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Biomedical subjects

G Böhme

Publications and source records attributed to G Böhme.

At least 19 recordsLinked to original sources

Quinupristin/dalfopristin-resistant enterococci of the satA (vatD) and satG (vatE) genotypes from different ecological origins in Germany.

The semisynthetic streptogramin combination quinupristin/dalfopristin (Synercid) is a promising alternative for treatment of infections due to multiply resistant gram-positive bacteria including vancomycin-resistant Enterococcus faecium. Resistance is mediated by acetyltransferases SatA (VatD) or SatG (VatE). Recent papers have indicated a possible link between the use of the streptogramin virginiamycin S/M as a feed additive in commercial animal husbandry and a selection of quinupristin/dalfopristin-resistant E. faecium (QDRE). We screened manure samples from two different turkey farms and from six different pig farms (using virginiamycin), samples from a sewage water treatment plant, 24 broiler carcasses, 10 pork samples, and 200 stool samples of nonhospitalized humans for QDRE. Our strain culture collection of hospital E. faecium isolates from the last 2 years was also reviewed for QDRE. All manure and sewage samples were positive for QDRE, as well as 11 from broiler carcasses (46%), 1 from pork (10%), and 28 from human stool specimens (14%). Thirty-six hospital isolates of E. faecium exhibited resistance to quinupristin/dalfopristin. In 141 QDRE of different origin satA (vatD) and satG (vatE) genes were detected (seven isolates from humans with an unknown resistance mechanism). Streptogramin resistance determinants were tansferable in filtermating experiments for 5 of 10 satA (vatD) and 9 of 22 satG (vatE) isolates. Different EcoRI patterns of satG (vatE) plasmids and corresponding hybridizations of the satG (vatE) gene indicated nonhomologous resistance plasmids in isolates of different origin. The results of this study indicate a common gene pool for streptogramin resistance in E. faecium of different ecological origin. A selection of QDRE using the streptogramin virginiamycin S/M as a feed additive and a spread of the resistance via the food chain to humans is probable.

Acetyltransferases↗

Nonlinear phenomena in the natural howling of a dog-wolf mix.

It was reported to the first author that a female dog-wolf mix showed anomalously rough-sounding vocalization. Spectral analysis of recordings of the vocalization revealed frequency occurrences of subharmonics, biphonation (two independent pitches) and chaos. Since these nonlinear phenomena are currently widely discussed as integral to mammalian vocalization [Wilden et al., Bioacoustics 9, 171-196 (1988)] or as indicators of vocal pathologies [Herzel et al., J. Speech Hearing Res. 37, 1008-1019 (1994); Riede et al., Z. Sgtkde 62 Suppl: 198-203 (1997)], we sought to understand the production mechanism of the observed vocal instabilities. First the frequency of nonlinear phenomena in the calls was determined for the female and four additional individuals. It turned out that these phenomena appear, but much less frequently in the repertoire of the four other animals. The larynges of the female and two other individuals were dissected post mortem. There was no apparent asymmetry of the vocal folds but a slight asymmetry of the arytenoid cartilages. The most pronounced difference, however, was an upward extension of both vocal folds of the female. This feature is reminiscent of "vocal lips" (syn. "vocal membranes") in some primates and bats. Spectral analysis of the female's voice showed clear similarities with an intensively studied voice of a human who produces biphonation intentionally. Finally, the possible communicative relevance of nonlinear phenomena is discussed.

Animals↗

Decreased incidence of VanA-type vancomycin-resistant enterococci isolated from poultry meat and from fecal samples of humans in the community after discontinuation of avoparcin usage in animal husbandry.

The use of the glycopeptide antibiotic avoparcin (AVO) as a feed additive in animal husbandry of many European countries led in 1994-1995 to frequent isolation of VanA-type vancomycin-resistant enterococci (VRE) from commercially produced animal foodstuffs as well as from fecal samples of nonhospitalized persons in Germany (Saxony-Anhalt state). However, at the end of 1997, a decreasing number of such VRE was detected in frozen and fresh poultry meat (chickens and turkeys) from German producers. At this point in time, AVO had been discontinued in animal husbandry for more than 2 and one-half years in Denmark/Norway, nearly 2 years in Germany, and about 8-9 months in all countries of the European Community and Switzerland, respectively. VRE were then only detected in very low concentrations in one-quarter of the poultry meat samples (eight of 31, originating from 18 distinct German producers and bought in 12 different supermarkets). A decline of VRE prevalence was also observed in the gut flora of healthy persons (VRE carriers) in the same region (Saxony-Anhalt state, Germany), having fallen from 12% (12/100) in 1994 when AVO was being used to 6% (6/100) in 1996 and 3% (13/400) in 1997 after it was discontinued. These results likely indicate the importance of antibiotic selective pressure by glycopeptides such as AVO for the presence of VRE in animal meat products from commercial animal husbandry. Additionally, it underlines the role of animal products for the spread of resistant bacteria and transferable resistance genes to humans in the community.

Animal Husbandry↗

Voice profiles and standard voice profile of untrained children.

Voice profiles were taken of 277 healthy children between the ages of 5 and 14 years. The measured phonetograms were grouped according to sex and years of age. In each group, the means and standard deviations of maximal and minimal volume of each frequency were calculated. The median was used to establish the upper and lower limits of the voice range of each group. No age-dependent changes of the group voice profiles were shown in the groups of 7 to 10 year olds. Out of that emerged a standard childhood voice profile of the untrained voice. After age 10, an increase of the dynamic range over the lowest frequencies was found. Because of the voice changes in puberty, a profile for 13- and 14-year-old boys could not be established.

Adolescent↗

Verotoxinogenic Citrobacter freundii associated with severe gastroenteritis and cases of haemolytic uraemic syndrome in a nursery school: green butter as the infection source.

A summer outbreak of severe gastroenteritis followed by haemolytic uraemic syndrome (HUS) and thrombotic thrombocytopenic purpura in a nursery school and kindergarten is described. Sandwiches prepared with green butter made with contaminated parsley were the likely vehicle of infection. The parsley originated from an organic garden in which manure of pig origin was used instead of artificial fertilizers. Clonally identical verotoxinogenic Citrobacter freundii were found as causative agents of HUS and gastroenteritis and were also detected on the parsley.

Adult↗

Enterococcus faecium strains with vanA-mediated high-level glycopeptide resistance isolated from animal foodstuffs and fecal samples of humans in the community.

The occurrence and the further spread of high-level glycopeptide-resistant, vanA-positive Enterococcus faecium strains outside of hospitals have been investigated. We could isolate such bacteria directly from thawing liquids of commercially produced frozen poultry (chickens, turkeys; no further data on previous feeding with avoparcin were available). In 5 of 13 samples of raw minced meat of pigs originating from 13 different butcher's shops, glycopeptide-resistant E. faecium (VanA type) could be detected after overnight broth cultivation of these samples. No glycopeptide-resistant enterococci could be isolated from meat samples of chickens that were fed without avoparcin. VanA type E. faecium strains were also identified in 12 fecal samples recovered from 100 nonhospitalized humans in the rural area of Saxony-Anhalt federal county. These results suggest a possible role of the food chain in the spread of glycopeptide-resistant E. faecium. Molecular typing (macrorestriction and multilocus enzyme analysis) reveal a wide dissemination of the vanA gene among strains of different ecological origins.

Animals↗

[Prenatal development of the mandibular gland and parotid gland in cats].

The prenatal development of the cat's mandibular and parotid gland was examined by means of serial section of 36 cat embryos at 14-62 days of development. Both glands were excised from the epithelium of the primitive oral cavity and branched up to day 36 of the branching phase into a specific connective tissue. This tissue contained besides fine collagenous fibres, a high amount of proteoglycans. In the subsequent separation phase, ducts and acini differentiated themselves in primitive lobules which were separated by connective tissue. In the prenatal differentiation phase, from about day 50 up to birth, intercalated ducts and striated ducts were formed. In the acini, mucous and serous cells contained different amounts of complex carbohydrates. This secretory component changed shortly before birth.

Animals↗

[High-frequency videocinematograpphy for the objective imaging of the velopharyngeal closure mechanism in cleft palate patients].

The use of high-frequency video cineradiography makes possible an objective and dynamic rendering of the individual velopharyngeal closer pattern. The high resolution and the depiction of the finest mucosal structures while in motion achieved by this technique opens up the possibility of exact and objective 3-dimensional evaluation of the velopharyngeal gap. Following secondary velopharyngoplasty on 80 cleft palate patients, the velopharyngeal closure was studied by means of high-frequency video cineradiography and this rendering was then compared to results obtained by nasoendoscopy and to the clinical findings. It became definitely apparent that the radiological technique is markedly superior in relation to clearness of depiction and ease of use, especially in young children. This imaging technique can be recommended without reservation for pre- and postoperative control of speech-improving procedures.

Adolescent↗

[Therapy of sensorineural hearing loss in the aged with arteriosclerotic disease: a comparison of hydroxyethyl starch and prostaglandin].

We assessed 42 patients (aged between 51 and 86 years, average age: 71.6 years) with chronic bilateral sensorineural hearing loss in old-age, who showed bilateral pathological loss of discrimination. This was a group of patients diagnosed with internal-angiological arteriosclerotic vascular disease (uni- or bilateral obliteration of the carotid artery, condition following a cerebral ischaemic attack or peripheral arterial occlusive disease). 21 patients received infusion treatment with hydroxyethylamylum (HAES-steril 10%), a further 21 patients were infused with prostaglandin (Prostavasin, PGE-1) for three weeks. Pure tone audiometric and speech audiometric assessments were carried out before and after the infusion treatment (minimal loss of discrimination, overall word discrimination). It was statistically shown that there was no significant improvement of the average auditory threshold between 0.5 and 8 kHz using hydroxyethylamylum and prostaglandin. However, the examination results verify an increase of the minimal loss of discrimination and an improvement of speech comprehension following therapy with hydroxyethylamylum and prostaglandin. Between these two substances no difference was to be proved statistically. Our therapeutic results can be explained by the following considerations: 1. An improved circulation of the inner ear and the auditory pathway is to be regarded as possible reason for the achievement of the therapeutic effect. 2. An influence on the transmitter system of the cochlea and the auditory pathway is conceivable.

Aged↗

[Hemorrhagic colitis and hemolytic-uremic syndrome--E. coli as the etiologic agent. I. Bacteriology and pathogenesis].

Since 1983 when the connection between haemorrhagic colitis (HC), haemolytic uraemic syndrome (HUS), and intestinal infections by verotoxin-producing E. coli (VTEC, EHEC) was demonstrated, a lot of arguments has been accumulated showing verotoxins (Shiga-like toxins, SLT) and adhesive fimbria to play a key role in the pathogenicity of the respective E. coli group. The toxins bind via Gb3 receptors to the target cells and after internalization inhibit the protein synthesis. Due to the particular clustering of receptors at cell surfaces, vascular endothelial cells, intestinal epithelial cells as well as kidney and nerve tissues are especially affected. The severity of illness is obviously dependent on the relation between release of toxins and the actual level of anti-toxin-IgG in the blood.

Bacterial Toxins↗

[Ultrasonic diagnosis of the tongue].

Ultrasonic diagnosis of the tongue supplements inspection and palpation, and, aside from computerized tomography and, in particular, nuclear spin tomography, broadens our knowledge. By way of introduction, transcutaneous treatment using the submental sound-scanner in "B" mode is described. If necessary, examination can be performed simultaneously in the "B" and "M" modes. Attention is drawn to the significance of the 5 cm distance between the floor of the mouth and the surface of the tongue. Indications range from the diagnosis of tongue carcinoma, including relapse diagnosis, to dynamic functional tests of neurological disorders and visual biofeedback in phoniatrics and logopedics. Median-line diagnosis is of critical importance in tongue carcinoma. Ultrasonic diagnosis of the tongue can be recommended as a simple and cost-saving routine method.

Deglutition↗

[Ultrasound diagnosis of the epiglottis].

In 1988 we described a method of diagnosis of the larynx using ultrasound, and called it echolaryngography. Now we discuss the ultrasound diagnosis of the normal epiglottis function and lesions of the epiglottis. In principle, three methods of examination are possible with simultaneous B- and M-mode display: transverse function test, sagittal function test and diagonal function test of the epiglottis. Transverse and sagittal transcutaneous access to the epiglottis is simple using a 7.5 MHz sector or linear transducer. Diagonal access, using a 5 MHz linear transducer, is not always successful. Lesions of the epiglottis in which ultrasound is useful include cysts, epiglottitis, and pretherapeutic staging of cancer. The pre-epiglottic space can also be assessed. The description of the clinical results is confined to carcinoma of the epiglottis. Ultrasound diagnosis before and after laser surgery for a lesion on the free edge of the epiglottis is described. In the second example the results of CT scans and ultrasound in a case of T4 supraglottic cancer of the larynx with invasion of the pre-epiglottic space are compared.

Cysts↗

[Sense and counter-sense--on the deconstruction of histories].

Today historiography (the writing of stories) presented as nothing but a search for truth merits the charge of naiveté. Since Freud we must understand any story told about life as a rationalization, that is, as a strategy of conducting one's life. The author argues the proposition that historiography can only fulfill its function of giving sense to life if it simultaneously admits its deconstruction, its counter-sense.

Dreams↗

[Hearing disorders in obliteration of the carotid artery. 2. Contribution to hearing loss in the aged].

Otologic-audiologic examination was carried out in 75 patients (between 42 and 86 years of age; average age: 65 years) with confirmed internal angiologic obliteration of the carotid artery, either unilateral or bilateral. There were 51 unilateral and 24 bilateral stenoses/occlusions. Diseases of the ear were excluded clinically and audiologically. - The mean hearing loss shows a sensorineural high tone loss in the tone audiogram. The range of scatter of high tone loss increases proportionally to the increase of frequency. - Compared with the physiological examination of geriatric patients, the total word comprehension and especially the minimal discrimination loss point towards a pathologic impairment of hearing. The total word comprehension amounts to 250.79% in the 51-60 age group, 237.79% in the 61-70 age group, 175.83% in persons aged 71-80 years, and 118.33% for those over 80 years of age. The minimal discrimination loss comprises 5.83% in the 51-60 age group, 9.79% in the 61-70 age group, 22.50% in patients between 71 and 80 years, and 48.00% in those over 80 years. - No connection between the extent of loss of hearing and the stage of obliteration of the carotid artery can be shown. However, the decompensation of total word comprehension and especially the minimal discrimination loss is a very important sign. - These findings contribute towards a differentiation of physiologic and pathologic hearing diseases in old age with particulas reference to the underlying arteriosclerotic disease.

Adult↗

[Clinical contribution to ultrasound diagnosis of the larynx (echolaryngography)].

This paper outlines sonographic indications in laryngeal diseases in adults, based on our ultrasonic technique for diagnosis of the larynx. Here, findings may be investigated that in combination with the indirect laryngoscopy and endoscopic techniques such as computer tomography and magnetic resonance imaging may contribute towards the differential diagnosis of laryngeal disease. The diagnostic possibilities of echolaryngography in inflammatory diseases, where an indirect laryngoscopy is either impossible or difficult, (e.g. epiglottitis), are presented. Additionally, sonographic findings in laryngeal paralysis (e.g. paralysis of the recurrent laryngeal nerve after strumectomy) in both benign and malignant tumours are discussed. Empirical data from 14 patients with laryngeal carcinoma are presented.

Epiglottitis↗

[Epidemiology of salmonellosis].

The diagnostically and in regard to surveillance rather comprehensively recorded salmonellosis bear the character of a model of zoonotic diarrhoeal diseases. Whereas those serovars predominantly adapted to human beings or animal species are without any importance in this connection, such serovars with own epizootic processes in different animal species with or without causing illness are able to be transferred to human beings via foods of animal origin and to act as etiological agents of gastroenteritis. Some strains of them equipped by special properties often encoded by plasmids can be transferred from man to man, too. In GDR in 1987 S. enteritidis (34.0%), S. typhimurium (17.9%), S. manhattan (7.7%) and S. agona (7.4%) amounted to two thirds of all the salmonella isolates in connection with human enteritis. For analyzing epizootic-epidemic processes in the case of rare serovars the identity of serovars is sufficient in first approximation, in the case of frequently isolated serovars the complex typing of the concerned strains by using epidemiological laboratory methods is required.

Animals↗