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Biomedical subjects

I Baumgartner

Publications and source records attributed to I Baumgartner.

At least 19 recordsLinked to original sources
PubMed1992

[Corneal ulcer. Current analysis from specialized ambulatory care of a clinic].

A review of 115 cases of ulcerative keratitis that were diagnosed and treated at the specialized ambulatory care center for infectious eye diseases at the 2. Department of Ophthalmology over a period of eight years (January 1983-April 1991) is presented. In the analysis of the etiology nearly half (47.7%) were observed following a trauma to the epithelium, 38 (= 33.0%) were associated with contact lens wear and the third largest group (10.4%) was associated with lid problems. It is apparent that over the course of the last years the spectrum of microorganisms associated with this localized inflammation has shifted: the prevalence of Staphylococci (1983-1986 = 65%) has decreased, whereas the incidence of gram-negative rods increased (1987-1990 = 49%). In 19% Pseudomonas aeruginosa could be isolated, mostly associated with soft contact lens wear. A total of 37.5% of the staphylococci isolates were found to be resistant to gentamicin, most probably as a consequence of the widespread, indiscriminate use of this antibiotic. An updated treatment schedule is presented.

Ambulatory Care↗
PubMed1992

[Corneal sensibility following epikeratophakia].

The postoperative rate of reinnervation following corneal surgery is widely considered to be a useful indicator of the healing process. This study reports the corneal sensitivity of 14 patients following epikeratophakia for different indications (myopia, aphakia and keratoconus) after time periods ranging from 7 to 104 weeks. All transplants were clear at the time of measurement. A newly developed aesthesiometer (using a low electric current for stimulation) was employed. Nine positions on the operated eye were chosen for the measurements, five locations of the non-operated fellow eye served as controls. On the operated eye the corneal sensitivity peripheral to the trephination were significantly reduced at the 9 and 12 o'clock positions as compared to the other eye. The 3 and 6 o'clock locations showed no significant difference. On the epikeratophakia lenticule the sensitivity was significantly reduced at all points, the center showing the largest difference (p less than 0.001). No correlation with age, sex or the indication for the procedure was observed. Although there was a trend of a positive correlation between the postoperative time period and the central corneal sensitivity, the follow-up was too short to reach significant levels. The nearly complete lack of corneal sensitivity, particularly in the center of the transplant is therefore well compatible with its long-time survival, even when the lenticule has been prepared with the cryolathe and lyophilized for transportation.

Adult↗
PubMed1992

[Double-blind study of the effect of dipyridamole in patients with intermittent claudication].

32 patients (mean age 65 years, range 51-75 years) were included in this controlled, double blind study to evaluate the effect of dipyridamole in patients with intermittent claudication. Following a run-in phase of one month, 15 patients received 400 mg dipyridamole per day and 17 patients placebo. Patient characteristics (risk factors, age, clinical and apparative tests) of both groups did not differ significantly before and during the study period. Mean pain free und absolute walking distance on the treadmill (3.2 km/h, 12.5 degrees gradient) increased significantly in both groups during study period (p < 0.001 and p < 0.01). Explanations are more intensive physical activity and increasing adaptation to treadmill exercise. However, dipyridamole did not induce a significantly longer walking distance in comparison with placebo. The working hypothesis that the drug with inhibiting properties of thrombocyte function prolongs walking distance in intermittent claudication, could not be confirmed.

Aged↗
PubMed1992

Retinal pigment epithelial cells in post mortem HLA typing of corneal donors.

Corneas used for transplantation are typically obtained from donors up to 48 hr post mortem. By this time, standard HLA typing usually is impossible because of the lack of viable lymphocytes in spleen and peripheral blood. To increase the number of HLA-typed corneas, we developed a method in which the retinal pigment epithelial (RPE) cells of the donor eye are isolated, cultured in the presence of 1000 IU/ml interferon-gamma (IFN-gamma), and, after 4 d, are typed for HLA Class I and Class II antigens in the standard NIH cytotoxicity assay. Sixty five donors were typed simultaneously using peripheral blood lymphocytes and RPE. One hundred and sixteen out of 120 HLA-A antigens, 125/127 HLA-B, 106/108 HLA-C, and 92/100 HLA-DR antigens were identical using the same technique. Donor age, sex, cause of death, time of enucleation post mortem, and time of RPE preparation post mortem, as well as duration of culture period prior to stimulation with IFN-gamma did not correlate with the results of HLA typing. These data show that RPE cells can substitute for lymphocytes in post mortem HLA typing. Consequently, every donor with corneas suitable for transplantation can be prepared for matched transplantation.

Adolescent↗
PubMed1991

Blepharitis--a diagnostic and therapeutic challenge. A report on 407 consecutive cases.

Over the last few years the number of patients with chronic bilateral blepharitis has increased dramatically. From January 1985 until the end of 1989, a total of 407 patients with this diagnosis underwent ophthalmological and dermatological investigations at our out-patient clinic. Keratoconjunctivitis sicca (KCS) in conjunction with blepharitis occurred in 14.5% of the patient population who also suffered from acne rosacea. A comparison of the spectrum of microorganisms that have previously been isolated from affected sites with data obtained in the present study revealed that the range of microorganisms associated with this chronic localized inflammation has apparently shifted in recent years. The prevalence of Staphylococcus aureus, which was considerable in the pre-antibiotic era, has markedly decreased, although a distinct entity of staphylococcal blepharitis seems to remain, either alone or in combination with seborrheic blepharitis (62.8% of our patients). The clinical picture, microbiological findings and therapy for this condition are presented.

Adolescent↗
PubMed1991

[Intermittent venous claudication].

Intermittent venous claudication develops mostly in young patients after iliac vein thrombosis and subsides promptly in the recumbent position. Plethysmographic assessment of calf volume during treadmill work permits objective diagnosis of the phenomenon remaining frequently unrecognized.

Adult↗
PubMed1991

[Diagnostic importance of the jugular veins].

Inspection, auscultation and doppler-sonographic examination of the jugular veins may give a clue for diagnosis of cardiac diseases. Angiological diseases include isolated thrombosis of the jugular vein and congenital ectasia. The neck veins are enlarged with thrombosis of the major upper extremity veins, if the orifice of the subclavian vein is also occluded and the normal outflow of the jugular vein is impeded. Thrombosis of the superior vena cava, compression of the mediastinal trunks by tumors, fibrosis or pericardial alterations causes dilatation of neck veins on both sides, best seen in the jugular veins.

Cardiovascular Diseases↗
PubMed1989

HLA typing from human donor eyes.

A method for HLA-ABC and HLA-DR typing of human donor eyes using pigmented retinal epithelial and uveal cells cultured in the presence of human recombinant gamma-interferon is described.

Adolescent↗
PubMed1989

[Acanthamoeba keratitis--a too seldom diagnosed disease?].

Acanthamoeba keratitis has become a difficult diagnostic and management problem in contact lens patients over the last few years. A young female contact lens wearer presented with a long history of painful central corneal ulcer. The suspected diagnosis of Acanthamoeba keratitis could only be confirmed by histology and electron microscopy following penetrating keratoplasty. Special stains of scrapings and culture of material on special media failed to establish the diagnosis. This rare (or underdiagnosed?) infection must be considered in the differential diagnosis of keratitis following contact lens wear.

Acanthamoeba↗
PubMed1989

[Hydrogel posterior chamber lenses--an improvement?].

Although the design of PMMA intraocular lenses has reached a stage of sophistication at which further modifications are unlikely to result in any major improvements in implant surgery, new materials with possibly improved mechanical and biologic properties should be evaluated carefully. The hydrogel lens (containing 38% poly-HEMA) is a soft, flexible, hydrophilic "single-piece" posterior chamber lens which could help to minimize intraoperative and postoperative IOL trauma. Fifty hydrogel intraocular lenses were implanted during a ten-month period using a standard extracapsular cataract extraction technique. Implantation was considered easy in most cases. As regards biocompatibility, stability of lens position, and visual acuity, the postoperative results are promising. In the follow-up period reported on, no central opacification of the posterior lens capsule was observed.

Aged↗
PubMed1988

Expression of the VEP13 antigen (CD16) on native human alveolar macrophages and cultured blood monocytes.

Human alveolar macrophages (AM phi) from thirteen patients, who were suffering from various lung diseases were harvested by bronchoalveolar lavage. Peripheral blood monocytes from eight healthy donors were isolated by Ficoll-Hypaque gradient centrifugation and adherence to plastic surface. To detect the VEP13 antigen (CD16) on these cells, a rosette assay employing ox erythrocytes coated by the CrCl3 method with purified VEP13 monoclonal antibody (Eo-VEP13) was used. A mean of 31.3% of freshly isolated AM phi and 3.9% of blood monocytes formed Eo-VEP13 rosettes. Monocytes cultured for 3 or 6 days in the presence of a supernatant from mouse L929 cells, which had been shown previously to improve long-term viability of human monocytes in culture, showed 12.5% and 25.3% Eo-VEP13 rosettes, respectively. No significant increase in VEP13 antigen expression was noted by culturing monocytes without L929 cell supernatant. The factor in L929 supernatant that induces VEP13 antigen expression has not been identified. Tunicamycin at 10 micrograms/ml inhibited significantly VEP13 antigen expression on monocytes. In contrast, IgG rosette formation was not reduced by tunicamycin. Our data show that subpopulations of native human AM phi and peripheral blood monocytes cultured in presence of a supernatant of L929 fibroblasts containing mainly murine CSF may express the CD16 antigen, which is normally found on large granular lymphocytes (LGL). Suppression by tunicamycin indicates that Fc receptor glycosylation takes place during a later differentiation step of mononuclear phagocytes.

Antibodies, Monoclonal↗
PubMed1988

[Why HLA-typing in keratoplasty? A review].

Due to the absence of vessels and lymph drainage, human cornea is the tissue grafted with the greatest success. From an immunological point of view, this advantage is lost when the recipient cornea has pronounced vascularization and is sensitized. In such cases, which have a poor prognosis, the postoperative success rate drops to below 50% due to graft rejection. The origin and point of attack of the immune reaction to the graft are the MHC antigens of the donor cornea, which occur on almost all nucleated cells. Since they are capable of triggering a T cell activation in the recipient they set immunological effector mechanisms in motion which lead to elimination of the cells carrying the alloantigen. Corresponding to the MHC antigen expression (both Class I as well as Class II) on all cells in all layers of the cornea, rejection reactions of all the various cell types (epithelial, stromal, endothelial) are also seen. By using histocompatible donor corneas it is possible to influence the afferent arm of the immune response preoperatively and thus to diminish its effect on the postoperative course.

Corneal Transplantation↗
PubMed1988

[Differential effect of incompatibilities of the HLA-A and HLA-B locus on the success of corneal transplants].

The positive influence of HLA-compatible donor material on successful transplantation was proven especially for prognostically unfavourable cases. Nevertheless it is not clear whether varying importance should be attached to the antigen incompatibilities at the HLA-A and HLA-B locus. 62 keratoplasty patients, 37 of whom had primarily poor prognoses and 25 patients with low risk of transplant rejection were prospectively given transplants in which more than two certain incompatibilities at the HLA-A and HLA-B locus had been ruled out. The number of Ag incompatibilities (separately according to locus) was related retrospectively to postoperative progress. An irreversible transplant failure had occurred in 6 patients (16%) four months after surgery in the high-risk group, whereas 31 transplants (84%) remained clear. The course of healing was without complications within the first four months in all patients with favourable starting position. The influence of the HLA disparities on transplantation success was examined by means of the chi-square test. Taking the Ag incompatibilities of both loci in combination into account showed an only marginally significant (p = 0.1) influence on the survival rate of the transplant. Here HLA-A incompatibilities appear to have only secondary significance, whereas incompatibilities at the HLA-B locus correlated inversely (p = 0.02) with the success of transplantation.

Chromosome Mapping↗