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Biomedical subjects

H Rosenthal

Publications and source records attributed to H Rosenthal.

At least 37 records · Page 2Linked to original sources

Parasitation with Pseudoterranova decipiens (Nematoda) influences the survival rate of the European smelt Osmerus eperlanus retained by a screen wall of a nuclear power plant.

A total of 354 adult European smelts Osmerus eperlanus (L.) were tested for their ability to survive the screen system of the cooling water inflow of a power plant. With increasing number of musculature parasitic third-stage larvae of Pseudoterranova decipiens, the survival rate of O. eperlanus decreased while the total number of externally visible injuries as well as the number of seriously injured specimens increased. The results indicate that even a single specimen of P. decipiens influences resistance and stamina and affects overall mortality of 7 to 20 cm long smelts. The initial effect of the parasites is to reduce swimming speed of infested fish, which leads to more frequent contact of these fish with the fine meshed screen of the cooling water inlet before they are removed by the automatic cleaning system. If the separated fishes are returned to the main stream, it becomes apparent that the cooling water inflow selectively reduces the number of living parasitised smelt in the area. Thus, the number of parasitic third-stage P. decipiens larvae in the local smelt population which are able to complete their life-cycle is also reduced. P. decipiens makes infested smelt more susceptible to negative anthropogenic influences such as cooling water intake or trawl fisheries.

Animals↗

Intravascular ultrasound-guided percutaneous fenestration of the intimal flap in the dissected aorta.

BACKGROUND: Aortic dissection with branch obstruction is associated with high morbidity and mortality. Fenestration of the dissection flap to relieve distal vessel ischemia is at present largely performed surgically. The surgical mortality and morbidity are high, because most patients are poor candidates for anesthesia or surgery. METHODS AND RESULTS: Nine percutaneous fenestrations (one with additional stenting of the infrarenal true aortic lumen) were performed under local anesthesia in seven patients with aortic dissection. The presenting symptoms were abdominal angina or claudication. By the transfemoral approach, the intimal flap was initially punctured with a needle-catheter combination through which a guidewire was placed across the dissection flap. The fenestration was carried out with a balloon catheter introduced over the guidewire. The procedure was performed under on-line guidance with intravascular ultrasound imaging. The procedure was performed successfully and without complications in all patients. After intervention, symptoms resolved in all seven patients. CONCLUSIONS: Intravascular ultrasound-guided percutaneous fenestration of the intimal flap in symptomatic aortic dissections with distal vessel involvement is a technically feasible and safe procedure that can effectively relieve the patient's symptoms.

Adult↗

[Therapy of persistent bleeding esophageal varices using intrahepatic portosystemic stent shunt and immediate liver transplantation].

A 41-year-old patient with liver cirrhosis due to autoimmune hepatitis received an emergency transjugular portosystemic stent shunt for uncontrolled acute variceal hemorrhage. Because of markedly impaired liver function, liver transplantation was considered to be indicated and was performed on the following day. Intraoperatively, one of the intrahepatic metal stents migrated unnoticed into the pulmonary artery. The postoperative course was uncomplicated and the displaced stent was left in situ. Eighteen months after the transplantation the patient is well with normal liver function and no pulmonary problems.

Adult↗

Cytogenetic findings in 73 osteosarcoma specimens and a review of the literature.

Tumor-specific chromosomal abnormalities have been identified in several histologic subtypes of sarcomas. Characterization of recurrent chromosomal abnormalities has provided direction for molecular investigations of pathogenetically important genes. Cytogenetic reports of osteosarcoma, the most common primary malignant bone tumor, are relatively rare. In this study, 73 osteosarcoma specimens from 51 patients were cytogenetically analyzed following short-term culture. Clonal chromosomal abnormalities were detected in 47 and included one haploid specimen, 18 near-diploid specimens, 17 near-triploid, 8 near-tetraploid, 1 near-hexaploid, and 2 specimens with multiple clones of different ploidy levels. Examination of the present data and previously published data (111 clonally abnormal osteosarcoma specimens) reveals that chromosomal bands or regions 1p11-13, 1q10-12, 1q21-22, 11p15, 12p13, 17p12-13, 19q13, and 22q11-13 are most frequently rearranged and the most common numerical abnormalities are +1, -9, -10, -13, and -17. Partial or complete loss of the long arm of chromosome 6 also was seen in all cases of the present study and all previously published cases describing structural abnormalities of 6q. Parosteal osteosarcoma, a prognostically favorable osteosarcoma subtype, was characterized by the presence of a ring chromosome accompanied by no or few other abnormalities. Complex karyotypes were seen nearly exclusively in the high-grade lesions. These findings indicate that specific chromosomal bands and/or regions are nonrandomly involved in osteosarcoma and may provide useful clinical information.

Adolescent↗

Initiation and perpetuation of rat adjuvant arthritis is inhibited by the anti-CD2 monoclonal antibody (mAb) OX34.

OBJECTIVE: The purpose of this study was to investigate the therapeutic potential of the anti-CD2 mAb OX34 first with regard to bone protection in established rat adjuvant arthritis (AA) and secondly with regard to prevention of AA induction. METHODS: Established AA was treated with dexamethasone (1 mg/kg body weight) for two days plus OX34 mAb or control mAb over three days (2 mg and then 1 mg) starting at different time points of the disease. For prevention studies animals were injected as above with mAb before induction of AA. Arthritis score (AS), hindpaw thickness, and body weight were blindly measured three times per week. Flow cytometry and hindpaw radiography were performed at the end of the study (day 29). RESULTS: Treatment of early AA with OX34 mAb combined with dexamethasone but not dexamethasone plus control mAb dramatically suppressed established AA as assessed by AS and hind paw thickness (> 65% and > 80% reduction, respectively; p < 0.05). Most importantly, early treatment in the course of AA almost completely prevented bone destruction in established AA. When given before AA induction OX34 alone prevented the initiation of arthritis compared with controls (AS reduction 83-95%, p < 0.05). In addition, OX34 plus dexamethasone treatment resulted in depletion of CD4+ T cells but not CD8+ T cells. IL2R+ and CD45RC- ('memory') T cells were significantly reduced. CONCLUSIONS: Anti-CD2 mAb treatment prevents AA induction confirming the role of CD4+ T cells in the induction phase of AA. In addition, early OX34 plus dexamethasone treatment resulted in pronounced clinical improvement and joint protection. OX34 treatment therefore inhibits the initiation and the perpetuation of rat AA.

Animals↗

MRI of breast cancer: influence of chemotherapy on sensitivity.

MR mammography (MRM) seems to be a sensitive method for detection of breast cancer. The effect of cytotoxic agents on the dynamics of contrast medium uptake in primary breast carcinoma or recurrent disease is not known. This study addresses this question and evaluates MRM as a method of monitoring therapeutic success. A total of 13 patients (age range 34-62 years) with histologically confirmed breast cancer were investigated. The patients received neoadjuvant intravenous (iv) chemotherapy. MRM and interpretation of the dynamic measurements were performed in a standardized manner after positioning the patient in a double breast coil. A gradient echo sequence (Flash 3D, TE 5 ms, TR 12 ms, flip angle 25 degrees) was acquired before and 1, 2, 3 and 8 min after intravenous injection of Gd-DTPA 0.15 mmol kg-1 body weight. A T2 weighted SE sequence (TE 103 ms, TR 6900 ms, 4 mm, field of view 350 mm) was also obtained. MRM was performed prior to histological evaluation and after chemotherapy. All cases of malignancy were correctly diagnosed with MRM. Based on MR findings, eight patients were classified as "responders" and the remaining as "non-responders". In the "responders" a flattening of the Gd-DTPA uptake curve after the first cycle of chemotherapy of complete absence of Gd-DTPA uptake after the fourth cycle was observed. The change in Gd-DTPA uptake behaviour led to an underestimation of the extent of tumour in two patients and false negative findings in four patients. MRM provides information regarding response to therapy following the first cycle. MRM does not provide information regarding invasive tumour tissue in "responders".

Adult↗

Der(16)t(1;16)(q21;q13) as a secondary structural aberration in yet a third sarcoma, extraskeletal myxoid chondrosarcoma.

Cytogenetic analysis of an extraskeletal myxoid chondrosarcoma revealed a der(16)t(1;16)(q21;q13) in addition to the t(9;22)(q22;12) described as characteristic for this chondrosarcoma clinicohistopathologic subtype. An identical der(16) has been identified as the most common secondary structural aberration in Ewing's sarcoma and alveolar rhabdomyosarcoma.

Chondrosarcoma↗

Hibernoma.

Hibernoma is a rare, benign soft tissue tumor composed of brown fat. A 42-year-old white man presented with an enlarging soft tissue mass located in his left medial thigh. This was evaluated radiographically by CT as well as MR imaging. An open biopsy revealed a hibernoma. The mass was subsequently excised in its entirety, maintaining a cuff of normal tissue. The patient has done very well postoperatively. Although nearly 100 cases have been reported, this case is presented to review the clinical and pathological presentation of this tumor and to describe its MR imaging characteristics.

Adult↗

A model of genital Chlamydia trachomatis infection using human xenografts in severe combined immunodeficiency mice.

We developed a new model of human genital Chlamydia trachomatis infection in order to characterize the pathogen-host relationship in a clinically relevant system using a human strain of C. trachomatis instead of the commonly employed mouse biovar (MoPn). Human endometrial tissue was xenografted into the skin of mice homozygous for the mutation severe combined immunodeficiency and inoculated with C. trachomatis serovar K. C. trachomatis efficiently infected the endometrium as shown by cell culture and immunofluorescence microscopy and persisted for more than 6 weeks. Chlamydial inclusions detected by direct immunofluorescence and electron microscopy appeared to be smaller than those produced by in vitro cell culture-grown chlamydiae. A pattern of localized mild infection prevailed, and infiltrative uncontrolled spread of chlamydiae was observed in only 1 of 10 infected grafts. This might correspond to the well-known tendency of the agent to cause asymptomatic infections. This model allows the study of a human genital infection resembling the clinical situation and offers the possibility to better characterize the host-parasite relationship with respect to pathogenicity and therapy.

Animals↗

Thrombosis of the terminal aorta, deep vein thrombosis, recurrent fetal loss, and antiphospholipid antibodies. Case report.

The antiphospholipid syndrome (APS) consists clinically of both arterial and venous thrombosis, recurrent fetal loss and thrombocytopenia associated with antiphospholipid antibodies (aPL). Most of these patients were initially found to suffer from systemic lupus erythematosus (SLE). There is an increasing group of patients who exhibit antiphospholipid antibodies and thrombotic complications without clinical features of SLE or related autoimmune disease termed primary antiphospholipid syndrome (PAPS). The case of a 29-year-old woman with thrombosis of the terminal aorta and deep vein thrombosis, recurrent fetal loss, antiphospholipid antibodies and serological support for an underlying connective tissue disease, probably preclinical SLE is reported.

Abortion, Habitual↗

Diarrhea, massive ascites, and portal hypertension: rare case of a splenic arterio-venous fistula.

Portal hypertension is a result of chronic liver disease in the majority of cases. Rare, potentially curable causes of portal hypertension include vascular conditions such as hepatic or portal venous thrombosis and arterio-portal fistulas. We present the rare case of a spontaneous splenic arterio-venous fistula in a 40 year old multiparous woman. The young woman presented with massive diarrhea, ascites, abdominal pain, and an abdominal machinery type bruit and represents the second ever reported case with diarrhea as presenting symptom of splenic arterio-venous fistula. The diagnosis was confirmed by color Doppler ultrasound. Transfemoral aortography was performed to assess the possibility of catheter embolization. Surgical intervention was initially complicated by collateral arterial tributaries of the fistula and finally resulted in a dramatic recovery with persistent resolution of all symptoms. This case report demonstrates a curable form of portal hypertension that must be considered in acute onset portal hypertension in multiparous women and in the absence of liver disease. A machinery type bruit in the upper left abdominal quadrant represents an important and simple diagnostic symptom found by auscultation. Color Doppler ultrasound represents a non invasive, universally applicable and fast method of establishing the diagnosis. The literature and management of splenic arterio-venous fistulas are reviewed.

Adult↗

Stable engraftment of human female genital mucous membrane xenografts on SCID mice.

We developed a model in which full-thickness human genital mucous membranes (fallopian tubes, endometrium) were heterotopically xenografted into the skin of severe combined immunodeficient (SCID) mice. The transplanted tissue retained its human phenotype for at least 4 weeks including the glandular epithelium, the lamina propria, and main parts of the grafted vessels. By using an occlusive chamber filled with covering phosphate-buffered saline we created a system that protected the moist human epithelial surface. This system will allow the study of the interaction of test substances, or of invasive, pathogenic microorganisms, with epithelial cells and other cellular components of the human genital mucosa under in vivo conditions.

Animals↗

Treatment of portal vein thrombosis by thrombectomy and regional thrombolysis.

BACKGROUND: Portal vein thrombosis is a rare disorder. The prognosis of both the acute and the chronic forms is determined by the resulting acute or chronic portal hypertension. The therapeutic approach of choice is controversial. METHODS: A case of etiologically unclear thrombosis of the portal vein system in a young man is reported, which was treated successfully by means of portal vein thrombectomy combined with intraoperative and postoperative thrombolysis with recombinant tissue plasminogen activator (rTPA). RESULTS: Initial thrombectomy established sufficient venous return. However, rethrombosis of the portal vein occurred 2 days later. In a second operation rethrombectomy was followed by intraoperative regional application of rTPA, which was continued after operation during a period of 48 hours through a catheter inserted in a mesenteric vein. Patency of the portal system was confirmed 1 week after the procedure. The 1-year follow-up reconfirmed this result (through indirect portography and Doppler sonography). The patient received the anticoagulant phenprocoumon. CONCLUSIONS: The combination of surgical thrombectomy and regional thrombolysis with rTPA could offer a feasible therapeutic option for selected patients with acute prehepatic portal vein thrombosis.

Acute Disease↗

Nipple discharge and abnormal galactogram. Results of a long-term study (1964-1990).

In case of abnormal nipple discharge of the female breast, galactography can detect variations of ductal calibre, intraductal alterations and ductal discontinuities. Between 1964 and 1990 we examined 2588 women by galactography and performed 826 duct excisions. In one out of 8 patients (13.4%) we diagnosed invasive carcinoma or ductal carcinoma in situ. In more than 40% a solitary ductal papilloma was detected. 13.7% of the patients were found to have extensive intraductal solid papillary or adenomatous epithelial proliferations. Comparison with collected statistical data reveals that other investigators are able to detect malignant changes in 1-23% of cases. We have managed the largest number of cases and have diagnosed pathologic ductal secretion in more than 3% of women we screened by physical inspection, mammography and sonography. The colour of the ductal discharge is of minor importance, as histologic analysis is mandated by the presence of ductal system alterations.

Breast Neoplasms↗

[Life expectancy of clinically occult breast cancer. Study of a comparative patient sample since 1975].

We have been observing 2 groups of 50 female patients with occult or clinical breast cancer each of whom was initially treated at the Gynaecologic Hospital of the University of Erlangen-Nürnberg between 1975 and 1978. During the follow-up period, 2 patients out of the group of occult cancer and 13 out of the group of clinical carcinoma died of their primary disease. Four women out of the group of occult cancer and 3 from the group of "clinical carcinoma" have developed recurrences. The differences in survival times according to Kaplan-Meier are immense, even if they are not significant owing to the small number of patients. But it is difficult to obtain and to evaluate larger groups of patients and longer follow-up periods due to the low percentage of occult cancer (7.7 to 10.5% only). There are 30 women out of the group of occult breast cancer living without relapse after an observation period up to 15 years. 27 patients out of the group of "clinical cancer" have not shown any evidence of recurrence up to now. This small difference after such a long follow-up period can be explained by the general life expectancy and by the age at initial treatment.

Adult↗

[Arthritic changes in small and large joints in digital and conventional x-ray images].

In order to evaluate the suitability of digital radiography for the diagnosis of skeletal abnormalities, inflammatory joint changes were used to test this technique. Early erosive changes, fine irregularities and marginal lamellar abnormalities demand a high degree of resolution from the imaging method. 6 observers studied images of the hand of 67 and of the foot of 19 patients. Joint changes were staged according to the scheme proposed by Larsen; in this study the early stages predominated. With similar techniques there were no significant differences between the digital and conventional techniques. Images of 39 large joints (knee, shoulder, elbow, ankle) were compared only subjectively since even minor differences in projection were able to obscure some erosions. However, in this case also both techniques appear to be of similar value.

Adult↗