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Biomedical subjects

M Just

Publications and source records attributed to M Just.

At least 19 recordsLinked to original sources
PubMed1999

[Experiences with temporary vena cava filters in 114 at-risk patients with thrombosis or thromboembolism].

BACKGROUND AND OBJECTIVES: The indications for temporary implantation of a vena cava filter remain unclear and there are as yet few data about its complications and reliability. It was the aim of this study to determine the efficacy and complication rate of the temporary use of a vena cava filter (VCF) in a large group of patients at high risk of pulmonary embolism, and thus contribute to defining the indications for such temporary implantation. PATIENTS AND METHODS: Between November 1991 and October 1997 a total of 118 VCF were implanted in four groups of a total of 114 patients (67 women, 47 men; average age 45.3 +/- 19.8 [12-82] years) to prevent pulmonary embolism: those (1) with massive or fulminant pulmonary embolism (n = 54); (2) with mechanical thrombus fragmentation and (or) local catheter-delivered systemic thrombolysis in pelvic, leg or caval vein thrombosis (n = 42); (3) with systemic thrombolysis in case of floating thrombi at the femoral, iliac or caval veins (n = 7); and (4) as perioperative measure in caesarean section, venous thrombectomy, other surgical interventions or when anticoagulation had to be discontinued in patients with deep vein thrombosis (n = 11). RESULTS: Filters remained implanted for a mean of 6.1 +/- 3.4 (1-16) days. Placement had to be corrected because of filter dislocation in eight patients. Proven pulmonary embolism occurred after filter implantation in only one patient, after filter displacement into the unthrombosed contralateral iliac vein. Thrombus deposition on the filter before its removal was demonstrated in nine patients: thrombolysis was effective in seven of them, while thrombosed filters had to be removed surgically in two. Residual thrombi were found on the filter in six further patients. No pulmonary embolism occurred in connection with filter removal. Local complications at or around the site of insertion of the introducing catheter occurred in 53 of the 114 patients (46.5%): haematoma in 42, infection in 21 and brachial vein thrombosis in three patients. CONCLUSIONS: The rate of clinically relevant pulmonary embolism can probably be reduced to a minimum by the implantation of a temporary vena cava filter. The overall complication rate is high, but serious complications are rare.

Adolescent↗
PubMed1999

Keratotsis punctata of the palmar creases: report of two cases associated with ichthyosis vulgaris.

Two patients with keratosis punctata of the palmar creases are described. The association with ichthyosis vulgaris and other disorders of keratinization is discussed. In both cases, histopathology revealed a close relation between the keratotic plug and the sweat glands. The role of genetic factors and manual activity in the pathogenesis is discussed. Treatment with oral etretinate resulted in a good improvement in the first patient, but prolonged low-dose maintenance therapy was required to prevent recurrence.

Adult↗
PubMed1999

p53 immunohistochemical expression in early posttransplant-associated malignant and premalignant cutaneous lesions.

BACKGROUND: Current evidence suggests that p53 accumulation is critical to the development of skin cancer in the general population. It is possible, however, that the molecular steps involved in transplant-associated and non-transplant-associated skin carcinogenesis may differ. OBJECTIVE: Our purpose was to examine p53 expression in premalignant and malignant skin lesions from renal transplant recipients (RTRs) in their first 3 years of immunosuppression, as well as in equivalent lesions from immunocompetent normal individuals. METHODS: p53 expression was examined by routine immunohistochemical methods using the anti-p53 monoclonal antibody DO7. RESULTS: p53 immunoreactivity was more prevalent in dysplastic epidermal keratoses and cutaneous carcinomas from RTRs than in equivalent lesions from nontransplant controls. Statistical analysis revealed significant differences, however, only in premalignant skin lesions (p = 0.03). CONCLUSION: This study demonstrates that accumulation of p53 protein is frequently encountered in both premalignant and malignant skin lesions of RTRs, and that this may occur as an early step in transplant-associated skin carcinogenesis.

Antibodies, Monoclonal↗
PubMed1998

Hereditary hypotrichosis simplex.

Hypotrichosis is a relatively common feature of a number of complex hereditary syndromes. However, the isolated variant, called hereditary hypotrichosis simplex (HHS), is especially uncommon. We present a Spanish family with 8 of 19 persons covering 4 generations affected by HHS. No associated ectodermal or other defects were noted. The pedigree was compatible with an autosomal dominant inheritance with variable penetrance.

Child↗
PubMed1998

Papular acrodermatitis of childhood related to poxvirus and parvovirus B19 infection.

Papular acrodermatitis of childhood (Gianotti-Crosti syndrome) is considered an unspecific cutaneous pattern related to an increasing number of infectious diseases. We report two cases of Gianotti-Crosti syndrome, one of which occurred in the setting of parvovirus B19 primary infection and the other followed poxvirus infection. Parvovirus B19 and poxvirus may represent new causative agents of Gianotti-Crosti syndrome.

Acrodermatitis↗
PubMed1997

Sequential combined therapy with thalidomide and narrow-band (TL01) UVB in the treatment of prurigo nodularis.

BACKGROUND: Prurigo nodularis (PN) is a chronic disease of which treatment choices are limited. Among them, thalidomide and phototherapy have been used with satisfactory results. Unfortunately, the possibility of side effects limits their use. OBJECTIVE: To evaluate the efficacy of a sequential combined treatment with thalidomide and ultraviolet B (UVB) therapy in order to minimize side effects and, thus, making possible a long-term treatment. METHODS: A prospective open trial combining thalidomide as initial therapy followed by narrow-band UVB (TL01) irradiation until complete or almost complete remission of the disease was achieved. RESULTS: An excellent response was obtained after an average of 12 weeks of thalidomide therapy and 32 UVB courses. CONCLUSIONS: Sequential combined therapy with thalidomide and narrow-band UVB therapy could improve the management of prurigo nodularis with minimal side effects, although it should probably be reserved to men and women over 50 years of age.

Administration, Oral↗
PubMed1996

Impact of polymerase chain reaction on clinical pertussis research: Finnish and Swiss experiences.

Since April 1993 in Finland and March 1994 in Switzerland, polymerase chain reaction (PCR) has been used routinely nationwide for the diagnosis of pertussis. Nasopharyngeal specimens from 3794 patients suspected of having pertussis and 1125 controls were tested. Finnish and Swiss assays found 23% and 36% of clinical specimens positive, respectively. PCR showed a higher incidence of pertussis infection among 1- to 6-year-old children in Switzerland than in Finland (P < .001). This difference may be due to the booster dose of vaccine given at 2 years of age in Finland but not in Switzerland. In Finland, PCR-confirmed asymptomatic cases were more common among children <7 years old than in older children (P < .001), whereas older children tended to have symptomatic infection. The use of PCR markedly improves the diagnosis of pertussis and opens new perspectives for epidemiologic and vaccine efficacy studies.

Adolescent↗
PubMed1995

Virosomes as carriers for combined vaccines.

Immunopotentiating reconstituted influenza virosomes (IRIV) are liposomes which carry the two glycoproteins of the influenza virus on their surface. A hepatitis A vaccine using IRIV as carrier has very good immunogenicity and is well tolerated. The objective of this study was to produce a fivefold combined vaccine against hepatitis A and B, diphtheria, tetanus and influenza A/B, and to show that in principle IRIVs can serve as carriers for multiple antigens which have good immunogenicity and are well tolerated. A total of four studies were carried out. Either the combined vaccine or the corresponding adequately tested alum-adsorbed single vaccines were tested for reactogenicity and immunogenicity in young adults. A hepatitis A and B combination on an IRIV base showed the same immunogenicity and toleration as the single vaccines. However, with the simultaneous coupling of all five vaccines on the same IRIV or the binding of Di-Te and HAV on different IRIVs there was a suppression of the humoral immune response against HAV (p = 0.03). The possibility that epitope-specific suppression had occurred could be ruled out. The suppression of the response against HAV could be circumvented by halving the quantity of Di-Te antigen in the combined vaccine so as to avoid antigenic competition. Surprisingly, the immunogenicity of Di-Te vaccination in the combination proved superior to that of a separate vaccination. All vaccinations were well tolerated.

Adult↗
PubMed1995

Role of octreoscan and correlation with MR imaging in Graves' ophthalmopathy.

Since the identification of somatostatin receptors on lymphocytes, orbital infiltration with mononuclear cells in Graves' ophthalmopathy has provided a rationale for receptor imaging with the radiolabeled somatostatin analog Octreotide. In 40 patients with Graves' ophthalmopathy and 10 controls, 110 MBq indium-Octreotide were administered i.v., and scans were performed at 4 and 24 h after injection. An uptake ratio between the orbits and the brain was determined. In 20 ophthalmophathy patients, magnetic resonance imaging (MRI) of the orbits was performed and the T2 relaxation time was measured within the rectus muscles. Compared to controls (4 h Octreotide uptake: median 6.0 counts/pixel/MBq, orbit/brain ratio 5.6), ophthalmopathy patients showed a 2- to 3-fold increased uptake (15.8 counts/pixel/MBq vs controls p = 0.0032; ratio 12.6, vs controls p = 0.003). When considering patients with active disease only, a higher uptake was registered (16.8 counts/pixel/MBq vs controls p 0.0048, ratio 15.6 vs controls p = 0.0006). Untreated patients showed a markedly higher uptake (23 counts/pixel/MBq) compared to patients receiving steroid therapy (12.6, p = 0.001). MRI of the orbit revealed a correlation between T2 relaxation time of the eye muscles and orbital uptake of Octreotide (p < 0.001).

Adult↗
PubMed1995

Polymerase chain reaction identification of Bordetella pertussis infections in vaccinees and family members in a pertussis vaccine efficacy trial in Germany.

The polymerase chain reaction (PCR) was recently added to conventional culture and serology for the diagnoses of Bordetella pertussis infection in a large vaccine efficacy trial in Germany. In vaccinees or family members who had illnesses with cough, two nasopharyngeal swabs (calcium alginate for culture and Dacron for PCR) were taken and initial and follow-up clinical data were obtained. PCR was done using oligonucleotide primers PTp1 and PTp2 which amplify a 191-base pair DNA fragment of pertussis toxin operon. From December, 1993, to May, 1994, 555 pairs of swabs were processed; 28 grew B. pertussis and 9 grew B. parapertussis. Twenty-six of the 28 subjects with B. pertussis-positive cultures also had positive PCR results as did one of the 9 B. parapertussis cases and 82 additional samples were positive by PCR. PCR increased the identification of subjects with B. pertussis infections by almost 4-fold. Clinical characteristics were analyzed by laboratory category (Group 1, 28 culture-positive; Group 2, 82 culture-negative, PCR-positive; and Group 3, 436 culture- and PCR-negative). Group 1 subjects were more likely to have a diagnosis of definite or probable pertussis and to have paroxysmal cough, posttussive vomiting, whooping and a cough duration of > or = 4 weeks than Group 2 or 3 subjects. In contrast Group 2 subjects were more likely than Group 1 subjects to have had previous pertussis immunization or prior antibiotics. PCR identified many mild illnesses caused by B. pertussis that were not identified by culture.

Adult↗
PubMed1995

Safety, immunogenicity, and pilot efficacy of Plasmodium falciparum sporozoite and asexual blood-stage combination vaccine in Swiss adults.

This study was part of a larger program to develop a vaccine effective against Plasmodium falciparum infection caused by sporozoites and clinical malaria caused by asexual blood stages. In a phase 1 study of safety and immunogenicity, two recombinant proteins (Ro 46-2717, a circumsporozoite [CS] protein) construct with a molecular mass of 35 kD, and Ro 46-2924, a merozoite surface antigen [MSA-2] construct with a molecular mass of 25 kD) adsorbed onto alum were injected in two low (20 micrograms) or two high (100 micrograms) doses in the right and left deltoid muscles of 33 healthy Swiss volunteers; six other volunteers received a placebo (alum alone). Twenty-six participants reported 51 immunization-related adverse events, mainly pain at the injection site. Mean antibody titers to CS protein and MSA-2 in an indirect immunofluorescence assay peaked four weeks after the second immunization without evidence of boosting (i.e., sharp increase in titer). By that time, 56% and 31% of the vaccinees seroconverted to CS protein and MSA-2, respectively, with the increase in MSA-2 titer being weaker than that for the CS protein. After a third immunization, five vaccinees volunteered to be challenged by three or four infective bites of Anopheles stephensi. Prepatent and incubation periods in all five were comparable with unvaccinated historic controls challenged under similar conditions, and all had symptoms of clinical falciparum malaria. We conclude that the vaccine components were safe and immunogenic but there was no evidence that this immunization regimen with the CS protein plus MSA-2 component was able to prevent infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

[Prevention of congenital toxoplasmosis in Europe].

To sound out prevalent opinions among health authorities in Europe concerning the control and prevention of congenital toxoplasmosis (CT), a questionnaire was sent to the 28 WHO member countries in Europe. The questionnaire was returned by 23 countries. Only 7 countries recommend systematic screening of pregnant women. The reasons given by the 14 countries which do not recommend systematic screening are diverse: recommendations are in preparation, unfavourable cost-benefit return, absence of satisfactory treatment, programme not possible, incidence level too low, etc. 11 countries have a surveillance system for CT, of which only 3 are among the countries which recommend systematic screening. However, the absence of a multidisciplinary approach does not permit proper surveillance of cases. It appears from this survey that control of CT is undertaken in a very heterogeneous manner in Europe and no country has a programme whose impact on CT can be measured. So far, the European experience does not permit conclusions either in favour of or against a programme for the systematic screening of CT. However, cost-benefit analysis plays a very important role in determining whether such a programme should be implemented. Parameters such as the security of diagnosis (standardization of methods, quality and experience of the laboratories) and the monitoring of cases (definition, multidisciplinary approach to the surveillance and long-term treatment of patients, national collection of case reports, evaluation of the programme) are indispensable for the implementation of an effective surveillance system.

Cost-Benefit Analysis↗
PubMed1994

[Immunogenicity and stability of an aluminum-free liposomal hepatitis A vaccine (Epaxal Berna)].

The high immunogenicity of the liposomal hepatitis A vaccine (Epaxal Berna) after a single dose and after a booster dose one year later has been confirmed in several studies with healthy adult volunteers: 95-100% and 96-100% seroconversion (> or = 20 mIE/ml) after 1 and 12 months respectively, as well as a booster effect in 100% of the cases after revaccination. The tolerability of this new, alum-free vaccine has been excellent with 6-25% local and 0-13% mild systemic reactions after a dose of 0.5 ml. Stability testing with and without detergent indicated partial internalization of the hepatitis A virions in the phospholipid bilayer of the liposome vesicles with storage. Immunization of 10 healthy adult volunteers with vaccine stored for 32 months at 4 degrees C showed, however, that the duration of storage has no influence on immunogenicity and tolerability of the vaccine.

Adult↗
PubMed1994

Phosphorylation of focal adhesion vasodilator-stimulated phosphoprotein at Ser157 in intact human platelets correlates with fibrinogen receptor inhibition.

Integrins and other adhesion receptors are essential components for outside-in and inside-out signaling through the cell membrane. The platelet glycoprotein IIb-IIIa (also known as fibrinogen receptor or integrin alpha IIb beta 3) is activated by platelet agonists, inhibited by cyclic-nucleotide-elevating agents, and is involved in the activation of protein tyrosine kinases including the 125-kDa focal adhesion kinase (pp125FAK). However, the molecular details of glycoprotein IIb-IIIa regulation are not well understood. Here we report that in ADP-activated human platelets cAMP- and cGMP-dependent protein-kinase-mediated phosphorylation of the focal adhesion vasodilator-stimulated phosphoprotein (VASP) at Ser157 correlates well with glycoprotein IIb-IIIa inhibition. Human platelets contain similar concentrations of glycoprotein IIb-IIIa complexes (fibrinogen binding sites) and VASP. Using gel-filtered platelets, cAMP-elevating agents [e.g. prostaglandin E1 and the forskolin analog 6-(3-dimethylaminopropionyl)forskolin (NKH 477)] caused VASP Ser157 phosphorylation and inhibited glycoprotein IIb-IIIa activation up to 70-100%. NO-generating, cGMP-elevating agents [e.g. 3-morpholinosydnonimine hydrochloride (SIN1) and sodium nitroprusside] stimulated VASP Ser157 phosphorylation and inhibited glycoprotein IIb-IIIa activation up to a maximal extent of 30-50%. The effects of cAMP- and cGMP-elevating agents on VASP phosphorylation and fibrinogen binding were reversible and could be mimicked by membrane-permeant selective activators of platelet cAMP- or cGMP-dependent protein kinase, respectively. Using threshold concentrations, the nitrovasodilator SIN 1 potentiated the effects of the forskolin analog NKH 477 with respect to inhibition of platelet aggregation, VASP phosphorylation and glycoprotein IIb-IIIa inhibition. It is proposed that the inhibition of glycoprotein IIb-IIIa induced by cyclic nucleotide involves cAMP-and cGMP-dependent protein-kinase-mediated VASP phosphorylation at Ser157.

Adenosine Diphosphate↗