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Biomedical subjects

L Lehmann

Publications and source records attributed to L Lehmann.

At least 55 records · Page 3Linked to original sources

The cytoplasmic tail of lysosomal acid phosphatase contains overlapping but distinct signals for basolateral sorting and rapid internalization in polarized MDCK cells.

Lysosomal acid phosphatase (LAP) is synthesized as a type I membrane glycoprotein and targeted to lysosomes via the plasma membrane. Its cytoplasmic tail harbours a tyrosine-containing signal for rapid internalization. Expression in Madine-Darby canine kidney cells results in direct sorting to the basolateral cell surface, rapid endocytosis and delivery to lysosomes. In contrast, a deletion mutant lacking the cytoplasmic tail is delivered to the apical plasma membrane where it accumulates before it is slowly internalized. A chimeric protein, in which the cytoplasmic tail of LAP is fused to the extracytoplasmic and transmembrane domain of the apically sorted haemagglutinin, is sorted to the basolateral plasma membrane. A series of truncation and substitution mutants in the cytoplasmic tail was constructed and comparison of their polarized sorting and internalization revealed that the determinants for basolateral sorting and rapid internalization reside in the same segment of the cytoplasmic tail. The cytoplasmic factors decoding these signals, however, tolerate distinct mutations indicating that different receptors are involved in sorting at the trans-Golgi network and at the plasma membrane.

Acid Phosphatase↗

[Retino-hypothalamic pathways in vertebrates].

Forty years ago Hollwich (1948) introduced the conception of an "energetic portion of the visual pathway". Contributions to this conception of a direct connection of the retina with the hypothalamus accumulated since then and summarized here in tabular form give rise to the following conclusions: In fish the main hypothalamic termination of retinofugal axons is the nucleus hypothalamicus opticus. It may pass for the suprachiasmatic nucleus of fishes. In amphibians retino-hypothalamic fibres project to the area praeoptica. In reptiles retinofugal fibres innervate hypothalamic neuronal populations called either Nucleus suprachiasmaticus or Nucleus praeopticus. In birds retinohypothalamic axons project to a circumscribed anterior hypothalamic area termed "suprachiasmatic nucleus" by some authors. In mammals at last the main part of the retinohypothalamic tract terminates in the suprachiasmatic nuclei, especially favouring their caudal and ventrolateral parts. The interneuronal connections are axo-dendritic synapses of the Gray Types-I and II. Connections of retinal neurons, especially with suprachiasmatic hypothalamic nuclei or their homologues, are by now well established facts. They represent relatively constant and phylogenically stable components of the centripetal retinal projection. These projections are probably in all, certainly in most of the vertebrates bilateral. Some former but also newer methods of research (Stumpf and Sar, 1975) also depicted optic fibers which terminate in hypothalamic sites apart from the nucleus suprachiasmaticus and the area hypothalamica anterior (Conrad and Stumpf, 1975). A review of the literature on the existence of nerve fibers directly connecting the retina with the hypothalamus is tabulated.

Animals↗

[Idiopathic intestinal pseudo-obstruction].

The extremely rare case of an idiopathic chronic intestinal pseudo-obstruction is pointed out here. This disease would manifest myomechanically by highly active, uncontrollable, non-propulsive contraction. It is caused by a collapse of smooth muscle control with cholinergic and beta adrenergic receptors being partially blocked, and by lacking reaction to substances which act on smooth muscles.

Adult↗

[Causes of gastrointestinal hemorrhages in chronic liver diseases].

356 patients with chronic liver diseases hospitalized in our clinic during the period from January 1, 1981, to December 12, 1983, were enrolled in a retrospective study. Of them 55 had been admitted for acute gastrointestinal hemorrhage. It appears that gastroscopy is the only method allowing to localize the origin of the bleeding with high certainty. Bleedings from varices (45%) and ulcers or erosions (22%) were seen most frequently. With regard to case history, clinic, paraclinic and prognosis, no significant differences were found between these various origins of the hemorrhages. Also it is remarkable that all bleedings occur with higher frequency in portal hypertension.

Adult↗

[Free cecum perforation with peritonitis as a rare complication of Crohn disease].

Perforation and peritonitis as complications of severe Crohn's disease are rare. Case reports of two young female patients are given who have been treated in 1983 because of peritonitis after perforation of Crohn's disease. The only therapeutic approach making sense is elimination of the intestine affected by the disease and repeated control laparotomies with for treatment of peritonitis and controlling sufficiency of the anastomosis. These patients are at high risk because of treatment with cortisone.

Adult↗

pH-control via secretin or antacid: prophylaxia of stress ulcers in high-risk surgical patients.

The efficacy of an antacid or synthetic secretin in elevating the intragastric pH above 4 was tested in a controlled, prospective study. Twenty-one high-risk surgical patients received an antacid and 17 secretin. Antacid prophylaxis resulted in a significantly higher intragastric pH than with secretin. This was especially true in patients with several risk factors. The percent of secretin patients with a pH below 4 was higher. An increase in dosage was necessary in 4 of the 17 patients receiving secretin and in none of those receiving antacids. One stress ulcer hemorrhage occurred during secretin prophylaxis.

Aged↗

[Intragastric pH increase using antacids or secretin for stress ulcer prevention in surgical risk patients].

The efficacy of an antacid or synthetic secretion on elevations in intragastral pH above 4 was tested in a controlled prospective study. 21 surgical high risk patients received an antacid, and 17 secretin. Antacid prophylaxis resulted in a significantly higher intragastral pH than with secretin. This was especially true in patients with several risk factors. The percentage of secretin patients with a pH reduction below 4 was higher. An increase in dosage was necessary in 4 of the 17 patients receiving secretin and in none of those receiving antacids. One stress ulcer hemorrhage occurred during secretin infusion.

Aged↗

[Prognosis of perforating gastroduodenal ulcer: simple closure or definitive ulcer operation?].

95 patients are reported, who had perforation of a gastroduodenal ulcer. In 47 cases the perforation was oversewn only; primary or secondary high selective vagotomy (HSV) were done in 33 cases and resection in 15 cases. Lethality of the first group was 23.3%; it was 9.1% after primary HSV and resection. No death was recorded in the group of 26 patients, who had secondary HSV or resection. In the group of patients surviving, which had symptoms for more than 3 months prior to surgery, 42.4% had new symptoms of ulcer diseases after surgery and 27.2% actual relapse, if the perforation had been oversewn only. These numbers were 16.2% after HSV and 5.4% after resection respectively. In patients where the ulcer was located intra- or postpylorically symptoms of ulcer disease were observed in 42.1% after simple oversewing, and in 15.4% after HSV or resection, the difference being significant. There was no difference between incidence of postoperative symptoms when ulcers was located prepylorically.

Adult↗

[Results of the surgical treatment of bleeding gastroduodenal ulcers].

Within 11 years 279 operations for acute bleeding from gastroduodenal ulcers were performed at the surgical University Clinic in Würzburg. Of the 279 patients, 140 had to be operated on immediately because of acute severe bleeding. Of the 158 bleeding duodenal ulcers, 104 had a selective proximal vagotomy (SPV), 29 had gastric resection, and in 25 the ulcer was simply closed. The overall mortality after SPV was 8.6%, 62% after gastric resection, and 40% after simple suture ligation. Recurrent bleeding occurred in 8.7% after SPV, 10.3% after gastric resection, and in 24% after suture ligation. Of the 89 bleeding gastric ulcers, 25 had a selective proximal vagotomy, 30 a gastric resection, and 34 excision of the ulcer. The overall mortality after SPV was 16%; after gastric resection it was 23.3% and 41.2% after ulcer excision. Recurrent bleeding was observed in 8% after SPV, in 10% after gastric resection and in 11.7% after ulcer excision.

Female↗

[Selective proximal vagotomy with ulcer excision or Billroth I resection in chronic stomach ulcer. A prospective randomized multicenter study].

In a prospective randomised multicenter study in 41 patients with chronic gastric ulcer type I according to Johnston we compared selective proximal vagotomy (SPV) plus ulcerectomy (21 patients) with a standardised Billroth I gastrectomy (20 patients). The follow-up period was at least 2 years. Preoperative characteristics of both groups did not differ. Intraoperatively, in 5 patients of the SPV group technical problems during dissection of the lesser curvature occurred. The main postoperative complaints were pain and epigastric fullness after SPV and bile vomiting, early dumping or diarrhea after Billroth I gastrectomy. 3 of 21 patients after SPV developed recurrent ulceration, whereas after BI resection no recurrence was observed. This study indicates a higher recurrence rate in gastric ulcer patients after SPV compared to Billroth I gastrectomy.

Clinical Trials as Topic↗

[Cimetidine with suture ligature of ulcers - an alternative in the treatment of severe acute gastroduodenal ulcer hemorrhage].

The results of SPV with suture ligation of the ulcer (n = 60), suture ligation combined with postoperative Cimetidine medication (n = 20) and suture ligation alone (n = 20) for severely bleeding gastroduodenal ulcers were studied retrospectively and compared. No significant difference could be found between suture ligations of the ulcer combined with SPV or Cimetidine concerning recurrent bleeding and specific or overall mortality. Their rate were highest after suture ligation alone as well in bleeding duodenal ulcers as in gastric ulcers.

Acute Disease↗

[Clinical results of Child' and Phillips' mesenteric plication for the prevention and therapy of small intestinal ileus].

Mesenteric plication was performed on 148 patients (99 adults and 49 children) in the Surgical Department of Würzburg University. Recurrent bowel obstruction occurred as an early complication in 6.8%. A relaparatomy was necessary in all cases. 4 out of 10 recurrences were due to complications of the method itself. Recurrent bowel obstruction in the form of a subileus occurred as a late complication in 2.2%. There was a concurrent peritonitis at the time of mesenterial plication in 52 patients. The number of relaparatomies in the presence or absence of peritonitis was 15.4% and 8.3%, respectively. No patient died of complications due to plication. The intestinal transit time was normal 2 to 11 years after the procedure in over 92% of the patients. The typical arrangement of the small bowel mucosa was absent in 81%.

Adult↗

Intravenous arteriography using scanned projection radiography.

Visualization of arteries using intravenous injections of contrast material requires an imaging system capable of (a) excellent sensitivity to dilute concentrations of contrast media and (b) adequate temporal resolution to minimize the effects of motion during the exposure. A line-scanned radiography system based on a CT fan-beam detector (high-pressure xenon ionization chamber) was used for phantom and animal studies of intravenous arteriography to demonstrate the potential advantages of this method. Even though line-scanned systems require long scan times compared to existing radiographic methods, they are capable of showing rapidly moving arteries without blurring. Concentrations of 3 mg/ml of iodine could be seen in vessels 2 mm in diameter. Phantom studies using kVp switching showed that bone or soft tissue could be selectively cancelled.

Angiography↗

[Mesenteric plication by the Childs-Phillips method for the prevention and therapy of small intestine obstructions. Experiences in 148 cases].

Transmesenteric small bowel plication (Childs-Phillips) was performed in 148 patients (99 adults, 49 children) at the University Clinic of Würzburg over a 10-year period. Of a total of 31 reinterventions, only 4 were caused by the method; recurrent intestinal obstruction occurred in 6.1%. In a total of 51 patients peritonitis was present at the time of mesenteric plication, which is not considered a contraindication for the method. Early postoperative mortality was 38.5%, but in none of these 57 cases was it due to the method itself.

Adolescent↗