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Biomedical subjects

M Bitzer

Publications and source records attributed to M Bitzer.

At least 55 records · Page 3Linked to original sources
PubMed1998

[Pigmented villonodular synovitis of the shoulder joint].

A 16-year-old student presented with painful swelling over the left proximal humerus. Magnetic resonance imaging showed a malignant-looking soft tissue mass of 7.5 x 6 x 4 cm invading the shoulder capsule. The patient did not remember initially a shoulder trauma, through postoperatively he reported a distortion trauma of the affected shoulder after a mountain bike accident. Intraoperatively we found two tumors infiltrating the axillary vessel and nerve structures originating from the shoulder joint capsule. Quick examination of the tissue revealed to signs of malignancy, further pathohistologic examination showed a local pigmented villonodular synovitis. Unusual is the clinical presentation of the lesion over the proximal humerus, leading us preoperatively to neglect the possibility of tumor origin from the shoulder capsule, especially since the patient didn't have any complaints or functional deficits of the shoulder joint.

Adolescent↗
PubMed1997

Chondroma of the cerebellopontine angle. Case report.

A patient is reported who had a solitary chondroma of the cerebellopontine angle. The tumor was totally removed. The diagnostic value of CT-scanning and MRI in this rare pathological condition are discussed.

Cerebellar Neoplasms↗
PubMed1997

Peritumoural brain oedema in intracranial meningiomas: influence of tumour size, location and histology.

Peritumoural brain oedema was examined retrospectively in 175 patients with 179 intracranial meningiomas. The influence of tumour size, location and histology were investigated. Tumour volume and localization, and the presence of peritumoural brain oedema (PTBOe) were determined by computed tomography (CT). The oedema-tumour volume ratio was defined as Oedema Index (Oel). All patients underwent microsurgical removal of the tumour. Surgically resected meningiomas were classified histopathologically based on criteria of the new World Health Organization (WHO) classification. A close relationship was found between the tumour size and the incidence of peritumoural oedema: with increasing size of the tumour the incidence of oedema also rises, the oedema index, however decreases. Frontobasal and temporobasal meningiomas showed a significant increase in the oedema incidence and the mean oedema index. If major parts of the surface of meningiomas were adjacent to subarachnoid cisterns only a slight tendency for the development of oedema was observed. WHO-III-meningiomas showed a significantly higher oedema incidence (61.1% vs. 94.4%; p < 0.004) and mean oedema index (Oel = 2.7 vs. 3.7; p < 0.0009) than WHO-I-meningiomas. Brain tissue was affected in 59 cases. 19 meningiomas with infiltration into adjacent brain parenchyma revealed a statistically significant increase in oedema incidence (94.7% vs. 51.7%; p < 0.0003) and mean oedema index (Oel = 3.9 vs. Oel = 2.2; p < 0.0001) when compared to tumours without any brain tissue involvement in the histopathological specimens. Tumours with large volume, fronto-temporo-basal location and anaplastic histology were not only associated with the highest incidence of oedema formation but also presented with an overproportionate infiltrative growth. Thus, a disruption of the arachnoid or a true brain infiltration may be an essential factor for the development of a PTBOe.

Adult↗
PubMed1997

ICP monitoring with a re-usable transducer: experimental and clinical evaluation of the Gaeltec ICT/b pressure probe.

Intracranial pressure monitoring requires reliable transducers at a justifiable price. At present, transducers for single or repeated use are available. We examined the Gaeltec model ITC/b solid state miniature transducer experimentally and clinically. Measurement accuracy was assessed in vitro at increasing steps of 5 mmHg from 0 to 80 mmHg. While new and recently serviced probes revealed minimal deviations from the preset values, frequently used transducers differed up to 7 mmHg. This occurred especially in the high pressure range above 50 mmHg. Additionally the drift was investigated at different pressure levels. After 24 hours we already found drifts of 2 mmHg with new and serviced probes and up to 4 mmHg with used ones. In clinical practice we implanted 150 transducers in 121 patients from 1983 until 1995. The probes were re-used up to twelve times, the average time being 7 times. 32.7% of all measurements were regarded as not reliable. Dislocation (16.7%), inability to calibrate (3.3%) and defect pressure probes (3.3%) were the most common complications. Repeated use of the Gaeltec ICT/b probe also seemed to result in an additional decay of measurement quality. The strain of frequent cleaning and sterilizing may have caused changes of the physical properties of the probes with time. Whether these results also apply to other types of ICP probes for repeated use needs further evaluation.

Adolescent↗
PubMed1997

Sendai virus efficiently infects cells via the asialoglycoprotein receptor and requires the presence of cleaved F0 precursor proteins for this alternative route of cell entry.

Biochemical evidence suggests that the asialoglycoprotein receptor (ASGP-R) can be used as an alternative receptor for a temperature-sensitive Sendai virus (SV) mutant. We now have investigated this possible alternative route of infection for SV wild-type (SV-wt) strain Fushimi by using a pair of cell lines which differ only with regard to ASGP-R expression. Infection studies after enzymatic destruction of conventional sialic acid-containing SV receptors (SA-R) revealed that only ASGP-R-expressing cells could be infected by SV-wt. This alternative route of cell entry could be completely blocked by incubation of cells with ASGP-R-specific antibodies prior to infection. Furthermore, cleavage of SV-F0 precursor protein into the subunits F1 and F2 was necessary to establish infection via ASGP-R, suggesting a fusion-mediated cell entry after binding of SV-wt to the ASGP-R on host cells. Interestingly, infection via ASGP-R was found to be nearly as efficient as infection via conventional sialic acid-containing SV receptors. A possible physiological role of the ASGP-R-mediated route of SV infection is discussed.

3T3 Cells↗
PubMed1997

The importance of pial blood supply to the development of peritumoral brain edema in meningiomas.

In a retrospective analysis, the authors studied the pial and dural blood supplies in 74 intracranial meningiomas and quantified their associated peritumoral brain edema (PTBE). The extent and localization of pial blush in relation to the total tumor volume were determined angiographically. The amount of edema and tumor size were calculated using computerized tomography. The edema-tumor volume ratio was defined as Edema Index (EI). There were 49 meningiomas with PTBE; of those tumors, 46 were supplied by pial vessels, and three were supplied exclusively by dural vessels. Tumors without PTBE showed no pial blush. The mean EI in meningiomas with pial blush was significantly larger (EI = 3) than in meningiomas without pial supply (EI = 1.1; p < 0.0001). Meningiomas with a smaller pial supply than dural supply had a significantly smaller mean EI than tumors with a pial supply equal to or greater than the dural supply (EI = 2.9 vs. EI = 3.7; p < 0.015). In 69.9% of cases with pial blood supply, major portions of the edema were located adjacent to the tumor region supplied by pial vessels. Edema index differences among tumors of different subgroups, as defined by size or histology, were significantly related to the pial supply in each subset. Thus, pial blood supply may be associated with the development of PTBE in meningiomas.

Adult↗
PubMed1995

Repeated decompressive craniectomy after head injury in children: two successful cases as result of improved neuromonitoring.

BACKGROUND Decompressive craniectomy in the treatment of posttraumatic brain swelling is not generally accepted. Until now the efficacy of operative decompressive craniectomy in posttraumatic brain swelling of children appeared more promising. However, the criteria for such procedures remain unclearly defined. METHODS We present two children who had repeated decompressive craniectomy following head injury, in order to control intracranial pressure (ICP) sufficiently. Our indications for performing a decompressive craniectomy in the presence of conservatively uncontrollable raised ICP are: (1) Patient is between the ages of 3 and 35 years. (2) An initial Glasgow Coma Scale (GCS) ranging between 4 and 8. (3) Three criteria have to be fulfilled at the same time: The cerebral perfusion pressure (CPP) has to drop to values of less than 60 mm Hg. It is impossible to control the ICP values (up to 45 mm Hg) conservatively. The diastolic velocity of the transcranial doppler sonography (TCD) has to decrease until only a systolic flow pattern is obtained. (4) No other mass lesion should be detected on cranial computed tomography (CCT) that could account for the rise in pressure. In both cases we performed bifrontal decompressive craniectomies. RESULTS Both patients survived. Seven months after the accident, patient No. 1 was oriented and could walk on her own with a mild right-side hemiparesis. Patient No. 2 could attend school 12 months postinjury. Both patients developed hygromas after the craniectomy. A shunt operation, however, was not necessary. CONCLUSIONS ICP monitoring, together with CCT examination, simultaneous recording of TCD, and systemic parameters, will reveal a patient at risk at a time when impending damage due to uncontrollable ICP may still be prevented. The simultaneous assessment of cerebral blood flow by transcranial doppler (TCD), in this situation, proves most valuable. It improves the guidelines of patient selection for decompressive craniectomy, in the presence of conservatively uncontrollable ICP.

Brain Edema↗
PubMed1995

Progressive cerebral occlusive disease after radiation therapy.

BACKGROUND: A case of progressive irradiation-induced cerebral vasculopathy with abnormal netlike vessels and transdural anastomoses (moyamoya syndrome) is presented. Radiological findings in an additional 40 cases reported in the literature are analyzed, and their clinical relevance is discussed. CASE DESCRIPTION: A 19-year-old woman presented with recurrent ischemic brain lesions after radiation therapy for treatment of a craniopharyngioma during childhood. Cerebral angiography 6 and 12 years after completion of radiation therapy revealed progressive cerebral arterial occlusive disease involving the internal carotid artery on either side of the circle of Willis, with abnormal netlike vessels and transdural anastomoses (moyamoya syndrome). CONCLUSIONS: Extensive similarities between irradiation-induced cerebral vasculopathy and primary moyamoya syndrome (Nishimoto's disease) support the notion that both disorders share common pathophysiological mechanisms. The occurrence of moyamoya-like vascular changes may not depend on specific trigger mechanisms but may rather represent a nonspecific response of the developing vascular system to a number of various noxious events.

Adult↗
PubMed1993

[The value of the AMBER system in demonstrating intrathoracic space-occupying lesions. A comparative ROC study of the AMBER and conventional technics for postero-anterior views of the thorax. Advanced Multiple Beam Equalization Radiography].

Since October 1991 the AMBER technique has been used for the diagnosis of chest diseases in about 4,000 patients. The ability of this technique, compared with conventional methods, for demonstrating intrathoracic masses on p.a. views has been assessed. Amongst the patients there were 43 with coin lesions, 18 with hilar and 33 with mediastinal masses. ROC analysis showed the AMBER technique to be superior in demonstrating coin lesions (AMBER 0.92, conventional 0.85) and mediastinal masses (AMBER 0.89, conventional 0.73). There was a small, statistically not significant, disadvantage in the AMBER technique for demonstrating hilar masses (AMBER 0.80, conventional 0.84).

Chi-Square Distribution↗
PubMed1993

[Subacute and chronic epidural hematoma after craniocerebral trauma].

During an 8-year period, fifteen patients with subacute or chronic epidural haematoma were seen among 110 treated cases of extradural haematoma corresponding to a frequency of 13.6%. Increasing headache, nausea, vomiting, mild drowsiness and cranial nerve palsy were the symptoms resulting in the correct diagnosis in most cases. Clinical and pathological findings are described, and the factors influencing the course of events are discussed. The most important factors are cerebral atrophy, age, source of bleeding and location. By means of early CT (computed tomography) diagnosis of haematoma, fatal outcome could be prevented in most of the cases.

Adolescent↗
PubMed1984

[Demonstration of IgG- and IgA-antibodies against Epstein-Barr virus-associated antigens with a microtiter enzyme immunoassay system. The determination of serum antibodies against the viral capsid antigen and the early antigen complex in the sera of tumor and infectious mononucleosis patients].

An enzyme-linked immunosorbent assay (ELISA) using micro-titre plates has been established for determination of IgG and IgA antibodies to the Epstein-Barr virus (EBV)-associated early antigen complex (EA) and the viral capsid antigen (VCA). The results obtained correlated well with the antibody titre determinations by the standard immunofluorescence technique. The ELISA was found to be about 15 to 30 times more sensitive than the immunofluorescence assay. Because of its high sensitivity, specificity and rapid performance the enzyme-immunoassay is a useful tool for large scale epidemiological studies of EBV-associated diseases as well as for the early diagnosis and monitoring of patients with EBV-associated tumours: Burkitt's lymphoma and nasopharyngeal carcinoma. IgG and IgA antibody titres to EA and VCA were determined in sera obtained from healthy controls, patients with EBV-associated tumours, infectious mononucleosis and various diseases known to be associated with EBV-reactivation, i.e. lymphomas and leukaemias. Except in sera of patients with nasopharyngeal carcinoma, IgA antibodies to VCA and EA could only be detected at a rather high frequency (36% IgA anti-VCA+, 21% IgA anti-EA+) and in substantial titres in sera obtained from patients with chronic lymphatic leukaemia.

Antibodies, Viral↗
PubMed1984

Detection of IgA antibodies to Epstein-Barr virus-associated antigens by ELISA.

The detection of IgA antibodies to the Epstein-Barr virus (EBV)-associated viral capsid antigen (VCA) and early antigens (EA) is of diagnostic and prognostic importance for patients with nasopharyngeal carcinoma (NPC). An ELISA for the determination of serum IgG antibodies to these antigens has been developed which uses the double antibody method. 136 sera obtained from healthy donors and patients with non-EBV related tumors and lymphomas were tested by ELISA; only 3 sera, from patients with chronic lymphatic leukemia, hairy cell leukemia and Burkitt-like lymphoma, contained antibodies of IgA class to VCA and EA. Ninety-five sera from patients suspected of having NPC were tested. IgA anti-VCA was found in 28 sera (29.5%), 12 of which also contained IgA anti-EA. The assays described are suitable for diagnosis and follow-up of patients with EBV-associated nasopharyngeal carcinoma. Furthermore, isolated EA components may be tested for their reactivity with IgA antibodies, as was shown for the 60 kDa polypeptide associated with the EA complex.

Antibodies, Viral↗
PubMed1984

Enzyme-linked immunosorbent assay for IgG antibodies to Epstein-Barr virus-associated early antigens and viral capsid antigen.

An enzyme-linked immunosorbent assay has been developed for the detection of IgG antibodies to Epstein-Barr virus-associated early antigens and late antigens including the viral capsid antigen. The antibody titers of human sera determined in this way correlate well with those by indirect immunofluorescence. ELISA was more sensitive than the IF method. The assays described may be used for rapid and sensitive diagnosis of EBV-related diseases. In addition, the ELISA will be useful for the determination of antibody titers to isolated EBV-associated antigens, e.g., purified components of the EA complex.

Antigens, Viral↗
PubMed1977

[Is hearing of the students damaged by environmental noise in their leisure time? (author's transl))].

An examination of 1300 students between the ages of 10 and 20 who had not yet been exposed to industrial noise was performed in order to establish to what extent general environmental noise influences hearing. The fact that there was no age-dependent increase of high tone hearing loss, as well as the small correlation between hearing loss and total noise load are evidence that there is no hearing loss produced by increasing environmental noise exposure of teenagers in Germany. Middle ear infections, infections diseases and skull trauma are suggested as causes of the usually minimal high tone hearing losses.

Adolescent↗
PubMedDate not supplied

Quantification of VP22-GFP spread by direct fluorescence in 15 commonly used cell lines.

BACKGROUND: The intercellular transport property of VP22 chimeric proteins offers the opportunity for the improvement of gene therapy delivery systems. Since enhanced therapeutic effects of transduced genes already have been exemplified for chimeric proteins VP22-p53 and VP22-tk, we were interested in examining whether spread of VP22 chimeric proteins is a general biological phenomenon not restricted to distinct tissues or species. METHODS: To study intercellular spread of VP22-GFP fusion proteins, 15 different mammalian cell lines were transfected with 200-2000 ng of VP22-GFP or GFP expression plasmids. Expression of VP22-GFP or GFP was monitored by fluorescence microscopy of live GFP fluorescence and direct FACS analysis. For selected cell lines, antibody detection of VP22-GFP spread was analysed by confocal microscopy as a control. RESULTS: Spread of VP22-GFP fusion proteins was detected in all 15 cell lines tested, and quantified by FACS analysis. Experimental conditions were found to be critical in the investigation of VP22-mediated intercellular spread. CONCLUSION: Results of our study indicate that spread of VP22 chimeric proteins is a general biological phenomenon not restricted to distinct tissues or species. Therefore, further evidence is provided that VP22-enhanced gene therapeutic effects may be obtained irrespective of the target organ/tissue to be addressed.

Animals↗
PubMedDate not supplied

ICP measurement control: laboratory test of 7 types of intracranial pressure transducers.

Intracranial pressure (ICP) monitoring has become an important parameter in the assessment of comatose patients, with raised intracranial pressure. The transducers in use have to fulfill the criteria of measurement accuracy, practicability and cost-effectiveness. However, these requirements are not always met in clinical practice. The need for ongoing quality control through independent laboratories remains. We have developed a laboratory set-up for the evaluation of intracranial pressure probes. Seven different types of currently used transducers have been tested for measurement accuracy. Under in vitro conditions 3 parameters were assessed: measurement accuracy, a 24 h drift and 10 day drifts. Tests for measurement accuracy were performed at increasing pressure levels of up to 80 mmHg. They were repeated 10 times per probe. This test allowed the simultaneous assessment of 5 different ICP probes. Drift was evaluated for 24 h and 10 days, at 6 pressure levels between 0 and 50 mmHg. Seven different types of ICP probes were tested (HanniSet, Camino, Codman, Spiegelberg, Medex, Epidyn and Gaeltec). Measurement accuracy was best with HanniSet probes. The maximum errors with this transducer were 3 mmHg. Camino and Codman showed similar results. Spiegelberg had slightly larger deviations. With Epidyn and Gaeltec the highest error were noted, up to 10 mmHg in the high pressure range. The 24 h drift was lowest with HanniSet (0.2 mmHg) and Camino (0.8 mmHg). The largest drifts were seen with Medex, Spiegelberg and Gaeltec (1.8 mmHg). Ten day drift was lowest with HanniSet (0.1 mmHg/day) and Codman (0.2 mmHg/day). The highest long-term drifts were found with Epidyn and Gaeltec (1.5 mmHg/day). Drift did not exhibit a linear pattern. After an initial rise in drift during the first 24-72 h, it decreased slowly during the next 7 days. Most ICP probes revealed measurement inaccuracy and drift. These results emphasize the necessity for ongoing evaluations of ICP probes. Therefore, tests for quality assurance are essential to establish a consistent standard of proficiency of ICP transducers.

Intracranial Pressure↗
PubMedDate not supplied

P2U-purinergic receptor activation mediates inhibition of cAMP accumulation in cultured renal mesangial cells.

Extracellular ATP has been reported to exert mitogenic and contractile effects on cultured renal mesangial cells (MCs). Since it is possible that these actions involve changes in the cAMP second messenger system, we examined the effect of extracellular nucleotides on the accumulation of cAMP in rat MCs. ATP, UTP and adenosine 5'-0-(3-thio)triphosphate (ATP gamma S) (100 microM) had no significant effects on baseline cAMP levels, but inhibited forskolin-stimulated accumulation of cAMP by 21-75% in the presence of the phosphodiesterase inhibitor 3-isobutyl-1-methylxanthine (IBMX). Maximal inhibitory effects were observed at 100 microM of ATP gamma S with a threshold dose of 1 microM. ATP gamma S, ATP and UTP were the most potent inhibitors indicating stimulation of the P2u receptor. The P2x agonists adenosine 5'-(alpha, beta-methylene) triphosphate and adenosine 5'-(beta, gamma-methylene) triphosphate, and the P2y agonist 2-methylthio-ATP did not affect cAMP accumulation. Treatment with the P2 receptor antagonist suramin (200 microM) reduced the inhibition by 58%. The inhibitory effects of the nucleotides were significantly attenuated by preincubation with pertussis toxin (10-100 ng/ml). Inhibition of phospholipase C and protein kinase C did not prevent the inhibitory effect of the nucleotides. Inhibitors of forskolin-stimulated cAMP accumulation had different effects on DNA synthesis in cultured MCs as measured by 3H-thymidine uptake at 48 h: ATP, ATP gamma S and the inhibitor of adenylyl cyclase, SQ 22536, stimulated DNA synthesis in MCs, while UTP showed no significant mitogenic effect. Agents which increased baseline levels of intracellular cAMP (forskolin, IBMX, dibutyryl-cAMP) significantly diminished DNA synthesis in MCs. The results indicate that the P2u-purinergic receptor mediates inhibition of forskolin-induced cAMP accumulation which is likely due to inhibition of adenylyl cyclase. This effect appears to be partially mediated by PTX-sensitive G proteins. While the increase in cAMP accumulation is anti-mitogenic, inhibition of cAMP accumulation by P2u receptors is not correlated with MC growth control. Thus, additional mechanisms other than inhibition of cAMP accumulation by P2u receptors are likely to be involved in the mitogenesis of extracellular ATP.

Adenosine Triphosphate↗