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Biomedical subjects

M Just

Publications and source records attributed to M Just.

At least 55 records · Page 3Linked to original sources

Reactogenicity and immunogenicity of inactivated hepatitis A vaccines.

Two inactivated hepatitis A virus (HAV) candidate vaccine strain were tested, derived from strains CLF and HM175. Neither vaccine increased liver enzymes levels and reactogenicity was similar to that observed with other alum-absorbed products. Antibody responses were dose-dependent and protection against HAV can be presumed to last for at least three years. All persons receiving 720 ELISA units (El.U) of the CLF vaccine seroconverted after one dose. For the HM175 vaccine, anti-HAV persisted until month 12 after injections at months 0 and 1, suggesting that the third dose of vaccine could be given at any time from month 6 to 12. A double dose of HM175 vaccine (1440 El.U) given as a single bolus resulted in 100% seroconversion by day 14 with a geometric mean anti-HAV level of 121 mIU/ml. This implies that rapid protection can be induced using large doses of inactivated HAV vaccine should time constraints dictate such an approach.

Adult↗

[MR tomography in testicular processes. The significance of Gd-DTPA enhanced sequences in comparison with plain T2-weighted sequences].

The value of T1-weighted sequences after intravenous administration of Gd-DTPA and of T2-weighted sequences was compared in 43 patients suspected of having scrotal abnormalities. T2-weighted sequences gave better demonstration of the tunica albuginea and better contrast between tumor and parenchyma. The two techniques were equally sensitive for demonstrating testicular tumors but orchitis was better demonstrated on the contrast enhanced sequences. Motion artifacts were less marked in the T1-weighted sequences with contrast enhancement. In selected cases, contrast enhancement may be a valuable addition to native protocols. Our experience has indicated that MRI provides specific findings in cases of orchitis which are clinically atypical; this facilitates the decision to conservative treatment and prevents unnecessary exploration of the testes.

Adolescent↗

[MR tomography of injuries of the medial collateral ligaments of the knee joint].

Frequency and characteristics of lesions of the medial collateral ligaments (MCL) were studied by MRI in 155 patients with trauma to the knee. There were abnormalities of the MCL in 38% of cases with ligamentous injuries and in 27% these were combined with meniscal tears. 11% of these patients showed isolated rupture of MCL and as a result of the MRI findings were treated conservatively. By means of T2*-weighted images the individual lesions could be accurately localised. Characteristic findings have been defined.

Humans↗

[MR tomography versus CT arthrography in glenohumeral instabilities].

In a prospective study the diagnostic value of MRI compared to CT arthrography (CT-A) was evaluated in 26 patients with 27 instable shoulder joints. Surgical and/or arthroscopic correlation was available in all cases. Both methods showed a high accuracy (96% CT-A, 94% MRI) in the evaluation of the glenoid labrum. CT-A was significantly superior to MRI in the detection of capsular lesions (sensitivity 96% vs. 44%, accuracy 96% vs. 72%, negative predictive value 96% vs. 67%). CT-A and MRI results regarding humeral head fractures were similar; fractures of the glenoid rim were better detected by CT-A, the difference, however, was statistically not significant. Overall, CT-A proved to be superior to MRI, as lesions of the joint capsule were shown with greater certainty.

Adolescent↗

[Epiphyseal dysplasia of the hip joint, its diagnosis and differential diagnosis with MRT].

Sixteen hip joints of eight patients with multiple epiphyseal dysplasia were examined by clinical investigation, plain films and by magnetic resonance imaging (MRI), using T1- and T2-weighted images and gradient echoes. MRI is useful in demonstrating the congruity of the joint, in the changes of the epiphyseal signal intensities and the epiphyseal line. Individual changes of the signal intensity patterns on T1- and T2-weighted scans are described. Although MRI exhibits a variety of patterns in different patients, a clearcut differentiation from Legg-Calvé-Perthes' disease is possible.

Adolescent↗

[Cystic space-occupying lesions of the seminal vesicles. Their demonstration with MRT].

Between October 1990 and March 1991, 8 patients with cystic lesions in the region of the posterior bladder wall, the seminal vesicles and the prostate were examined by MRI. In all cases there was accurate characterisation of the lesion and of its anatomy. In 3 patients with abnormalities in the retrovesical space there was very good agreement with the operative findings. 4 patients were treated conservatively. In these patients there was good agreement with the findings on cystoscopy, CT and sonography.

Adult↗

[The value of MR tomography in acute shoulder dislocations].

24 patients up to two weeks after primary traumatic shoulder dislocation were examined at 0.5 and 1.5 T. Surgical and/or arthroscopic correlation was available in 13, CT-arthrographic correlation in 16 patients. A joint effusion allowing sufficient evaluation of the capsulolabral complex was present in 21/24 (87.5%) cases. 11/14 patients with combined dislocated detachments of the glenoid labrum and capsular lesions were subsequently operated upon. Marrow edema of the humeral head was found in 16/19 Hill-Sachs lesions and in 4/5 fractures of the greater tuberosity. Two patients presented with a lesion of the long biceps tendon associated with rotator cuff tears and were also subsequently operated upon. MRI performed shortly after primary traumatic shoulder dislocation allows a comprehensive evaluation of the intraarticular lesions and decisively influences further therapy.

Adolescent↗

[Measurement error estimation in MR tomographic volumetry of the left ventricle with the multisection technic].

A multi-slice technique for MRT measurements of the left ventricular volume is much faster than the use of single-slice methods and is therefore better tolerated, leaving time for additional measurements. The end-diastolic left ventricular volume can be reliably measured by this method (123.3 +/- 13.5 ml vs. 124.1 +/- ml). The end-systolic volume is consistently overestimated by 23.7 +/- 18.3% compared with the reference value obtained by single slice measurements (47.9 +/- 8.9 ml vs 39.1 +/- 7.9 ml). Correspondingly, stroke volume and ejection fraction is underestimated on average by 10.6 +/- 9.7% and 10.6 +/- 7.6% respectively).

Adult↗

Immunopotentiating reconstituted influenza virus virosome vaccine delivery system for immunization against hepatitis A.

Hepatitis A virus (HAV) was purified from MRC-5 human diploid cell cultures, inactivated with formalin, and evaluated for safety and immunogenicity in humans. Three vaccine formulations were produced: (a) a fluid preparation containing inactivated HAV, (b) inactivated HAV adsorbed to Al(OH)3, and (c) inactivated HAV coupled to novel immunopotentiating reconstituted influenza virosomes (IRIV). IRIV were prepared by combining phosphatidylcholine, phosphatidylethanolamine, phospholipids originating from the influenza virus envelope, influenza virus hemagglutinin, and neuraminidase. The HAV-IRIV appeared as unilamellar vesicles with a diameter of approximately 150 nm when viewed by transmission electron microscopy. Upon intramuscular injection, the alum-adsorbed vaccine was associated with significantly (P < 0.01) more local adverse reactions than either the fluid or IRIV formulations. 14 d after a single dose of vaccine, all the recipients of the IRIV formulation seroconverted (> or = 20 mIU/ml) versus 30 and 44% for those who received the fluid and alum-adsorbed vaccines, respectively (P < 0.001). The geometric mean anti-HAV antibody titer achieved after immunization with the IRIV-HAV vaccine was also significantly higher (P < 0.005) compared with the other two vaccines.

Adjuvants, Immunologic↗

[Diagnostic goals in aortic dissection. Value of transthoracic and transesophageal echocardiography].

The combination of different ultrasound techniques like transthoracic, suprasternal, subcostal and transesophageal echocardiography have a high sensitivity and specificity in the diagnosis of aortic dissection. The limitation of this combined ultrasound technique is related to the visualization of the ascending part of the aortic arch which, cause of the interposition of the trachea, can not be visualized completely. The beginning or the end of a dissection in this part of the aorta may be misinterpreted. False negative results are rare. False positive results due to artefacts resulting from reverberations in an ectatic ascending aorta have to be taken into account. The most important diagnostic aims in acute or chronic aortic dissection can be described: 1. confirmation of the diagnosis by visualization of the intima membrane, 2. the differentiation of the true and false lumen depending on visualization of spontaneous echocardiographic contrast thrombus formation, slow or reduced reversed flow, systolic diameter reduction and signs of entry jet into the false lumen, 3. detection of intimal tear, demonstrating communication by two-dimensional or color Doppler echocardiography, 4. determination of the extent of the dissection with classification according to DeBakey type I, II and III or Stanford A and B with differentiation to communicating or non-communicating dissection, antegrade or retrograde dissection limited to the descending aorta or expanding to the ascending aorta, 5. detection of wall motion abnormalities as a sign of preexisting coronary artery disease or myocardial ischemia due to ostium occlusion by an intimal flap, coronary artery rupture or collapse of the true lumen during diastole, 6. detection and grading of aortic insufficiency, 7. detection of side branch involvement by suprasternal, subcostal and abdominal sonography, which will gain the information which side can be chosen for cannulation or catheterization at the femoral artery, 8. detection of pericardial pleural effusion and mediastinal hematoma as a sign of emergency as rupture can occur within minutes. Without surgical intervention have be performed. Based on these informations, surgery can be performed in all acute situations in type A dissection without further investigations. This decision is particularly important in patients with signs of emergency like pericardial or pleural effusion or mediastinal hematoma.

Aortic Dissection↗

Evaluation of 5.1-[NANP]19, a recombinant Plasmodium falciparum vaccine candidate, in adults.

In a randomized single-blind study, 13 healthy adult volunteers were subcutaneously immunized with 2 or 3 single 50 or 400 micrograms doses of a Plasmodium falciparum recombinant vaccine candidate designated 5.1-[NANP]19. The vaccine caused transitory reactions at the injection site. Eight (62%) volunteers had a greater than or equal to 4-fold increase of antibody titer against sporozoites in immunofluorescence assay, all 13 seroconverted in IgG enzyme-linked immunosorbent assay against [NANP]50 antigen, and in 6 (46%) a lymphocyte proliferation index greater than or equal to 3 against 5.1 antigen was observed. Seven volunteers were challenged with mosquitoes infected with P. falciparum. All developed detectable parasitemia after 7 to 12 days and all received drug therapy within 24 hours. One volunteer with a cellular response to 5.1 had two negative in vitro parasite cultures before treatment, despite overt parasitemia. He was the only challenged volunteer who remained free of malaria symptoms.

Adult↗

Undulin is a novel member of the fibronectin-tenascin family of extracellular matrix glycoproteins.

We characterized cDNA clones specific for the extracellular matrix glycoprotein undulin. Two sets of cDNA clones were isolated from a human placental lambda gt11 expression library and from a rhabdomyosarcoma cell line encoding two partially identical carboxyl-terminal polypeptides of 843 (Un1) and 443 (Un2) amino acids suggesting differential splicing of a single gene transcript. Northern blot analysis of human rhabdomyosarcoma cell poly (A) RNA with cDNA specific for Un1 identified transcripts of approximately 4.2, 6.5, and 8.5 kilobases, whereas a probe specific for Un2 detected a single mRNA of approximately 5 kilobases. Since a monoclonal antibody that is reactive with a sequence encoded by Un1 and not by Un2 detects the bands considered characteristic for undulin in Western blots, the mRNAs related to Un1 may code for the major part of the undulin molecule. The protein sequences deduced from Un1 and Un2 reveal an amino-terminal differentially spliced von Willebrand factor A domain, characteristic of proteins that interact with interstitial collagens, which is linked to fibronectin-like type III homology units by a unique sequence of 57 amino acids. Whereas Un2 encodes two complete and one incomplete type III homologies followed by a unique acidic carboxyl-terminal domain of 118 amino acids, Un1 codes for seven complete and one truncated type III homologies, followed by a short proline-rich carboxyl-terminal segment of 23 amino acids. Considering the 298 amino acids occurring in identical segments, the 989 different amino acid positions deduced from clones Un1 and Un2 represent an estimated 40% of the overall undulin sequence. In the context of 1) rotary shadowing electron microscopy data showing undulin as a structure composed of nodules that are interconnected by flexible rods of varying size, 2) the presence of three major bands of Mr 270,000, 190,000, and 180,000 in sodium dodecyl sulfate-polyacrylamide gel electrophoresis, with 3) common antigenic epitopes and similar peptide maps (Schuppan, D., Cantaluppi, M.C., Becker, J., Veit, A., Bunte, T., Troyer, D., Schuppan, F., Schmid, M., Ackermann, R., and Hahn, E.G. (1990) J. Biol. Chem. 265, 8823-8832), our finding of differentially spliced type III homology units, as found in tenascin and fibronectin, suggests that undulin is another member of the fibronectin-tenascin family of extracellular matrix glycoproteins. Furthermore, as in fibronectin and tenascin, undulin bears an additional subset of interactive domains tailored to specific structural and functional roles in development and differentiation.

Amino Acid Sequence↗

MRI-assisted radiation therapy planning of brain tumors--clinical experiences in 17 patients.

A new and simple method for precise determination of lateral opposed treatment portals was developed and used in 17 patients. Compared to CT, MRI led to significant changes of portals in 59% (10/17) of cases. Individual shielding blocks could be precisely designed by use of our new method. MRI is the procedure of choice in local radiation therapy planning of brain tumors.

Adolescent↗

Graves ophthalmopathy: role of MR imaging in radiation therapy.

Twenty-three patients with Graves ophthalmopathy who underwent radiation therapy were monitored by means of magnetic resonance (MR) imaging. T2 relaxation times of extraocular muscles and orbital fat, areas of extraocular muscles, and degree of exophthalmos were measured by means of MR imaging at the beginning, at the end, and 3 months after completion of radiation therapy. As a result, patients with primarily elevated T2 times of extraocular muscles showed a better therapy response regarding muscle thickening than patients with primarily normal T2 times. Elevated T2 times, which probably represent acute inflammatory changes, were markedly decreased at the end of therapy. Therefore, quantitative MR imaging favors the choice of anti-inflammatory therapy regimens in patients with elevated T2 times of extraocular muscles. However, the clinical response (activity scores) to the low-dose treatment protocol that was used did not correlate well with primarily elevated T2 times. Furthermore, T2 times increased again after cessation of therapy. Whether a higher radiation dose or a different fractionation scheme leads to better results must be clarified by means of further study.

Adult↗

Antithrombotic effects of recombinant hirudin in different animal models.

The effect of recombinant hirudin (r-hirudin; HBW 023) was studied in four different models of thrombosis as well as on bleeding time. Arteriolar thrombus formation was induced in rats either by argon laser injury or by photochemical reaction. r-Hirudin, given by intravenous infusion, significantly inhibited arteriolar thrombus formation and arterial bleeding time at a dose of 40 micrograms/kg.min. In rabbit jugular veins and carotid arteries, occluding thrombi were produced by stenosis and endothelial damage. r-Hirudin reduced the incidence of thrombosis dose dependently (ED50 0.7 and 1.0 mg/kg i.v. in arteries and veins, respectively). Caval vein thrombosis was initiated in rats by insertion of a stainless steel coil. This thrombosis was dose dependently reduced by the injection of r-hirudin (ED50 0.16 mg/kg i.v.). The duration of the antithrombotic effect of 0.25 mg/kg of r-hirudin in caval veins was about 60 min, whereas the arterial bleeding time was significantly prolonged in these rats for only 20 min. The plasma level of r-hirudin had dropped to 0.12 micrograms/ml 60 min after injection. These results suggest that the duration of the effect on bleeding time may be shorter than the antithrombotic action of r-hirudin.

Animals↗

[Nitric oxide dependence of the anti-thrombotic effect of sydnonimines in coronary arteries of swine].

The metabolites of sydnonimine-derivatives generate nitric oxide (NO) and inhibit, like NO, platelet aggregation and adhesion. The purpose of the present study in anesthetized pigs was to examine if sufficient NO is generated by 3 sydnonimine-derivatives in vivo in order to prevent platelet-dependent arterial thrombosis. Stenosis of mechanically damaged coronary arteries resulted in cyclical blood flow reductions due to recurrent formation and embolization of platelet-thrombi. Injection of molsidomine (0.3 mg/kg) significantly reduced the frequency of cyclical flow reductions by 66%: 1.8 +/- 0.8/30 min versus 5.3 +/- 0.5/30 min before injection (p less than 0.01, n = 6). Molsidomine decreased arterial blood pressure by 34 +/- 7 mmHg (systolic) and 23 +/- 6 mmHg (diastolic) in these animals. Two further sydnonimine-derivatives were studied at a dose with similar hemodynamic effects. The onset of action of CAS 936 (2 mg/kg) was slow as compared to molsidomine. Therefore, CAS 936 reduced the frequency of cyclical flow reductions by 29% in the first hour following injection, but by 50% (p less than 0.05, n = 7) during the second hour. The remaining flow cycles were very small (mean size reduction 88%). C 89-4095 (0.6 mg/kg) prevented cyclical flow reductions nearly completely (reduction by 93%, p less than 0.01, n = 6). The subsequent injection of oxyhemoglobin reinitiated cyclical flow reductions in all three treatment groups. The antihypertensive drug dihydralazine (0.25 mg/kg) reduced blood pressure in 6 pigs by 38 +/- 3 (systolic) and 35 +/- 5 (diastolic) mmHg but had no effect on the frequency of cyclical coronary flow reductions.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Two trials of an acellular DTP vaccine in comparison with a whole-cell DTP vaccine in infants: evaluation of two PT doses and two vaccination schedules.

The present trials being carried out in Switzerland and Turkey, the reactogenicity and immunogenicity of acellular DTP vaccines containing either 25 micrograms or 8 micrograms of PT and 25 micrograms of FHA were compared with those of a conventional whole-cell DTP vaccine during a primary vaccination course following either a 0-1-2 schedule starting at three months of age (Switzerland) or a 0-2-4 schedule starting at two months of age (Turkey). The whole-cell vaccine was associated with significantly more local reactions than the acellular vaccines; general reactions were also more frequent among whole-cell recipients. The 25 micrograms PT dose vaccine was no more reactogenic than the 8 micrograms PT dose vaccine. There was no evidence of increases in frequencies of local or general reactions from one acellular vaccine dose to the next. The 25 micrograms PT dose acellular DTP vaccine resulted in immune responses to all four antigens (PT, FHA, diphtheria and tetanus toxoids) at least equivalent to those observed with whole-cell vaccination. Significantly lower anti-PT antibody levels were seen with the 8 micrograms PT dose vaccine.

Antibodies, Bacterial↗