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Biomedical subjects

J Freihorst

Publications and source records attributed to J Freihorst.

34 records · Page 2Linked to original sources
PubMed1992

Pulmonary artery sling with tracheal stenosis: primary one-stage repair in infancy.

Pulmonary artery sling is often associated with tracheal stenosis. In many cases repair of the vascular anomaly alone does not relieve dyspnea. Primary one-stage repair with long segment tracheal resection (2.4 cm) and relocation of the left pulmonary artery using cardiopulmonary bypass and deep hypothermic circulatory arrest is described in a 6.5-month-old girl weighing 6.5 kg. This technique resulted in normal ventilation and pulmonary flow distribution.

Bronchi↗
PubMed1991

Diagnosis of chronic granulomatous disease and of its mode of inheritance by dihydrorhodamine 123 and flow microcytofluorometry.

Dihydrorhodamine 123 (DHR) attached to membranes of granulocytes (PMN) and monocytes is caused to fluoresce by reactive oxygen intermediates (ROI) indicating the ability of phagocytes to produce these microbicide metabolites in a flow microcytofluorimeter. Whole blood samples from five boys with known chronic granulomatous disease (CGD) and from their mothers (and from one father and one grandmother), were examined following erythrocyte lysis in order to test this new method. An incubation period of 10 min with phorbol-myristate-acetate, followed by another 15 min incubation period with DHR before flow microcytofluorimetric analysis of 5 or 10 x 10(3) phagocytes, was sufficient to obtain the following results. PMN and monocytes from four patients with CGD could clearly not produce any ROI whereas cells from one patient displayed decreased activity in ROI production as compared to cells from a healthy donor. The X-linked mode of inheritance was detected in six carriers by the presence of two different cell populations (one normal ROI-producing and one negative or less active population). All the phagocytes from one mother produced ROI in normal amounts suggesting an autosomal mode of inheritance. All in all, the method presented provides a fast and most simple tool to diagnose CGD, to determine a decrease or total lack of ROI production and to establish the mode of inheritance of the disease.

Flow Cytometry↗
PubMed1991

[Local immunization against P. aeruginosa with an outer-membrane-protein vaccine].

Averting initial colonization of the respiratory tract with P. aeruginosa would be of great benefit for patients with cystic fibrosis (CF). Our approach to this problem is mucosal immunization with a vaccine prepared from the OMP fraction of a PAO-1 strain of P. aeruginosa. Sprague-Dawley rats were given 5 intragastric doses of the vaccine on 5 consecutive days and an intranasal booster dose 21 days later. Immunized animals developed high titers of OMP-specific IgG antibodies in serum and a specific IgA response in bronchioalveolar and small intestinal lavage samples, all determined by ELISA. When challenged 7 days after the booster (day 28) by intratracheal injection of live bacteria of a heterologous strain of P. aeruginosa the immunized rats showed enhanced bronchopulmonary bacterial clearance compared to nonimmunized controls, as indicated by bacterial counts from homogenized lung tissue taken 4 hrs after challenge. Thus, mucosal immunization with OMP vaccines might hinder initial colonisation of the lungs with P. aeruginosa.

Administration, Intranasal↗
PubMed1991

[Juvenile laryngeal papillomatosis--a case report].

Juvenile papillomatosis of the larynx is a disease of viral origin and is a rare cause of hoarseness and stridor in childhood. Although the tumours are basically benign, they may present problems in therapy due to their localisation and marked tendency to recur. According to the present state of knowledge, a combination of laser coagulation and alpha-interferon therapy is the treatment of choice. It can be applied on a long-term basis effectively and with few side effects due to individualised dosage determination. We report on a girl patient of 2 1/2 years of age with recurrent juvenile papillomatosis of the larynx. Long-term alpha-interferon therapy was so far successful in preventing progress of the pattern of findings. Treatment is well tolerated after the most suitable dose has been found for a particular patient. No side effects were seen that would have compelled us to discontinue the treatment. We are planning to continue interferon therapy for at least 1 to 2 years with regular endoscopic control.

Child, Preschool↗
PubMed1990

Management of mycotic rupture of the ascending aorta after heart-lung transplantation.

A 19-year-old woman underwent heart-lung transplantation for obstructive bronchiolitis. Eleven days later mycotic rupture of the ascending aorta occurred. Emergency cardiopulmonary bypass was instituted via the femoral vessels and the chest was reopened under cardiac massage. Perforation of the aorta at the site of insertion of the cardioplegic cannula in the donor aorta was seen. Under circulatory arrest the infected area was excised, a pericardial patch plasty was performed, and the region was covered with a muscle flap. Postoperatively, Candida albicans was found in the excised specimen of the aorta, in drainage fluid, and in the bronchoalveolar lavage. High doses of antimycotics were administered intravenously and for irrigation of the mediastinum, which resulted in an eradication of fungi in all cultures 7 days later. Six weeks after reoperation the patient was discharged home, and she remains well 9 months postoperatively.

Abdominal Muscles↗
PubMed1990

Effect of rotavirus infection and malnutrition on uptake of a dietary antigen in the intestine.

Intestinal absorption of ovalbumin (OVA), a dietary macromolecule, was studied in malnourished and normally nourished suckling mice after experimentally induced infection with rotavirus. All mice developed diarrhea within 24 to 48 h postinoculation. The malnourished animals exhibited more severe symptoms and an increased number of rotavirus-containing enterocytes in intestinal sections as compared to well-nourished mice when examined 3 d postinoculation, at the peak of diarrhea. Histopathologic examination revealed villus atrophy and pronounced vacuolization of villus enterocytes in association with malnutrition and rotavirus infection. The combination of malnutrition and viral infection resulted in more severe mucosal damage, including disruption of microvillus borders. After a single oral dose of 100 micrograms OVA at 3 d postinoculation, the concentration of OVA in serum, gastric content, intestinal lavage fluid, and intestinal tissue homogenates was measured at different time intervals. The concentrations of OVA in intestinal tissue were significantly higher in malnourished animals, whereas lower values were found in rotavirus-infected animals. In all mice, OVA was rapidly absorbed and could be consistently detected in the serum within 5 min. OVA levels peaked at 45 to 60 min and then gradually declined. In malnourished infected animals, the uptake of OVA was rapid and resulted in significantly higher serum levels when compared to well nourished or uninfected controls, respectively. The peak uptake of OVA per g body wt was about 4.5 times more in malnourished infected compared to well-nourished infected mice and 2.5 times higher in normally nourished infected animals when compared to uninfected controls. These results indicate that rotavirus infection in association with malnutrition may cause a significant rise in gut permeability to environmental macromolecules.

Animals↗
PubMed1990

[Mediastinal sequestration with ectopic pancreatic tissue].

We report on a five-year-old patient with a chronic pneumonia of the upper left lobe of the lung, in whom a broncho-enteric sequestration with ectopic pancreas was found in the mediastinum. Reviewing the literature, different theories on the embryogenesis of this extremely rare anomaly are discussed.

Bronchopulmonary Sequestration↗
PubMed1990

[Bronchopulmonary diseases in primary immune deficiencies].

Data of 124 patients with primary immunodeficiencies were examined in a retrospective study in respect of incidence and severity of bronchopulmonary immunodeficiencies. Relapsing pneumonias were seen in 40 patients (32.3%) and bronchiectases in 15 cases (12.1%). Children with severe antibody deficiencies or combined immunodeficiencies were involved particularly often. Avoidance of pulmonary complications is of special prognostic importance with these patients.

Bronchitis↗
PubMed1989

Maternal determinants of neonatal immune response to ovalbumin: effect of breast feeding on development of anti-ovalbumin antibody in the neonate.

Inbred Brown-Norway female rats were immunized intraperitoneally with ovalbumin (OVA) or sham-immunized 14 days before and 10 days after mating. In subsequent studies with OVA, babies fed by immunized mothers, regardless of whether they were born from immunized or sham-immunized mothers, showed suppression of IgG, IgM and IgE anti-OVA responses. In additional studies, these babies developed OX-8-positive but W3/25-negative phenotypic suppressor T-cells specific for anti-OVA antibody production. However, these regulatory cells did not react with OVA itself when tested for in vitro proliferative response to OVA. Subsequent immunization of the neonates with OVA appeared to abrogate suppression of IgG and IgM antibody responses. However, maternally induced suppression of IgE persisted and was not influenced by subsequent immunization.

Animals↗
PubMed1988

Modulation of systemic and mucosal immune responses to inhaled ragweed antigen in experimentally induced infection with respiratory syncytial virus implication in virally induced allergy.

Groups of BALB/c mice were either sham-infected or infected intranasally with respiratory syncytial virus (RSV). On the third day following intranasal inoculation, all groups of mice were exposed by inhalation to ragweed antigen for 5 consecutive days and rechallenged with ragweed on day 31. Development of antibody activity to ragweed antigen was examined in serum and bronchial washings at regular intervals employing an ELISA assay for IgG and IgA antibody activity and passive cutaneous anaphylaxis for IgE-specific responses. The serum IgG and IgE antibody response to ragweed following primary exposure developed at significantly higher levels in mice previously infected with RSV, compared to sham-infected controls. In addition, an earlier rise in serum IgE response to ragweed occurred in the RSV-infected animals. IgG and IgA anti-ragweed antibody activity in bronchial washings was also observed with significantly higher levels in the RSV-infected animals when compared to the controls, although a similar increase in antigen-specific IgE activity in bronchial washings was found in both groups of animals. These findings support the possibility that mucosally restricted virus infections of the respiratory tract may enhance the development of sensitization and the magnitude of antibody responses to other inhaled allergens found concomitantly in the respiratory tract during acute infection.

Administration, Inhalation↗
PubMed1988

Effect of respiratory syncytial virus infection on the uptake of and immune response to other inhaled antigens.

Groups of BALB/c mice were sham infected or inoculated intranasally (IN) with live RSV. From Day 4 to 8 after infection, the animals were exposed IN to ovalbumin (OVA) with or without alum adjuvant. At different intervals, levels of OVA concentration in serum, IgG-anti-OVA antibody activity in serum, and IgA-anti-OVA antibody activity in bronchial washings were determined, employing the ELISA technique. IgE-anti-OVA antibody titers in serum and bronchial washings were assessed by PCA. OVA concentrations in serum were significantly higher in RSV-infected animals compared to uninfected controls. The use of alum adjuvant also increased OVA uptake in uninfected animals but to a lesser extent than RSV infection. RSV-infected animals developed significantly higher OVA-specific antibody titers of IgG isotype in serum and IgA isotype in bronchial washings than the uninfected controls, while alum enhanced the immune response less markedly but still significantly in uninfected mice. An IgE antibody response to OVA in serum was demonstrable in 50% of RSV-infected mice immunized IN with OVA and alum, while all uninfected animals and RSV-infected animals immunized with OVA alone (without adjuvant) failed to develop a detectable IgE response. These findings suggest that infections with viral agents such as RSV may function as adjuvants for other antigens inhaled during acute respiratory infection. These observations may explain the alterations in the immune response to other antigens in patients with acute viral-induced bronchopulmonary diseases.

Adjuvants, Immunologic↗
PubMed1985

Difference quantitation of planar and tomographic heart scintigrams with identification of segments using reconstructive three-dimensional reference modelling.

A patient-specific three-dimensional rotational ellipsoidal shell was reconstructed from planar myocardial scintigrams. This model was homogeneously filled with radioactivity ('ideal') and then projected onto the same planes as the actual scintigrams, including the absorption of heart and background. After normalization and inhomogeneous background correction, the actual and 'ideal' images were compared in order to quantify the myocardial, ischemic and infarcted volumes (difference quantitation). 201Tl defects appeared as hot spots. The a priori three-dimensional model was cut into 14 segments by six planes. Tomographic sectional views in any desired plane made possible the identification of the 14 spatial myocardial segments on slice images for difference quantitation. The orientation of the long axis of the left heart responsible for different inseparable overprojections of segments was accounted for. The mathematics of segmentation and reconstructive three-dimensional modelling is described. Computed examples are given. A total of 624 201Tl scintigrams from 78 patients were analysed according to this method. The results obtained for the myocardial, ischemic and infarcted volumes, the orientation of the left heart's axis in the thorax and the identification of spatial myocardial segments on projected and tomographic images, as well as the global myocardial and background kinetics of 201Tl are discussed. The procedure of reference modelling and difference quantitation might also be useful in other imaging modalities, such as emission-computed tomography, single-photon emission computed tomography, computed tomography or nuclear magnetic resonance.

Heart↗
PubMedDate not supplied

Immunization of the gastrointestinal tract with bacterial and viral antigens: implications in mucosal immunity.

The effects of oral immunization with Pseudomonas aeruginosa (PAOI), Chlamydia trachomatis or respiratory syncytial virus (RSV) on the development of specific antibody responses in the intestine, respiratory tract and genital secretions was studied in several animal models. Oral immunization resulted in the development of specific immunity in distant mucosal sites. However, its role in influencing the outcome of reinfection challenge at the distant site varied with the antigen. Little or no protection was observed against infection with Pseudomonas aeruginosa in the respiratory tract. Limited protection was observed against respiratory tract infection with RSV. On the other hand oral immunization appeared to be quite effective in preventing respiratory or genital infection with Chlamydia trachomatis. Finally, preliminary studies have suggested that intestinal immunization via the process of breast feeding can also be employed as an effective means to induce anti-idiotypic immunity against RSV in the breast feeding neonates.

Animals↗