PubMed Health⌕ Search

Biomedical subjects

D Reichelt

Publications and source records attributed to D Reichelt.

At least 19 recordsLinked to original sources
PubMed1999

[Cryptococcal meningoencephalitis in HIV infected immigrants. Diagnostic and therapeutic aspects with reference to evidence-based medicine"--an overview].

Cryptococcal meningitis is one of the most frequent forms of meningoencephalitis in AIDS patients. Before the introduction of triazole antibiotics like difluconazole, the frequency of this meningitis among AIDS patients was 5-10%, yet declined during the last years. Clinically, nonspecific signs of a meningeal inflammation predominate while focal neurological signs are rare. Rapid institution of high-dose antimycotic therapy is the keystone to improve prognosis and decrease mortality. Antimycotics of choice are amphotericin B, fluconazole, and flucytosin. Diagnosis is established by detection of cryptococcal antigen in cerebrospinal fluid, microscopic demonstration of cryptococci using India-ink, and cryptococcal cultures. Recent developments aim to improve antimycotic therapies. During the last years, lifelong secondary prevention with difluconazole was established. Cryptococci which are resistant against fluconazole and amphotericin B are a special challenge, yet fortunately are rare. Longterm outcome of patients is determined by the progression of the underlying immunosuppression. Therefore, combination of secondary prophylaxis with modern antiviral substances is important. Clinical decision analysis in patients with suspected cryptococcal meningitis is presented using methods from evidence-based medicine.

AIDS-Related Opportunistic Infections↗
PubMed1999

Cerebral vasculopathy in HIV infection revealed by transcranial Doppler: A pilot study.

BACKGROUND AND PURPOSE: There is growing evidence for affection of cerebral vessels during human immunodeficiency virus (HIV) infection. We prospectively evaluated cerebrovascular reserve capacity (CRC) in HIV-seropositive patients by transcranial Doppler sonography (TCD) after systemic administration of acetazolamide. We hypothesized that a disturbed vasoreactivity would reflect the cerebral arteries' involvement in HIV infection. METHODS: We assessed the mean blood flow velocity (BFV) of the middle cerebral artery and its increase after intravenous administration of 1 g acetazolamide (CRC) in 31 HIV-infected individuals without symptoms of cerebrovascular disease (mean+/-SD age, 39+/-11 years). Stenotic or occlusive lesions of the large brain-supplying arteries were excluded by color-coded duplex and transcranial imaging. BFV and CRC were also measured in an age-matched group of 10 healthy control subjects. Patients were classified according to clinical, laboratory, and neurophysiological parameters. We also performed cerebral MRI (n=25) and rheumatological blood tests (n=26). RESULTS: Baseline BFV and CRC both were significantly reduced in HIV-infected patients as compared with control subjects (P<0.05, Student's t test). These findings did not correlate with duration of seropositivity, helper cell count, or other clinical, rheumatological, and neuroradiological findings. CONCLUSIONS: Our findings support the hypothesis of a cerebral vasculopathy etiologically associated with HIV infection.

AIDS Dementia Complex↗
PubMed1998

Progressive peripheral and central sensory tract lesion in HIV-infected patients evidenced by evoked potentials (a three-year follow-up study).

OBJECTIVE: To investigate progression of peripheral and central sensory tract lesion and its correlation to immunological deterioration. METHODS: Clinical and neurophysiological investigation (evoked potentials of the median and tibial nerve) and immunological parameters (CD4-cells, beta 2-microglobuline) were followed up in 160 patients (24 females, 136 males, HIV infection for 2.7 +/- 2.3 years, mv +/- 1 sd) up to four times over approximately 3 years regardless of disease stage and evidence of neurological symptoms. Recordings were done using needle electrodes over the Th12 and C7 spinous process and from the scalp (10/20 system) in the conventional manner. Statistical analysis was performed intraindividually and in comparison to normal laboratory values (n = 96). RESULTS: All parameters deteriorated during the follow-up period. Statistical analysis showed significant differences between probands and patients for evoked potentials, but also a significant deterioration for evoked potentials after three years at the end of the follow-up study. A significant correlation between progressive impairment of evoked potentials and laboratory data was found. CONCLUSION: HIV infection induces a progressive lesion of the ascending sensory tracts. The results indicate a peripheral neuropathy as well as a progressive lesion of the ascending central sensory tracts. Pathogenesis of polyneuropathy and of central sensory tract lesion is up to now conjectural. Laboratory investigations indicate a clear-cut correlation between immunological alterations induced by HIV infection and its neurologic manifestation on ascending sensory tracts.

Adult↗
PubMed1998

Impact of antiretroviral treatment on AIDS dementia: a longitudinal prospective event-related potential study.

We investigated the impact of antiretroviral treatment on event-related potentials (ERP) as a possible marker of AIDS dementia. A total of 154 HIV-infected patients without central nervous system (CNS) neoplasm or opportunistic infection were examined and randomized to receive either zidovudine 500 mg/day or no antiretroviral treatment. The participants were prospectively examined by visually evoked ERP in a longitudinal design. Latencies and amplitudes of ERP were evaluated at the beginning of the study, after 1 year, and after 2 years. After 1 year, 98 patients could be analyzed, 47 of whom were taking zidovudine. In the treatment group, P3 latency was 419 +/- 55 msec at baseline and 424 +/- 52 msec at follow-up (not significant). In the patients without treatment, P3 latency was 437 +/- 42 msec at baseline and 462 +/- 53 msec at follow-up (p < .0001, Wilcoxon test). A significant inverse correlation existed between P3 latency and CD4 cell count in both groups. The increase of P3 latency in untreated patients and a stable P3 latency in treated patients could be confirmed in a subgroup analysis of 21 patients with a follow-up of three examinations in a 2-year period. Our data suggest that zidovudine has a positive impact on AIDS dementia as measured by ERP. This finding was observed in patients in different stages of HIV infection, thus suggesting that zidovudine is indicated in all stages of HIV infection to treat encephalopathy.

AIDS Dementia Complex↗
PubMed1997

High-signal lesions in the midbrain on T1-weighted MRI in an HIV-infected patient.

In addition to opportunistic infections, neoplasms or cerebrovascular complications, metabolic encephalopathies are a classical cause of diffuse brain dysfunction in HIV infection and are frequent in the terminal stage. We report an HIV-infected patient with symmetrical, focally increased signal in the midbrain on proton density-and T1-weighted MRI without corresponding high signal on T2-weighted images or on CT. While the precise nature and cause of this uncommon finding is not fully understood, the available evidence suggests that these lesions might represent a novel metabolic encephalopathy.

AIDS Dementia Complex↗
PubMed1990

[The effect of vitamin E on the survival rate and biochemical parameters such as isocitrate dehydrogenase, lactate and selected peptidases and proteases during endotoxic shock in the rat].

Protective effect of the investigated alpha-tocopherol solution regarding survival and changes of several biochemical parameters in rat endotoxin shock could already be demonstrated after application of the solvent (special oil HCO-60) alone. An additional effect of Vitamin E was observed only in DP IV activity and leukocyte counts.

Animals↗
PubMed1987

[Experiences with bronchoalveolar lavage in disseminated and other lung diseases].

In 860 patients 980 bronchoalveolar lavages were performed. The repeated BAL allows conclusions of the effect of treatment and the prognosis of the disease. BAL is together with other clinical findings an important new method in pulmology. Its value in diagnosis of interstitial pulmonary diseases and other pulmonary diseases is described with special view to occupational expositions.

Alveolitis, Extrinsic Allergic↗
PubMed1984

Co-existence of immunoreactivity to anti-dopamine, anti-serotonin and anti-vasotocin in the cerebral giant neuron of the pond snail Lymnaea stagnalis.

Consecutive sections of certain neurons in the central ganglia of the pond snail Lymnaea stagnalis appear to be immunoreactive to anti-dopamine and anti-serotonin. The Cerebral Giant Neurons stain in addition with anti-vasotocin. The observations indicate the presence of two biogenic amines within the same neuron and in addition their co-existence with a biologically active peptide.

Animals↗
PubMed1980

Photoperiod-dependent neural control of the activity of the neurosecretory canopy cell in the lateral lobes of the cerebral ganglia of the freshwater pulmonate Lymnaea stagnalis (L.).

In the lateral lobes of the cerebral ganglia of the pulmonate freshwater snail Lymnaea stagnalis (L.) one large neurosecretory canopy cell (CC) and two droplet cells (DC) are present. With the ganglion-transplantation technique and with quantitative electron microscopy it is shown that photoperiodic stimuli control the neurosecretory activity of the CC via a stimulatory extrinsic neural pathway. The eyes do not play an important role in this regulatory process. The neurosecretory activity of the DC is not affected by differences in photoperiod. The significance of the photoperiodic control of CC activity is discussed in relation to the pathway for the endocrine control of reproduction which is known to be photoperiod-dependent.

Animals↗
PubMed1980

Immunocytochemical identification of neural elements in the central nervous systems of a snail, some insects, a fish, and a mammal with an antiserum to the molluscan cardio-excitatory tetrapeptide FMRF-amide.

With an antiserum to the molluscan cardio-excitatory tetrapeptide FMRF-amide neurons and/or nerve fibers were immunocytochemically identified in the central nervous systems of a snail (Lymnaea stagnalis), some insects (Leptinotarsa decemlineata, Periplaneta americana, Locusta migratoria, Pieris brassicae), a fish (Poecilia latipinna) and a mammal (mouse). The fact that immunoreactive material was observed in neurohaemal organs (corpora cardiaca of the insects) as well as in axon terminals ending on other neurons, seems to indicate that this peptide can function as a neurohormone and/or as a neurotransmitter. The results sustain the hypothesis that biologically active peptides have a wide distribution in the animal kingdom.

Animals↗
PubMed1980

[Laboratory staged-programme in diseases of the lung. Aspects and recommendation. (author's transl)].

The dynamic of biochemical processes opened recently an enlarged arsenal of new diagnostic possibilities for the physician. The exponential increase of scientific knowledge led to a progressive increase in the frequency of laboratory analyses. First the laboratories attempted to confront this development by means of rationalization of the structure, organization and analytic factors. Today the laboratories are confronted with a wide-spread polypragmasy, the demand of redundant parameters and irrelevant analyses increases. This contradiction can be solved only by a process of interdisciplinary responsibility. Very important is a change with the result of an improvement of the parameterpalettes leading to a rationalization of the diagnosis. Up to now there is a loch of systematical scientific investigations for the objectiveness and improvement of laboratory parameterpalettes concerning basis diagnosis, differential diagnosis and control of therapy effects in lung diseases. Obviously the cause for this problem in the structure and function of the organ "lung". In this special cases laboratory diagnosis possesses inbordinale relevance. As for the diagnostical process parameters of the function as well as X-ray diagnosis and morphological findings possesses priority. In this study an attempt is made to classify the diagnostically relevant parameters and to force them in a staged system of the medical supervision. With this conception the physician has the possibility to demand laboratory investigations on a scientifically founded basis.

Efficiency↗
PubMed1979

ACTH-like immunoreactivity in two electronically coupled giant neurons in the pond snail Lymnaea stagnalis.

Two giant neurons (diameter 130 micron) were identified immunocytochemically by means of the unlabeled antibody enzyme technique with anti-ACTH 1-39 and 1-24 in the pond snail Lymnaea stagnalis. The cells are located in the visceral and the right parietal ganglion, respectively. They contain moderately electron dense elementary granules (diameter 150-160 nm). By means of the intracellular horseradish peroxidase injection technique it was shown that the cells send fibres into the neuropiles of various ganglia and into nerves. Synapses occur on the fine fibre branches in the neuropile. Synapse-like structures were found on the cell bodies and on the major fibres. The giant neurons are electrotonically coupled. With toluidine blue staining for small peptides it was demonstrated that in the central nervous system of the pond snail numerous peptidergic neurons occur in addition to those identified with the classical staining methods for neurosecretion.

Adrenocorticotropic Hormone↗