Biomedical subjects

F Jacobs

Publications and source records attributed to F Jacobs.

84 records · Page 5Linked to original sources

PubMedDate not supplied

European Medical Device Directive: impact on nuclear medicine.

The European Council Directive 93/42/EEC concerning medical devices (14 June 1993) assigns new responsibilities and imposes technical requirements both to the manufacturer and user of medical devices. In this paper the general outlines of the directive are discussed with a particular emphasis on the risk classification of products, the compliance and evaluation process and the CE-marking regulations. Furthermore, some practical implications are highlighted for devices and tools relevant to the field of nuclear medicine such as radiation detectors, gamma- and PET-cameras and software.

Absorptiometry, Photon↗

PubMedDate not supplied

MUC1-specific CTLs are non-functional within a pancreatic tumor microenvironment.

Pancreatic cancer is a highly aggressive, treatment refractory disease and is the fourth leading cause of death in the United States. In humans, 90% of pancreatic adenocarcinomas over-express altered forms of a tumor-associated antigen, MUC1 (an epithelial mucin glycoprotein), which is a target for immunotherapy. Using a clinically relevant mouse model of pancreas cancer that demonstrates peripheral and central tolerance to human MUC1 and develops spontaneous tumors of the pancreas, we have previously reported the presence of functionally active, low affinity, MUC1-specific precursor cytotoxic T cells (pCTLs). Hypothesis for this study is that MUC1-based immunization may enhance the low level MUC1-specific immunity that may lead to an effective anti-tumor response. Data demonstrate that MUC1 peptide-based immunization elicits mature MUC1-specific CTLs in the peripheral lymphoid organs. The mature CTLs secrete IFN-gamma and are cytolytic against MUC1-expressing tumor cells in vitro. However, active CTLs that infiltrate the pancreas tumor microenvironment become cytolytically anergic and are tolerized to MUC1 antigen, allowing the tumor to grow. We demonstrate that the CTL tolerance could be reversed at least in vitro with the use of anti-CD40 co-stimulation. The pancreas tumor cells secrete immunosuppressive cytokines, including IL-10 and TGF-beta that are partly responsible for the down-regulation of CTL activity. In addition, they down-regulate their MHC class I molecules to avoid immune recognition. CD4+ CD25+ T regulatory cells, which secrete IL-10, were also found in the tumor environment. Together these data indicate the use of several immune evasion mechanisms by tumor cells to evade CTL killing. Thus altering the tumor microenvironment to make it more conducive to CTL killing may be key in developing a successful anti-cancer immunotherapy.

Adoptive Transfer↗

PubMedDate not supplied

Quinolones in the treatment of lower respiratory tract infections.

Because of their antimicrobial activity and pharmacologic properties, fluoroquinolones should be particularly suitable for the treatment of lower respiratory tract infections, although they might be less efficient in pneumococcal diseases. In fact, the overall clinical success rate of enoxacin, ofloxacin, pefloxacin, and ciprofloxacin is greater than 85%, and their efficacy compares favorably with that of other antibiotics. For acute exacerbation of chronic bronchitis, however, beta-lactam or macrolide agents probably remain a first choice unless sputum reveals gram-negative pathogens; in the same way, drugs other than quinolones seem better indicated in community-acquired pneumonia because of the prevalence of Streptococcus pneumoniae in these infections. In contrast, nosocomial pulmonary infections due to gram-negative pathogens should be excellent candidates for therapy with new quinolones. These drugs, used with or without erythromycin and rifampin, might be useful in the treatment of legionnaires' disease.

4-Quinolones↗

PubMedDate not supplied

Brucella endocarditis: the role of combined medical and surgical treatment.

Brucella endocarditis, although a rare complication of brucellosis, is the main cause of death related to this disease. This report describes a case of aortic endocarditis due to Brucella abortus in an elderly farmer with known aortic stenosis. Urgent valve replacement was performed because of progressive heart failure despite appropriate antimicrobial treatment. The infection was cured with trimethoprim-sulfamethoxazole and rifampin given for 3 months after surgery. A review of the literature reports on the 38 other cases of cured brucella endocarditis made clear the need for combined antimicrobial treatment and surgical valve replacement.

Aged↗

PubMedDate not supplied

Role of bronchoalveolar lavage in diagnosis of disseminated toxoplasmosis.

In three cases of acute disseminated toxoplasmosis developing soon after renal (two patients) or hepatorenal (one patient) transplantation, Toxoplasma gondii trophozoites were visualized on Giemsa-stained smears of bronchoalveolar lavage fluid. Trophozoites were also found in bone marrow smears in one instance. Seroconversion occurred late in two cases and was not detected before the patient's death in the third. These observations underline the potential of bronchoalveolar lavage as a diagnostic procedure for disseminated toxoplasmosis.

Adolescent↗

PubMedDate not supplied

Trichoderma viride infection in a liver transplant recipient.

A liver transplant recipient developed infection of a perihepatic haematoma due to Trichoderma viride. Before the infection was diagnosed, the patient received intense immuno-suppressive and prolonged antibacterial and anti-fungal therapies. Although the death of the patient was not directly related to the fungal infection, abundant quantities of this pathogen were recovered in the haematoma at post-mortem examination, despite previous surgical removal and treatment with amphotericin B and fluconazole.

Adult↗

PubMedDate not supplied

Regional binding index of the radiolabeled selective 5-HT2A antagonist 123I-5-I-R91150 in the normal canine brain imaged with single photon emission computed tomography.

The pattern of the specific 5-HT2A (5-hydroxytryptamine 2A receptor) antagonist 123I-5-I-R91150 was measured in 10 healthy dogs without neurologic and behavior abnormalities. Eight cortical regions (left and right fronto-, temporo-, parieto-, and occipitocortical area), one global subcortical region (including the thalamic system) were compared with a reference region lacking receptors; that is, the cerebellum. The 123I labeled radioligand was injected intravenously 100-200 minutes before acquisition. Both transmission and emission data were obtained with a triple head gamma camera equipped with high-resolution fanbeam collimators. The emission data were corrected for scatter and attenuation. To delineate different cerebral regions more accurately, the regions of interest (ROI) defined in a former study on brain perfusion measured with 99mTc-ethyl cysteinate dimer (ECD) in the same dogs were used. The co-registration of the 99mTc-ECD and the 123I-5-I-R91150, obtained from each dog, was realized with the help of corresponding transmission maps. By normalizing each regional cerebral activity to the activity observed in the cerebellum, the regional radioactivity (binding index) could be relatively quantified. Highest brain uptake was noted in the frontocortical brain areas (right: 1.85, left: 1.89), followed by the temporocortical region (right: 1.58, left: 1.56). Least uptake was noted in the more caudal and middle brain regions [occipito- (right: 1.46, left: 1.41), parietocortical (right: 1.30, left: 1.26), and striatal region (1.19)]. No gender nor age influence was noted in this series. The 123I labeled serotonin-2A receptor ligand seems to have similar cortical binding in the normal canine brain, as shown in humans and other animal species. A frontocortical to occipitocortical (rostrocaudal) binding index gradient was identified within the dog, which has not been seen in imaging studies from humans and other animal species. The significance of these results will need further investigation. This normative data can be used to compare regional brain uptake of the 123I-radioligand to dogs with behavioral disorders related to the serotonergic system, in future studies.

Animals↗

PubMedDate not supplied

Treatment of acute diarrhoea: update of guidelines based on a critical interuniversity assessment of medications and current practices.

Further to a thorough analysis of the problem of acute diarrhoea and the therapeutic options, recommendations were defined following a multidisciplinary approach. These guidelines take into account the reality of frequent self-medication. They further differ as a function of age (children, primarily treated by ORS and for whom self-medication is not advised versus adults who can self-medicate), symptoms (uncomplicated diarrhoea versus dysentery) and location where the diarrhoea is contracted (at home or when travelling).

Acute Disease↗

PubMedDate not supplied

Salmonella endarteritis, about two cases and their management.

Mycotic aneurysms due to Salmonella are a classical but uncommon complication of Salmonella infections. We report two cases of such aneurysms, the first one having developed two successive aneurysms of the iliac arteries due to Salmonella typhimurium. The literature on Salmonella endarteritis is briefly reviewed. The importance of an aggressive surgical approach of the mycotic aneurysm, with removal of all infected material and extra-anatomic bypass through contaminated tissue is emphasized. The role of antibiotic treatment is also discussed.

Aged↗

PubMedDate not supplied

[Fever upon return from the tropics].

Tropical infections are responsible for about half of the febrile episodes among travelers coming back from (sub-)tropical areas. Among these, the infections requiring urgent therapy must be recognized in priority. Without early and specific therapy, malaria may rapidly become lethal. This infection must therefore be searched by repeated blood smears. If negative, typhoid fever, amoebic liver abscess or rickettsial infection are frequent and may also be lethal if left untreated. The diagnostic approach of a febrile illness in a traveler coming back from the tropics is developed.

Diagnosis, Differential↗

PubMedDate not supplied

Mediastinitis caused by Aspergillus fumigatus with ruptured aortic pseudoaneurysm in a heart transplant recipient: case study.

The case of a heart transplant recipient with a ruptured aortic pseudoaneurysm caused by an Aspergillus fumigatus mediastinitis is reported. Contamination of surgical fields occurring by air seeding during surgery appears to be the most probable source of infection. Subtle infectious signs of the wound and subacute course are remarkable features of this case.

Aortic Aneurysm↗

PubMedDate not supplied

Long-term disease-free survival after liver transplantation for alveolar echinococcosis.

Alveolar echinococcosis of the liver is an uncommon and fatal disease resulting from hepatic infection by Echinococcus multilocularis. Liver transplantation has been proposed for unresectable cases with chronic complications, but up to now, no long-term follow-up has been reported. We report the case of a 29-year-old female who is disease-free more than six years after liver transplantation for a recurrent alveolar echinococcosis of the liver, confirming the place for liver transplantation in this disorder.

Adult↗