Search PubMed⌕ Search

Biomedical subjects

U Neubert

Publications and source records attributed to U Neubert.

At least 37 records · Page 2Linked to original sources
PubMed1993

Molecular detection of Borrelia burgdorferi in formalin-fixed, paraffin-embedded lesions of Lyme disease.

A system for the detection of a Borrelia burgdorferi (Bb)-specific gene segment in formalin-fixed, paraffin-embedded skin lesions is described. A nested polymerase chain reaction technique is used to selectively amplify in vitro a short segment of a Bb-specific gene recently described by Rosa et al. (J Infect Dis 1989: 160: 1018). The design of oligonucleotide primers for the amplification of a relatively short gene segment allows the successful analysis of DNA which has been altered by fixation in formalin. Using this technique, Bb-specific DNA was clearly identified in 8 of 12 specimens of erythema chronicum migrans and in 1 case of lymphadenosis benigna cutis. These skin lesions are known to represent cutaneous manifestations of Lyme disease. Negative control reactions, using DNA from borrelial strains not related to Lyme disease, were negative. The system enables the dermatopathologist to identify Bb in routinely fixed clinical specimens and allows the rapid analysis of various skin diseases for which an association with Bb so far has only been hypothesized.

Base Sequence↗
PubMed1992

[Pigmented urticarial erythema with flaccid atrophy as expression of an unusual manifestation of Lyme borreliosis].

Unusual courses of infections with borrelia burgdorferi can make diagnosis problematic, but early and adequate therapy is mandatory to avoid further complications. In this paper a patient is presented who developed urticarial erythemas and hyperpigmentation with slack skin atrophy. Positive serological findings and the regression of the skin eruptions under antibiotic therapy confirmed the diagnosis of an unusual manifestation of Lyme borreliosis.

Atrophy↗
PubMed1991

Chlamydia trachomatis induces an inflammatory response in the male genital tract and is associated with altered semen quality.

U. urealyticum with 15.8% and C. trachomatis antibodies with 15.4% were the most prevalent microbiological findings in 209 male infertility patients. The inflammatory marker granulocyte-elastase was significantly increased in men with C. trachomatis; these men also showed significantly decreased citric acid levels indicating inflammatory damage of the prostate induced by C. trachomatis.

Antibodies, Bacterial↗
PubMed1990

[Cutaneous leishmaniasis of the ear muscle. A case report].

Cutaneous leishmaniasis is a parasitic infection which is especially endemic in the southern parts of Europe, in several regions of Africa, and in South and Central America. Whether treatment is necessary or not depends on the virulence of the germ, the infection's localization, and the host's immunological reaction. Because of the high rate of recidivation and the large number of undesirable side-effects of systemic chemotherapy of localized cutaneous leishmaniasis, several methods of local therapy have been tested. This case report demonstrates one of several approaches to the local treatment of this disease. Despite progress in this field, cutaneous leishmaniasis will continue to be a considerable medical and sociopolitical problem, because successful treatments in under-developed countries must be highly efficient, cost little, be easy to administer, and have a low rate of undesirable side-effects.

Administration, Topical↗
PubMed1989

[Clinical aspects of Borrelia burgdorferi infections].

Skin lesions due to Borrelia burgdorferi-like erythema migrans, lymphadenosis cutis benigna, and acrodermatitis chronica atrophicans - are hall-marks of a systemic infection, which tends to a chronically relapsing course. Even if the skin lesions are missing, or disappear spontaneously, the infection may persist and affect other organs. This presumption is supported by the outcome of a long-term follow-up study on seropositive forest workers. In association with meningopolyneuritis (Garin-Bujadoux-Bannwarth disease) and acrodermatitis chronica atrophicans - myositis and fasciitis have been recently reported as further possible manifestations of Borrelia burgdorferi infection. Borrelial infection during pregnancy should promptly be treated with antibiotics in high dosages, in order to prevent maternal-fetal transmission of borrelial organisms resulting in stillbirth or congenital defects of the newborn.

Acrodermatitis↗
PubMed1989

Myositis caused by Borrelia burgdorferi: report of four cases.

Myositis was proven histopathologically in 4 patients (age range 36-66 years) who suffered from early or late stages of Borrelia burgdorferi infection. Muscle weakness was present in 3 patients, 1 complaining of additional myalgias. One man came to medical attention because of skin discoloration and swelling of one leg. Deep biopsy from skin, fascia and muscle revealed acrodermatitis chronica atrophicans, panniculitis, fasciitis, and myositis, respectively. Creatine kinase was slightly elevated in 3 cases and normal in one. Infiltrates were found in the perimysium and within the muscle bundles, mainly around small vessels. The infiltrates consisted of many B cells and T4 lymphocytes with fewer cytotoxic T cells, suggesting that Borrelia myositis might be due to a local immune response to unknown Borrelia antigens. Cultivation of Borrelia from muscle was not successful. Antibiotic therapy cured the myositis.

Adult↗
PubMed1989

Lyme-borreliosis and possible association with HLA-antigens.

The frequencies of HLA A, B, C and DR antigens were evaluated in 220 persons from West Germany with inapparent and manifest Borrelia burgdorferi infections. Thirty-seven forest workers showing elevated antibody titres against Borrelia burgdorferi had asymptomatic infection, and are described as stage 0. One hundred and eighty-three patients presented with the clinical stages 1-3 of the infection. Control persons (n = 655) were typed in the same time period and by identical staff. HLA CW3 was present in 36.3% of patients as compared to 23.2% of the controls (RR = 1.88, pcorr = 0.03) and was significantly associated with manifest infection. In addition, the antigen A2 was found slightly but not significantly more frequent in the patients (55.2% vs 44%; pcorr = 0.41). The phenotype combination HLA A2 and Cw3, however, was significantly elevated in patients (24.6% vs 10.8%; pcorr = 0.0005). In contrast to these class 1 antigens, HLA DR3 showed a tendency of negative association with manifest infection. But this finding was not yet found to be significant (15.3% vs 25.3%; RR = 0.53, pcorr = 0.26). The frequency of HLA DR2 showed a constant decrease from stage 0 to stage 3 (inapparent infection to late complications). Using the rank correlation coefficient of Spearman, this association was found to be significant (-1.00, p less than or equal to 0.05). All other tested HLA antigens and antigen combinations showed no significant differences. The data suggest that HLA CW3 may be associated with Borrelia burgdorferi infection, whereas HLA DR2 and DR3 may be associated with less incidence of severe courses and less complications in this disorder.

Borrelia Infections↗
PubMed1989

[Diagnosis and therapy of ulcus molle today. Case report and review of the literature].

Chancroid, an ulcerous disease of the genitalia caused by Haemophilus ducreyi, occurs rarely but regularly in Germany. Exact diagnosis is based on the clinical features and a direct smear, and in particular on cultivation of the organism, showing its unique macromorphological characteristics. The sensitivity of cultivation has increased due to the development of selective media for primary isolation. Resistance problems during the last decade meant that a change to new therapeutic strategies was unavoidable. The work presented here includes a case report and a review of the recent literature, it illustrates modern methods of diagnosis and treatment of Haemophilus ducreyi infections 100 years after the first description of the organism.

Administration, Topical↗
PubMed1988

[In vitro effectiveness of ofloxacin and ciprofloxacin in genital Chlamydia trachomatis isolates measured by minimal inhibitory concentration and minimal bactericidal concentration].

Although Chlamydia trachomatis is usually susceptible to the most frequently applied chemotherapeutic agents in non-gonococcal urethritis in men and its counterpart in women--i.e., tetracycline and erythromycin--the clinical results are less satisfying than those in comparable gonococcal infections. Therefore, potent therapeutical alternatives are urgently called for. From this point of view, we investigated the in vitro susceptibility of 35 recent isolates of genital Chlamydia trachomatis from Munich to the new quinolones ciprofloxacin and ofloxacin. With both chemotherapeutics, the highest minimum inhibitory concentration amounted to 2.0 micrograms/ml; 1.0 micrograms/ml of ofloxacin inhibited 97% of the strains, ciprofloxacin but 57%. The highest minimum bactericidal concentration was 6.0 micrograms/ml. 5.0 micrograms/ml of ciprofloxacin killed all infectious particles in 91% of the strains, the corresponding figure for ofloxacin read 74%. Thus both quinolones of the second generation proved more or less equally effective in vitro. In view of the limited clinical experience gained so far with regard to these chemotherapeutic agents, we suggest further clinical study in this matter.

Chlamydia Infections↗
PubMed1988

Evidence for frameshift mutations in the hisH gene of Escherichia coli causing synthesis of a partially active glutamine amidotransferase.

Among eight strains carrying acridine-induced mutations in hisH, five which mapped at four different sites in the promoter-distal region of the gene showed His+ phenotypes on media containing a purine. By complementation analysis, hisH enzyme was shown to be required for growth on purines. Purine-sensitive His+ revertants of strains able to grow on purines carried second-site mutations which in one case could be shown to map in hisG. Strains able to grow on purines were able to grow on 2-thiazolyl-DL-alanine, too. We conclude that frameshift mutations in the promoter-distal part of the hisH gene of E. coli do not completely abolish the activity of the gene product.

Anthranilate Synthase↗
PubMed1988

Antibiotic therapy of early European Lyme borreliosis and acrodermatitis chronica atrophicans.

In a study on 121 consecutive patients with erythema migrans, 65 patients obtained oral penicillin, 36 tetracyclines, and 20 amoxicillin-clavulanic-acid. Follow-up was carried out for a median of 29, 17, and 7 months, respectively. In another limited trial on 29 patients with acrodermatitis chronica atrophicans (ACA), 14 patients received oral penicillin, 9 parenteral penicillin, and 6 tetracyclines. There was no statistically significant difference among treatment groups in both therapeutic trials, with the exception of different follow-ups due to the nonrandomized study design and different occurrence of the Jarisch-Herxheimer reaction in patients with erythema migrans. Later extracutaneous manifestations developed in 27% of the patients with erythema migrans and in 47% of the patients with ACA despite antibiotic therapy. We could not prove the superiority of any antibiotic tested in either early or late European Lyme borreliosis.

Acrodermatitis↗
PubMed1987

Antibiotic therapy in early erythema migrans disease and related disorders.

Between December 1978 and July 1985, we used various antibiotics for the treatment of 97 adult patients with early erythema migrans disease (EMD). Six patients with borrelial lymphocytoma (BL) and 20 with acrodermatitis chronica atrophicans (ACA) were treated similarly. Follow-up was for a median of 20, 14, and 12 months, respectively. The erythema migrans and all associated symptoms resolved within a median of 3 weeks (0.5-18.4), BL within 7 weeks (4-16), and ACA partly or completely within several months. A Jarisch-Herxheimer (-like) reaction was observed in 8 patients with EMD. Fourteen patients with EMD and one with ACA developed an exacerbation of symptoms or new manifestations between the 2nd and 20th day, and 28 patients with EMD and one with ACA continued to have or acquired various symptoms greater than or equal to 3 weeks after initiation of therapy. Arthralgia, neurologic and constitutional symptoms, and in one instance a slight pulmonary interstitial edema developed in EMD. More severe initial illness was a risk factor for the development of later symptoms in EMD. Retreatment was more often necessary in ACA than in EMD. A patient with ACA had a recurrence after 5 1/2 years. IgG antibody titers rose at least fourfold in 5 patients with ACA and in 1 with EMD despite therapy. We tentatively recommend minocycline or high doses of parenteral penicillin for the treatment of these disorders.

Acrodermatitis↗
PubMed1987

[Diagnosis and therapy of ulcus molle].

In developing countries of tropical Africa and South-East Asia chancroid is the most important cause of genital ulzerations. In the last decade also in industrial countries of the western hemisphere sporadic epidemics of this sexually transmitted disease were observed. This surprising revival of a disease already thought to have died out induced advances in cultivation and characterization of the etiologic agent as well as new therapeutic approaches. Treatment regimens based on erythromycin, cephalosporins of the third generation or a combination of amoxillin with the beta-lactamase inhibitor clavulanic acid can be recommended. Penicillins and tetracyclines are mostly ineffective because of plasmid-mediated resistance in Haemophilus ducreyi. As in other sexually transmitted diseases simultaneous infections with other pathogens have to be taken into consideration. The sexual partners of the patients should likewise be examined and if need, be treated.

Anti-Bacterial Agents↗