PubMed Health⌕ Search

Biomedical subjects

G Erbs

Publications and source records attributed to G Erbs.

At least 19 recordsLinked to original sources
PubMed1997

[Physiologic and pathologic patterns of reaction to silicone breast implants].

Local morphological reaction patterns on breast implants can be of high significance as possible starting point for controversely discussed systemic immune response triggered by silicon or silicone. Therefore, the collagenous capsules of 149 explanted mammoplasty prostheses were examined macroscopically, under a scanning electron microscope and light-microscopically using antibodies to the macrophage antigen CD68, vimentin, muscle actin, and the proliferation antigen MIB1, and were then correlated with anamnestic data (implanted type of prosthesis, indication for im- or explantation). According to our examinations, the in-vivo durability of the prostheses' shells is considerably decreasing with the expansion of their surfaces. Regardless of the type of the prostheses' surface regularly a chronic-proliferating inflammation pattern could be identified in the periprosthetic capsulectomy specimens starting with a synovial metaplasia of proliferating CD-68-negative and vimentin-positive mesenchymal cells in the area surrounding the implants and ending by its transformation into a stage of dense hyaline collagenous fibrous tissue after an advanced implantation period (> 2 years). By this, the texturing of the prosthesis surface modifies only the course, but not the quality of the chronically fibrosing inflammation. Bleeding of prosthesis as well as the incorporation of the polyurethane-foam coating of different prosthesis types into the periprosthetic breast capsule lead to a significant lymphoplasmacytic infiltration, partly with participation of local vessels as defined in a "silicone vasculitis". Morphological signs of an at least local immune response are detectable in 8.3% of the examined fibrotic capsules even without a morphologically identifiable foreign-body embedding. They can be possibly referred to- as well as the complete absence of hyaline collagenous fibrous tissue in 30% of the cases-a yet not causally clarified, inter-individually different susceptibility of the implant bearers. Only the systematic registration of the above-mentioned morphological reaction patterns in a "prosthesis-passport" together with the additional clinical observation of the patients can ensure in future the realistic estimation of potential health risks caused by silicone breast implants.

Actins↗
PubMed1991

Differential regulation of T- and B-lymphocyte activation in severely burned patients.

We studied the in vitro expression and regulation of the CD23 and CD25 (Tac) surface antigens by peripheral blood lymphocytes (PBL) from severely burned patients (burn injuries ranging from 25% to 72% TBSA) in order to evaluate T- and B-lymphocyte activation processes after thermal trauma. The spontaneous and cytokine (IL-4, IL-2)-induced expression of CD23 which represents a B-cell activation marker was significantly reduced during the second to fifth week postburn when compared to healthy donors. In contrast, CD25, which is expressed on activated T cells, showed a marked increase both spontaneously, indicating an in vivo activation, and after stimulation with IL-2 or PHA. Concomitantly, T-cell proliferation induced by PHA or Con A was suppressed. However, the number of T and B cells remained unchanged. The data demonstrate the impairment of early events in the lymphocyte program in severely burned patients. The activation of B cells is downregulated, since they become refractory to external helper signals. In addition, T cells are highly activated but fail to proceed to proliferation in response to mitogenic stimuli.

Adult↗
PubMed1990

Basophil releasability in severely burned patients.

Thermal injury is known to induce dysregulation of the immune system; however, the precise mechanisms have to be clarified. We investigated the histamine release of basophil granulocytes from severely burned patients (n = 12) after stimulation with anti-IgE or the Ca-ionophore A 23187, respectively. The anti-IgE-induced basophil histamine release of all patients was reduced in comparison to healthy donors beginning at day one postburn (p.b.) (5.0 +/- 2.3% vs. 30.5 +/-3.4%), while the Ca-ionophore-induced release was not decreased before day two p.b. Basophils of patients who finally succumbed to their injuries showed poor responsiveness (to zero levels) over the total time. In contrast, the basophil releasability of surviving patients returned to nearly normal levels (fifth to seventh week p.b.). Already in the second week p.b. there was a significant difference in histamine release between survivors and nonsurvivors [e.g., days 6-9 p.b.: 23.7 +/- 4.0 vs. 6.9 +/- 2.7 (p less than 0.005) after Ca-ionophore stimulation]. The altered basophil histamine release was neither due to a diminished dose- or a delayed time-response to the stimuli nor due to differences in the basophil counts or the cellular histamine content. Our data indicate that the decrease of the basophil releasability, which may be secondary to altered signal transduction pathways in severely burned patients correlates with the clinical outcome.

Adult↗
PubMed1990

Studies on B-lymphocyte dysfunctions in severely burned patients.

We studied in vitro functional parameters of peripheral blood B-lymphocytes from severely burned patients (n = 10; burn injuries ranging from 25 to 72% TBSA). While the number of B-cells remained unchanged, B-cell proliferation induced by Staphylococcus aureus strain Cowan I (SAC) was normal or even enhanced at early and late phases postburn, but showed a marked suppression during the second to fourth week. A similar pattern was observed for the pokeweed mitogen (PWM)- or SAC-stimulated synthesis of immunoglobulin M (IgM), whereas IgG production was decreased over the whole postburn period monitored. Cytokine (interleukin 4)-induced B-cell activation as indicated by the expression of the CD23 surface antigen was impaired throughout the second to fifth week. In parallel, the release of the proteolytic cleavage product sCD23 which represents a B-cell growth and differentiation factor was reduced. Our data provide evidence that activation, proliferation, and differentiation processes of B-lymphocytes are impaired in severely burned patients, which may contribute to their enhanced susceptibility to infection and sepsis.

Adult↗
PubMed1990

Metabolism of platelet activating factor (PAF) and lyso-PAF in polymorphonuclear granulocytes from severely burned patients.

We studied the metabolism of 3H-platelet activating factor (PAF) and lyso-PAF in human polymorphonuclear granulocytes (PMN) from severely burned patients (n = 6) on days 1, 5, 9, 15, and 25 post-trauma. All patients suffered from a severe burn trauma of more than 30% total body surface area. Stimulation of PMN in healthy donors (n = 10) with the Ca-ionophore resulted in the conversion of 3H-lyso-PAF into PAF (18 +/- 2% of total radioactivity) and alkyl-acyl-glycero-phosphorylcholine (alkyl-acyl-GPC, 50 +/- 6%). In burned patients a significantly reduced formation of 3H-PAF was observed between days 1 and 15 post-trauma (day 9: 1 +/- 1%, p less than 0.0001). This pattern was normalized again in patients (n = 5) who survived the trauma after septic periods and was observed during the second week post-trauma. In one patient who succumbed to his injuries a sustained inhibition of PAF formation was observed up to his death. The decreased formation of PAF correlated weakly with the appearance of immature granulocytes within the analyzed cell fraction (ratio of immature cells versus PAF-formation, r = -0.55, p = 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[In vitro virulence of wound infecting staphylococcal isolates from severely burned patients].

The hemolysin and histamine releasing activity of 30 S. aureus strains isolated from third degree burns of heavily burned patients was detected. The culture supernatants (cs) of Staphylococcus aureus isolated during episodes of invasive burn wound infection displayed significantly lower amounts of hemolysin and histamine releasing activity as compared to cs of bacteria isolated when no sign of septicemia was present. In contrast, when washed bacterial cells were analysed, a reversed ratio could be observed. These data clearly indicate that in strains isolated during invasive burn wound infection pathogenicity factors remain attached to the bacterial surface of the staphylococci investigated.

Animals↗
PubMed1989

Studies on the mechanisms of granulocyte dysfunctions in severely burned patients--evidence for altered leukotriene generation.

The leukotriene generation (LTB4, 20-OH-LTB4, 20-COOH-LTB4) from PMNs of severely burned patients (n = 6) was studied by reversed-phase HPLC. Granulocytes from all patients showed a decrease in leukotriene generation which only returned to normal levels when the patients recovered from their injuries. The leukotriene generation induced by different stimuli, i.e., the Ca++-ionophore A23187 (7.3 microM) or opsonized zymosan (2 mg) in the presence of exogenous arachidonic acid (60 microM) showed similar stimulation profiles. The cellular differentiation of the respective granulocyte fractions revealed that the decreased leukotriene generation was accompanied by the occurrence of immature granulocytes in the peripheral blood. Furthermore, the studies in the presence of exogenous arachidonic acid showed that the defect in leukotriene generation from granulocytes of surviving patients was due to the availability of metabolizable substrate (i.e., free arachidonic acid). Granulocytes from one nonsurviving patient showed in addition a defect in the metabolic ability of arachidonic acid to generate the respective leukotrienes. The generation of reactive oxygen species did not correlate with the observed alterations in the formation of the leukotrienes.

Adult↗
PubMed1989

Induction of inflammatory mediators (histamine and leukotrienes) from rat peritoneal mast cells and human granulocytes by Pseudomonas aeruginosa strains from burn patients.

Clinical isolates of Pseudomonas aeruginosa from severely burned patients were analyzed with regard to their capacity to induce inflammatory-mediator release from rat mast cells or human granulocytes. The bacterial strains were characterized according to their cell-associated hemolysin activity as well as their secreted hemolysin and phospholipase C activities. P. aeruginosa expressing heat-labile hemolysin and phospholipase C induced histamine release from rat mast cells and leukotriene formation from human granulocytes, while bacterial strains expressing heat-stable hemolysin were potent releasers of histamine but did not lead to leukotriene formation. The mediator-inducing capacity was dependent on the growth characteristics of the bacterial strains. The purified glycolipid (heat-stable hemolysin) of P. aeruginosa was a potent inducer of histamine release but did not initiate leukotriene formation. Exotoxin A did not affect inflammatory-mediator release. P. aeruginosa with leukotriene-inducing capacity also enhanced omega oxidation of endogenous leukotriene B4, suggesting an additional inactivation of the chemotactic potential. Our data suggest that both hemolysins of P. aeruginosa contribute to the pathogenicity of P. aeruginosa by inducing and modulating inflammatory-mediator release from various cells.

Adjuvants, Immunologic↗
PubMed1988

Decreased expression of leukotriene B4 receptor sites on polymorphonuclear granulocytes of severely burned patients.

Polymorphonuclear granulocytes were isolated from patients with burn injury and the specific binding of (3H)leukotriene B4 was assessed. We observed a decreased receptor expression as compared to healthy donor cells, which may be the result of receptor downregulation as a consequence of cellular preactivation. In addition, leukotriene B4-synthesis was also reduced and differential cell counts demonstrated a shift from segmented neutrophils to immature cells. In survivors the values returned to normal parameters whereas nonsurvivors who succumbed in the course of generalized sepsis showed depressed cellular functions up to their death.

Burns↗
PubMed1988

Generation of leukotrienes from human polymorphonuclear granulocytes of severely burned patients.

The Ca ionophore A23187-induced leukotriene (LT) release (LTC4, LTB4, 20-OH-LTB4, 20-COOH-LTB4) of human PMN's from severely burned patients (n = 6) was studied by reversed-phase HPLC. The patients' granulocytes demonstrated a decrease (to zero levels) in LT generation postburn. The level of generated LT's resembled that of healthy donors when the patients recovered from their trauma (after day 40 postburn). In contrast, the granulocytes of patients who finally succumbed to their injuries showed poor responsiveness over the total time. An enhanced LTC4 production by granulocytes correlated with an increase in eosinophils within the granulocyte fraction. In addition, the reduced LTB4 production was accompanied by an enhanced LTB4 metabolism to biologically less active products (omega-oxidated metabolites). Thus, the capacity of patients' PMN's to release chemotactic substances was further decreased. The onset of this PMN dysfunction correlated with the onset of invasive microbial growth as determined by the quantitative bacterial analysis of full-thickness biopsy specimens. Our data provide evidence that the altered mediator release of patients' PMN's is closely related to a depressed host defense.

Adult↗
PubMed1987

Metabolism of leukotriene B4 by polymorphonuclear granulocytes of severely burned patients.

Leukotriene B4 release from polymorphonuclear granulocytes of severely burned patients was reduced as compared to healthy donor cells. This decrease is due to an enhanced conversion of LTB4 into the 20-hydroxy- and 20-carboxy-metabolites and further to a decreased LTB4-synthesis. In addition, studies on the exogenous LTB4-conversion revealed an unidentified compound which was derived from LTB4. Our data suggest a modulation of the enzymatic activities involved in omega-oxidation of LTB4 (isoenzymes of cytochrome P-450).

Adult↗
PubMed1987

[Epidemiologic studies of the microbial colonization of severely burned patients].

Bacteria isolated between 1/1/1983 and 12/31/1984 from the burns of 122 patients in a burns unit at the Ruhr-Universität Bochum were studied. Grampositive bacteria were predominant in colonizing the burn wounds (62.5% of all strains isolated). In the patients with more than 40% of total body surface area (TBSA) burn, isolation of Staph aureus was most frequent. The exogenous colonization rate with Staph. aureus was 86%. Coagulase negative Staphylococci were identified in 89.6% of all patients (71.4% of the patients with more than 40% TBSA burn). There was a constant decline in detecting Pseudomonas aeruginosa from the second half of 1983. Microbial sensitivity testing was performed in 834 cases. Gramnegative strains of bacteria resistant to Ampicillin, Mezlocillin, Piperacillin and Ticarcillin were found in 10 up to 97% of the tested strains. Acinetobacter calcoaceticus var. antitratus and Enterobacter cloacae usually displayed a wide resistant pattern. Some strains were resistant as to 16 antibiotics. The incidence of multiresistant Staph. aureus was studied. The time course of multiresistance was paralleled by the incidence of a 6-fold resistance to Benzylpenicillin, Oxacillin, Tetracyclin(T), Gentamycin(G), Erythromycin(E), and Sulfadiacin(S). The probability of simultaneous resistance to 2 of the 4 antibiotics (T, G, E, S) ranged between 0.7 and 0.98. 98 out of 336 Staph. aureus isolates showed a simultaneous resistance to T, G, E and S (29%).

Adolescent↗
PubMed1987

[Comparison of 4 methods of bacterial count determination in burn wounds].

The present study includes twelve patients with second and third degree fresh burns involving 10-70 per cent total body surface area. Standardized surface swab, gaze pad contact, Rodac plates, and burn wound biopsy cultures were obtained twice per week. The various techniques were compared by 48 independent measurements. Confluent growth occur in more than 70 per cent of the Rodac agar plates. There was a significant (alpha less than 1%) correlation between the results of the surface swab and the gaze pad method. A comparison of the number of viable bacteria detected with the burn wound biopsy technique and the surface methods (gaze pad and surface swab) showed no significant correlation. In addition, the number of colony forming units in 8 parallel cultures obtained from different sites of the burn wound was determined. The standard error of mean (SEM) varied between 1.01 log (biopsy), 0.91 log (gaze pad) and 0.61 log (surface swab). Several case reports emphasize that the quantitative biopsy culture seems to give most reliable data in predicting burn wound sepsis.

Adult↗
PubMed1985

[Primary closure of split thickness skin donor sites using surgical foil].

The advantages of using an operation foil for wound dressing when split thickness skin grafts have been taken are presented. For some years we have used an air and steam permeable plastic foil for wound dressing in cases where split thickness skin grafts have been taken. The advantages of this procedure in our opinion are: It minimizes postoperative pain. It allows inspection of the wound whenever it appears desirable because of the transparency of the foil. It reduces the cost of wound dressing and also nursing procedures.

Humans↗
PubMed1985

[Reduction mammoplasty using a W-form incision technic].

A modified technique of skin resection in reduction mammoplasties is presented. The vertical tissue excision is carried out through a zig-zag incision so that the scars lie in the direction of the skin tension and thus result in less visible scars.

Adult↗
PubMed1984

[Long-term results of pisiform bone transposition in lunate necrosis].

Kienböcks disease is one of the most frequent manifestations of avascular necrosis. Multiple different surgical and conservative methods for treatment have been described. The transposition of pisiform on its vascular pedicle to replace the reamed out necrotic portion of the lunate has permitted revascularization and healing of the lunate. In the following article, the operative technique is described and the results of a five year follow-up study on 32 patients who underwent this operation are presented. On the basis of this study, we found, even in advanced cases of Kienböcks disease, that 50% of the 14 followed-up patients became free of symptoms or had pain only under stressful conditions.

Carpal Bones↗