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Biomedical subjects

D Boehm

Publications and source records attributed to D Boehm.

25 records · Page 2Linked to original sources

Effectiveness of HB2 (anti-CD7)--saporin immunotoxin in an in vivo model of human T-cell leukaemia developed in severe combined immunodeficient mice.

The transplantation of the human T-cell acute lymphoblastic leukaemia (T-ALL) cell line HSB-2 into severe combined immunodeficient (SCID) mice was found to produce a disseminated pattern of leukaemia similar to that seen in man. The intravenous injection of 10(7) HSB-2 cells was associated with a universally fatal leukaemia. Histopathological examination of animals revealed the spread of leukaemia initially from bone marrow to involve all major organs including the meninges. An immunotoxin (HB2-Sap) was constructed by conjugating the anti-CD7 MAb HB2 to the ribosome-inactivating protein saporin. An in vitro protein synthesis inhibition assay revealed specific delivery of HB2-Sap immunotoxin (IT) to CD7+ HSB-2 target cells with an IC50 of 4.5 pM. When SCID mice were injected with 10(6) HSB-2 cells and then treated 8 days later with a single intravenous dose of 10 micrograms of immunotoxin there was a significant therapeutic effect evidenced by the numbers of animals surviving in the therapy group compared with untreated controls (chi 2 = 5.348, P = 0.021). These results demonstrate the useful application of human leukaemia xenografts in SCID mice and the potential therapeutic effect of an anti-CD7 immunotoxin in human T-ALL.

Animals↗

Extended cardiopulmonary preservation: University of Wisconsin solution versus Bretschneider's cardioplegic solution.

Application of the University of Wisconsin cold storage solution has rapidly expanded to include medium-term to long-term preservation of virtually all intraabdominal organs. Its use in intrathoracic organ transplantation has also been suggested. We therefore examined the efficacy of the University of Wisconsin solution in a primate allotransplantation model for preservation of hearts, and as a simple single-solution system for static preservation of heart-lung blocks, for periods of ischemia ranging from 6 to 24 hours. For comparison, we employed the histidine-tryptophane-ketoglutarate cardioplegic solution of Bretschneider. University of Wisconsin solution provided superior results with regard to clinical outcome and hemodynamic recovery of hearts after ischemic periods of up to 16 hours. This was in contrast to Bretschneider's solution, which allowed storage of hearts for periods of only up to 10 hours. Heart-lung blocks were equally well preserved with either University of Wisconsin or Bretschneider's solution after 6 to 12 hours, although the University of Wisconsin solution group exhibited a more notable increase in pulmonary water content. This was in accordance with histological data, which suggested that, although hemodynamic recovery of hearts stored for periods longer than 10 hours was poor, preservation of pulmonary ultrastructure was far superior using Bretschneider's solution as compared with University of Wisconsin solution after an ischemic period of up to 16 hours.

Adenosine↗

Case report. Disseminated sporotrichosis presenting as sarcoidosis: electron microscopic and immunologic studies.

A 50-year-old black man with constitutional symptoms, cutaneous nodules, and bilateral hilar adenopathy was found to have non-caseating granulomata on bronchial biopsy. He was treated with corticosteroids for sarcoidosis. Within five months he was found to have disseminated sporotrichosis. Electron microscopy revealed mycelial forms of S. schenckii in superficial lesions and yeast forms from deep tissue sites: no novel forms were seen. Blood mononuclear cell studies revealed hyperactive suppressor cells with respect to non-specific T cell targets and the antigen specific target. Examination of the initial biopsy material after digestion with diastase before PAS staining revealed budding yeast consistent with S. schenckii. This case emphasizes the need for careful histopathologic examination of clinical material before a diagnosis of sarcoidosis is made, and reveals an immunologic abnormality which may account for the patient's anergic state and susceptibility to S. schenckii infection.

Bronchial Diseases↗

The stabilizing sling for the long head of the biceps tendon in the rotator cuff interval. A histoanatomic study.

A histoanatomic study of the rotator cuff interval was done in 13 cadaveric specimens to investigate the relation of its ligamentous structures to the long head of the biceps tendon, with a special focus on revealing a stabilizing function. After macroscopic evaluation, the lateral half of the rotator cuff interval capsule was cut into three sections: medial, middle, and lateral. These sections were embedded in methacrylate, and then serial sections were made and stained for polarized light microscopy. The superior glenohumeral ligament was seen to form a fold having the macroscopic appearance of a U-shaped anterior suspension sling for the long head of the biceps tendon. Microscopic evaluation revealed an important role of the fasciculus obliquus in the roof of this sling. Fibers of the supraspinatus tendon join the posterosuperior part of the sling. The subscapularis tendon is not involved in this suspensory mechanism. As a result of these observations, we determined that the superior glenohumeral ligament and the fasciculus obliquus are the most important ligamentous reinforcements of a stabilizing sling for the long head of the biceps tendon in the rotator cuff interval. Their histologic appearance indicates they function to protect the long head of the biceps against anterior shearing stress. A lesion of this sling might lead to anterior instability of the biceps tendon.

Adult↗

Women and HIV/AIDS: act local/think global.

The numbers of those affected by the HIV virus worldwide are staggering. Emerging research demonstrates a number of lower cost medical approaches that would significantly reduce the rates of transmission of the virus. Nursing plays a critical role in quality-of-life issues at time of diagnosis. Supportive caregiving by compassionate use of vocabulary and knowledgeable resourcing for patients is part of nursing practice in HIV/AIDS care.

Adolescent↗

Heterotopic heart transplantation in 1988--recent selective indications and outcome.

Considering a worldwide average 1-year survival rate of nearly 90% after orthotopic heart transplantation, the question arises as to whether there is still an indication for heterotopic heart transplantation. Since 1967, 132 heart transplantations have been performed at our institution. From 1974 to 1983 only heterotopic transplantations were performed. Since 1985, quadruple-drug therapy has been used for immunosuppression. This consists of low dose cyclosporine in combination with azathioprine, methylprednisolone (in lower dosages), and rabbit antithymocyte globulin (for the first 4 to 6 days after operation and as rescue therapy for severe rejections). Fifty-five transplantations have been performed with this therapy (44 orthotopic and 11 heterotopic). The indications for heterotopic transplantations were either elevated pulmonary vascular resistance (4 to 6 Wood units, n = 6), or a gross donor and recipient weight mismatch (more than 20%) in candidates who showed signs of severe cardiac decompensation (n = 6). One patient had both indications. The 1-year survival rate for those patients was 83%. Currently seven of the 11 patients are alive with life spans ranging from 6 months to 2.5 years after operation. Causes of deaths were infections (n = 3) and chronic graft rejection (n = 1). The recipients were restudied with right-sided heart catheterizations performed from 2 months to 2 years after transplantation. In all patients the cardiac output increased significantly from a mean of 4.0 to 5.8 L/min (p less than 0.0005). In patients with elevated pulmonary vascular resistance, this value decreased after heterotopic transplantation from a mean of 4.9 to 2.4 Wood units.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗