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Biomedical subjects

P Kirschner

Publications and source records attributed to P Kirschner.

At least 19 recordsLinked to original sources
PubMed1992

Disseminated "Mycobacterium genavense" infection in patients with AIDS.

We describe 18 patients with advanced HIV infection, most of whom had a chronic illness characterised by fever, diarrhoea, and massive loss of weight. Biopsy and necropsy samples revealed abundant acid-fast microorganisms in intestines, liver, spleen, lymph nodes, and many other tissues, which did not grow on solid media, although limited growth was observed in liquid blood cultures. Using primers complementary to bacterial 16S rRNA we amplified DNA sequences from tissue and leucocyte extracts and from blood-culture bottles. The sequences obtained were unique and suggest that the microorganism is a new member of the genus Mycobacterium, for which we propose the name "Mycobacterium genavense". Disseminated infection with "M genavense" should be considered in the differential diagnosis of HIV-infected patients with extreme immunosuppression, wasting, and fever.

Acquired Immunodeficiency Syndrome↗
PubMed1992

[MR tomography versus CT arthrography in glenohumeral instabilities].

In a prospective study the diagnostic value of MRI compared to CT arthrography (CT-A) was evaluated in 26 patients with 27 instable shoulder joints. Surgical and/or arthroscopic correlation was available in all cases. Both methods showed a high accuracy (96% CT-A, 94% MRI) in the evaluation of the glenoid labrum. CT-A was significantly superior to MRI in the detection of capsular lesions (sensitivity 96% vs. 44%, accuracy 96% vs. 72%, negative predictive value 96% vs. 67%). CT-A and MRI results regarding humeral head fractures were similar; fractures of the glenoid rim were better detected by CT-A, the difference, however, was statistically not significant. Overall, CT-A proved to be superior to MRI, as lesions of the joint capsule were shown with greater certainty.

Adolescent↗
PubMed1992

Synergistic interaction of interferon-beta and interferon-gamma in coxsackievirus B3-infected carrier cultures of human myocardial fibroblasts.

The antiviral effects of human interferon-beta (IFN-beta) and human recombinant interferon-gamma (rIFN-gamma) were studied in persistently coxsackievirus B3-infected carrier cultures of human myocardial fibroblasts over a period of 21 days. Synergism was observed with concentrations as low as 30 IU of IFN-beta plus 10 IU of rIFN-gamma/mL, reducing mean viral titers from 6.0 x 10(7) to 1.3 x 10(4) pfu/mL and number of infected cells from 14.4% to 0.1% as determined by quantitative in situ hybridization. Higher concentrations of IFNs (both > or = 30 IU/mL) were associated with transient antagonism followed by antiviral synergism. With 100 IU of IFN-beta plus 30 IU of rIFN-gamma/mL, elimination of infectious virus was consistently achieved and sustained for 6 weeks after cessation of IFN application, whereas at least threefold higher concentrations were required with single drugs. In summary, our data support a concept of low-dose IFN combination schedules that might become useful in the treatment of enteroviral heart disease.

Cells, Cultured↗
PubMed1992

Mycobacterium confluentis sp. nov.

A new rapidly growing mycobacterium was isolated from human sputum. This organism grew at 22, 31, 37, and 41 degrees C and possessed catalase, acid phosphatase, acetamidase, urease, nicotinamidase, pyrazinamidase, and nitrate reductase activities. It did not produce nicotinic acid, hydrolyze Tween, or have benzamidase, isonicotinamidase, succinidamidase, and arylsulfatase activities. A mycolic acid analysis revealed a simple, unique pattern. The organism is susceptible to antituberculotic drugs. A comparative 16S rRNA sequence analysis placed this organism within the confines of the genus Mycobacterium, most closely related to the thermotolerant rapidly growing species. On the basis of the pattern of enzymatic activities and metabolic properties, as well as the unique 16S rRNA sequence, we propose that our single strain represents a new species, for which we propose the name Mycobacterium confluentis. The type strain is strain 1389/90; a culture of this strain has been deposited in the German Collection of Microorganisms and Cell Cultures as strain DSM 44017.

Base Sequence↗
PubMed1992

Genetic heterogeneity within Mycobacterium fortuitum complex species: genotypic criteria for identification.

A 1.5-kb segment of the DNA that encodes 16S rRNA was amplified by polymerase chain reaction, and 880 nucleotide positions were determined from each of the described biovariants of Mycobacterium fortuitum. Signature sequences which allow rapid identification of M. fortuitum strains at the biovariant level are described. Our data demonstrate a close phylogenetic relationship between Mycobacterium senegalense and M. fortuitum and indicate that the described biovariants of M. fortuitum represent genetically distinct taxa.

Base Sequence↗
PubMed1991

[CT arthrography of the shoulder after surgical repair for ventral instability].

25 patients who had undergone a modified Lange repair were examined postoperatively after about four years, both clinically and by CT arthrography. Ventral redislocation was no longer seen postoperatively. As regards residual ventral instability, there was agreement between CT arthrography and the clinical findings in 20/25 patients (90%). Newly developed or residual dorsal instability could be accurately demonstrated by the presence of pathological changes of the dorsal labrum and by the observation of a wide dorsal joint recess. CT arthrography did not provide reliable evidence concerning loss of function and mobility of the treated shoulder. However, the presence of marked capsular folding suggests a poor clinical result.

Adult↗
PubMed1990

[ESWL with the Lithostar--experience with 3,000 treatments].

The experiences with 3,000 extracorporeal shock wave lithotripsies of kidney and ureteral calculi using the Lithostar are reported. Indications, contraindications and therapeutic approach are reviewed and the importance of out-patient follow-up is stressed. The success rate of 75% (including further spontaneous passage of residual desintegrated calculi) is good in the view of an unselected and unfavourable patient population. In the other patients a second ESWL treatment may be necessary. In the initial period in 6% of the patients percutaneous nephrolitholapaxy or open operation have been performed whereas in the last 100 patients it was not necessary.

Adolescent↗
PubMed1990

[Possibilities of computerized arthrotomography in the diagnosis of shoulder instabilities].

Shoulder instability can usually be diagnosed by examination of the history and a careful physical examination. Additional diagnostic studies include radiographic investigations and arthroscopy as a functional and very comprehensive diagnostic procedure for shoulder lesions. Conventional radiographic investigations with special projections have proven to be reliable in revealing bony changes of the glenoid and of the humeral head, whereas CT arthrography is very helpful in evaluating capsulolabral lesions associated with shoulder instability. This kind of investigation is a highly sensitive and less invasive technique. Combined with intraarticular application of contrast medium the extent of pathologic changes associated with instability can be imaged and differentiated from other intraarticular causes of dysfunction. During a 1-year period, 42 patients were studied by double contrast arthrography followed by CT examination, and 33 were found to have a shoulder instability. The intention of this report is to describe a few CT arthrographic findings in the presence of pathologic anatomy of unstable shoulders.

Adolescent↗
PubMed1989

Detection of parvovirus in a patient with "reactive arthritis" by in situ hybridization.

We used in situ hybridization to search for the presence of viruses in synovial fluid cell preparations obtained from patients with various forms of knee arthropathies. One patient, presenting with acute reactive arthritis, was found to replicate parvovirus DNA in cells from synovial fluid whereas six other patients with various other forms of arthritis were negative for parvovirus infection. Five patients with osteoarthritis, constituting a control group in which an infectious etiology would not be expected, were consistently negative. In addition, no hybridization was found when synovial cell preparations of all patients were hybridized in situ with DNA probes specific for Epstein-Barr virus, cytomegalovirus, or enteroviruses.

Adult↗
PubMed1989

[Postoperative continuous passive motion following augmentation of anterior cruciate ligament ruptures with polydioxanone ligaments. Early results of a prospective study].

During a period of six months 30 patients underwent surgery at the St. Vincenz and Elisabeth Hospital at Mainz (Germany) because of a rupture of the anterior cruciate ligament (ACL). 26 persons could be examined three and six months after surgery. The surgical technique was the PDS augmented suture or the PDS augmented central third of the patellar tendon depending on the age of the rupture. All patients were rehabilitated with early exercises including CPM during the stationary phase. The influence of CPM on swelling, effusion, mobility, muscle atrophy, stability and time of after-treatment will be presented. The findings lead to the conclusion that CPM has great influence on prevention of muscle atrophy and early, unlimited mobility.

Adult↗
PubMed1989

[Complications of Redon drainage following hip joint replacement operations--an analysis of the causes].

After the introduction of Redon high-vacuum drainage, a considerable decrease in post-operative haematomas has been noted. But some of the complications could not be prevented by using the Redon system. They were in fact the result of it. The Redon system cannot be classified as a "closed" wound drainage. During bottle replacement, the system must be disconnected. An effective closed system must remain absolutely tight from application to removal of the drain so no possibility exists of contamination/infection from the outside. After introduction of a continuously absolutely closed system in a prospective study with three different systems the influence after hip joint arthroplasty operations on wound healing was investigated. The wounds were drained with the Redon high-vacuum system or the newly developed, permanently closed drainage system with maximum obtainable low pressure of 80% vacuum and 50% vacuum. Here the maximum obtainable vacuum builds up slowly in relation to the accumulated amount of wound fluids. The loss of low pressure in Redon systems differs between the drains. In the intra-articular drains the mixture of air and blood results in a linear decrease and follows not a hyperbola like in subcutaneous drains. Because of the high suction at the beginning of the Redon drainage necrotic muscle cells adhere to the outside of the drain openings and clogs them up mechanically. The stronger the suction effect on the tissue, the more fatty live cells and small vessels enter the lumen of the drain in the Redon system and 80% vacuum. This mechanisms result in bleeding from the drain canal after removal of the drain and "secondary" haematomas.(ABSTRACT TRUNCATED AT 250 WORDS)

Equipment Design↗
PubMed1988

Isolation of mutations of the phage Mu ner gene.

A method was devised which allows the easy detection of mutations within the ner gene of Mu DNA. This method is based upon the observation that a transcriptional gene A-galK fusion containing the complete ner gene and the cts62 allele does not express the galK gene in an Escherichia coli strain lacking functional integration host factor under inducing conditions (white colonies on MacConkey galactose plates at 42 degrees) In contrast, a gene ner-galK fusion which lacks part of the ner gene exhibits GalK activity (red colonies) on MacConkey galactose plates at 42 degrees. After mutagenesis of a plasmid carrying a transcriptional gene A-galK fusion, putative ner mutants could be identified on indicator plates. Cloning experiments locate the mutation(s) to the right of the HindIII site which is situated within the early promoter of Mu DNA. One of the mutants was sequenced and revealed two substitutions: one within the-10 region of the early promoter, and another near the end of the ner gene. The former lesion was shown to be pleiotropic.

Bacteriophage mu↗
PubMed1988

[Percutaneous removal of kidney calculi and extracorporeal shockwave lithotripsy in patients with hemorrhagic diatheses].

Hemorrhage is the main complication of percutaneous kidney stone removal. Shock-wave lithotripsy also may causes bleeding complications. It seems that both procedures are contraindicated on patients with coagulation disorders. On the base of two cases the specification of treatment by patients with hemorrhagic diatheses is demonstrated. Modern treatment modalities of urinary stone disease are also applicable to those patients, when attention is paid to some conditions and attentive measures are taken.

Adult↗
PubMed1987

In situ detection of enteroviral genomes in myocardial cells by nucleic acid hybridization: an approach to the diagnosis of viral heart disease.

We have developed an in situ hybridization assay capable of detecting enteroviral RNA in myocardial cells, using molecularly cloned coxsackievirus B3 cDNA as a diagnostic probe. Because of the high degree of nucleic acid sequence homology among the numerous enteroviral serotypes, including the group A and B coxsackieviruses and the echoviruses, detection of these various agents commonly implicated in human viral heart disease is possible in a single hybridization assay. We demonstrate the considerable potential of this method for an unequivocal diagnosis of enteroviral heart disease as well as for pathogenicity studies. Using athymic mice persistently infected with coxsackievirus B3 as a model system, we show that the myocardium is affected in a disseminated, multifocal manner.

Animals↗