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Biomedical subjects

C Heinz

Publications and source records attributed to C Heinz.

At least 19 recordsLinked to original sources
PubMed2006

[Uveitis and the aging].

Uveitis can be found in all age groups, but the age of disease onset may provide important information on the etiology of the disease. New data on the epidemiology of uveitis disclose a higher incidence and prevalence in older patients then has previously been found. Masquerade syndromes which mimic uveitis may be found especially in younger and older patients. These have to be excluded from regular intraocular inflammation. Here, intraocular lymphoma plays a major role which is most often associated with severe clinical, diagnostic and therapeutic challenges. One of the major complications of uveitis is cataract formation. Keeping in mind the importance of pre- and postoperative treatment, even implantation of an intraocular lens in older patients with uveitis is currently a safe procedure.

Age Factors↗
PubMed2006

Corneal calcification following intensified treatment with sodium hyaluronate artificial tears.

AIM: To report a potential adverse effect of intensified treatment with sodium hyaluronate artificial tears. METHODS: Five cases of deep calcium deposition in the cornea associated with ocular surface disease and frequent use of hyaluronic acid artificial tears are described. All patients used one formulation of phosphate buffered hyaluronate eye drops when rapid calcification developed. All eyes required corneal graft surgery for visual rehabilitation. Specimens at keratoplasty were available for light microscopy and investigation by dispersive x ray analysis. The phosphate concentration in the medication used for topical treatment was measured and compared to alternative hyaluronate preparations. RESULTS: Light microscopy showed dense mineralisation of the entire stroma. The crystalline deposits consisted of hydroxyapatite, Ca5(PO4)3OH. A 50-fold higher concentration of phosphate was measured in the sodium hyaluronate eye drops used for treatment (50.9 mmol/l) when compared with normal serum. The other hyaluronate formulations showed phosphate concentrations from <0.1 mmol/l to 10.9 mmol/l. CONCLUSIONS: The hyaluronate artificial tear formulation "Hylo-Comod" favours the formation of insoluble crystalline calcium phosphate deposits in presence of epithelial keratopathy. This is because of its high phosphate concentration and typically frequent instillation. Manufacturers and prescribers should be aware that topical preparations may contain considerable amounts of phosphate which may lead to sight threatening corneal complications.

Aged↗
PubMed2006

Transscleral diode laser cyclophotocoagulation as primary surgical treatment for secondary glaucoma in juvenile idiopathic arthritis: high failure rate after short term follow up.

AIM: To evaluate the success rates of transscleral diode cyclophotocoagulation (TD-CPC) for secondary glaucoma in patients with juvenile idiopathic arthritis (JIA) as primary surgical treatment. METHODS: Retrospective chart review of 12 paediatric patients with JIA associated uveitis and secondary open angle glaucoma. RESULTS: 21 eyes of the 12 patients had chronic anterior uveitis, 21 eyes had secondary open angle glaucoma, and 19 eyes were treated 41 times with TD-CPC. Patients underwent a mean of 2.15 treatment sessions per eye. Pretreatment intraocular pressure (IOP) was 30.2 (5.5) mm Hg before the first treatment, 30.5 (5.7) mm Hg before the second treatment, and 28.7 (6.3) mm Hg before the third treatment. Reduction of IOP 6 weeks after treatment was highest after the second and third treatments with 9.4 (8.8) and 8.7 (5.8) mm Hg, respectively and 5.2 (10.7) mm Hg after the first treatment. Qualified success (IOP </=21 mm Hg with glaucoma medication) was achieved at the end of follow up in six of 19 eyes (32%, follow up time 10.1 (9.3) months). CONCLUSION: TD-CPC as a primary surgical treatment in JIA patients, is often unsatisfactory in eyes with uveitic glaucoma.

Antihypertensive Agents↗
PubMed2005

[Vision-threatening complications in childhood uveitis].

PURPOSE: We analyzed the epidemiologic data and vision-threatening complications in different forms of childhood uveitis. METHODS: This retrospective study included 187 consecutive patients with onset of uveitis before the age of 16 years classified as anterior (AU), intermediate (IU), posterior (PU), and panuveitis (PanU). We analyzed the epidemiologic data as well as visual acuity, uveitic complications and the conservative and surgical therapy. RESULTS: Associated disease was observed in 85 of 187 patients. The most common complications in AU patients were cataract, posterior synechiae, band keratopathy and CME. IU was accompanied by dense vitreous opacities, cataract and CME. Macular scars were the most frequent cause for visual loss in PU. PanU was complicated by dense vitreous opacities, cataract, retinal detachment, CME and phthisis bulbi. CONCLUSIONS: Childhood uveitis is frequently associated with systemic immune-mediated diseases. The diverse uveitis types have different but typical complications.

Adolescent↗
PubMed2005

[Uveitis in childhood sarcoidosis].

BACKGROUND: Sarcoidosis is a rare cause of uveitis in childhood. Differentiation from other rheumatic diseases may be difficult. We report on five children with uveitis in childhood sarcoidosis and review the previous literature. RESULTS: Children were aged between seven month and 13 years at the time of diagnosis of uveitis. Four of the five patients had panuveitis, the fifth one had intermediate uveitis. In addition, three children had systemic disease with skin, joint and central nervous system involvement. The two children younger than 5 years showed the clinical triad of eye, joint and skin disease. Uveitic complications included corneal band keratopathy, cataract, posterior synechiae, macular scars and choroidal neovascularisation. Vision-limiting complications were found in six of nine eyes at the first visit. CONCLUSION: In childhood sarcoidosis two clinical courses can be differentiated. Younger children aged up to five years express a clinical triad of arthritis, skin lesions and uveitis. In the older group of patients, the clinical course is more similar to that of adults. Rapid diagnosis and quiescence of disease are of particular importance to improve the long-term visual prognosis.

Adolescent↗
PubMed2005

[Diagnostic and therapeutic recommendations for mucous membrane pemphigoid of the eye].

Mucous membrane pemphigoid (MMP) is often accompanied with a chronic cicatrizing conjunctivitis that may eventually lead to loss of vision. The study is intended to investigate the current scientific knowledge on the diagnosis of and therapy for MMP involving the eye. Previous studies published before December 2004 have been systematically reviewed for their level of evidence. Consequently, recommendations for patient management are provided.

Chronic Disease↗
PubMed2005

Adenoviral p53 gene transfer inhibits human Tenon's capsule fibroblast proliferation.

BACKGROUND/AIM: Although antiproliferative drugs have been used successfully to prevent scarring after filtration surgery in patients with glaucoma, complications associated with their use (such as hypotony or endophthalmitis) energise the search for an alternative treatment. Single application of beta radiation leads to long term growth arrest and expression of p53 in human Tenon's capsule fibroblasts (hTf). The authors assume that the activation of p53 is one of the cellular triggers. Their aim was to analyse the effect of p53 overexpression on hTf and to determine which pathways are involved. METHODS: A recombinant adenoviral vector (rAd.p53) containing transgenes encoding for human p53 and green fluorescent protein (GFP) was used to induce overexpression of p53 in hTF and a control vector (rAd.GFP). Transgene expression was detected by western blot (p53 and p21WAF-1/Cip1). Cell proliferation and viability were investigated using cell counts, 5'-bromodeoxyuridine incorporation (BrdU assay) and tetrazolium reduction (MTT assay). RESULTS: Infection of hTf with rAd.p53 resulted in significant inhibition of cell proliferation, DNA synthesis, and metabolic activity in vitro. Western blot showed increased levels of p53 and p21WAF-1/Cip1 in rAd.p53 infected cells, but not in rAd.GFP and uninfected cells. Apoptosis was excluded with flow cytometry. CONCLUSIONS: Adenoviral p53 gene transfer leads to significant growth inhibition in hTf. P53 induces p21(WAF-1/Cip1) expression and does not cause apoptosis in hTf in vitro. p53 as an antiproliferative drug has the potential to replace mitomycin C and 5-fluorouracil in glaucoma surgery.

Adenoviridae↗
PubMed2004

[Corneal perforation associated with vitamin-A-deficiency].

PURPOSE: Vitamin A has been identified as a substantial substrate for ocular surface integrity. Vitamin A deficiency, which can be caused by different etiologies, may lead to severe complications including corneal perforation. PATIENTS: Case reports of three patients with vitamin A deficiency. The observed etiologies leading to vitamin A deficiency were: (1) primary biliary cirrhosis, (2) malnutrition induced by alcohol abuse, and (3) malabsorption syndrome caused by a graft-versus-host disease of the intestine after bone marrow transplantation. RESULTS: In all three cases vitamin A serum levels were below normal values. In two patients retinol binding protein was also reduced. Two of three had corneal perforation, which required penetrating keratoplasty (pKP). In one of these cases, pKP was performed three times on both eyes due to a rapid corneal stromal melting leading always to corneal perforation. The third case developed severe corneal thinning of both eyes with the formation of a descemetocele. Vitamin A substitution improved symptoms and ocular surface integrity. CONCLUSION: Vitamin A in combination with zinc is a crucial factor for maintaining conjunctival and corneal ocular surface integrity. Moreover, vitamin A regulates mucin production of the ocular surface epithelium, which is known to be an important part of the ocular surface defense. Several different primary diseases might cause vitamin A deficiency. Especially patients with rapid progressive corneal ulceration should be examined for vitamin A deficiency. Substitution of vitamin A should be initiated as early as possible to prevent serious disease progression.

Adult↗
PubMed2003

Mycophenolate mofetil inhibits human Tenon fibroblast proliferation by guanosine depletion.

BACKGROUND/AIM: Mycophenolate mofetil could be a useful antiproliferative drug in glaucoma filtering surgery. In this study the authors set out to investigate whether growth inhibition of mycophenolate mofetil on human Tenon fibroblasts is mediated by guanosine depletion. METHODS: Cultured human Tenon fibroblasts were incubated in various concentrations of mycophenolate mofetil with and without supplementation of guanosine. RESULTS: Growth inhibition was concentration dependent. The effect could be completely antagonised by guanosine supplement. CONCLUSION: Human Tenon fibroblasts depend on the de novo synthesis pathway of guanosine. No sufficient salvage pathway from purine degradation appears to exist.

Cell Division↗
PubMed2000

Selective extraction and purification of a mycobacterial outer membrane protein.

MspA forms water-filled channels in the mycolic acid layer of Mycobacterium smegmatis thereby allowing the diffusion of hydrophilic solutes through this permeability barrier into the periplasm. MspA is the first member of a new family of porins and is extremely stable against chemical and thermal denaturation. We developed a purification procedure based on selective extraction of MspA with detergents from whole cells of M. smegmatis at high temperatures. Anion-exchange and size-exclusion chromatography yielded about 230 microg apparently pure and highly active MspA per liter of culture. This was a 20-fold increased yield compared to previous purification protocols. Similar amounts of pure MspA were obtained with the detergents isotridecylpolyethyleneglycolether, lauryldimethylamine oxide, and octylpolyethylene oxide indicating that this purification procedure is not restricted to a specific detergent. This study will promote the structural and functional analysis of MspA and might be valuable for the isolation of porins from other mycolic acid-containing bacteria.

Chromatography, Ion Exchange↗
PubMed1999

Cloning of the mspA gene encoding a porin from Mycobacterium smegmatis.

Porins form channels in the mycolic acid layer of mycobacteria and thereby control access of hydrophilic molecules to the cell. We purified a 100 kDa protein from Mycobacterium smegmatis and demonstrated its channel-forming activity by reconstitution in planar lipid bilayers. The mspA gene encodes a mature protein of 184 amino acids and an N-terminal signal sequence. MALDI mass spectrometry of the purified porin revealed a mass of 19 406 Da, in agreement with the predicted mass of mature MspA. Dissociation of the porin by boiling in 80% dimethyl sulphoxide yielded the MspA monomer, which did not form channels any more. Escherichia coli cells expressing the mspA gene produced the MspA monomer and a 100 kDa protein, which had the same channel-forming activity as whole-cell extracts of M. smegmatis with organic solvents. These proteins were specifically detected by a polyclonal antiserum that was raised to purified MspA of M. smegmatis. These results demonstrate that the mspA gene encodes a protein of M. smegmatis, which assembles to an extremely stable oligomer with high channel-forming activity. Database searches did not reveal significant similarities to any other known protein. Southern blots showed that the chromosomes of fast-growing mycobacterial species contain homologous sequences to mspA, whereas no hybridization could be detected with DNA from slow growing mycobacteria. These results suggest that MspA is the prototype of a new class of channel-forming proteins.

Amino Acid Sequence↗
PubMed1999

Fat mass in infants and toddlers: comparability of total body water, total body potassium, total body electrical conductivity, and dual-energy X-ray absorptiometry.

BACKGROUND: Accurate assessment of body composition in infants and children is fundamental to understanding normal growth and development. Validation of methods applicable to pediatric populations is needed. In the absence of a gold standard, this study was conducted to compare methods using total body water, total body potassium, total body electrical conductivity, and dual-energy x-ray absorptiometry measurements for the estimation of body fat mass in infants and toddlers. METHODS: Repeated body composition measurements were performed on 76 healthy term infants at 0.5, 3, 6, 9, 12, 18, and 24 months of age. Total body water was determined by deuterium dilution and converted to fat-free mass. Total body electrical conductivity was used to measure fat mass. Total body potassium was estimated by whole-body counting and converted to fat-free mass. Dual-energy x-ray absorptiometry was used to estimate fat mass at 0.5, 12, and 24 months only. Data were analyzed by repeated measures analysis of variance, followed by Bonferroni multiple comparisons at 5%. RESULTS: Significant differences among methods were encountered at each age (p = 0.001-0.05). The rank order of the methods and the magnitude of the method differences were a function of age, not of gender or infant feeding mode. Wide limits of agreement imply that the methods are not interchangeable for group or individual measurements. CONCLUSIONS: Methods using total body water, total body potassium, total body electrical conductivity, and dual-energy x-ray absorptiometry to estimate body fat mass in infants and toddlers are not interchangeable and require further development and validation.

Absorptiometry, Photon↗
PubMed1992

[Basic considerations in the rehabilitation of foreign workers].

Rehabilitation involves executive duties, the patient must actively cooperate with the rehabilitation team, and both sides must set clear goals. In the case of rehabilitation of foreigners, it is difficult to set goals because of language and cultural differences. The rehabilitation clinic in Bellikon hospitalizes so many foreigners that it decided to comply with their demands by choosing a specific personnel. In fact, with the purpose of improving the basis for communication, the clinic employs therapists and nursing staff that come from other countries and cultures, offering them further vocational training, too. Not only should misunderstandings and feelings of frustration be avoided as far as possible, but interactive therapy should become the foundation stone for a successful treatment and rehabilitation. The conference on rehabilitation that was organized by the SAR in autumn 1991 made up a part of these efforts.

Cultural Characteristics↗
PubMed1991

[Rehabilitation of patients following brain injuries: specialized institution or general rehab center?].

The capacity for the rehabilitation of patients who have been affected by a brain injury does not meet the needs. Additional capacities are to be created in Switzerland. It is discussed whether it is preferable to create specialised institutions for the rehabilitation of the brain injured patient or whether these patients should rather be admitted to general rehabilitation centers. The advantages and disadvantages of these two options are discussed. The advantages of the admission of brain injured patients to general rehabilitation centers is stressed and the demand for special strategies and staff is described.

Brain Injuries↗
PubMed1991

[Analysis of health care needs and evaluation five years after severe brain injuries].

Five years after severe head injury with persistent and extensive deficits of brain functions and loss of working capacity, an assessment and analysis of demand was performed with 31 patients and their relatives. The main impairments consist in the severe changes of personality and in cognitive deficits; they contrast with the spare physical handicaps. A main demand of the relatives are local family groups which are still lacking in many parts of the country.

Activities of Daily Living↗
PubMed1990

[Subjective sequelae of splenectomy].

111 of 806 former patients splenectomized at the Würzburg university hospital during the years 1968-1983 were interviewed for their complaints since their operation. Investigations included the use of Beck's inventory for measuring depression and the Giessen questionnaire for the evaluation of general complaints used in psychosomatic medicine. There was a significant increase of symptoms after splenectomy as compared to the normal population. A special list of 18 questions to investigate typical postsplenectomy complaints was answered by 95 of these 111 persons and by a control group of "statistical twins" with similar upper abdominal surgery without splenectomy. The leading difference was the highly significant increase of the susceptibility to infections after splenic loss followed by accelerated exhaustion and increased physical and mental weakness. The distribution of other complaints like for instance the intolerance to alcohol hitherto judged as typical sequelae of splenectomy was not statistically different in both splenectomy was not statistically different in both groups. Since the symptoms listed above as significantly increased in the splenectomized patient were closely correlated with the susceptibility to infection they seem to be rather the expression of the decreased resistance than direct consequences of the loss of the spleen.

Adolescent↗