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Biomedical subjects

H Müller

Publications and source records attributed to H Müller.

At least 1,117 records · Page 62Linked to original sources
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Relations between spontaneous and induced arterial lesions in swine and arteriosclerosis in humans.

The rabbit which for practical reasons is so frequently used for experimental arteriosclerosis considerably differs from humans in its metabolism, nourishment, and arterial wall responses to atherogenic noxae. In this respect, domestic pigs show more resemblance to the conditions in man, and they have recently been used for experimental research work in the field of atherosclerosis. Our own investigations performed with a view to constructing an antherosclerosis model being as far as possible resemblant to conditions prevailing in humans have shown that among various forms of diets only one combined form which is rich in cholesterol (1.5 percent) and lipids (15 percent) produces changes in the intima that in certain arterial regions correspond to lesions found in humans. These are lipofibrous beds up to complicated atheromas. The location of the spontaneous changes (without atherogenic diet) suggest that these may be considered as early stages. The various forms of development were studied light- and electron-microscopically; moreover the development of the blood lipids was determined biochemically during the experiment.

Animals↗
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Distribution and infection of Langerhans cells in the skin of HIV-infected healthy subjects and AIDS patients.

The in situ content of cells of the reticuloendothelial system and lymphatic cells was examined in the skin of eight symptom-free HIV-positive individuals, three AIDS patients and eleven healthy immunocompetent volunteers. The epidermis was obtained in vivo by the suction blister technique. The numbers of CD68+, CD3+, CD8+, CD25-(IL2R)+ and HLA-DR+ intraepidermal cells proved to be independent of the number of CD4+ peripheral blood lymphocytes. At the same time, the intraepidermal concentrations of these cells were generally low in symptom-free HIV-infected individuals. The strong inverse correlation between the number of epidermal Langerhans cells (LC) and the severity of immunodeficiency was quantitatively confirmed; an increase in LC in symptom-free HIV-infected individuals was found. Thus, the reduction in these cells which was observed in the epidermis of AIDS patients began at a significantly elevated level. In contrast to results from other studies, in AIDS patients, in the present study, the concentration of epidermal LC did not differ significantly from that of healthy immunocompetent volunteers. The immunohistochemical technique can be as effective as in situ hybridization for the detection of HIV in the skin. Our results suggest that the viral load of the skin is rather low in HIV-infected subjects. HIV was demonstrated in one cell of one AIDS case by in situ techniques and this result was confirmed by a polymerase chain reaction examination using the same amount of tissue as for the in situ techniques.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
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In vitro analysis of HIV- and non-HIV-infected monocytes/macrophages from healthy subjects and patients with malignant tumours.

Phenotype and release of IL1 alpha, IL6 and TNF alpha were examined in monocytes derived from 14 healthy donors and 24 tumour patients in a long-term culture using immunohistochemical, RNA in situ hybridization and ELISA techniques. After stimulation with LPS and IFN-gamma, blood monocytes and resulting macrophages showed an overall decrease in cytokine release from the 6th to the 48th day of culture, both with and without HIV infection. HIV infection provided a strong stimulus for IL6 production and a weak stimulus for IL1 alpha production, whereas TNF alpha release decreased after HIV infection. Non-HIV-infected monocytes/macrophages from patients with malignancies showed significantly reduced cytokine production after stimulation, in comparison with monocytes/macrophages from healthy subjects. In vitro HIV infection of monocytes from tumour patients caused severe depression of cytokine production during the whole time of observation. In all experiments a parallel was observed between the extent of cytokine release and the presence of young/early inflammatory macrophages as identified by the antibody MAC387/27E10 in situ. In contrast, cytokine expression assessed semiquantitatively by immunohistochemical staining in situ showed discordant development, since it increased during long-term culture, while supernatant concentrations of cytokines declined. Simultaneously, significant cytokine RNA levels could be found in macrophages from the 6th to the 24th day of culture, as detected by in situ hybridization. After 48 days of culture, no more cytokine RNA was detectable, while macrophages continued to exhibit distinct immunohistochemical positivity for cytokine antibodies. From these results, it is concluded that macrophages kept in culture for a long period become inhibited in their secretion. HIV has an ambivalent effect on cytokine production in Mo/Mac, resulting in an increase in IL6 and IL1 as well as a decrease in TNF alpha production. Mo/Mac of non-HIV-infected tumour patients show significantly reduced cytokine production in comparison with Mo/Mac from healthy subjects. The sum of the HIV infection in vitro and the tumour burden results in a dramatic reduction in cytokine release in Mo/Mac. This finding may provide a possible explanation for the specific aggressive behaviour of non-Hodgkin's lymphoma and Hodgkin's disease in AIDS.

Antigens, Differentiation↗
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Successful treatment of intimal hyperplasia in renal arteries by endovascular brachytherapy.

PURPOSE: The present study shows the possibility of preventing restenosis of renal arteries by endovascular brachytherapy. METHODS AND MATERIALS: We present a patient suffering from rapid restenosis of both renal arteries with decreasing renal function. Percutaneous transluminal angioplasty (PTA) and stent implantation were unable to stop hypertension and to stabilize renal function. Both renal arteries and the right pole artery were treated by endovascular brachytherapy in one session. RESULTS: Six months after intervention, intraarterial digital subtraction angiography (DSA) showed no evidence of recurrence, and the blood pressure remained normal without medical treatment. CONCLUSION: Endovascular brachytherapy can help to prevent restenosis in renal arteries. It is possible to treat both renal arteries and one pole artery in one session without any disadvantage.

Angiography, Digital Subtraction↗
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[Late hormonal complications after brain tumor treatment in childhood and adolescence: literature review and a model of integrated hormone aftercare].

The variety of endocrine late-effects after brain tumour therapy in childhood is well known. Growth is usually impaired first due to a hypothalamo-pituitary growth hormone (GH) deficiency or a radiation-induced neurosecretory dysfunction of GH secretion. Generally, all hypothalamo-pituitary axes can be affected. Disturbances of puberty, gonadal function, thyroid function and adrenal function can manifest after a long posttherapeutic interval. A retrospective analysis of the auxological and endocrinological data assessed within the German brain tumour study HIT 91 showed that endocrinological follow-up of these patients was not satisfactory. Therefore we have developed a concept for the new brain tumour study: auxological and laboratory parameters will be assessed before oncological therapy and in regular intervals (4, 12, 18, 24 months after the end of tumour therapy). 24 months after the end of tumour therapy all hypothalamo-pituitary axes are to be evaluated with pharmacological stimulation tests.

Aftercare↗
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[Are there predictors for proliferative retinopathy of prematurity and is supplemental oxygen a useful conservative treatment option?].

BACKGROUND: Especially very immature preterm babies develop retinopathy of prematurity (ROP). This study aims at analysing risk factors for proliferative ROP and realizing the efficiency of supplemental oxygen therapy. PATIENTS: 180 preterm babies with birth weight < or = 1 500 grams were included retrospectively. METHODS: To determine potential predictors all preterm babies with ROP grade > or = 3 were matched to pairs with similar immature babies with ROP 1 or 2. Additionally we examined the influence of supplemental oxygen therapy on the coagulation rate of high grade retinopathy. RESULTS: 44 % of the preterm babies showed ROP. A longer duration of ventilation (21 vs. 33 days), a longer duration of oxygen supplementation (59 vs. 78 days), relapsing sepsis (10 vs. 19 babies with sepsis > 2 times), a large total volume of transfusions (median: 150 mL vs. 105 mL), chronic lung disease (CLD) (6 vs. 15 babies with oxygen requirements at 36 weeks post-menstrual age), a duration of intubation for more than 28 days (13 vs. 6 babies) and the lack of phototherapy (21 vs. 9 babies) were risk factors associated with ROP > or = 3 using univariate analysis [p < 0.05]. Only the both last criteria correlated with high grade ROP after logistic regression. The supplemental oxygen therapy showed no influence on the coagulation rate of high grade ROP. Possibly this therapy influences the frequency of surgical treatment of amotio- and of putting on a cerclage, but this remains still speculative because of the low case number. We saw no negative effect on the frequency of CLD and on the survival of the babies. CONCLUSIONS: Especially measures against long duration of intubation could help to prevent high grade ROP. The supplemental oxygen therapy may have a positive effect on course.

Female↗
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Differential diagnosis of suprasellar tumors in children.

In contrary to the adult age the most common suprasellar tumors in children are with decreasing frequency craniopharyngiomas, chiasmatic/hypothalamic low-grade gliomas, germinomas and lesions attributable to a Langerhans cell histiocytosis. For differential diagnostic purposes also the rare hypothalamic hamartoma and meningeal metastases in the infundibular recess of the third ventricle are included. The typical aspects of the various tumors on computed tomography (CT) and magnetic resonance imaging (MRI) together with important clinical differences are illustrated. On the basis of imaging results and clinical symptoms differential diagnosis between the various tumor entities should be feasible in many cases. Of course, only in strictly defined cases like typical chiasmatic/hypothalamic and optic pathway gliomas or bilocular germ cell tumors a histological confirmation is dispensable.

Adolescent↗
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The impact of overweight on the development of diabetes after heart transplantation.

BACKGROUND: Overweight is defined with a body mass index (BMI) >25. A BMI >25 is known as an independent risk factor for increased morbidity and mortality. The influence of an increased BMI on the development of diabetes and on survival after heart transplantation (HTX) was investigated. METHODS: A total of 137 patients (116 men, 21 women), who underwent HTX at our Department from 1986 to 2002, were included in the study. For group stratification, the pre-operative BMI values were taken (group I: BMI 25). Groups were compared for primary disease, age and sex, development of renal failure, development of diabetes, and survival. The probability of survival and the freedom-from-diabetes interval were calculated by the use of Kaplan-Meier method. RESULTS: No significant differences between groups I and II were found concerning primary disease, age and sex, and occurrence of renal failure. There was a tendency towards increased survival (p = 0.18) in group I. Patients of group II developed diabetes after HTX more frequently than those of group I (p < 0.001). Cox regression revealed that pre-operative BMI >25 is a highly significant independent risk factor for post-operative development of diabetes mellitus (DM) (p < 0.001). CONCLUSION: Overweight prior to HTX appears to negatively influence long-term survival after HTX, although this difference did not reach statistical significance. Pre-operative overweight is a significant and independent risk factor for the development of post-transplant diabetes.

Adult↗
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Therapy of sinuorbital aspergillosis with amphotericin B colloidal dispersion.

Invasive aspergillosis is a feared complication in the management of patients with malignancies. We report a 13-year-old boy with acute myelogenous leukaemia and chronic sinusitis who developed a sinuorbital fungal infection during cytostatic and prolonged antibiotic treatment. The clinical findings, diagnostic measures and treatment and its adverse effects are described and discussed. Special emphasis is given to our experience of the use of colloidal dispersed amphotericin B (Amphocil).

Adolescent↗
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Estimating the frequency of nonpaternity in Switzerland.

In linkage analysis and gene mapping in general, typing error and/or errors in specifying pedigree relationships between individuals typically lead to an upwards bias in recombination fraction estimates and to a loss of power for detecting linkage. [Ott J: Analysis of Human Genetic Linkage. Baltimore, Johns Hopkins University Press, 1991]. The presence of nonpaternity is the most common source of error of misspecification of pedigree relationships between individuals that can have a negative impact on pedigree analysis. We have developed estimates of underlying nonpaternity probabilities based on observed Mendelian inconsistencies. The methods were applied to a sample of 1,607 children and their parents. Genetic marker data were investigated to test for exclusions due to nonpaternity. Among the 1,607 children, 11 or 0.68% exclusions were found. When a constant nonpaternity rate was assumed for each child, its maximum likelihood estimate turned out to be 0.78% with asymptotic 95% confidence limits of 0.41% and 1.35%. When varying nonpaternity rates were assumed, its mean was estimated as 0.83% with asymptotic 95% confidence limits of 0.32% and 1.33%.

Child↗
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Subcutaneous hyalohyphomycosis caused by Acremonium recifei: case report.

We present a case of subcutaneous hyalohyphomycosis due to Acremonium recifei, a species whose habitat is probably the soil, first identified in 1934 by Arêa Leão and Lobo in a case of podal eumycetoma with white-yellowish grains and initially named Cephalosporium recifei. A white immunocompetent female patient from the state of Bahia, Brazil, with a history of traumatic injury to the right hand is reported. The lesions was painless, with edema, inflammation and the presence of fistulae. Seropurulent secretion with the absence of grains was present. Histopathological examination of material stained with hematoxylin-eosin showed hyaline septate hyphae. A culture was positive for Acremonium recifei. Treatment with itraconazole, 200 mg/day, for two months led to a favorable course and cure of the process. We report for the first time in the literature a case of subcutaneous hyalohyphomycosis due to Acremonium recifei in a immunocompetent woman. Treatment with itraconazole 200 mg/day, for two months, resulted in cure.

Acremonium↗
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Subcutaneous phaeohyphomycosis caused by Phoma cava. Report of a case and review of the literature.

We report a case of subcutaneous phaeohyphomycosis observed in a male patient presenting pulmonary sarcoidosis and submitted to corticosteroid treatment. He presented nodular erythematous-violaceous skin lesions in the dorsum of the right hand. Histopathological examination of the biopsied lesion revealed dematiaceous hyphae and yeast-like cells, with a granulomatous tissual reaction. The isolated fungus was identified as Phoma cava. A review of the literature on fungal infection caused by different Phoma species, is presented. The patient healed after therapy with amphotericin B. followed by itraconazole.

Amphotericin B↗
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Repetitive chemoembolization with melphalan plus intra-arterial immuno-chemotherapy within 5-fluorouracil and granulocyte-macrophage colony-stimulating factor (GM-CSF) as effective first- and second-line treatment of disseminated colorectal liver metastases.

BACKGROUND/AIMS: In order to improve local and systemic efficacy of chemotherapeutic interventions we have used a combination of high concentrated plus low continuous regional chemotherapy modulated by GM-CSF cytokine in the treatment of inoperable colorectal liver metastases. METHODOLOGY: Sixty-six patients with disseminated inoperable colorectal liver metastases received continuous intra-arterial chemotherapy with 5-FU plus GM-CSF short time application plus chemoembolization Melphalan via an angiographically positioned hepatic artery catheter. The regimen consisted of the following steps: On day 1 + 2 1400 mg/m2 5-FU administered intra-arterially in a continuous circadian mode, 60 mg/m2 Rescuvolin given i.v. as a 2-hour infusion, 80 micrograms/m2 GM-CSF given i.a. as a 1-hour infusion, day 3 chemoembolization with 25 mg/m2 Melphalan plus Lipiodol and Gelfoam. RESULTS: 66 patients (38 male/28 female) with a median age of 60.4 years and a median Karnofsky index of 87.3 were treated with 299 cycles of immunochemoembolization. Fifty-four percent of these patients had received prior systemic chemotherapy. Side effects were manifested in all patients, mainly upper abdominal pain lasting one to four days and grade 1 or 2 vomiting. Systemic side effects were mild and transient with a very low rate of leukopenia. Using World Health Organization response criteria, the following responses could be demonstrated CR 1.0%, PR 42.4%, MR 24.2%, SD 18.2%, NR 12.1%. Time to progression was 8 months. Median survival has not been reached after an observation time of 28 months. Two-year survival was 66%. There was no statistically significant difference between chemonaive patients and patients pretreated by any kind of systemic therapy. CONCLUSIONS: Repetitive high concentrated regional chemotherapy by use of chemoembolization combined with continuous administered 5-FU and supplemented with GM-CSF is an effective tool in the therapy of disseminated colorectal liver metastases as front line as well as a second-line treatment.

Adenocarcinoma↗
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Influence of endothelium on the vasoconstrictor effect of dihydroergotamine in pithed rats.

The aim of the present paper was to investigate whether endothelial damage influences the vasoconstrictor activity of dihydroergotamine in pithed normotensive rats. Intravenous administration of dihydroergotamine caused a dose-dependent increase in mean arterial blood pressure. Endothelial lesions were produced by a bolus injection of homocysteine (100 mg/kg) or methionine (100 mg/kg every 24 hr for 6 days). In these animals, the resting blood pressure was not influenced, while the dihydroergotamine-induced pressor effect was significantly enhanced with an increase in the maximum effect. Pretreatment of the animals with NG-nitro-L-arginine (10 mg/kg), which inhibits the biosynthesis of the endothelium-derived relaxing factor in endothelial cells, markedly enhanced the pressor response to dihydroergotamine accompanied with an increase in the maximum response. Intravenous administration of NG-nitro-L-arginine alone led to a sustained increase in blood pressure by 19 +/- 4 mm Hg. In comparative studies with noradrenaline, the dose-response curve for the pressor effect was shifted to the left after pretreatment of the rats with methionine or NG-nitro-L-arginine, whereas the maximum effect remained unchanged. The results suggest that the impaired basal release of the endothelium-derived relaxing factor accounts for the increased vasoconstrictor activity of dihydroergotamine. This might be an explanation for the vasospastic effects of dihydroergotamine in arterial vessels with endothelial damage.

Animals↗