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Schmidt D, Ruehlmann E, Branscheid D, Magnussen H, Rabe K. Passive sensitization of human airways increases responsiveness to leukotriene C<SUB>4</SUB>. Eur Respir J 1999. [DOI: 10.1183/09031936.99.14231599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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477
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Schmidt D, Ruehlmann E, Branscheid D, Magnussen H, Rabe KF. Passive sensitization of human airways increases responsiveness to leukotriene C4. Eur Respir J 1999; 14:315-9. [PMID: 10515407 DOI: 10.1034/j.1399-3003.1999.14b13.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Passive sensitization of human airways in vitro causes increased responsiveness to histamine and induces specific immunoglobulin (Ig)E-dependent contractile responsiveness to allergen. Leukotrienes (LTs) and, to a lesser extent, histamine are the major mediators of allergen-induced contraction. Since it is unclear whether passively sensitized airways are also hyperresponsive to cysteinyl leukotrienes, this study investigated the effect of passive sensitization on LTC4-, in addition to histamine- and allergen-induced contractions in vitro. Bronchial rings from nine nonatopic patients were sensitized overnight with serum containing high levels of total IgE (>250 U x mL(-1)) and allergen-specific IgE against Dermatophagoides farinae (fluorescence allergosorbent test) (FAST class > or =3). The potency (-log10 of the mediator concentration causing a half maximal response (pEC50) of histamine was significantly increased in serum-sensitized tissues compared to nonsensitized controls ((mean+/-SEM) pEC50 5.20+/-0.27 versus 5.64+/-0.18; p=0.02) and maximal contractions were enhanced (877+/-47 versus 543+/-51 mg; p<0.0001). Similarly, the potency of LTC4 was significantly increased in sensitized compared to nonsensitized bronchial rings (pEC50 9.37+/-0.20 versus 8.66+/-0.26; p=0.004); maximal contractions were also enhanced (811+/-57 versus 361+/-86 mg; p<0.0001). These data demonstrate that passive sensitization of human airways induces an increase not only in histamine but also in leukotriene responsiveness. Therefore, it might be speculated that allergen responses in sensitized airways are effected through a combination of increased mediator release from inflammatory cells and increased responsiveness of airway smooth muscle.
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478
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Hori A, Schmidt D, Kuebber S. Immunohistochemical survey of migration of human anterior pituitary cells in developmental, pathological, and clinical aspects: a review. Microsc Res Tech 1999; 46:59-68. [PMID: 10402273 DOI: 10.1002/(sici)1097-0029(19990701)46:1<59::aid-jemt6>3.0.co;2-s] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Developmentally pathological conditions of the anterior pituitary cells include failed separation of the primary pituitary gland into sellar and pharyngeal ones, ectopic migration into the subarachnoid space, and basophil invasion into the posterior lobe although the last is a physiological phenomenon with pathological potentiality in certain circumstances. Pituitary primordium appears at about 4 weeks of gestation. One of the causes of the pituitary gland agenesis may be a formation of the primary hypothalamic ganglionic hamartoma just at the time of occurrence of the pituitary primordium, as analyzed in cases of Pallister-Hall syndrome. A double pituitary in a single individual is a rare malformation. Its pathogenesis is considered as a result of notochordal anomaly. In the 8th gestational week, the primary pituitary gland separates into sellar and pharyngeal parts. The disturbance of this histogenesis results in a rare pituitary malformation, a "pharyngosellar pituitary." Despite the failed separation in this case, differentiation of the pituitary cells proceeds and the hormone production of this malformed pituitary gland can be displayed immunohistochemically. In this case, the distribution of the different hormone producing cells was atypical, particularly in those of gonadotropic hormones and ACTH. Life-long existence of the pharyngeal pituitary is a normal anatomical state in humans. Cell differentiation (hormone production) in the pharyngeal pituitary occurs about 4-10 weeks later than in the sellar pituitary. In pharyngeal pituitary, all kinds of adenohypophyseal hormones are produced. Extracranial pituitary adenomas (with intact sellar pituitary), exclusively found in the nasopharynx, sphenoid sinus, and clivus, may occur from the pharyngeal pituitary while another tumorigenesis can develop from the residual tissue fragment in the craniopharyngeal canal. The "overshoot" of the adenohypophyseal cell migration in the distal part of the sellar pituitary is frequently observed in the leptomeninges of the peri-infundibular or peri-hypothalamic region as ectopic pituitary cell clusters that are apparently independent of the pars tuberalis. It is suggested that these cells, frequently found in "normal" individuals, may be one of the possible origins of the intracranial ectopic pituitary adenomas. However, the reason why a majority of the reported intracranial ectopic pituitary tumors are ACTH-adenomas remains unexplained, since the ectopic cells, found in "normal" individuals, consist of fairly different hormone-producing cells. A further enigmatic phenomenon is a "basophil invasion." ACTH-positive cells invade from the pars intermedia into the posterior lobe of the pituitary. This invasion increases in intensity and frequency according to increase in age. However, the invasion of ACTH cells is observed as early as in the fetal life. The invasive cells display occasionally cell atypia as well as mitotic activity. The origin of extremely rare pituitary adenomas inside the posterior lobe can be explained by the existence and proliferative activity of basophil invasion.
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479
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Dallenbach-Hellweg G, Schmidt D. History of gynecological pathology. VI. Jacob Felix Marchand. Int J Gynecol Pathol 1999; 18:281-7. [PMID: 12090599 DOI: 10.1097/00004347-199907000-00016] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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480
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Maurer JJ, Schmidt D, Petrosko P, Sanchez S, Bolton L, Lee MD. Development of primers to O-antigen biosynthesis genes for specific detection of Escherichia coli O157 by PCR. Appl Environ Microbiol 1999; 65:2954-60. [PMID: 10388689 PMCID: PMC91442 DOI: 10.1128/aem.65.7.2954-2960.1999] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/1999] [Accepted: 04/20/1999] [Indexed: 11/20/2022] Open
Abstract
The chemical composition of each O-antigen subunit in gram-negative bacteria is a reflection of the unique DNA sequences within each rfb operon. By characterizing DNA sequences contained with each rfb operon, a diagnostic serotype-specific probe to Escherichia coli O serotypes that are commonly associated with bacterial infections can be generated. Recently, from an E. coli O157:H7 cosmid library, O-antigen-positive cosmids were identified with O157-specific antisera. By using the cosmid DNAs as probes, several DNA fragments which were unique to E. coli O157 serotypes were identified by Southern analysis. Several of these DNA fragments were subcloned from O157-antigen-positive cosmids and served as DNA probes in Southern analysis. One DNA fragment within plasmid pDS306 which was specific for E. coli O157 serotypes was identified by Southern analysis. The DNA sequence for this plasmid revealed homology to two rfb genes, the first of which encodes a GDP-mannose dehydratase. These rfb genes were similar to O-antigen biosynthesis genes in Vibrio cholerae and Yersinia enterocolitica serotype O:8. An oligonucleotide primer pair was designed to amplify a 420-bp DNA fragment from E. coli O157 serotypes. The PCR test was specific for E. coli O157 serotypes. PCR detected as few as 10 cells with the O157-specific rfb oligonucleotide primers. Coupled with current enrichment protocols, O157 serotyping by PCR will provide a rapid, specific, and sensitive method for identifying E. coli O157.
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481
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Schmidt D, Dent G, Rabe KF. Selective phosphodiesterase inhibitors for the treatment of bronchial asthma and chronic obstructive pulmonary disease. Clin Exp Allergy 1999; 29 Suppl 2:99-109. [PMID: 10421832 DOI: 10.1046/j.1365-2222.1999.00018.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Theophylline is commonly used in the treatment of obstructive airway diseases. The identification and functional characterization of different phosphodiesterase (PDE) isoenzymes has led to the development of various isoenzyme-selective inhibitors as potential anti-asthma drugs. Considering the distribution of isoenzymes in target tissues, with high activity of PDE3 and PDE4 in airway smooth muscle and inflammatory cells, selective inhibitors of these isoenzymes may add to the therapy of chronic airflow obstruction. However, initial data from clinical trials with selective PDE3 and PDE4 inhibitors have been somewhat disappointing and have tempered the expectations considerably since these drugs had limited efficacy and their use was clinically limited through side effects. The improved understanding of the molecular biology of PDEs enabled the synthesis of novel drugs with an improved risk/benefit ratio. These 'second generation' selective drugs have produced more promising clinical results not only for the treatment of bronchial asthma but also for the treatment of chronic obstructive pulmonary disease.
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482
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Schmidt D. [Recent anticonvulsants]. Internist (Berl) 1999; 40:567-73. [PMID: 10407770 DOI: 10.1007/s001080050371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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483
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Schmidt D, Amrani A, Verdaguer J, Bou S, Santamaria P. Autoantigen-independent deletion of diabetogenic CD4+ thymocytes by protective MHC class II molecules. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 1999; 162:4627-36. [PMID: 10202002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Some MHC class II genes provide dominant resistance to certain autoimmune diseases via mechanisms that remain unclear. We have shown that thymocytes bearing a highly diabetogenic, I-Ag7-restricted beta-cell-reactive TCR (4.1-TCR) undergo negative selection in diabetes-resistant H-2g7/x mice by engaging several different antidiabetogenic MHC class II molecules on thymic (but not peripheral) hemopoietic cells, independently of endogenous superantigens. Here we have investigated 1) whether this TCR can also engage protective MHC class II molecules (I-Ab) on cortical thymic epithelial cells in the absence of diabetogenic (I-Ag7) molecules, and 2) whether deletion of 4.1-CD4+ thymocytes in I-Ab-expressing mice might result from the ability of I-Ab molecules to present the target beta-cell autoantigen of the 4.1-TCR. We show that, unlike I-Ag7 molecules, I-Ab molecules can restrict neither the positive selection of 4.1-CD4+ thymocytes in the thymic cortex nor the presentation of their target autoantigen in the periphery. Deletion of 4.1-CD4+ thymocytes by I-Ab molecules in the thymic medulla, however, is a peptide-specific process, since it can be triggered by hemopoietic cells expressing heterogeneous peptide/I-Ab complexes, but not by hemopoietic cells expressing single peptide/I-Ab complexes. Thus, unlike MHC-autoreactive or alloreactive TCRs, which can engage deleting MHC molecules in the thymic cortex, thymic medulla, and peripheral APCs, the 4.1-TCR can only engage deleting MHC molecules (I-Ab) in the thymic medulla. We therefore conclude that this form of MHC-induced protection from diabetes is based on the presentation of an anatomically restricted, nonautoantigenic peptide to highly diabetogenic thymocytes.
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484
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Verdaguer J, Amrani A, Anderson B, Schmidt D, Santamaria P. Two mechanisms for the non-MHC-linked resistance to spontaneous autoimmunity. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 1999; 162:4614-26. [PMID: 10202001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Genetic susceptibility and resistance to most autoimmune disorders are associated with highly polymorphic genes of the MHC and with non-MHC-linked polygenic modifiers. It is known that non-MHC-linked polymorphisms can override or enhance the susceptibility to an autoimmune disease provided by pathogenic MHC genes, but the mechanisms remain elusive. In this study, we have followed the fate of two highly diabetogenic beta cell-specific T cell receptors (Kd and I-Ag7 restricted, respectively) in NOR/Lt mice, which are resistant to autoimmune diabetes despite expressing two copies of the diabetogenic MHC haplotype H-2g7. We show that at least two mechanisms of non-MHC-linked control of pathogenic T cells operate in these mice. One segregates as a recessive trait and is associated with a reduction in the peripheral frequency of diabetogenic CD8+ (but not CD4+) T cells. The other segregates as a dominant trait and is mediated by IL-4- and TGF-beta1-independent immune suppressive functions provided by lymphocytes that target diabetogenic CD4+ and CD8+ T cells, without causing their deletion, anergy, immune deviation, or ignorance. These results provide explanations as to how non-MHC-linked polymorphisms can override the susceptibility to an autoimmune disease provided by pathogenic MHC haplotypes, and demonstrate that protective non-MHC-linked genes may selectively target specific lymphoid cell types in cellularly complex autoimmune responses.
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MESH Headings
- Amino Acid Sequence
- Animals
- CD8-Positive T-Lymphocytes/immunology
- CD8-Positive T-Lymphocytes/metabolism
- Cell Movement/genetics
- Cell Movement/immunology
- Clonal Anergy/genetics
- Clonal Deletion/genetics
- Crosses, Genetic
- Diabetes Mellitus, Type 1/etiology
- Diabetes Mellitus, Type 1/genetics
- Diabetes Mellitus, Type 1/immunology
- Diabetes Mellitus, Type 1/pathology
- Female
- Genes, T-Cell Receptor beta/immunology
- Immune Tolerance
- Immunity, Innate
- Interleukin-4/metabolism
- Islets of Langerhans/immunology
- Islets of Langerhans/metabolism
- Islets of Langerhans/pathology
- Lymphocyte Count
- Major Histocompatibility Complex/genetics
- Major Histocompatibility Complex/immunology
- Male
- Mice
- Mice, Inbred C57BL
- Mice, Inbred MRL lpr
- Mice, Inbred NOD
- Mice, Transgenic
- Molecular Sequence Data
- Receptors, Antigen, T-Cell, alpha-beta/biosynthesis
- Receptors, Antigen, T-Cell, alpha-beta/deficiency
- Receptors, Antigen, T-Cell, alpha-beta/genetics
- Transforming Growth Factor beta/metabolism
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485
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Loeffler J, Hebart H, Bialek R, Hagmeyer L, Schmidt D, Serey FP, Hartmann M, Eucker J, Einsele H. Contaminations occurring in fungal PCR assays. J Clin Microbiol 1999; 37:1200-2. [PMID: 10074553 PMCID: PMC88676 DOI: 10.1128/jcm.37.4.1200-1202.1999] [Citation(s) in RCA: 131] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/1998] [Accepted: 12/18/1998] [Indexed: 11/20/2022] Open
Abstract
Successful in vitro amplification of fungal DNA in clinical specimens has been reported recently. In a collaboration among five European centers, the frequency and risk of contamination due to airborne spore inoculation or carryover contamination in fungal PCR were analyzed. The identities of all contaminants were specified by cycle sequencing and GenBank analysis. Twelve of 150 PCR assays that together included over 2,800 samples were found to be contaminated (3.3% of the negative controls were contaminated during the DNA extraction, and 4.7% of the PCR mixtures were contaminated during the amplification process). Contaminants were specified as Aspergillus fumigatus, Saccharomyces cerevisiae, and Acremonium spp. Further analysis showed that commercially available products like zymolyase powder or 10x PCR buffer may contain fungal DNA. In conclusion, the risk of contamination is not higher in fungal PCR assays than in other diagnostic PCR-based assays if general precautions are taken.
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486
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Abstract
BACKGROUND Infectious endocarditis can lead to embolic arterial retinal occlusions. Which therapy is indicated? RESULTS A 33-year-old man suddenly became blind in his left eye as the result of a central retinal artery occlusion (CRAO). This occurred during high-dosage treatment for infectious endocarditis that had been diagnosed 3 weeks earlier. The echocardiogram showed distinct vegetation and an abscess on the aortic valve. The CRAO together with the ultrasound findings was considered an absolute indication for surgery of the aortic valve. During this emergency operation, a 2 cm deep abscess cavity was found between the mitral and aortic valves. After removal of the abscess, together with the infected valve, a prosthetic valve was inserted. Following the operation, the patient made an uneventful recovery. The antibiotic treatment was continued for several months. The left eye remained sightless. No recurrence of infectious endocarditis occurred during the follow-up of 2 1/4 years. A branch retinal arterial occlusion occurred in the right eye of a 35-year-old man who had suffered from chronic infectious endocarditis for several months. Insufficiency of more than one valve had been diagnosed on several occasions. The patient, a drug-addict, had refused surgical treatment on each occasion. After 3 months, the right eye became completely blind owing to CRAO. Following high-dosage treatment with antibiotics, the infectious endocarditis was healed. The right eye remained blind. One year later the patient died. CONCLUSION Retinal arterial occlusion of embolic origin in a patient with infectious endocarditis is an indication for immediate medical and/or surgical treatment. This is of particular importance if there is ultrasound evidence of an abscess in the valve area.
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487
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Rudolph P, Bonichon F, Gloeckner K, Collin F, Chassevent A, Schmidt D, Coindre JM, Parwaresch R, Klöppel G. Comparative analysis of prognostic indicators for sarcomas of the soft parts and the viscerae. VERHANDLUNGEN DER DEUTSCHEN GESELLSCHAFT FUR PATHOLOGIE 1999; 82:246-52. [PMID: 10095442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Purpose of this study was to determine which parameters may be best applied to determine the prognosis of soft tissue and visceral sarcomas, the two groups being regarded as biologically different. In a cohort of 184 soft tissue tumors (STT) and 53 gastrointestinal stromal tumors (GIST), the following factors were examined for their diagnostic and prognostic relevance: patient age, sex, tumor location, histological type, tumor size, tumor grade, DNA ploidy status, mitotic count, and immunohistochemical proliferation index. Tumors were graded according to the FNCLCC system, and antibody Ki-S11 (Ki-67) served as a proliferation marker. Median clinical follow-up time was 48 months. In STT, morphological criteria allowed a ready discrimination between benign and malignant lesions, which was only warranted by histopathological grading in GIST. 178 of all 236 tumors were thus classified as malignant. Whilst most parameters yielded significant results in the univariate analysis, age, sex, and histological type were irrelevant. A proliferation index > 20% predicted a poor outcome in soft tissue sarcomas, in contrast to a threshold of 10% for GIST. In both groups, the Cox multivariate analysis selected the proliferation index as the sole independent predictor of overall survival, whereas it was superseded by the tumor grade with respect to metastatic spread. In conclusion, soft tissue and visceral sarcomas appear to behave basically in a similar manner. Both tumor grade and immunohistochemical proliferation index are of major prognostic value. Concerning the growth fraction, however, different cut-off points should be selected for sarcomas of the soft tissues and those of the digestive tract.
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488
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Rudolph P, Kellner U, Schmidt D, Kirchner V, Talerman A, Harms D, Parwaresch R. Ki-A10, a germ cell nuclear antigen retained in a subset of germ cell-derived tumors. THE AMERICAN JOURNAL OF PATHOLOGY 1999; 154:795-803. [PMID: 10079257 PMCID: PMC1866408 DOI: 10.1016/s0002-9440(10)65326-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Monoclonal antibody Ki-A10 recognizes a nuclear antigen of 25 and 22 kd apparent molecular mass, which is abundantly expressed by immature gonocytes, spermatogonia, and spermatocytes, whereas it is absent in spermatids, spermatozoa, oocytes, and normal somatic tissues. In a broad spectrum of human cancers the antibody showed no reactivity except for a small subset of malignant lymphomas. Because of this restricted expression pattern, we examined 173 germ cell tumors and 18 sex cord stromal tumors immunohistochemically to assess the distribution of the Ki-A10 antigen. A strongly positive reaction was found in classic seminomas, dysgerminomas, spermatocytic seminomas, and the germ cell component of gonadoblastomas. Yolk sac tumors presented a heterogeneous reactivity pattern ranging from overall positivity to complete lack of antigen expression, and in three of eight choriocarcinomas, a few clusters of cytotrophoblast cells were strongly labeled. All other tumors, including Leydig and Sertoli cell tumors as well as placental tissue, were negative. Our findings suggest that specific germ cell antigens can be retained in germ cell tumors along particular differentiation pathways. Ki-A10 is the first marker that consistently labels spermatocytic seminoma, further confirming its germ cell origin and suggesting a close relationship to classic seminoma. The antibody may serve for diagnostic purposes and promises new insights into the process of germ cell differentiation and the development of germ cell-derived neoplasia.
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489
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Basting R, Corvin S, Händel D, Hinke A, Schmidt D. Adjuvant immunotherapy in renal cell carcinoma--comparison of interferon alpha treatment with an untreated control. Anticancer Res 1999; 19:1545-8. [PMID: 10365142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND Adjuvant immunotherapy of RCC with interferon alpha is still controversial. It was the aim of this study to investigate, whether a selected group of patients with a non-metastatic RCC can profit from this therapy. MATERIALS AND METHODS Survival data of 125 patients with a non-metastatic RCC, who underwent a tumor-nephrectomy were analyzed retrospectively, 33 of these patients received an adjuvant immunotherapy with interferon alpha for 1 year. All tumors were classified by the TNM-system. Statistical evaluation was performed by the Kaplan-Meier-Method and the logrank-test. RESULTS Tumor stage was seen to be an important prognostic factor in RCC with a significantly better outcome in pT2- as compared to pT3-tumors. Tumor grading was without any prognostic relevance. Adjuvant interferon alpha therapy had no effect on overall survival. After separation of the patients into pT2- and pT3/4-tumors again interferon alpha showed no significant benefit for one of the 2 groups. CONCLUSIONS The adjuvant therapy with interferon alpha shows no significant benefit in the treatment of non-metastatic RCC. Tumor stage is no suitable factor to select a group of patients, who might profit from an interferon alpha therapy. Further studies are necessary to isolate better selection factors.
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490
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Schmidt D, Richter B. [Otorhinolaryngologic findings in Horton temporal arteritis. Review of the literature and case report]. HNO 1999; 47:176-82. [PMID: 10231701 DOI: 10.1007/s001060050378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Otorhinolaryngological findings of a temporal arteritis frequently occur in the beginning and/or course of the disease. A purulent sinusitis can be a sign of recurrence of the arteritis and was diagnosed in a 77-year-old woman with known disease that had been biopsied 6 years earlier. Puncture of the maxillary sinus was considered necessary, but no bacteria were found in purulent sinus discharge. When antibiotic treatment failed to bring about a resolution of the inflammatory condition, steroid therapy was begun and the patient recovered within a few days in response to this treatment. The clinical findings in this case show that early diagnosis and treatment by the otorhinolaryngologist are necessary in order to prevent severe complications of the disease.
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491
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Basting R, Corvin S, Händel D, Hinke A, Schmidt D. Adjuvant interferon alpha therapy in renal cell carcinoma (RCC): prognostic value of DNA cytophotometry. Anticancer Res 1999; 19:1493-5. [PMID: 10365130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND Adjuvant immunotherapy with interferon alpha in non-metastatic RCC is still controversial. It was the aim of the present study to investigate whether tumor ploidy can help to isolate a group of patients profitting from this treatment. MATERIALS AND METHODS Survival data of 119 patients undergoing tumor nephrectomy because of a non-metastatic RCC were analyzed retrospectively. Ploidy was measured in every tumor by means of DNA-cytophotometry. 24 patients received an adjuvant therapy with interferon alpha for one year. Statistical evaluation was performed by the Kaplan-Meier-Method with the logrank-test. RESULTS Ploidy could be measured in all tumors. 56 (47%) tumors showed a diploid, 63 (53%) an aneuploid DNA-distribution. Ploidy was seen to be a good prognostic factor in RCC with significantly better survival in patients with diploid than those with aneuploid tumors. The adjuvant interferon therapy provided a marginal however not significant better survival in diploid tumors. Patients with aneuploid RCC had no benefit from this treatment. CONCLUSIONS The data show that an interferon treatment in non-metastatic RCC might improve survival in patients with the prognostic better diploid tumors. However further investigations are necessary to give a general recommendation for this therapy in this group of patients. Additional molecular tumor factors like S-phase analysis and others might also improve patient selection.
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492
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Pitten FA, Müller G, König P, Schmidt D, Thurow K, Kramer A. Risk assessment of a former military base contaminated with organoarsenic-based warfare agents: uptake of arsenic by terrestrial plants. THE SCIENCE OF THE TOTAL ENVIRONMENT 1999; 226:237-245. [PMID: 10085570 DOI: 10.1016/s0048-9697(98)00400-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Organoarsenic-based chemical warfare agents (CWAs) such as the sternutators diphenylchloroarsine (CLARK I), diphenylcyanoarsine (CLARK II) or phenyldichloroarsine (PFIFFIKUS) still pose a notable risk in countries where former military bases that have stored these weapons have not yet been reclaimed. In fact, this is the case for many countries of Eastern Europe and the CIS. One of the most important military bases of the former Third Reich, the Heeresmunitionsanstalt I and II, is situated close to the German-Polish border at Loecknitz (Fig. 1). The German army stored and decanted different compounds of CWAs at this military base until 1945. When the Soviet Army destroyed the base in 1946, large amounts of CWAs and other organoarsenic compounds polluted the soil. Today up to 250 g (!) of arsenic may be found in 1 kg of soil at some places in this area. Since 1991, a Government Working Group has been working on the risk assessment in order to define the scope of reclamation measures. This study investigates the contamination and the uptake of arsenic by plants because little is known about the bioavailability and metabolism of sternutators and their constituents. The total arsenic concentration of nine different species of terrestrial plants with at least six samples per species is presented. In spite of the considerable arsenic contamination of the soil (mean value 923 mg arsenic/kg soil) the plant contamination remained comparably low. The median value of arsenic contamination of the above-ground organs of velvet grass, Holcus lanatus, was 0.7 mg/kg dry wt. and the mean value was 4.3 mg/kg dry wt. due to some highly contaminated samples. The highest arsenic concentration registered was 26 mg/kg dry wt. in a sample of H. lanatus, which was most probably caused by soil particles adhering to the plant. The chemical structure of the arsenic compounds carried by the above-ground plant organs has been determined by gas chromatographic investigations and showed an uptake of triphenyl arsine by the plants.
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493
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Fröscher W, Krämer G, Schmidt D, Stefan H. [Serum concentration of anticonvulsants. Practical guidelines for measuring and useful interpretation. Therapy Committee of the German Section of the International Epilepsy League]. DER NERVENARZT 1999; 70:172-7. [PMID: 10098154 DOI: 10.1007/s001150050419] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The clinical relevance of being informed on the serum concentration of antiepileptic drugs has been judged very differently during the last decades. Therefore the Commission on the treatment of epilepsy (German section of the International League against Epilepsy) had the task to outline the importance of therapeutic monitoring of anticonvulsant serum concentrations. The possibility of determining the serum concentration of anticonvulsants induced the elaboration of "therapeutic drug level ranges". The usefulness of determining serum concentrations of antiepileptic drugs in clinical management of patients with epilepsy depends decisively on the following questions: Can the efficacy of antiepileptic drug treatment be increased by serum concentration monitoring? Can the rate of adverse effects of antiepileptic drugs be reduced by serum concentration monitoring? Clinical experience suggests numerous indications of therapeutic drug monitoring, scientific studies however, supporting these empirical guidelines are not available. Therefore, therapeutic drug monitoring may be restricted for some special situations which have to be justified in every single case. Tailored determinations with specific purposes are e.g.: resistance to therapy, including suspected irregular intake; suspected intoxication, particularly during combined therapy; the possibility of significant changes in the dosage-serum concentration relationship (interactions with other drugs, unusual pharmacokinetics in childhood, in pregnancy etc.).
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494
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Meiser BM, Pfeiffer M, Schmidt D, Reichenspurner H, Ueberfuhr P, Paulus D, von Scheidt W, Kreuzer E, Seidel D, Reichart B. Combination therapy with tacrolimus and mycophenolate mofetil following cardiac transplantation: importance of mycophenolic acid therapeutic drug monitoring. J Heart Lung Transplant 1999; 18:143-9. [PMID: 10194038 DOI: 10.1016/s1053-2498(98)00002-3] [Citation(s) in RCA: 133] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Interest has recently been expressed in tacrolimus and mycophenolate mofetil (MMF), two potent immunosuppressants, for a variety of transplant indications. The efficacy of this combination was assessed as primary therapy following cardiac transplantation. METHODS Forty-five patients were enrolled; 15 into Phase I and 30 to Phase II of the study. Intravenous tacrolimus was administered for 2-3 days to all patients prior to conversion to oral therapy; target blood concentrations were 10-15 ng/mL. Treatment also consisted of steroids and MMF. During Phase I, a fixed 2 g/day dose of MMF was given whilst doses were adjusted according to mycophenolic acid (MPA) plasma levels during Phase II (target range 2.5-4.5 microg/mL). Mean follow-up was 696 +/- 62 days and 436 +/- 88 days for Phases I and II, respectively. RESULTS Phase I: Patient survival was 100%. Rejection was diagnosed in 66.7% of patients (mean number of episodes per patient 1.33 +/- 1.18). Retrospective analyses indicated that whereas mean MPA plasma levels >3.0 microg/mL were not associated with rejection, no correlation was found with tacrolimus blood concentrations. Phase II: A survival rate of 96.7% was evident, one patient having died from aspergillosis. Diagnoses of rejection were made in 10.0% of patients (0.10 +/- 0.31 episodes per patient) and confounding factors were present in all 3 cases. MPA trough levels were 1.0 +/- 0.3 microg/mL at this time. Resolution was apparent following pulse steroid therapy. Steroids were successfully withdrawn from all patients who completed 6 months' treatment. CONCLUSIONS Combination therapy with tacrolimus and MMF is associated with suppression of acute myocardial rejection; however, this is dependent upon routine therapeutic drug monitoring.
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495
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Meiser BM, Pfeiffer M, Schmidt D, Ueberfuhr P, Reichenspurner H, Paulus D, von Scheidt W, Kreuzer E, Seidel D, Reichart B. The efficacy of the combination of tacrolimus and mycophenolate mofetil for prevention of acute myocardial rejection is dependent on routine monitoring of mycophenolic acid trough acid levels. Transplant Proc 1999; 31:84-7. [PMID: 10083018 DOI: 10.1016/s0041-1345(98)01448-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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496
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Okragly AJ, Niles AL, Saban R, Schmidt D, Hoffman RL, Warner TF, Moon TD, Uehling DT, Haak-Frendscho M. Elevated tryptase, nerve growth factor, neurotrophin-3 and glial cell line-derived neurotrophic factor levels in the urine of interstitial cystitis and bladder cancer patients. J Urol 1999; 161:438-41; discussion 441-2. [PMID: 9915421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
PURPOSE The 2 prominent features of interstitial cystitis are pain and increased numbers of mast cells in the bladder. In this pilot study we determined the concentration of soluble mediators associated with activation of sensory neurons and/or mast cells that were present in the urine. MATERIALS AND METHODS The study groups included 4 interstitial cystitis patients, 7 kidney donors with no history of bladder disease as negative controls, 6 bladder cancer patients and 7 patients with urinary tract infection as reference controls. Urine samples were assayed for different soluble mediators using immunoassays for tryptase (a marker for mast cell activation), neurotrophic factors (markers of neuronal plasticity) and chemokines (markers of inflammatory cell activity). Results were normalized based on creatinine concentration. RESULTS There was a marked increase in the average amounts of tryptase and 3 neurotrophic factors in patient urine. Interestingly, the mediator profile in the urine of bladder cancer patients was indistinguishable from that of interstitial cystitis patients with respect to these same 4 proteins. There was no difference between normal control and urinary tract infection urine samples. CONCLUSIONS These findings may account for several clinical and pathological features found in interstitial cystitis and bladder cancer. Although preliminary due to the limited numbers of patients, they also suggest that increased levels of neurotrophin-3, nerve growth factor, glial cell line-derived neurotrophic factor and tryptase in the urine could serve as a basis for adjunct diagnosis, monitoring and treatment of interstitial cystitis.
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497
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Krause BJ, Schmidt D, Mottaghy FM, Taylor J, Halsband U, Herzog H, Tellmann L, Müller-Gärtner HW. Episodic retrieval activates the precuneus irrespective of the imagery content of word pair associates. A PET study. Brain 1999; 122 ( Pt 2):255-63. [PMID: 10071054 DOI: 10.1093/brain/122.2.255] [Citation(s) in RCA: 142] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The aim of this study was to evaluate further the role of the precuneus in episodic memory retrieval. The specific hypothesis addressed was that the precuneus is involved in episodic memory retrieval irrespective of the imagery content. Two groups of six right-handed normal male volunteers took part in the study. Each subject underwent six [15O]butanol-PET scans. In each of the six trials, the memory task began with the injection of a bolus of 1500 MBq of [15O]butanol. For Group 1, 12 word pair associates were presented visually, for Group 2 auditorily. The subjects of each group had to learn and retrieve two sets of 12 word pairs each. One set consisted of highly imaginable words and another one of abstract words. Words of both sets were not related semantically, representing 'hard' associations. The presentations of nonsense words served as reference conditions. We demonstrate that the precuneus shows consistent activation during episodic memory retrieval. Precuneus activation occurred in visual and auditory presentation modalities and for both highly imaginable and abstract words. The present study therefore provides further evidence that the precuneus has a specific function in episodic memory retrieval as a multimodal association area.
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498
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Krska Z, Kudrna K, Schmidt D, Kvasnicka J. [Antibiotic prophylaxis in hip joint surgery]. SBORNIK LEKARSKY 1999; 100:291-300. [PMID: 11221478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
Nosocomial deep wound infections are serious complications after hip joint surgery. Our aim was to determine whether there is a difference in rates of nosocomial infections between group of patients after elective surgery of hip replacement and group of patients with hip replacement after trauma. Both groups of patients had perioperative prophylaxis with amoxycillin. We found that the overall trauma patients infection rate was 0.9 per cent compared with 1.5 per cent for elective surgery infections. In both groups of patients a postsurgery stress was documented according to increase of acute phase proteins (C-reactive protein, orosomucoid and fibrinogen) in plasma for a minimum 10 days after surgery. We conclude, that both groups of patients had benefit from amoxycillin prophylaxis therapy.
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499
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Beigang R, Schmidt D, Timmermann A. Hyperfine induced perturbation of the 5s19d Rydberg state of87Sr. ACTA ACUST UNITED AC 1999. [DOI: 10.1088/0022-3700/15/6/005] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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500
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Hellerstein M, Hanley MB, Cesar D, Siler S, Papageorgopoulos C, Wieder E, Schmidt D, Hoh R, Neese R, Macallan D, Deeks S, McCune JM. Directly measured kinetics of circulating T lymphocytes in normal and HIV-1-infected humans. Nat Med 1999; 5:83-9. [PMID: 9883844 DOI: 10.1038/4772] [Citation(s) in RCA: 455] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The dynamic basis for T-cell depletion in late-stage HIV-1 disease remains controversial. Using a new, non-radioactive, endogenous labeling technique, we report direct measurements of circulating T-cell kinetics in normal and in HIV-1-infected humans. In healthy, HIV-1-seronegative subjects, CD4+ and CD8+ T cells had half-lives of 87 days and 77 days, respectively, with absolute production rates of 10 CD4+ T cells/microl per day and 6 CD8+ T cells/microl per day. In untreated HIV-1-infected subjects (with a mean CD4 level of 342 cells/microl), the half-life of each subpopulation was less than 1/3 as long as those of healthy, HIV-1-seronegative subjects but was not compensated by an increased absolute production rate of CD4+ T cells. After viral replication was suppressed by highly active antiretroviral therapy for 12 weeks, the production rates of circulating CD4+ and CD8+ T cells were considerably elevated; the kinetic basis of increased CD4 levels was greater production, not a longer half-life, of circulating cells. These direct measurements indicate that CD4+ T-cell lymphopenia is due to both a shortened survival time and a failure to increase the production of circulating CD4+ T cells. Our results focus attention on T-cell production systems in the pathogenesis of HIV-1 disease and the response to antiretroviral therapy.
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