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Biomedical subjects

H Bartels

Publications and source records attributed to H Bartels.

At least 19 recordsLinked to original sources
PubMed1992

[Prognostic factors in diffuse peritonitis].

In order to evaluate their prognostic relevance for survival 46 variables were submitted to univariate as well as multivariate analysis in a group of 184 patients with diffuse peritonitis. In the univariate analysis a significant correlation with the outcome was found for the following parameters: age greater than or equal to 70 years, preexisting hepatic or cardiac disease, no eradication of the primary source of infection at first laparotomy for peritonitis, cardiovascular instability, respiratory failure, hyperbilirubinemia, thrombocytopenia, elevated serum creatinine and diminished creatinine clearance at the beginning and proof of pseudomonas aeruginosa in the peritoneal exsudate and of candida albicans in the blood culture during the course of the peritonitis. In the multivariate analysis the surgical eradication of the primary source of infection at the first laparotomy for peritonitis, serum creatinine at the beginning of peritonitis, age greater than or equal to 70 years and a preexisting hepatic disease proved to be the independent variables with significant prognostic relevance for survival of the patients.

Aged↗
PubMed1992

Co-localization of vimentin and cytokeratins in M-cells of rabbit gut-associated lymphoid tissue (GALT).

The occurrence of cytokeratins, vimentin, and desmin in the dome epithelia and adjacent non-dome epithelia in four locations of gut-associated lymphoid tissues (GALT) of adult and newborn rabbits (Peyer's patches, sacculus rotundus, caecal lymphoid patches and appendix) was studied with monoclonal antibodies, using the indirect immunoperoxidase technique. In all locations investigated in adult animals, antibodies specific for vimentin labelled (1) M-cells, which engulf intra-epithelial lymphocytes, (2) columnar epithelial cells at the base of the domes lacking an apparent contact with lymphocytes ("immature" M-cells), and (3) flat cells, which lie in the lamina propria under the dome epithelium, and which line the basal lamina with thin cytoplasmic processes. In newborn rabbits, columnar epithelial cells resembling the immature M-cells of adults were selectively stained with vimentin antibodies. In M-cells, the strongest immunoreactivity was present in the perinuclear region and close to the pocket membrane, whereas the most apical and most basal parts of the cytoplasm showed no vimentin-immunoreactivity. Enterocytes in the dome epithelium and in the non-dome epithelium were vimentin-negative. M-cells and enterocytes bound antibodies against cytokeratin peptides 18 and 19 in adult and newborn animals. Compared with enterocytes, M-cells showed less intense staining for cytokeratins. Dome epithelia and no-dome epithelia did not contain desmin-immunoreactive cells. The results suggest that vimentin is a sensitive marker for M-cells in rabbit GALT.

Animals↗
PubMed1992

Combination therapy with interferon alpha-2b plus low-dose interferon gamma in pretreated patients with Ph-positive chronic myelogenous leukaemia.

Between March 1988 and July 1990, 28 adults with chronic myelogenous leukaemia (CML) were treated with a combination of recombinant human interferon (IFN) alpha-2b s.c. (initial dose 4 x 10(6) U/m2) and recombinant human IFN gamma s.c. (50 micrograms totally) daily. All patients were in chronic phase disease and had been treated previously with chemotherapy or bone marrow transplantation. A complete haematologic remission was achieved in three patients (11%), a haematologic remission in 12 patients (43%), and a partial haematologic remission in seven patients (25%). Six patients did not respond to this schedule. Acute side-effects were flu-like symptoms, fever and chills. During long-term treatment six patients developed polyarthralgia. Haematotoxicity WHO grade III occurred in three patients, and WHO grade IV in two patients. One patient developed psychosis, and in another patient an exacerbation of a pre-existing sarcoidosis was observed. We conclude that this combination is tolerable and effective in inducing haematological remissions in pretreated CML patients.

Adolescent↗
PubMed1992

Captopril modifies the response of infarcted rat hearts to isoprenaline stimulation.

In this study the effect of the angiotensin converting enzyme (ACE) inhibitor captopril on beta-receptor responsiveness was investigated in failing rat hearts after experimental myocardial infarction. Infarcted rats were treated for 8 weeks with either captopril added to the drinking water (100 mg/kg/day; n = 5) or drinking water alone (n = 7). Treatment was started 2-3 days before myocardial infarction. A third group of untreated rats without myocardial infarction served as control (n = 6). At the end of the treatment period the hearts were perfused as described by Langendorff, and a cumulative dose-response curve of isoprenaline was obtained in each heart. In comparison with noninfarcted hearts, the response of heart rate and peak pressure rate (dP/dt) to isoprenaline stimulation was significantly depressed in hearts of infarcted rats. Chronic treatment with captopril significantly attenuated the reduced responsiveness to isoprenaline stimulation. This improved responsiveness in captopril-treated rat hearts might be due to prevention of "down-regulation" of myocardial beta-adrenoceptors. Other factors should also be considered, such as prevention of structural alterations in the noninfarcted myocardium, e.g., myocardial hypertrophy and fibrosis. Differences in infarct size did not play an important role, since infarct size was comparable in both groups of infarcted rats. This partial preservation of beta-adrenergic responsiveness was accompanied by a significant reduction in right ventricular weight and lung weight, suggesting that captopril also improved the signs of heart failure. Therefore, the results of this study indicate that early ACE inhibition in myocardial infarction may be useful in preventing deterioration of cardiac function.

Administration, Oral↗
PubMed1992

Free epinephrine, norepinephrine and dopamine in saliva and plasma of healthy adults.

To investigate whether salivary catecholamine levels reflect short term changes of sympathoadrenal activity, we simultaneously measured plasma and saliva epinephrine, norepinephrine and dopamine concentrations at rest, during bicycle ergometry and during epinephrine infusion in 12 healthy adults, using a radioenzymatic method. Whereas all plasma catecholamines significantly increased during bicycle ergometry and epinephrine infusion, no changes were observed in the salivary catecholamine concentrations and the salivary catecholamine flow rate after stimulation by rhythmic chewing. Moreover, salivary catecholamine concentrations were related neither to heart rate nor to blood pressure. Obviously, free catecholamines are rapidly inactivated by enzymatic degradation, neuronal reuptake or extraneuronal uptake in tissues before they diffuse through the tight junctions into the saliva. Therefore, stimulated saliva catecholamine levels do not reflect short term changes in the activity of the sympathoadrenal nervous system.

Adult↗
PubMed1992

[The therapeutic results of programmed relaparotomy in diffuse peritonitis].

The therapeutical concept of programmed relaparotomy was performed in 184 patients with diffuse peritonitis from 4/1984 to 4/1991. Clinical results were prospectively documented and a total of 46 variables (e.g. risk factors, clinical parameters, laboratory tests, microbiological screenings, score systems) both univariate and multivariate were tested for prognostic significance. Total lethality rate was 26% (48/184 patients). If complete eradication of the source of infection was surgically achieved (150 patients/82%) lethality rate was only 9%. In contrast, lethality rate was 100% in patients with unsuccessful surgical focus eradication. Eradication of the source of infection during the first operation (104 patients/56%) resulted in a lethality rate of 6%, compared to 17% for patients who needed two or even more operations (46 patients/25%). Eradication of the source of infection during the first laparotomy ("focus eradication on time") was the most important prognostic parameters. Of further prognostic significance but with declining importance where serum-creatinine at the beginning of the treatment, patient's age (greater than less than 70 years) and preexistent hepatic disease.

Adolescent↗
PubMed1991

Characterization and preliminary attempts for derivatization of crystals of large ribosomal subunits from Haloarcula marismortui diffracting to 3 A resolution.

An improved form of crystals of large (50 S) ribosomal subunits from Haloarcula marismortui, formally named Halobacterium marismortui, diffracting to 3 A resolution, has been obtained by the addition of 1 mM-Cd2+ to the crystallization medium, which contained more than 1.9 M of other salts. The improved crystals, grown from functionally active particles to an average size of 0.3 mm x 0.3 mm x 0.08 mm, are isomorphous with the previously reported ones, which diffracted to 4.5 A. They are of space group C222(1), cell dimensions a = 210 A, b = 300 A, c = 581 A, and contain one particle in the asymmetric unit. Their superior internal order is reflected not only in their high resolution, but also in their reasonable mosaicity (less than 0.3 degrees). In contrast to the previously grown crystals, the new ones are of adequate mechanical strength and survive well the shock-cooling treatment. Due to their weak diffracting power, all crystallographic studies have been performed with synchrotron radiation. At cryotemperature, these crystals showed no measurable decay for a few days of irradiation and a complete diffraction data set could be collected from a single crystal. Efforts for initial phasing by specific and quantitative derivatization with super-dense heavy-atom clusters are in progress.

Crystallization↗
PubMed1991

Partial trisomy 1q. A nonrandom primary chromosomal abnormality in myelodysplastic syndromes?

Cytogenetic and clinical data of 11 patients with de novo myelodysplastic syndromes and partial or total trisomy of the long arm of chromosome 1 are presented. In eight of these patients trisomy 1q was the sole karyotypic change and therefore can be classified as a primary chromosome anomaly. A remarkably young median age of 36.5 years was noticed in this patient group.

Adolescent↗
PubMed1991

[Diagnostic procedure in postoperative complications].

17% of postoperative ICU patients develop postoperative complications. In 84% of cases, complications are related to surgery, in 16% they are not. The main postoperative surgical complications are abdominal sepsis (65%), postoperative bleeding (25%), and bowel obstruction (7%). Therefore, the primary objective of postoperative investigations must be to check the sites of operation. Bedside procedures are examination of drainage fluid, sonography, endoscopy, and X-ray (gastrografin swallow). The diagnostic value of these procedures is 80%. Other diagnostic procedures include CT, angiography, and diagnostic laparatomy.

Critical Care↗
PubMed1991

Occluding junctions in the epithelia of the gut-associated lymphoid tissue (GALT) of the rabbit ileum and caecum.

The zonulae occludentes of the dome epithelia and adjacent non-dome epithelia in four locations of the gut-associated lymphoid tissue (GALT) in the rabbit ileum and caecum (Peyer's patches, sacculus rotundus, caecal lymphoid patches, appendix) were studied in freeze-fracture replicas. In all locations the zonulae occludentes of the dome epithelium are composed of more junctional strands than in the corresponding non-dome epithelium. In the dome epithelia of Peyer's and caecal lymphoid patches the zonulae occludentes show considerable structural variation; the number of superimposed strands is approximately 10 (range 5-18). In the dome epithelia of sacculus rotundus and appendix, in addition to zonulae occludentes, extended networks of junctional strands (fasciae occludentes) are present particularly between M-cells and enterocytes. The zonulae occludentes consist of approximately 8 to 9 (range 5-15) superimposed strands; the fasciae occludentes extend up to a depth of 20 microns on the lateral membranes. The presence of the fasciae occludentes correlates with the appearance of regularly shaped clusters of lymphocytes, which are most developed in the dome epithelia of sacculus rotundus and appendix. These results suggest (1) that in contrast to the dome epithelia of Peyer's and caecal lymphoid patches those of sacculus rotundus and appendix are compartmentalized, and (2) that the mobility of lymphocytes and diffusion of antigens in the dome epithelia of sacculus rotundus and appendix is restricted.

Animals↗
PubMed1991

[Management of postoperative cardiovascular instability exemplified by esophageal surgery].

The postoperative course of 95 patients following esophagectomy was analyzed with regard to the occurrence of cardiac arrhythmias and circulatory instability. In 86 subjects (90%), post-operative atrial and ventricular arrhythmias were recorded. In all, 29 patients (30%), showed hypotonic episodes, with arterial mean pressures of less than 65 mmHg being recorded. Preloading was reduced in 8 cases, as was afterloading in 16 subjects, whereas in 5 patients actual cardiac failure occurred. There was a strong correlation between circulatory instability and postoperative surgical complications. All 24 subjects who developed surgical complications (that is, 80% of all patients exhibiting circulatory instability) experienced hypotonic episodes. In this group of patients, management should consist of a rational combination of vasoactive substances together with surgical removal of the focus. This analysis supports our proposition that in postoperative instability, one should always suspect initial, actual surgical complications and initiate adequate diagnostic and therapeutic measures.

Arrhythmias, Cardiac↗
PubMed1991

[The role of antibiotic therapy for postoperative infectious complications].

Prospective analysis of the postoperative course of 1461 patients following major visceral surgery showed that postoperative complications scurred in 17.3% (253) of cases; 81% of the complications were related to the surgical procedure (surgical complications), whereas in 18.2% (46) of the patients, they complications were not related to surgery (non-surgical complications). Among septic cases, the relationship between surgical vs non-surgical complications was 141 to 29 patients, or 5:1. Early surgical reintervention was performed in all 141 patients exhibiting abdominal sepsis. Only 103 subjects (73%) in this group received additional antibiotic treatment. In contrast, all 29 patients who developed non-surgical sepsis were initially treated with antibiotics. When postoperative septic complications occur, abdominal sepsis should be considered first. Early surgical reintervention is always the treatment of choice for these complications. Antibiotics are regarded only as an adjuvant measure. For the rather rare septic complications that are not related to surgery, antibiotic therapy is used.

Abdomen↗
PubMed1991

[Early detection of changes in peripheral blood vessels in children and adolescents with insulin-dependent diabetes mellitus using Doppler ultrasound].

A clinically established method for early diagnosis of a macroangiopathy in a preclinical state has not been available so far. It was therefore checked whether vascular changes in diabetics can already be detected in childhood and adolescence by determination of pulse wave velocity using the Doppler ultrasound technique. The pulse wave velocity (PWV) was determined in 63 diabetics with a mean age (mean +/- s) of 16.2 +/- 3.3 years and a mean duration of diabetes (mean +/- s) of 8.5 +/- 4.7 years and in 45 control subjects with a mean age of 15.8 +/- 3.8 years by simultaneous recording of the pulse curves from the femoral artery and the posterior tibial artery. The diabetics had a very much higher PWV than the control group (mean +/- s: 10.9 +/- 1.6 m/s as compared to 9.9 +/- 0.8 m/s; p less than 0.001). In 21 out of 63 diabetics, the values were above the 2s range of controls. Indeed, nine of these 21 patients had values above the 3s range. In the diabetics, there was a significant correlation between PWV and the duration of diabetes and mean blood pressure. Vascular changes can already be demonstrated in childhood and adolescence by measurement of the PWV using the Doppler ultrasound method in diabetics. A longitudinal study would be necessary to establish whether this enables early diagnosis of macroangiopathy.

Adolescent↗
PubMed1990

Predominant periportal expression of the phosphoenolpyruvate carboxykinase and tyrosine aminotransferase genes in rat liver. Dynamics during the daily feeding rhythm and starvation-refeeding cycle demonstrated by in situ hybridization.

The zonal distribution of phosphoenolpyruvate carboxykinase (PCK) and tyrosine aminotransferase (TAT) mRNA in liver was studied by in situ hybridization with radiolabelled cRNA probes and the abundance of PCK and TAT mRNA was quantified by Northern blot analysis of total RNA with biotinylated cRNA probes. Livers were taken from rats during a normal 12 h day/night rhythm, when they had access to food only during the dark period from 7 pm to 7 am, or during refeeding, when they had access to food after having been starved for 60 h. 1. Daily feeding rhythm: High levels of PCK mRNA were distributed mainly in the periportal and intermediate zone during the fasting period at noon and 6 pm. Feeding caused a rapid decrease in PCK mRNA level and a restriction of PCK mRNA localization to the periportal area within the first 2 h. No further alterations were observed during the following hours of the feeding period. TAT mRNA was distributed also in the periportal and intermediate zone during the fasting period. Feeding first reduced the mRNA level without changing the distribution pattern. Then towards the end of the feeding period TAT mRNA increased again to half-maximal levels and became restricted mainly to the periportal area. 2. Starvation-refeeding cycle: High amounts of PCK mRNA as well as of TAT mRNA were localized predominantly in the periportal and intermediate zone after 60 h of starvation. PCK and TAT mRNA both decreased markedly during the first 2 h of refeeding and then remained almost constant.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

Development and evaluation of an enzyme-linked immunoassay for the prostate: specific antigen utilizing two monoclonal antibodies.

PSA is an important tumor-marker for prostatic cancer disease. We developed a sensitive, simple and inexpensive Sandwich ELISA for PSA with two monoclonal antibodies. The precision and reliability of the assay are reflected in the low inter- and intraassay coefficient of variation. PSA was not detectable in sera from normal females (n = 50). Sera from males with different serum levels of PSA (normal males, patients with prostate hypertrophy, prostate cancer patients, n = 79) and 15 prostate cancer patients treated with Zoladex were measured by our ELISA and by a commercially available RIA. The correlation coefficient between these both test systems was close to 1 (r = 0.97).

Antibodies, Monoclonal↗