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Biomedical subjects

K Hartmann

Publications and source records attributed to K Hartmann.

At least 19 recordsLinked to original sources
PubMed2006

Pharmacokinetics of enrofloxacin and its efficacy in comparison with doxycycline in the treatment of Chlamydophila felis infection in cats with conjunctivitis.

The concentrations of enrofloxacin were measured in the tears, saliva and serum of 14 cats with signs of upper respiratory tract infection and eight with no signs, after daily doses of 5 mg/kg. Enrofloxacin concentrations above the minimum inhibitory concentration of Chlamydophila felis were found in the saliva and tears of the cats with and without signs of upper respiratory tract infection. In a prospective randomised clinical trial, the efficacy of enrofloxacin against C. felis infection in cats with conjunctivitis was compared with the efficacy of doxycycline. Twenty-five cats were randomly assigned to treatment with either enrofloxacin or doxycycline for 14 days; 15 of the cats tested positive for C. felis by an immunofluorescent antibody test on conjunctival swabs. The two treatment groups showed equal improvements in the clinical signs of conjunctivitis and C. felis infection status; in each group three cats were still C. felis antigen-positive after the 14-day course of treatment, indicating a persistent infection. No side effects were observed in the cats treated with enrofloxacin.

Animals↗
PubMed2006

[Necrosis and reconstruction of the inferior oblique muscle after removal of a wooden intra-orbital foreign body].

A 39-year-old patient presented 3 days after a bicycle accident with a progressive left periorbital inflammatory swelling and diplopia in upgaze. On the day of the accident, a cranial x-ray did not reveal a fracture or an orbital foreign body, and the 2.5 cm skin wound on the left lower eyelid was sutured. For further evaluation, computer tomography) was performed. This did not show a radio-opaque, orbital foreign body. An explorative orbitotomy was carried out and revealed a 3.7 cm long wooden fragment medial to the inferior oblique muscle (OI). The extraconal portion of OI was found to be necrotic. Complete reconstruction of the OI was not possible due to the extent of the necrosis. The residual muscle was fixated to the orbital septum. Recovery was good and the diplopia resolved after 6 months. This case emphasizes the importance of a meticulous inspection of skin wounds with a high risk of remaining wooden foreign bodies and shows the possibility of functional recovery of extraocular muscles following partial reconstruction.

Adult↗
PubMed2006

Recurrent varicose veins: sonography-based re-examination of 210 patients 14 years after ligation and saphenous vein stripping.

BACKGROUND: The objective of this study was to assess the frequency of varicose recurrence 14 years after flush ligation of the saphenofemoral (SFJ) or saphenopopliteal (SPJ) junction with additional stripping of the incompetent saphenous vein. PATIENTS AND METHODS: Our study group comprised 245 extremities of 210 patients operated upon in 1990 for either great saphenous vein (GSV) or small saphenous vein (SSV) incompetence. Limbs were assessed with Duplex ultrasound by a practitioner other than the original surgeon and relevant patient data was recorded. RESULTS: In 68.5% of re-examined limbs Duplex imaging provided no evidence for recurrent varicose veins at the former SFJ or SPJ. This included 15 legs (= 6.1%) where reflux immediately proximal to the junction but originating from adjacent veins (i.e. pudendal vein, epigastrical vein) was detected. In 31.5%, reflux from the operated SFJ or SPJ (junctional recurrence) was detected but only a minor percentage of legs (6.9%) had actually developed a clinically relevant recurrent varicosity (> 3 mm in diameter) branching out from the former junction and requiring treatment. Patients with a BMI < 30 were less likely to suffer recurrent varicose veins (no recurrence in 72.7%) than patients with a BMI > or = 30 (no recurrence in 54.5%). CONCLUSIONS: 14 years after flush ligation of the SFJ or SPJ with stripping of the incompetent saphenous vein, junctional recurrences were found in less than one-third of re-examined extremities. In the absence of surgical errors, we must assume neovascularisation as cause for these recurrences. Duplex US determined a clinically relevant recurrence (> 3 mm in diameter) in only 7% of limbs. Post-operative varices seem to develop less often after SPJ surgery than after SFJ surgery and according to our data, obesity (BMI > or = 30) constitutes a significant risk factor.

Adult↗
PubMed2006

The prothrombin 20209 C-->T mutation in Jewish-Moroccan Caucasians: molecular analysis of gain-of-function of 3' end processing.

BACKGROUND: Mutations of the 3' end mRNA-processing signal of the prothrombin (F2) gene have been reported to cause elevated F2 plasma concentrations, thrombosis, and complications of pregnancy. Whereas the common F2 20210*A mutation is almost exclusively found in Caucasians, the F2 20209*T mutation has been reported in Afro-Americans and Afro-Caribbeans only. PATIENTS AND METHODS: Using LightCycler technology, three unrelated Jewish-Moroccan patients tested for obstetric complications were found to be carriers of the F2 20209*T allele. A detailed molecular analysis was performed to identify the functional impact of this mutation. RESULTS: We report three unrelated women of Jewish-Moroccan origin with a F2 20209*T mutation and fetal loss or infertility. The functional analysis revealed that the F2 20209*T mutation stimulates 3' end processing and up-regulates prothrombin protein expression as assessed by a highly sensitive luminescence-based reporter system. CONCLUSIONS: This is the first report of 20209*T in Caucasians, and functional analysis demonstrates that F2 20209*T falls into a general category of mutations of the F2 gene, which may possibly contribute to thrombophilia and complications of pregnancy by interfering with a tightly balanced architecture of non-canonical F2 3' end formation signals.

Adult↗
PubMed2005

Antagonistic and agonistic GnRH analogue treatment of precocious puberty: tracking gonadotropin concentrations in urine.

BACKGROUND: The pharmacodynamics of gonadotropin-releasing hormone (GnRH) agonists includes an initial 'flare-up' of the pituitary-gonadal axis, followed by reduced luteinizing hormone (LH) secretion. The question is if combining a short-acting antagonist with a long-acting agonist can diminish gonadotropin flare-up. METHODS: To achieve quick downregulation in patients with recently diagnosed central precocious puberty (CPP, 7 patients) or short stature with short predicted final height (3 patients), we combined the GnRH antagonist cetrorelix (3 subcutaneous injections every 72 h) at the beginning of GnRH agonist treatment (leuprorelin or triptorelin) in 6 patients and compared the effect to 4 patients treated solely with GnRH agonist. To monitor effects, we measured LH and FSH concentrations in urine collected from initial morning urination during the first month of treatment. RESULTS: In both treatment groups, gonadotropin flare-up could be detected in urine levels increased due to the flare-up phenomenon which was of short duration (<5 days) in the majority (5 of 6) of combined-treated patients and in the minority (1 of 4) of patients treated by agonist alone. During the first 10 days of treatment, mean LH concentration measured in urine was significantly lower in 4 CPP patients treated by the combined therapy compared to 3 CPP patients treated by the agonist only (mean LH combined therapy: 10.4 +/- 2.8 vs. 20.1 +/- 11.0 mU/ml in the agonist-only group, mean +/- SEM, p < 0.05). Significant correlations between stimulated serum LH in GnRH test prior to treatment and maximum urine LH after initiating GnRH analogue treatment (r = 0.547, p = 0.043), as well as basal serum LH and basal urine LH (r = 0.685, p = 0.014) were found. CONCLUSION: Combined GnRH agonist and antagonist treatment led to rapid gonadotropin suppression. Also, urine measurements of LH and FSH seemed suitable for monitoring gonadotropin-inhibiting or -stimulating properties of GnRH analogues in individual patients. However, a controlled trial of a larger patient cohort is required to decide which treatment is the most effective.

Adolescent↗
PubMed2005

Factors associated with upper respiratory tract disease caused by feline herpesvirus, feline calicivirus, Chlamydophila felis and Bordetella bronchiseptica in cats: experience from 218 European catteries.

A full history of the management practices and the prevalence of upper respiratory tract disease (URTD) at 218 rescue shelters, breeding establishments and private households with five or more cats was recorded. Oropharyngeal and conjunctival swabs and blood samples were taken from 1748 cats. The prevalences of feline herpesvirus (FHV), feline calicivirus (FCV), Chlamydophila felis and Bordetella bronchiseptica were determined by PCR on swab samples. An ELISA was applied to determine the prevalence of antibodies to B. bronchiseptica. The rates of detection by PCR of each pathogen in the cats in catteries with and without ongoing URTD were, respectively, FHV 16 per cent and 8 per cent; FCV 47 per cent and 29 per cent; C. felis 10 per cent and 3 per cent; and B. bronchiseptica 5 per cent and 1.3 per cent; the seroprevalences of B. bronchiseptica were 61 per cent and 41 per cent, respectively. There was evidence that FHV, FCV and B. bronchiseptica played a role in URTD. The risk factors associated with the disease were less than excellent hygiene, contact with dogs with URTD, and larger numbers of cats in the cattery or household.

Animals↗
PubMed2004

[Urticaria. Classification and diagnosis].

Urticaria belongs to the most frequent dermatologic diseases. Although the pathogenesis of urticaria is not fully understood, systematic studies in recent years have identified the most important triggering factors of the different forms of urticaria. Based on these results, it is recommended to restrict diagnostic procedures in acute urticaria to history and physical examination, while in chronic urticaria, one should exclude drugs, infections, pseudoallergic reactions, and autoimmune processes as causes. For the diagnosis of physical urticaria, standardized provocation test are recommended.

Acute Disease↗
PubMed2004

[Non-invasive determination of intracranial pressure. Physiological basis and practical procedure].

It has been shown in some recently published papers that the intracranial pressure can be determined by dynamometric measurement of the outflow pressure of the central retinal vein (VOP). The knowledge gained by the basic experiments of Baurmann in 1925 has been forgotten by the ophthalmic community for many years. In this paper the basic phenomena of venous collapse are outlined which are fundamentally different from the biomechanics of the arterial collapse phenomenon observed by ophthalmodynamometry. A practical guideline is given for the dynamometric measurement of venous outflow pressure which equals the intracranial pressure. Performing dynamometry of the central retinal vein enables the ophthalmologist to determine intracranial pressure in a non-invasive way.

Humans↗
PubMed2003

Evidence for altered mast cell proliferation and apoptosis in cutaneous mastocytosis.

BACKGROUND: Mastocytosis presents as a focal or generalized increase of mast cells, particularly in the skin, but also in other organs. Activating mutations of KIT (formerly c-kit), the receptor of the mast cell growth factor stem cell factor (SCF), appear to play a key role in the pathogenesis of sporadic adult onset mastocytosis. However, these mutations are not present in childhood-onset and familial mastocytosis and also fail to explain the heterogeneity of adult-onset disease. Other factors such as prolonged survival of mast cells may therefore participate in causing and modulating the pathological increase of mast cells in mastocytosis. OBJECTIVES: To examine the expression of proliferation and apoptosis markers in the mast cells of cutaneous mastocytosis lesions in order to gain further insight into the pathogenesis of mastocytosis. METHODS: Lesional cutaneous biopsies from eight infants with solitary mastocytomas, five children with multiple mastocytomas, 11 children with generalized urticaria pigmentosa, 12 adults with urticaria pigmentosa, and skin from seven normal controls were used in this study. Serial sections were stained with toluidine blue to quantify mast cell numbers and with antibodies against the proliferation marker Ki67 protein, the tumour suppressor protein p53, and the inhibitor of cyclins and cyclin-dependent kinases p21WAF1/CIP1, using the alkaline phosphatase antialkaline phosphatase technique. The terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick end labelling (TUNEL) method was used to assess apoptosis. RESULTS: Cutaneous mast cell counts were significantly increased in all patient sections, particularly in childhood lesions, and similarly, a small but significant increase of proliferation was found in the lesional mast cells of all patients. Enhanced mast cell numbers and proliferation was associated with a significant decrease of TUNEL staining, particularly in mastocytomas. p53 expression was highly variable, with an overall significant increase in all patient skin mast cells, whereas p21 expression was barely observed at all. CONCLUSIONS: These findings further support the concept that an imbalance of mast cell proliferation and apoptosis is prevalent in mastocytosis lesions that may account in part for the increased focal mast cell accumulation in this condition.

Adolescent↗
PubMed2003

One year follow up of macular translocation with 360 degree retinotomy in patients with age related macular degeneration.

AIM: To evaluate the benefits of macular translocation with 360 degree retinotomy in patients with exudative age related macular degeneration (ARMD). METHODS: A consecutive interventional case series was performed on patients who underwent macular translocation between June 1997 and January 2000 at the department of ophthalmology, University of Aachen, Germany. A retrospective pilot study was set up with a minimum follow up of 12 months in 39 consecutive patients with subfoveal choroidal neovascularisation secondary to ARMD. The surgical technique included pars plana vitrectomy, induction of retinal detachment, 360 degree retinotomy, removal of the choroidal neovascular membranes (CNVM), macular translocation, peripheral laser retinopexy, and silicone oil endotamponade. RESULTS: 18 patients showed predominantly occult CNVM, six patients had predominantly classic CNVM, and 15 showed subretinal haemorrhage. At the 12 month follow up 13 patients (33%) showed an improvement in visual acuity of more than three lines (logMAR scale), 18 patients (46%) retained stable visual acuity with a change of equal or less than three lines (logMAR scale), and eight patients (21%) showed a decrease in visual acuity of more than three lines (logMAR scale). Recurrence of CNVM was observed in three (8%) eyes at 5-11 months postoperatively. Other complications included proliferative vitreoretinopathy with retinal detachment (n=10), peripheral epiretinal membranes (n=9), macular pucker (n=2), corneal decompensation (n=2), and hypotony (n=11). 18 patients (46%) complained about persistent diplopia. CONCLUSION: Macular translocation surgery is able to maintain or improve distant vision in the majority of patients with exudative ARMD. Proliferative vitreoretinopathy and diplopia are the two major complications. A prospective randomised controlled trial comparing macular translocation with observation for patients with the occult form of exudative ARMD may be justified.

Aged↗
PubMed2003

A teledermatological approach to enhance diagnostic accuracy in dermatohistopathology.

We determined whether digital photographs of skin lesions could enhance diagnostic accuracy in dermatohistological evaluations. Two dermatohistopathologists examined 375 unsorted consecutive cases. On a standardized questionnaire they recorded whether the final diagnostic interpretation would be improved by the availability of digital images of the skin lesions. In 101 cases (27%) they said that digital photographs would be helpful. Subsequently, 30 histological analyses were performed with and without digital photographs of the skin lesions. Presentation of digital photographs reduced the number of differential diagnoses significantly, from a median of 3 to 2. Ratings of ability to make a single definitive diagnosis increased significantly with the presentation of digital photographs. Enhancement of information given by the digital images was scored a median of 6 (on a scale of 0-10, with higher scores reflecting greater enhancement). Digital photographs of skin lesions are likely to refine diagnostic accuracy in histopathology.

Dermatology↗
PubMed2003

Hyperbaric oxygen: does it promote growth or recurrence of malignancy?

It has been a concern that a therapeutic modality recommended as an adjunct to healing and administered to promote proliferation of fibroblasts, epithelial cells and blood vessels in a wound could also lead to proliferation of malignant cells and angiogenesis in a malignant tumor. The first reported concern that hyperbaric oxygen (HBO2) might have cancer growth enhancing effects appeared in a paper by Johnson and Lauchlan in 1966. In a series of patients treated with HBO2 radiosensitization, they reported a more frequent than expected incidence of metastases and an unusual pattern of metastases. The published literature from clinical reports, animal studies and cell culture studies are reviewed. Putative mechanisms whereby HBO2 could have carcinogenic effects are discussed. The processes of angiogenesis in wound healing and in cancer growth are compared and contrasted. In vitro, in vivo and clinical studies strongly suggest no more than a neutral effect of HBO2 on tumor growth. In fact some studies suggest a negative impact of HBO2 on malignant progression or formation. For angiogenesis, similarities in wound healing and cancer are striking but significant differences are found including the relative importance of angiogenic factors and the process of cessation of angiogenesis. Tumors that grow in hypoxic environments are more prone to metastases and more lethal to the patient. They are also more likely to mutate toward resistant genotypes. Discussion of postulated mechanisms of carcinogenesis including free radical and immunosuppressive effects points out why they are not likely to enhance or cause cancer growth or initiation. In conclusion, the published literature on tumor angiogenesis mechanisms and other possible mechanisms of cancer causation or accelerated growth provides little basis for HBO2 to enhance malignant growth or metastases. A history of malignancy should not be considered a contraindication for HBO2 therapy.

Animals↗
PubMed2002

[Suspected neurological side-effects of tick-borne meningoencephalitis vaccination: experiences of the Swiss Adverse Drug Reaction Reporting Center].

The number of patients affected by tick-born encephalitis (TBE) in Switzerland has increased in the last years and an extension of the endemic foci of TBE has been observed. Therefore, active immunization by TBE vaccination has become more important. The possible adverse vaccine reactions have to be known as exactly as possible. The Swiss Drug Monitoring Center SANZ received from 1987 until June 2000 33 spontaneous cases reporting on 39 neurological adverse reactions in a close temporal relationship with a TBE vaccination and a suspected causal relationship. The following adverse reactions were reported most frequently: headache in 36%, neuropathy in 18% and meningeal irritation in 13%. Twelve out of 33 patients were hospitalized due to the adverse reaction. All neurological reactions were reversible. The spontaneous reporting scheme of the SANZ does not allow to calculate the incidence of neurological reactions after TBE vaccination. In general, adverse neurological reactions after TBE vaccination seem to be rare. According to the experiences of SANZ all reported neurological reactions were reversible.

Adolescent↗