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Biomedical subjects

R Eckhardt

Publications and source records attributed to R Eckhardt.

31 records · Page 2Linked to original sources

[Circulating immune complexes and in vivo fixation of immunoglobulin G, A and C3 onto hepatocytes in patients with Crohn's disease (author's transl)].

In vivo fixation of immunoglobulin and C3 onto the hepatocellular membrane of patients with Crohn's disease was studied by immunofluorescence. IgG binding was observed in 93% of patients with disease activity but not in patients without disease activity. C3 binding was present in 21% of patients with active disease. IgA binding was found in approximately one half of all patients with Crohn's disease irrespective of disease activity. The immunoglobulin and C3 binding to hepatocytes was not correlated with histopathological findings. Circulating immune complexes were detected with the Raji cell assay in approximately one half of all patients with Crohn's disease and showed no correlation to disease activity. The following conclusions can be derived from these studies: 1. The in vivo fixed IgG represents immune complexes, which is eliminated by the liver as part of the physiological clearance function. 2. These aggregates bind to hepatocytes predominantly via IgGFc receptors. 3. Hepatocellular bound IgG and C3 show no correlation to histopathological liver alterations. 4. In vivo bound hepatocellular IgG aggregates have different properties than the immune complexes detected by the Raji cell assay.

Adolescent↗

K-lymphocytes (killer-cells) in Crohn's disease and acute virus B-hepatitis.

Total lymphocyte counts, B-, T-, C'3 receptor-bearing lymphocytes, and K-cell activity were studied in peripheral blood in patients with Crohn's disease and inflammatory liver disease. Patients with active untreated Crohn's disease and acute virus B hepatitis exhibited a markedly increased K-cell activity measured in a plaque assay when compared with normal controls (P less than 0.01). Patients with immunosuppressive treated Crohn's disease, HBsAg-positive chronic active hepatitis, and cirrhosis of the liver showed only a slight increase of K-cell activity (P less than 0.01). In the postacute phase of hepatitis (four to 12 weeks from onset) K-cell activity fell to normal levels. The number of B-lymphocytes showed a relative and absolute decrease in all groups of patients. With the exception of patients with acute HBsAg-positive hepatitis and the post-acute phase of hepatitis all the other groups showed statistically decreased absolute numbers for C'3 receptor-bearing lymphocytes. The significant decrease in K-cell activity and the number of T-lymphocytes in Crohn's disease treated with immunosuppressive drugs was interpreted as an effect of azathioprine and prednisone on these lymphocyte subpopulations.

Acute Disease↗

[Surgical and medical treatment of Crohn's disease (author's transl)].

Regional enteritis does present therapeutical problems because of the unpredictable course of this disease. 162 patients were operated upon in the Surgical Department of the University of Mainz Medical School between 1964 and 1976. Medical and surgical treatment of these patients has been rather different due to the heterogenity of the patient group. Curative therapy of regional enteritis does not exist. Medical treatment is aimed at converting the active form of the disease into an inactive, 'burnt out' form. One therapeutic regimen widely used is the combination of salazosulfapyridin and corticosteroids, another regimen is the combination of azathioprine and prednisolone. Surgery is indicated when complications arise and after medical treatment has failed. The optimal approach is resection of the afflicted part of the intestine. Even after surgery prognosis is doubtful and depends upon the activity of the disease in each individual case.

Acute Disease↗

Cellular immune reactions against common antigen, small intestine, and colon antigen in patients with Crohn's disease, ulcerative colitis, and cirrhosis of the liver.

Patients with ulcerative colitis showed in 71-93%, patients with cirrhosis of the liver in 64-91%, cellular immunity against Common Antigen (CA) and human fetal intestinal antigens as measured by the leucocyte migration test (LMIT). Patients with Crohn's disease exhibited cellular immune reactions to a lesser degree - from these only patients without immunosuppressive therapy differed significantly from normal controls (p less than 0.05). Approximately 30% of patients with Crohn's disease and ulcerative colitis had elevated antibody titers against intestinal antigens and CA. A high percentage of patients in both diseases showed a reciprocal relationship between cellular and humoral immunity. It was concluded that Crohn's disease and ulcerative colitis can be separated in most cases using intestinal antigens and CA in the LMIT. The occurrence of cellular immunity against these antigens cannot be interpreted as being the only pathogenetic principle in these two diseases. It is also concluded that there appears to be only a weak immune tolerance against intestinal antigens. The high percentage of cellular immune reactions in patients with cirrhosis of the liver demonstrates that this group may have an impairment of the physiological elimination of antigens by the liver.

Antibodies↗

[Congenital mitral stenosis. Report on 33 patients].

Thirty-three patients with congenital mitral stenosis are presented. Congenital mitral stenosis occurs as an isolated malformation and in combination with additional cardiac lesions. A new classification into 5 groups is suggested. It is possible to classify congenital mitral stenosis with and without additional lesions according to these 5 groups. This is of particular clinical advantage. Isolated congenital mitral stenosis is a rare malformation. In combination with additional obstructive left-sided cardiac malformations mitral stenosis occurs more frequently. In infancy and early childhood the so-called parachute valve is a stenotic lesion. According to our experience the parachute valve tends to the development of additional mitral incompetence in older children. This observation is of clinical and diagnostic importance. In patients with additional valvular aortic stenosis the mortality is very high. The operative treatment of congenital mitral stenosis with a parachute valve in combination with other obstructive lesions of the left ventricular outflow tract and the aorta without removal of the parachute valve seems to be unable to improve the hemodynamic situation and the prognosis of these patients. There is not enough experience with artificial valves in congenital mitral stenosis in early childhood.

Adolescent↗

[Special case report: Gangrene of all 4 extremities caused by disseminated intravascular coagulation in pneumococcal sepsis].

The rare case of a child with gangrene of all extremities following intravascular coagulation in pneumococcus septicaemia is described. The two years old spanish girl showed a gangrene of all four extremities and accompanying celloid scars. The operative treatment, the orthopaedic technical fitting as well as the problems are discussed.

Amputation, Surgical↗