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Biomedical subjects

J Rainer

Publications and source records attributed to J Rainer.

14 recordsLinked to original sources

Chronic paracoccidioidomycosis in a female patient in Austria.

Presented here is a case of chronic paracoccidioidomycosis that occurred in a Cuban female living in Austria and was first misdiagnosed as tuberculosis. The clinical picture was one of progressive pulmonary insufficiency with fever, weight loss and productive cough. Since antituberculous therapy was started but did not achieve a long-term clinical response, an intensive diagnostic work-up was performed. Paracoccidioides brasiliensis was then diagnosed by histopathology, serology, microbiology and molecular identification. Antifungal therapy was commenced immediately with amphotericin B (1 mg/kg/day) for 10 days, followed by voriconazole (200 mg/day po) for at least 3 months, and the lesions disappeared almost completely. This report presents the first published case of imported paracoccidioidomycosis in a female patient in Austria.

Adult↗

Glucocorticoid-induced apoptosis and glucocorticoid resistance: molecular mechanisms and clinical relevance.

The ability of glucocorticoids (GC) to efficiently kill lymphoid cells has led to their inclusion in essentially all chemotherapy protocols for lymphoid malignancies. This review summarizes recent findings related to the molecular basis of GC-induced apoptosis and GC resistance, and discusses their potential clinical implications. Accumulating evidence suggests that GC may induce cell death via different pathways resulting in apoptotic or necrotic morphologies, depending on the availability/responsiveness of the apoptotic machinery. The former might result from regulation of typical apoptosis genes such as members of the Bcl-2 family, the latter from detrimental GC effects on essential cellular functions possibly perpetuated by GC receptor (GR) autoinduction. Although other possibilities exist, GC resistance might frequently result from defective GR expression, perhaps the most efficient means to target multiple antileukemic GC effects. Numerous novel drug combinations are currently being tested to prevent resistance and improve GC efficacy in the therapy of lymphoid malignancies.

Animals↗

Biodiversity and concentration of airborne fungi in a hospital environment.

The biodiversity and concentration of airborne fungi were monitored over a period of 6 months in a special-care unit of a hospital. Air sampling was performed in a corridor that was also accessible to visitors and in an adjacent bone-marrow transplantation (BMT) unit using an air sampler and two isolation media. Altogether, 98 fungal species could be identified, among them Aspergillus fumigatus and A. terreus as well as 48 other species reported as potential pathogens. The average contamination values of the corridor air ranged from 124 to 485 cfu m-3. Neither the degree of fungal air contamination nor the species composition inside the special care unit differed from those found in the corridor. By means of data obtained with a light-activated sensor, a possible influence of human activities on diurnal changes of fungal propagule concentration was shown.

Air Microbiology↗

Molecular variability of Pseudallescheria boydii, a neurotropic opportunist.

The sequences of the internal transcribed spacer (ITS) ribosomal DNA (rDNA) domain data obtained by restriction fragment length polymorphism analysis with 18S rDNA and fingerprinting (M13) for clinical and environmental strains of Pseudallescheria boydii (anamorph, Scedosporium apiospermum) were compared to those for related species of Pseudallescheria, Petriella, and Scedosporium. The infraspecific variability of P. boydii was considerable. There were five different lengths in the 18S rDNAs within P. boydii due to the occurrence of introns. In several cases, strains isolated from a single pond or ditch proved to be genetically very different. Nevertheless, some lineages had a regional distribution. The variability found is unlikely to be explained by meiotic recombination alone. Pseudallescheria fusoidea, Pseudallescheria ellipsoidea, and Pseudallescheria angusta were found to be synonyms for P. boydii. Scedosporium prolificans was found amid Petriella species in the ITS tree and showed no infraspecific variability. The type strain of Rhinocladium lesnei proved to be identical to Graphium putredinis. Acladium castellanii, which is morphologically reminiscent of S. apiospermum, was also found to be a separate species, but with an unknown affiliation.

Animals↗

Black fungi: clinical and pathogenic approaches.

Data are presented on the clinically relevant black yeasts and their relatives, i.e., members of the Ascomycete order Chaetothyriales. In order to understand the pathology of these fungi it is essential to know their natural ecological niche. From a relatively low degree of molecular variability of the black yeast Exophiala dermatitidis, potential agent of brain infections in patients from East Asia, it is concluded that this species is an emerging pathogen, currently going through a process of active speciation. It is found to be an oligotrophic fungus in hot, moist environments, such as steambaths. Cladophialophora-, Fonsecaea- and Ramichloridium-like strains, known in humans as agents of chromoblastomycosis, are frequently found on rotten plant material, but the fungal molecular diversity in the environment is much higher than that on the human patient, so that it is difficult to trace the etiological agents of the disease with precision. This approach has been successful with Cladophialophora carrionii, of which cells resembling muriform cells, the tissue form of chromoblastomycosis, were found to occur in drying spines of cacti. Phagocytosis assays provide a method to distinguish between pathogens and non-pathogens, as the killing rates of strict saprobes proved to be consistently higher than of those species frequently known as agents of disease. The therapeutic possibilities for patients with chromoblastomycosis are reviewed.

Antifungal Agents↗

Bone marrow transplantation for Maroteaux-Lamy syndrome (MPS VI): long-term follow-up.

We describe the results of bone marrow transplantation (BMT) in four patients with mucopolysaccharidosis type VI (MPS VI, McKusick 253200)--Maroteaux-Lamy disease. The indications for transplantation were cardiomyopathy in three patients and severe obstructive sleep apnoea in one. The follow-up period ranges between 1 and 9 years, and three of the patients are at mainstream schools. In all of the patients the facial features have become less coarse and the cardiac manifestations have improved or remained stable. However, skeletal changes have persisted or even progressed, although posture and joint mobility have improved and all the patients have remained ambulatory and active. BMT appears to prolong survival and improve the quality of life in MPS VI patients, but careful selection of patients is essential.

Bone Marrow Transplantation↗

[Myoglobinuria and carnitine palmitoyltransferase deficiency. Diagnostic procedure and differential diagnosis].

Carnitine palmitoyltransferase (CPT) deficiency is the most common metabolic cause of recurrent myoglobinuria. We describe five patients with CPT deficiency who were recruited during a 24-months period. Phenotypic expression ranged from mild myalgia without myoglobinuria to severe exercise-induced attacks and a lethal course. The pathophysiological basis of the clinical heterogeneity is discussed. The diagnostic procedure includes a neurological and electromyographical examination as well as an exercise test and extensive biochemical investigations of muscle biopsy specimens. Accurate diagnosis allows an early introduction of preventive measures and clearly improves the outcome.

Adult↗

Hemocyanin synthesis in the blue crab Callinectes sapidus.

1. The synthesis of hemocyanin in the blue crab, Callinectes sapidus, was investigated by molecular techniques. 2. Polyadenylated mRNA was prepared from the hepatopancreas and translated in rabbit reticulocyte lysate. 3. Translation products were immunoprecipitated with immobilized antihemocyanin IgG. Analysis of the IgG-bound polypeptides by sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed two polypeptides comigrating with authentic Callinectes hemocyanin. 4. A synthetic degenerate 17-mer oligonucleotide mixture derived from the amino acid sequence of the "copper B" binding site of crustacean hemocyanins was prepared. Northern blotting showed the probe to hybridize with one major 2.3 kb RNA species. 5. These results indicate that the hepatopancreas is the site of hemocyanin synthesis.

Animals↗

Corneal edema induced by cold.

We report on a patient, who regularly developed reversible corneal edema of the right eye after cold stress. Cycling tours in cold weather and windy conditions seemed to precipitate the edema. After a provocation test, we also observed transient, corneal edema. A few reports in the literature suggested that Raynaud's disease or trigeminal neuropathy might be responsible for cold-induced corneal opacification. None of these conditions was present in our patient, as proved by laboratory tests and magnetic resonance imaging. We found that contact lenses were an effective prophylaxis against corneal edema.

Adult↗

Retroviral infections (HIV-1, HIV-2, and HTLV-I) in rural northwestern Tanzania. Clinical findings, epidemiology, and association with infections common in Africa.

During a three-week period in March/April 1987, the authors examined 253 consecutive patients referred to a rural hospital in northwestern Tanzania. Sera were tested for antibodies to human immunodeficiency virus type 1 (HIV-1), human immunodeficiency virus type 2 (HIV-2), and human T-lymphotropic virus type I (HTLV-I), as well as for various parasites, hepatitis B virus, and Treponema pallidum. Neopterin (urinary and serum) was chosen as the immunologic parameter. In eight of the 253 patients (3.2%), a clinical diagnosis of acquired immunodeficiency syndrome (AIDS) was established. Three of the AIDS patients had HIV-1 antibodies, two had HIV-1 antigen, one had both HIV-1 and HIV-2 antibodies, and in one patient, only HIV-2 antibodies were found. The total HIV-1 and HIV-2 seroprevalence (antibodies plus antigen) was 4.3%; HTLV-I seroprevalence was 9.9%. No correlation could be found between HIV (or HTLV-I) seropositivity and raised levels of antibody to the above pathogens. There was, however, a significantly positive correlation between HIV seropositivity and history of gonorrhea, whereas a history of operations, injections, vaccinations, blood transfusions, or scarification did not influence the level of HIV seropositivity. The most frequently noted epidemiologic association with HIV seropositivity was traveling to or coming from Uganda or Rwanda. Two thirds of the studied Tanzanians had elevated neopterin levels, and all seven HIV-seropositive patients with clinical signs of AIDS had extremely high serum and urinary neopterin levels compared with HIV-seropositive patients without signs of AIDS. Increased neopterin levels reflect a stimulation of the T-cell/macrophage system.

Acquired Immunodeficiency Syndrome↗

Multiple-threshold transmission of affective disorders.

Data on bipolar and unipolar affective disorders were gathered on first-degree relatives of 255 patients with both illness types. As consistent with a model of continuous liability, bipolar probands were found to have more bipolar relatives and more relatives with any affective disorder than unipolar probands. Multiple-threshold models of inheritance were applied to the data using clinical polarity as a threshold determinant. The hypothesis of multifactorial inheritance was ruled out. Autosomal single-major-locus inheritance provided an acceptable fit to the data. It is proposed that separate genetic mechanisms for bipolar and unipolar disorders need not be present. The two illness types are represented in the model at different thresholds on a single continuum of genetic-environmental liability in which bipolar illness is claimed to be more deviant genetically than unipolar illness.

Bipolar Disorder↗

Myotonic myopathy with painful muscle contractions and decrease of symptoms by cold.

Myotonic reaction and paresis accompanied by painful muscle contractions limited to the upper limbs, which decrease remarkably in the cold, were observed in a 29 year old man. The histological investigation revealed minimal non-specific signs of myopathy. The biochemical studies of muscular tissue contained a normal amount of myophosphorylase, acid maltase and glycogen. Ischemic work induced normal elevation of venous lactate. The activities of CPK, LDH and SGOT in the blood serum were occasionally increased. The EMG showed typical myotonic bursts and electrical silence during painful muscle contractions. Repetitive high frequency stimulation demonstrated a clear initial increase of the amplitude of action potentials followed by a decrease in the contracted muscle. The father of the patient suffered from dystrophia myotonica. This coincidnece suggests that this myotonic myopathy is a variant of dystrophia myotonica.

Cold Temperature↗