hepatitis-C virus infection in children with chronic post-transfusion hepatitis.
The prevalence of hepatitis-C virus (HCV) infection was investigated in a group of children with chronic post-transfusion hepatitis using a first- and second-generation HCV-antibody ELISA, 2 confirmatory tests (a second-generation recombinant immunoblot assay and a line immunoassay) as well as an HCV-polymerase chain reaction (PCR). In 33% of the children, clear discrepancies were observed between the 4 different HCV-antibody detection assays, indicating that the serological diagnosis of HCV infection is still problematic. HCV RNA was detectable by PCR in only 69% of the antibody positive patients, which may be due to a fluctuation of viraemia during the course of infection. Such a fluctuation was demonstrated in 6 patients from whom serum samples drawn at different times were investigated. In contrast, in 8 of the 15 seronegative patients, HCV infection was identified only by PCR, although the hepatitis had already persisted for more than 2 years. Antibody assays and PCR together detected HCV infection in about 90% of the patients with chronic hepatitis. When markers of hepatitis B infection were also investigated, only 6% of the cases remained undiagnosed.
Base Sequence↗
Amniotic fluid N-acetyl-beta-D-glucosaminidase activity and renal abnormalities.
Amniotic fluid N-acetyl-beta-D-glucosaminidase (NAG) activity was measured in 21 normal pregnancies to determine reference values, and in 10 pregnancies with fetuses who had prenatally recognised renal and urinary tract malformations. The normal values obtained at 17-19 and 28-31 gestational weeks did not differ, and an activity of 105 units NAG/mmol creatinine was the upper limit of the normal range. Raised NAG activities were found in four fetuses with oligohydramnios and severe bilateral renal disease, and also in two infants with a normal amount of amniotic fluid, only unilateral renal lesions, and a normal renal function after birth. Three of four cases with normal NAG activities had malformations without kidney damage, but one baby with prune belly syndrome was subsequently found to have dysplastic kidneys and renal failure. Our preliminary results suggest that a high level of NAG activity in the amniotic fluid indicates unilateral or bilateral kidney damage but is not proof of intrauterine renal failure.
Acetylglucosaminidase↗
Prenatal diagnosis of myotonic dystrophy using closely linked flanking markers.
We report on two cases of prenatal diagnosis of myotonic dystrophy (DM), using flanking markers APOC2 or CKMM on the proximal side and D19S51 on the distal side. By double digestion (TaqI and NcoI) of PCR amplified CKMM, the informativeness was increased from a PIC value of 0.57 to 0.69. Altogether, with a PIC value of 0.64 for APOC2, 0.69 for CKMM, and 0.27 for D19S51 (BglI), presymptomatic and prenatal diagnosis can thus be offered to approximately 24% of persons with a risk between 0.0004 and 0.0008 using these flanking markers.
Adult↗
[Mass screening of blue color vision in divers with the desaturated Lanthony-15-Hue Test].
We tested 1002 persons, 572 divers (including 38 who had diving accidents) and 430 nondivers, for defects of the blue-sensitive system during the years 1988 and 1989. Recent research has shown functional disorders of color vision in divers, linked to previously described alterations of the retinal capillary system and pigment epithelium. The desaturated Lanthony-15-HUE test was used as a screening method. No defect of the blue-sensitive system was found, either in divers or in nondivers. Our results are similar to those of other researchers. One exception was that we found no correlation between age and error score. We found no evidence for retinal damage caused by diving.
Adult↗
[Hepatitis C antibodies in children and adolescents with congenital blood coagulation disorders].
Antibodies to hepatitis C (anti-HCV) were determined in 24 children and adolescents with congenital disorders of haemostasis. 13 out of 24 patients (54%) were positive for anti-HCV. Comparison of the prevalence of positive anti-HCV and the quantity of non-virus inactivated factor VIII concentrates administered before 1985 showed positive anti-HCV in 100% of patients receiving more than 300 U factor VIII/kg b.w./month, in 88% of patients receiving 100 to 300 U factor VIII/kg b.w./month, and in 60% of patients receiving less than 100 U/kg b.w./month. 13 out of all 16 patients (81%) treated with non-virus-inactivated concentrates before 1985 were positive for anti-HCV. In contrast, all patients treated with virus inactivated concentrates were negative for anti-HCV. Elevated aminotransferases were frequently found in 8 out of 13 patients (62%) positive for anti-HCV, but only in 3 out of 11 patients (27%) negative for anti-HCV. The risk of developing chronic hepatitis was about 2.5-fold higher in patients positive for hepatitis C-antibodies than in patients negative for hepatitis C-antibodies.
Adolescent↗
[Early summer meningoencephalitis vaccination, a preventive medicine measure with high acceptance in Austria].
The vaccination against Tick-borne encephalitis (TBE) was accepted by the Austrian population on a broad scale. Of the estimated 5 million Austrians at risk of TBE, as of 1987 only 1.7 million were unvaccinated. From the very small number of TBE cases despite vaccination we were able to calculate a protection rate of 95% after 2 vaccinations and of 99% after 3 or more vaccinations. Since 1984 as a consequence of the vaccination campaign a steady decline of TBE could be observed in Austria. More than 10 years ago improved procedures enabled the production of a highly purified vaccine, thus reducing the number of side effects to a minimum. We here present data from 2067 vaccinees who reported on eventual side reactions by means of a questionnaire. The reactions reported did not exceed those which could be expected after application of a placebo vaccine. Due to high immunogenicity of the vaccine a booster effect can be achieved even some years after a missed vaccination, precluding the necessity of beginning a new series.
Antibodies, Viral↗
[Testing for hepatitis C].
Over the past 10 years, 12,146 cases of hepatitis were diagnosed in the Virology Department of Vienna University. 30.3% were hepatitis A, 39.2% hepatitis B, 3.0% cytomegalovirus and 1.5% Epstein-Barr virus infections. The remaining 25.8% were diagnosed as non-A, non-B hepatitis (NANB). Therefrom, a sample of 167 sera from acute and 78 from chronic hepatitis NANB were tested for hepatitis C. 9.6% of the acute and 44.9% of the chronic cases were positive. We conclude from these data that about 12% of all hepatitis cases in Austria are caused by the hepatitis C virus. In addition, risk groups for hepatitis C were tested. The highest prevalence (80%) was found in drug addicts. Polytransfused (organ transplanted) patients had antibodies in 44.8% of cases. Of 78 dialysis patients, 7 were positive but nearly all positives came from one single dialysis unit, thus indicating a prevalence of 30% there.
Adult↗
Safety and immunogenicity of an inactivated hepatitis A candidate vaccine in healthy adult volunteers.
The reactogenicity and immunogenicity of a formaldehyde-inactivated hepatitis A vaccine have been investigated. Three different dose levels of vaccine (180, 360 and 720 ELISA units) were administered to healthy volunteers according to a 0, 1, 2 and 12 month schedule. The vaccine was safe and well tolerated. Reactions observed following vaccination were essentially mild and were not dependent upon the quantity of antigen administered. All subjects had measurable titres of anti-HAV antibodies after the full vaccination course; the immune response to the vaccine was dose-related. Antibody titres in vaccinees at month 13 were between 60- and 190-fold higher than those observed in a group of subjects given anti-HAV immunoglobulin.
Adolescent↗
Interindividual comparability of blood glucose alterations after meals of complex carbohydrates.
Young male and female probands underwent an DGTT (oral glucose tolerance test) using a glucose load of 1 g/kg b.wt. The alterations in blood glucose levels were checked and plotted by a Biostator. A week later groups of those probands were fed an isocaloric meal of complex CH, namely either potatoes, noodles or white bread. The resulting BG curves were also checked by a Biostator. It turned out that: 1. the shapes of the BG curves after glucose load were not interindividually comparable. 2. there was neither a similarity of the shapes of the BG curves within the groups after any of the different CH levels. 3. But if one compares the shape of the BG curves after glucose load and after a meal of any of the complex CH of one and the same person, there is a striking similarity in those curve shapes. The differences between them lie just in the mostly lower BG values of the curves after CH meals compared with those after glucose load. 4. Therefore the resulting graph of both of those curves is in all observed cases a straight line with a probability better than 0.001, called OGTT-calibrating resulting graph.
Adult↗
Relevance of hepatitis B DNA detection in patient's serum.
Detection of HBV-DNA showed a satisfactory sensitivity (6 pg/ml) and high specificity: 15 patients with hepatitis A, 6 with CMV, 7 with EBV infection, 81 with hepatitis NANB as well as 174 persons with isolated HBc antibodies and 9 hepatitis B vaccinees gave negative results. However, out of 118 persons with a history of hepatitis B (HBs and HBc antibodies positive), one repeatedly had a positive result. We followed 58 patients with chronic hepatitis B, 25 healthy antigen carries, and 16 HBV-infected dialysis patients over an extended period with multiple blood sampling. Most of those patients showed changes of detectability of HBV-DNA. Typically, periods with positive DNA tests were followed by intervals with negative tests which could last for up to a few years. 75% of dialysis patients were positive in all sera available, while 48% of healthy antigen carriers were consistently negative. Additionally, 9 patients with a history of recent hepatitis B and a positive HBs antibody test as well as 4 patients with simultaneous infection by A and B were tested for HBV-DNA. In none of these two groups, a variation from the pattern usually found in hepatitis B was established. A case of intrauterine infection with hepatitis B virus is reported. Because the blood of the mother was free from HBV-DNA and HBe antigen at delivery and because the hepatitis B immunoglobulin prophylaxis failed in the child who developed HBs antigen very soon after delivery, it has been concluded that the child was infected in utero. The highest values of HBV-DNA determined quantitatively were found in dialysis patients which explains the high risk of acquiring hepatitis B in the dialysis unit. The results from earlier studies on the prognostic relevance of HBV-DNA and the risk of medical personnel as a source of infection with hepatitis B are discussed briefly.
Chronic Disease↗
[Fast frequency electroretinogram differentiates ocular hypertension].
On the basis of the 30 Hz responses it was possible to divide the patients (total 38 eyes) into two groups. The PERGs of one group (abnormal OHT) resembled responses of typical glaucomatous eyes, with greatly diminished or abolished 30 Hz amplitudes. The PERGs of the other group (normal OHT) were indistinguishable from those of normal eyes.
Diagnosis, Differential↗
[A new laser scan system for video ophthalmoscopy. Initial clinical experiences also in relation to digital image processing].
The clinical advantages of a scanning laser ophthalmoscope (SLO) and video imaging of fundus pictures are described. Image quality (contrast, depth of field) and imaging possibilities (confocal stop) are assessed. Imaging with different lasers (argon, He-Ne) and changes in imaging rendered possible by confocal alignment of the imaging optics are discussed. Hard copies from video images are still of inferior quality compared to fundus photographs. Methods of direct processing and retrieval of digitally stored SLO video fundus images are illustrated by examples. Modifications for a definitive laser scanning system - in regard to the field of view and the quality of hard copies - are proposed.
Computer Systems↗
[A new laser scan system for video-ophthalmoscopy. Initial clinical experiences also in connection with digital image processing].
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Diabetic Retinopathy↗