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Biomedical subjects

L Bergmann

Publications and source records attributed to L Bergmann.

189 records · Page 11Linked to original sources
PubMedDate not supplied

A randomized study of imipenem compared to cefotaxime plus piperacillin as initial therapy of infections in granulocytopenic patients.

The objective of the presented, randomized study was to compare the efficacy of antimicrobial monotherapy with imipenem (3 x 0.5g/d) to a combination therapy with cefotaxime (3 x 2g/d) plus piperacillin (3 x 4g/d) for empirical treatment of infections in neutropenic patients. In 165 patients, 237 infectious episodes were evaluable. The overall response rate of patients treated with cefotaxime plus piperacillin was 67/115 (58%), of those treated with imipenem 66/122 (54%). In patients not responding to the initial therapy regimen within 2 or 3 days, the antimicrobial therapy was modified. After therapy modification 85/100 patients were cured. Fever of unknown origin (FUO) showed the most favourable course compared to other infection types, with a response in 46/59 (78%) and in 35/50 (70%) cases, respectively. In comparison, pneumonias were successfully treated in only 3/21 (14%) and 7/37 (19%) cases. Even including patients with modified therapy, only 66% (21/32) of pneumonia episodes responded. The unfavourable results in pneumonias is mainly due to the high rate of 13 systemic mycoses in this group (22%). Overall, a similar response was observed in patients treated with cefotaxime plus piperacillin in comparison with imipenem. In primary bacteremias however, an advantage was observed in patients treated with imipenem (20/27; 74%) compared with cefotaxime plus piperacillin (11/23; 48%).

Adolescent↗
PubMedDate not supplied

[Clinical and molecular genetic findings in four girls with Rett syndrome].

We report on four mental retarded girls with typical clinical signs of Rett syndrome. Rett syndrome is an X-linked neurodevelopment disorder which develops after a period of normal development at the age of 6 to 18 months, affecting 1/10 000 - 15 000 girls. Recently, the MeCP2-gene encoding the methyl-CpG-binding protein 2 has been shown to be mutated in 80 percent of girls with Rett Syndrome, studied so far. In our patients with Rett syndrome two common mutations of the MeCP2-gene, R168X (n=2) and T158M were found. In the 4th patient a novel "missense" mutation R294G was identified.

Child↗
PubMedDate not supplied

[Optimizing epilepsy therapy in children and adolescents with lamotrigine].

Lamotrigine is a broadly effective antiepileptic drug in mono- and add-on therapy for children and adolescents with focal and generalized epilepsies. Some epileptologists consider lamotrigine as the drug of primary choice in older school children and adolescents because of its good tolerability (no increase of body weight, no impairment of cognitive functions, due to new data probably no teratogenic properties). Lamotrigine can be used with good efficacy in numerable epilepsy diseases, such as tuberous sclerosis, juvenile neuronal lipofuscinosis and Rett syndrome. The first studies show that lamotrigine is also effective in children under 2 years of age. For therapy of difficult-to-treat epilepsies the combination of lamotrigine with valproate has proved as especially useful. This clinical observation is supported by new results of animal experiments. The dose-dependant and typical CNS side effects vertigo, ataxia, nausea, tremor and diplopia are found most frequently. The rate of allergic skin rashes which was very high before 1998 has decreased markedly by new dosage guidelines and is now as low as in older antiepileptic drugs. Lamotrigine does not impair cognitive functions, especially not memory and language. It has mood-stabilizing features and may improve quality of life. In animal experiments lamotrigine shows antiepileptogenic and neuroprotective effects.

Adolescent↗
PubMedDate not supplied

Correlation study of two methods for evaluating corneal endothelial damage in vitro: the Janus green photometry technique versus cell counting.

Counting of endothelial cells after vital staining is a time-consuming method which, in addition, requires considerable experience and does not normally allow for the study of the entire endothelial cell surface. However, the Janus green photometry technique (JGPT) is an objective, time- and personnel-saving procedure which also has the advantage of allowing for the evaluation of the whole endothelial cell surface. A comparative simultaneous experimental study of the two methods had not been reported. Freshly excised pig corneas (n = 58) were preserved in MK storage medium for 4, 7, 14 and 20 days at 4 degrees C. All corneas were stained with Janus green and alizarin red. A 7-mm corneal button corresponding to an endothelial surface of 38.46 mm2 was punched out. The percentage of damaged cells was determined with cell counting (CC) and with JGPT, and the results were statistically compared. Two methods for CC were used. Cells were counted either directly under the microscope or in photomicrographs. The overall correlation between the results of CC and JGPT was R = 0.98. However, when endothelial cell damage was higher than 30%, CC became an estimation by approximation, since necrotic areas were confluent, whereas with JGPT the results were usable even when the damage was 100%. Thus it appears that although the two methods can be used interchangeably, JGPT may in some instances be the method of choice.

Animals↗
PubMedDate not supplied

Life quality of patients with metastatic renal cell carcinoma and chemo-immunotherapy--a pilot study.

Renal cell cancer (RCC) accounts for 2-3% of all malignant tumors in adults. Due to the indolent course of disease and the few signs and symptoms in early stages the majority of patients presents with metastatic disease when diagnosed. The aims of systemic therapy of RCC are therefore palliative. Recent research shows the key role of immune mechanisms in the course of RCC. The therapeutic use of cytokines, mainly interleukin-2 (IL-2) and interferon-alpha (IFN) results in improvement of remission rates. To date it is unknown to what extent multiple cycles of chemo-immunotherapy alter the life quality (LQ) of patients with metastatic RCC. We monitored life quality during therapy in a three-armed protocol with interferon-alpha 2a, interleukin-2, 5-fluorouracil (5-FU), isotretinoin (ISO) and vinblastin (VBL). Life quality was impaired by two factors: response to chemo-immunotherapy and therapy side effects. A steep decrease of LQ-scores was seen in week 1 of therapy, LQ improved then for patients with stable disease (SD) and partial remission (PR) but not for those with progressive disease (PD).

Adult↗
PubMedDate not supplied

[A new in vitro test of endothelial viability. Vital staining using Janus green with spectrophotometric analysis of the color extract].

A new in vitro technique has been developed to measure by simple photometry the amount of Janus Green extracted with absolute alcohol from isolated corneas after vital staining. The amount of stain corresponds to the percentage of damaged endothelial cells and is a reliable parameter of endothelial viability. More rapid and easier to perform than the usual cell counting of devitalized cells this technique may be used to study the endothelial damage induced e.g. by experimental surgery, intraocular solutions, IOL material, cornea storage solutions.

Animals↗
PubMedDate not supplied

Auxiliary heterotopic partial liver transplantation in pigs with acute ischemic liver failure.

BACKGROUND/AIMS: Fulminant hepatic failure (FHF) is usually fatal without liver transplantation. Auxiliary heterotopic partial liver transplantation (AHPLT) may offer advantages over orthotopic liver transplantation (OLT) or any other heterotopic procedure for the treatment of patients with fulminant liver failure. We studied AHPLT in a severe acute hepatic failure model in pigs. METHODOLOGY: Group A (control: n = 5) underwent portal vein and hepatic artery ligation and side-to-side portocaval shunting. Group B (AHPLT: n = 15) underwent host portal vein and hepatic artery ligation and AHPLT. RESULTS: All of the pigs in group A died within 48 hours from massive liver necrosis. Ten of the 15 pigs (67%) in group B had well-functioning grafts. Five of these ten died between 8 and 17 days postoperatively due to various complications. The remaining five survived for sixty days postoperatively in healthy condition. At the time of sacrifice, four of these five had well-functioning grafts weighing 739 +/- 52 g (mean +/- SEM) and regenerated, but still atrophied, host livers weighing 262 +/- 23 g (p < 0.0002). On the other hand, the one remaining pig had an atrophied graft weighing 310 g and a well-regenerated host liver weighing 470 g, probably due to a late, poorly functioning graft associated with severe rejection. CONCLUSION: AHPLT may result in survival despite host hepatic failure, and the host liver may recover within two months, despite total interruption of blood inflow.

Animals↗