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Biomedical subjects

B Klötzer

Publications and source records attributed to B Klötzer.

At least 19 recordsLinked to original sources
PubMed2000

Plasma homocysteine and lipoprotein profile in patients with peripheral arterial occlusive disease.

Several studies have identified moderate hyperhomocysteinemia (HCy) as an independent risk factor for atherosclerosis. The purpose of this case control study was to determine lipoprotein profile and homocysteine concentration in serum of 85 male patients with peripheral arterial occlusive disease (PAOD) and in 51 normolipidemic age-matched male controls. Cholesterol, triglycerides, and high-density lipoprotein (HDL) cholesterol as well as subfractions HDL2 and HDL3 cholesterol, low-density lipoprotein (LDL) cholesterol, apo B, apo A-I, and lipoprotein particles LpA-I and LpA-I:A-II were measured in serum. Homocysteine, folic acid, and vitamins B6 and B12 were determined with the help of high-pressure liquid chromatography. The 677 C --> T mutation in the methylenetetrahydrofolate reductase (MTHFR) gene was analyzed in PAOD patients. Patients with peripheral arterial occlusive disease showed a significantly higher mean concentration of homocysteine than control subjects (p<0.001). There was a negative correlation between the levels of homocysteine and vitamin B12 as well as folic acid (for vitamin B12: r=-0.40 and for folic acid: r=-0.38). The prevalence of hyperhomocysteinemia (Hcy >16 micromol/L) in the patients was 45% in contrast to 8% in controls. HDL cholesterol, HDL3 cholesterol, Apo A-I, and Lp A-I were significantly reduced in patients and triglycerides were elevated. The elevated plasma homocysteine concentration is frequently seen in homozygous carriers of a point mutation (677 C --> T) in the methylenetetrahydrofolate reductase gene, as the product of this gene is an enzyme, participating in homocysteine remethylation. The homozygous state for the 677 C --> T mutation was found in 13.3% of PAOD patients.

Aged↗
PubMed1998

[Grönblad-Strandberg syndrome from the angiological viewpoint].

HISTORY AND CLINICAL FINDINGS: A 42-year-old man was admitted for treatment of peripheral vascular disease in the left leg (stage III of Fontaine). A year before he had undergone a right aortofemoral bypass operation. On admission there was stenosis of the left pelvic axis and bilateral femoral artery occlusion. In addition there were changes in the skin with abnormal folds, loss of elasticity and yellowish spots over the sides of the neck and the flexor surfaces of all large joints. In addition vision in the left eye was impaired. These findings suggested connective tissue disease involving the skin, eye and arterial system. INVESTIGATIONS: Routine haematological tests were normal as were clotting parameters. Serum concentration of GOT, GPT, gamma-GT were slightly increased. There was a dysproteinaemia with raised HDL and LDL levels. Resting electrocardiogram was normal, showing sinus rhythm and left axis deviation. The crurobrachial pressure index was clearly abnormal: 0.6 on the right and 0.5 on the left. Angiography of the pelvic and left arteries revealed long-segment femoral and partial lower-leg occlusions bilaterally. Abdominal sonography indicated diffuse parenchymal calcifications in both kidneys and angioid streaks on bilateral fundoscopy. Skin biopsy showed defects of elastic fibres and perivascular inflammatory infiltration, while capillary microscopy revealed twisting of the capillaries, most of them with normal lumen. These findings taken together indicated pseudoxanthoma elasticum (PXE) or Grönblad-Strandberg syndrome. TREATMENT AND COURSE: A thrombendarterectomy was performed on the left superficial femoral artery, after which the left popliteal artery became palpable, the pressure indices for the left leg were slightly better, and the patient was discharged home without further complications and improved leg perfusion. CONCLUSION: Possible cardiovascular involvement had to be taken into account in patients with PXE, and long-term angiological monitoring is indicated.

Adult↗
PubMed1998

[Therapy and follow-up of injuries after laparoscopic operations].

From May 1993 to September 1997 we treated 22 patients with complications after laparoscopic surgery. We report on 18 patients after laparoscopic cholecystectomy, three patients after diagnostic laparoscopy and one after TAPP. Two patients died (hepatic failure and without any possibility of definitive therapy) and the injuries of the other 20 patients were repaired.

Biliary Fistula↗
PubMed1990

[Initial experiences in diagnosis of graft rejection following clinical heart transplantation. Detection of graft-directed activated T-cells].

The binding of antigen-loaded carrier to mononuclear cells of heart transplant recipients has been investigated by means of an antigen-specific rosette technique. The increase of rosette forming cells and the inhibition of this reaction with monoclonal antibodies against activated T-cells is a sign of a beginning rejection. 3-6 days later infiltrating immunological competent cells are seen in biopsy.

Adult↗
PubMed1987

[Transplantation antigen specific rosette test and its inhibition with autologous serum--a new immunologic method for predicting rejection crisis following allogeneic organ transplantation].

A combination of transplantation-antigen-specific rosette test with inhibition of rosette formation, using autologous serum, was used in postoperative follow-up checks on patients who had undergone allogeneic kidney transplantation and proved successful in early diagnosis or prediction of rejection episodes even before clinical manifestation. The numbers of antigen-detecting and antigen-binding cells differed considerably from each other, depending on patients who had undergone kidney transplantation. Almost complete inhibition of antigen detection was generally achieved by addition of patient serum. If sensitization to alloantigen in excess of the limit value (30 RBZ/10(3) KHZ) is accompanied by rosette formation with autologous serum addition in excess of about 18 RBZ/10(3) KHZ, clinically relevant rejection can be expected to occur after another two or three days and will have to be treated by immunosuppressives. Such partial or even complete elimination of rosette inhibition is usually only of short length (one day) and has rarely been observed to last longer. No rejection calling for treatment will develop, on the other hand, as long as blocking serum factors provide for high-stability inhibition of any bond of transplantation antigen (rosette formation). Constantly low rosette formation with serum addition and without was exhibited by control persons (blood donors, patients with cerebrocranial trauma) in daily examinations. Limit values of 18 or 30 RBZ/10(3) KHZ were not surpassed.

Graft Rejection↗
PubMed1986

[Immunologic characterization of the rejection of the allogenic transplanted kidney in pigs with and without immunosuppression].

After allogenic renal transplantation in pigs kinetics of the immunological reactivity have been investigated in order to diagnose rejection crisis. In a first series of 26 transplants without any immunosuppression we secured the diagnosis of rejection in 95% of cases of acute or chronic rejection by a combination of antigen-specific rosette test, inhibition of this parameter by autologous serum, complement dependent cytotoxicity and antibody dependent cell-mediated cytotoxicity. The antigen-specific rosette test reacts very early, 2-3 days before a bad clinical feeling in the course of acute rejection or 5-14 days by chronic rejection. Under the therapy with prednisolone and azathioprine we could not reach any prolongation of survival by arbitrary donor-recipient-selection. Under immunosuppression antibodies have never been observed by acute rejection in CDC and ADCC. In every case of acute rejection an increasing rosette formation of specific antigen binding cells appeared 2-3 days before an increasing of serum creatinine. In the case of other complications like infection or thrombosis this test is not reacting. However, by thrombosis of arteria or vena renalis there can be an increased specific rosette formation either independent of this process by beginning of immune reaction or by causal connection of both processes (necrotizing thrombotic rejection). So we have given the evidence, that the antigen-specific rosette test on a high level meets all requirements of a specific diagnosis of rejection under immunosuppression in pig.

Animals↗
PubMed1984

[The importance of active rosette-forming cells and specific antigen-binding cells in the diagnosis of rejection after allogeneic orthotopic kidney transplantation].

After allogeneic renal transplantation in 26 female pigs the kinetics of the immunological reactivity against the graft have been investigated with a specific test, the antigen specific rosette test and an unspecific test, the active E-rosette test. In acute and chronic rejection the level of antigen specific rosette forming cells reflects very well the clinical signs of rejection. Because of early occurrence of immunological reactivity in the case of frequent (daily) testing this test is suitable for a relative sure prediction of rejection episodes. In spite of their relative good correlations to the increase of serum creatinine, posttransplant increase and decrease of active rosette forming cells are not always in an uniform temporal relation to the rejection process. For that reason this test alone is not suitable for diagnosis of rejection. However, high preoperative values (greater than or equal to 18% active T cells) refer to an increased readiness to immunological reactivity of recipient against the graft and reflect contraindication to transplantation. If active rosette forming cells (greater than or equal to 18%) and antigen specific rosette forming cells show maxima at the same time, than follow in high significance strong cell mediated rejections. On this way the active E-rosette test completes the values of the antigen specific rosette test.

Animals↗
PubMed1984

[Antigen-specific rosette inhibition test with autologous serum--a possibility for the detection of blocking factors in chronic rejection of allogeneic orthotopic kidney transplants].

After allogeneic renal transplantation in 26 female pigs the kinetics of the immunological reactivity have been investigated in order to diagnose a rejection crisis. The animals were not treated with immunosuppressive substances. The antigen specific rosette test is an useful parameter for estimation of immune reactions against a graft. Moreover, the inhibition of this test by autologous serum taken in the course of a chronic graft rejection is caused by blocking factors. Therefore this inhibition test would be suitable for an exact determination of specific immune reaction against the graft. By exclusion of false positive results by means of the rosette reaction test a high significant correlation between the antigen specific rosette formation and the clinical symptoms of the rejection could be observed. As long as blocking factors are protecting the graft against activities of immunocompetent cells respectively their effector molecules, recipient serum is able to inhibit the rosette formation. On the other hand a strong increase of rosette forming cells in a pig whose serum does not show an inhibitory activity is correlated with clinical symptoms of a rejection.

Animals↗
PubMed1977

Quantitative alterations of immune serum globulin concentrations in pigs transplanted with a renal allograft.

The variation of immune serum globulin concentrations in 14 pigs was determined after unilateral allogenic renal transplantation. Measures by which it is possible to exert certain immunological influences were not taken. Subsequent to transplantation there was observed a significant decrease in both IgM and IgG which was not correlated with the behaviour of plasma proteins and albumin. Because of the relatively small loss of IgG in the urine of animals on which transplantations were performed, this cannot be considered to be the cause of the decrease in immunoglobulin. It was already on the 3rd day after transplantation that an increase in IgM was observed which after reaching a peak of about + 30% was again followed by a distinct decrease of which the minimum was noted between the 6th and 15th days after transplantation. 10 animals died within the first phase, and in 4 of them death occurred on account of rejection for which histological evidence could be obtained. Although 3 of the 4 animals surviving for a longer period of time were also observed to suffer from distinct rejective crises between the 8th and 15th day after transplantation, they were able to overcome those crises without any therapeutical intervention. After some time, however, they were experiencing another IgM peak (this time greater than + 80%) which was followed, after 3 to 11 days, but the final crisis of rejection and death of the animal. In a few cases, glomerular IgM deposits were found in transplanted kidneys.

Animals↗
PubMed1977

[Animal model for the study of the anhepatic state].

Hepatectomy in the pig is impossible without simultaneous removal of intrahepatic caval vein. The authors covered the vascular gap using a siliconized glass prosthesis, completed with rubber tubes. 16 animals were operated upon in this manner and survived between 6 and 34 hours. In only two cases thrombi were found in the prosthesis.

Animals↗