PubMed Health⌕ Search

Biomedical subjects

A Kiers

Publications and source records attributed to A Kiers.

9 recordsLinked to original sources
PubMed2005

[A Somali man with a painful thyroid mass: thyroid tuberculosis].

A 21-year-old man from Somalia presented with a painful mass in the thyroid, 6 months offatigue, weight loss and fever. Two separate courses of antibiotics did not improve his condition. Thyroid function tests were normal. The chest X-ray showed an enlarged hilus with some pulmonary infiltration around it. The diagnosis ofthyroid tuberculosis was established by cytological, microbiological and PCR testing of a fine needle aspirate of a thyroid lymph node. Treatment with antituberculosis agents resulted in a complete clinical response. The differential diagnosis of a painful thyroid mass encompasses subacute granulomatous thyroiditis, infectious thyroiditis, radiation- or trauma-induced thyroiditis and haemorrhage in the thyroid lymph nodes. Although thyroid tuberculosis is mainly a disease of developing countries, increasing immigration can lead to a higher incidence of this rare form of extrapulmonary tuberculosis and should therefore also be considered in patients with a painful thyroid mass.

Adult↗
PubMed1998

Diagnosis of Mycobacterium microti infections among humans by using novel genetic markers.

As a result of DNA typing of Mycobacterium microti isolates from animals in the United Kingdom and The Netherlands, we diagnosed four human M. microti infections. These are the first M. microti infections among humans to be reported. Three of the patients were immunocompromised and suffered from generalized forms of tuberculosis. The fourth patient was a 34-year-old immunocompetent male with a persistent cough and undefined X-ray abnormalities. Two of the M. microti infections were recognized by their IS6110 restriction fragment length polymorphism (RFLP) patterns, which showed a high degree of similarity with those of M. microti strains isolated from a pig and a ferret in The Netherlands. The two other human M. microti infections were recognized by using the recently developed DNA fingerprinting method, "spoligotyping," directly on clinical material. All M. microti isolates from the United Kingdom and The Netherlands were found to contain an exceptionally short genomic direct repeat region, resulting in identical two-spacer sequence reactions in spoligotyping. In contrast, the highly similar IS6110 RFLP patterns of the vole strains from the United Kingdom differed considerably from the RFLPs of all M. microti strains isolated in The Netherlands, suggesting that geographic isolation led to divergent strains in the United Kingdom and on the continent.

Adult↗
PubMed1997

Use of DNA fingerprinting in international source case finding during a large outbreak of tuberculosis in The Netherlands.

SETTING: Tuberculosis outbreak in a low prevalence country. OBJECTIVE: Description of an international source tracing process in which restriction fragment length polymorphism (RFLP) analysis played an essential role. DESIGN: In 1993 a large scale source tracing process was initiated in Harlingen, a harbour town in the north of The Netherlands, after a child with tuberculous meningitis was reported for which no source could be identified. Traditional contact tracing followed the detection of sources of infection. RFLP was used to map the tuberculosis transmission and identify the source case. RESULTS: The investigation extended from the north to several places in the west of The Netherlands. In total 6519 persons were screened; there were 276 infections, among which 49 cases of active tuberculosis were identified. RFLP analysis of Mycobacterium tuberculosis isolates from all 28 culture positive patients showed the 'Harlingen' type DNA fingerprint. After 5 months source tracing led to the identification of the source case in the United Kingdom. Up to June 1996 altogether 37 patients (The Netherlands 28; the UK 7; Surinam 1; Morocco 1) were found to have isolates with the Harlingen type DNA pattern. Despite a thorough evaluation, in 5 of the 37 patients no relation to the source case or the outbreak in Harlingen could be established. CONCLUSION: RFLP typing proved a very useful instrument in guiding the process of international source tracing and contact investigation.

Adolescent↗
PubMed1996

[Border-crossing source tracing in tuberculosis via DNA fingerprint technique].

OBJECTIVE: Description of the value of modern DNA analysis ('restriction fragment length polymorphism'; RFLP) as a method for mapping tuberculosis transmission. DESIGN: Descriptive. SETTING: Social Health Service Noord-Friesland, the Netherlands. METHOD: A large-scale tuberculosis investigation was conducted in Harlingen in 1993 when a 2,5 year old patient with tuberculous meningitis was reported. Source tracing and contact tracing extended from Harlingen to the west of the Netherlands and even abroad. Modern DNA analysis (RFLP) was used to map the tuberculosis transmission. RESULTS: A total of 6519 persons were screened and 276 infected people were identified, of whom 49 were suffering from active tuberculosis. RFLP analysis showed in 27 of them a 'Harlingen' type Mycobacterium tuberculosis DNA pattern identical to that of the index patient. The source patient was finally traced in England. By the end of 1994 3 more patients were found with the same DNA pattern; their relation with the source patient and the outbreak of tbc remained unrevealed. CONCLUSION: The Harlingen outbreak was extensive and characterized by time-consuming source tracing. Modern DNA analysis proved to be a very useful instrument in identifying the source case.

Adult↗
PubMed1984

Nitrogen-13 and xenon-133 ventilation studies.

Due to the solubility of xenon-133 in blood and tissues, errors are introduced in the determination of regional pulmonary ventilation. We investigated these errors by comparing the results from ventilation measurements with Xe-133 and N-13 in five normal subjects (both at rest and during exercise) and in seven patients after a pneumonectomy. In the normal subjects at rest, the upper lung fields showed no significant difference in the uptake rates of the two gases. In the middle and lower lung fields, however, the uptake rate for Xe-133 was higher than for N-13. During exercise a significant increase of the specific ventilation was found in the upper lung fields for N-13 compared with Xe-133. In the pneumonectomy patients the overall uptake rate for Xe-133 in the intact hemithorax was 25% larger than for N-13. Over the pneumonectomized hemithorax the uptake of the fastest component of Xe-133 was (8.5 +/- 1.3)% of the total. The total chest-wall contribution of Xe-133 was (27 +/- 8)% of the total count rate.

Adult↗
PubMed1982

An electromagnetic valve for rebreathing exercise studies.

An electromagnetic valve for use in exercise rebreathing studies is described. This valve enables the investigator to connect a rebreathing system immediately after the onset of inspiration even at high breathing frequencies. The rapid switching causes minimal leakage; the rebreathing bag can be washed out and refilled without disconnection during exercise testing. For one year this valve has been used in measurements of functional residual capacity and diffusing capacity during exercise in volunteers as well as in patients.

Electromagnetic Phenomena↗
PubMed1980

An improved method for the analysis of xenon-133 washin and washout curves.

A method is described for analysis of xenon-133 washin and washout curves, in the presence of a slowly varying background. The method uses least-squares fitting of a single exponential together with a quadratic function to correct for the background. The method has been applied both to simulated data and to data from 25 patients. The accuracy in the relevant lung parameters was 5% over a wide range of the specific ventilation. A comparison is made with other methods in use to measure regional lung-function parameters. Our method produces reliable results even when specific ventilation is low, which can occur in patients with chronic airflow obstruction, where other methods may incur errors of more than 45%.

Airway Obstruction↗
PubMedDate not supplied

Changes in functional residual capacity during exercise in patients with exercise-induced asthma.

Forty-eight patients with a history of exercise-induced asthma were exercised on ambient breathing (T = 18-20 degrees C, relative humidity = 45-55%). There were 19 responders and 29 non-responders according to post-exercise spirometry. During the first minutes of exercise at a workload of 25-50 W, the functional residual capacity (FRC) was measured by a rebreathing technique. There was a significant increase in FRC in responders (p less than 0.025). A loose though significant correlation was found between the rise in FRC during exercise and the fall in forced expiratory volume in one second (FEV1) after exercise (r = -0.429, p less than 0.005). The effects of a sympathomimetic drug were studied in five responders submitted to a second exercise test 4 h after the first one. Spirometry returned to normal but FRC remained high between both tests. During the second test neither spirometry nor FRC changed. The results suggest that different mechanisms may be responsible for changes in FRC and in maximal expiratory flow in exercise-induced broncho constriction.

Adolescent↗