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Biomedical subjects

I Stroehmann

Publications and source records attributed to I Stroehmann.

34 records · Page 2Linked to original sources

Evidence for subtypic determinants in the HLA-DW3 cluster.

This study was undertaken to get more insight into the previously suggested heterogeneity of the HLA--DW3 cluster. Preliminary evidence of DW3 heterogeneity was derived from results of intrafamilial mixed lymphocyte culture tests (MLC) where cells of apparently homozygous offspring revealed unexpected stimulations of one of the parents' cells. Therefore, 15 different homozygous typing cells (HTCs) of DW3 specificity were tested against 43 HLA-DW3 heterozygous individuals. The response patterns of the 43 HLA-DW3 heterozygous cells toward 13 HTCs leads to the definition of at least three groups of DW3 stimulating cells. According to these patterns, four groups of responding cells could be classified. These results were confirmed by a MLC checkerboard experiment running all DW3-HTCs against each other. Discussing all possible explanations for these observations, the authors conclude that the existence of DW3 subtypes having some properties in common is the most likely interpretation of the results obtained. Family segregation studies will be needed to define the genotypic situation of the DW3 cluster.

Antibody Specificity↗

Pigeon breeders' lung lacking detectable antibodies.

Whereas fifteen pigeon fanciers suffering from extrinsic allergic alevolitis from avian dust had high titres of antibodies against pigeon antigens, antibodies were not demonstrable, even by immunofluorescence, in the serum of a symptomatic individual exposed to minimal amounts of avian dust. Following exposure to larger quantities of pigeon dust inhalation challenges, a low titre of antibodies appeared, but disappeared again after avoidance of the allergen. Cell-mediated immunity was elevated in the lymphocyte transformation test and also decreased after avoidance of allergen contact. Therefore, it seems likely that the antibody is not the only mediator of pigeon breeder's lung. Inhalation challenges and T cell-dependent immune reactivity may reveal more avian dust sensitive individuals suffering from fibrosis without the typical history of extrinsic allergic alevolitis and without detectable antibodies.

Allergens↗

Rat transplantation antigens. V. A variation of the KCl-method releasing low molecular weight antigen.

Extraction of soluble histocompatibility antigen from normal rat lymphoid cells by hypertonic salt (3 M KC1) releases high mol. wt material. It the original lymphoid cell suspension is washed more than once before extraction, antigenic acitivity disappears as measured by inhibition of cytotoxic antibody. This activity is mostly retained in the supernatants of the washing procedures. Extraction of these cell-free supernatants produced an antigenic material with a mol. wt of approximately 60,000. This suggests that at least part of the material accessible for KCl-extraction is released very early from the cell surface from the mechanical action, necessary for preparing the cell suspension.

Animals↗

Reduction of infection frequency by intravenous gammaglobulins during intensive induction therapy for small cell carcinoma of the lung.

Thirty-two patients with small cell carcinoma of the lung received intensive induction chemoradiotherapy. In a randomized prospective study, we compared the outcome of patients who received 30 g immunoglobulin i.v. divided into three doses per therapy course for infection prophylaxis (Group A) with patients undergoing the same anti-tumor therapy (Group B). All patients were prospectively randomized to one of two groups in order to evaluate the role of intravenous immunoglobulin therapy for infection prophylaxis. Group A received 30 g intravenous immunoglobulin during each course of chemotherapy. Group B was a control group that received identical chemoradiotherapy but did not receive any immunoglobulin therapy. All patients had a severely impaired cellular immune response. IgG serum concentrations were significantly higher in group A. Patients who received intravenous immunoglobulin had significantly fewer infections during the entire treatment period than patients who did not receive prophylactic treatment.

Adult↗

[Therapy of seronegative oligoarthritis with salazopyrine].

In an open, controlled study we treated 55 patients suffering of psoriatic arthritis (PsA), 29 patients suffering of Bechterew's disease (MB) and 16 patients with Reiter's syndrome with Salazopyrin at a daily dosage of 2000 mg. We monitored the following criteria of activity: duration of morning stiffness, joint index, global well being scored by the patient and erythrocyte sedimentation rate. All these criteria improved during the treatment; there was a profound improvement in the RS group, whereas the MB group showed only a slight improvement; the PsA group ended between this two extremes. The effect of the drug appeared between week 5 and 15 of treatment. 21% of all patients had to discontinue the treatment because of severe side effects; this figure correlates with the percentages given in the literature. Most of these side effects appeared from week 3 to week 7 of treatment; after week 15 none of the patients had to discontinue the medication of because of severe side effects.

Adult↗

[Heart involvement in progressive systemic sclerosis (generalized scleroderma)].

17 patients with progressive systemic sclerosis were examined for cardiac involvement using standard ECG, chest X-ray, 24-h Holter ECG, and echocardiography. The control groups consisted of 7 patients with mixed connective tissue disease, 10 patients with systemic lupus erythematosus, and 10 patients with rheumatoid arthritis. The results disclosed a cardiac involvement of 70% using all 4 methods, which is more than is reported in the literature. The data also show that all 4 methods are necessary to diagnose the cardiac involvement. Conduction and rhythm disorders especially are more frequent than in other collagen vascular diseases. The use of calcium channel blockers is discussed as a new therapeutic possibility.

Electrocardiography↗

[The established rheumatologist in the tension field between health care deficits and cost control in public health].

The outpatient treatment of rheumatoid patients in Germany depends on certain conditions. Rheumatologists in Germany need to cooperate much more with hospitals specialized in this field than other subspecialties of Internal Medicine. Because of historical reasons many other physicians such as orthopedics, internists, general practitioners participate in this field in contrast to our neighbours in the western hemisphere, where rheumatology is solely covered by rheumatologists. It is therefore conceivable to calculate a rheumatologists/population relation of appr. 1:200,000 and not less than this figure. Starting a business as rheumatologist needs certain conditions, which are specified. One major challenge will be the new law directing out-patient treatment in Germany (Gesundheitskontrollgesetz). It forces the doctor to relate his work to a more financial background with various restrictions and regulations. In this context our goal(s) must be the institution of a specified position in the "Gebührenordnung", to pay for our intense and time consuming efforts to treat our patients.

Combined Modality Therapy↗