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Biomedical subjects

B Gerber

Publications and source records attributed to B Gerber.

At least 19 recordsLinked to original sources

A string of enzymes, purification and characterization of a fusion protein comprising the four subunits of the glucose phosphotransferase system of Escherichia coli.

A multidomain protein comprising the four subunits of the glucose phosphotransferase system of Escherichia coli was constructed by fusion of the transmembrane subunit IICBGlc and the three cytoplasmic proteins, IIAGlc, HPr, and enzyme I. The subunits were linked in the above order with Ala-Pro-rich linkers; the fusion protein was overexpressed in E. coli and purified by Ni2+ chelate affinity chromatography. Approximately 3 mg of the fusion protein could be purified from 1 liter of culture. The phosphotransferase activity of the purified fusion protein was 3-4 times higher than that of an equimolar mixture of the isolated subunits. The mannose transporter, which also requires enzyme I and HPr, was not an effective competitor in the overall phosphoryltransfer reaction when the fusion protein was used, whereas it was a competitor when an equimolar mixture of the separate subunits was employed. Transphosphorylation activity of the fusion protein was almost indistinguishable from the wild-type IICBglc. Addition of extra IICBGlc subunit could significantly stimulate the phosphotransferase activity of the fusion protein, addition of extra IIAGlc subunit and enzyme I, in contrast, was slightly inhibitory, and HPr had almost no effect. An optimal detergent-lipid ratio is required for maximum activity of the fusion protein. Our results suggest that Ala-Pro-rich linker sequences may be of general use for the construction of catalytically active fusion proteins with novel properties.

Amino Acid Sequence

[Roentgen morphometry of the shoulder in diseased rotator cuff. Value of plain roentgen examination in comparison with arthroscopy].

A comparison between the pathomorphological substrate and the X-ray morphometry of the shoulder joint was made with 482 arthroscopically treated patients. Radiological parameters and indices for the prediction of the development of the impingement-syndrome were developed from this comparison. With these parameters and indices is it possible to predict the pathomorphological substrate and to differentiate between subacromial and coracoidal impingement.

Acromioclavicular Joint

Surgery for acute ascending aortic dissection: closed versus open distal aortic repair.

One hundred twelve consecutive patients with acute ascending aortic dissection and submitted to immediate surgery were retrospectively analyzed with regard to perioperative mortality and morbidity. The patients were divided into two groups according to whether distal aortic repair was carried out by the open procedure (using deep hypothermic circulatory arrest, group A: 68 patients) or by the closed technique (without circulatory arrest, group B: 44 patients). Patients' ages ranged from 24 to 78 years (mean 57.4 years). No significant difference was found between the two groups in terms of age and sex distribution. However, the prevalence in the extent of clinical and anatomical alterations was significantly higher in group A (hemodynamic instability, pericardial tamponade and neurological deficit). The duration of hypothermic circulatory arrest for group A patients averaged 25 min and ranged from 12 to 65 min. The overall perioperative mortality was 17% (19/112 patients); it was 20.6% (14/68) in group A and 11.4% (5/44) in group B; the difference was not statistically significant but consistent with a clear trend. The trend towards a higher mortality in group A mainly reflected the more severe and complex anatomical characteristics and could not be attributed to the circulatory arrest per se. The period of deep hypothermic circulatory arrest in the survivors (25 min) was similar to that of the group with lethal outcome (32 min). Among the non-lethal complications, however, group A patients more frequently showed clinical signs consistent with cerebral injury: apart from the transient symptoms suggestive in reversible diffuse cerebral damage, five patients in group A had a permanent focal neurological deficit (versus one patient in group B).(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease

[Histology and cytology of laparoscopically operated "simple ovarian cysts"].

In a retrospective study the histopathological findings of 127 laparoscopically operated unilocular anechoic smooth-walled ovarian cysts have been correlated with clinical characteristics (age, duration of observation, complaints, hormonal treatment), size by ultrasound, kind and colour of cysts content as well as cytological findings. The age of patients differed from 16-61 years (mean +/- s: 36 +/- 16). The histopathologic findings yielded 15 (11.8%) functional cysts, 30 (23.6%) persistent corpus luteum cysts, 9 (7.1%) endometriomas, 7 (5.5%) cystic teratomas, 9 (7.1%) undifferenciated cysts and 57 (44.9%) cystadenomas. There were no differences between histopathologic diagnosis groups according to age and cysts size by ultrasound. Functional cysts with complaints (n = 6) may explain that the observation time in 60% of all functional cysts was smaller than 6 weeks, whereas persistent corpus luteum cysts, endometriomas, cystic teratoma and cystadenomas had been observed for longer than 6 weeks in more than two thirds. Intraoperative evaluation of cysts content as "chocolate"-like was suspicious of endometriomas, but was also present in cysts of other histopathological findings. By means of cytology, endometrioma (siderophages) was suspected in 44.4% and a cystadenoma in 42.1% of all histopathologically verified cases. In all, the cytologic findings were useful for correct histopathological diagnosis in only 33.9% of all 127 cases. It is concluded that differential diagnosis of simple ovarian cysts is not possible by clinical characteristics, neither by ultrasound nor by cytological evaluation. Ovarian cysts should be observed for at least two hormonal cycles. A hormonal treatment by combination preparations containing high doses of oestrogen is also recommended. In cases of persisting ovarian cysts laparoscopic removal is necessary.

Adolescent

[Responsibility for patient education and incidence of homologous blood transfusions in unilateral breast cancer operations].

According to a judgement by the German Federal Court of 17 December 1991 the surgeon is legally bound to inform the patient before hand of the risk of a possible homologous blood transfusion during surgery. If the transfusion probability exceeds 5%, this obligation is really relevant, 228 patients with primary breast cancer of stage pT1 - 3N0 - 2M0 had been treated either radically (n = 146) or by a breast-preserving operation (n = 82) from January 1989 to December 1993. 400 to 800 ml erythrocyte preparations had been placed at disposal in advance for each patient. The rate of blood transfusions, pre- and postoperative haemoglobin (Hb), age, tumour size, lymph node involvement, kind and duration of operation as well as postoperative course have been analysed 43 of 228 (18.9%) patients received a homologous blood transfusion within 24 hours after operation. Transfusion rate per year decreased from 39.4% (1989) to 44.8% (1990), 12.2% (1991), 16.6% (1992) and 3.1% in 1993. On the contrary mean pre-and postoperative haemoglobin levels did not differ significantly (p < 0.05) between the different years: 13.4 +/- 0.8 respectively 12.1 +/- 1.1 g/dl (1989) and 13.5 +/- 1.3 respectively 12.1 +/- 1.3 g/dl (1993). Patients who had transfusions were significantly (p < 0.05) more likely to suffer from preoperative anaemia and larger tumors, and they have been treated by mastectomy more frequently compared to patients without transfusion. There were no correlations between transfusions and age, tumour size, lymph node involvement, kind and duration of operation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

[Experiences with 2 different techniques of breast reduction-plasty].

About 58 patients with reduction mammoplasty is reported. 27 women were operated after the technique of Beller and Wagner, 31 women after the technique of Bostwick. The average weight of reduced breast tissue was about 800 g per side in both techniques. The results are reported and critically discussed. The authors prefer the method of Bostwick because of the possibility of more individuality and variability in breast surgery.

Adult

Recombinant human leukemia inhibitory factor is mitogenic for human bone-derived osteoblast-like cells.

Recombinant human leukemia inhibitory factor (rhLIF) is mitogenic for human bone-derived osteoblast-like cells in vitro. [3H]-thymidine incorporation into DNA was stimulated dose-dependently in a prostaglandin E2-independent manner. rhLIF exerted no effect on either the basal or 1,25(OH)2D3-induced synthesis of osteocalcin or alkaline phosphatase (AP) activity. Following treatment with rhLIF, radiolabelled cell nuclei were co-localized with AP, indicating that the mitogenic effect of rhLIF occurs on cells of the osteogenic lineage. Local generation of LIF at the human bone surface may therefore serve as a potential autocrine/paracrine mitogen for progenitor cells of the osteoblastic lineage and so could correlate with the known bone forming properties of LIF.

Alkaline Phosphatase

[Diagnosis of urinary tract infections in puerperium].

Urinary tract infections (UTI) are the most frequent nosocomial infections of women during puerperium. Since, in these women, diagnostic accuracy is affected by lochial secretion, suprapubic urinary bladder puncture (SPB) is recommended. Between December 1989 and January 1993, we subjected 903 women to suprapubic urinary bladder puncture (SpBP) at the 4th or 5th day after delivery. A urine culture of SpBP was done in all cases. Semiquantitative leukocyte counts (n = 891) and nitrite test (n = 830) were done on mid-stream urine (MSU). Side by side with microbiological investigation for urinary tract pathogens via SpPB, MSU was performed in 246 cases immediately after SpPB had been carried out. Leukocyte counts were also estimated in SpBP urine samples. In 370 (41.1%) of 903 SpBP, one or more microorganisms were cultivated. Only 36 (4.0%) of 903 women showed UTI symptoms. Microorganisms were detectable via SpBP in only 26 (72.7%) of these 36 symptomatic patients. Vaginal-operative or secondary caesarean section are related to an increased UTI rate (p < 0.001). UTI were also significantly (p < 0.0001) more frequent in women subjected to catheterisation sub partu (54.5%) compared to no catheterism (24.4%). No significant differences between the number of leukocytes in MSU sediment and the SpBP findings were seen. Semiquantitative leukocyte counts in SpBP offered a significantly (p < 0.001) increased number of leukocytes in cases with microorganism detection in SpBP irrespective of MSU findings. These results justify the designation of uterine tract infection also in the absence of complaints as "infection" and not common "bacteriuria".(ABSTRACT TRUNCATED AT 250 WORDS)

Bacteria

[Changes in surgical treatment of cystic teratoma--620 cases].

Among 3492 patients with ovarian tumors subjected to operation between 1/1957 and 3/1994 at the Department of Obstetrics and Gynaecology at the University of Rostock 620 (17.8%) cases of teratomas were found. Histology findings, age, tumor size, bilaterality and malignity of these 620 cases were analyzed. The histologic differentiation yielded 604 (17.3%) mature teratomas (dermoid cysts), 15 monodermale and 1 immature teratoma. Division of total period in the time before and after 1990-since then we have got the possibility of laparoscopic operation-reveals that presumably by increasing use of ultrasound a decrease in mean age at time of diagnosis from 40.2 +/- 20 to 30.7 +/- 12 as well as in tumor size (9 +/- 4 resp. 4 +/- 2 cm) has been achieved. A secondary malignant transformation of epithelial component has been found in 0.5% (3/604) and bilaterality in 11% of the cases. With regard to general rules of laparoscopic operations the intact dermoid cyst enucleation is recommended in premenopausal and extirpation in postmenopausal women. For opening, reduction of volume, and removal of the dermoid cyst from the abdominal cavity, an endo-bag or endo-catch respectively should be used.

Adolescent

[Puerperal and non-puerperal mastitis].

Report about 82 women with inflammatory breast diseases, who were hospitalized during january 1988 and december 1993. 37 women had a puerperal mastitis, 39 women a non-puerperal mastitis and 6 had perimamillary abscesses. In 35 (42.7%) of the 82 patients abscesses occurred. The different etiology and bacteriology as well as resulting treatment guidelines are discussed. In the treatment of puerperal mastitis, staphylococcus effective penicillins keep the first place. The therapy of non-puerperal mastitis consists in prolactin inhibiting drugs and broad spectrum antibiotics. In abscesses and fistulas surgical treatment is necessary, the same in recurrences. If the process is suspicious for breast cancer diagnostic excision is to perform.

Abscess

Plasma clozapine concentrations predict clinical response in treatment-resistant schizophrenia.

Steady-state blood clozapine concentrations in 58 schizophrenic patients varied more than 45-fold (40-1911 ng/mL) after fixed-dose treatment (400 mg/day). Discriminant function analysis determined that a blood clozapine concentration of 420 ng/mL optimally distinguished responders from nonresponders. After 4 weeks of treatment, only 8% of those patients with a blood clozapine concentration < 420 ng/mL responded compared with 60% of those who had a blood clozapine concentration > 420 ng/mL. When plasma concentrations were increased above 420 ng/mL (by a double-blind random assignment procedure), nonresponders increased their response rate to 73% if their plasma concentrations at Week 12 exceeded 420 ng/mL compared with a response rate of 29% if their Week 12 levels remained below 420 ng/mL (chi 2 = 4.2, p < .04).

Adult

[Postmenopausal hemorrhage and endometrial cancer in tamoxifen therapy].

Report about 8 patients with endometrial pathology during tamoxifen therapy: 1 endometrial cancer, 1 adenomyosis uteri and 6 endometrial polyps. The knowledge about effects of tamoxifen on endometrium and possibilities of prevention are discussed. Sonographic screening of patients during tamoxifen therapy and if need by endometrial biopsy is necessary especially if tamoxifen is given longer than 2 years. No more than 30 mg should given in adjuvant therapy.

Aged

Functional significance of the A-current.

This work considers the response to simulated synaptic inputs of an excitable membrane model. The model is essentially of the Hodgkin-Huxley type, but contains an A-current in addition to sodium and delayed-rectifier potassium channels. The results were compared with previous simulations in which the stimulus was an injected current. These two types of stimuli give somewhat different results because synaptic stimuli directly change the membrane resistance, whereas injected current does not. The results of synaptic stimulation were similar to injected current in that very low frequencies of action potentials were elicited only where the stimulus was slightly above threshold. For most of the range of synaptic inputs that produced oscillatory behavior, the A-current had little effect on oscillation frequency. With synaptic stimuli as with injected current, the model membrane's spiking behavior does not begin immediately when an excitatory stimulus is imposed on a quiescent state. The delay before spiking is closely related to the inactivation time of the A-current. The synaptic results were different from the injected current results in that when substantial inhibition was present, the ability to produce very-low-frequency spiking was absent, even just above the excitatory threshold. The higher the degree of inhibition, the narrower the range of spike frequencies that could be elicited by excitation. At very high inhibition, no degree of excitation could elicit spiking.

Action Potentials

Glycosylation of acute phase proteins and interleukins following hip arthroplasty. Inflammation parameters studied in 10 patients.

We analyzed changes in glycosylation and serum concentrations of alpha 1-acid glycoprotein (AGP), antichymotrypsin (AC), interleukin-6 (IL-6), soluble interleukin-2 receptor (sIL-2R) and C-reactive protein (CRP) following hip arthroplasty. Glycosylation of AGP and AC showed an increased reactivity to concanavalin A between postoperative Day 2 and Day 5 and Day 10, respectively. Serum levels of AGP and AC increased at the earliest on Day 5. The AC levels returned to baseline by Day 10. AGP, however, exhibited increased values beyond Day 14. CRP levels were elevated at Day 2 and remained increased beyond Day 14. sIL2R showed increased values at Days 5, 10 and 14. IL-6 was the first parameter to increase, and it returned to baseline in less than 5 days.

Acute-Phase Proteins

[Granular cell tumor of the breast].

Report about a 46 year old women with granular cell tumor of the breast. Clinical features, mammography and sonography has appearances highly suspicious for breast cancer. Tumorectomy and axillary lymphonodectomy were performed. Estrogen and progesterone receptor both were histochemically and biochemically negative. Estradiol and prolactin levels in serum were normal. Cathepsin D in cytosol was slightly elevated, DNA-flow-cytometry revealed no signs of malignancy. Evident was the high content of protein S100 in cytosol of tumor cells.

Adipose Tissue

[Treatment of acute salpingitis with tetracycline/metronidazole with or without additional balneotherapy, Augmentin or ciprofloxacin/metronidazole: a second-look laparoscopy study].

110 patients suffering from laparoscopical verified salpingitis and desire for a baby, were treated with tetracycline (oxytetracycline or doxycycline; TC)/metronidazole (n = 67), augmentan (n = 22) or cipropfloxacin/metronidazole (n = 21). After an average period of 11.6 weeks, all patients underwent second-look laparoscopy with dye insufflation. In 34 patients treated with TC/metronidazole, the effects of additional physio-therapeutical measures were examined under conditions as they prevail in a Spa. 33 patients without balneotherapy served as controls. All the 4 groups were comparable (p greater than 0.05) in respect of mean age, percentage, share of nulliparous women, salpingitis gonorrhoica, contraceptive behaviour and also of the stage of salpingitis. All antibiotic regimens used resulted in a prompt decrease of inflammatory clinical signs after five days (temperature, blood sedimentation rate, leukocytes). Only 2 of 34 patients treated by additional cure at a Spa reported complaints, whereas complaints were reported by 14 of 33 control patients (p less than 0.01), 7 of 22 (p less than 0.01) treated with augmentan and to 7 of 21 (p less than 0.01) treated with ciprofloxacin/metronidazole. The tubal occlusion rates amounted to 33.3% (TC/metronidazole), 32.3% (TC/metronidazole and balneotherapy), 22.7% (augmentan) and 23.8% ciprofloxacin/metronidazole. The differences did not attain statistical significance (p greater than 0.05). With regard to adhesions, there were, likewise, no significant differences between findings at first laparoscopy and second look-laparoscopy, respectively. It is concluded, that additional physiotherapeutic measures, after antibiotic therapy of acute salpingitis, reduce the frequency of lower abdominal pain, but do not result in an improvement of tubal occlusion and reduction of adhesions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Possible dual effect of synapses that are putatively purely excitatory or purely inhibitory: bases in stability theory and implications for neural network behavior.

Depolarization of an excitable membrane has a dual effect; excitatory in that it causes rapid opening of calcium and/or sodium channels but inhibitory in that it also causes those channels to inactivate. We considered whether apparently paradoxical or dual behavior might be exhibited by excitatory and inhibitory synaptic inputs. We used the classic Hodgkin-Huxley model for voltage-gated channels plus leakage channels of appropriate selectivity for ligand-gated postsynaptic channels. We summarize a model cell's behavior by calculating elicited firing frequency as a function of reversal potential and conductance of summed synaptic inputs, using stability theory and direct simulations. Dual behavior is elicited in the model with reasonable densities of ligand-gated channels. Thus a particular synaptic input to a neuron may be either excitatory or inhibitory depending on simultaneous activity of other synaptic inputs to the cell. This input-output map may give rise to biologically realistic and rich behaviors as an element of computed neural networks, and still be computationally tractable.

Animals

[Late metastasis of a breast carcinoma to the uterine corpus and cervix].

In a 55-years-old woman 11 years after radical operation of a left-sided breast cancer a late metastasis in the uterine corpus was diagnosed and treated by subtotal hysterectomy. In the further course a carcinoma developed in the opposite breast, which may be most probably a second primary breast cancer. However a contralateral metastasis of the earlier treated breast cancer cannot certainly be excluded. Finally, a metastasis of the left sided-breast cancer was diagnosed in the uterine cervix. This case shows, that gynaecological bleedings also may be caused by atypical metastasis of a breast cancer.

Breast Neoplasms