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Biomedical subjects

H Köhler

Publications and source records attributed to H Köhler.

At least 487 records · Page 27Linked to original sources

[Studies on the use of megestrol acetate for estrus synchronization in heifers].

Megestrol acetate has been tested for its applicability to synchronisation of oestrus in 463 mature heifers in the framework of preclinical and clinical experiments. Clinical tests and studies in the context of laboratory diagnostics have shown that 40 mg/die megestrol acetate, administered in two applications with twelve hours in-between and over 15 days, are necessary for maximum synchronisation effect. The resulting oestrus was found to be prolonged, with ovulations taking place within two or three days. Technological requirements in this context are discussed. Megestrol acetate is found to be suitable for oestrus synchronisation in heifer. Tests conducted under industrialised conditions have shown conception rates to be identical with those obtained by administration of chloromadinone acetate.

Animals↗

Complementary idiotypy in the regulation of the immune response.

A new concept is presented for the interactions of two complementary antibodies in the immune response. These antibodies bind to each other by means of their variable sequence determinants and therefore are designated as complementary idiotypes. Under certain conditions, both complementary idiotypes are produced by the same animal at the same time. An idiotype can drastically affect the expression of the complementary idiotype in the animal, inducing a peripheral quench effect of antibody-binding activity and a central effect on the immunocompetent cell, which produces the complementary idiotype. It is proposed that complementary idiotypes might be induced during every immune response, thus playing an essential role in the regulation of the immune response.

Animals↗

The macrophage electrophoretic mobility (MEM) test for the diagnosis of hydatidiform mole and choriocarcinoma. Preliminary report.

In 1970, Field and Caspary reported that lymphocytes from patients with malignant disease can be stimulated by a basic protein from human brain (human encephalitogenic protein--HEP). The stimulated lymphocytes are capable of releasing the macrophage-slowing factor, which reduces the electrophoretic mobility of guinea-pig macrophages. In general, this effect was not found with lymphocytes from patients without malignant disease. This paper deals with the application of the MEM test using HEP and HCG as antigen in the diagnosis of trophoblastic disease. We have found cellular sensitization against HCG in all patients with gestational trophoblastic tumours and against HEP in patients with hydatidiform moles of the group II or III as well as choriocarcinoma. Patients with malignant tumours of different localization showed a cellular sensitization against HEP, but only some against HCG. In pregnant women no cellular sensitization against HEP as well as HCG was detected. The results of the MEM test using HEP as antigen in patients with gestational trophoblastic tumours are compared with the clinical findings and the histological diagnosis. By means of this combination a more exact evaluation of the biological activity of the trophoblastic disease was obtained.

Adult↗

Hydroxyethyl starch-induced macroamylasemia.

Summarizing, the following results were obtained: 1. After infusion of 500 ml hydroxyethyl starch 6% in all patients an increase of serum amylase occurred, which in most cases reached values twice as high as the basal value. 2. This hyperamylasemia is caused by the formation of a high molecular HES-amylase complex, which cannot be easily eliminated. 3. In no case was hyperamylasemia associated with other clinical signs or symptoms.

Amylases↗

[Formation of high-molecular aggregates between serum amylase and colloidal plasma substitutes (author's transl)].

The distribution of molecular weights of human serum amylase was studied by gel filtration of serum, obtained before and after infusion of the colloidal plasma substitutes hydroxyethyl starch, dextran and gelatin, respectively. Both in serum, drawn after intravenous infusion of hydroxyethyl starch, and in a solution of hydroxyethyl starch with serum we observed a significant increase in the molecular weight of serum amylase. The occurrence of this "macroamylase" may be explained by the formation of aggregates between hydroxyethyl starch and amylase. Because of its high molecular weight the elimination of this, presumably, enzyme-substrate-complex is retarded, thus leading to the observed increase of serum amylase activity. In contrast to these observations concerning hydroxyethyl starch no change in the apparent molecular weight of serum amylase was observed following the infusion of either gelatin or dextran or their solutions with serum.

Amylases↗

Immune response to phosphorylcholine. III. Requirement of the Fc portion and equal effectiveness of IgG subclasses in anti-receptor antibody-induced suppression.

Anti-idiotypic antibody raised against the BALB/c myeloma proteins TEPC-15 or HOPC-8 inhibits induction of the immune response to phosphorylcholine (PC). (Fab')2 and Fab' fragments from anti-idiotype serum were prepared and anti-idiotypic antibody was purified by absorption and elution from idiotype or anti-IgG subclass immunoabsorbents. The parent material, the purified anti-idiotypic antibodies and the Fab' fragments were assayed for: i) binding to the idiotype by using a sensitive radioimmunoassay, and ii) specific suppression of the response to PC in vitro. The correlation of binding to suppression was very similar for anti-idiotype serum and both kinds of purified antibody. However, the Fab' fragments only bound to the idiotype and did not suppress. These findings indicate that the Fc portion of anti-idiotypic anti-receptor antibody (ARA) is essential for inducing suppression but that ARA-induced suppression is independent of the IgG isotype. It is postulated that idiotype suppression is mediated by the interaction of anti-idiotype with the antigen receptor and the Fc receptor thereby cross-linking both receptors.

Animals↗

[Autoimmunity in chronic inflammatory eye disease (author's transl)].

Preparations of allogenous and xenogenous retinal rod outer segments (ROS) were found to be adequately antigenic for detection of cellular immunity in human chorioretinitis. The electrophoretic mobility test was used for estimation of delayed-type hypersensitivity. No significant results with ROS were found in patients with panophthalmia or in control subjects. It is assumed that the results reported here in chronic ophthalmic inflammation may be produced by or connected with autoimmune processes.

Autoantigens↗

[Total parathyroidectomy and autologous parathyroid transplantation in secondary hyperparathyroidism (author's transl)].

In a 17-year-old female patient with marked secondary hyperparathyroidism and progressive bone changes all four parathyroid glands were removed. Part of the endocrine tissue was reimplanted into the muscles of the forearm. The transplant took successfully and showed a satisfactory function. Total parathyroidectomy and autologous parathyroid transplantation has a number of advantages as compared with subtotal parathyroidectomy: The function of the transplant can be directly observed and tissue can be easily removed in the further course of the disease. It is thus possible to regulate parathormone secretion over long periods in patients with chronic renal failure.

Adolescent↗

[Plasma-cAMP in primary and secondary hyperparathyroidism (author's transl)].

3 patients with operatively proven primary hyperparathyroidism showed normal plasma cAMP concentrations. 5 patients in chronic dialysis treatment independent of the level of parathyroid hormone had increased plasma cAMP concentrations. These observations suggest that there is under these circumstances no regulation of plasma cAMP by the parathyroid hormone.

Cyclic AMP↗

Suppression by autogenous complementary idiotypes: the priority of the first response.

Complementary idiotypes or antibodies are considered to have combining site structures which are at least partly directed against each other. Complementary antibodies were induced in A/He mice by immunization with phosphorylcholine (PC)-containing antigens and by immunization with the PC-binding IgA myeloma protein TEPC-15 (T15). Both responses were monitored by enumerating plaque-forming cells (PFC) and assaying serum antibody levels against the corresponding antigens. Mice immunized at least three times with T15 in adjuvants had markedly suppressed responses to subsequent immunization with PC; similarly, mice preimmunized multiple times with PC had suppressed responses to immunizations with T15. In contrast, mice immunized with T15 in the interval between "primary" and "secondary" immunizations with PC had undiminished PFC responses to both antigens but significantly decreased antibody titers to PC. Simultaneous responses were also induced by immunizations with T15 superimposed on weekly immunizations with PC; with this regime, immunization with T15 actually enhanced the PFC response to PC, but serum antibody to PC was significantly lower than for mice immunized with PC only. Levels of serum antibody to PC were probably lower, either because anti-PC antibody was complexed with the complementary antibody directed against T15, or because the antibody directed against T15 prevented synthesis and/or release of anti-PC antibody by cells in vivo. Thus, an established prior autogenous immune response can dramatically suppress a subsequent primary complementary response, but the effects of complementary responses on each other are more complex with different sequences of immunization. Also, the effects of variables such as the amounts and ratios of the classes of antibodies on regulation of complementary responses remain to be defined.

Animals↗

[Demonstration of hepatitis-B(surface) antigen with the Hepatest: a new passive haemagglutination test (author's transl)].

The Hepatest, a passive haemagglutination test, proved to be, like other tests of this group, significantly more sensitive for routine examination of hepatitis B(surface) antigen than tests of the first and second generation, but was not as sensitive as the Ausria II 125 test. The lowest HBs antigen concentration demonstrable in the Hepatest was 31 ng/ml for the subtype ad and 47 ng/ml for subtype ay (in the Ausria II 125 test lowest concentrations were 1.0 and 1.5 ng/ml, respectively). There were several false-positive reactions in the specificity test. Thus all positive reactions would need to be checked, more often than with the Ausria test. But the Hepatest proved to be the most practicable of all the third generation tests, both with regard to shortness of reaction time, technical requirements and ease of reading off the results.

Adult↗

[Severe course of an infection with Leptospira grippotyphosa (author's transl)].

In a 22 years old female patient severe jaundice, renal failure and myocarditis developed 3 days after the onset of fever and other uncharacteristic symptoms. In dark-field microscopy leptospires were found. Inspite of high-dose penicillin therapy exitus letalis occurred in myocardial and circulatory failure, due to a severe interstitial myocarditis. Leptospira grippotyphosa could be proven serologically as the causative bacterium. It is pointed out, that leptospirosis inspite of their rare occurrence should be included in the differential diagnosis of infections of undetermined origin, especially if jaundice develops. The demonstration of leptospira in blood, cerebro-spinal fluid or urin by means of darkfield microscopy may quickly support the diagnosis. Since the course of severe leptospirosis can be influenced significantly only up to the 4th day after the onset, high-dose penicillin G or tetracycline therapy should be initiated already when the clinical suspicion is present.

Acute Kidney Injury↗

Macrophage electrophoretic mobility (MEM) test in malignant gynaecological diseases.

All patients examined [52] with malignant disease of the female genital tract showed lymphocyte reactions to encephalitogenic factor (EF) of more than 10% as measured by the macrophage electrophoretic mobility (MEM) test and its modification (MOD-MEM). Whilst 13 patients with non-malignant disease of the genital tract and 30 normals showed lymphocyte reaction to EF of less than 6%, 4 patients with nonmalignant gynaecological disease gave values above the 10% limit. The lymphocyte reactions of this latter group of patients were discussed with respect to their previous clinical histories. Some of the malignant cases were carcinoma of the cervix in situ so that the MEM test would appear to be of value in the early diagnosis of cancer. The need for caution in the interpretation of results is discussed as well as further possible applications of the technique.

Carcinoma in Situ↗

[The macrophage electrophoretic mobility LAD test--a diagnostic method for multiple sclerosis (author's transl)].

With the MEM test (Field) one can establish a cellular immune reaction becarus the sensitized lymphocytes release the macrophage slowing factor (MSF) upon interaction with the appropriate antigen. A macrophage migration inhibition was detected in some neurological diseases with destruction of the parenchyma. The modification MEM-LAD (linoleic acid depression) test made further differentiation possible in the 146 neurological patients and normals. The reduction of macrophage mobility inhibition was 94.7 + 4.7% in multiple sclerosis (MS) cases as compared with that of normals of 55.1 + 3.7% and of other neurological diseases of 47.8 + 7.1%. There were no significant differences due to the course and duration of the disease or to immunosuppressive therapy. The pathogenically important results in relatives of MS patients with values between the MS and normal group (78.5 + 0.7%) in mothers suggested a familial (genetic) disposition. The same value was found in a monozygotic twin of an MS patient. The results in the children studied showed that besides the endogenic metabolic component the aetiopathogenically important exogenic factors can operate early in life. In correlation with the principle of the MEM-LAD test the suppressive action of linoleic acid can result in a further therapeutic concept.

Adolescent↗

[Value and worthlessness of clinical studies in the diagnosis of brain death].

Death was ever determined on the basis of extinguished partial functions of the entire organism (partial death). In intensive medicine with its possibilities of reanimation, with its possibilities of artificial maintenance of breathing and circulation the individual death of man is equated with his cerebral death. It comes only under conditions of reanimation and nearly always shows a clinically recognizable development. Practically above all "the syndromes in the forefield of cerebral death" are of interest as well as its obligatory and optional symptoms, the valency of which was critically tested. A 5-year-analysis (1969 to 1973) of 487 deaths in an internal intensive therapy unit (18% of mortality) was shown that causes, frequency and age distribution of the mortal conditions of disease as well as the average survival time of 4.5 days, in which cases, however, 43% of all deaths occurred within the first 24 hours, very rarely caused us to establish the irreversibility of the loss of the cerebral function on account of an organic dysfunction, but rather resulting from the question of the interruption of an absurd reanimation.

Brain Death↗