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Biomedical subjects

C Eichler

Publications and source records attributed to C Eichler.

At least 19 recordsLinked to original sources

Air in the uterine cavity after embryo transfer.

OBJECTIVE: To examine the effect on the pregnancy rate (PR) caused by air bubbles loaded into the transfer catheter to bracket the embryo-containing medium. DESIGN: Prospective, randomized study. SETTING: One hundred ninety-six consecutive ETs in the Institute of Sterility Treatment. INTERVENTIONS: Air bubbles were loaded into the transfer catheter concomitantly with the medium in group I (n = 98), whereas in group II (n = 98) no air bubbles were used. RESULTS: The PR of group I equals that of group II. CONCLUSIONS: Bracketing the embryo-containing medium by air bubbles offers several advantages, especially the possibility of tracking the air on the ultrasound monitor to localize the embryos after the ET. For these reasons we recommend using the proven method.

Adult

Scurvy.

Scurvy is caused by a deficiency of ascorbic acid. We describe a 31-year-old Hispanic man who had perifollicular hemorrhages, follicular hyperkeratosis, corkscrew hairs, and gingival hemorrhage after consuming a peculiar and restricted diet for 1 year. A diagnosis of scurvy was made and the patient's disease resolved after treatment with vitamin C.

Adult

[Risk of CMV infection and illness after kidney transplantation].

Between 1980 and 1986 465 cadaveric kidney transplants were performed at the Kidney Transplant Centre Berlin-Friedrichshain. The post-transplant risk to acquire a cytomegalovirus (CMV) infection depended on the preoperative CMV antibody status of donor and recipient, on the nettoimmunosuppression and on the recipient's age. The highest infection rate and the most serious courses showed seronegative recipients from seropositive donors. The typical time interval of clinical manifestation included the postoperative months 1-3. A significant dependence of the frequency of infection on different immunosuppressive protocols could not be proven. But there was a significant coincidence between CMV infection and rejection crises. In spite of the raised frequency of rejection crises an influence of the CMV infection on the 1-year-graft and patient survival rates could not be demonstrated. Both an early diagnosis and an adequate therapy are of particular importance.

Age Factors

[Immunohistologic differentiation of interstitial infiltration cells in biopsies of transplanted kidneys].

Despite known morphological criteria of kidney allograft rejection a definite diagnosis of interstitial rejection in not possible in each case. Therefore, by an enzyme histological differentiation of infiltrating cells in the transplant biopsy specimen this problem should be solved. It was used the PAP method against pan T lymphocytes, T4 and T8 lymphocytes, monocytes and granulocytes. An acute interstitial rejection can be verified if 1. the number of lymphocytes and their subpopulations did increase over the maximum values, 2. without vascular rejection is the T4/T8 ration less than 1 and 3. in the presence of vascular rejection is the T4/T8 ratio greater than 1. Additional information about cyclosporin injury or viral infections may be possible. It is possible increase markedly the rate of safer diagnosis by immunohistological differentiation of infiltrating cells.

Biopsy

[Incidence and prognostic value of cytomegalovirus-specific antibodies of the IgM class in kidney transplant recipients].

In a retrospective study of 326 patients which have been received a renal allograft between 1985 and 1988 at the Berlin Kidney Transplant Centre, all recipients were divided into 3 groups according to their antibody status against cytomegalovirus (IgM+/IgG+; IgM-/IgG+; IgM-/IgG-). Frequency and severity of CMV infections in the early period after kidney transplantation have been compared. Primary infections could be observed in 51/112 (45.5%) patients (group 3), secondary infections in 60/190 (31.6%) patients (group 2). In 7.4% of all recipients (24/326) CMV-specific IgM antibodies could be found at the time of transplantation (group 1). In primary infections the patients have had a significantly higher frequency of moderate or severe CMV diseases as in secondary infections (24.4 vs. 8.3%). In group 3 this frequency was 16.7%. In conclusion, it is not necessary to select renal allograft recipients according their positive CMV-IgM-antibody status, but a close-meshed posttransplant control is indicated.

Antibodies, Viral

[Detection of cytomegaloviruses using monoclonal antibodies in aspiration biopsy material of kidney transplants].

In 56 kidney transplant recipients 93 specimens from transplant aspiration biopsy and peripheral blood were examined on the presence of cytomegalovirus (CMV) using the monoclonal antibody (mab) H 11. The used mab H 11 did react safe and exclusive in the acute infection period with the virus antigen. This antigen detection makes possible the laboratory diagnosis of a CMV infection 11 days (median value) prior to detection of specific IgM antibodies. In comparison with the cytological evaluation of fine needle aspiration biopsy the rejection process could be differentiated from infection.

Antibodies, Monoclonal

[Analysis of T-cell subpopulations and expression patterns of lymphocytic activation markers in patients in the early phase following kidney transplantation using laser flow cytometry].

In 10 patients after kidney transplantation the T cell subpopulations (CD4, CD8) and the number of activated lymphocytes (IL-2R and transferrin receptor+, 4F2+, HLA-DR+, CD3+) in the peripheral blood were determined. In 9 out of 9 cases with rejection a clear immune activation could observed. In patients with CMV-associated rejection crisis the CD4/CD8 ratio was significantly higher compared with patients with rejection crisis but without CMV infection. In all patients with CMV infection (n = 5) an increase of activated lymphocytes was observed. In a clinical-immunological monitoring the dynamics of the CD4/CD8 ratio, the expression of activation marker (especially CD3+, HLA-DR+ and 4F2+) and the absolute number of lymphocyte subpopulations should included.

Adult

[PUVA treatment of organ transplants--experimental and clinical results].

The aim of the present study was to evaluate the influence of a pretreatment of the heart and kidney donor with the photosensitizer 8-methoxypsoralen plus ex vivo longwave ultraviolet irradiation of the graft (PUVA) on survival time and immunogenicity of rat heart and kidney allografts. PUVA pretreatment significantly prolonged the survival of these transplants in allogenic recipients. Furthermore, a synergistic effect with conventional immunosuppression (azathioprine, cyclosporine) was demonstrated. Immunohistological studies using monoclonal antibodies showed a significant reduction of MHC class II antigen expression in heart cryostat sections after PUVA treatment. In clinical kidney transplantation the number of rejection episodes was significantly lower in the first 3 months in the PUVA-treated patient group.

Adult

Prolonged rat heart allograft survival and reduced graft immunogenicity after photochemical donor and transplant pretreatment.

The purpose of these experiments was to evaluate the influence of pretreatment of the heart donor with the photosensitizer 8-methoxypsoralen plus ex vivo longwave ultraviolet irradiation of the graft (PUVA) on survival time and immunogenicity of rat heart allografts in a donor-recipient combination that was different at the major histocompatibility complex (MHC). PUVA treatment of the donor hearts significantly prolonged their survival in allogeneic recipients. The efficacy of this therapy was dependent on the time of ultraviolet irradiation. Immunohistological studies using monoclonal antibodies to rat MHC class I and II antigens showed a significant reduction of class II antigen expression in heart cryostat sections after PUVA treatment. No differences were seen in the tissue distribution of class I antigen. This reduction of donor MHC class II antigens may influence the antigen presentation as well as the activation of T helper cells. In conclusion, PUVA treatment is effective to reduce the immunogenicity and to improve the graft survival time of rat heart allografts. These experimental findings are new and suggest a possible clinical application of photochemical pretreatment.

Animals

Reduced MHC class II antigen expression on rat heart and kidney cells after in vitro exposure to longwave ultraviolet irradiation.

The pretreatment of both kidney and heart donor with the photosensitizer 8-methoxy-psoralen followed by in vitro longwave ultraviolet graft irradiation (PUVA therapy) significantly prolonged graft survival times in rats even across a strong major histocompatibility complex (MHC) barrier. Immunohistological studies using monoclonal antibodies (Mab) to rat MHC class I and II antigens showed a significant reduction of class II antigen expression after PUVA therapy in both Sprague-Dawley rat kidneys and hearts. Using MHC class I Mab there were no differences in distribution pattern in untreated as well as in PUVA treated organs. Thus, our results represent the first in vivo evidence that photochemotherapy-induced graft survival time prolongation is closely connected with its ability to reduce MHC class II antigen expression.

Animals

[Echocardiography findings before and following beta-irradiation (106Ru/106Rh) of choroid melanoma].

Echographic follow-up examinations were performed in 72 patients in whom a choroidal melanoma was treated with (106Ru/106Rh) applicators. The observation period was between 6 and 15 months. Echographic measurement of tumor prominence and assessment of the degree of reflection proved to be important indicators for judging the success of beta radiation therapy. If the prominence diminishes and the degree of reflection increases after treatment, regression of the tumor may safely be assumed to have occurred. Apart from an increase in the prominence of the tumor, a constantly low or even falling level of reflection are signs of a less favorable prognosis.

Choroid

[Persistence of antibodies of the IgG class against cytomegaloviruses in blood donors].

High titre plasmas gained from blood donors are the initial material used for producing human immunoglobulin containing cytomegalovirus antibodies (CMV-HIG). For this purpose the sera gained from 467 permanent donors at the District Institute for Blood and Transfusion Service in Berlin were investigated on their CMV antibody content of IgG class by means of an indirect immunofluorescence test (IFT). The infection rate of blood donors amounted to 62% (291/467). CMV-IgG titre greater than or equal to 1:40 was determined in 88 sera (18.8%) and greater than or equal to 1:160 in 14 sera (3%). Two CMV-HIG laboratory samples (charges 3113 and 3117) were produced from these plasmas. Particularly immunoglobulin fraction of charge 3117 (No. 3117 N II) revealed excellent antibody titres (IFT 1:640 [CMV-IgG] or 1:40 [CMV-IgM] respectively, neutralisation test 1:32). Checks made with the donors' CMV-IgG titres after repeated application of plasmapheresis resulted in maximal titres changes of two dilution stages in a period of 15 months. Thus, in producing CMV-HIG a sure, tested pool of donors can be resorted to.

Antibodies, Viral

[In vitro sensitivity of T lymphocytes to theophylline in healthy adults and patients following cadaver kidney allotransplantation].

In the peripheral blood of healthy adults the number of theophylline-resistant T-lymphocytes (T-res) is 51 +/- 4% and 1,161 +/- 326/microliter, respectively, and the number of theophyllins-sensitive 11 +/- 2% and 252 +/- 95/microliters. The membrane markers show a heterogeneous distribution. The quotient from T-res/T-sens is 4.9 +/- 1.3. Within the T-sens 14% are CD4+ and 30% CD8+, 29% carry Fc-IgC and 34% Fc-IgM-receptors. Thus the T-res in their netto-function were helper cells and the T-sens suppressor/cytotox cells. Before the transplantation the preoperative ratio of the two subpopulation is significantly diminished (Q = 3.66 +/- 1.53), however, prognostic statements cannot be deduced from this. Activations of the immune system (rejection crises, cytomegalovirus infections) are accompanied by significant diminutions of the T-sens, whereby the T-res/T-sens-Quotient increases. Thus they are unequivocally included into immunoregulatory processes.

Adolescent