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Biomedical subjects

I Bergmann

Publications and source records attributed to I Bergmann.

At least 19 recordsLinked to original sources

[Pulmonary microscopic tumor embolism syndrome].

HISTORY: A 76-year-old woman and a 62-year-old man were both referred to our clinic because of an unexplained weight loss, increasing dry cough and shortness of breath. INVESTIGATIONS: Investigations revealed an adenocarcinoma of the colon with retroperitoneal, mediastinal and supraclavicular lymph node metastasis and poorly differentiated carcinoma of the prostate with extensive bone metastases. During their hospital stay both patients developed increasing shortness of breath and clinical signs of right heart failure. Echocardiography confirmed severe pulmonary hypertension and dilatation of the right ventricle in both patients. Despite the high degree of clinical suspicion CT scans of the thorax could not demonstrate pulmonary embolism. DIAGNOSIS, TREATMENT AND COURSE: During the following days the patients condition deteriorated further and both patients' died from irreversible right heart failure. Both autopsies showed extensive metastatic adenocarcinoma with marked angiosis carcinomatosa of the lungs with numerous occlusions of small arteries and arterioles and resulting cor pulmonale. Thrombotic pulmonary embolism could not be detected. CONCLUSION: In patients with malignant neoplasms, especially adenocarcinomas, dyspnea and signs of increasing pulmonary artery pressure, the possibility of a microscopic pulmonary tumor embolism should be considered after exclusion of more usual causes especially thrombotic pulmonary embolism. In selected cases a cytologic examination of blood aspirated from a wedged pulmonary artery catheter can be performed to prove angiosis is carcinomatosa.

Adenocarcinoma↗

Selection of foot and mouth disease vaccine strains--a review.

The choice of the most appropriate strains of foot and mouth disease (FMD) virus vaccines to use in FMD control programmes and to store in vaccine antigen reserves is based on the matching of representative field isolates from outbreaks around the world to available vaccine strains. However, those involved in FMD control at a national level do not always give this work a high priority, while in countries without effective control of FMD there is little incentive to collect samples or to overcome the constraints on submission to international reference laboratories. In the short term, specific initiatives for targeted collection can provide samples on a periodic basis, but a long-term solution requires the development of FMD control measures. This must be underpinned by the strengthening of local Veterinary Services and laboratories, and by demand-driven provision of sufficient amounts of high-quality vaccine. Difficulties may be increased by commercial constraints on disclosure of the strains used for vaccine production and on the supply of reagents needed for matching tests. Vaccine matching tests are mainly based on in vitro methods - such as virus neutralisation, enzyme-linked immunosorbent assay with polyclonal antibodies and complement fixation - and are performed in a relatively small number of laboratories around the world. In addition to the difficulties of gathering representative field and vaccine strains, neither the reagents nor the methods used for vaccine matching are fully harmonised. Consequently, there is no strict equivalence in the results obtained. Alternative approaches using monoclonal antibody panels and/or viral capsid gene sequencing are being developed and could complement the currently employed serological tests. However, there is limited in vivo cross-protection information, more of which is essential for future validation of the vaccine matching methods. In response to the funding and leadership deficit for vaccine strain selection, a network of World Organisation for Animal Health (OIE) and Food and Agriculture Organization FMD reference laboratories has been established; this gives these laboratories the potential to strengthen the coordination of their work and reporting and thereby improve recommendations on vaccine strain selection.

Animals↗

Use of the reverse transcription polymerase chain reaction (RT-PCR) for the rapid diagnosis of foot and mouth disease in South America.

Foot and mouth disease (FMD) is a limiting factor for the economic progress of the animal industry in South America. The presence of the disease results in the imposition of national and international sanitary barriers to animals and animal products, and, most especially, a reduction in the availability of protein from animal origin and in income. Rapid and accurate identification of infected animals, those with either clinical or subclinical disease as well as with persistent infection, is essential for maintaining an efficient eradication programme. The polymerase chain reaction was used to rapidly identify infected animals. With a primer set that corresponds to a conserved region of the 3D sequence of the viral genome, it was possible to amplify, regardless of the serotype, 116 strains of FMD virus, of which 109 were strains collected from outbreaks of FMD throughout South America from 1945 to the most recent outbreaks in 2000/2001. The PCR technique should be of considerable value in facilitating the diagnosis of FMD in South America. where laboratory resources are limited and a rapid response is needed, particularly in areas where national programmes for controlling or eradicating the disease are being implemented.

Animals↗

Value of micro-CT as an investigative tool for osteochondritis dissecans.

PURPOSE: To evaluate micro computed tomography (micro-CT) for the assessment of osteochondritis dissecans in comparison with histology. MATERIAL AND METHODS: Osteochondritis dissecans lesions of 3 patients were evaluated using micro-CT (0.125 mA, 40 keV, 60 microm slice thickness, 60 microm isotropic resolution, entire sample) and light microscopy (toluidine blue, 3-5 microm slice thickness). The methods were compared regarding preparation time, detectability of tissue types and morphologic features of bone and cartilage. RESULTS: Non-destructive micro-CT imaging of the entire sample was faster than histologic preparation of a single slice for light microscopy. Morphologic features of bone and cartilage could be imaged in a comparable way to histology. It was not possible to image cells or different tissue types of bone and cartilage with micro-CT. CONCLUSION: Micro-CT is a fast, non-destructive tool that may be a supplement or, if detailed histologic information is not necessary, an alternative to light microscopy for the investigation of osteochondritis dissecans.

Adult↗

Proteolytic activity among various oral Treponema species and cloning of a prtP-like gene of Treponema socranskii subsp. socranskii.

The proteolytic activity of 11 treponemal strains representing different phylogenetic groups was investigated by SDS-polyacrylamide gel electrophoresis with copolymerised casein, gelatin and fibrinogen as substrates. The activity was specified to be trypsin- and chymotrypsin-like by the cleavage of synthetic substrates BAPNA and SAAPFNA, respectively. Nine strains degrade casein and the synthetic substrate BAPNA. Chymotrypsin-like activity specifically inhibited by phenylmethylsulfonyl fluoride was found in four treponemes. Southern blot analysis using a Treponema socranskii subsp. socranskii-specific prtP probe confirmed the presence of prtP homologous genes in these four strains. The internal fragments of the chymotrypsin-like protease genes were cloned and sequenced after PCR amplification. Here we report the cloning of the complete prtP-like gene of T. socranskii subsp. socranskii, an organism shown to possess epidemiologic relevance in periodontitis.

Blotting, Southern↗

Radiographic knee osteoarthritis in floorlayers and carpenters.

OBJECTIVES: The aim of the present study was to examine the relationship between knee-straining work and radiological findings of knee osteoarthritis and to study the relation between radiological findings and self-reported knee complaints and clinical signs of knee osteoarthritis. METHODS: The material consisted of 133 floorlayers, 506 carpenters, and 327 compositors, 26-72 years of age, who had completed a questionnaire and reported no previous knee trauma. A stratified sample of these questionnaire respondents, 50 floorlayers, 51 carpenters, and 49 compositors, were radiologically examined for knee osteoarthritis by 2 radiologists. The X-ray films were independently assessed by 2 radiologists and blinded with respect to knee complaints, trade, and age. RESULTS: The radiological investigation showed estimated prevalences of knee-osteoarthritis (grades 2-4) for 14% of the floorlayers, 8% of the carpenters, and 6% of the compositors (not significantly different). For the subjects > or =50 years of age the estimated prevalences of the combination of radiological grades 2-4 for knee osteoarthritis and knee complaints during the last 12 months were 29% [95% confidence interval (95% CI) 17-44%], 9% (95% CI 1-26%), and 1% (95% CI 1-10%) for the floorlayers, carpenters, and compositors, respectively. Radiological grades 2-4 were mainly found for subjects above the age of 50 years, subjects with knee complaints, and floorlayers. Radiological knee osteoarthritis was positively associated with self-reported knee complaints and with clinical signs of intraarticular and retropatellar crepitation. CONCLUSIONS: The data suggest that work in which a considerable amount of time is spent in knee-straining positions may be a risk factor for the development of knee osteoarthritis above the age of 50 years.

Adult↗

Nerve growth factor evokes hyperalgesia in mice lacking the low-affinity neurotrophin receptor p75.

Endogenous nerve growth factor (NGF) has been shown to be an important mediator of inflammatory pain and exogenous application of recombinant human NGF (rhNGF) produces pain and hyperalgesia in animals and humans. Since NGF can act through two receptors types, the high affinity tyrosine kinase A (trkA) receptor and the low affinity p75 receptor, we used transgenic mice lacking p75 to analyse the relative importance of these receptors. After systemic injection of rhNGF (5 mg/ kg), pharmacokinetic studies revealed similar serum levels and elimination profiles of exogenously administered rhNGF in both strains of mice. Although animals lacking p75 have increased mechanical and thermal withdrawal thresholds they developed both heat and mechanical hyperalgesia after systemic injection of rhNGF whose magnitude did not differ significantly from wildtype animals. This means that NGF-induced hyperalgesia can occur in the absence of the p75 receptor and suggests that the trkA receptor is sufficient to mediate the acute noxious action of NGF.

Animals↗

Focal hyperhidrosis: effective treatment with intracutaneous botulinum toxin.

OBJECTIVE: To evaluate the effect of intracutaneous injections of botulinum toxin type A on excessive focal hyperhidrosis. DESIGN: Therapeutic before-and-after trial over 4 months. SETTING: Neurological and dermatological university departments. PATIENTS: Eleven patients with excessive axillary, palmar, or plantar hyperhidrosis fulfilling the following criteria: (1) local and systemic drug therapy had failed to improve their symptoms; (2) the patients were severely disabled with respect to their occupation and social activities; and (3) a successful treatment by botulinum toxin would obviate the need for destructive surgical procedures. INTERVENTIONS: Three mouse units of botulinum toxin (Botox) per 4-cm2 skin area was injected intracutaneously in 16 axillae, 8 palms, and 2 soles. MAIN OUTCOME MEASURES: Reduction of hyperhidrosis as documented by the Minor iodine-starch test and gravimetrical assessment of local spontaneous sweat production measured over 1 minute. RESULTS: In all patients, botulinum toxin completely abolished sweating in the injected areas (P<.001) within 3 to 7 days. No relevant adverse effects occurred and no clinical recurrence of hyperhidrosis was observed within the follow-up period of up to 5 months. Occasionally, subclinical reactivation of sweat gland function was observed 4 months after treatment. CONCLUSIONS: Intracutaneous botulinum toxin seems preferable to any hitherto used conservative or surgical procedures and may become the therapy of choice in pathological focal hyperhidrosis.

Adult↗

Selective degeneration of sudomotor fibers in Ross syndrome and successful treatment of compensatory hyperhidrosis with botulinum toxin.

We report a 5-year follow-up of a patient with Ross syndrome. A biopsy of the anhidrotic skin immunostained with protein gene product 9.5 visualized by confocal microscopy revealed selective loss of sudomotor fibers, whereas epidermal innervation remained intact, providing the first morphologic evidence of selective loss of sudomotor fibers in this syndrome. Among the different treatment strategies employed for the patient's disabling segmental hyperhidrosis, intracutaneous injection of botulinum toxin A was the most helpful.

Adaptation, Physiological↗

[Differential diagnosis of tumorous space-occupying lesions of the parotid gland: angiolymphoid hyperplasia with eosinophilia and Kimura disease].

BACKGROUND: Subcutaneous mass lesions of the head and neck are common in angiolymphoid hyperplasia with eosinophilia (ALHE) as well as in Kimura's disease, most often in a periauricular location in young and middle aged adults. Often these benign angioproliferative lesions of unknown etiology will be misdiagnosed as parotid tumors although the majority are paraglandular. Whereas ill-defined lesions involving the parotid gland are frequently observed in Kimura's disease, only one case of intraparotid ALHE is reported in the literature. CASE REPORT: To this we add one further case: a 24-year-old man with a solid and well displaceable tumor of the left preauricular region. At ultrasound and intraoperatively we found a well demarcated tumor with high central vascularization surrounded by multiple networks of veins. One larger artery entered the lesion directly, visible as vascular structure on the cut surface. This blood vessel may have represented a vascular pattern (3 mm in diameter) that was identified as an artery by flow velocity measurement at duplex sonography. Histopathologically we saw the characteristic features of ALHE: numerous capillary proliferations showing prominent epithelioid endothelia cells with typical "hop nail" appearance, focal lympho-plasmacellular infiltrations and many eosinophils. The most conspicuous microscopic feature was a large thick-walled artery with total occlusions of the lumen that partially corresponded to duplex sonographic and macroscopic findings. CONCLUSION: In our opinion, this may be indicative of a primary arterial disorder with secondary vascular proliferation and chronic inflammation. The treatment of choice is local excision with a safe margin of healthy tissue, since insufficient removal can result in recurrence.

Adult↗

Analysis of cutaneous sensory neurons in transgenic mice lacking the low affinity neurotrophin receptor p75.

Mice with a targeted mutation of the p75 low affinity neurotrophin receptor display smaller peripheral nerves and dorsal root ganglia. Here we show that transgenic mice have a significant elevation of thresholds to noxious mechanical and heat stimuli compared with p75+/+ control mice. Immunocytochemical analysis using antibodies against PGP 9.5 (a panaxonal marker) and calcitonin gene related peptide (CGRP, which labels peptidergic neurons) showed a reduction to 73% and 54%, respectively, of the epidermal innervation density. However, analysis of the cell size distribution of toluidine blue-stained dorsal root ganglia showed no selective loss of neurons of particular diameters. Moreover, the neurochemical profile of dorsal root ganglia cells as defined by trkA, CGRP, IB4 and RT97 immunostaining revealed no significant differences in comparison with p75+/+ animals. Staining of the dorsal horn of the spinal cord for CGRP and IB4 was also normal in p75-/- animals. Taking into account a previously reported loss of approximately 50% dorsal root ganglion neurons, we conclude that all types of sensory neurons are equally depleted in p75-/- mice and that the absence of p75 impedes the development of more than one neuronal subtype.

Animals↗

Coxsackie B1 virus-induced murine myositis: a correlative study of muscular lesions and serological changes.

We investigated the role of humoral factors in the pathogenesis of Coxsackie B1 virus-induced murine myositis (CB1-myositis). At 2, 4 and 8 weeks after inoculation, serum was studied for circulating immune complexes (CIC) (Raji-cell assay), haemolytic complement activity (CH50 titre) and anticytoplasmic autoantibodies (Western blotting, immunoprecipitation) in relation to degree of mononuclear cell infiltration and muscle fibre necrosis. At 2, 4 and 8 weeks, cell infiltration correlated positively to muscle fibre necrosis. From 2 weeks on, moderate quantities of CIC were found in nearly all CB1-inoculated mice, but without correlation to histological changes. Except for a positive correlation of CH50 titre to muscle necrosis at 4 weeks (r = 0.60; P = 0.02), CH50 titres did not correlate to muscle lesions. Anticytoplasmic and other known autoantibody specificities were absent. In conclusion, first, in CB1-myositis CIC occurred from 2 weeks on, but no correlative evidence was found for their involvement in pathogenesis, neither for that of complement nor for anticytoplasmic autoantibodies. Secondly, cell infiltration correlated positively to muscle necrosis, underscoring the importance of cellular mechanisms. Thus, our data do not support, or conclusively exclude, a role for humoral processes in CB1-myositis.

Animals↗

The platelet glycoprotein IIb/IIIa complex is involved in the adhesion of activated platelets to leukocytes.

The adhesion of activated platelets to leukocytes (rosette formation) seems to be mediated by CD62 on platelets and its counter-receptor (CD15 or a sialic acid-containing glycoprotein) on polymorphonuclear leukocytes (PMNL). However, neither treatment of platelets with an anti-CD62 antibody or fucoidan nor treatment of PMNL with anti-CD15 antibody or neuraminidase are able to inhibit completely the adhesion. Therefore, we have studied the platelet GPIIb/IIIa complex (CD41a) for its involvement in the adhesion of activated platelets to PMNL. The following evidences point to a participation of CD41a in the adhesion of activated platelets to leukocytes: a) inhibition of adhesion by monoclonal antibodies (mab) raised toward CD41a, b) inhibition of adhesion by peptides such as RGDS and echistatin, c) inhibition of adhesion by dissociation of the CD41a complex with EGTA, and d) inhibition of rosette formation using platelets from a thrombasthenic patient which have almost no CD41a in the surface membrane but a normal expression of CD62. It is likely that fibrinogen is involved in the adhesion of platelets to PMNL via CD41a, since fibrinogen increases the rosette formation of ADP-stimulated platelets. Furthermore, the incubation of unstimulated platelets with fibrinogen and an antibody raised against glycoprotein IIIa which stimulates fibrinogen binding to the platelet surface results in an enlarged rosette formation.

Amino Acid Sequence↗

[CT in the prognostic evaluation of apoplexy].

The purpose of our prospective study was to determine whether cranial computed tomography in connection with neurological assessment was useful in prognostic evaluation of survival after acute stroke. Two-hundred and forty-five consecutive stroke patients were included. Each underwent detailed neurological assessment and cranial computed tomography without intravenous contrast injection. The lesions were divided according to neuroanatomic regions. In the statistical analyses we used a multiple logistic regression model. Computed tomography showed that 76% of the patients had infarcts. 11% had haemorrhages, and 13% had no acute lesion. Forty-three patients had more than one acute lesion, and 57 had one or more old infarcts. The temporal, parietal and frontal regions and the basal ganglia were most often affected. We concluded that age, level of consciousness, and involvement of the temporal lobe on computed tomography were factors of prognostic significance regarding survival in the acute phase.

Acute Disease↗

Measurement of abdominal and intra-abdominal fat in postmenopausal women by dual energy X-ray absorptiometry and anthropometry: comparison with computerized tomography.

The aim was to develop a model for prediction of intraabdominal adipose tissue (AT) with combined dual energy X-ray absorptiometry (DXA) and anthropometry in postmenopausal women. Intra-abdominal and subcutaneous AT from the 1st to the 4th lumbar intervertebral disk was measured by computerized tomography (CT) (as a reference method) in 25 postmenopausal women (BMI 19.9-35.1 kg/m2). Fat was measured in the corresponding region by DXA. Abdominal sagittal diameters, skinfold thicknesses, and circumferences were also measured. Measurements of abdominal fat by CT and DXA were valid (r = 0.9, s.e.e.%: 7%). Measurement of abdominal fat by DXA explained about 80% of the variation in the intra-abdominal AT (by CT), whereas the waist to hip ratio was the only variable that correlated significantly with the intra-abdominal to subcutaneous AT ratio. Abdominal fat measured by DXA, the waist to hip ratio, and the sum of trunk skinfold thicknesses could in combination accurately predict the intra-abdominal AT measured by CT (r2 = 0.91, s.e.e.% = 15%). The sagittal diameter, measured either anthropometrically or by CT, was not a superior predictor of the intra-abdominal AT. We conclude that the intra-abdominal AT can be predicted in postmenopausal women by DXA combined with anthropometry.

Abdomen↗

Multimodality treatment in stage IV squamous cell carcinoma of the head and neck. A long-term follow-up.

We treated 114 patients with advanced inoperable head and neck cancer with a combined-modality protocol that included two cycles of chemotherapy followed by radiotherapy or three chemotherapy and in 18 patients with a radiosensitizing agent. At the beginning of the treatment all but one patient presented with a stage IV cancer. With a follow-up of 42-58 months, four patients are alive (three from the radiosensitizing group and one of the chemotherapy group). Complete response after the radiosensitizing agent correlated with superior prolonged disease-free survival in comparison to complete responses after chemotherapy at the level of p less than 0.009.

Adult↗

Computed tomography in prognostic stroke evaluation.

BACKGROUND AND PURPOSE: Computed tomography is now routinely used in many hospitals to investigate cerebrovascular disease. The purpose of our prospective study was to determine whether cranial computed tomography in connection with neurological assessment was useful in prognostic evaluation of survival after acute stroke. METHODS: Two-hundred forty-five consecutive stroke patients were included in the project during a 1-year period. Each had a detailed neurological assessment 24-72 hours after stroke onset and underwent cranial computed tomography without intravenous contrast injection within the first week after admission. The lesions were divided according to neuroanatomic regions. In the statistical analyses we used a multiple logistic regression model with survival/death as the binary variable. RESULTS: Computed tomography showed 76% of the patients had infarcts, 11% had hemorrhages, and 13% had no acute lesion. Forty-three patients had more than one acute lesion, and 57 had one or more old infarctions. The temporal, parietal, and frontal regions and the basal ganglia were most often affected. CONCLUSIONS: We conclude that age, level of consciousness, and involvement of the temporal lobe on computed tomography were factors of prognostic significance regarding survival in the acute phase.

Adult↗