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Biomedical subjects

J Pfeifer

Publications and source records attributed to J Pfeifer.

52 records · Page 3Linked to original sources

Perforation of the cecum by a toothpick. Case report and review of the literature.

Perforation of the colon can have any number of causes. Most often, it is the result of carcinoma or diverticulitis; specific inflammatory disease of the large intestine is a less common cause. Other possibilities are iatrogenic perforation, perforation as a result of blunt or penetrating abdominal trauma, and ingestion of a foreign body. A case of perforation of the cecum by a toothpick 3 weeks after consumption of a beef olive is reported; possible diagnostic problems, other conditions that need to be considered in the differential diagnosis and treatment are discussed.

Aged↗

[Surgical therapy of chronic anal fissure--do additional proctologic operations impair continence?].

78 patients with chronic anal fissures have been mainly operated on by lateral internal sphincterotomy (LATS). Continence have been evaluated by questionnaire at least 9 months postoperatively. Patient without any additional proctological operation had minor disturbances of continence in 17%. Patient with additional operations had disturbances of continence in 30%. Especially the subgroup of patients with LATS and haemorrhoidectomy had bad results. In this group only 45% were fully continent.

Adult↗

Collagen membrane barrier therapy to guide regeneration in Class II furcations in humans.

This study was undertaken to evaluate the effectiveness of resorbable collagen membranes in guided tissue regeneration. The study participants were 38 adults with moderate to advanced periodontitis. Each patient had at least one Class II furcation defect which could serve as either a test or control tooth. The cases were randomized prior to selection, so that investigators did not known whether the patient would be a test case or a control case until the time of surgery. Sites were surgically exposed and measurements were recorded from the cemento-enamel junction (CEJ) directly coronal to the furcation area to the alveolar crest, and to the base of the defect. Horizontal furcation measurements were also made, using a color coded furcation probe. The test patients had a trimmed and shaped collagen membrane barrier placed over the prepared furcation area. The control patients received the identical surgical management, except that no collagen membrane barrier was placed. All patients received normal post-surgical care, and at 12 weeks post-surgery, were scheduled for re-entry surgery. The re-entry mucoperiosteal flaps were designed to expose the furcation area for measurements, as described above. There was clinical improvement in all measurements made in both the test and control patients over the 3-month period. The horizontal furcation measurement and the CEJ to base of alveolar defect measurements did yield a statistically significant improvement when comparing the test patients to the controls.

Adult↗

Neisseria gonorrhoeae PilC expression provides a selective mechanism for structural diversity of pili.

Pili of Neisseria gonorrhoeae undergo both phase and structural variation. Phase variation of gonococcal pili can be caused by a RecA-independent on/off switch in PilC, a protein involved in pilus biogenesis. We show here that spontaneous nonpiliated PilC- derivatives as well as PilC- insertional mutants have also acquired sequence alterations in pilE relative to the pilE gene of the piliated MS11mk(P+)-u parent, so that the pilin produced is processed to soluble S-pilin and can be released into the medium. It is proposed that pilin alterations are selected for in PilC- bacteria if the parental nonassembled pilin is toxic to the cells--i.e., is not degradable to S-pilin at rates sufficient to allow viability of the cells. Toxicity is indicated by the extreme instability of certain unassembled pilin sequences and by the low frequency of nonpiliated, pilin+, PilC- variants that emerge from piliated recA- cells. The presence of a point mutation changing leucine-39 to phenylalanine at the cleavage site for S-pilin in one nonpiliated, PilC-, recA- variant relative to its piliated parent is a further argument for a selective mechanism of structural diversity of the gonococcal pilin.

Amino Acid Sequence↗

Introduction of intersubunit disulfide bonds in the membrane-distal region of the influenza hemagglutinin abolishes membrane fusion activity.

Influenza virus hemagglutinin (HA) mediates viral entry into cells by a low pH-induced membrane fusion event in endosomes. A number of structural changes occur throughout the length of HA at the pH of fusion. To probe their significance and their necessity for fusion activity, we have prepared a site-directed mutant HA containing novel intersubunit disulfide bonds designed to cross-link covalently the membrane-distal domains of the trimer. These mutations inhibited the low pH-induced conformational changes and prevented HA-mediated membrane fusion; conditions that reduced the novel disulfide bonds restored membrane fusion activity. We conclude that structural rearrangements in the membrane distal region of the HA are required for membrane fusion activity.

Animals↗

The Crl protein activates cryptic genes for curli formation and fibronectin binding in Escherichia coli HB101.

Curli are thin, coiled, temperature-regulated fibres on fibronectin-binding Escherichia coli. The subunit protein of curli was highly homologous at its amino terminus to SEF-17, the subunit protein of thin, aggregative fimbriae of Salmonella enteritidis 27655 strain 3b, suggesting that these fibres form a novel class of surface organelles on enterobacteria. E. coli HB101 is non-curliated and unable to bind soluble, iodinated fibronectin. The phenotypically cryptic curlin subunit gene, csgA, in HB101 is transcriptionally activated by expressing the cytoplasmic Crl on a multicopy plasmid. Transcriptional activation of csgA by Crl was observed after growth at 26 degrees C but not at 37 degrees C, even though crl transcription was not thermoregulated. A deletion of the 39 carboxy-terminal residues abolished Crl activity, whereas a deletion of 10 residues at the C-terminus did not, implying that a region between residue 93 and 122 in the 132-amino-acid-residue large Crl protein is required for activating curli expression in E. coli HB101. crl is a normal housekeeping gene in E. coli and it is suggested that its gene product may either be a DNA-binding protein affecting chromatin structure as has been suggested for histone-like protein H1 or interact with specific regulatory protein(s) controlling transcription of genes required for curli formation and fibronectin binding.

Amino Acid Sequence↗

The Kasabach-Merritt syndrome: severe bleeding disorder caused by celiac arteriography--reversal by heparin treatment.

Studies are presented on a 62-yr-old woman with extreme hepatomegaly due to a giant hemangioma with alterations in the clotting system indicating a consumption coagulopathy. There was a fall of hemoglobin, fibrinogen, antithrombin III, and platelet number after arteriography of the truncus celiacus. Furthermore, there was sustained bleeding in the patient's right thigh caused by puncture of the arteria femoralis. Continuous administration of iv heparin corrected the clotting disorder including a rise in platelets from 95,000/microliters to 148,000/microliters, permitting surgical removement of the hematoma. Celiacography is a useful tool for the diagnosis of hepatic hemangiomata, as well as ultrasound, computed tomography, and magnetic resonance imaging. Being an invasive technique, it requires testing for possible consumption coagulopathy if used in patients with hemangiomatosis. Its application should be restricted to cases in which exact diagnosis cannot be established by other means.

Angiography↗

[The question of IgE activity in the mucosa of the large intestine].

The importance of the IgE mediated inflammatory process of the large bowel mucosa was investigated by examining rectal biopsies using the peroxidase-antiperoxidase method in 172 patients to demonstrate IgE cells in the inflammatory infiltrate. IgE-positive cells could be demonstrated in small numbers in all specimens. The numeration of the plasma cells in the inflammatory infiltrate showed in most cases between 1 and 3% positive cells, only in four specimens between 5 and 6% and in two over 10%. The four groups of the specimen biopsied showed no difference in the frequency of IgE cells. The larger number of such cells in colitis ulcerosa should be viewed as the result of the more intense inflammatory process in the specimen. There was no difference either in the frequencies of mast cells in the mucosa. The findings of this investigation do not support a causative role of IgE mediated processes, in particular of the chronic inflammatory bowel disease.

Chronic Disease↗

[Computerized tomography study in carpal tunnel syndrome].

A comprehensive study shows that the computer tomogram in proven carpal tunnel syndrome displays changes in the structures in the carpal tunnel like edema or fibrous modifications of the synovium in a clear form. Tumors and bone constrictions are also demonstrated by the help of the tomogram. In the same way, thickening of the flexor retinaculum or its displacement causing compression of the median nerve can be seen. Postoperatively we can differentiate between good and poor results. Nevertheless, we do not think the computer tomogram should be part of the standard examination of the carpal tunnel syndrome.

Carpal Bones↗

[Functional scintigraphy in the diagnosis of gastroesophageal reflux (author's transl)].

The accepted diagnostical procedures to prove a gastroesophageal reflux by direct or indirect methods do not allow any quantification and are of limited sensitivity. A quantification is possible by use of a gamma-camera with a computer-system after application of a small amount of 99m Tc-DPTA (reflux scintiscan). The high accuracy of this method could be proven by evaluation of 51 patients with suspected gastroesophageal reflux esophagitis or after total gastrectomy. The results were compared with the histological findings. With this method we found after total gastrectomy the expected high incidence of relux. The long-term results after semifundoplication were not as good as after fundoplication. The reflux scintiscan is a less invasive, but reliable method to detect the gastroesophageal reflux.

Gastroesophageal Reflux↗