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Biomedical subjects

K D Müller

Publications and source records attributed to K D Müller.

At least 37 records · Page 2Linked to original sources
PubMed1997

Obligate intracellular bacterial parasites of acanthamoebae related to Chlamydia spp.

The phylogeny of obligate intracellular coccoid parasites of acanthamoebae isolated from the nasal mucosa of humans was analyzed by the rRNA approach. The primary structures of the 16S and 23S rRNA molecules of one strain were determined in almost full length. In situ hybridization with a horseradish peroxidase-labeled oligonucleotide probe targeted to a unique signature site undoubtedly correlated the retrieved 16S rRNA sequence to the respective intracellular parasite. This probe also hybridized with the second strain, suggesting a close relationship between the two intracellular parasites. Comparative sequence analysis demonstrated a distinct relationship to the genus Chlamydia. With 16S rRNA similarities of 86 to 87% to the hitherto-sequenced Chlamydia species, the intracellular parasites are likely not new species of this genus but representatives of another genus in the family of the Chlamydiaceae. Consequently, it is proposed to provisionally classify the endoparasite of Acanthamoeba sp. strain Bn9 as "Candidatus Parachlamydia acanthamoebae." From an epidemiological perspective, the results suggest that small amoebae could be environmental reservoirs and vectors for a variety of potentially pathogenic bacteria including members of the Chlamydiaceae.

Acanthamoeba↗
PubMed1996

[75-Se-labeled bile acid analog absorption in various gastrointestinal diseases using a whole body counter].

AIM: It is possible to detect disturbances of bile acid absorption using a whole body counter after administration of Se-75 labelled bile acid analogues. We scrutinized the benefit of a modification of the test method. METHODS: We investigated 77 patients with different forms of a gastrointestinal disease. After application of Se 75 homotaurocholic acid we measured patient-activity up to 7 days later including whole-body profile scans in the first 6 h. RESULTS: The fractional retention after 7 days was between 20 and 67%. In cases of impaired absorption it was below 12%. Patients with liver diseases and after cholecystectomy (without bile acid resorption disturbance) showed normal values. Patients with Crohn's disease of the ileum or with intestinal ileac by-pass or with colestyramine treatment or with disturbance of vitamin B12-absorption or with cystic fibrosis showed a disturbance of bile acid absorption. The normal whole-body half-life was more than 2.8 days. The 24 and 72 h values were 62 and 31% in cases with normal absorption. Smaller values are signs of bile acid malabsorption. Impulse rates measured with the whole body counter are of an order of magnitude that allows to reduce the usually administered dose of 37 kBq to 9.25 kBq. CONCLUSION: This is an efficient method to detect disturbances of bile acid absorption. The usually administered activity of 37 kBq can be reduced to 9.25 kBq.

Adult↗
PubMed1994

[Intravenous or oral 131I treatment of hyperthyroidism and thyroid cancer?].

The purpose of this study was to determine differences in 131I biokinetics after oral or intravenous treatment of hyperthyroidism (0.81 GBq) or differentiated thyroid cancer (1.85 GBq) following thyroidectomy. 20 patients with differentiated carcinoma and 20 patients with hyperthyroidism were studied. In each group 10 patients were treated perorally and 10 patients intravenously. The integrated whole-body activities during therapy were significantly lower, by an average 23% (cancer) and 45% (hyperthyroidism) than after oral application. It is most likely that these differences between oral and intravenous application are due to the higher serum activity after intravenous therapy. It is concluded that a higher activity dose of 131I must be given orally to achieve the same target dose as after intravenous application.

Administration, Oral↗
PubMed1993

123I-metaiodobenzylguanidine scintigraphy in the detection of irregular regional sympathetic innervation in long QT syndrome.

Twelve patients with the long QT syndrome were studied to determine the usefulness of 123I-metaiodobenzylguanidine (MIBG) single-photon emission tomography (SPECT) at 2 h and 6 h after injection; the results were compared to 10 healthy volunteers (controls). Uptake of MIBG in the left ventricle at 2 h after injection was significantly reduced in patients with the long QT syndrome (1.43 +/- 0.13 vs 1.66 +/- 0.15 in controls, heart-to-mediastinum ratio, P < 0.002) and washout after 6 h was faster on a planar view image. Decreased MIBG uptake could be observed preferentially in the anterior and lateral walls near the apex. The half-time values of MIBG washout from the left ventricle were significantly reduced in the long QT syndrome (6.4 +/- 1.5 h) compared to controls (16.7 +/- 15.3 h, P < 0.002). In three cases, the same pattern of disturbed activity distribution was maintained even after surgical left cardiac sympathetic denervation. The present results strongly support the hypothesis that an inhomogenous regional distribution of sympathetic nerve terminals accompanied by an overall reduction in their absolute number may play an important role in the pathogenesis of the long QT syndrome. Additional functional disturbances, possibly related to the uptake of catecholamines in the left ventricle may coexist with regional inhomogeneity of nerve terminals. The differences observed from one case to the other may be related to the variation in severity of the disease. MIBG SPECT imaging seems an interesting new tool for the quantitative assessment of presynaptic sympathetic nerve terminal disturbances in the left ventricle of patients with the long QT syndrome.

3-Iodobenzylguanidine↗
PubMed1992

Evidence that sustained growth suppression of intestinal anaerobic bacteria reduces the risk of acute graft-versus-host disease after sibling marrow transplantation.

The influence of intestinal bacterial decontamination on the occurrence of grades II to IV acute graft-versus-host disease (GVHD) was retrospectively analyzed in 194 predominantly adult patients treated by genotypically identical sibling marrow transplantation under conditions of strict protective isolation and intestinal antimicrobial decontamination. Forty-five patients (23%) developed acute GVHD and univariate analysis identified four features that significantly increased the risk for this reaction: chronic myeloid leukemia as the underlying disease, as compared with all other disease categories (P < .0001); female marrow donors for male recipients, as compared with other gender combinations (P < .005); ineffective, as compared with sustained growth suppression of intestinal anaerobic bacteria (P < .006); and methotrexate as the sole immunoprophylactic compound, as compared with cyclosporine containing regimens (P < .05). Using the duration of anaerobic growth suppression as a time-dependent explanatory variable, proportional hazards regression analysis confirmed these features as independent predictors for acute GVHD with relative risk estimates of 1.9 (95% confidence interval [CI], 1.3 to 2.7) for the immunoprophylactic regimen (P < .0004), of 1.8 (95% CI, 1.3 to 2.5) for the underlying disease (P < .0005), of 1.7 (95% CI, 1.2 to 2.5) for anaerobic decontamination (P < .002), and of 1.3 (95% CI, 1.1 to 1.6) for the donor/recipient gender combination (P < .008), respectively. Best subset selection modeling also identified the quality of anaerobic decontamination as the third most important predictor for acute GVHD, when all four significant features were included. Estimates of acute GVHD stratified by the quality of anaerobic bacterial growth suppression showed a strong influence of anaerobic decontamination in patients burdened by at least one of the other unfavorable factors (P < .009). In conclusion, this study provides strong evidence that sustained growth suppression of intestinal anaerobic bacteria after clinical sibling marrow transplantation can independently modulate the occurrence of grades II to IV acute GVHD, which is in concordance with previous results from animal transplantation models. Antimicrobial chemotherapy specifically targeted to the intestinal anaerobic bacterial microflora may be complementarily useful in preventing acute GVHD and should be investigated in a prospective trial.

Adolescent↗
PubMed1992

Cholesterol binding of Helicobacter pylori.

H. pylori cells grown on cholesterol-free medium adsorb cholesterol from serum, egg yolk, and VDRL reagent. The binding of cholesterol does not influence the hydrophobicity of the cells. The haemagglutinating activity is slightly diminished. The cell-bound haemolytic activity is completely inhibited. The affinity of H. pylori for cholesterol probably acts as factor of chemotaxis and adherence.

Adsorption↗
PubMed1992

Rapid identification of Legionella species from a single colony by gas-liquid chromatography with trimethylsulphonium hydroxide for transesterification.

Transesterification of bacterial fatty acids to methyl esters with trimethylsulphonium hydroxide (TMSH) was compared with a conventional method for the identification of Legionella species by capillary gas chromatography. There was an extensive coincidence in the gas chromatographic profiles of bacterial fatty acid methyl esters (FAMEs) obtained by the two methods. However, the TMSH procedure needs less initial material and is much more simple and rapid. The chromatographic pattern of FAMEs obtained from a single colony is sufficient for the identification of the genus Legionella, and L. pneumophila can be clearly distinguished from other Legionella species.

Chromatography, Gas↗
PubMed1991

Hemodynamic, anti-ischemic, and neurohumoral effects of slow-release isosorbide-5-mononitrate in patients with coronary artery disease after short- and long-term therapy.

In 20 patients with established coronary artery disease, stable angina pectoris and reproducible ST-segment depression, the pharmacokinetics and pharmacodynamic effects of 60 mg slow-release isosorbide-5-mononitrate (IS-5-MN) (10 patients) after a 7-day therapy were compared with those of a placebo group (10 patients) using a randomized double-blind, placebo-controlled study design. Ten patients could be controlled after long-term therapy over a mean of 399 +/- 111 days. There was no significant change under IS-5-MN of either blood pressure, heart rate, rate-pressure product, or myocardial oxygen consumption. Treatment over one week significantly reduced ST-segment depression 4 and 8 h after drug intake (38-48% of the placebo value, p less than 0.01). Maximum reduction in ST-segment depression was found 4 and 8 h after IS-5-MN intake both after one-week and long-term therapy at the time of peak plasma drug concentration (341 +/- 95 and 405 +/- 125 ng/ml, respectively). At a residual plasma concentration below 100 ng/ml, ST depression was not significantly improved 24 h after drug intake compared with placebo. Technetium-99m ventriculography showed an insignificant increase in ejection fraction and a slight reduction of ventricular volumes after both short- and long-term therapy with IS-5-MN (p greater than 0.05). The drug's plasma levels were higher under chronic than under short-term therapy which may be due to enzyme saturation. Maximum IS-5-MN plasma concentrations at a mean of 445 +/- 116 ng/ml were reached after 5.8 +/- 2.9 h. Beta-phase half-life of elimination was 9 +/- 3 h. IS-5-MN administered as a single 60 mg dose of a slow-release preparation/day proved to have a favorable pharmacokinetic profile as well as an efficient antiischemic activity after both short- and long-term therapy. Problems of tolerance or activation of hormonal counter-regulation due to vasodilation were not observed.

Adult↗
PubMed1991

Flocculation of venereal disease research laboratory reagent by Helicobacter pylori.

Helicobacter pylori strains flocculated with Venereal Disease Research Laboratory (VDRL) reagent in a glass slide test. Other pathogenic bacterial and fungal strains were nonreactive. The specific VDRL reaction property of Helicobacter pylori indicates an affinity of the cells for lipoidal substances, and can be used as a diagnostic aid for species identification.

Bacteria↗
PubMed1991

[Alinidine in multi-vessel coronary disease: reduction of stress-induced ischemic reaction].

Ten patients suffering from an angiographically documented coronary two- or three-vessel disease were examined to evaluate the effects of the specific bradycardiac agent alinidine during a bicycle stress test. Hemodynamic and electrocardiographic parameters were compared before and after an intravenous application of 30 mg of the substance. The alinidine plasma levels 30 min after the injection were 160.6 +/- 22.5 ng/ml) (mean +/- SEM). Alinidine significantly (p less than 0.05) reduced the resting levels of heart rate (8.5%), double product (10.3%), myocardial oxygen consumption (9.1%), and cardiac output (9.0%). During exercise, significantly less ST-segment depression (p less than 0.001) in the EKG was observed after alinidine application in nine out of 10 patients, and the rise of pulmonary artery pressure was significantly reduced (34.7 vs 38.1 mm Hg, mean p less than 0.05). However, alinidine had no effect on the maximum heart rate at the end of exercise. We, therefore, assume that the substance has additional anti-ischemic properties.

Adult↗
PubMed1990

A new and rapid method for the assay of bacterial fatty acids using high resolution capillary gas chromatography and trimethylsulfonium hydroxide.

Gas-liquid chromatography of cellular fatty acids is a useful tool for the identification of bacteria. Derivatization of bacterial fatty acids to methyl esters by conventional techniques is usually time-consuming and complicated. A new one-step technique using trimethyl-sulfonium hydroxide allows the direct formation of fatty acid methyl esters within 1-2 min. Some random examples of profiles demonstrate that straight, branched, saturated, unsaturated, hydroxy and cyclopropyl fatty acids match conventional preparations well. The method is a very sensitive one, since only a few colonies are sufficient for preparation of fatty acid methyl esters.

Aeromonas↗
PubMed1990

Comparison of inhibitory and bactericidal activity of antipseudomonal antibiotics against Pseudomonas aeruginosa isolates from cystic fibrosis patients.

Using a broth microtiter dilution method, the minimum inhibitory (MIC) and minimum bactericidal concentrations (MBC) of so-called antipseudomonal antibiotics were determined against 79 Pseudomonas aeruginosa isolates from cystic fibrosis patients. On the basis of the MIC values and using DIN breakpoints, the percentual susceptibilities led to the following rank order: imipenem (91%), ciprofloxacin (90%), tobramycin (87%), amikacin (87%), ceftazidime (82%), cefsulodin (76%), piperacillin (71%), azlocillin (62%), followed by gentamicin, ceftriaxone, mezlocillin, netilmicin, and cefotaxime (less than 50%). However, evaluating MBC values according to DIN breakpoints, only ciprofloxacin (82%), tobramycin (77%), amikacin (58%), and imipenem (57%) showed a pronounced antipseudomonal effectiveness. The data indicate that MBC determinations are necessary to evaluate the antibiotic susceptibility of P. aeruginosa rather than MIC determinations, at least in patients with impaired defence mechanisms which require bactericidal therapy.

Amikacin↗
PubMed1990

[Prophylaxis and therapy of fungal infections with fluconazole in patients after bone marrow transplantation].

In an open study 31 patients undergoing bone marrow transplantation for various haematological diseases received fluconazole as prophylaxis or treatment of fungal infections. In 26 of these patients an antecedent oral prophylaxis with polyene antimycotics had failed to prevent infections with Candida species. Five of the 31 patients received fluconazole as primary prophylaxis because of non-compliance for polyene antimycotics. Fluconazole was administered orally at a daily dose of 100 mg and 200 mg, respectively (n = 29), or intravenously at a dose of 100 mg and 400 mg (n = 2). Cure or efficient prophylaxis was achieved in 22/31 patients (71%) after a median of 52 (9 to 546+) treatment days. In three patients (10%) Candida was eradicated but the infection reappeared 14-28 days after cessation of the drug; in 6 patients (20%) the infection was persistent or progressive. Four patients developed lethal Aspergillus infection while on fluconazole medication. A moderate and reversible elevation of liver function tests under therapy was observed in 9 patients and was possibly attributable to fluconazole in 3 of them (10%). One patient developed tremor which resolved after cessation of fluconazole. No other adverse drug reactions could be noted. We conclude that fluconazole is a relatively safe and effective drug for the prevention and treatment of superficial and, possibly, deep Candida infections in severely immunocompromised patients. It is presumably without preventive value in Aspergillus infections.

Adult↗
PubMed1988

Complete thrombotic obliteration of the ascending aorta and the aortic arch as a cause of acute heart failure in a newborn.

Thrombosis of the great vessels, and especially of the aorta, is rare in neonates. We report a case with thrombosis of the ascending aorta, aortic arch, brachiocephalic trunk and subclavian artery. Clinically, severe heart failure occurred on the 1st day of life and the diagnosis was confirmed by echocardiography and cardiac catheterization, including angiocardiography. Left ventricular function was found to be extremely depressed. An infusion with prostaglandin E1 was initiated in order to improve the systemic circulation by dilating the arterial duct. The infant died of neurological complications prior to surgery.

Aorta↗
PubMed1987

[Serological studies of early summer meningoencephalitis risk in the Saarland].

To evaluate the risk of acquiring TBE in the Saarland, tick-borne encephalitis (TBE) antibodies were investigated in the sera of 408 persons working in forestry, 44 patients with suspected viral infection of the central nervous system, and of 439 animals which had been particularly exposed to ticks. A complement fixation test was used for all sera. The human sera were additionally tested with an enzyme-linked immunosorbent assay. TBE antibodies were found in eight forestry employees who had been vaccinated against TBE. All other persons as well as the animals did not show TBE antibodies. The very low antibody rate in the risk groups indicates that the Saarland is free of natural foci of TBE. At present, there is no argument for a general TBE immunprophylaxis in that area.

Adolescent↗