[Comment on: "Phototherapeutic keratectomy in recurrence of granular corneal dystrophy after keratoplasty"].
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Corneal Dystrophies, Hereditary↗
Biomedical subjects
M Vogel
Publications and source records attributed to M Vogel.
Is the morphologically right atrioventricular valve tricuspid?
BACKGROUND AND AIM OF STUDY: Classification of the components of the right atrioventricular valve by its anatomical configuration is problematic and needs clarification. METHODS: Fifty hearts were studied so as to analyze carefully the structure of the right atrioventricular valve and to define its component parts. Cross-sectional echocardiograms were reviewed to demonstrate the valve in closed position, and reconstructed in three-dimensional fashion. RESULTS: The majority of specimens (62%) had three readily identifiable leaflets, but some (30%) could be described as having two leaflets while (8%) had four leaflets. The cross-sectional echocardiograms reviewed showed three definite lines of closure in all cases. CONCLUSIONS: The eccentric placement of the anterior papillary muscle causes the leaflets to close with three lines of apposition, and this makes the valve readily distinguishable from its mitral partner. When present, extra "scallops" in the structure of the right atrioventricular valve merely allow better coaption of the leaflets. So, although the term "cusp" is less than adequate as the descriptive basis for the structure of an atrioventricular valve, the right atrioventricular valve should still be considered to be tricuspid.
Echocardiography↗
Low-grade non-Hodgkin's lymphoma after high-grade non-Hodgkin's lymphoma in a child with ataxia telangiectasia.
BACKGROUND: Non-Hodgkin lymphomas (NHL) account for approximately 50% of neoplasms in patients with ataxia telangiectasia (AT). Prognosis is poor. Published data regarding the treatment of NHL in patients with AT suggested that these children respond poorly to therapy. The authors report on an infant with AT with mediastinal high-grade T-NHL who remained in continuous complete remission after chemotherapy. Diagnosis of AT was established after tumor diagnosis. METHODS AND RESULTS: The 7-month-old boy was treated according to the acute lymphoblastic leukemia-Berlin, Frankfurt, Münster 86 protocol. The therapeutic response was prompt, but therapy had to be stopped because of severe side effects. Surprisingly, the boy remained in a stable complete remission for 3 1/2 years. Then tumors in both kidneys occurred and the child died a few months later. Postmortem examination demonstrated large tumors in both kidneys caused by a low-grade malignant lymphoma of B-cell lineage. CONCLUSION: Congenital immune deficiency should be ruled out at diagnosis of rare malignancies in respect to age. NHL in patients with AT can be cured, but poor tolerance to chemotherapy has to be considered. Patients whose disease has been cured may be at high risk for development of a second independent malignancy.
Ataxia Telangiectasia↗
Human anti-IgE antibodies by repertoire cloning.
Anti-IgE antibodies have been detected in sera of patients with an allergic disease where they might play a role in the regulation of (Ig)E-mediated reactions. Using a recombinant phage surface display expression system a combinatorial library of antibody heavy and light chains was constructed from peripheral blood mononuclear cells from an atopic donor immunized with tetanus toxoid. Screening of the library allowed the identification of a large number of phages displaying human monovalent antigen-binding fragments (Phab) against tetanus toxoid and IgE. Surprisingly, we found a high frequency of Phab against particular IgE myelomas that was comparable to the frequency found for Phab against tetanus toxoid. However, most of these Phab were directed to different idiotypic determinants, depending on the IgE myeloma used for the panning procedure. Nevertheless, two clones were found to have anti-isotypic specificity and were shown to react specifically with the CH2 domain of the IgE heavy chain.
Adult↗
[Micro-callus formation of spongiosa. An up to now underestimated repair mechanism of the skeletal system].
Microcallus formations are demonstrable in nearly all cancellous bones by means of suitable preparation techniques. Histologically, these structures are immature fibrous bone formed in local overloaded parts of the trabeculae. Using a preparation technique that allows combined two- and three-dimensional analysis, 26 normal human spines and 11 osteoporotic spines were investigated for microcallus. Microcallus formations occur frequently in people over 45 years of age. They are mainly localized in the lower thoracic and lumbar spine and occur significantly more frequent in females than in males. The number of microcallus formations depends more on the microarchitecture of the cancellous bone than on individual trabecular parameters. In about 33% of cases microfractures are demonstrable in the centre of the microcallus formation. In non-invasive studies the bone mass could be misinterpreted due to microcallus. Although it indicates instability of the bone structure, microcallus formation is not a purely negative mechanism. It stabilizes and regenerates the bone tissue. Furthermore, complete new trabeculae can be formed due to bridges of microcallus between residual trabeculae. Osteoporosis is not the result of an inability to form microcallus.
Adolescent↗
Three-dimensional analysis of the spine in autopsy cases with renal osteodystrophy.
The spinal column was removed from nine autopsy cases with chronic maintenance dialysis and sectioned in the sagittal plane to a thickness of 1 millimeter using a surface-stained block grinding technique. A combination of two- and three-dimensional analysis included an evaluation of the spine deformity index (SDI), the bone volume (BV/TV), the trabecular interconnection (TBPf), the trabecular thickness (Tb.Th), the trabecular number (Tb.N) as well as a qualitative investigation of the structure of cancellous bone. The control group consisted of 26 autopsy cases with intact skeletons. An iliac crest biopsy made a direct comparison of the diagnostic biopsy location and the spinal column possible. The SDI showed vertebral fractures in renal osteodystrophy (ROD) of types I and II, in spite of a trabecular bone volume within normal limits. The trabecular bone volume showed mean values and a distribution throughout the spinal column familiar in the skeletally-intact control group. Those cases with a longer history of hemodialysis showed higher BV/TV values regardless of age and sex. A trabecular volume within normal limits did not mean physiological trabecular interconnection. Perforations were commonly observed with ROD. Classical, hidden and tunnelling perforations were distinguished. Microcallus formations were frequently seen in the periphery of vertebrae at rod nodes, rods and plate intersections. Three-dimensional analysis in ROD shows a greater alteration in architecture than can be assumed from the two-dimensional histological sections.
Autopsy↗
Vertical human immunodeficiency virus transmission: a study of placental pathology in relation to maternal risk factors.
We examined 48 placentas of human immunodeficiency virus (HIV)-exposed pregnancies morphologically for HIV-specific changes and immunohistologically for the presence of HIV antigen and RNA. Findings were correlated to infectious states of the children and maternal risk factors. Few HIV antigen-positive Hofbauer cells and HIV RNA positive syncytiotrophoblast and Hofbauer cells were detected. HIV-positive cells in the placenta did not correlate with intrauterine infection and maternal immunologic parameters. Light microscopically, we found two changes: immaturity of the terminal villi and allantois vasculopathy. These changes, however, are not HIV specific. Our results show that vertical HIV transmission cannot be diagnosed by morphological examination of the placenta.
Acquired Immunodeficiency Syndrome↗
Transthoracic real-time three-dimensional echocardiography using the rotational scanning approach for data acquisition.
Transthoracic real-time three-dimensional echocardiography using the rational scanning approach for data acquisition became a feasible modality for cardiac imaging during the last 4 years. Several attempts for reconstruction of the heart have been made using different methods. In this study we evaluate the data acquisition using the rotational approach from the transthoracic window. Thirty-five children with congenital heart disease were enrolled in the study. All of them underwent complete two-dimensional and Doppler echocardiogram followed by three-dimensional reconstruction using rotational image acquisition. The rotational approach enabled us to acquire good data from subcostal, apical, and suprasternal notch positions by rotating the transducer from 0 degrees-180 degrees. Novel views of the atrioventricular valve, semilunar valve, atrial, and ventricular septi were established by spatial plane imaging from the three-dimensional echocardiography. This reconstruction enables spatial imaging of cardiac structures and deficiencies. Three-dimensional echocardiography will enhance the understanding of complex congenital heart disease.
Child↗
Enhanced comprehension of dynamic cardiovascular anatomy by three-dimensional echocardiography with the use of mixed shading techniques.
Advances in ultrasound instrumentation and computer technology provide us an opportunity to develop methods to perform three-dimensional echocardiography in patients. Optimal methods of displaying three-dimensional images are critical for the perception of depth and distances. We examined the utility of various shading techniques in volume-rendered three-dimensional images in 22 patients with a variety of cardiac defects. Distance coding, gray level gradient shading, texture shading, and mixtures of these shading techniques were used. Our observations suggest that the mixture of shading techniques portray the dynamic three-dimensional anatomy better than a single type of shading. Appropriate mix of shadings could provide dynamic three-dimensional echocardiograms of clinical utility.
Echocardiography↗
Dynamic three-dimensional echocardiography with a computed tomography imaging probe: initial clinical experience with transthoracic application in infants and children with congenital heart defects.
OBJECTIVE: To assess the clinical applicability of a prototype computed tomographic echocardiographic imaging probe in paediatric patients with congenital heart disease. DESIGN: A phased array echocardiographic transducer (64 elements, 5 MHz) mounted on a sliding carriage was used transthoracically in various positions on the chest. The transducer moves from the outflow tract to the apex of the heart in 0.5 to 1.3 mm increments and records a tomographic slice of the heart at each increment level. Parallel images are recorded at a frame rate of 25-30 images/s. At each level a complete cardiac cycle is recorded. The images are digitised and stored in the image processing computer, which reconstructs the anatomical structures of the heart in a three-dimensional format by means of different grey scales. PATIENTS: 45 paediatric patients (age range 3 days to 17 years) with various congenital heart defects who had been admitted to hospital for diagnostic or therapeutic cardiac catheterisation or surgery. RESULTS: Good quality echocardiographic pictures were obtained in all but two of the 45 patients. Three-dimensional reconstructions of the heart were possible from transthoracic echocardiograms. The recorded cardiac chambers and valves were displayed in three-dimensions in real time (four-dimensionally). The heart was also displayed in real time in any desired plane and in up to five planes simultaneously without having to change the position of the transducer on the chest. Different parts of the heart were displayed in a view similar to that seen by a surgeon during an operation. Image acquisition took 3-5 minutes and three-dimensional reconstruction of various cardiac structures 20-90 minutes. CONCLUSIONS: The computed tomographic imaging probe facilitates acquisition of echocardiographic data as multiple planes can be obtained from one transducer position. Display of three-dimensional structures of the heart may enhance the understanding of cardiac anatomy.
Adolescent↗
Domain-specific anti-IgE antibodies interfere with IgE binding to Fc epsilon RII.
Human anti-IgE autoantibodies have been identified and implicated in the regulation of IgE-mediated reactions and IgE synthesis. In order to study the potential regulatory role of anti-IgE antibodies on IgE binding to the Fc epsilon RII we used a panel of IgE-specific monoclonal antibodies that were mapped by Western blotting against a series of recombinant epsilon domain peptides. Antibodies specific for all epsilon domains were detected except those against C epsilon H1. Using a competitive inhibition cell-binding assay on Fc epsilon RII + 8866 cells, we identified two major patterns of anti-IgE activity. Antibodies specific for the C epsilon H3 domain removed IgE whereas those specific for the C epsilon H2 domain enhanced IgE binding to the Fc epsilon RII. The anti-C epsilon H2 antibodies, in contrast to the anti-C epsilon H3 antibodies, could not dissociate cell-bound IgE from the Fc epsilon RII. Using preformed immune complexes of IgE and anti-IgE antibodies, it was clear that the anti-C epsilon H2 antibodies bound more IgE to the Fc epsilon RII by addition of immune complexes to the cell surface. Our results suggest that the opposing actions of either inhibition or enhancement of IgE binding by anti-IgE antibodies are related to their epsilon domain specificity.
Animals↗
In-vitro cell growth of human urothelial tumor cell lines under exposure with IL-3, GM-CSF, G-CSF and by combined administration with methotrexate, vinblastine, adriamycin and cisplatin.
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Antineoplastic Combined Chemotherapy Protocols↗
[Imaging methods in the diagnosis of congenital heart defects].
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Angiocardiography↗
Neuroendocrine and autoimmune regulation of the allergic response.
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Animals↗
Umbilical venous erythropoietin and umbilical arterial pH in relation to morphologic placental abnormalities.
OBJECTIVE: To investigate the relation between the biochemical markers of umbilical venous erythropoietin and umbilical arterial pH and morphologic placental abnormalities in fetal hypoxia. METHODS: Placentas from 300 high-risk newborn infants (gestational age 24-42 weeks) were examined macroscopically and microscopically following standardized criteria. The morphologic findings were correlated with the erythropoietin concentration in umbilical venous blood and with umbilical arterial pH at birth. Venous hematocrit and circulating nucleated red blood cells were measured in 112 of these infants during the first 6 hours of life. RESULTS: The umbilical venous erythropoietin concentration correlated significantly (r = 0.74) with the number of circulating nucleated red blood cells. In 26 placentas without morphologic abnormalities, the median (and 25th and 75th percentiles) erythropoietin concentration was 35.2 mU/mL (19.2-48.7) and umbilical arterial pH was 7.30 (7.20-7.33). The erythropoietin concentration was elevated significantly when placental examination showed evidence of acute villous circulatory disturbance (61.3 mU/mL; 24.2-125.1), fetal vasculopathy (85.6 mU/mL; 23.7-119.7), or chorioamnionitis with fetal reaction (51.3 mU/mL; 27.7-118.7). The erythropoietin concentration varied significantly with the stage of placental meconium phagocytosis; it was 62.7 mU/mL (16.3-125.9) if meconium phagocytosis was classified as recent, 128.2 mU/mL (44.4-1483.2) if it was classified as a few hours old, and 66.2 mU/mL (46.3-140.1) if it was classified as a few days old. Umbilical arterial pH was not altered significantly with different morphologic placental abnormalities. CONCLUSIONS: Fetal erythropoietin production is stimulated by hypoxia after a few hours' delay and leads to increased erythropoiesis. Placental examination combined with measurement of umbilical venous erythropoietin and umbilical arterial pH provides information about earlier fetal hypoxia.
Age Factors↗
[Initial clinical experience with dynamic three-dimensional echocardiography (echo-CT) for imaging congenital heart defects in children].
A prototype computed tomographic echocardiographic imaging probe was examined for its usefulness in diagnosing congenital heart disease in pediatric patients. A 64-element, phased-array, 5 Mhz, echocardiographic transducer mounted on a sliding carriage was used transthoracically on various positions of the chest. The transducer moves from the outflow tract to the apex of the heart in .5 to 1.3 mms increments and records a tomographic slice of the heart at each increment level. Parallel images are recorded at a frame rate of 25-30 images/s and are ECG- and respiration-gated. At each level a complete cardiac cycle is recorded. The images are digitized and stored in the image processing computer which reconstructs the anatomic structures of the heart in a three-dimensional format by means of different gray-scales. 54 pediatric patients with a variety of congenital heart defects were examined. Good quality echocardiographic pictures were obtained in all but 2 of the 54 patients. In these, three-dimensional reconstruction of the heart was possible from transthoracically acquired echocardiographic studies. The recorded cardiac chambers and valves could be displayed in a three-dimensional format in real-time (four-dimensionally). One could also display the heart in real-time in any desired plane and in up to 5 planes simultaneously without having to change the transducer position on the chest. Different parts of the heart could be displayed in a view similar to the one a surgeon has during the operation. Between 40 and 130 tomographic slices per patient were recorded. Image acquisition took 3-5 min and three-dimensional reconstruction of various cardiac structures took 20-90 min.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
Transient association of the HNK-1 epitope with 5'-nucleotidase during development of the cat visual cortex.
During early postnatal development of the kitten visual cortex the ectoenzyme 5'-nucleotidase undergoes a characteristic redistribution. Until about postnatal week 6 it is essentially confined to synaptic contacts in input layer IV and its expression is related to the use-dependent segregation of thalamic afferents into ocular dominance columns. Subsequently, 5'-nucleotidase becomes distributed uniformly throughout all layers and is then associated selectively with glial cells. Here we describe an age-dependent alteration in the expression of a carbohydrate epitope of 5'-nucleotidase which correlates with the developmental change of the enzyme's localization. We have isolated 5'-nucleotidase from the occipital cortex of kittens of varying age and from adult cats and investigated by immunoblotting the association of the HNK-1 carbohydrate epitope with the protein. 5'-Nucleotidase carries the HNK-1 epitope in kittens of 3-9 weeks but the epitope is absent from 12-week-old kittens or adult cats. Thus, the appearance of the HNK-1 epitope correlates with the transient localization of the enzyme at synapses. The HNK-1 carrying 5'-nucleotidase may be involved in synaptogenesis and use-dependent modifications of synaptic connections.
5'-Nucleotidase↗
Isolation of a Ca2+ or Mg(2+)-activated ATPase (ecto-ATPase) from bovine brain synaptic membranes.
An ATPase was isolated from synaptosomal plasma membranes derived from bovine cerebral cortex. The protein has an apparent molecular mass of 50 kDa and a pI of 5.3 to 5.9. It can be labelled by incubation of intact synaptosomes with azido-GTP or azido-ATP. The isolated ATPase can be activated to a similar extent in the presence of millimolar concentrations of Mg2+ or Ca2+. It does not hydrolyze ADP. Maximal activity is obtained between pH 7.5 and 8.5. Typical inhibitors of cytoplasmic ATPases do not affect enzyme activity. The enzyme is specifically inhibited after previous incubation of intact synaptosomes in the presence of the slowly membrane-permeable enzyme inhibitor diazotized sulfanilic acid. Incubation of intact synaptosomes with diazotized sulfanilic acid results in a small increase in the apparent molecular mass of the enzyme. Our results suggest that the active site of the membrane bound enzyme faces the extracellular medium. It thus would represent an ecto-ATPase.
Adenosine Triphosphatases↗