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Biomedical subjects

M Ulrich

Publications and source records attributed to M Ulrich.

At least 73 records · Page 4Linked to original sources
PubMed1993

Soluble intercellular adhesion molecule-1 in cerebrospinal fluid: an indicator for the inflammatory impairment of the blood-cerebrospinal fluid barrier.

A soluble form of the intercellular adhesion molecule-1 (sICAM-1) was measured in paired cerebrospinal fluid (CSF)/blood samples from 123 patients with different neurological diseases. Mean levels of circulating ICAM-1 in the blood were mean +/- SD = 423 +/- 184.6 ng ml-1 (range 44-1115 ng ml-1). Considerable differences of sICAM-1 in the CSF of patients were observed between disease groups. In acute bacterial meningitis, sICAM-1 levels as high as 1/5 of the serum concentration were detected in the CSF (n = 24; mean +/- SD = 33.0 +/- 23.7 ng ml-1; range: 4.8-93.9 ng ml-1). These changes coincided with a severe blood-CSF barrier dysfunction as indicated by a high CSF/blood ratio for albumin (mean +/- SD = 46.7 +/- 52.2; range: 16.8-249.3). In patients with polyradiculitis (n = 9; mean +/- SD = 14.5 +/- 11.9 ng ml-1; range: 2.6-43.7 ng ml-1) a similar covariation between the albumin and sICAM CSF/blood ratios was detected. In patients with multiple sclerosis (n = 9; mean +/- SD = 5 +/- 4.3; range: 0-12.7 ng ml-1) or HIV infection with neurological symptoms (n = 18; mean +/- SD = 4.9 +/- 3.2; range; 1-11.9 ng ml-1) low levels of sICAM-1 were detected in the CSF associated with intact blood-CSF barrier function in most patients. Among 13 patients with viral meningitis, only four had detectable levels of sICAM-1 in their CSF (mean +/- SD = 1.0 +/- 1.5 ng ml-1; range: 0-3.7).(ABSTRACT TRUNCATED AT 250 WORDS)

Antigens, CD↗
PubMed1993

Leprosy in women: characteristics and repercussions.

"Health is often measured in terms of low mortality; nevertheless, merely being alive is not a measure of the quality of life" H. Méndez Castellanos. Physiological, socioeconomic and cultural factors play important roles in the response of women to Mycobacterium leprae and in the impact of leprosy on their lives. They appear to develop stronger immunological responses to M. leprae than men, as suggested by lower incidence and less severe clinical forms of disease in most areas of the world, as well as stronger reactions of cell-mediated immunity after prophylactic vaccination. Genetic factors and physiological status including pregnancy, intercurrent infection and malnutrition might be among the factors which modulate this response. Women in leprosy-endemic areas of the world, with few exceptions, suffer from marked economic and social dependency and inferiority which can only be heightened by the social stigma associated with leprosy. Nevertheless, they bear an enormous responsibility for the health of their families, often as head of the household, and they often possess a unique capacity to influence community opinion. With the introduction of multidrug therapy, leprosy control throughout the world is no longer an unrealistic goal. Active vaccination may constitute the other factor necessary for eventual eradication of the disease. The incorporation of women at all levels into active roles in health care programs may constitute one of the decisive factors in the success or failure of leprosy control.

Adolescent↗
PubMed1993

Antigen-specific immunodeficiency and its relation to the spectrum of American cutaneous leishmaniasis.

Delayed-type hypersensitivity (DTH) and antibodies against Leishmania have been studied in 207 Venezuelan patients with localized, muco-cutaneous and diffuse forms of American cutaneous leishmaniasis, representing the clinical spectrum of this disease. Muco-cutaneous disease appears to be related to inadequate immunomodulation or defective killing mechanisms; about 40% of these patients show exaggerated DTH, which is inversely related to antibody levels and is more pronounced in less extensive lesions. Patients with diffuse disease present severe antigen-specific immunodeficiency, apparently limited to T cell-mediated protection, DTH and its in vitro correlates. Treatment of patients with diffuse cutaneous leishmaniasis using a combination of chemotherapy and combined vaccine immunotherapy (heat-killed promastigotes plus BCG) has induced clinical inactivity and positive DTH in about one third of these patients, accompanied by marked lowering of antibody levels. These results are discussed in terms of Type 1 T cell responses, protective in cell-mediated immune reactions, and Type 2 T cell responses, non-protective in cell-mediated reactions, in the spectrum of leishmaniasis. Factors related to the induction of favorable Type 1 responses to intracellular pathogens are discussed in terms of a possible mechanism of the combined vaccine efficacy and priorities in vaccine development.

Animals↗
PubMed1993

BCG vaccination protects against leprosy in Venezuela: a case-control study.

A total of 64,570 household and other close contacts of about 2000 leprosy cases were screened for eligibility for entry into a trial of a new leprosy vaccine. The screening procedure included a clinical examination for leprosy and for the presence of BCG and lepromin scars. Ninety-five new cases of leprosy were identified, and the prevalence of BCG and lepromin scars among them was compared with similar data from matched controls selected from among those with no evidence of leprosy. The difference in the prevalence of BCG scars in the two groups was used to estimate the protection against leprosy conferred by BCG vaccination. One or more BCG scars was associated with a protective efficacy of 56% (95% confidence limits 27% to 74%). There was a trend of increasing protection with four or more BCG scars, but this was not statistically significant. There was no evidence that the efficacy of BCG varied with age or according to whether or not the contact lived in the same household as a case. The protective effect was significantly higher among males, and was significantly greater for multibacillary than for paucibacillary leprosy.

Adolescent↗
PubMed1993

[The gel centrifugation test: comparison of antibody identification at 37 degrees C with antibody identification at room temperature].

The indirect antiglobulin test (antibody screening) (IAT) using the 'DiaMed-ID Micro Typing System' (ID system) was performed in two different ways: (1) incubation (Liss/Coombs version) at room temperature (RT) and (2) incubation (also Liss/Coombs version) at 37 degrees C. 106 antibody-containing sera were tested by IAT at RT and at 37 degrees C. The comparison of the results showed a high correlation between both methods: 49 of 106 antibodies were positive in the IAT at both RT and 37 degrees C, 51 antibodies were negative at both temperatures. Five antibodies were identified only in IAT performed at RT. 1/106 antibodies of the specificity anti-D (Rh prophylaxis) was not detected in the antibody screening at RT and in the conventional tube test. The antibody screening at RT using the ID System could be performed simultaneously with AB0 blood group typing without losing sensitivity and specificity. The modification of IAT using the ID System is more sensitive than the conventional tube test.

Agglutinins↗
PubMed1992

Determination of lectin characteristics by a novel agglutination technique.

A technique generally applicable for the determination of lectin characteristics is described. A sensitive light transmission/scattering method was adapted for the determination of lectin levels and lectin activity. Applying this procedure Geodia cydonium lectin-mediated agglutination was studied in an agglutimeter device using erythrocytes and even T-lymphocytes. In the Geodia lectin/T-lymphocyte system chosen, (i) a lectin concentration as low as 0.57 micrograms/ml could be measured accurately, (ii) the observed cell agglutination velocity constant with a maximal value of 0.75 min-1 was calculated, and (iii) the size of the agglutinates at a given lectin concentration and time period was estimated. The Geodia lectin activity was determined in parallel also in the erythrocyte system. Here, compared to the lectin/T-lymphocyte system the agglutination efficiency of the Geodia lectin-mediated agglutination was more than 10-fold higher and the lowest detectable lectin concentration was 0.06 micrograms/ml. Compared to the hemagglutination assay the lectin/erythrocyte system turns out to be more sensitive and to give much more information on agglutination behavior; this conclusion is supported by additional data using a second lectin isolated from Pellina semitubulosa. The superiority of the agglutination method described here over other known methods must be seen in its accuracy; moreover more lectin characteristics can be determined.

Agglutination↗
PubMed1992

Determination of lectin-cell-binding parameters by a new agglutination technique.

We applied a recently described technique which is based on a light transmission/scattering method to determine the association characteristics of the Geodia lectin to sheep erythrocytes. The agglutination assays were performed in a total volume of 3 ml with 5.4 x 10(6) erythrocytes/ml. At a concentration of 360 ng/ml 50% of the lectin molecules were bound to the cells within the first 10 s of incubation. Scatchard analyses revealed an association constant (K(a)) of 0.9 +/- 0.1 x 10(8) M-1 and a number of 3.8 +/- 0.6 x 10(6) lectin binding sites on one erythrocyte. The method was also successfully applied to determine quantitatively the inhibitory potential of sugars competing with cell surface glycoproteins for the lectin binding site. At a lectin concentration of 360 ng/ml 1 mM of lactose or 70 mM of D-N-acetylgalactosamine are required to inhibit lectin-mediated agglutination by 50%. These analyses confirm the potential of the novel light absorption agglutination technique to evaluate lectin characteristics.

Animals↗
PubMed1991

IgM antibodies to native phenolic glycolipid-I in contacts of leprosy patients in Venezuela: epidemiological observations and a prospective study of the risk of leprosy.

In a randomized, double-blind vaccine trial in Venezuela, about 29,000 contacts of leprosy patients have been vaccinated with either a mixture of heat-killed Mycobacterium leprae and BCG or BCG alone, and are being re-surveyed annually to detect new cases of leprosy. All contacts had a serum sample collected at the time of entry into the trial, and 13,020 of these sera have been analyzed for antibodies to phenolic glycolipid-I (PGL-I). Antibody levels have been related to various characteristics of the contacts and to their risk of developing leprosy in the following 4 years. A strong association was found between PGL-I antibody level and the risk of developing leprosy, in spite of possible modification of the incidence rate induced by vaccination. Antibody levels were higher in females than in males, and declined progressively with age. Household contacts had higher levels than did non-household contacts, and levels were higher in individuals from the state in Venezuela which has the highest incidence of the disease. No substantial differences were found in antibody levels between contacts of multibacillary and paucibacillary patients, which may in part reflect the influence of treatment, and there was no clear association with the presence of BCG or lepromin scars or with skin-test responses to PPD and leprosy soluble antigen. The assay of antibodies to PGL-I seems unlikely to provide a sensitive or specific test for infection with M. leprae, and measuring PGL-I antibody levels as a screening procedure to identify those at high risk of developing leprosy is unlikely to be particularly useful in most leprosy control programs. Such assays may be useful for the epidemiological monitoring of changes in the intensity of infection with M. leprae in a community and for the study of carefully defined groups of contacts during some phases of control programs.

Adolescent↗
PubMed1991

Generation of Pseudomonas aeruginosa aerosols during handwashing from contaminated sink drains, transmission to hands of hospital personnel, and its prevention by use of a new heating device.

Pseudomonas aeruginosa was isolated from sinks of washing basins, showers, toilets and bathtubs, from the personnel and patients of a mixed infectious disease ward in a German children's hospital during a prospective 4-week epidemiological study. 81% of all sinks were contaminated with P. aeruginosa strains. Upon entering the hospital, all personnel hand cultures were P. aeruginosa-negative. However, during duty, 42.5% of the personnel members carried different P. aeruginosa strains on their hands. Detection of P. aeruginosa strains in sinks preceding the isolation of identical genotypes from personnel hands suggested a transmission route from sinks to hands. Opening of water taps generated aerosols containing P. aeruginosa sink organisms which contaminated hands during hand washing. Survival times of various P. aeruginosa strains in aerosols was dependent on strain characteristics, light and humidity, and t 1/2 differed between 3-76 min. Heating of washing basin sinks to 70 degrees C with a new, safe and inexpensive device inhibited bacterial growth in sinks, generation of P. aeruginosa aerosols, and resulted in hand cultures negative for P. aeruginosa after washing.

Aerosols↗
PubMed1990

[Peripheral arterial complications of various catheter angiography methods].

Between 1980 and 1988 12,251 arterial punctures for cardiac catheterization (CC), percutaneous transluminal angioplasty (PTA), or pure diagnostic intraarterial angiography (IAA) have been performed in our clinics. 54 (0.44%), 39 (0.63%, CC), 12 (0.67%, PTA), 3 (0.07%, IAA) patients suffered from a complication at the site of the arterial puncture necessitating surgical correction. Adults developed false aneurysms or large hematomas whereas children tended to show thrombotic arterial occlusions. Generally the surgical procedures of these complications proved to be quite simple (over two thirds) but some, especially in children, turned out to be more difficult. 3 arterial spasms in children and 1 prolonged wound healing in the groin, all without long-term sequelae and 1 severe graft infection necessitating ligation of the common femoral artery with severe ischemic signs for several months were the only complications of our corrective surgical procedures. We therefore plead for these iatrogenic complications of arterial puncture for an early correction performed by a surgeon with at least some experience in vascular surgery.

Adolescent↗
PubMed1989

Immunotherapy of localized, intermediate, and diffuse forms of American cutaneous leishmaniasis.

The clinical efficacy of immunotherapy for localized American cutaneous leishmaniasis with a combination of heat-killed Leishmania mexicana amazonensis promastigotes and viable BCG (bacille Calmette Guérin) has been compared with meglumine antimoniate chemotherapy and with BCG alone in a controlled clinical study in 217 patients. The results in the first two groups were comparable, with greater than 90% clinical cures with an average time of 16-18 w required for healing. The cure rate was considerably lower (42%) and more prolonged in the group receiving BCG alone. Secondary effects were observed in less than 5% of the patients receiving combined immunotherapy or BCG alone. In contrast, 49% of the patients receiving chemotherapy showed side effects. High therapeutic efficacy was also observed using combined immunotherapy in patients with intermediate and diffuse cutaneous leishmaniasis who were previously unresponsive to chemotherapy. Cure or clinical improvement was seen in all 11 patients with intermediate forms of the disease, and marked clinical improvement was observed in 9 of 10 patients with diffuse disease. The results on the efficacy of the combined vaccine in immunotherapy for American cutaneous leishmaniasis provide a strong rationale for studying its effectiveness in prophylactic trials.

Adolescent↗
PubMed1988

Analysis of the class-specific immune response to Yersinia enterocolitica virulence-associated antigens in oro-gastrically infected rabbits.

The antibody response was analysed in rabbits oro-gastrically infected (i) with virulent-(plasmid-carrying) Yersinia enterocolitica 0:3 (v-rabbits) and (ii) with the avirulent (plasmid-cured) derivative (av-rabbits). In an immunoblot assay with whole cell lysate proteins from the infecting virulent Yersinia strain, a significant IgG response was evident in convalescent-sera of v-rabbits and of av-rabbits, demonstrating that all rabbits seroconverted. However, v-rabbits mounted a stronger immune response to the cell lysate proteins than av-rabbits and the immune response persisted for a longer time. The post-challenge sera also reacted with whole cell lysate proteins of Escherichia coli and Salmonella typhimurium, indicating cross-reactivity between the different members of Enterobacteriaceae. In contrast, the antibody response against plasmid-encoded released proteins (RPs) appeared specific for infection with virulent strains in that the sera of av-rabbits failed to recognize the plasmid-encoded proteins. Six days following challenge with the virulent Yersinia strain all animals mounted a serum IgM and IgA response to RPs, followed by IgG antibodies on day 9. While the IgM and IgA serum antibody response rapidly decreased (within five-seven and eight-ten months, respectively), IgG antibodies to RPs were still present one year after challenge. Fourteen months after the first infection both the av-rabbits and the v-rabbits were reinfected with the virulent Yersinia strain and the antibody response to RPs was monitored. The v-rabbits only responded with a significant increase of IgG antibodies, indicating that they were primed to the RPs whereas the av-rabbits produced IgM, IgA and IgG specific antibodies like those seen in the primary response of v-rabbits. This study indicates that the rabbit model is helpful and adequate to analyse the character and kinetics of the antibody response during Yersinia infection.

Agglutination Tests↗
PubMed1988

Serological patterns and specificity in American cutaneous leishmaniasis.

Sera from diverse clinical forms of American cutaneous leishmaniasis show remarkably different patterns of reactivity to Leishmania mexicana and L. braziliensis after absorption with these two species of Leishmania. The enhanced species specificity of absorbed sera was confirmed by reactions with well characterized reference strains. The use of pairs of enriched polyclonal sera from mucocutaneous and diffuse cutaneous leishmaniasis permits the preliminary classification of isolates in the L. mexicana or L. braziliensis complexes by a simple, inexpensive, and quantitative immunoassay.

Animals↗
PubMed1987

Immunotherapy versus chemotherapy in localised cutaneous leishmaniasis.

In a randomised trial a combination vaccine consisting of live BCG together with killed leishmania promastigotes was compared with a standard antimonial regimen in 94 patients with localised cutaneous leishmaniasis. Three vaccinations over 32 weeks gave a similar cure rate (94%) to three 20-day courses of meglumine antimonate. In the immunotherapy group side-effects were few (5.8%) and slight whereas in the chemotherapy group they were frequent (52.4%) and often serious. Immunotherapy is a low-cost, low-risk alternative to chemotherapy in localised cutaneous leishmaniasis, applicable by primary health services in rural areas.

Adolescent↗
PubMed1987

Immunosuppression and cellular immunity reactions in leprosy patients treated with a mixture of Mycobacterium leprae and BCG.

Suppressor reactivity was studied in a group of leprosy patients before and after immunotherapy with a mixture of Mycobacterium leprae and BCG. The treatment increases the responses in lymphocyte transformation tests to levels which are comparable to those observed in BT-TT patients and reduces suppressor activity. The soluble extract of M. leprae appears to be more sensitive than purified intact bacilli in the lymphocyte transformation tests, but this preparation did not induce suppressor reactivity with the regularity observed when using a Dharmendra preparation.

BCG Vaccine↗