Biomedical subjects
Publications and source records attributed to H Brunner.
2,213 sera of normal persons and of men with nongonococcal urethritis were tested by CF. 4.5% of the males, 9.2% of the females, and 10.8% of the urethritis-patients had titers of 1 : greater than or equal to 16 when tested against a group-specific chlamydial antigen. The usefullness of the CFT for seroepidemiological studies was confirmed.
The known mechanisms of pathogenicity of Mycoplasma pneumoniae are discussed. In addition, evidence is provided for the participation of the immune system in the pathogenesis of M. pneumoniae disease. In a working hypothesis the stimulation of a protective and/or a reactive immune response is postulated, depending on the predisposition of the host, the infecting dose, the frequency of contact and the virulence of the organisms. Because well studied animal models are available, the Mycoplasma-Pneumonia is well suited to investigate the pathogenesis of infections caused by bacteria and the defense of the host.
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Surface carbohydrate structures, containing alpha-D-glucosyl or sterically closely related residues, were visualized on mycoplasma membranes by cytochemical staining procedure with concanavalin A and iron-dextran complexes.
A massive haemorrhage from a duodenal ulcer verified on endoscopy in a 21 year-old patient was stopped by a 62--hour infusion of somatostatin at a dosage of 250 microgram/hour. Suppression of gastric secretion is probably more important than the reduction in splanchnic blood flow with regard to the mechanism of action of this drug. No side effects were observed.
An indirect staphylococcal radioimmunoassay (SRIA) has been developed for determination of M. pneumoniae antibodies. This test allows the detection of antibodies in various immunoglobulin (Ig) classes similar to the previously described radioimmunoprecipitation test (RIP). SRIA has two advantages over RIP: first, it uses 100-fold less anti-Ig reagents than RIP; second, bound can be separated from unbound antigen more easily by the relatively heavy staphylococci. SRIA antibodies, belonging to the IgA class of Ig, could be detected in nasal secretions of volunteers infected intranasally with ts H43 of M. pneumoniae. In sera of patients with M. pneumoniae pneumonia antibodies to the IgG or the IgM class of Igs could be determined separately. This is especially important for an early diagnosis of M. pneumoniae disease.
312 patients with non-specific prostato-urethritis were investigated with a standardised procedure using the four glass test. In 42.3% of patients mycoplasma was isolated which in almost all cases was Ureaplasma urealyticum. Clinically patients were symptom-free after eradication of mycoplasma in cases where previously urea-plasma counts of more than 10,000 CFU/ml prostatic secretion and of more than 1000 CFU/ml urine had been demonstrated. In cases where there were smaller counts of Ureaplasma urealyticum and where Mycoplasma hominis had been demonstrated tetracycline therapy did not lead to cure in any case.
The haemodynamic effects produced by intravenous infusions of the beta-blocking agents metoprolol and propranolol in doses of 0.3 and 1 mg/kg/10 min were compared in anaesthetized dogs. When administered in a dose of 0.3 mg/kg/10 min, metoprolol caused a longer-lasting increase in pulmonary-arterial pressure and total pulmonary resistance, a greater increase in pulmonary capillary pressure and a more marked decrease in O2 partial pressure in the arterial blood than propranolol. These differences are probably due to differences in the pharmacokinetics of the two drugs. The effects of the two beta-blockers in a dose of 1 mg/kg/10 min were similar. At neither of the dose-levels tested were the changes induced by the compounds in the various parameters studied clearly dose-related.
Fractions in the molecular weight range of the so-called middle molecules (500--3000 daltons) were isolated on a preparative scale from hemofiltrate of patients. Hemofiltration was performed with an RP-6 dialyzer using a predilution technique. The hemofiltrate was concentrated and desalinated by reverse osmosis with membranes with a normal cut-off of 500 daltons. The retentate was freeze-dried, redissolved in volatile buffer and fractionated on Sephadex G-15 macrocolumns. The middle molecule molecular weight range in the elution profiles (detected at 206 and 280 nm simultaneously) was marked with peptides. Isolated fractions in the middle molecule molecular weight range showed strong inhibitory activity upon 3H-thymidine incorporation into rat bone-marrow cells in vitro. The described combination of hemofiltration, reverse osmosis and gel chromatography is suggested as a useful approach to the isolation of these ninhydrin-positive substances which, according to their proved heterogeneity, are to be subfractionated by further procedures.
Frozen, unfixed sections of human liver biopsies from patients with acute, subchronic, and chronic hepatitis or fibrotic liver disease were studied in indirect immunofluorescence with specific antisera to type I and type III procollagen. In early stages of both hepatitis and fibrotic liver disease, intralobular type III collagen synthesis is increased. Maximum values are reached years after the onset of disease. Intralobular procollagen I content is not increased in the acute stage, but rises only later. An increase of procollagen I seems to herald irreversible liver changes. This approach allows for exact localization and semiquantitative analysis of the synthesis of type I and type III collagen, and adds a new parameter to the diagnostic approaches in liver diseases.
In the case of 8 amblyopic patients the ERG and the brightness VECP, as well as the TV-pattern reversal VECPs in whole field and upper and lower half field stimulation, were traced. In the ERG (a- and b-wave) and the brightness VECP significant differences were established neither in the amplitude nor in the latenz between amblyopic and healthy eyes. The amplitude of the pattern reversal VECPs in whole field and lower half field stimulation was significantly reduced in all 8 patients on the side of the amblyopic eye.
Side effects of pentagastrin were registered in 50 patients before application of a gastric suction drainage tube, during the basal secretion period as well as after injection of 6 microgram/kg pentagastrin resp. 1 ml of physiological saline. Discrete symptoms occurred significantly more frequently after pentagastrin application: 28% of patients complained about nausea, 24% about tremor, 22% about hot feeling. These sensations occurred immediately after injection and continued for several minutes. In 4 persons the test had to be stopped because of collapse. There was no correlation between the frequency of symptoms, age of the patient, sex or gastric acidity. Causal relationships to lowering of blood pressure or changes of gastrointestinal motility are discussed.
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The treatment of gastric ulcer by the H2-receptor-antagonist Cimetidine results in an ulcer healing rate of 60 to 80% during a 4 to 6 weeks therapy cure. In most studies Cimetidine is superior to placebo or equipotent to a high dose antacid regimen, the latter being accepted to be of beneficial effect on ulcer healing. In the Zollinger-Ellison-syndrome Cimetidine inhibits largely gastric acid hypersecretion and represents for the first time a true alternative to total gastrectomy.
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