[From the furthest section of the ileum to the amygdala....].
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Aged↗
Biomedical subjects
M Heitz
Publications and source records attributed to M Heitz.
Pseudomonas putida as the dominant toluene-degrading bacterial species during air decontamination by biofiltration.
The microbial communities established in three laboratory-scale compost matrix biofilters fed with toluene were characterized. The biofilters were operated for 7 weeks at inlet concentrations of toluene ranging over 250-500 ppm with daily irrigation, using a nutrient solution containing variable concentrations of nitrogen, supplied as urea, and other inorganic salts. The indigenous microflora of the compost included toluene-degrading species, making inoculation unnecessary. The numerically predominant toluene-degrading strains were isolated from the most diluted positive wells of most-probable-number counts on mineral medium with toluene as sole carbon source and identified by rRNA 16S gene sequencing. On the basis of sequence similarity, all the isolated strains were assigned to the species Pseudomonas putida, although some variations were observed in their respective sequences. It is concluded that the mode of biofilter operation including a daily supply of non-carbon nutrients created an environment favoring the constant numerical predominance of this fast-growing toluene-degrading species.
Air Pollutants↗
[Stents in the tracheobronchial tree].
Interventional procedures in bronchoscopy such as tissue ablation by laser, bronchusdilatation, stenting, endobronchial radiotherapy have a firm established position as treatment modalities for severe tracheobronchial obstruction. They allow quick and effective treatment of sometimes life threatening tracheal and bronchial obstructions. This article focuses on stents in the airways. A brief description of historic development is given. Currently available and frequently used stents are shown. There advantages and disadvantages are discussed. Indications for Stent-insertion in particular and for interventional endoscopy are summarized and the different techniques for insertion outlined. Based on the published literature results and complication rates are discussed.
Airway Obstruction↗
Discovery of (R)-1-[2-hydroxy-3-(4-hydroxy-phenyl)-propyl]-4-(4-methyl-benzyl)-piperidin-4-ol: a novel NR1/2B subtype selective NMDA receptor antagonist.
Starting from Ro-25-6981 as a lead compound, highly potent and selective NR1/2B subtype selective NMDA receptor antagonists, with low activity at alpha(1) adrenergic receptors were developed.
Excitatory Amino Acid Antagonists↗
NMDA-mediated activation of the medial amygdala initiates a downstream neuroendocrine memory responsible for pseudopregnancy in the female rat.
In female rats, genitosensory stimulation received during mating initiates twice-daily prolactin (PRL) surges, a neuroendocrine response that is the hallmark of early pregnancy or pseudopregnancy (P/PSP). Nocturnal and diurnal PRL surges are expressed repeatedly for up to 2 weeks after copulation, suggesting that a neuroendocrine memory for vaginocervical stimulation (VCS) is established at the time of mating. These studies investigated whether the processing and retention of VCS involves acute glutamatergic activation or de novo protein synthesis within the medial nucleus of the amygdala (MEA), a VCS-responsive brain site that is implicated in P/PSP initiation. Pharmacological activation of the MEA with the glutamate agonist, NMDA, initiated nocturnal PRL surges, causing a PSP state in females that had not received VCS. P/PSP initiation by mating was prevented by intra-amygdalar infusion of the NMDA receptor antagonist, 2-amino-5-phosphonopentanoic acid (AP-5), provided that it was administered before mating. AP-5 treatment also disrupted mating-induced c-fos expression in the principle bed nucleus of the stria terminalis and the ventrolateral division of the ventromedial hypothalamic nucleus, but not in the medial or anteroventral periventricular preoptic nuclei. Neither P/PSP nor downstream cellular activation was prevented when a protein synthesis inhibitor, anisomycin, was administered to the MEA. The results indicate that MEA cells are critical to the early processing of VCS through NMDA channel activation, rapidly conveying information to downstream hypothalamic cell groups that modulate neuroendocrine function.
Amygdala↗
Biofiltration of air contaminated with toluene.
In industrial activities, operation of air biofilters may be interrupted for a long period of time. In order to examine the effect of shut-down on the performance of biofilters, a pilot scale biofiltration unit was restarted up after a non-use duration of eight months. After a reacclimation period of eight days, the biofilter reached an elimination capacity of 35 g x m(-3) x h(-1) compared to 38 g x m(-3) x h(-1) before shut-down, for the same operating conditions. The results obtained indicate that the microorganism activity was completely restored and this was confirmed by the microbial count tests performed on filter bed material samples. The impact of varying the inlet concentration of toluene on biofilter performance was also investigated. A maximum elimination capacity of 120 g x m(-3) x h(-1) was achieved, compared to 135 g x m(-3) x h(-1) before shut-down. The biofilter removal efficiency exceeded 96% for inlet concentrations up to 1.8 g x m(-3). Temperature measurements revealed that the filter bed temperature depends strongly on the intensity of microbial activity and the biofilter effectiveness in eliminating toluene. Experimental data were compared with the calculations of a mathematical model. Comparison showed that the theoretical model was successful in predicting the performance of the biofiltration unit.
Air Pollution↗
Helicobacter pylori in the oral cavity reflects handling of contaminants but not gastric infection.
Helicobacter pylori colonises the gastric mucosa, but can also be found within the oral cavity. The presence of H. pylori was monitored in the oral cavity of 22 patients with duodenal ulcer, before and after antibiotic treatment and of 24 hospital employees who were or were not professionally exposed to H. pylori. Gastric infection was determined by breath test. Bacteria in the oral cavity were detected by nested PCR of samples containing saliva and dental plaque, using primers specific for 16S rRNA and ureC genes. Before treatment, 9 out of 22 infected ulcer patients harbored H. pylori in their oral cavity. Bacteria disappeared from the oral cavity of 3 of 7 cured patients. Twelve of 17 exposed subjects harbored H. pylori in their oral cavity, while no bacteria could be detected in the mouths of the 7 nonexposed subjects. Presence of bacteria in the oral cavity reflects handling of contaminants; it does not correlate with gastric infection and does not seem to promote it.
Adolescent↗
[Anatomy and blood supply of the penis and urethra].
The exact knowledge of the topographic anatomy of the urethra as well as the macro- and microcirculation of the penis [6] are the basics of reconstructive urethral surgery. Adherence to the fundamentals and principles of tissue transfer [5] are necessary to fascilitate conditions for successful treatment of the various disorders of the male urethra. Mutural description of the anatomy of the male urethra in conjunction with external male genitals is necessary because of developmental similarities as well as the close anatomical relationship. The arterial and venous blood supply of the urethra and the penis have to be taken into account if vascularized flaps from the penile skin or the prepuce are used in urethral reconstruction. The dual arterial and venous vascularity of the genital skin is of fundamental importance to a successful outcome of the operative treatment. The purpose of this article is, to summarize the relevant anatomical knowledge of reconstructive urethral surgery.
Adolescent↗
[Therapy of female urinary incontinence with the AMS 800 artificial sphincter. Indications, outcome, complications and risk factors].
Indications, results and complications of 144 women who have undergone implantation of the current model AMS 800 since 1983 and remained in continuous follow-up in our department are presented. Included are 70 patients suffering from stress urinary incontinence (SUI) type III after 208 previously unsuccessful incontinence procedures, 54 patients with incontinence due to neurogenic bladder dysfunction (NBD) and 20 patients with congenital or acquired internal sphincter weakness of other causes. In the NBD group, apart from sphincter implantation a total of 113 additional operations were necessary due to complex malfunctions of the urinary tract: augmentation ileocystoplasty in 51 patients, ureterocystoneostomy in 23 patients and 43 operations at the bladder neck. One hundred and twenty-six patients (86%) achieved total continence and 5 patients (3%) were significantly improved. In 9 females (6%) incontinence persisted, and 4 patients ultimately underwent urinary diversion into a Kock pouch. With the implanted artificial sphincter 116 patients (81%) are able to empty their bladder spontaneously, without residual urine and without the necessity of intermittent self catheterisation. Under the aforementioned conditions implantation of the artificial urinary sphincter AMS 800 is the most effective therapy for complex female incontinence.
Equipment Design↗
Sequential development of resistance to fluoroquinolones and erythromycin in an isolate of Campylobacter jejuni.
A severe episode of Campylobacter jejuni gastroenteritis in a patient with HIV infection was treated with ciprofloxacin and, because of therapeutic failure, subsequently with roxithromycin. After treatment, C. jejuni was again isolated from feces and shown to be resistant to both drugs. We present molecular evidence of the sequential development of both types of resistance in the patient isolate. To our knowledge, this is the first case with documented evidence showing sequential emergence of resistance to fluoroquinolones and erythromycin in a strain of C. jejuni during treatment.
Adult↗
An Airway Wallstent for the treatment of tracheobronchial malignancies.
BACKGROUND: The palliative effect of a new Airway Wallstent with a polyurethane covering was tested in patients with inoperable malignant lesions of the central airways. METHODS: Thirty six stents were inserted in 27 patients with obstruction (n = 24) or fistulae (n = 3), 15 of whom later received radiotherapy. The degree of symptom relief was assessed 1, 30, and 90 days after stent insertion. RESULTS: Stent deployment was successful in all patients. Significant improvements were observed one day after placement compared with before placement, with no change at 30 and 90 days, in dyspnoea index (mean (SD) 3.2 (0.7) before stent insertion compared with 1.8 (0.7) one day after insertion); Karnofsky index (32 (18) before insertion compared with 55 (15) one day after insertion); and obstruction of airway diameter (85 (11)% before insertion compared with 10 (12)% on day 1 after stent insertion). Stent-related complications needing later interventions included retained secretions (five patients), granuloma formation at ends of the stent (four patients), and stent migration (four patients). Over a median observation period of two months (range two days to 8.5 months) all stent coverings remained intact without delamination or tumour ingrowth. CONCLUSIONS: The Airway Wallstent provided excellent palliation for malignant obstructions and fistulae of the central airways. Retention of secretions and granuloma formation at the ends of the stent warrant minor technical improvements.
Adult↗
The use of the covered Wallstent for the palliative treatment of inoperable tracheobronchial cancers. A prospective, multicenter study.
STUDY OBJECTIVE: To investigate the safety, efficacy, and tolerance of the covered Wallstent for the palliative treatment of inoperable tracheobronchial cancer. DESIGN: An 8-month prospective study employing either a rigid bronchoscope or a flexible delivery system for prosthesis insertion. SETTING: Multicentric setting involving four teaching hospitals in Switzerland and Germany. PATIENTS: Forty patients (29 men, 11 women), average age of 62 years, presenting with an inoperable tracheobronchial cancer. INTERVENTIONS: After partial airway recanalization with an Nd-YAG laser, the covered Wallstent was inserted 23 times using a rigid bronchoscope (Rigidstep device), and 27 times using a flexible delivery system (Telestep device) under fluoroscopic and endoscopic visualization. RESULTS: Clinical and endoscopic examination at 1, 30, and 90 days showed improvement in the bronchial lumen and in the dyspnea index. No serious complication (death, perforation, hemorrhage, inability to remove an improperly placed prosthesis) was observed during surgery. Late complications included migration (12%), inflammatory granulations or tumor regrowth at the tip of the prosthesis (36%), and symptomatic retention of secretion (38%). CONCLUSIONS: Compared with other tracheobronchial prostheses, notably the Dumon stent, the covered Wallstent presents the following advantages: insertion with visual guidance, treatment of extrinsic compressions and esophagobronchial fistulas, and little chance of migration when the prosthesis diameter is chosen correctly. The following disadvantages can be noted: high price; both repositioning and extraction of the released stent are more difficult, though certainly possible; and risk of granulations at the tips of the prosthesis and retention of secretions. Suggestions are made for potential improvements to the stent and insertion system that may result in a significant decrease in early and late complications.
Adult↗
Immunization of BALB/c mice against Helicobacter felis infection with Helicobacter pylori urease.
BACKGROUND/AIMS: Because Helicobacter pylori is a potentially dangerous human pathogen, the protective potential of oral immunization with H. pylori urease and its subunits was evaluated in an animal model. METHODS: Mice were orally immunized with H. pylori sonicate, urease, or recombinant enzymatically inactive urease subunits and then challenged with Helicobacter felis. Control mice were sham-immunized. RESULTS: H. felis colonization was present 5 days after challenge in 9 of 10 sham-immunized, 6 of 9 sonicate-immunized, and 3 of 10 urease-immunized animals (P = 0.031 vs. sham-immunized). Twelve days after challenge, urease B-immunized mice had a weaker colonization than sham-immunized controls, whereas urease A had no effect. After 70 days, most urease A- and urease B-immunized mice had cleared the colonization (10/17: P = 0.0019; 16/20: P = 0.00002 vs. sham-immunized). In urease B-immunized animals, protection was often associated with corpus gastritis. CONCLUSIONS: Oral immunization with H. pylori urease protects mice against H. felis infection. Enzymatically inactive urease A and B subunits contain protective epitopes. It is unclear whether protection depends on the development of a mononuclear inflammatory response in the gastric corpus. Our observations should encourage the development of a human vaccine.
Administration, Oral↗
[Laser therapy of bronchial carcinoma].
Endobronchial laser-therapy is reviewed in perspective to other palliating modalities such as radio- and chemotherapy. Laser treatment is most suited for exophytic tumors of the trachea and larger bronchi. Favorable for reventilation of atelectases are: short duration of luminal obstruction patent peripheral bronchi as evidenced by computed tomography, exophytic growth in the main or intermediary bronchus. The intervention can be performed using either fiber optics or the rigid bronchoscope in one or more sessions. For processes in the trachea or the main bronchi the method of choice is a single treatment using the rigid instrument.
Airway Obstruction↗
[Quantitative determination of bacterial sensitivity--indications and methods].
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Anti-Bacterial Agents↗
[Quantitative sensitivity determination of bacteria. Indications and methods].
The authors describe the indications for quantitative susceptibility tests and also the methods themselves (agar dilution, macrodilution, combination tests, tests for beta-lactamase production). This study forms part of a series on susceptibility methods which started with a paper on disk susceptibility testing (this journal, 1984; 114: 1079-1086).
Anti-Bacterial Agents↗
[Klebsiella oxytoca beta-lactamases: study of their action on 3d-generation cephalosporins].
Indole-positive Klebsiella pneumoniae or K. oxytoca are usually resistant to penicillins as a result of the production of a chromosomally-mediated beta-lactamase with a low level of synthesis (specific activity approximately 50 to 100 mU/mg). Although most strains are susceptible to the majority of cephalosporins, some strains exhibit resistance to cephalosporins including third-generation drugs. These resistant strains produce a chromosomally-mediated beta-lactamase with a high level of synthesis (specific activity approximately 5,000 mU/mg or higher). Four beta-lactamases have been identified on the basis of their isoelectric points: pI = 5.5, 5.7, 6.0 and 6.3; nevertheless they have similar kinetic constants, and are inhibited by clavulanic acid. These enzymes hydrolyze most third-generation cephalosporins, in the following order of decreasing velocities: cefoperazone, ceftriaxone, cefotaxime, cefodizime, cefpirome; ceftazidime, and cefoxitin, cefotetan, latamoxef, cephamycins which are totally resistant to these enzymes.
Cephalosporins↗
[Determination of the sensitivity of microorganisms to antimicrobial agents; standardization of the antibiogram].
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Anti-Bacterial Agents↗