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Biomedical subjects

M Rotter

Publications and source records attributed to M Rotter.

At least 19 recordsLinked to original sources
PubMed1992

Expression of HER-2/neu in renal-cell carcinoma. Correlation with histologic subtypes and differentiation.

Twenty-four renal-cell carcinomas (RCC) and corresponding non-neoplastic kidney tissue were examined for amplification and expression of the HER-2/neu gene. Gene amplification was examined by slot-blot analysis, mRNA expression by in situ hybridization and Northern blot analysis, and protein expression by immunohistochemistry. Northern-blot analysis revealed lower expression of HER-2/neu mRNA in clear-cell (p less than 0.001) and compact (p less than 0.001) tumor subtypes, while chromophilic, chromophobic and tubulo-papillary subtypes did not show significant differences in HER-2/neu gene expression, as compared with non-neoplastic kidney tissues. HER-2/neu gene expression was not significantly associated with tumor stage. Low differentiation (G3) was associated with lower HER-2/neu gene expression, but the number of G3 cases was too small for statistical analysis. HER-2/neu gene amplification was not found in any of the tumors. The results of in situ hybridization and immunohistochemistry generally agreed with those of Northern-blot analysis. We conclude that HER-2/neu gene expression correlates with Thoenes' classification of RCC and may be inversely related to tumor differentiation; it is probably not involved in progression of RCC, in contrast to carcinomas of other locations (e.g. breast, ovary).

Blotting, Northern↗
PubMed1992

Absence of interaction between tenoxicam and warfarin.

The influence of tenoxicam on plasma warfarin concentrations and on its anticoagulant effect has been studied in healthy volunteers. Tenoxicam did not alter the plasma warfarin concentration versus time profile. Treatment with it for 14 days had no effect on the average dose of warfarin required to maintain the prothrombin time within a specified range. The coumarin dose index, an indicator of warfarin sensitivity, remained unchanged during tenoxicam administration. The results demonstrate the lack of a clinically relevant effect of tenoxicam on warfarin-induced anticoagulation.

Adult↗
PubMed1991

The human embryonic myosin alkali light chain gene: use of alternative promoters and 3' non-coding regions.

Recently we have found evidence that the human embryonic myosin alkali light chain (MLC1 emb) gene has two functional promoters and that its mRNAs exhibit heterogeneity in their 3'untranslated regions (UTR). To study this more in detail we have isolated and characterized the human MLC1emb gene. We focussed in particular on 2 kilobases of 5'flanking region and the alternative 3'UTRs. RNA primer extension and S1 mapping analyses revealed that the MLC1emb gene can indeed be driven either by a proximal or a distal promoter, both in fetal and adult cardiac tissue. These MLC1emb RNAs can contain either the proximal or distal 3'UTR. In contrast to this, in fetal as well as adult masseter muscle MLC1emb mRNA is predominantly transcribed from the proximal promoter and contains mainly the distal 3'UTR. These results explain the known heterogeneity of MLC1emb mRNAs. Finally, we present evidence that the murine MLC1emb gene also contains a functional distal promoter element which has hitherto been undetected.

Animals↗
PubMed1991

An ABA and GA modulated gene expressed in the barley embryo encodes an aldose reductase related protein.

In most higher plants a period of desiccation is the terminal event in embryogenesis. Excised barley embryos acquire desiccation tolerance at a precise developmental stage and cDNA clones have been isolated which are temporally linked with desiccation tolerance. One such clone (pG22-69) with a putative gene product of 34 kd displays high structural homology to mammalian genes encoding an NADPH dependent aldose reductase involved in the synthesis of sorbitol. This first aldose reductase gene of plants is expressed constitutively during embryo maturation and is modulated by the plant hormones abscisic acid (ABA) and gibberellic acid (GA). Immunohistochemistry showed that the protein is preferentially expressed in tissues formed at early stages in embryogenesis. Measurements of enzymatic activity indicate that pG22-69 encodes an active aldose reductase. The finding of this reductase activity and the cloning of the corresponding gene supports the existence of a metabolic pathway in plants playing a role in the synthesis of osmolytes like sorbitol. The significance of this work is that genes of related structure and functions are being used in diverse organisms to fulfil stress related biological requirements.

Abscisic Acid↗
PubMed1991

Educational programmes for infection control in Austria.

Educational aims and strategies (simply arousing awareness, sensitivity and understanding; and/or training in practical skills and knowledge; or the ability to teach infection control, and to convince those taught) depend on the target group. Infection control is part of the curriculum for students of medicine and other health care professions, and is included in course examinations. Postgraduate doctors may seek training on courses which are organized by the Hygiene Institute of the University of Vienna in co-operation with the Austrian Society of Hygiene, Microbiology and Preventive Medicine. Registered nurses may enroll in the Austrian Nurses' Association training scheme (6 weeks of theory with professional work for 2 years), leading to approval as Hygieneschwester/-pfleger. Postgraduate in-hospital education for all health-care professions occurs in many Austrian hospitals, with resources from Vienna and Linz. Hospital managements, health authorities and politicians are influenced via their own educational activities and via publications.

Austria↗
PubMed1991

[Vascular malformations of the uterus].

Arteriovenous fistulae of the uterus are rare. We report on a patient with a vascular malformation of the uterus complicated by hypermenorrhea. Symptoms, possible complications and therapy are discussed.

Adult↗
PubMed1990

[Endoscopic and percutaneous implantation of self-expanding endoprostheses in biliary stenosis].

Self-expanding metal stents were implanted in 30 patients (14 men and 16 women, mean age 67 [40-86] years) with malignant (n = 27) or benign (n = 3) obstruction of the biliary tract (hepatic duct bifurcation: n = 14; choledochal duct: n = 16). The stents were introduced and left in place endoscopically in 13, percutaneously and transhepatically via a 7 or 9 F catheter in 17 patients. The stents, which expand to a diameter of 7-10 mm, in all cases achieved complete drainage, as confirmed by cholangiography. Jaundice completely disappeared in 28 of 30 patients. No complications were noted during a 30-day period of observation. After a median follow-up period of 90 days, 17 patients have been without jaundice for a median period of 141 (30-330) days. A recurrence of jaundice was noted in three patients (restenosis proximal to the stent in 2, incrustation with bile in one). Ten patients died, without any signs pointing to stent occlusion. These data indicate that the probability of stent patency in malignant stenoses of 200 days after implantation is 84%, so that stents in most cases provide a safe and effective means of drainage. Because they have a relatively large lumen with small surface area infection, occlusion and migration apparently occur less often than with conventional synthetic prostheses.

Adult↗
PubMed1990

Resistance of gram-negative bacilli and staphylococci from blood cultures to aminoglycoside antibiotics. Comparison of 3 in vitro investigations from Austria 1982-1988.

A total of 790 blood culture isolates was collected during 3 study periods in 1982/83, 1984/85 and 1987/88. Staphylococci were the most frequent bacteria in the first two periods (56.5% and 63%, respectively). During the last period, E. coli was the most frequent of all species (27%). Differences in the distribution of bacteria between the laboratories were considerable. In one laboratory in Vienna, coagulase-negative staphylococci dominated in all 3 study periods (32%, 33% and 47%). Susceptibility against gentamicin, tobramycin and netilmicin (MIC less than or equal to 4 mg/l), as well as against amikacin (MIC less than or equal to 8 mg/l) were determined by a microdilution method. The resistance rates against gentamicin (G) were 25%, 21% and 25%, against tobramycin (T) 27%, 19% and 25%, against netilmicin (N) 6%, 4% and 19%, and against amikacin (A), 5%, 2% and 19%. Most resistant strains were staphylococci (G 26%-41%, T 26%-46%, N 3%-31%, A 3%-36%), whereas gram-negative bacilli were more susceptible (G 12%-14%, T 7%-11%, N 7%-9%, A 1%-7.5%). The increase of resistance against netilmicin and amikacin in staphylococci was most striking. Nearly all those strain could be attributed to one laboratory in Vienna. Most of them were coagulase-negative staphylococci. In the first study period, the most frequent pattern was resistance against gentamicin and tobramycin, whereas in the last period resistance to all 4 aminoglycosides dominated. The study demonstrates considerable local differences in antibiotic resistance. Monitoring of antibiotic resistance in collaborative studies using standardized methods should be a valuable tool in planning strategies for controlling an epidemic spread of resistance.

Amikacin↗
PubMed1990

[Public health aspects of the hands].

After explanation of the importance of hands for the transmission of infections the strategy for prevention of germ transmission was developed. In central position is thereby separation and measures of reduction of germ number according to their indication how hygienic handwashing, antiseptic handwashing, hygienic hand disinfection under the special consideration of virus disinfection and surgical hand disinfection.

Colony Count, Microbial↗
PubMed1989

Plasma concentrations of free and sulfoconjugated dopamine, epinephrine, and norepinephrine in healthy infants and children.

Plasma concentrations of free and sulfoconjugated catecholamines were measured in healthy infants and children under resting conditions. Free norepinephrine and epinephrine levels were up to three times higher in healthy children under 2 years than in adults, even under true resting conditions. In contrast, free dopamine concentrations of all age groups fell within the normal range for adults. The levels of sulfoconjugation were in the adult range.

Adolescent↗
PubMed1989

Bacterial contamination of dialysate in dialysis-associated endotoxaemia.

Bacteriological investigations and endotoxin (ET) determinations were performed during a routine haemodialysis session for six patients. The glucose free dialysate was prepared with untreated tap water. All patients were dialysed for 5 h. Pseudomonas aeruginosa was regularly isolated in numbers up to 10(7) cfu ml-1 from samples of the dialysate inflow, the dialysate site and the dialysate outflow. ET levels in the plasma of the patients increased continuously during haemodialysis and were always higher in the blood outflow line of the dialyzer than in the blood inflow. Despite the high bacterial counts in the dialysate and the increasing ET levels in the patients plasma neither bacteraemia nor fever was observed. The former is due to the impermeability of the dialyzer membrane for bacteria, the latter is explained by low pyrogenicity of P. aeruginosa endotoxin. Inspection of the dialyzer machines revealed that air-traps and heater-unit for the incoming (untreated) tap water before mixing with the dialysate concentrate were the only sites where high bacterial release was feasible, as this part of the machine escaped disinfection due to the construction of these devices. We recommend the regular disinfection of all parts of a dialyzer machine, including heating units, air traps and valves.

Dialysis Solutions↗
PubMed1989

[CT-guided biopsy: methods, results and complications].

Percutaneous CT-guided biopsies were carried out in 350 patients; on 291 occasions, 14- or 18-gauge and, on 59 occasions, an 0.95 mm cutting biopsy cannula was employed. Using the 14- and 18-gauge needles, a histological diagnosis was possible in 191 cases, a sensitivity of 82.7%. The 0.95 mm cannulas proved successful in 39 of the 59 punctures, producing a markedly lower sensitivity of 66.2%. The most common cause of an incorrect biopsy with large needles was bad position of the needle, whereas the small needles provided inadequate material. Complications which, however, did not require treatment, occurred in 5 patients (1.4%).

Biopsy, Needle↗
PubMed1989

[Causation of stomatitis during cytostatic chemotherapy for head and neck tumors].

In a prospective trial involving 17 patients with head and neck tumors an attempt was made to relate the occurrence of stomatitis during cytostatic chemotherapy to changes in the resident microbial population, if any. Of the 17 patients who received the same cytostatic regimen, 10 developed stomatitis after a mean interval of 12 days. Smears were taken of the 2 patient subgroups (with and without stomatitis) at the onset of treatment and after comparable intervals during treatment and compared to those of a normal control group. Pretreatment smears did not show any quantitative or qualitative differences in the aerobic and anaerobic microbial spectrum between the 3 subgroups examined. During treatment patients developing mucositis were found to show a statistically significant multiplication of pathogens, while the other 2 groups still did not differ from one another. Together with the direct cytostatic effect of chemotherapy, proliferation of pathogens in the oral cavity appears to contribute to the development of stomatitis.

Adult↗
PubMed1989

[Monitoring infection at the intensive care unit--a multicenter pilot study].

During a period of 3 months an infection survey was carried out in 4 intensive care units (ICUs), 2 in Vienna, Austria, and one each in Ulm and Münster, Federal Republic of Germany, using a common protocol. A total of 329 patients was monitored prospectively. This pilot study was performed to evaluate the usefulness of parameters included in the monitoring form. It was attempted to characterize the patient populations of the four units. Mean duration of stay (1-12 days), mortality (8-26%), leading diagnosis upon admission, intubation rate (41-91%) and use of pulmonary artery catheter (12-35%) were distinctly different. The rate of patients admitted already with an infection was 9-43%, septicemia was diagnosed in up to 27% of the diseased. The rate of infection acquired in the unit was between 12 and 37%, the most frequent types were bronchopneumonia, septicemia and urinary tract infection. When septicemia patients were compared to non-septicemia patients who had been admitted for more than 3 days, it appeared that the latter stayed significantly shorter at the ICU and showed less frequently bronchopneumonia or urinary tract infection at the time of admission. Septicemia patients acquired more frequently additional infections like broncho-pneumonia or urinary tract infection while staying at the ICU. The median day of onset of septicemia was the fifth day and only in a quarter of cases diagnosis could be supported by a positive blood culture. The use of antibiotics in the 4 ICUs is compared and shows marked differences. Based upon experience with this type of infection survey a new modified protocol is introduced, which displays the time course of documented events.

Anti-Bacterial Agents↗
PubMed1989

[Application of an infection control protocol at an anesthesiology intensive care unit].

We studied the efficiency and practicability of a new protocol for surveillance of nosocomial infection in 99 patients admitted to our intensive care unit (ICU) between October 1985 and March 1986. The protocol contained the therapy given before admission to the ICU and daily records of: (1) therapy suspected to increase the risk of nosocomial infection (ventilatory support, operations, hemofiltration, central venous and arterial catheters, Swan-Ganz catheters, etc.); (2) parameters possibly associated with bacterial infections (white blood cell count, body temperature, platelet count, creatinine clearance, hemodynamic values, clinical suspicion of infection, suspected site of infection, pathological chest X-ray, etc); and (3) bacteriologic data (results of cultures from blood, tracheal aspirate, urine, wound secretions) and antibiotic treatment. Sepsis was diagnosed in 28 patients, and 28 had positive blood cultures; these two groups were not identical. Twenty-nine patients died, more than half of them having a serious nosocomial infection. Factors associated with nosocomial infection were: fever greater than 38.5 degrees C, recurrent fever, leucocytosis, leucopenia, thrombocytopenia; duration of stay at the ICU; ventilatory support, operations, mass transfusions, and therapy with catecholamines. Use of a Swan-Ganz catheter and hemofiltration were associated with nosocomial infection, but they were usually begun after the clinical onset of sepsis. Therapy administered before admission to the ICU was not associated with nosocomial infection. Bacterial colonization of tracheal aspirate was detected in 2/3 of the ventilated patients. The most common bacteria isolated were staphylococci in blood cultures. Pseudomonas sp. and Candida albicans in tracheal secretions, and Candida albicans in urine cultures.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesiology↗
PubMed1988

[The antibacterial effect of ciprofloxacin, ofloxacin and norfloxacin in vitro].

MICs of ciprofloxacin (CIP), ofloxacin (OFL) and norfloxacin (NOR) were assessed with a total of 523 strains of 7 species (spp) of enterobacteriaceae, various pseudomonads, methicillin-susceptible and -resistant S. aureus, L. monocytogenes, Legionella species and C. difficile. In addition, the MBCs were assessed with S. aureus and E. coli. With break-points of less than or equal to 0.5 and greater than or equal to 4 mg/l all strains of E. coli, K. oxytoca, P. mirabilis and indole-positive Proteus spp. were susceptible to all 3 antibiotics. Proportions of susceptible strains almost as high were found with E. cloacae, S. marcescens, K. pneumoniae and methicillin-susceptible staphylococci. With Legionella spp. the MICs of CIP and OFL always indicated susceptibility, whereas with NOR only 62% of the strains were inhibited. Pseudomonads, especially others than P. aeruginosa, were only moderately susceptible to CIP and OFL, but never to NOR. Listeria monocytogenes was susceptible to OFL in 96%, to CIP in 56%, but never to NOR. C. difficile was always resistant. The MBC-values either equalled the MICs or surpassed them up to 2 times at maximum indicating a bactericidal mode of action. Despite of slightly lower MICs of CIP in vitro, OFL seems to be comparably effective. NOR is regarded less effective.

Bacteria↗