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Biomedical subjects

R Ackermann

Publications and source records attributed to R Ackermann.

At least 145 records · Page 8Linked to original sources
PubMed1987

Demonstration of locally synthesized borrelia antibodies in cerebrospinal fluid.

Antibodies against Borrelia burgdorferi develop slowly. Low titers can be anamnestic. In order to prove the etiology of manifestations of erythema chronicum migrans disease of the nervous system like meningopolyneuritis Garin-Bujadoux-Bannwarth or progressive borrelia encephalomyelitis we used the ELISA to measure specific IgG antibodies against Ixodes ricinus borrelia per microgram IgG in serum and cerebrospinal fluid. With the mentioned method we were able to demonstrate locally synthesized antibodies in the cerebrospinal fluid. Until the 110th day of illness a difference between serum and CSF in favour of the latter as high as five binary dilution steps could be found. Later on in time the difference decreased to four dilution steps or less.

Antibodies, Bacterial↗
PubMed1987

Erythema chronicum migrans disease in the Federal Republic of Germany.

Epidemiology and clinical presentation of Erythema chronicum migrans disease are not well known yet. During a period of only 19 months, serological and clinical investigation of 2955 patients rendered 1106 cases of infection whose widespread incidence was remarkable: of the 328 administration districts of the FRG, 205 were affected. Accordingly, positive antibodies against Borrelia burgdorferi could be demonstrated in an average of 15.7% of the investigated rural population (2830 persons). Typical clinical signs were encountered in 817 of 1106 infected persons. Erythema (458 cases) and meningopolyneuritis (404 cases) were especially prominent. In comparison to Lyme disease the occurrence of arthritis (63 cases), carditis (13 cases) multiple erythema, recurrence, and central nervous symptoms in meningopolyneuritis (10%) were rare. On the other hand, progressive borrelia encephalomyelitis (45 cases) was surprisingly common. Acrodermatitis chronica atrophicans occurred in 72 cases; lymphadenosis benigna cutis in 5 patients. The variability of this disease is demonstrated by the combined syndromes occurring in only 27% of the cases.

Acrodermatitis↗
PubMed1987

Infectiousness for humans of Ixodes ricinus containing Borrelia burgdorferi.

We studied the rate of transmission of Borrelia burgdorferi from ticks (Ixodes ricinus) to man under field conditions in a case control study. At a holiday camp in southern Germany 384 ticks were removed from 272 persons. Information on symptoms possibly related to Borrelia infection were obtained by a questionnaire to be sent back six weeks after the tick bite. Ticks were examined by immunofluorescence microscopy (IFT) for Borrelia and 49 (12.8%) were found positive. Blood was obtained from 41 persons bitten by Borrelia positive and 41 age and sex matched persons bitten by Borrelia negative ticks. Sera from age and sex matched patients of local hospitals and clinics served as additional controls. Antibody titers were obtained by indirect IFT about 13 weeks after tick bite. Titers 1 : greater than 32 suggested recent infection and 1 : 32 immunity. In the exposed group there were about half as many persons with titers 1 : less than 32 (n = 14) than in the control group (n = 27) suggesting that either part of the infected ticks was in a non-infectious state or the hosts were immune. In the exposed group there were 46.4% (n = 19) and in the control group, bitten by Borrelia negative ticks, 14.7% (n = 6) persons with titers 1 : greater than 32, but 5/6 of these persons in the control group recalled additional tick bites in 1984. Only one child (in the exposed group) developed an Erythema chronicum migrans, and no other Borrelia related manifestations were reported. The manifestation rate of the Borrelia-related disease was 4%.

Adolescent↗
PubMed1987

Can recombinant human alpha-2 interferon prevent recurrence of high-grade superficial bladder tumors?

Eight patients with superficial bladder cancer were treated by systemic interferon (IFN) alpha-2 application to investigate whether the rate of local tumor recurrence could be diminished. All patients had recurrent high-grade urothelial cancer. Recombinant human IFN alpha-2 was administered by daily intramuscular injections for a period of 6 weeks. The natural-killer cell activity and the antibody-dependent cellular cytotoxicity was augmented for a short time only. However, this was of no clinical benefit. Tumor recurrence was observed in seven out of the eight patients within 6 months following therapy. IFN serum levels, which were measured during interferon treatment, did not inhibit tumor cell proliferation in vitro.

Carcinoma, Transitional Cell↗
PubMed1986

[Spread of early-summer meningoencephalitis in the Federal Republic of Germany].

Between 1978 and 1984 there were 299 serologically confirmed cases of tick-borne encephalitis in the Federal Republic of Germany (180 males, 119 females; aged 1-82 years). A previous tick bite was recalled by 258 (86.2%). The illness had taken the form of a feverish infection in 13, meningitis in 161, meningoencephalitis in 13, and meningomyeloencephalitis in 14. There were three deaths (1%), and permanent neurological sequelae in 20 (7%). The incidence of new cases cases between April and October varied from eight to 118 per year. The Federal Republic of Germany (FRG) was the place of infection in 239, other European countries in 52 (42 in Austria). In the FRG the disease occurred predominantly in Bavaria (156), half of the cases in Lower Bavaria and eastern and northern Upper Bavaria and in Baden-Württemberg (78), concentrated in the regions around Freiburg and Karlsruhe, a few (3) in Hessen and Rhineland-Palatinate (2). No cases were noted in other parts of the FRG. Antibody studies on 8526 persons in the endemic regions of Bavaria and Baden-Württemberg produced rates of 2.0 and 1.2%, respectively. The rate increased with age, to a peak of 2.4% in the seventh decade. Those working in forestry and agriculture had a higher antibody rate, at 4.6 and 3.3% respectively, than civil servants, employees and housewives (0.4-0.9%). In some areas the antibody rate varied from less than 1 to 6%. Those with higher antibody rates also had higher infection rates, and vice versa.

Adolescent↗
PubMed1986

Locally synthesized antibodies in cerebrospinal fluid of patients with AIDS.

Twelve patients with AIDS were examined by enzyme-linked immunosorbent assay for antibody activity of IgG in serum and CSF. Two patients were only anti-HTLV III antibody carriers (stage I), two had lymphadenopathy syndrome (stage II) and eight had manifest AIDS (stage III). Eight of the 12 patients had 2- to 8-fold higher antibody titres in CSF than in serum, indicating that anti-HTLV III antibodies were produced in the nervous system. One of these patients with obviously locally synthesized anti-HTLV III antibodies in CSF belonged to stage I, two to stage II and five to stage III. Only four of these eight patients also showed locally synthesized IgG in CSF as measured by laser-nephelometry. In contrast, 61 controls with normal CSF (12), impaired blood-CSF barrier (12) multiple sclerosis (12) and various infections of the CNS other than HTLV III (25), the last two groups with locally synthesized IgG in CSF, all revealed negative results. It appears possible that locally synthesized anti-HTLV III antibodies in CSF are a sensitive and early indicator of an HTLV III infection of the nervous system.

Acquired Immunodeficiency Syndrome↗
PubMed1985

[Erythema migrans borreliosis in the Federal Republic of Germany. Epidemiology and clinical aspects].

A positive antibody titre against Ixodes-ricinus-Borrelia (burgdorferi), using indirect immunofluorescence or ELISA, could be detected in serum and (or) liquor of 935 (32%) out of a total of 2955 patients between January 1984 and July 1985. In 289 of these cases the typical clinical manifestations were lacking whereas a characteristic disease picture enabled a diagnosis to be made in 171 patients with negative or borderline antibody titres. The 1106 cases of infection observed covered all regions of the country. A typical clinical syndrome was seen in 817 (74%) of these. Most common were erythema chronicum migrans (n = 458) and meningopolyneuritis Garin-Bujadoux-Bannwarth (n = 404); in 42% of the cases meningopolyneuritis was preceded by an erythema. Arthritis (n = 63), acrodermatitis chronica atrophicans (n = 72), carditis (n = 13) and lymphadenosis benigna cutis (n = 5) were much less common. Chronic Borrelian encephalomyelitis (n = 45) appeared surprisingly often (n = 45). The fact that in 73% of cases the various syndromes appeared alone, were double in 24% and combined only in 3%, illustrates the polymorphic nature of this disease.

Adolescent↗
PubMed1985

[Progressive Borrelia encephalomyelitis. Chronic manifestation of erythema chronicum migrans disease of the nervous system].

A 54-year-old housewife became ill with transient diplopia followed by facial paralysis, tremor of the right hand and a progressively worsening disturbance in gait. Four years after the first appearance of the disease bilateral hypacusia, paralysis of the right hypoglossal nerve, dysarthria, severe spastic tetraparesis with ataxia, urinary retention and an organically induced character change were present. Lumbar puncture fluid contained 51/mm3 lymphocytes and 1164 mg/dl protein. Immunoglobulin A, G and M, synthesised locally, could be detected in cisternal fluid. The serum had a high antibody titre against Ixodes ricinus-Borrelia antigen and the same antibodies, formed locally, were present in the lumbar fluid. The neurological deficiencies improved markedly under parenteral penicillin treatment and the antibody titre decreased. The detection of Borrelian antibodies, especially those synthesised locally in the CSF, enabled an aetiological diagnosis to be made in seven other patients aged 18-47 years in whom the disease had been present for 1 to 8 years. These patients likewise presented symptoms characteristic of a disseminated disease of the CNS, with spastic pareses and evidence in the spinal fluid of chronic inflammation and disruption of CSF barriers in particular. This progressive encephalomyelitis differs from the common and spontaneously healing meningo-polyneuritis (Garin-Bujadoux-Bannworth), the usual manifestation of erythema chronicum migrans of the nervous system, in its progressive nature, its invasion of the CNS and the possible long lasting severe damage when not specifically treated.

Adolescent↗
PubMed1985

Cerebrospinal fluid virus antibodies. A diagnostic indicator for multiple sclerosis?

Specific antibody activities (antibody per weight unit IgG) of serum and CSF against a broad variety of viruses were compared in multiple sclerosis and certain inflammatory diseases of the central nervous system, e.g. neurosyphilis, as well as herpes simplex and zoster encephalitis. No "unspecific" antiviral activities within the CSF compartment were found in the non-MS diseases. The most frequent antibodies locally produced were directed against measles, rubella and zoster antigens. A diagnostic test with these three viruses would give positive results in about 80% of patients with MS. This finding is not as frequent as the oligoclonal pattern of the CSF gamma-globulins but would have a considerably greater diagnostic significance.

Antibodies, Viral↗
PubMed1985

Functional properties of natural killer cells in carcinoma of the prostate.

Functional properties of natural killer cells were analyzed in a 51chromium-release assay by modulating their activity with human beta-interferon using 1) peripheral mononuclear cells of 16 patients with carcinoma of the prostate and 7 healthy male donors, and 2) mononuclear cells from the periprostatic lymph nodes of 6 patients with stage pT2N0M0 prostatic cancer and 5 without malignancy. Cell lines EB 33, PC 3, DU 145 and CaKi 1 were used as target cells. Spontaneous cell-mediated cytotoxicity of peripheral mononuclear cells was depressed in patients with advanced prostatic cancer; however, the natural killer cells responded as those of the healthy controls to beta-interferon. The beta-interferon effect was time and dose dependent. In mononuclear periprostatic lymph node cells virtually no spontaneous cell-mediated cytotoxicity was detected. The reactivity of mononuclear periprostatic lymph node cells from patients with prostatic cancer was significantly less improved by beta-interferon stimulation than the mononuclear periprostatic lymph node cells of healthy subjects. The stimulation of mononuclear periprostatic lymph node cells by beta-interferon was reduced significantly compared to simultaneously tested autologous peripheral mononuclear cells.

Adult↗
PubMed1985

[Meningopolyneuritis (Garin-Bujadoux, Bannwarth) erythema chronicum migrans disease of the nervous system transmitted by ticks].

The clinical spectrum of this remarkable non-syphilitic spirochaetosis (spirochaeta infection) of the nervous system is described in light of 53 further cases with reference to our earlier description of 47 cases. As the etiological diagnosis is not possible in all cases the knowledge of clinical courses is especially important. Males are affected almost twice as often as women. The disease is especially prevalent in the sixth decade. Usually, the syndrome begins in the warm season with exquisite pain and other sensory irritations in combination with marked malaise. Initial signs during the winter as well as painless clinical courses were also noted. About one half of the patients remembered contact with arthropodes or a chronic migrating erythema. In most cases (95%), asymmetrical peripheral signs followed the painful stage. More than two thirds of the patients showed affection of cranial nerves, usually facial palsy. Twenty percent demonstrated paresis of the extremities alone, the combination of involvement of cranial nerves and extremities was noted in one third of the cases. The sensory signs were usually only mild. Occasionally, the neurological impairment was limited to isolated sensory impairment. In contrast to the closely related Lyme disease, central nervous affection as well as cardiac and arthritic involvement is rare: 34 percent demonstrated mild psychopathological impairment; in one case a Babinski-phenomenon was elicited. Knee joint pain and gonarthritis were found in one case each. Even though meningeal signs were usually absent, the CSF showed alterations suggestive of chronic lymphocytic meningitis in all cases. At the same time, local synthesis of all three immune globulins was documented, especially of IgM (85%).

Adolescent↗
PubMed1985

Immunological findings in patients with superficial bladder cancer during human alpha-2-interferon treatment.

6 patients with recurrent high grade superficial bladder cancer were treated with human recombinant alpha-2-Interferon (alpha 2-IFN). After initial transurethral electroresection of macroscopically visible tumor, human recombinant alpha 2-IFN was administered by daily intramuscular injections for a period of 6 weeks. The influence of IFN on the patients' immune reactivity was assessed by determination of the natural killer (NK) cell activity. Within the first week, in all the patients an increase of the NK cell activity was noted. This, however, was only a short-term effect. An increase of the IFN dosage did not lead to further NK cell stimulation. Determination of the IFN serum levels during IFN treatment revealed maximum levels of 260 IU/ml. They were measured 2 weeks after therapy begin. During treatment no further increase of IFN serum levels were found. The augmentation of the NK cell activity does not seem to depend on IFN serum levels. The amount of IFN found in patients' sera did not effect tumor cell growth in vitro.

Female↗
PubMed1985

[Complications and late sequelae following radical cystectomy and supravesicle urinary diversion].

Until recently radical cystectomy combined with urinary diversion was only justified by most urologists as a therapeutic measure for the management of bladder cancer, when other forms of treatment failed controlling the disease. This attitude was mainly based on a high morbidity and mortality rate of up to 20% of the cases. Improved selection of the patients, progress in improving preoperatively the physical conditions of the patients, intra- and post-operative intensive care and improvement of the surgical technique have contributed considerably to reduce the risks of this procedure. Effective preparation of the small and large bowel, early anticoagulation and digitalis medication as well as an efficient antibiotic treatment starting intraoperatively, and optimal parenteral hyperalimentation are of particular importance. Adjuvant preoperative radiation therapy and a simultaneously performed pelvic lymph node dissection do not contribute to an increased morbidity or mortality rate. Taking into account all available preventive measures, the mortality rate of about 20% 20 years ago has been reduced to about 1-5% at present.

Follow-Up Studies↗