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Biomedical subjects

H Vogelsang

Publications and source records attributed to H Vogelsang.

At least 127 records · Page 7Linked to original sources
PubMed1994

Analysis of human T cell clones reactive with group V grass pollen allergens.

Twenty-seven T cell clones (TCC) reactive with group V allergens of Phleum pratense (Phlp V) were established from the peripheral blood of 3 patients allergic to grass pollen. Twenty-four TCC showed the helper cell phenotype CD3+, CD4+, CD8-; the remaining clones were CD3+CD4-CD8+. T cell recognition of Phlp V was exclusively HLA-DR restricted. Many of the Phlp V reactive TCC (19 of 27; 70%) were stimulated additionally by other group V allergens isolated from Lolium perenne, Poa pratensis, and Dactylis glomerata. These data indicate the existence of cross-reacting T cell epitopes among group V allergens of different grasses. The Phlp V triggered cytokine production demonstrated in 13 out of 24 CD4+ TCC a Th2-like pattern (high interleukin 4/gamma-interferon ratios) suggesting group V allergens as important targets of grass pollen specific IgE.

Adult↗
PubMed1993

Intestinal permeability and the prediction of relapse in Crohn's disease.

To see whether intestinal permeability (IP) predicted relapse in Crohn's disease, we measured IP in 72 patients with quiescent Crohn's disease using the lactulose-mannitol test. The permeability index (lactulose/mannitol) was significantly higher in patients than in controls (0.046 [SEM 0.005] vs 0.018 [SEM 0.002], respectively). Patients were followed for 1 year after the test. 26 of the 37 patients with raised permeability, but only 6 of the 35 with normal permeability relapsed within 1 year after the test (p < 0.001). The sensitivity of the permeability test as a predictor for relapse was 81%. A significant correlation was found between the value of the permeability index and the probability of relapse (p < 0.01). These results show that increases in intestinal permeability precede clinical relapses in Crohn's disease and so are an indicator of subclinical disease. The measurement of intestinal permeability may lead to a better understanding of the pathogenesis of Crohn's disease.

Adult↗
PubMed1993

In patients with common variable immunodeficiency, interleukin-6 and expression of its receptor on B-cells are normal.

In a group of patients suffering from common variable immunodeficiency (CVID), levels of interleukin-6 (IL6) were measured and found to be in the normal range or even increased, for single patients. IL6 production of peripheral blood mononuclear cells was shown to be in the normal range when corrected for monocyte number. To exclude the possibility that the Interleukin-6 receptor (IL6R) on B-cells is missing, its expression was measured by assessing the binding of a Phycoerythrin-derivative of IL6 by flow cytometry and correlated with various markers for B-cells and T-cells. As compared with normal controls, no statistically significant deviation of the group as a whole nor for individual patients could be shown. It was concluded that lack of B cell differentiation in the presence of normal to high IL6 as shown for these patients is not due to inability of the B cells to detect IL6 in the serum.

Antigens, CD↗
PubMed1993

Endoscopic ultrasonography versus computed tomography in the differential diagnosis of perianorectal complications in Crohn's disease.

In this prospective study the performance of transrectal or transvaginal endoscopic ultrasonography (EUS) was compared with that of computed tomography (CT) in the diagnosis of perirectal fistulae, abscesses and diffuse inflammatory changes in the lower pelvis in 25 patients with Crohn's disease. Results were verified by surgery in eight patients and by correlation with findings on endoscopy, barium radiography and fistulography, and the clinical course in all other patients. EUS was superior to CT in diagnosing fistulae (14 vs 4 correct diagnoses) and inflammatory infiltration of the lower pelvic muscles (11 vs 2 correct diagnoses). The methods were equivalent in diagnosing perianorectal abscesses. CT was superior in the detection of inflammatory changes in the pararectal fasciae and fatty tissue which could not be detected by EUS. It is concluded that EUS should be used as the primary method for diagnosing perianorectal changes in patients with Crohn's disease especially in the case of fistulae and abscesses, having the added advantage of lack of radiation for the patient.

Abscess↗
PubMed1993

Molecular forms of pseudocholinesterase in patients with Crohn's disease.

Previous studies have shown that pseudocholinesterase (PCHE) is low in patients with Crohn's disease (CD). This finding, however, failed to be of clinical relevance due to the wide normal range. PCHE consists of four main molecular forms designated as C1, C2, C3 and C4 according to their electrophoretic mobility. The question of the present study was to assess the influence of CD on the distribution and pattern of the PCHE isozymes. We therefore investigated the electrophoretic separation of PCHE in 16 healthy volunteers (HV), in 15 patients with quiescent CD (QCD; CD activity index: median = 71, interquartile range = 44-122) and in 10 patients with active CD (ACD; CD activity index: 229, 173-304). In most of the cases total serum PCHE activity was within the normal range even in patients with active CD. No changes of the isozyme pattern were found but the percentage distribution was significantly influenced by the inflammatory activity in patients with active CD:C1 (HV: 14.7%, 13.7-18.1%; QCD: 16.0%, 9.8-19.9%; ACD: 8.5%, 2.9-12.5%, p < 0.01) and C2 (HV: 8.0%, 6.7-10.5%; QCD: 9.0%, 7.9-9.7%; ACD: 6.7%, 3.2-8.6%, p < 0.05) were decreased in active CD while the C4 component (HV: 66.8%, 62.5-69.9%; QCD: 63.1%, 54.9-73.8%; ACD: 77.3%, 70.7-90.1%, p < 0.01) was increased. The percentage of the C3 band (HV: 5.7%, 4.6-6.9%; QCD: 6.8%, 4.6-8.4%; ACD: 5.3%, 2.8-6.8%, NS) was unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Effect of a lactose-free diet on irritable bowel syndrome].

Pathological lactose-H2-breath test is a frequent finding in patients with suspected irritable bowel syndrome. We found it in 33 of 55 patients (60%) with chronic non-specific abdominal symptoms. Follow-up examinations after 15 months (mean) exhibited that lactose-free diet relieved symptoms in 57% of these patients completely or nearly completely. In contrast, only 12% of the patients without lactose malabsorption showed equal amelioration on the various unspecific diets and medications. The lactose-free diet succeeded particularly in young patients and patients with a short history of complaints. Therefore, we recommend lactose-H2-breath test in all patients with suspected irritable bowel syndrome for optimizing therapy.

Adult↗
PubMed1993

[In vitro IL-6- and immunoglobulin-production in patients with variable immunodeficiency syndrome (CVID)].

In vitro immunoglobulin and IL-6 synthesis were investigated in patients with CVID and healthy controls. The IL-6 production was increased in CVID patients. However, after calibration to equal monocyte counts in the mononuclear cell population the difference between patients and controls was no longer significant. The immunoglobulin production in CVID was decreased but no correlation between immunoglobulin and IL-6 production was found. From these results we suggest that monocyte activation might be of importance in terms of secondary organ lesions frequently occurring in CVID patients.

Cells, Cultured↗
PubMed1993

Are single measurements of pseudocholinesterase and albumin markers for inflammatory activity or nutritional status in Crohn's disease?

Serum pseudocholinesterase (PCHE) activity and serum albumin concentration have been used as markers for inflammatory activity as well as malnutrition in Crohn's disease (CD) with controversial results. Therefore we investigated the valence of both proteins as markers of inflammation and/or malnutrition in 50 patients with active CD [Crohn's disease activity index (CDAI): median = 243; interquartile range = 191-288] and 70 patients with quiescent CD (CDAI: 62; 25-96). Thirty patients were malnourished, 18 with active [body weight: 84%; 79-88% IBW (ideal body weight)] and 12 with quiescent CD (87.5%; 81.5-88% IBW), and 90 patients were well nourished, 32 with active (96%; 93-112% IBW) and 58 with quiescent CD (104.5%; 96-116% IBW). Median values of PCHE activity and albumin concentration were within the normal range in both groups, in patients with active as well as quiescent CD. PCHE activity was decreased only in 24 patients (48%) with active, but also in 11 (15.7%) patients with quiescent disease. Albumin concentration was decreased in 12 patients (24%) with active and in one patient (1.4%) with quiescent disease. Comparing the two patient groups PCHE activity and albumin concentration were significantly lower in active than in quiescent CD [PCHE: 3.70 kU/l; 3.00-4.30 kU/l vs. 4.80 kU/l; 3.75-5.82 kU/l, p < 0.001; Albumin: 38.0 g/l; 35.1-39.9 g/l vs. 43.8 g/l; 40.8-46.3 g/l, p < 0.001]. Both proteins were significantly lower in malnourished than in well nourished patients, except albumin in patients with quiescent CD. Repeated measurements of PCHE and albumin in patients during and after active phases showed significant increases of both proteins.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[Results of allogenic and autologous bone marrow transplantation in children with acute myeloid leukemia].

We report on our experience of bone marrow transplantation (BMT) in children with acute myeloblastic leukaemia (AML) and high risk of relapse (initial WBC greater than 20 x 10(9)/l, FAB M 5, M 6, M 7). 32 children were grafted between november 1982 and october 1991 at the Children's Hospital of the University of Jena. Two patients underwent an allogenous BMT in relapse and died from progressive disease. In 13 children an allogeneic BMT was performed in first complete remission. One patient relapsed, two patients died from severe acute graft-versus-host disease, and two patients died from encephalopathy and cardiomyopathy. Eight of the 13 patients are living and well 18 months to eight and a half year after BMT. Seventeen patients received an autologous (unpurged) BMT. Four of them relapsed four to seven months after BMT. The disease free survival (DFS) for the 29 patients grafted in remission was 0.65. There was no statistical significant difference in DFS between patients with allogeneic and autologous BMT. We conclude that in children with AML and high risk for relapse BMT offers a real chance for better survival. Autologous BMT avoids the problems of graft-versus-host disease and of finding suitable donors for allogeneic marrow transplantation.

Adolescent↗
PubMed1991

Comparison of enteral nutrition and drug treatment in active Crohn's disease. Results of the European Cooperative Crohn's Disease Study. IV.

This study compared the effect of enteral nutrition as the sole therapy of active Crohn's disease with drug treatment. Patients with active Crohn's disease (Crohn's Disease Activity Index greater than 200) were randomized to receive either enteral nutrition with a liquid oligopeptide diet (n = 55) or a combination of 6-methylprednisolone, 48 mg daily, subsequently tapered, and sulfasalazine, 3 g daily (n = 52). The two groups were not different with respect to age, sex, body weight, location of disease, or treatment before the study. The severity of disease was similar at the beginning of the study in both groups [Crohn's Disease Activity Index (mean +/- SEM), 323 +/- 12 vs. 316 +/- 11]. Remission was defined as a decrease of the initial Crohn's Disease Activity Index by 40% or at least 100 points. Twenty-nine patients in the diet group and 41 patients in the drug group reached remission within 6 weeks of therapy (chi 2 test, P less than 0.01). The median elapsed time to remission was 30.7 days in the diet group compared with 8.2 days in the drug group (Mantel Cox, P less than 0.01). To determine whether one of these treatments was more beneficial for a subgroup of patients, the effectiveness of both treatments was analyzed separately in patients with very severe disease (initial Crohn's Disease Activity Index greater than 300) and less severe disease (initial Crohn's Disease Activity Index less than 300), and in patients with different disease location. However, no influence of initial disease activity or disease location on the effect of either treatment could be shown. These data show that enteral nutrition is less effective than a combination of 6-methylprednisolone and sulfasalazine in treating active Crohn's disease.

Adult↗
PubMed1989

Bone disease in vitamin D-deficient patients with Crohn's disease.

Vitamin D deficiency is frequently observed in patients with Crohn's disease and may be associated with an increased risk of development of metabolic bone disease. To estimate the incidence of metabolic bone disease by noninvasive methods, 31 patients (17-75 years old) with Crohn's disease and low 25-hydroxyvitamin D (25-OHD) levels in winter were investigated in the following summer by measuring the bone mineral content (BMC) of the distal radius by single photon absorptiometry and the cortical area ratio (CAR) calculated from radiographs of the right hand and by x-ray of the lumbar spine. Forty-five percent of the patients showed signs of metabolic bone disease. BMC and CAR correlated with 25-OHD serum levels (P less than 0.05), especially in men. Furthermore, the amount of sun exposure has an influence not only on 25-OHD serum levels both in summer and in winter (P = 0.0006), but also on the BMC (P = 0.07). Consequently, vitamin D deficiency is of major importance for the development of metabolic bone disease in patients with Crohn's disease. Vitamin D deficiency can be prevented by increasing sun exposure and long-term vitamin D supplementation.

Adolescent↗
PubMed1989

Small bowel function after surgery for chronic radiation enteritis.

The retention of the gamma-emitting 75Se-homotaurocholic acid (SeHCAT) after 72 and 168 h was assessed in 10 patients after ileal resection for radiation injury (group I). 6 patients suffering from chronic postirradiation diarrhea (group II) and 6 patients in whom the ileum had been resected for other indications (group III) were also examined. The retention of SeHCAT was abnormally low (less than 50%) in all cases after 72 h and below 20% in 19 out of 21 cases after 168 h. The length of resected small bowel (groups I and III) was inversely related with SeHCAT retention after 72 h (r = 0.63; p = 0.015), but not after 168 h. There was no correlation between the diarrhea score and the extent of bowel resection, SeHCAT retention or xylose absorption. Hydrogen breath test with lactulose revealed a significantly shortened orocecal transit time in group I, compared to groups II and III. Xylose absorption was significantly reduced in patients with positive 5 g xylose-H2 breath test. In groups I and III, however, xylose absorption tended to improve with increasing time interval following resection (r = 0.79; p = 0.003). It is concluded that radiation injury in addition to small-bowel resection contributes significantly to malabsorption and diarrhea in patients after ileal resection for radiation sequelae. The chronic radiation damage seems to act mainly through impaired motility.

Body Weight↗
PubMed1989

Plasma level and renal excretion of iotrolan after lumbar injection in patients.

Ten milliliters of iotrolan containing 240 mg I/ml were injected into the lower lumbar subarachnoid space of ten patients. Plasma level and urinary and fecal excretion were monitored for 3 days after injection. The mean iodine concentration in the plasma of about 50 micrograms/ml (6% of the dose given in the total plasma volume) peaked at 1 to 2 hours after injection. After reaching the maximum values, the iotrolan concentration in the plasma decreased with a half-life of about 4 hours (median value). About 90% of the injected dose was found in the urine and about 1% was detected in the feces.

Adult↗
PubMed1988

Acidic colonic microclimate--possible reason for false negative hydrogen breath tests.

About 5% of normal subjects fail to produce increased hydrogen breath concentration after ingestion of the non-digestible carbohydrate lactulose (low hydrogen producers). The existence of low hydrogen producers limits the diagnostic use of hydrogen (H2) breath tests. We studied the effects of lactulose and of magnesium sulphate (MgSO4) pretreatment on stool-pH and on hydrogen exhalation after oral loading with lactulose or lactose in 17 hydrogen producers and 12 low hydrogen producers. In seven hydrogen producers acidification of stool pH by lactulose pretreatment (20 g tid) decreased hydrogen exhalation and three of seven (43%) became low hydrogen producers. In contrast, after pretreatment of eight low hydrogen producers with magnesium sulphate (5 g twice daily) all eight produced hydrogen after a lactulose load. Similarly four lactose intolerant low hydrogen producers had abnormal lactose hydrogen breath tests after MgSO4 pretreatment. MgSO4 pretreatment neither resulted in false positive lactose hydrogen breath tests in five lactose tolerant hydrogen producers, nor increased the hydrogen exhalation in five additional hydrogen producing controls after ingestion of lactulose. The results of these studies confirm that hydrogen production from lactulose decreases when the colonic pH is lower (lactulose pretreatment), and increases when colonic pH is higher (MgSO4 pretreatment). In low hydrogen producers the lacking increase of H2 exhalation after ingestion of non-digestible carbohydrates can be overcome by MgSO4 pretreatment, thus increasing the sensitivity of the test by avoiding false negative hydrogen breath tests in low hydrogen producers with disaccharide malabsorption or maldigestion. The underlying mechanism of this remarkable effect of MgSO4 pretreatment warrants further investigation.

Breath Tests↗
PubMed1988

[T-cell subpopulations and suppressor activity in atopic and infection-induced asthma].

We determined the T-lymphocyte subpopulations by means of monoclonal antibodies (CD 3, CD 4, CD 8) and the so-called suppressor index (increased lymphocyte stimulation after 24 h preincubation) in 20 patients with extrinsic asthma and in 18 patients with intrinsic asthma. In patients with extrinsic asthma we found an increase of ratio CD 4/CD 8. The short-living suppressor activity was significantly decreased in patients with intrinsic asthma.

Antibodies, Monoclonal↗
PubMed1987

Morphologic criteria of progression and regression of cardiac hypertrophy.

The heart is able to adapt itself to a demanded load by increasing (hypertrophy) or decreasing (regression of hypertrophy) its muscular mass within a wide range. Overstressing of the ability of adaptation is accompanied by degenerative changes of myocytes. Semiquantitative investigations of endomyocardial biopsies (EMCBs) of patients with dilative cardiomyopathy (DCM) and hypertrophic nonobstructive cardiomyopathy (HNCM) show a fibrosis of the interstitial space, as well as almost similar changes of myofibrils and mitochondria. A reduced number of myocytes in hearts with DCM could explain the decreased functional capacity. Quantitative investigations of endomyocardial biopsies and myectomy specimens in patients with hypertrophic obstructive cardiomyopathy have revealed that hypertrophy and, to a certain extent, hyperplasia of muscle fibers cause asymmetrical thickening of the septum. Experimental investigations of the regression of training-induced hypertrophy in rats have shown that nearly all parameters (cardiac weight, thickness of muscle fibers, myofibrillar mass, interstitial space, and capillary width) returned to the values of controls 14 days after termination of a swimming training regimen. A significantly higher density of capillaries after regression of muscle fiber hypertrophy compared to controls points to a temporal dissociation in the regression of myocyte size and capillary network. Decrease in RNA concentration and an increased number of autophagic vacuoles give evidence for decreased anabolism and increased catabolism may occur during regression. In humans, fibrosis of the myocardium and scar formation explain the irreversibility of cardiac hypertrophy, as observed in some patients with valvular heart disease, despite valve replacement.

Adult↗
PubMed1986

[Morphologic studies following coronary thrombolysis and PTCA].

Compared with those of other species human coronary arteries show a particularly marked diffuse thickening of the intima. Superimposed on this diffuse thickening local sclerotic changes develop. In early stages they contain plenty of lipids which are mainly stored in modified smooth muscle cells, partly also in cells of monocytic origin. Normally ruptures of arteriosclerotic plaques are responsible for thrombotic occlusions in extensive transmural myocardial infarctions. They are caused by ruptures of the fibrous layer covering the necrotic core of the plaque. By thrombolytic therapy platelet thrombi can be dissolved but the causal stenosing plaques remain. Arteriosclerotic stenoses can be dilated by PTCA. In doing so tears in the area of the plaque can be observed. Often there is partial detachment of the intima from the media, sometimes even extensive dissection. Proliferation of smooth muscle cells is important regarding healing of these tears. They build up a neointima and can cause restenoses in cases of massive proliferation. So far it is unknown how often platelet thrombus formations and their successive stages are involved in causing restenoses. In addition it is not yet clear how far stretching of the media and the collagenous fibers of the adventitia contributes to a permanent dilatation of the lumen after PTCA.

Angioplasty, Balloon↗