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Biomedical subjects

T Engelhardt

Publications and source records attributed to T Engelhardt.

26 records · Page 2Linked to original sources
PubMed1997

Obstetric and gynaecological patients in an intensive care unit: a 1 year review.

Management of the critically ill patient forms a significant proportion of obstetric and gynaecological (O & G) practice. There have however, been very few reports on the management of such patients in intensive care units (ICU). We review all O & G patients admitted to the surgical ICU at King Edward VIII Hospital, Durban, South Africa, and make recommendations regarding management of such patients. The medical records of all O & G patients admitted to the surgical ICU between the period January-December 1992 were analysed. Of all admissions to the ICU 13.6% (n = 122) were O & G patients. Eclampsia was the most common diagnosis accounting for 66% of all obstetric admissions. Of all eclamptics in the study period 24% were admitted to the ICU. The overall maternal mortality was 21%. O & G patients form a major workload of surgical ICUs and the majority of these patients are women with eclampsia. Management of such patients requires an understanding of the physiological changes of normal and abnormal pregnancies. Therefore, all large obstetrical units in developing countries should establish their own ICU in order that patient care, health personnel training and continuing health care education may be improved.

Adolescent↗
PubMed1996

Identification and characterization of the bovine herpesvirus 5 US4 gene and gene products.

The BHV-5 strain N569 (BHV-5/N569) homolog to the BHV-1 US4 gene was sequenced and characterized. RNA analyses showed that a 1.8-kb mRNA which contains the BHV-5/N569 US4 open reading frame initiates 55 nucleotides upstream from the predicted translational start codon and terminates 17 nucleotides downstream from the consensus sequence for polyadenylation. Comparison of the deduced amino acid sequences of the predicted US4 encoded proteins of BHV-5/N569 and BHV-1 strain Schönböken (BHV-1/Schö) revealed 75% identity. An antiserum, raised in rabbits after infection with a BHV-5/N569 US4 ORF expressing recombinant vaccinia virus, specifically precipitated a 65-kDa protein and a diffusely migrating protein species with an apparent molecular mass between 90 and > 240 kDa from the supernatant of BHV-5/ N569 infected cells. Treatment of immmunprecipitated proteins with chondroitinase AC demonstrated that the latter contains glycosaminoglycans. The mobility of the BHV-5/N569 US4 gene products was identical to the BHV-1 US4 ORF encoded glycoprotein G (gG) and glycoproteoglycan G (gpgG; G. M. Keil, T. Engelhardt, A. Karger, and M. Enz. J. Virol. 70, 3032-3038, 1996) and were therefore named BHV-5 gG and BHV-5 gpgG. Immunoprecipitations with sera from BHV-1 infected cattle indicated a type-specific immune response to gG, since these sera failed to react with vaccinia virus-expressed gG-5 but recognized vaccinia virus-expressed gG-1.

Alphaherpesvirinae↗
PubMed1996

Bovine herpesvirus 1 U(s) open reading frame 4 encodes a glycoproteoglycan.

Sequence analysis of the short unique (Us) segment of the bovine herpesvirus 1 (BHV-1) genome predicted that the Us open reading frame (ORF) 4 encodes a protein with homology to glycoprotein G (gG) of other alpha-herpesviruses (P. Leung-Tack, J.-C. Audonnet, and M. Riviere, Virology 199:409-421, 1994). RNA analysis showed that the Us ORF4 is contained within two transcripts of 3.5 and 1.8 kb. The 3.5 kb RNA represents a structurally bicistronic RNA which encompasses the Us ORF3 and Us ORF4, whereas the 1.8-kb RNA constitutes the monocistronic Us ORF4 mRNA. To identify the predicted BHV-I gG, recombinant vaccinia virus expressing the Us ORF4 was used to raise specific antibodies in rabbits. The antiserum recognized a 65-kDa polypeptide and a very diffusely migrating species of proteins with an apparent molecular mass of between 90 and greater than 240 kDa in supernatants of BHV-1-infected cells which was also precipitated together with 61- and 70-kDa polypeptides from cell-associated proteins. The specificity of the reaction was demonstrated by the absence of these proteins from the supernatant of cells infected with the Us ORF4 deletion mutant BHV-l/gp1-8. Treatment of the immunoprecipitated proteins with glycosidases and chondroitinase AC showed that the 65-kDa protein constitutes gG, which contains both N- and O-linked carbohydrates, and that the high-molecular-mass proteins contain glycosaminoglycans linked to a 65-kDa glycoprotein that is antigenically related to gG. These molecules were therefore named glycoproteoglycan C (gpgG). Pulse chase experiments indicated that gG and gpgG were processed from a common precursor molecule with an apparent molecular mass of 61 kDa via a 70-kDa intermediate. Both gG and gpgG could not be found associated with purified virions. In summary, our results identify the BHV-I gG protein and demonstrate the presence of a form of posttranslational modification, glycosamino-glycosylation, that has not yet been described for a herpesvirus-encoded protein.

Animals↗
PubMed1989

Ischemic intestinal necrosis as a cause of atypical abdominal pain in a sickle cell patient.

The authors present a case report of a sickle cell patient with end-stage renal disease treated with peritoneal dialysis who presented with abdominal pain. Although the pain was not unlike that typically associated with his crises, the absence of characteristic joint and chest pain made the diagnosis of "crisis" unlikely and favored the admitting diagnosis of peritoneal dialysis-related peritonitis. After the patient failed to improve with a medical regimen, including antibiotics, surgical consultation was obtained. Complete small bowel obstruction and diffuse peritonitis necessitated emergency surgery at which necrosis of terminal ileum was encountered. Histologic study of the resected specimen showed microvascular thrombosis with sickled erythrocytes. The authors review this rare complication and discuss the clinical problems of diagnosing typical and atypical abdominal pain in the sickle cell patient with and without concomitant crisis.

Abdominal Pain↗
PubMedDate not supplied

Swelling of capillary endothelial cells contributes to traumatic hemorrhagic shock-induced microvascular injury: a morphologic and morphometric analysis.

The endothelial cell (EC) response during the first 2 h after traumatic hemorrhagic shock (THS) was analyzed in the rat mesentery by electron microscopy. Using a computer-assisted image analysis system, we interactively measured THS-induced changes of the area and the mean height of EC as well as the number of swollen EC occluding the capillary lumen. Analysis distinguished between capillaries presenting with the lumen blocked by corpuscular blood cells and capillaries with an open lumen. THS resulted in a significant increase in EC height of capillaries with an open lumen, but not of capillaries with lumen blocked by blood cells when compared with the control group (p < 0.05). This phenomenon was found to be most prominent 60 min after THS. In addition, THS was accompanied by a significantly increased number of swollen EC which occluded capillaries with an open lumen. From these results we conclude that swelling of EC contributes to THS-induced microvascular injury. Occlusion of the capillary lumen by EC swelling may be regarded as the morphological correlate of the THS-induced 'no-reflow' phenomenon.

Animals↗
PubMedDate not supplied

Early ultrastructural changes of myocardial endothelial cells in traumatic haemorrhagic shock in rats.

The aim of this study was to assess early traumatic haemorrhagic shock (THS)-induced changes in myocardial endothelial cells (mECs) both morphologically and morphometrically. The mECs of capillaries of the left ventricular myocardium were investigated by electron microscopy 15, 30, 60, and 120 min after a standardised THS and compared to a control group. With the use of a computer-assisted image analysis system, we measured the following morphometric parameters--height, area, circumference, cytoplasmic processes, and interendothelial junctions--and determined the number and distribution of cytoplasmic vesicles in every mEC. THS induced a significantly increased formation of cytoplasmic processes and a redistribution of cytoplasmic vesicles towards the cell centre, with the changes peaking between 15 and 60 min. There was no evidence of an increase in mEC height or area/circumference ratio used as indicators for early mEC oedema, although the latter dropped significantly after 15 min. No increase in damaged mitochondria was observed and the interendothelial junctions remained close. The THS-induced ultrastructural changes represent early mEC activation. Irreversible damage of mECs does not occur.

Animals↗
PubMedDate not supplied

Are Fortune 100 companies responsive to chronically ill workers?

We conducted a survey of Fortune 100 companies to determine their response to the growing number of employees with chronic conditions. We found that although all companies cover some services that are particularly beneficial to persons with chronic conditions, gaps in coverage remain. We also found large variations in cost-sharing mechanisms, number of covered visits, and lifetime maximum benefit provisions, which are especially important to persons with chronic conditions. In general, for persons with chronic conditions the benefits offered by these Fortune 100 companies are superior to those offered by Medicare.

Chronic Disease↗