Biomedical subjects
Publications and source records attributed to H Neubauer.
Of four tested identification systems (API 20E, API Rapid 32 IDE, Micronaut E, and the PCR-based Yersinia enterocolitica Amplification Set), API 20E is still the system of choice for identifying pathogenic Yersinia isolates. It provides the highest sensitivity both at the genus and at the species level and has the best cost-effectiveness correlation.
The significance of host defense mechanisms in primary listeriosis in vivo is incompletely understood. Here, we show that tumor necrosis factor receptor p55-/- (TRp55-/-) mice are susceptible to Listeria monocytogenes infection in the presence of leukocyte recruitment, inflammatory cytokine production (including IFNgamma), nitric oxide synthesis, and oxidative burst formation. Mice deficient for oxidative burst (p47[phox-/-] mice) are relatively resistant to listeriosis. Despite activation of these antibacterial effector systems, TRp55-/- phagocytes in vivo are incapable of confining and eradicating L. monocytogenes inside phagolysosomes. Bone marrow chimeras reveal that for eradication of L. monocytogenes, TRp55 is crucially required only on cells from hematopoietic origin. Unexpectedly, prior to death, exocrine pancreatic cells undergo apoptosis in TRp55-/- mice. Collectively, these data demonstrate that in vivo, TRp55 initiates a protective, listericidal mechanism in phagocytes that differs from nitric oxide production and oxidative burst formation and that uncontrolled listeriosis results in necrotizing pancreatitis in TRp55-/- mice.
Polymerase chain reaction was applied to the rapid identification and detection of mousepox virus. This was accomplished by selection of primers targeting the A-type inclusion body protein gene. By investigating 20 strains belonging to five different species of the genus Orthopoxvirus, amplification was achieved only with the seven mousepox virus strains examined. The size of the resulting DNA fragment accounted for 116 base pairs and contained a recognition site for the restriction enzyme HindII, thus confirming its viral origin. Amplification of mousepox virus specific sequences was also possible from infected mouse lung tissue and serum.
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Staphylococcus carnosus reduces nitrate to ammonia in two steps. (i) Nitrate was taken up and reduced to nitrite, and nitrite was subsequently excreted. (ii) After depletion of nitrate, the accumulated nitrite was imported and reduced to ammonia, which again accumulated in the medium. The localization, energy gain, and induction of the nitrate and nitrite reductases in S. carnosus were characterized. Nitrate reductase seems to be a membrane-bound enzyme involved in respiratory energy conservation, whereas nitrite reductase seems to be a cytosolic enzyme involved in NADH reoxidation. Syntheses of both enzymes are inhibited by oxygen and induced to greater or lesser degrees by nitrate or nitrite, respectively. In whole cells, nitrite reduction is inhibited by nitrate and also by high concentrations of nitrite (> or = 10 mM). Nitrite did not influence nitrate reduction. Two possible mechanisms for the inhibition of nitrite reduction by nitrate that are not mutually exclusive are discussed. (i) Competition for NADH nitrate reductase is expected to oxidize the bulk of the NADH because of its higher specific activity. (ii) The high rate of nitrate reduction could lead to an internal accumulation of nitrite, possibly the result of a less efficient nitrite reduction or export. So far, we have no evidence for the presence of other dissimilatory or assimilatory nitrate or nitrite reductases in S. carnosus.
Congenital elongation of the palpebral fissure associated with large eyelids was named euryblepharon after Desmarres in 1854. In some cases the length of the lower lid margin exceeded that of the upper lid margin by more than 3 mm. The lids are lax and the elongated lid margin of the lower lid is only partially in contact with the globe. In marked cases of euryblepharon there may be an additional minor vertical shortening of the upper lid. However, the abnormalities described by Desmarres did not produce severe kerato-conjunctival xerosis. We speculate that euryblepharon as originally described is merely a mild manifestation of congenital lagophthalmos. More severe forms show additional malformations, leading to pronounced insufficiency of lid closure. We report on four patients with severe congenital lagophthalmos. The appearance differs from that of euryblepharon by the following details: (a) a symmetrical congenital retraction of both the lower and the upper lid margins; (b) a marked vertical shortening of the lids (case 1 was referred for bilateral descemetoceles); (c) tarsal aplasia; and (d) severe kerato-conjunctival xerosis after insufficient surgical treatment, leading to different degrees of disability. The surgical approach involved bilateral shortening of the lid margins and free transplantation of retroauricular skin. Stabilization of the lax lower lid margin was achieved by lyodura strips applied with medium tension and in contact with the lid margin. At 5 years after the first operation a petty horizontal shortening of the lower lids was necessary because of circumscribed trichiasis. The dura strip remained present. The long-term result as evaluated at more than 8 years following the first operation was very satisfactory.
Instruments allowing to give a psychiatric expertise on the ability of demented people to give a will are needed. Criteria for an estimation of the course of dementing illnesses and for an increased suggestibility in coming to a decision are critically reviewed.
Mousepox was diagnosed in and eradicated from a laboratory mouse colony at the Naval Medical Research Institute. The outbreak began with increased mortality in a single room; subsequently, small numbers of animals in separate cages in other rooms were involved. Signs of disease were often mild, and overall mortality was low; BALB/cByJ mice were more severely affected, and many of them died spontaneously. Conjunctivitis was the most common clinical sign of disease in addition to occasional small, crusty scabs on sparsely haired or hairless areas of skin. Necropsy findings included conjunctivitis, enlarged spleen, and pale liver. Hemorrhage into the pyloric region of the stomach and proximal portion of the small intestine was observed in experimentally infected animals. In immune competent and immune deficient mice, the most common histologic finding was multifocal to coalescing splenic necrosis; necrosis was seen less frequently in liver, lymph nodes, and Peyer's patches. Necrosis was rarely observed in ovary, vagina, uterus, colon, or lung. Splenic necrosis often involved over 50% of the examined tissue, including white and red pulp. Hepatic necrosis was evident as either large, well-demarcated areas of coagulative necrosis or as multiple, random, interlacing bands of necrosis. Intracytoplasmic eosinophilic inclusion bodies were seen in conjunctival mucosae and haired palpebra. Ectromelia virus was confirmed as the causative agent of the epizootic by electron microscopy, immunohistochemistry, animal inoculations, serologic testing, virus isolation, and polymerase chain reaction. Serologic testing was of little value in the initial stages of the outbreak, although 6 weeks later, orthopoxvirus-specific antibody was detected in colony mice by indirect fluorescent antibody and enzyme-linked immunosorbent assay procedures. The outbreak originated from injection of mice with a contaminated, commercially produced, pooled mouse serum. The most relevant concern may be the unknown location of the source of the virus and the presence of a reservoir for this virus within the United States.
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The prevalence of psychiatric disorders in general hospital inpatients can be estimated at 30-50%. In Germany, hardly any studies have provided an assessment of prevalence rates and specific treatment necessities. In this study, 400 patients from medical and surgical departments were interviewed with a structured clinical interview. The point prevalence of all psychiatric disorders (clinical diagnoses) was 46.5%. The most prevalent groups of disorders were organic brain syndromes, depressive disorders, and alcoholism. With regard to disease entities, no significant differences between the samples from internal medicine and from surgery could be found. Compared to a German population sample, only organic brain syndromes, depressive reactions and alcohol dependency tend to be higher in a general hospital. Consultation/liaison interventions were found to be necessary in nearly half of the whole sample. In one-fourth of the patients continuous psychiatric care after hospital discharge was required.
In the treatment of elderly patients the question often arises whether they are able to give an informed consent to medical operations. According to German jurisdiction the patient must be able to comprehend the kind, the aim and the consequences of the projected surgical operation as well as to declare his will. If this is not the case, he cannot give an informed consent, being "under disability" and in Germany a guardian has to be installed by the court. E.g., moderately demented or delirious patients are unable to give an informed consent to medical operations. A discussion on this topic is under way, as to whether a patient has the right to give an informed consent in advance in case of becoming unable to declare his will (in dementia etc.).
Lactobacillus sanfrancisco LTH 2581 can use only glucose and maltose as sources of metabolic energy. In maltose-metabolizing cells of L. sanfrancisco, approximately half of the internally generated glucose appears in the medium. The mechanisms of maltose (and glucose) uptake and glucose excretion have been investigated in cells and in membrane vesicles of L. sanfrancisco in which beef heart cytochrome c oxidase had been incorporated as a proton-motive-force-generating system. In the presence of ascorbate, N,N,N',N'-tetramethyl-p-phenylenediamine (TMPD), and cytochrome c, the hybrid membranes facilitated maltose uptake against a concentration gradient, but accumulation of glucose could not be detected. Similarly, in intact cells of L. sanfrancisco, the nonmetabolizable glucose analog alpha-methylglucoside was taken up only to the equilibration level. Selective dissipation of the components of the proton and sodium motive force in the hybrid membranes indicated that maltose is transported by a proton symport mechanism. Internal [14C]maltose could be chased with external unlabeled maltose (homologous exchange), but heterologous maltose/glucose exchange could not be detected. Membrane vesicles of L. sanfrancisco also catalyzed glucose efflux and homologous glucose exchange. These activities could not be detected in membrane vesicles of glucose-grown cells. The results indicate that maltose-grown cells of L. sanfrancisco express a maltose-H+ symport and glucose uniport system. When maltose is the substrate, the formation of intracellular glucose can be more rapid than the subsequent metabolism, which leads to excretion of glucose via the uniport system.
In this paper criteria for the assessment of the ability of psychiatric patients to give an informed consent are presented. Legal and medical aspects including jurisdiction are discussed. Some elements for a judgement of an informed consent are proposed.
rDNA hirudin plasma concentrations in man and rhesus monkeys were determined over a period of 15 and 24 h. The plasma concentration of alpha-human thrombin-hirudin complex was measured after administration of the complex to rhesus monkeys. The complex was also determined after administration of hirudin to man and rhesus monkeys to study a possible formation of a complex with alpha-human thrombin in blood. The determination of hirudin was performed by a sandwich ELISA, using polyclonal and monoclonal antibodies and the chromogenic thrombin substrate assay. The alpha-human thrombin-hirudin complex concentration in the plasma of rhesus monkeys was measured over a period of 48 hours. The results of a sandwich ELISA were compared with those of the chromogenic thrombin substrate assay. A good agreement between the total hirudin concentrations analyzed by the hirudin ELISA and the alpha-human thrombin-hirudin complex ELISA and those of the chromogenic thrombin substrate assay, measuring total hirudin, too, was observed.
Antibodies were raised against the carboxy terminus of the insulin A chain in sheep, goat and rabbit using as antigen the synthetic octapeptide YQLENYCN conjugated to bovine serum albumin (BSA). All of the antisera obtained cross-reacted with molecules containing this peptide sequence. Using these antibodies, we developed a radioimmunoassay that could detect the insulin A chain itself, both denatured and natural mammalian and avian insulins, as well as proinsulins and insulin fusion proteins from microorganisms.
With regard to jurisdiction various problems of malpractice in psychotherapy are discussed. Malpractice is described in diagnosis, differential diagnosis, suicidal intent, indication to therapy and treatment. Proof for malpractice and its damage in psychotherapy is difficult to submit in evidence.
The uptake of beta-lactam antibiotics into small intestinal enterocytes occurs by the transport system for small peptides. The role of membrane-bound peptidases in the brush border membrane of enterocytes from rabbit and pig small intestine for the uptake of small peptides and beta-lactam antibiotics was investigated using brush border membrane vesicles. The enzymatic activity of aminopeptidase N was inhibited by beta-lactam antibiotics in a non-competitive manner whereas dipeptidylpeptidase IV was not affected. The peptidase inhibitor bestatin led to a strong competitive inhibition of aminopeptidase N whereas the uptake of cephalexin into brush border membrane vesicles was only slightly inhibited at high bestatin concentrations (greater than 1 mM). Modification of brush border membrane vesicles with the histidine-modifying reagent diethyl pyrocarbonate led to a strong irreversible inhibition of cephalexin uptake whereas the activity of aminopeptidase N remained unchanged. A modification of serine residues with diisopropyl fluorophosphate completely inactivated dipeptidylpeptidase IV whereas the transport activity for cephalexin and the enzymatic activity of aminopeptidase N were not influenced. With polyclonal antibodies raised against aminopeptidase N from pig renal microsomes the aminopeptidase N from solubilized brush border membranes from pig small intestine could be completely precipitated; the binding protein for beta-lactam antibiotics and oligopeptides of apparent Mr 127,000 identified by direct photoaffinity labeling with [3H]benzylpenicillin showed no crossreactivity with the aminopeptidase N anti serum and was not precipitated by the anti serum. These results clearly demonstrate that peptidases of the brush border membrane like aminopeptidase N and dipeptidylpeptidase IV are not directly involved in the intestinal uptake process for small peptides and beta-lactam antibiotics and are not a constituent of this transport system. This suggests that a membrane protein of Mr 127,000 is (a part of) the uptake system for beta-lactam antibiotics and small peptides in the brush border membrane of small intestinal enterocytes.
Magnetic brain stimulation and bulbocavernosus reflex (BCR) testing were performed to evaluate the central motor conduction time (CMCT) to the bulbocavernosus muscle (BC). In six healthy subjects CMCT ranged from 13.81 ms to 16.9 ms with a mean value of 15.77 ms (SD 1.38 ms). This equals a central motor conduction velocity of about 40 m/s, which can only be realized in fast conducting pyramidal tract fibres. Testing of pyramidal tract function by BC-CMCT might improve the diagnosis of male sexual dysfunction.