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Biomedical subjects

M Widmer

Publications and source records attributed to M Widmer.

At least 19 recordsLinked to original sources
PubMed2006

Avoiding misclassification bias with the traditional Charnley classification: rationale for a fourth Charnley class BB.

Long-term follow up of patients with total hip arthroplasty (THA) revealed a marked deterioration of walking capacities in Charnley class B after postoperative year 4. We hypothesized that a specific group of patients, namely those with unilateral hip arthroplasty and an untreated but affected contralateral hip was responsible for this observation. Therefore, we conducted a study taking into consideration the two subclasses that make up Charnley class B: patients with unilateral THA and contralateral hip disease and patients with bilateral THA. A sample of 15,160 patients with 35,773 follow ups that were prospectively collected over 10 years was evaluated. The sample was categorized into four classes according to a new modified Charnley classification. Annual analyses of the proportion of patients with ambulation longer than 60 min were conducted. The traditionally labeled Charnley class B consists of two very different patient groups with respect to their walking capacities. Those with unilateral THA and contralateral hip disease have underaverage walking capacities and a deterioration of ambulation beginning 3 to 4 years after surgery. Those with bilateral THA have stable overaverage walking capacities similar to Charnley class A. An extension of the traditional Charnley classification is proposed, taking into account the two different patient groups in Charnley class B. The new fourth Charnley class consists of patients with bilateral THA and was labeled BB in order to express the presence of two artificial hip joints and to preserve the traditional classification A through C.

Adult↗
PubMed2001

[Management of non-specific musculoskeletal disorders--role of ergonomics].

Non-specific musculoskeletal disorders are a major health problem. Despite good prognosis socio-economic burden is important. Just a few treatment strategies are known to reduce work-disability. An early ergonomic assessment helps to determine the level of disability and further rehabilitation strategies. An assessment consists of a self-rating of the physical capacities and a physical performance test. Work-place demands and psychosocial factors should also be considered by interview. An ergonomic work-place analysis supports this information and facilitates reintegration. Furthermore, work-place adaptations can be performed.

Adult↗
PubMed1999

Performance of native and recombinant antigens for diagnosis of Helicobacter pylori infection.

The aim of this study was to evaluate the performance of three antigenic preparations for serological diagnosis of Helicobacter pylori infection: (i) native antigens from Helicobacter pylori strain N6 or its aflagellated isogenic mutant N6flbA-, or an acellular extract (antigen AgFA) from a pool of six clinical strains; (ii) recombinant antigens consisting of CagA fused to MS2 polymerase and HspA or recombinant UreA and UreB fused to the maltose-binding protein, and (iii) the preparations provided with two commercial kits, the Cobas Core (Roche Diagnostic Systems, France) and the Pylori Stat (BioWhittaker, Belgium). All preparations were used in an enzyme immunoassay to test 92 sera from dyspeptic patients for whom the status of Helicobacter infection was established. Sensitivities were higher (90 to 100%) for the native antigens and the commercial kits than for the recombinant antigens. Specificities were higher than 90%, except with UreA + UreB (42%). The most useful antigens were those extracted from strains N6 and N6flbA-.

Adolescent↗
PubMed1998

[Ascites. Tuberculous peritonitis].

Because of deteriorating general health, weight loss of 5 kg and leftsided epigastric pain a 44 year old innkeeper was evaluated unsuccessfully for 1 month. Thereafter a protein- and lymphocyte-rich ascites developed. CT-scans revealed a thickened visceral peritoneum and multiple, marginally increased retroperitoneal lymph nodes. The history of the patient originating from former Jugoslavia was suspicious for inadequately treated tuberculous pericarditis. Hence this diagnosis tuberculous peritonitis became probable but for practical reasons could not be proven neither by biopsy nor by culture. Under probatory antituberculous treatment the patient's general condition improved rapidly, the ascites disappeared and initially elevated parameters for infection normalized.

Adult↗
PubMed1998

Delayed rejection of soluble tumor necrosis factor receptor-secreting tumor allografts.

BACKGROUND: Exogenous soluble tumor necrosis factor receptor (TNFR) has been shown to be an effective immunosuppressant. It has yet to be tested whether tissues secreting soluble TNFR, when transplanted into a foreign host, could locally generate immunosuppression and therefore manifest prolonged survival. METHODS: A murine tumor line was transfected with the gene encoding a chimeric protein consisting of the extracellular domain of the human 75-kDa TNFR fused to the Fc region of the human IgG1 heavy chain. This tumor line was then injected into allogeneic recipients. RESULTS: Transfected tumor cells were shown to secrete soluble TNFR. When transplanted into minor histocompatibility antigen-disparate allogeneic recipients, these tumor cells grew as a solid tumor and resisted rejection, whereas untransfected tumors and interleukin-4 receptor transfectant controls were rejected within 4 weeks. The resistance to rejection could be reversed by coadministration of an anti-TNFR monoclonal antibody. CONCLUSIONS: Prolongation of graft survival can be achieved by genetically altering transplanted tissue to secrete soluble cytokine receptors.

Animals↗
PubMed1998

Mice lacking the type I interleukin-1 receptor do not lose bone mass after ovariectomy.

We measured the effects of ovariectomy on the bone mass of mice that lacked type I interleukin-1 receptor (IL-I R1 -/- mice) in two genetic backgrounds (C57BL/6 x 129/Sv and C57BL/6) to investigate the role of interleukin-1 in the actions of estrogen on bone. At three weeks after surgery, ovariectomized wild-type mice decreased trabecular bone volume in the proximal humerus by 70% in a C57BL/6 x 129/Sv background and 48% in a C57BL/6 background compared to sham-operated controls. In contrast, there was no significant decrease in trabecular bone mass in IL-1 R1 -/- mice after ovariectomy. The estrogen status of all groups was confirmed by measurement of uterine wet weight. These results demonstrate that a functional IL-1 response pathway is required for mice to lose trabecular bone mass after ovariectomy in this model and they imply that IL-1 is an important mediator of the effects of ovariectomy on bone mass. Hence, therapeutic interventions that block the effects of IL-1 on bone may be beneficial for treating diseases of rapid bone loss such as post-menopausal osteoporosis.

Animals↗
PubMed1996

Enhancement of thymopoiesis after bone marrow transplant by in vivo interleukin-7.

Bone marrow transplantation (BMT) is followed by a period of profound immune deficiency, during which new T lymphocytes are generated from either stem cells or immature thymic progenitors. Interleukin-7 (IL-7) induces proliferation and differentiation of immature thymocytes. We examined whether the in vivo administration of IL-7 to mice receiving BMT would alter thymic reconstitution. Lethally irradiated C57BL/6 mice received syngeneic BMT, followed by either IL-7 or placebo from days 5 to 18 post-BMT. At day 28, BMT recipients that had not received IL-7 had profound thymic hypoplasia (< 5% of normal), with relative increases in the numbers of immature thymocytes, decreased numbers of mature peripheral (splenic) T lymphocytes, and severely impaired T- and B-cell function. In contrast, transplanted mice treated with IL-7 had normalization of thymic cellularity, with normal proportions of thymic subsets and T-cell receptor beta variable gene (TCRV beta) usage, normal numbers of peripheral CD4+ T lymphocytes, and improved antigen-specific T- and B-cell function. In the BMT-IL-7 mice, there was an eightfold increase in the number of immature CD3-CD4-CD8- thymocytes in G2-M of the cell cycle, indicating that restoration of thymic cellularity was due to enhanced proliferation of immature thymic progenitors. Similar effects following IL-7 administration were also observed when donor bone marrow was depleted of mature T lymphocytes, indicating that IL-7 administration affected immature hematopoietic progenitors. IL-7 promotes thymic reconstitution after BMT, and may be useful in preventing post-BMT immune deficiency.

Animals↗
PubMed1995

In vivo antitumor effects of unconjugated CD30 monoclonal antibodies on human anaplastic large-cell lymphoma xenografts.

CD30 is a M(r) 120,000 surface antigen identified originally by the Ki-1 monoclonal antibody (moAb) against primary and cultured Reed-Sternberg cells present in Hodgkin's disease and anaplastic large-cell lymphomas (ALCLs). Examination of two ALCL cell lines (Karpas 299 and Michel) demonstrated cell surface expression of CD30. Incubation of these lymphomas with two anti-CD30 moAbs that recognize the ligand-binding site (M44 or HeFi-1) resulted in significant growth inhibition in vitro, with significant decreases in cell viability. Another anti-CD30 moAb, Ber-H2, which recognizes a determinant not involved in ligand binding, had no effect on ALCL growth in vitro. When these human ALCL lines were transferred i.v. into mice with severe combined immune deficiency, the mice developed extensive metastasis in the s.c., brain, or eye tissues. The treatment of mice with either M44 or HeFi-1 anti-CD30 moAbs resulted in significant increases in survival, with some mice remaining disease free for more than 100 days. Thus, anti-CD30 treatment is efficacious for CD30+ ALCL cell lines in vivo, and unconjugated anti-CD30 moAbs may be of potential clinical use.

Adult↗
PubMed1995

TNF-alpha mediates recruitment of neutrophils and eosinophils during airway inflammation.

Airway inflammation is characterized by leukocyte extravasation around the peribronchial mucosa and into the airway of the lung. In the present study we utilized a model of airway inflammation induced by intratracheal challenge with soluble parasite (Schistosoma mansoni) egg Ag (SEA) in presensitized mice. The subsequent inflammatory response and leukocyte recruitment consists of early neutrophil (8 to 24 h) and later eosinophil (48 to 72 h) infiltration into the interstitium and airway. Little neutrophil and no eosinophil recruitment was observed in presensitized control mice challenged with vehicle. Multiple studies have demonstrated a crucial role for TNF-alpha during inflammatory responses. In these experiments we investigated the role of TNF-alpha in Ag-specific eosinophilic airway inflammation. Measurement of TNF-alpha expression by reverse transcriptase-PCR and ELISA in whole lung homogenates of SEA-challenged mice demonstrated an early increase in TNF-alpha levels (1 to 8 h). To determine the specific role of TNF-alpha in leukocyte recruitment during airway inflammation, mice were treated with soluble TNF-alpha receptor linked to an Fc Ab molecule (sTNFr-:Fc). This treatment has previously been used to effectively neutralize TNF in vivo. Intratracheal SEA-challenged mice treated with sTNFr-FC demonstrated significantly decreased leukocyte recruitment into the lung and airway. The inflammatory response in the lungs in sTNFr-Fc-treated mice was significantly decreased throughout the study period, as compared with control mice. An approximate decrease in early neutrophil infiltration into the airway was observed when sTNFr-Fc was administered 2 h before the Ag challenge. Eosinophil infiltration was also diminished when sTNFr-Fc was administered before Ag challenge. Interestingly, when sTNFr-Fc was administered therapeutically 24 h after Ag challenge, the eosinophil response was nearly abrogated at 48 h after challenge. These studies indicate that TNF-alpha acts as an initial inflammatory cytokine that subsequently regulates both early neutrophil infiltration and eosinophil recruitment into the lung and airspace.

Animals↗
PubMed1995

Scalp dermatitis, distinctive hair abnormalities and atopic disease in the ectrodactyly-ectodermal dysplasia-clefting syndrome.

We report a 2-year-old girl with a combination of the ectodermal dysplasia, ectrodactyly, cleft lip/palate (EEC) syndrome, distinctive hair abnormalities, scalp dermatitis and atopic disease. To our knowledge, this is the first report of scalp dermatitis in the EEC syndrome. Distinctive structural hair abnormalities shared by the syndromes of ectodermal dysplasia and clefting are helicotrichia, pili torti et canaliculi, and cuticle defects, all of which were observed in the present case. A high incidence of atopic disease in certain subsets of ectodermal dysplasia has been reported. In our patient this manifested as food-induced exacerbation of atopic dermatitis, associated with positive prick tests and significant levels of circulating specific IgE.

Abnormalities, Multiple↗
PubMed1995

Regulation of endothelial VCAM-1 expression in murine cardiac grafts. Roles for TNF and IL4.

The in vivo mechanisms of vascular endothelial activation and VCAM-1 expression were studied in murine heterotopic cardiac grafts. Preliminary studies demonstrated that cardiac allograft endothelia develop reactivity with MECA-32 monoclonal antibody (MAb) and M/K-2 (anti-VCAM-1) MAb within 3 days of transplantation, whereas cardiac isografts develop MECA-32 reactivity but no M/K-2 reactivity. Additional studies demonstrated that a single treatment of cardiac isograft recipients with the anti-CD3 MAb 145-2C11 induces VCAM-1 expression on isograft microvascular endothelia within 24 hours. We have used this experimental system to identify the cytokines responsible for expression of VCAM-1 and MECA-32 MAb reactivity on graft vascular endothelia. We report that the expression of VCAM-1 on isograft endothelia that was induced with anti-CD3 MAb was blocked by simultaneous treatment with either pentoxifylline, soluble tumor necrosis factor (TNF) receptor (TNFR-Fc), anti-IL4 MAb, or soluble IL4R, but not by anti-IFN-gamma MAb. Alternatively, a similar pattern of isograft endothelial VCAM-1 expression was stimulated in the absence of anti-CD3 MAbs with a single injection of human recombinant TNF-alpha, or with recombinant murine IL4 provided as IL4/anti-IL4 MAb complexes. In addition, the IL4-induced VCAM-1 expression was completely blocked by a single intravenous treatment of the isograft recipients with TNFR:Fc. This suggests that high concentrations of TNF-alpha can stimulate endothelial VCAM-1 expression, but these concentrations are apparently not achieved in cardiac isografts. In the absence of an inducing agent such as anti-CD3 MAb, the stimulation of VCAM-1 expression with exogenous IL4 may reflect functional interaction between endogenous TNF and exogenous IL4, as suggested by the blocking experiments with TNFR:Fc. Although cardiac isograft endothelia normally develop reactivity with MECA-32 MAb within 3 days of transplantation, treatment of cardiac isograft recipients with anti-CD3 MAb accelerated MECA-32 reactivity to within 24 hours of transplantation. This accelerated expression can be experimentally manipulated in the same way as M/K-2 reactivity, suggesting that similar mechanisms may control the development of these two inflammatory endothelial phenotypical markers, despite their differential expression in cardiac isografts and allografts.

Animals↗
PubMed1995

[Evaluation of the Coulter method for reticulocyte count].

Although the automation of reticulocyte counts was developed in the beginning of the 80's, the reticulocyte modules integrated in the hematology analysers have been only recently made available. The purpose of our study is the evaluation of the reticulocyte module included in the Coulter STKS, performed in the Necker-Enfants-Malades hospital laboratory. Regarding the technical conditions of use, this simple and user-friendly method can be easily adapted to routine use. Results, as compared to those obtained with two reference methods, microscopy and cytofluorometry, are accurate if the operator's attention is drawn by some causes of interferences, generally flagged by the instrument.

Evaluation Studies as Topic↗
PubMed1994

[Actinobacillus actinomycetemcomitans isolated from a mycetoma (of the forearm)].

Mycetomas are subacute or chronic infections usually localized on unprotected skin areas and caused by fungi or Actinomyces. We report the case of a patient who suffered a splinter injury on his wrist after a motor accident. Six months later a cutaneous abscess with Actinobacillus actinomycetemcomitans developed on his wrist. Complete healing was obtained within 1 month after administration of ceftriaxon and doxycycline. The therapeutic management will be discussed.

Abscess↗
PubMed1994

A mouse model of lung injury induced by microbial products: implication of tumor necrosis factor.

Mice of the C57BL/6 strain were injected with bacterial lipopolysaccharide (LPS) followed by formylnorleucyl-leucyl-phenylalanine (FNLP) by the intraperitoneal route; markers of acute lung injury were examined in mice given a fusion protein of soluble human tumor necrosis factor-alpha (TNF-alpha) receptor (p80) linked to the Fc portion of human IgG (TNFR:Fc) or excipient. Challenge with LPS/FNLP elicited an adult respiratory distress syndrome-like pathology characterized by sharp increases in levels of lactate dehydrogenase (LDH) and total proteins in bronchoalveolar lavage as well as in lung myeloperoxidase (MPO) content at 16 and 20 h after challenge. Infusion of 1 mg of TNFR:Fc 2 h before challenge very significantly abrogated the increases in LDH, protein levels, and MPO. Histologic analysis revealed that LPS/FNLP infusion resulted in an intravascular neutrophil agglomerate and perivascular/peribronchial damage; the extent of tissue lesions was significantly reduced, but not abrogated, by TNF-alpha depletion. There were moderate levels of antigenic TNF-alpha in lung homogenates at 16 and 20 h after challenge, not affected by infusion with TNFR:Fc. No bioactive TNF-alpha was detected in lung homogenates of challenged mice given TNFR:Fc. High levels of antigenic interleukin-6 (IL-6) were found in lung homogenates of challenged mice treated with TNFR:Fc or with diluent. Elevated levels of antigenic IL-6 and TNF-alpha were found in sera of challenged mice at 16 and 20 h after injection; TNFR:Fc-treated mice had a higher level of antigenic TNF-alpha than did challenged mice given diluent, but it was not bioactive.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗