Identification of a Meckel's diverticulum by wireless capsule endoscopy.
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Adolescent↗
Biomedical subjects
J Schmidt
Publications and source records attributed to J Schmidt.
High prevalence of Mycobacterium avium subspecies paratuberculosis IS900 DNA in gut tissues from individuals with Crohn's disease.
BACKGROUND AND AIMS: Conflicting results exist about the presence of Mycobacterium avium subspecies paratuberculosis (MAP) specific IS900 DNA in Crohn's disease (CD) tissues. Therefore, we examined IS900 in a large number of gut samples from patients with CD (n = 100) and ulcerative colitis (UC, n = 100), and in non-inflamed control tissues (nIBD, n = 100). We hypothesised that IS900 DNA detection might be associated with distinct clinical phenotypic characteristics in CD. METHODS: The prevalence of MAP DNA in surgically resected tissues was examined using a mechanical-enzymatic disruption technique and nested IS900 specific polymerase chain reaction (PCR). CD patients were stratified according to the criteria of the Vienna classification and other clinical characteristics. RESULTS: IS900 PCR detection rate was significantly higher in CD tissue samples (52%) than in UC (2%) or nIBD (5%) specimens (p<0.0001). In CD patients, IS900 DNA was detected in samples from both diseased small bowel (47%) as well as from the colon (61%). No firm association between MAP specific IS900 detection rates and clinical phenotypic characteristics in CD could be established. However, corticosteroid medication constituted a factor which tended to have a negative influence on IS900 DNA detection rates in CD (p<0.01). CONCLUSIONS: The presence of MAP specific IS900 DNA is a predominant feature of CD. Therapeutic intervention against MAP might represent a potential target for disease mitigation in Crohn's disease.
Adult↗
Monitoring a mouse colony for Helicobacter bilis using a Helicobacter-genus-specific nested PCR.
Although Helicobacter infections of laboratory mice are usually subclinical, they may interfere with in vivo experiments and thus may lead to misinterpretation of data. As such, it is important to provide a means to unequivocally identify infections with murine Helicobacter spp. In the present study, a nested polymerase chain reaction (PCR) was established and shown to be 10 to 100 times more sensitive than the single-step PCR commonly used for routine diagnosis of Helicobacter spp. Experimental infection of Helicobacter-free mice demonstrated that faeces, caecum, colon and rectum but not liver are equally suitable for the detection of H. bilis. However, use of faecal pellets is advantageous since detection of H. bilis is possible one week after infection and analysis of faeces instead of tissues avoids euthanasia of animals. Furthermore, it generates representative data for all animals housed in the same cage and analysis can be repeatedly performed. Use of samples from breeding pairs but not offspring provides representative information about the Helicobacter status of a mouse colony. Both C3H/HeJ and C57BL/6 mice appear to be susceptible to H. bilis and persistent infection was observed during the 20-week experimental period. Analysis of pooled faecal pellets by nested PCR seems to be the most sensitive approach for H. bilis monitoring of the given breeding colony.
Animals↗
Mouse antibody production test: can we do without it?
Introduction of microbiologically contaminated materials into mice can cause infections of the recipients and jeopardize experimental protocols. As such, the methods used to screen biological materials should be sensitive, reliable and suitable for routine diagnostic work. In this report, the sensitivity of the viral plaque assay, mouse antibody production test and polymerase chain reaction (PCR) for detection of MHV-A59 and MMVp, two of the most prevalent pathogenic viruses in experimental mouse facilities, was compared. Analysis of serial tenfold dilutions of virus stocks revealed that the sensitivity of the mouse antibody production test on day 28 (10(-10) dilution) was at least 10 times higher than that of the viral plaque assay (10(-9) dilution) and 10(4) times more than that of the RT-PCR (10(-6) dilution) for detection of MHV-A59. For detection of MMVp, the PCR (10(-10) dilution) proved to be 10(6) times more sensitive than the viral plaque assay (10(-4) dilution) and the mouse antibody production test on day 28 (10(-4) dilution) which were equally sensitive. Based on the present study, it was shown that the method for diagnosis of viruses in biological materials should be employed only after the sensitivity has been determined for the viruses of interest implying that the most sensitive method needs to be determined independently for each virus.
Animals↗
Microstructural characterization of micro- and nanoparticles formed by polymer-surfactant interactions.
We have studied the nano- and microparticles formed by complexation of PDAC [poly(diallyldimethyl-ammoniumchloride)] and SDS (sodium dodecyl sulfate). The complexation phenomenon was characterized by light scattering and zeta-potential measurements. The nature of the complexes was revealed by direct-imaging cryogenic temperature transmission electron microscopy (cryo-TEM), showing nanometric details of the complexes formed around the point of neutralization. The images also reveal how those aggregates are solubilized by excess surfactant, first into faceted particles with threadlike micelles attached to their surfaces, prior to complete solubilization, then into lacelike aggregates, and finally into spheroidal micelles. The nanostructure of the complexes strongly suggests they are made of a hexagonal liquid crystalline phase. This was further supported by small-angle X-ray scattering (SAXS).
Journal Article↗
[Acute abdominal dilatation, a serious complication in the case of anorexia nervosa].
INTRODUCTION: The prognosis of anorexia nervosa (AN) is severe (death in 2 to 5% of cases). AN is closely linked to episodes of bulimia. OBSERVATION: A 25 year-old woman suffering from anorexia nervosa was hospitalised for an occlusive syndrome with vomiting, presence of abdominal cramps, absence of hydroaeric sounds and suspension of stools and gas. The biological examinations were normal. The abdominal scan revealed voluminous gastric dilatation. The diagnosis of functional occlusive syndrome was retained. With medical treatment and follow-up in intensive care the gastric dilatation progressively regressed. DISCUSSION: The periods of restricted nourishment during NA are interspaced by episodes of bulimia and at the origin of sometimes severe digestive complications. The abnormalities in gastric motility can lead to major dilatation of the stomach with the risk of perforation. The onset of abdominal pain in the context of AN during an episode of bulimia must evoke the diagnosis of acute gastric dilatation with major risk of perforation.
Abdominal Pain↗
Critical period for a teratogenic VLA-4 antagonist: Developmental effects and comparison of embryo drug concentrations of teratogenic and non-teratogenic VLA-4 antagonists.
BACKGROUND: Integrins such as VLA-4 (Very late antigen 4, integrin alpha4beta1) play key roles in cell-cell interactions that are critical for development. Homozygous null knockouts of the VLA-4 alpha4-subunit or VCAM-1 (VLA-4 cell surface ligand) in mice result in failure of the allantois and chorion to fuse leading to interrupted placentation and cardiac development and embryo lethality. Embryo-fetal studies of three VLA-4 antagonists, IVL745, IVL984, and HMR1031 [Crofts et al., Birth Defects Res B 71:55-68 (this issue), 2004] with exposure on gestation days (GD) 6-17 (rat), 6-18 (rabbit) or 6-15 (mouse) showed that only IVL984 treatment resulted in embryo lethality and cardiac defects. Objectives of the current study were to determine the critical period for inducing IVL984-related embryo-fetal effects, and to test the hypothesis that these effects were due to higher embryo drug concentrations. METHODS: IVL984 was administered at 40 mg/kg/day to pregnant rats on GD 4 and 5, GD 6 and 7, GD 8 and 9, GD 10 and 11, or GD 12 and 13. Animals were euthanized on GD 21 and uteri and fetuses were examined. A treatment period of GD 10-12 was selected for subsequent toxicokinetic (TK) studies in which IVL984, HMR1031, or IVL745 was administered to pregnant rats and rabbits. On GD 12, maternal plasma, extra-embryonic tissue (placenta and amniotic fluid), and embryonic tissue were collected and analyzed for drug concentrations. RESULTS: In the IVL984 critical period study in pregnant rats, treatment on GD 10 and 11 resulted in increased post-implantation loss, skeletal variations, and spiral septal defects similar to those observed in standard embryo-fetal development studies with treatment throughout organogenesis. There were no embryo-fetal effects after treatment on GD 4 and 5, GD 6 and 7, or GD 8 and 9. There was a single aorta malformation after treatment on GD 12 and 13. In the TK studies, IVL745, HMR1031, and IVL984 were all detectable in embryonic tissue and there was no evidence for accumulation. Rat and rabbit embryo exposures (AUC or dose-adjusted AUC) on GD 12 could not explain the observed teratology (IVL984<HMR1031<IVL745). Further analyses incorporating pharmacological activity, clearance, and protein binding data provided a positive correlation between embryonic exposure and teratogenic potency. CONCLUSIONS: The critical period for IVL984 in the rat, GD 10 to 11, corresponds to the expression of alpha-4 integrin on the chorion and VCAM-1 on the allantois and myocardium as well as chorioallantoic fusion and formation of the spiral septum. Embryo drug levels adjusted for pharmacological activity, clearance, and protein binding provide a possible explanation for the differing teratogenic potency of IVL984, HMR1031, and IVL745.
Abnormalities, Drug-Induced↗
[Prevalence of hantavirus infections in Germany].
Hantaviruses belong to the group of "emerging" viruses. Pathogenic European hantaviruses can cause a human disease designated "hemorrhagic fever with renal syndrome" of varying severity. In general, diagnostics of hantavirus infections are based on immunofluorescence assays using virus-infected cells or enzyme immunoassays and Western blot tests using recombinant nucleocapsid proteins. For highly sensitive detection of hantavirus-specific antibodies in the enzyme immunoassay, a homologous hantavirus nucleocapsid protein is needed as a diagnostic antigen. Serological typing of hantavirus infections can be obtained by neutralization assays, which in certain cases require the use of late convalescent sera. The seroprevalence in the normal German population is about 1%. In professionally exposed risk groups, e. g., forest workers, a seroprevalence higher than that in the normal population was observed. Endemic regions for hantavirus infections are located mainly in Baden-Württemberg. In the years 2001-2003 an annual number of about 200 clinically apparent hantavirus infections were registered in Germany. Neutralization assays detected almost exclusively human infections caused by Puumala and Dobrava viruses, only very rarely by Tula virus. Until this day in Germany mainly mild to moderate courses of human hantavirus infections have been documented. Besides infections caused by "German" hantaviruses, up to 10% of the clinically apparent hantavirus infections registered annually in Germany are caused by infections imported from other countries, mainly from Europe. So far only very limited molecular genetic data about the circulating hantaviruses in Germany are available. Additional investigations are needed to get a more precise picture about the distribution of hantaviruses in Germany and to calculate the resulting risk for the human population.
Communicable Disease Control↗
[Kausch-Whipple pancreaticoduodenectomy. Technique and results].
The Kausch-Whipple operation is the standard procedure for resection of pancreatic head cancer, distal bile duct cancer, and periampullary cancers. It is also used for some cases of chronic pancreatitis. Traditionally, this operation is associated with high perioperative morbidity and mortality. The aim of our study was to present our current technique for Kausch-Whipple pancreaticoduodenectomy and to demonstrate that acceptable perioperative and long-term outcomes can be achieved by a standardised technique in a high-volume centre.
Follow-Up Studies↗
Transferrin receptor is a marker of malignant phenotype in human pancreatic cancer and in neuroendocrine carcinoma of the pancreas.
Transferrin receptor (TFRC) is a membrane-bound protein expressed in larger amounts in proliferating, e.g., malignant, cells than in quiescent cells. The specific expression of TFRC can represent a diagnostic tool or a therapeutic target in solid tumours expressing this antigen. Whether TFRC is expressed in human pancreatic tumours is unknown. The aim of this study was the investigation of the expression of TFRC and transferrin in human pancreatic cancer and in neuroendocrine tumours of the pancreas. Fifty one specimens of human pancreatic cancer and 14 samples of pancreatic neuroendocrine tumours were obtained after surgery. The expression of TFRC, transferrin and cytokeratin was studied by standard immunohistochemistry. Flow cytometry was used for the investigation of TFRC expression in nine cell lines of ductal pancreatic cancer in vitro. In contrast to normal tissue, 93% of pancreatic tumour cells showed positive (82%) or heterogeneous (11%) expression of TFRC. It was strongly expressed by malignant epithelial cells; normal stromal and endothelial cells were not stained by anti-TFRC antibodies. Primary tumours and metastases showed a similar frequency of TFRC expression. Three neuroendocrine carcinomas showed positive expression of TFRC by malignant tumour cells. The expression of TFRC was negative in benign neuroendocrine tumours of the pancreas. The cell lines of pancreatic cancer were characterised by a low expression of TFRC in vitro. In contrast to normal pancreatic tissue and benign neuroendocrine tumours of the pancreas, pancreatic cancer and neuroendocrine carcinoma are therefore characterised frequently by high expression of TFRC. Hence, TFRC represents a marker of malignant transformation in the pancreas that could be applied as potential diagnostic and therapeutic target.
Biomarkers, Tumor↗
A continuous-wave and pulsed electron spin resonance spectrometer operating at 275 GHz.
An electron paramagnetic resonance (EPR) spectrometer is described which allows for continuous-wave and pulsed EPR experiments at 275 GHz (wavelength 1.1 mm). The related magnetic field of 9.9 T for g approximately 2 is supplied by a superconducting solenoid. The microwave bridge employs quasi-optical as well as conventional waveguide components. A cylindrical, single-mode cavity provides a high filling factor and a high sensitivity for EPR detection. Even with the available microwave power of 1 mW incident at the cavity a high microwave magnetic field B1 is obtained of about 0.1 mT which permits pi/2-pulses as short as 100 ns. The performance of the spectrometer is illustrated with the help of spectra taken with several samples.
Carbon↗
Fibreoptic intubation in patients after radiotherapy for carcinoma of the head and neck: difficulty and predictability.
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Adolescent↗
[Questioning of relatives--potentials for the internal quality management in institutions caring for the elderly].
The German care quality assurance law ("Pflege-Qualitätssicherungs-Gesetz", PQsG) calls for internal quality management in residential care facilities. Empirical surveys with residents, their relatives and employees are essential to get transparency and to assess the quality of service. Within the scope of the present study more than 1400 relatives of residents of 31 residential care institutions were surveyed. Therefore in preliminary studies a questionnaire for the relatives was developed, which collects data concerning quality aspects on various aspects (for example care, staff, medical care, cooperation with relatives). On the average, relatives judged the quality of the institutions as good. The overall mean of 2.2 (scale values between 1.8 ["administration/management"] and 2.5 ["care"]) reveals a positive aspect, but there is substantial variation between institutions. Empirical surveys are important tools for internal quality management. Among other things, their results can be used as input for specific quality circle work and thus for continuous improvement. Used continually in the sense of a routine-monitoring system, surveys can also serve to evaluate quality management procedures.
Adult↗
[Outcome quality of psychosomatic rehabilitation: goal attainment scaling on the basis of a structured catalogue of therapy goals].
Within the scope of a multicenter study regarding the outcome quality of inpatient psychosomatic rehabilitation a structured catalogue of therapy goals (SZK, strukturierter Therapiezielkatalog) was developed. The catalogue contains 89 predetermined therapy goals as well as the option to formulate further goals in own words. The SZK is available both as a patient and as a therapist version. At the beginning of treatment up to five primary objectives are chosen from the list. At the end of treatment and at the 1-year follow-up the level of achievement of objectives is assessed. Moreover the SZK contains the option to mark goals as not relevant any more and to add goals which came up during the treatment and to evaluate them regarding the level of achievement. The study on hand asks for empirical identification of the target structure. Furthermore, reliability and validity of the calculated measures of goal attainment are analysed. As the most important finding the SZK turns out to be a practical and economical assessment instrument for goal-oriented evaluation.
Adult↗
Loss of heterozygosity in the HLA class I region in human pancreatic cancer.
An altered human leukocyte antigen (HLA) class I expression constitutes an important tumor-escape mechanism counteracting T-cell mediated immune responses. We utilized the technique of microsatellite analysis to characterize the loss of heterozygosity (LOH) in the HLA class I region in 24 samples of patients with human ductal pancreatic carcinoma. The expression of HLA class I and the infiltration by T cells were studied in parallel by standard immunohistochemistry. The present study demonstrates LOH in the HLA class I region in five patients with pancreatic carcinoma. Immunohistochemical analysis showed that pancreatic carcinomas were frequently characterized by a total or partial loss of expression in HLA class I antigen. The positive or negative LOH status corresponded with the expression analysis in eight cases. Reduction of HLA class I expression without LOH was found in 14 cases. Lymphocyte infiltration with CD3+, CD4+, and CD8+ T cells did not show significant differences between LOH-positive and LOH-negative tumors. In conclusion, LOH does not seem to be the only factor for the reduced expression of HLA class I antigen as well as for the T-cell infiltration in this type of tumor.
CD3 Complex↗
Tumour suppression induced by the macrophage activating lipopeptide MALP-2 in an ultrasound guided pancreatic carcinoma mouse model.
BACKGROUND AND AIM: Carcinoma of the exocrine pancreas has a particularly poor prognosis. Therefore, novel therapeutic strategies such as immunotherapy are required. Here we investigated the immunomodulatory capacity of macrophage activating lipopeptide 2 (MALP-2), which binds to toll-like receptors 2 and 6 and induces activation of nuclear factor kappaB in monocytes. This causes the release of early stage leucocyte attracting chemokines and proinflammatory cytokines. METHODS: MALP-2 was tested in a new orthotopic ultrasound guided pancreatic cancer mouse model. This model is close to the biological situation and avoids the stress and immunostimulation caused by laparotomy. Cells from the syngeneic, highly aggressive, and metastatic cell line Panc 02 were administered orthotopically, by ultrasound guidance, to C57bl/6 mice. MALP-2 was administered intratumorally or intraperitoneally and tumour growth, immune status, and leucocyte infiltration at the tumour site were determined. RESULTS: We showed a tumour suppressive effect induced by a single injection of MALP-2. Median survival increased from 21 to 30 days (p<0.002). Combining chemotherapy (gemcitabine) with MALP-2 treatment caused further prolonged survival (median survival 27 days with chemotherapy alone v 37 days for combined treatment; p<0.0002). The life prolonging effect was paralleled by a significant increase in cytotoxic T cells, restoration of beta2 integrin expression on lymphocytes, and high expression of CD45RB on T helper cells. Immunohistochemical stains showed strong cytotoxic T lymphocyte and natural killer cell infiltration. CONCLUSIONS: In conclusion, in a model of orthotopic pancreatic cancer in mice, we induced a tumour suppressive effect by treatment with a synthetic lipopeptide. Treatment with MALP-2 could be an option for immunotherapy in pancreatic cancer.
Adenocarcinoma↗
Simplification of rat intubation on inclined metal plate.
Small-animal intubation is often necessary during inhalation anesthesia to allow steady-state conditions for large operations and in vivo experiments in all fields of experimental surgery. In rats, placing an orotracheal tube is technically difficult primarily because of the small size of the subject and the lack of equipment specifically designed for this task. We describe a simple rat intubation technique in which the animal is suspended in dorsal recumbency on an inclined metal plate. The animal, anesthetized with ether, is fixed to a 70 degrees-inclined metal plate in a dorsal position by means of a Mersilene ribbon hooked around the upper incisors. This method of positioning the animal is the most important step in the intubation process and further facilitates the technique already described by other authors. A human otoscope was used as a laryngoscope, intubation was performed using the Seldinger technique, and a 14-gauge intravenous catheter served as an endotracheal tube. This inexpensive technique is quickly learned and can be used in any laboratory. Safe and reliable airway management can thus be achieved, permitting in vivo examinations and operations.
Anesthetics, Inhalation↗
Band erosion with gastric cancer.
Adjustable gastric banding is a well-established procedure for the treatment of morbid obesity. We present a 62-year-old female who experienced the rare complication of intragastric band perforation due to a gastric adenocarcinoma localized at the site of gastric banding, 10 years after insertion of the band.
Adenocarcinoma↗