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Biomedical subjects

R Baumann

Publications and source records attributed to R Baumann.

At least 91 records · Page 5Linked to original sources

Development of resistance to macrolide antibiotics in an AIDS patient treated with clarithromycin for Campylobacter jejuni diarrhea.

In an AIDS patient with diarrhea, identical isolates of Campylobacter jejuni susceptible and, later, resistant to macrolide antibiotics were isolated from feces before and after treatment with clarithromycin. Results of rRNA gene restriction analysis and serotyping suggest that development of resistance rather than simultaneous infection with a susceptible and a resistant strain was responsible for this phenomenon. This is the first report of in vivo development of resistance by Campylobacter jejuni in a patient treated with a macrolide for Campylobacter jejuni infection.

Acquired Immunodeficiency Syndrome↗

Prevalence and significance of anticardiolipin antibodies in Crohn's disease.

Crohn's disease is a chronic inflammatory bowel syndrome in which thrombotic complications occur in the active phase. Phospholipid-binding antibodies such as anticardiolipin antibodies and lupus anticoagulants have been shown to be associated with thrombosis. Their presence has been assessed in a group of 50 patients with Crohn's disease among whom 44 had active disease. The overall prevalence of anticardiolipin antibodies was about 22%, while none of these patients had lupus anticoagulant. Anticardiolipin antibodies have been observed in both active and quiescent CD and their presence does not seem to be related to the site of CD lesions. The presence of phospholipid-binding antibodies could be a sign of vascular alterations that are potentially thrombogenic per se, and their predictive value with respect to the specific inflammatory syndrome of Crohn's disease is discussed.

Adolescent↗

Systemic treatment of ectopic pregnancies with single-dose methotrexate.

STUDY OBJECTIVE: To evaluate the success rate, side effects, reproductive outcome, and possible pitfalls of systemic low-dose methotrexate (MTX) for treatment of ectopic pregnancy (EP). DESIGN: Longitudinal, nonrandomized trial Setting. Department of Obstetrics and Gynaecology at a teaching hospital in Germany. PATIENTS AND INTERVENTIONS: Forty women with EP were treated with a single dose of MTX 20 to 40 mg intravenously. The highest pretreatment human chorionic gonadotropin (hCG) titer was 21,100 mIU/ml. MEASUREMENTS AND MAIN RESULTS: Thirty-seven patients (92.5%) were treated successfully. Thirty-four (85%) received a single dose of MTX. Six (15%) required a second dose about a week later. Three patients (7. 5%) required surgical intervention. Serum MTX levels decreased below 0.1 micromol/L (45.4 microg/L) within 24 hours. In 53.8% of women hCG levels decreased directly after treatment; in 46.2% levels increased within the first 5 days after treatment. CONCLUSIONS: In selected patients, systemic low-dose MTX is an effective way to treat EP, and has no demonstrable side effects.

Adult↗

[Pregnancy following sterilization and endometrium resection].

We report on the successful outcome of a pregnancy after bipolar electrocoagulation of Fallopian tubes for sterilisation followed by electroresection of the endometrium for menorrhagia. Reasons for sterilisation failure are discussed with special attention to benefits and risks of endometrial ablation as a new "minimally invasive" therapy for menstrual disorders. We propose guidelines for patients' counselling and preoperative consent.

Adult↗

Control of red cell function of late chick embryos: role of extracellular ATP/AMP and egg size.

Hypoxia is the alleged stimulus for initiation of increase of carbonic anhydrase II (CAII) and 2,3-diphosphoglycerate (2,3-DPG) synthesis of red blood cells from late chick embryos. The PO2-dependent regulation of red cell metabolism is mediated by unknown humoral factors [Million et al., Am. J. Physiol. 261 (Regulatory Integrative Comp. Physiol. 30): R1188-R1196, 1991]. In the present investigation we have analyzed whether interindividual differences in egg size (which result in different surface area-to-mass ratios) affect the timing of initiation of 2,3-DPG and CAII synthesis in late chick embryos. We also investigated the effect of extracellular adenine nucleotides on red cell organic phosphate pattern and O2 affinity to test whether the inhibitory effect of normal or elevated PO2 on 2,3-DPG synthesis and the concomitant increase of ATP (and O2 half-saturation pressure) can be mimicked by these agents. The results show that differences in egg size affect the timing of CAII and 2,3-DPG synthesis, indicating that PO2-dependent regulation of red cell function allows adjustment to the properties of the individual egg. We also found that extracellular ATP, which is rapidly degraded to AMP by red cell ectoenzymes, can alter the red cell phosphate pattern and O2 affinity, i.e., significantly increase red cell ATP, decrease red cell 2,3-DPG and O2 affinity, and thus mimic the effect of normoxia and hyperoxia. These findings suggest that extracellular adenine nucleotides may be involved in the PO2-dependent regulation of embryonic red cell metabolism.

2,3-Diphosphoglycerate↗

[Effects of color on implicit and explicit memory tests].

We report two experiments that explore why recent investigations of implicit memory did not find any effects of color information on test performance. The argument that previous failures to find effects of repetition priming were due to an arbitrary association between objects and colors was found to be wanting. To the contrary, both experiments showed no or small effects of repetition for objects paired with their prototypical colors. A second argument according to which subjects attend to the colors at encoding did not fare much better. More importantly, however, we found strong effects of repetition priming with a conceptual implicit memory measure, whereas previous research had relied exclusively on perceptual tests of implicit memory. In both experiments, the subjects were asked to choose a suitable color for each object at testing. No instructions about remembering the objects were given. The results demonstrated strong preferences for the previously seen colors in the color-choice task. Furthermore, this effect was present to the same extent with picture objects and with object names, corroborating the conceptual nature of the implicit memory measure. Finally, we observed many functional dissociations with explicit measures of memory for color information, demonstrating implicit use of memory in the conceptual choice-test for colors.

Attention↗

[Treatment of lithiasis of the common bile duct by endoscopic sphincterotomy and laparoscopic cholecystectomy].

This paper evaluates the treatment of common bile duct stones by endoscopic sphincterotomy (SE) and laparoscopic cholecystectomy (CL). 733 patients presenting with symptomatic cholelithiasis were operated on between March 1990 April 1993; 131 (18%) of them had a preoperative suspicion of common bile duct stones (LVBP): jaundice for 41, biliary acute pancreatitis for 27 and altered liver function tests for 63. 131 retrograde cholangiographies (CPRE) were attempted with an associated SE (113 cases) in the presence of LVBP, biliary pancreatitis, enlargement of common bile duct and appearance of forced papilla. CL was performed 24 to 48 hours later. CPRE +/- SE had no mortality; 1 patient presented a retroduodenal perforation of CBD, requiring surgery. 58 cases (44.2%) of LVBP were diagnosed, without a statistically significant difference according to the clinical pattern. In the group with altered liver function tests only alkaline phosphatase was significantly predictive of LVBP. There was no mortality or morbidity related to CL; conversion rate was 9.8%; 4 of 12 cases of conversion were related to persistence of stones in the common bile duct, without any possibility of laparoscopic extraction. Mean hospital stay was 7.4 days. Efficacy of this sequential method of treatment of LVBP was 91.3%: this method seems satisfactory, not dangerous and minimally invasive, and should be indicated for pre-operative suspected common bile duct stones.

Adolescent↗

Changing Epstein-Barr viral ZEBRA protein into a more powerful activator enhances its capacity to disrupt latency.

The Epstein-Barr viral transcriptional activator ZEBRA induces expression of viral early lytic genes when introduced into cells bearing latent Epstein-Barr virus. We show here that a ZEBRA-herpes simplex viral protein 16 (VP16) fusion protein induces early viral lytic gene expression in Epstein-Barr virus-containing cells more efficiently than does wild-type ZEBRA. The fusion protein is also a more powerful transcriptional activator in these cells, as assayed with reporter constructs. Our experiments also suggest that ZEBRA manifests a function required for full activity on certain natural promoters but not on promoters bearing oligomerized ZEBRA binding sites; this function cannot be provided by VP16.

Cells, Cultured↗

Control of cell pH in immature primitive red cells from chick embryo.

1. The intracellular pH in primitive red cells from 4 day chick embryos was measured with the digitonin null-point method and the fluorescent indicator SNARF-1. At physiological pHe of 8.0 red cell pH is 7.39 at day 4. 2. The calculated proton equilibrium potential of -38 mV is in good agreement with previous measurements of Em (Engelke et al., 1988) and supports the conclusion that the Em is dominated by a proton conductance. 3. The sodium-proton exchanger is present in primitive red cells but quiescent under physiological conditions. 4. The results indicate that the bicarbonate-chloride exchange via Band 3 protein is impaired.

Animals↗

Comparing regions of the Epstein-Barr virus ZEBRA protein which function as transcriptional activating sequences in Saccharomyces cerevisiae and in B cells.

The ZEBRA protein activates expression of Epstein-Barr virus early-lytic-cycle genes in human B lymphocytes. Here it is shown that ZEBRA also behaves as a sequence-specific transcriptional activator in Saccharomyces cerevisiae. Deletional mutagenesis defined three regions of ZEBRA that participate in activation in S. cerevisiae. These regions are designated YI (amino acids [aa] 1 to 25), YII (aa 51 to 102), and YIII (aa 228 to 245). Two of the three regions of the native ZEBRA protein act together to mediate activation when assayed on ZEBRA binding sites. However, when fused to the DNA binding domain of GAL4 and assayed on GAL4 binding sites, regions YII and YIII were each sufficient to confer activation in S. cerevisiae. Regions of ZEBRA which affected activation in S. cerevisiae were also required in human B lymphocytes. The amino-terminal region of ZEBRA (aa 1 to 98) was required for activation both in S. cerevisiae and in human B cells; deletion of the carboxy-terminal 18 aa also significantly reduced activation in both cell types. Thus, the behavior of ZEBRA in human B cells and S. cerevisiae suggests that the protein contains universal activation motifs that interact with conserved components of the transcription machinery. However, certain deletion mutants of ZEBRA containing mutations in the N-terminal region exhibited discordant behaviors in S. cerevisiae and in B cells. For example, deletion of ZEBRA aa 26 to 51 impaired activation to a great extent in B cells but had little or no effect in S. cerevisiae. The discordant mutants may reflect interactions with a variable domain of a conserved component or unique interactions with specialized components of the basal transcription apparatus in different cells.

B-Lymphocytes↗

[Portal cavernoma compressing the bile duct. Apropos of three cases].

Three cases of biliary tract compression caused by a cavernous transformation of the portal vein are reported. Revealing symptoms of biliary disease were anicteric and asymptomatic cholestasis in one patient, and cholangitis and obstructive jaundice in one case each. Endoscopic retrograde cholangiograms showed that the compression was located in the common bile duct in two cases and in the main bile duct in one. The responsibility of the portal cavernoma was established by the disappearance of jaundice after splenorenal shunt in one case. Biliary consequences of a portal cavernoma are very uncommon. Compression by the turgescent venous network combined with a sclero-inflammatory reaction of the biliary tract are the most likely causes.

Aged↗

[HIV-associated malignant lymphomas].

In a retrospective analysis of data from 35 cases with malignant lymphoma from a cohort of 2017 HIV-infected patients, the stage of HIV-disease, the CD4 counts at the time of diagnosis, and the use of antineoplastic agents or radiotherapy were correlated with outcome. 6 patients had Hodgkin's lymphoma (HL) and 29 non-Hodgkin-lymphoma (NHL). 11 of these lymphomas were classified according to the international working formulation (IWF) as high grade (H, I and J, respectively) and 8 as intermediate grade (G). 10 could not be classified. 22 patients with NHL had stage IV disease according to the Ann Arbor classification, all of whom had manifestations at extranodular sites. 23 patients with NHL were treated with multiagent chemotherapy (18 with m-BACOD or CHOP, 5 patients with various other regimens) and four of them had additional radiotherapy. One patient received radiotherapy only. Two of 24 treated patients showed complete and five a partial response. Median survival of patients without treatment (all of them in poor general condition at the time of diagnosis) was 1.8 months and treated patients survived a median of 5 months. The pretreatment CD4 count was the most important predictor of survival. Patients with prior Aids-diagnosis showed a tendency towards shorter survival. The observed remission rate indicates that HL in HIV-infected patients is better treatable than HIV-associated NHL. However, the overall outcome of HL in our patients was clearly less favorable compared to the course of HL usually seen in patients without HIV infection. The proportion of patients with HL among all patients with malignant lymphoma and HIV disease was unexpectedly larger in our cohort compared to others. Therefore, a possible association of HL and HIV infection, as addressed by several other authors, needs further clarification.

Adult↗

Intestinal carcinoid tumor and myotonic dystrophy. A new association?

The occurrence of multiple carcinoid tumors of the small bowel with liver metastases is reported in a patient with a previous myotonic dystrophy. In addition to the association of myotonic dystrophy with multiple endocrine adenomatosis type 2A, hyperparathyroidism, and neurofibromatosis, this case report gives further evidence for the propensity of such patients to develop neuroendocrine tumors.

Carcinoid Tumor↗

Trophoblast tissue culture of human intrauterine and ectopic pregnancies and treatment with methotrexate.

The application of drugs for conservative treatment of patients with ectopic pregnancy has been used worldwide for several years. In-vitro studies, however, are very few. We therefore examined the effects of methotrexate on trophoblast tissue cultures derived from intrauterine and ectopic pregnancies. Methotrexate was administered either 12 h or 6 days after initiation of the culture. Human chorionic gonadotrophin (HCG) levels were measured in the culture medium. All cultures showed secretion of HCG within the first 16 days. Methotrexate concentrations less than 3.8 x 10(-4) mol/l had no effect on HCG secretion. Cultures of ectopic pregnancies required a concentration about 10x higher to induce an equivalent reduction of HCG levels compared to intrauterine pregnancies. A few intrauterine and ectopic pregnancies showed no reduction of HCG values after treatment. These results suggest that data obtained from studies on intrauterine pregnancies may not be transferable to ectopic pregnancies in all instances. In some regimens approximately 8 days are required before the effect becomes measurable. In combination with our clinical data, we therefore recommend not to repeat a methotrexate dose too early in treatment of patients with ectopic pregnancies. The possibility that non-responding patients could exist should be kept in mind.

Chorionic Gonadotropin↗