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Biomedical subjects

G Gruber

Publications and source records attributed to G Gruber.

At least 19 recordsLinked to original sources

[Ultrasound image of the Lachman test in lesions of the anterior cruciate ligament].

The sonographic examination of the knee-joint can, in many pathological alterations of the knee-joint, supply additional informations. In the standardized ultrasound examination of the knee-joint ventral and dorsal sectional planes will be adjusted (4, 7, 14, 17). For the examination of the lesions of the anterior cruciate ligament direct adjustment techniques in the aere of origin of the anterior cruciate ligament (15, 16) and indirect examination methods are known (7, 8, 9, 20). While Hien chose a direct medial parapatellaric horizontal sagittal sectional plane in the course of the lig. patellae (8), we carry out our examination in a ventral infrapatellaric sagittal plane. The examinations were conducted with an ultrasound unit of the type Siemens Sonoline SL 2 with a linear transducer with a frequency of 5 MHz without a stand off pad. In the course of a prospective clinical examination an anteromedial test of stability of both knee-joints was conducted on 360 patients with the help of a sonographic Lachman-test. Two examination groups were formed: in group 1 60 patients with a arthroscopically secured lesion of the anterior cruciate ligament were registered and set against 300 probationers with "empty" anamnesis of the knee-joint of group 2. In the group of patients with a cruciate ligament injury a tibia translation of 5.3 mm in the Lachman-test was found; the side difference between the leg injured and the one uninjured amounted to 3.0 mm. In the control group the tibia translation amounted to 2.9 mm with a side difference of 0.9 mm.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

[A basic psychodiagnostic program for internists].

The increasing frequency of disturbances of the health, in which psychic and/or social influential factors are significant, reflects also in the number of patients of the specialist of internal medicine who is working in the outpatient department, the hospital and in a subspeciality. This requires from the specialists of internal medicine, if he will satisfy the claims of his patients for a comprehensive diagnostics and effective therapy, from the very beginning and in all phases of the care the involvement of a basic psychodiagnostics. Hereby the problem in question is an enhanced internal establishment of the anamnesis under psychodiagnostic aspect, which serves for the clarification of psychic and/or social influences on signs and symptoms, the experience of the and the course of the disease. An orientating systematization and a way to the positive diagnostics of neuroses, psychosomatic diseases or disturbances and further functional syndromes in the field of internal medicine are presented which demand the graduated psychotherapeutic measure.

Humans

[Psychophysiologic particularities in patients with functional syndromes].

Patients with gastroenterological or cardiovascular functional syndromes (n = 109) were examined by means of an extensive psychological standardized diagnostic programme and psychological strain analysis was carried out under psychogenic stress in laboratory. The results were compared with healthy probands (n = 51) likewise examined. Patients with functional syndromes significantly discriminated of healthy probands by more psychosocial risk constellation under strain caused by more distress and in parameters of performance and in psychophysiological field in some strain variables (heart rate, blood pressure, acral vasomotricity) and their dynamics.

Adult

Isolation of human monoclonal antibody isoproteins by preparative isoelectric focusing in immobilized pH gradients.

A method for preparative isolation of human monoclonal antibody isoproteins is described in the present paper. A human monoclonal antibody directed against the transmembrane protein gp 41 from the human immunodeficiency virus (HIV-1) was used in this study. The antibody belongs to the IgG1 subtype and exhibits antibody dependent cellular cytotoxicity. The resolving power of conventional preparative protein separation techniques such as ion-exchange chromatography, chromatofocusing and lectin affinity chromatography is too poor for a complete separation of isoproteins. The more sophisticated technique of chromatofocusing on FPLC-based material (Mono P, Pharmacia) did not satisfy our expectation. With semipreparative IEF in immobilized pH gradients we were able to prepare the different isoproteins of a human monoclonal antibody in milligram amounts. No significant difference between the single isoproteins with respect to specificity and avidity to the recombinant antigen (rec gp 160) was detected. Therefore, we assume that the separation conditions did not influence the immunochemical nature of the antibody and significant denaturation and/or precipitation of the IgG did not occur. Furthermore the method affords preparative separation with resolution equivalent to analytical runs. Experiments for scale up and further characterization of isoproteins (carbohydrate composition, amino acid analysis, half life times etc.) are in progress.

Animals

Biochemical HLA typing: a population study in 112 Caucasians.

In order to define frequencies and associations of biochemically defined HLA-A and -B specificities and their variants and subtypes in a Caucasian population, biochemical HLA typing was performed in a panel of 112 Austrians. Already known rare variants of HLA-A2, A3, A30, Aw33 and B39 and the more frequent subtypes of HLA-B27, B35, B44 and, in addition, a so far unknown variant of HLA-B18 were present in the panel. Family segregation analyses of the biochemically defined HLA class I variants revealed that they could be found only in certain rare haplotypes, most of them in high linkage disequilibrium. The basic variant of HLA-A30, for example, obviously occurred only in the HLA-A30, B49, Cw7 haplotype, similar to the Aw33 acidic variant, which was exclusively found in the Aw33, Bw58, Cw3 haplotype. None of the biochemical variants was found in frequent common haplotypes.

Biochemistry

A new HLA-B antigen, BHT: definition by serological and biochemical means.

In 3 unrelated individuals, a new, so far unknown HLA-B-locus antigen was found. This HLA-B antigen, provisionally termed 'BHT', is recognized by extra reactions with alloantisera against the B5 cross-reactive group. BHT can be clearly discerned from all cross-reactive antigens by one-dimensional isoelectro focusing (1D IEF), as it reveals, on IEF gels, a characteristic, rather neutral double-banding pattern different from all known HLA class I bands. The BHT banding pattern, which is identical in all 3 BHT-positive individuals, segregates with the haplotype A28, BHT, Cw7, DRw6.

Genotype

[On the problem of stress].

After references to the different interpretations of stress in the framework of the stress-demand relations and the activity needs relations a psychophysiologically orientated stress concept is presented which contributed to the explanation of preservation of health and development of health, but also of origination and course of disease. Hereby qualitative peculiarities of the character and the appearance of the stress as well as of the origination of stress are emphasized.

Adaptation, Psychological

Physiological and psychological response to a three-month mental strain period in students.

Biochemical and immunological parameters, physical and mental performance, subjective complaints and behavioural characteristics were compared before and after 14 final examinations undertaken by 64 students during a three-month examination period. A decrease in cholesterol, triglycerides, HDL-cholesterol, physical performance and an increase in LDL/HDL cholesterol quotient, lactate level, mental performance were accompanied by a lower frequency of mental complaints and higher frequency of physical complaints. From the multidimensional variance and discriminant analysis 17 of the 44 variables discriminated between the state prior to and after the examination period. The results are interpreted in terms of the psychophysiological adaptation to adequate mental stress.

Adult

Adrenergic receptors and sodium reabsorption in normotensive subjects as related to salt sensitivity.

We have studied proximal tubular sodium reabsorption as measured by lithium clearance, alpha-2 and beta-2 adrenergic receptors on circulating platelets and lymphocytes, respectively, and urinary aldosterone after variations of sodium intake in 24 normotensive volunteers. Fractional lithium clearance was 14.8% +/- 2.64 under a high salt diet of 200 mmol per day. After a low salt diet of 50 mmol/d for two weeks fractional lithium clearance did not change significantly (13.3% +/- 3.35). There were no correlations between alpha-2 adrenergic receptors, beta-2 adrenergic receptors or the alpha-2/beta-2 ratio and fractional lithium clearance, irrespective of the high or low salt diet. In contrast, a significant correlation was found between urinary aldosterone excretion and alpha-2 receptor densities under low salt diet (r = -0.55, n = 17, p less than 0.02). There were no correlations between beta-2 adrenoceptor density, alpha-2/beta-2 ratio and urinary aldosterone during high or low salt diet. Whereas our results are inconclusive about the value of lithium clearance determinations as a measure of proximal tubular sodium reabsorption during variations of sodium intake, we conclude, that alpha-adrenoceptor density, as measured on circulating blood cells, may possibly be representative for alpha-adrenergic equipment of the kidney. The inverse correlation between urinary aldosterone excretion in subjects equilibrated on a low salt diet of 50 mmol/d and alpha-2 adrenoceptor densities could be interpreted as an indirect evidence, that those subjects with a high alpha-2 adrenoceptor equipment show a high proximal tubular sodium reabsorption and thus can afford a low rate of aldosterone mediated distal tubular sodium reabsorption to maintain sodium balance. Our results are thus in accord with our previous hypothesis, that different receptor equipment of individual subjects may cause marked differences in sodium handling by the kidney. These differences may be responsible, at least in part, for the degree of salt sensitivity in individual subjects.

Absorption

[Scintigraphy and sonography in the diagnosis of thyroid autonomy. A retrospective study of 526 patients].

The place of scintigraphy and ultrasonography in diagnosis was analysed retrospectively in a series of 526 patients with confirmed thyroid autonomy. Male:female ratio was 1:4.6; peak age incidence was in the sixth decade. 5.6% of patients were younger than 30 years and in each case had a sonographic focus. A normal thyroid size was found in 6.5% on palpation and in 10% by ultrasound. Normal thyroid function was found in 287 patients (56%), of whom 48% had a positive TRH test, the remainder being hyperthyroid. Unilocular autonomy was present in 57%, multilocular in the remainder. With increasing degree of autonomy there was an increase in echo-density. In 351 patients (74%) the adenoma was echo-poor, in 16% echo-normal and in 10% echo-dense. Focal findings on sonography were noted in 94% of patients. The incidence of thyroid carcinoma was 1.5% (2 of 136 patients with goitre resection), the carcinoma not being located in the autonomous tissue. It is concluded that a thyroid of normal size does not exclude autonomy. Patients younger than 30 years require scintigraphic examination only if there are focal signs. Echogenicity of a thyroid focus does not correlate with function. The incidence of cancer in the presence of autonomy is low. There was no case of thyroid carcinoma in the autonomous region.

Adult

[Diagnostic and prognostic significance of so-called rheumatoid vasculitis--2].

51 patients with rheumatoid arthritis and high rheumatoid factors (mean titres 928) underwent examination for the demonstration of an extraarticular organ manifestation within the scope of the cooperation between the Department of Medicine of the Karl-Marx-University Leipzig and the Institute for Rheumatology of the Academy of Medical Sciences of the USSR in Moscow. The frequency of nodous rheumatism (about 60%) is comparable with the frequency of polyneuropathy. In 20% of the patients a systemic muscle atrophy, a hepatomegaly as well as a Raynaud-syndrome were stated. By means of skin biopsy in 28% perivascular infiltrates were found. Altogether in 6 patients (12%) a participation of the lungs and the pleura, respectively, could be proved. Only rarely a clinically manifest heart disease caused by the rheu-we we found an pericardial effusions in 3 cases. In systemic manifestation, such as myositis, participation of the eyes or vasculitis of the digital arteries with necrosis, were only sporadically to be established. Among 22 patients we found an pericardial effusions in 3 cases. In systemic manifestation in most cases increased parameters of activity were found. From the practical point of view apart from increased titers of the rheumatoid titres and circulating immune complexes (C1q-BT) increased concentrations of the C-reactive protein are prognostically significant. The presence of high rheumatoid factor titres alone as well as the isolated presence of rheumatic nodes must not always be connected with an unfavourable prognosis. When severe extraarticular manifestations are present a possibly early, intensive occasionally extracorporeal treatment is indicated.

Adolescent

[Parameters of acral vasomotor activity--sensory arousal variables in psychological stress].

By means of complex methods in 65 test persons from a large number of parameters the photopulse amplitude and the rheographic quotient at the finger apart from the heart rate and the blood pressure were established as very sensitive demand variables under psychic stress. The temporary and formal criteria of the volume pulse curves are less well suitable for this purpose. In the different reaction patterns the inclusion of sensitive biosignals of the acral vasomotricity is an information gain for the demand diagnostics under psychic stress.

Adult

Up-regulation of alpha 2 adrenoceptors and down-regulation of beta 2 adrenoceptors by high-salt diet in normotensive men: enhanced up-regulation of operative (alpha 2:beta 2) adrenoceptor ratio predicts salt sensitivity.

In 24 normotensive male volunteers (age 20-25 years) reduction of sodium intake from 200 to 50 mmol/day over 2 weeks resulted in a 14% fall of alpha 2-adrenoceptors of platelets from 209.5 to 179.4 fmol/mg (P less than 0.01) and in a 16% rise of beta 2-adrenoceptors of lymphocytes from 13.3 to 16.2 fmol/mg (P less than 0.05) which was reversible by 2 weeks of high sodium intake. In contrast to the comparatively minor changes of alpha 2- and beta 2-adrenoceptor density, the functionally probably more relevant 'operative (alpha 2:beta 2) adrenoceptor ratio' decreased by 53% from 22.9 to 14.9 (P less than 0.01) during the low-salt diet. Although neither the individual changes of alpha 2- and of beta 2-adrenoceptor densities correlated with individual blood pressure changes induced by variations in sodium intake, there was a highly significant positive correlation (r = 0.55, n = 33; P less than 0.01) between the rises of the 'operative adrenoceptor ratio' and the rises of blood pressure induced by high salt intake. We conclude that the 'operative adrenoceptor ratio', although only determined on alpha 2- and beta 2- and not on alpha 1- and beta 1-adrenoceptors, and only on circulating blood cells, may be representative for sympathetic resistance vessel tone, at least as a function of variations of salt intake. Enhanced up-regulation of the 'operative adrenoceptor ratio' in the salt-sensitive part of the population may be one important early step in the development of essential hypertension.

Adult

[Hereditary salt sensitivity as a cause of essential hypertension: studies of membrane transport and intracellular electrolytes].

Based on oscillatory long-term blood pressure recordings and on biochemical findings in 62 normotensive and 54 untreated hypertensive subjects, who were investigated during their usual high sodium diet and after moderate salt restriction, we have developed a concept for the pathogenesis of essential hypertension, which differs from current concept proposed by others: We demonstrated that normotensive subjects with a positive family history of hypertension respond to sodium restriction from 200 to 50 mmol/day over 2 weeks with a minute fall of mean blood pressure of 2.9 +/- 0.7 mmHg (+/- SEM), whereas in subjects with a negative family history of hypertension blood pressure remained unchanged (-0.93 +/- 0.67 mmHg). This difference was only revealed by computing the "basal blood pressure average" from 240 heart beats, but not by conventional sphygmomanometric blood pressure measurements. Normotensives with heredity of hypertension or "salt sensitive" normotensive subjects were not different from subjects with a negative family history in the sodium pump, Na-K-cotransport or intracellular sodium and potassium of erythrocytes. In contrast, the former group had an increased sensitivity to infused noradrenaline, which might be responsible for enhanced tubular sodium reabsorption in subjects with a positive family history of hypertension (or "salt sensitive" subjects). We only found an increased K-permeability of red cells in established hypertension, which was compensated for by a an increased activity of the sodium pump. These cell membrane defects were more pronounced in more severe hypertension. In the course of essential hypertension a cell membrane defect may develop as a consequence rather than a cause of the disease.

Adult

Salt sensitivity in normotensives with family history of hypertension: studies of membrane transport, intracellular electrolytes and alpha 2-adrenergic receptors.

Using long-term automatic blood pressure recording it has previously been shown that subjects with family history of hypertension show a minute fall of blood pressure during sodium restriction, which is reversible by high sodium intake. Thus normotensives with hypertensive antecedents as a group are salt-sensitive, whereas normotensives without heredity of hypertension as a group are salt-resistant. The present study compares intracellular sodium, potassium and calcium, sodium pump activity, NaK-cotransport of red blood cells and density and affinity of alpha 2-adrenergic receptors of platelets in normotensive subjects classified according to family history of hypertension and according to 'salt sensitivity' and 'salt resistance'. Neither the family history of hypertension nor salt sensitivity correlated with intracellular sodium, potassium, calcium, Na-pump activity and NaK-cotransport. Alpha 2-adrenergic density was higher in salt-sensitive than in salt-resistant subjects (P < 0.05) but similar in subjects with a positive and negative family history of hypertension. However, alpha 2-adrenergic receptor density decreased significantly during 2 weeks of moderate salt restriction from 169.6 +/- 34.2 to 142.6 +/- 30.8 (P < 0.01, paired t-test), which may explain the decreased pressor response to infused noradrenaline observed in a previous study during moderate salt restriction. It is concluded that in humans there is no association of genetic predisposition of hypertension or of salt sensitivity to an alteration of sodium pump activity, NaK-cotransport, intracellular sodium and calcium. Alpha 2-receptor density of platelets deserves further study as a possible predictor of salt sensitivity in normotensives.

Adult