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B Kurtz

Publications and source records attributed to B Kurtz.

At least 19 recordsLinked to original sources

lambda 5, but not mu, is required for B cell maturation in a unique gamma 2b transgenic mouse line.

gamma 2b transgenic mice have a severe B cell defect, apparently caused by strong feedback inhibition of endogenous H-gene rearrangement coupled with an inability of gamma 2b to provide the survival/maturation functions of mu. A unique gamma 2b transgenic line, named the C line, was found to permit B cell development. When the C line is crossed with a mu-membrane knockout line, gamma 2b+ B cells develop in the homozygous knockout. In contrast, a transgenic line representative of all the other gamma 2b lines is completely B cell deficient when mu-mem is deleted. Strikingly, the C phenotype is dominant in C x other gamma 2b transgenic line crosses. There is no evidence for higher gamma 2b transgene expression or other position effects on the transgene in the C mouse. The sequences of the three gamma 2b transgene copies in the C line are identical to that of the original transgene. These results have led to the conclusion that in the C line the transgene integration constitutively induces a gene whose expression can replace mu. To more clearly delineate the stage at which the altered phenotype of the C line is expressed, C mice were crossed onto a lambda 5 knockout background. In the absence of lambda 5, the C line produces no B cells. Since it was also found that gamma 2b can associate with the surrogate light chain (sL; lambda 5/Vpre-B), the crosses between C line gamma 2b mice and lambda 5 knockout mice suggest that gamma 2b/sL is required for B cell maturation in this mouse line. Thus, gamma 2b alone is unable to replace mu for pre-B cell survival/maturation; however, in combination with an unknown factor and the sL, gamma 2b can provide these nurturing functions.

Alleles

Crossing the SJL lambda locus into kappa-knockout mice reveals a dysfunction of the lambda 1-containing immunoglobulin receptor in B cell differentiation.

Mice of the SJL strain produce approximately 50 times less serum lambda 1 immunoglobulin light chains than other mouse strains. The defect is genetically linked to the lambda locus, but it is unknown whether it is due to regulatory alterations or known structural changes. We find no mutation in the SJL lambda 3-1 enhancer which regulates both lambda 1 and lambda 3. To investigate the defect further, the production of lambda light chains was amplified by crossing SJL with kappa-knockout mice. In kappa-knockout mice with the wildtype lambda locus (kappa -/- lambda +/+), the majority of serum light chains are lambda 1. In contrast, kappa-knockout mice with the SJL lambda locus (kappa -/- lambda s/s) show a pronounced expression of lambda 2 and lambda 3, with only some expression of lambda 1. The results show that the SJL defect is lambda 1 specific, since the linked lambda 3 expression is normal. As the transcription and rearrangement of lambda 1 appear normal in SJL, the defective lambda 1 synthesis is most likely due to a point mutation in the lambda 1 constant region resulting in a glycine to valine substitution. At the cellular level, in kappa-knockout mice with the SJL lambda locus there are fewer immature, and especially mature, lambda 1 B cells and the production of lambda 1 plasma cells is strongly inhibited. The lambda 1 specificity of the defect suggests that the point mutation in SJL C lambda 1 creates an immunoglobulin receptor complex which is dysfunctional in B cell differentiation.

Animals

Ultrasound diagnosis of splenic lymphoma: ROC analysis of multidimensional splenic indices.

To assess the efficacy of splenic size in the sonographic diagnosis of lymphomatous involvement of the spleen, the authors studied 31 patients with splenic lymphoma (Hodgkin's disease, 17 and non-Hodgkin's lymphoma, 14) and 218 individuals without evidence of splenic disease. All subjects were studied with both a linear and a sector transducer. The longitudinal, transverse and diagonal diameters of the spleen were measured, and two- and three-dimensional splenic indices were calculated. The analysis of the diagnostic performance of these criteria, compared by means of receiver-operating characteristic (ROC) curves, revealed that diagnosis of splenic involvement by malignant lymphoma was considerably more reliable with a sector than with a linear scanner. If the longitudinal diameter was measured with a sector scanner, sensitivities were 66% and 74%, at specificities of 95% and 90% respectively (cut-off points: 12.5 cm and 11.3 cm, respectively). For the sector scanner, there was no advantage in using other diameters or multidimensional indices. Additional ROC analysis of recently published data indicating excellent discrimination capacity of a computed tomography index revealed that these results were largely owing to patient selection. In contrast, our data suggest that the potential of current non-invasive assessment of splenic lymphoma is limited. However, ultrasound may eventually help to eliminate staging laparotomy in selected cases, e.g. in patients with low risk of abdominal disease and with increased surgical risk.

Adult

[Transhepatic balloon dilatation of the ductus choledochus and the removal of choledochal calculi].

In eight patients with stones in the bile duct, the concretions were removed percutaneously; in six, they were pushed into the duodenum following dilatation of the papilla and in two patients they were removed percutaneously by a transhepatic route using a Dormier basket. In two patients a stenosis at a choledocho-jejunostomy was successfully dilated by a percutaneously introduced balloon catheter. In five patients stenoses due to tumours of the bile duct were dilated percutaneously and an endoprosthesis introduced. There were no serious complications. The percutaneous transhepatic approach for the treatment of bile duct stones and of malignant obstruction is a valuable alternative to endoscopic and surgical treatment.

Aged

[Comparative diagnosis of focal liver changes using computed tomographic and scintigraphic methods].

The value of scintigraphic methods for the diagnosis of focal lesions of the liver (IDA, colloids, blood pool) in comparison to dynamic sequential computer tomography (CT) has been examined in this study. We found CT to be diagnostic in typical cases. For example, focal nodular hyperplasia is characterized by a rapid, strong increase and subsequent decrease after application of contrast medium (71%), whereas hemangiomas show a delayed density increase mostly at the rim (20%). In the event of deviations from the typical pattern, scintigraphic methods have to be applied which then often yield a specific diagnosis, especially in hemangiomas, focal nodular hyperplasia, and adenomas (71%). Ultrasound findings indicating the possible presence of hemangiomas or focal nodular hyperplasia should lead to scintigraphic studies prior to CT, not only for reasons of economy.

Adult

Diagnosis of liver cirrhosis with US: receiver-operating characteristic analysis of multidimensional caudate lobe indexes.

To assess the utility of changes in the volume of the caudate lobe in the sonographic diagnosis of liver cirrhosis, the authors studied 58 patients with histologically proved cirrhosis, 18 patients with fatty liver, 28 patients with liver metastases, seven patients with lymphomatous liver involvement, and 75 healthy individuals. The longitudinal (CL), transverse (CT), and anteroposterior (CAP) diameters of the caudate lobe and the transverse diameter of the right lobe (RL) were measured, and one-, two-, and three-dimensional caudate lobe indexes and ratios were calculated. The analysis of the diagnostic performance of these criteria, compared by means of receiver-operating characteristic curves, revealed that the ratio of the three-dimensional caudate index (CI3) to the right lobe diameter (CI3/RL = [CL X CT X CAP]/RL) was superior to all other calculated criteria. At a specificity of 95%, the sensitivity of CI3/RL was 94.7%, compared with 73.3% for CT/RL. No significant differences were found between the control group and patients with fatty liver, metastases, or lymphomatous involvement. The study suggests that CI3/RL is the most reliable quantitative criterion for the US diagnosis of liver cirrhosis.

Fatty Liver

[Renal involvement in malignant lymphoma: significance of imaging technics for determining spread].

Large autopsy series show an incidence of 33 to 62% of renal involvement in all patients with malignant lymphoma; at the time of diagnosis, this is found only very rarely. The present paper describes three patients with renal involvement at the time of diagnosis. The value of sonography, CT and angiography in detecting renal involvement and its clinical significance in the management of malignant lymphoma is discussed.

Adult

[1st results of the diagnosis of focal liver and spleen lesions using gradient echo sequences].

15 healthy subjects and 39 patients with focal liver and spleen lesions were examined via MR tomography at 1.5 tesla. Gradient field echos at small angle excitation (less than 90 degrees) were employed. The imaging time per layer was 10 seconds so that rapid imaging could be carried out at respiratory standstill. This enabled visualisation of liver and spleen without interference by breathing artifacts and with accurate localisation. Focal lesions can be imaged best at low flip-angle pulses (liver) or low to medium-angle pulses (spleen). The primary liver cell carcinoma is visualised as an inhomogeneous structure with similar signal intensity as the surrounding tissue. All other examined liver lesions (metastases, haemangiomas, lymphatic infiltrates, echinococcus cysts, FNH, gummae) showed greater signal intensity than the remaining organ at small angle excitation. Furthermore, contrast reversals were seen at medium-angle pulses. Contrariwise, with the exception of the light-coloured spleen infarcts, spleen lesions (lymphatic infiltrate, Boeck's disease or sarcoidosis) appeared darker at all excitation angles than the surrounding tissue.

Humans

[Focal changes in the spleen. Ultrasonic morphological characteristics and their clinical significance].

Focal changes in the spleen were rare findings in a large clinical material (less than 1% of cases). In a prospective study, which included 580 patients, lesions in the spleen were found in 40. Four focal lesions were due to infiltrates from non-Hodgkin's lymphoma. Twenty-one lesions with low echoes consisted of twelve infiltrates from Hodgkin's disease (six patients) or non-Hodgkin's lymphoma (six patients), five were due to fresh splenic infarcts and one each to an abscess, a metastasis from a carcinoma of the stomach, sarcoid and a haemorrhage. In only three of ten highly echogenic foci was a diagnosis possible (one leukaemic infiltrate and two scars following splenic infarcts). The significance of the sonographic demonstration of focal splenic lesions for diagnosis and treatment is discussed. The advantages of a sector scanner for evaluation of the spleen and splenic size are mentioned.

Hodgkin Disease

[The internal echo pattern of the normal pancreas. An assessment of the aging process and body weight dependence by sonographic gray-scale analysis].

Sonography of the pancreas was evaluated quantitatively in 94 normal subjects. The grey-scale values in the head and body of the pancreas were measured and compared with those of retroperitoneal fat. The echogenicity of the pancreas and the contrast between pancreas and fat were correlated with the age and weight of the subjects. Semi-quantitative studies revealed a positive correlation between echogenicity and age (r = 0.505); this can be confirmed to a high degree of statistical significance by quantitative analysis of pancreatic grey-scale values (r = 0.55 for the head and 0.71 for the body). Further improved correlation with age is obtained by computing the sonographic contrast between the pancreas and the retroperitoneal fat (r = 0.66 for the head and 0.77 for the body of the pancreas). It is concluded that determination of the grey-scale value can provide additional information particularly if one uses retroperitoneal fat as a reference tissue.

Adipose Tissue

Pharmacokinetics of phenoxymethyl penicillin (penicillin V) in calves.

Phenoxymethyl penicillin (penicillin V) was administered intravenously (i.v.) and orally to pre-ruminant calves and the distribution and elimination kinetics, as well as the oral bioavailability, were determined. After i.v. injection, the drug was distributed rapidly in the body, the elimination half-life (t1/2 beta) was 34 min and the apparent volume of distribution at steady-state (Vd ss) was 0.30 l/kg. Mean peak serum drug concentrations were directly related to the oral dose administered, i.e. 0.22 microgram/ml, 1.06 micrograms/ml and 2.14 micrograms/ml after dosing at 10, 20 and 40 mg/kg, respectively. The elimination t1/2 of the drug after oral dosing varied between 90 and 110 min, and the oral bioavailability was approximately 30% of the dose. The co-administration of phenoxymethyl penicillin and probenecid resulted in elevation and prolongation of serum drug concentration. The percentage of drug bound to serum proteins was 78.8% +/- 8.2%. Phenoxymethyl penicillin was probably inactivated and degraded in the gastrointestinal tract of 6-week-old calves fed exclusively hay, silage and concentrates as very low and erratic serum drug concentrations were measured after these calves were dosed orally with the drug at 40 mg/kg. In view of the narrow antibacterial spectrum of the drug and the relatively high dose required, it appears that phenoxymethyl penicillin can only be of limited practical value for the treatment of bacterial infections in preruminant calves.

Administration, Oral

Clavulanate-potentiated amoxycillin: in vitro antibacterial activity and oral bioavailability in calves.

The minimal inhibitory concentrations (MIC) of amoxycillin and clavulanate-potentiated amoxycillin (amoxycillin:clavulanic acid, 4:1 by weight) were compared for 171 Salmonella, 170 Escherichia coli, and 32 Pasteurella isolates recovered from infected neonatal calves. In the presence of clavulanic acid, the MIC of amoxycillin was reduced to levels less than or equal to 12.5 micrograms/ml for all the Salmonella group B, all the Pasteurella, and for 12 out of the 44 E. coli isolates which were resistant to amoxycillin (MIC greater than or equal to 100.0 micrograms/ml). For isolates sensitive to amoxycillin (MIC less than or equal to 1.56 microgram/ml) there was no change in MIC values in the presence of clavulanic acid. A small proportion of Salmonella and E. coli isolates were resistant to clavulanate-potentiated amoxycillin. In a cross-over trial involving 10 preruminant (2 weeks old) calves, amoxycillin trihydrate and clavulanate-potentiated amoxycillin were administered orally at 10 mg/kg. An analysis of serum amoxycillin level data showed that the pharmacokinetic parameters t1/2ab, Cmax, t1/2 beta, AUC, Cp degree, and f' (estimated drug absorption ratio) were the same after treatment with amoxydrate and clavulanate-potentiated amoxycillin. Administration of clavulanate-potentiated amoxycillin and probenecid resulted in elevation and prolongation of serum amoxycillin levels. Computations showed that in preruminant calves serum amoxycillin concentrations sufficient to inhibit sensitive pathogens can be maintained by oral clavulanate-potentiated amoxycillin treatment at 10 mg/kg TID. At two times that dose rate serum drug concentrations capable of inhibiting 50% of all types of pathogens examined can be maintained.(ABSTRACT TRUNCATED AT 250 WORDS)

Amoxicillin

Clinical pharmacokinetics of five oral cephalosporins in calves.

The minimal inhibitory concentrations (MIC) of cephalexin, cephradine, cefaclor, cefatrizine and cefadroxil for Salmonella species, Escherichia coli and Pasteurella multocida isolated previously from young calves were determined. The MIC90 values for cephalexin, cephradine and cefadroxil ranged between 3.12 micrograms ml-1 and 12.5 micrograms ml-1, whereas those of cefatrizine and cefaclor were 3.12 micrograms ml-1 and 0.78 microgram ml-1, respectively. Each drug was administered intravenously and orally to groups of pre-ruminating calves and orally to early ruminating calves. Although the pharmacokinetic characteristics of the drugs after intravenous injection were similar to other beta-lactam antibiotics, significant differences between the cephalosporins examined were found in respect of certain kinetic parameters. The drugs showed rapid absorption into the systemic circulation after oral administration to pre-ruminating calves but the elimination half-life values (t1/2 beta) varied between three hours (cefaclor and cefadroxil) and nine hours (cefatrizine). The bioavailability of the drugs was about 35 per cent of the administered dose. Co-administration of probenecid with each antibiotic caused a twofold or greater increase in peak serum drug concentrations (Cmax) but the effect on t1/2 beta was variable. Cephalexin, cephradine and cefaclor given to the ruminating calves resulted in very low serum or plasma concentrations and their use should be restricted to younger calves. Cefadroxil was found to give the highest serum concentrations in this age group but had significantly lower bioavailability when compared with the unweaned calves. Provisional oral dosage regimens were computed for each cephalosporin on the basis of the MIC data and the kinetic parameters derived from intravenous and oral drug administration.

Absorption