Biomedical subjects
Publications and source records attributed to P Kern.
Almost 4000 sera from seven African states were examined for antibodies to ATLV/HTLV-1. Between 1% and 8% of healthy people from sub-Saharan Africa have such antibodies. The highest frequency was observed in Gabon. There were considerable variations between villages. The percentage of seropositives and the mean titre increased with age. Our findings suggest that the African continent is the largest endemic area for ATLV.
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D-erythro-neopterin, a biochemical marker of cell-mediated immune response, was found to be significantly (p less than 0.001) elevated in the serum of homosexual patients with acquired immunodeficiency syndrome and related lymphadenopathy syndrome. The most pronounced rise was observed in viral diseases causing a numerically measurable activation of the immune system such as EBV or CMV infections. In the latter patient groups, the increase in T8+, HLA-DR+ and monocytic antigen+ lymphocyte subsets correlated with the raised neopterin level. Thus, neopterin seems to be released under various conditions in viral diseases and may reflect a functional state of T-lymphocytes irrespective of the actual number expressing differentiation antigens on the cell surface.
The efficacy of oltipraz as a schistosomicidal drug was investigated in Gabonese children suffering from urinary schistosomiasis in the dosages of 1 X 25 mg/kg body weight, 1 X 35 mg/kg body weight, and 2 X 20 mg/kg body weight and compared to praziquantel, 2 X 30 mg/kg body weight. The study was undertaken in 165 patients, and follow-up investigations were carried out 6 weeks and 12 weeks after treatment. Oltipraz showed less efficacy compared to praziquantel when dosages of 1 X 25 and 1 X 35 mg/kg body weight were given. However, oltipraz 2 X 20 mg/kg body weight was equivalent to praziquantel 2 X 30 mg/kg body weight. Parasitological cure was obtained in 79% of patients treated by oltipraz and 81% of patients treated by praziquantel. Side effects were insignificant in both treatment groups. Thus, the same parasitological cure could be achieved by oltipraz as well as by praziquantel, but with a lower dosage of oltipraz.
158 school children from Lambarene and its surroundings suffering from intestinal manifestations of schistosomiasis due to Schistosoma intercalatum, Schistosoma haematobium, or mixed infections were randomly allocated to patient groups to be treated with oltipraz and praziquantel respectively. Oltipraz was tested in three dosage regimens, i.e., 1 X 25 mg/kg, 1 X 35 mg/kg, and 2 X 20 mg/kg and compared to 2 X 30 mg/kg praziquantel in each of the treatment groups. 45 days and 90 days after treatment, the children were thoroughly investigated. Rectoscopy was only performed in part of the children. The number of children with viable egg excretion had significantly dropped after therapy (p less than 0.001). Parasitological cure after 90 days was obtained in 86% of patients treated with 2 X 20 mg oltipraz and 90% of patients treated by praziquantel. A comparative effectiveness was achieved with the other dosage regimens of oltipraz, too. The efficacy of the new schistosomicid oltipraz is identical with that of praziquantel for patients with intestinal manifestation. The rectal biopsies taken 45 days and 90 days after therapy still contained numerous eggs which were mostly calcified or granulated.
A 37-year-old homosexual man suffering from AIDS (= Acquired Immune Deficiency Syndrome) is described. This man died from disseminated Kaposi-sarcomas about one year after establishing the diagnosis.
Colony-forming cells of the granulocytic/macrophage ( CFCGM ) and eosinophilic ( CFCEo ) series were grown from bone marrow and/or peripheral blood of 20 patients with persistent eosinophilia mainly due to helminthic diseases and of 17 patients without eosinophilia. The semi-solid culture technique of haemopoietic cells was applied using different sources of colony-stimulating factor (CSF). After 14 d of incubation the number of CFCs as well as their differentiation into the CFCGM and CFCEo was evaluated. The total median CFC count in the bone marrow differed significantly between the patient and the control group. No difference of the total colony count was observed when culturing peripheral-blood lymphocytes of patients or controls. 47% Luxol-fast-blue positive colonies were identified in the peripheral blood cultures from patients with eosinophilia as compared with 56% from controls using human placenta-conditioned medium as source of CSF. In contrast, bone-marrow cultures showed a significantly lower proportion of CFCEo (14% v. 18% resp.). No difference could be observed with regard to the source of stimulus. Thus, the discrepancy of the peripheral-blood and bone-marrow eosinophilia and of the in vitro culture findings may indicate that the commitment of granulocytic progenitor cells into the eosinophilic series is unaffected by a defined stress, such as helminthic diseases or is not measurable in the culture dish.
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An analysis of erythroblast cell kinetics utilizing quantitative 14C-autoradiography has been performed in five cases of acute Plasmodium falciparum malaria prior to and, in four patients, 3 or 6 days after the onset of antimalarial therapy. Associated with no or only moderate anemia were changes of erythroblast morphology, a considerable shift in the frequency of red and white blood cell precursors in the bone marrow, and a reduced rate of erythroblast proliferation. There was a marked loss of polychromatic erythroblasts, which was smaller but still detectable during the therapeutic phase. The results provide some quantitative data on the extent of "parenchymal damage" of bone marrow and stress the impact of ineffective erythropoiesis and reduced rate of erythropoietic proliferation on the emergence of anemia in Plasmodium falciparum malaria.
The differentiated phenotype of bovine epithelial lens (BEL) cells consists primarily of type IV collagen production with homogeneous cellular form and monolayer organization. We have previously described how, after several subcultures, BEL cells lost this phenotype, which was replaced by a complex collagen mixture consisting predominantly of type I and type III collagens and a minor proportion of type IV collagen. The cells became irregular and formed multilayers. These dedifferentiated cells can re-express their initial morphological properties when subcultured on an extracellular matrix (ECM) in presence of an eye-derived growth factor (EDGF), as described in the first paper of this series [30]. Furthermore, those cells passaged only one time on ECM + EDGF partially re-express the native differentiated collagen phenotype. The cells synthesize a majority of type IV collagen (up to 65%) with minor amounts of interstitial collagens. As in early subcultured cells, the major proportion of total collagen accumulated in the cell layer. Taken together, the morphological and biochemical data emphasize the relationship between cell shape and collagen phenotype expression. They also provide a reversible system for the study of normal gene expression and pathological alterations.
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Serological investigations (immunoglobulin, haptoglobin, cryoglobulin, and antibody determination against Plasmodium falciparum and P. malariae antigens) were performed in 64 adults of the Albert-Schweitzer-Hospital, Lambarene, Gabon. The patients were referred consecutively for ultrasound examination of the upper abdominal tract. 31 patients had clinically and sonographically an enlarged spleen, whereas 34 had a normal-sized spleen. 18 patients were regarded as having a gross splenomegaly without an obvious underlying cause (tropical splenomegaly (TSS]. No significant differences were seen between the patient groups with regard to immunoglobulin M or antiplasmodial antibody concentration. Thus, a causal association of splenomegaly with chronic malaria infections could not be established. The haptoglobin levels were significantly (P less than 0.01) reduced in patients with splenomegaly. Peripheral T-lymphocyte subsets as defined by monoclonal antibodies showed in all 4 cases with gross splenomegaly examined distinct abnormalities. Tropical splenomegaly is thought to encompass a variety of diseases, most of them presenting an intermediate stage of reactive to autonome disorders of the lymphatic system.
During 1981, three cases of pulmonary paragonimiasis were diagnosed and successfully treated at the Albert Schweitzer Hospital, Lambarene, Gabon. Circumstances prevented our receiving eggs for identification of the lung fluke species involved. The history revealed that all the patients originated from the same small village Mitoné, some 10 km north of Lambarene. Extensive testing in the region failed to reveal further cases. Our efforts, therefore, were concentrated on the study of the intermediate crustacean hosts responsible for the human infections. We examined 90 fresh-water crabs of the species Sudanonautes aubryi and S. africanus collected from small creeks located close to the village of the patients. 14 per cent of the former species and 8 per cent of the latter contained freely moving, non-encysted metacercariae resembling those of Paragonimus uterobilateralis. A domestic cat was subsequently infected with these metacercariae. During autopsy of the cat some 260 days later, 2 adult lung flukes were recovered and clearly identified as P. uterobilateralis, confirming the diagnosis on the larval metacercariae. These findings support the surmise that the human cases of paragonimiasis in the same area could be attributed to an infection with P. uterobilateralis.
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