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Biomedical subjects

R Herz

Publications and source records attributed to R Herz.

At least 19 recordsLinked to original sources
PubMed1999

Gastritis associated with Crohn disease can be masked by Helicobacter pylori gastritis.

BACKGROUND: Crohn disease (CD) is typically associated with focal inflammatory infiltrations. It is, however, unclear to what extent this CD-associated gastritis is masked by Helicobacter pylori gastritis. METHODS: One hundred and three patients with CD underwent upper endoscopy. Antrum and corpus biopsy specimens were obtained and histologically evaluated for the presence of CD gastritis or H. pylori gastritis. In patients infected with H. pylori, eradication of the organism was initiated with repeated endoscopy/histology 7 days after termination of therapy. RESULTS: Thirty patients were infected by H. pylori. Definite diagnosis of CD gastritis was made in 4 patients, in contrast to 31 of the 73 patients with no H. pylori gastritis (P < 0.001). In 19 patients with either no (n = 13) or only suspected diagnosis of CD gastritis (n = 6), elimination of H. pylori enabled definite diagnosis of CD gastritis in 5 of 13 and 4 of 6 patients, respectively. CONCLUSION: Elimination of H. pylori facilitates the diagnosis of CD gastritis.

Adult↗
PubMed1998

Mapping of antigenic determinants of purified, lipid-free human serum amyloid A proteins.

Serum amyloid A (SAA) is the major apolipoprotein of high-density lipoproteins (HDL) present during the acute-phase reaction. To map specific epitopes on purified, lipid-free SAA, sequence-specific antibodies raised against synthetic peptides corresponding to amino acid residues 1-17, 14-30, 27-44, 40-63, 59-72, 68-84, 79-94 and 89-104 of human SAA1 were studied. Using the indirect sandwich dissociation-enhanced lanthanide fluorescence immunoassay, antibodies raised against epitopes comprising residues 1-17, 14-30, 40-63 and 79-94 failed to recognize the corresponding domains on isolated human SAA1/SAA2 or a mixture of both isoforms, indicating that these epitopes are masked, apparently because of specific folding and/or self-aggregation (dimerization). The accessible antigenic determinants of isolated SAA are epitopes comprising residues 31-39, 64-78 and 95-104. The present findings indicate that: (i) the same epitopes are exposed, irrespective whether SAA is HDL-associated or in its lipid-free form and that (ii) monomeric and dimeric SAA co-exist to a similar extent in the lipid-free form, irrespective of whether conditions are non-denaturating, denaturating, acidic or basic. From our studies it is proposed that isolated, purified SAA may serve as a reliable standard for quantification of HDL-associated SAA and for mimicking the interaction of acute-phase HDL particles with peripheral tissues in vitro.

Epitope Mapping↗
PubMed1997

A novel antibody-dependent cellular cytotoxicity epitope in gp120 is identified by two monoclonal antibodies isolated from a long-term survivor of human immunodeficiency virus type 1 infection.

Two monoclonal antibodies (MAbs), 42F and 43F, were isolated some 14 months apart from a single long-term survivor of human immunodeficiency virus type 1 (HIV-1) infection. These MAbs were found to be indistinguishable in terms of their isotypes, specificities, affinities, and biological activities. Both 42F and 43F directed substantial antibody-dependent cellular cytotoxicity (ADCC) against cells infected with four divergent lab-adapted strains of HIV-1, but no neutralizing activity against these strains was detectable. The ability of MAbs 42F and 43F, as well as that of MAbs against two other gp120 epitopes, to direct ADCC against uninfected CD4+ cells to which recombinant gp120SF2 had been adsorbed (i.e., "innocent bystanders") was demonstrated to be less efficient by at least an order of magnitude than their ability to direct ADCC against HIV-1-infected cells. Flow cytometry analyses showed that 42F and 43F also bind to native primary isolate Envs from clades B and E expressed on cell surfaces. By direct binding and competition assays, it was demonstrated that the 42F/43F epitope lies in a domain of gp120 outside the previously described CD4-binding site and V3 loop ADCC epitope clusters. Immunoblot analysis revealed that the 42F/43F epitope is not dependent on disulfide bonds or N-linked glycans in gp120. Epitope mapping of 42F and 43F by binding to linear peptides demonstrated specificity of these MAbs for a sequence of 10 amino acids in the C5 domain comprising residues 491 to 500 (Los Alamos National Laboratory numbering for the HXB2 strain). Thus, 42F and 43F define a new ADCC epitope in gp120. Because of the relative conservation of this epitope and the fact that it appears to have been significantly immunogenic in the individual from which these MAbs were derived, it may prove to be a useful component of HIV vaccines. Furthermore, these MAbs may be used as tools to probe the potential importance of ADCC as an antiviral activity in HIV-1 infection.

Amino Acid Sequence↗
PubMed1996

[The quality of life after extirpation of the rectum for carcinoma].

BASIC PROBLEM AND AIM OF STUDY: The quality of life for patients who have undergone total rectal resection for carcinoma is impaired by the artificial intestinal stoma. Their psychosocial disorders were analysed in relation to the method of looking after the stoma (with or without controlled stool emptying by intestinal irrigation) and compared with patients who had a after continence-preserving operation for rectal carcinoma. PATIENTS AND METHODS: Of the 205 patients (aged 58.6 +/- 8.1 years; 72 women and 133 men) 78 had a continence resection (group 1), 127 had a colostomy (irrigation in 81, group 2a; merely looking after the colostomy bag in 46, group 2b). Their personality characteristics were tested prospectively with the State-Trait Anxiety Inventory (STAI) and quality of life parameters with a standardized questionnaire. RESULTS: While personality traits were similar, significantly fewer patients in group 2a complained about disturbances of self esteem (32.9 vs 60.0%; P < 0.01), and had pessimistic future expectations (20.5 vs 46.5; P < 0.01) than those in group 2b. There was no significant difference in these two parameters between groups 1 and 2a. The irrigation procedure was taught to 60.5% of patients during their hospital stay. Accepting irrigation was more common when rehabilitation was begun early rather than delayed (72.9 vs 42.9%; P < 0.01). Disturbances of erection occurred in 69.9% of men younger than 60 years after the operation. CONCLUSIONS: Compared with conventional bag care, regular irrigation improves the quality of life for patients with a colostomy. Postoperatively disordered erection is an independent risk factor for any abnormal self esteem and depression. They should be stressed more during history taking and therapeutically.

Adult↗
PubMed1996

[Effect of elevated head position in bed in therapy of gastroesophageal reflux].

In a randomized multicentric trial the effect of sleeping with the bed-head raised was studied in inpatients with reflux symptoms. All patients underwent an endoscopic and pH-metric examination. As a result from the diagnostic procedures three groups were formed: group 1 - refluxlike dyspepsia (endoscopic and pH-metric examination normal), group 2 - reflux disease without esophagitis (endoscopy normal, pH-metric examination abnormal), group 3 - refluxesophagitis (endoscopy abnormal). All patients were randomly assigned to either sleeping with horizontal bed-head or having the bed-head raised (15 cm). Furthermore, the patients in group 3 were put on treatment with omeprazole (20 mg twice a day) those in group 2 were treated with a procinetic drug (cisapride 30 mg). The patients in group 1 had no drug therapy. However, antacids were allowed in all patients. For a two-week-period reflux symptoms and use of antacids were registered. No difference was seen in the symptom-score or use of antacids. Also sub-group analysis (sex, age, body-mass-index, severity of esophagitis and nocturnal reflux) did not reveal any impact of sleeping with the bed-head raised on reflux symptoms or use of antacids.

Adult↗
PubMed1995

A double-blind study of pantoprazole and omeprazole in the treatment of reflux oesophagitis: a multicentre trial.

BACKGROUND: Pantoprazole is a new substituted benzimidazole which is a potent inhibitor of gastric acid secretion by its action upon H+,K(+)-ATPase. AIM: To compare pantoprazole 40 mg with omeprazole 20 mg as once daily dosing in the treatment of reflux oesophagitis (grades II and III). METHODS: This double-blind, randomized, multicentre study included 286 patients. Patients were reendoscoped after 4 weeks, and continued to receive a further 4 weeks of treatment if they were not healed at this time. RESULTS: After 4 weeks of treatment, complete healing occurred in 126/170 (74%) patients in the pantoprazole group and in 67/86 (78%) patients in the omeprazole group (per-protocol analysis). At 8 weeks, the corresponding healing rates were 153/170 (90%) and 81/86 (94%). The differences between the treatment groups were not significant (P = 0.57 and 0.34). Improvement in the principal symptoms of reflux oesophagitis was also very similar between the treatment groups, with 59% and 69% at 2 weeks, and 83% and 86% at 4 weeks, respectively, being free from any individual symptom. Both treatments were well tolerated. CONCLUSIONS: This study has shown pantoprazole and omeprazole to be similarly effective and well tolerated in the treatment of mild to moderate reflux oesophagitis.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1994

[Water melon stomach or antrum gastritis--differential diagnostic aspects].

The gastric-antral-vascular-ectasia (GAVE), the "Watermelon-stomach", is a capillary ectasia of the antrum mucosa. It appears as longitudinal intensive redness of the mucosa. This endoscopic picture is caused by fibromuscular obliteration of the lamina propria and vascular ectasia with fibrinthromby. The pathogenesis of the disease is unknown. Clinical manifestation is chronic blood-loss with consecutive anaemia. The "Watermelon-stomach" is often not recognized and mistaken as "refractory antrumgastritis". Laser-coagulation is a not-operative therapy of GAVE.

Biopsy↗
PubMed1992

[Helicobacter pylori-associated hypertrophic gastritis. Imitation of Ménétrier disease].

A 42-year-old man developed giant fold gastritis that was associated with massive Helicobacter pylori colonization, highly active, high-grade gastritis and severe hypoproteinemia with gastric protein-loss syndrome. Histology revealed marked focal foveolar hyperplasia of the body and fundic mucosa. Combination treatment with amoxicillin and omeprazole resulted in the eradication of the Helicobacter pylori. Concomitantly, the foveolar hyperplasia, gastritis and the giant folds regressed completely, and the protein loss was arrested. It would appear highly likely that colonization with Helicobacter pylori had led to the formation of the giant folds and to gastric protein loss. The clinical picture described here mimics Ménétrier's disease, the cause of which is still unknown, and possibly represents a subgroup of this heterogeneous clinical entity.

Adult↗
PubMed1992

Stereometabolism of ethylbenzene in man: gas chromatographic determination of urinary excreted mandelic acid enantiomers and phenylglyoxylic acid and their relation to the height of occupational exposure.

Ethylbenzene is an important industrial solvent and a key substance in styrene production. Ethylbenzene metabolism leads to the formation of mandelic acid, which occurs in two enantiomeric forms, and phenylglyoxylic acid. To decide which enantiomer is preferably formed, 70 urine samples of exposed workers were taken at the end of shifts and--after 3-pentyl ester derivatisation--gas chromatographically analysed. The R/S ratio of mandelic acid enantiomers in urine amounts to 19:1, which means that R-mandelic acid is a major metabolite and S-mandelic acid is one of the minor urinary metabolites of ethylbenzene in man. The R/S ratio is independent of ambient air concentration of ethylbenzene within the investigated range. Compared to an ethylbenzene monoexposure the height of total mandelic acid excretion is decreased in the case of coexposure to other aromatic solvents.

Benzene Derivatives↗
PubMed1991

Characterization of monoclonal antibodies against the human immunodeficiency virus matrix protein, p17gag: identification of epitopes exposed at the surfaces of infected cells.

Eight monoclonal antibodies reactive with the matrix protein of human immunodeficiency virus type 1 (HIV-1), p17gag, were isolated from rats which had been immunized with solubilized HIV-1 lysate. The epitope specificities of these antibodies were determined with a series of synthetic peptides representing overlapping regions of p17. Six of the antibodies were mapped to three distinct regions of p17, while two antibodies (G11g1 and G11h3) reacted only with intact recombinant p17, suggesting that they were directed against conformational or discontinuous epitopes. All the antibodies bound to HIV-infected cells which had been permeabilized with acetone, but only G11g1 and G11h3 reacted with live HIV-infected cells. Specificity studies with diverse virus strains demonstrated that these two antibodies recognized distinct epitopes, one which was group specific for HIV-1, and one which was shared with HIV type 2 and simian immunodeficiency virus. Binding competition studies indicated that these epitopes were proximal in native p17. Despite their reactivity with intact cells, these two antibodies did not possess appreciable virus-neutralizing activity. These results indicate that a form of p17 is expressed on the surfaces of live HIV-infected cells which is accessible to some, but not all, antibodies against p17. These cell surface molecules may play a role in the generation of antibodies against p17gag that are characteristic of early stages of HIV infection, and they may act as natural targets for the immune system and as potential targets for immunotherapy of HIV-infected cells.

Amino Acid Sequence↗
PubMed1986

[Tryptophan metabolism in liver diseases: a pharmacokinetic and enzymatic study].

Tryptophan is considered to be one of the agents involved in the pathogenesis of hepatic encephalopathy. In our study, we evaluated tryptophan metabolism in liver disease. A bolus of 1.5 g of L-tryptophan was administered intravenously to 14 patients with noncirrhotic liver disease, 40 patients with liver cirrhosis, and 8 healthy volunteers. As pharmacokinetic parameters, the half life, clearance, and volume of distribution of free and total tryptophan were determined using a biexponential formula. In addition, the activity of liver tryptophan pyrrolase, the key enzyme of tryptophan metabolism, was measured in liver biopsy specimens of 15 patients with noncirrhotic liver disease, 8 patients with cirrhosis of the liver, and 4 patients with histologically normal livers. Healthy subjects and patients with noncirrhotic liver disease both showed similar results in measured and calculated data. In contrast, patients with cirrhosis revealed significant alterations of the pharmacokinetic parameters of free and total tryptophan: the half-life was increased by 195% and 176%, the clearance was decreased by 73% and 34%, respectively, and the activity of tryptophan pyrrolase was decreased by 22%. The tryptophan transfer in cirrhosis amounted to only 0.75 +/- 0.03 g per 24 h compared with 2.6 +/- 0.34 g per 24 h in healthy individuals. The findings demonstrate that patients with cirrhosis show a marked reduction in their ability to metabolize tryptophan. This should be taken into account in the oral and parenteral nutrition of those patients.

Adult↗
PubMed1986

The disposition of intravenous L-tryptophan in healthy subjects and in patients with liver disease.

The disposition of free and of total tryptophan following an intravenous load of 1.5 g of L-tryptophan was evaluated in eight patients with non-cirrhotic liver disease, 40 patients with cirrhosis of the liver (21 Child's A, 15 Child's B, 4 Child's C) and in 14 healthy subjects. Cirrhosis affected disposition of tryptophan by (a) decreasing the clearance of both free and total tryptophan by 64% (P less than 0.001) and 34% (P less than 0.01), respectively, (b) by increasing the apparent volume of distribution of total tryptophan by 42% (P less than 0.01) by expansion of the peripheral compartment, resulting in (c) a threefold increase in the half-life of tryptophan. Apart from a reduction in free tryptophan clearance, these changes in tryptophan disposition were not apparent in patients with non-cirrhotic liver disease. Elevated fasting free tryptophan plasma concentrations are an indicator of impaired tryptophan metabolism in cirrhosis. They result from a decreased hepatic clearance of tryptophan rather than from a reduction in tryptophan protein binding. This study emphasises the markedly differing pharmacokinetic behaviour of tryptophan in cirrhotic patients compared with normal subjects and with patients with non-cirrhotic liver disease.

Adult↗
PubMed1985

[Hyperimmunoglobulinemia E, recurring staphylococcal infections and a defect in granulocyte chemotaxis in adults. A variant of Job's syndrome].

Two cases in adults with recurrent staphylococcal infections associated with abnormal granulocytic chemotaxis and hyperimmunoglobulinaemia E (Job's syndrome) are described. The pathophysiological mechanisms seems to consist of an abnormal IgE reaction against staphylococcal antigens causing secondary abnormality of granulocyte function. Abnormal cellular immune function was demonstrated in vitro and in vivo. Corticosteroid administration at first proved effective in both patients. One patient developed Hodgkin's disease of the mixed type in the course of the disease.

Adrenal Cortex Hormones↗