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  • 1
    Electronic Resource
    Electronic Resource
    Polyclonal Antibodies Directed Against an Epitope Specific for the α4-Subunit of GABAA Receptors Identify a 67-kDa Protein in Rat Brain Membranes (1994)
    Oxford, UK : Blackwell Science Ltd
    Journal of neurochemistry 62 (1994), S. 0 
    Details
    ISSN: 1471-4159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: Polyclonal antibodies were raised to the C-terminal part of the γ-aminobutyric acidA (GABAA) receptor α4-subunit. These anti-peptide α4 (517–523) antibodies specifically identified a protein with apparent molecular mass 67 kDa in rat brain membranes. This protein was enriched by immunoaffinity chromatography of brain membrane extracts on Affigel 10 coupled to the anti-peptide α4 (517–523) antibodies and could then be identified by the anti-α4-antibodies as well as by the GABAA receptor subunit-specific monoclonal antibody bd-28. This appears to indicate that the 67-kDa protein is the α4-subunit of GABAA receptors. Intact GABAA receptors appeared to be retained by the immunoaffinity column because other GABAA receptor subunit proteins like the β2/β3-subunits and the γ2-subunit were detected in the immunoaffinity column eluate. Furthermore, in addition to the 67-kDa protein, a 51-kDa protein could be detected by the antibody bd-28 and the anti-peptide α4 (517–523) antibody in the immunoaffinity column eluate. A protein with similar apparent molecular mass was identified by the α1-subunit-specific anti-peptide α1 (1–9) antibody. In contrast to the α1-subunit, the 51-kDa protein identified by the anti-α4 antibody could not be deglycosylated by N-Glycanase. The identity of the 51-kDa protein identified by the anti-α4-antibodies thus must be further investigated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1471-4159.1994.62020764.x
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  • 2
    Electronic Resource
    Electronic Resource
    Low incidence of invasive fungal infections after bone marrow transplantation in patients receiving amphotericin B inhalations during neutropenia (1994)
    Springer
    Annals of hematology 68 (1994), S. 21-26 
    Details
    ISSN: 1432-0584
    Keywords: Fungal infection ; Bone marrow transplantation ; Amphotericin B inhalations
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The incidence of invasive fungal infections after bone marrow transplantation (BMT) was analyzed in 303 consecutive marrow graft recipients (allogeneicn=271, autologousn=27, syngeneicn=5). All patients received inhalations with amphotericin B (10 mg twice daily) during neutropenia. The overall incidence of invasive fungal infections within the first 120 days after transplant was 3.6% (11/303; aspergillosis: 6; yeast infection: 5). Four of the 11 cases occurred early, and seven cases were observed after neutrophil recovery and discontinuation of amphotericin B inhalation treatment. Late infection was significantly associated with the development of acute graft-versus-host disease. Four of the 11 infections (early 2/4; late: 2/7) were observed in patients with a history of previous fungal infection. Other patient and treatment characteristics were not helpful in defining potential risk factors. In particular, the incidence of invasive fungal infections did not differ between patients with more or less strict reverse isolation measures. Occasional side effects such as initial mild cough and bad taste were rare, usually disappeared during continued administration, and were in no case the reason for discontinuation of treatment. These data suggest that aerosolized amphotericin B may be a useful, convenient, and efficient prophylactic antifungal regimen in BMT.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01695915
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  • 3
    Electronic Resource
    Electronic Resource
    Molecular epidemiological study ofPseudomonas aeruginosa isolates from patients with acute leukemia (1990)
    Springer
    European journal of clinical microbiology & infectious diseases 9 (1990), S. 257-261 
    Details
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In an attempt to determine the genetic relationship between strains ofPseudomonas aeruginosa isolated from patients with acute leukemia, a recently described restriction fragment from the region upstream of the exotoxin A structural gene was used as a probe in Southern hybridization. The overall rate of cultures positive forPseudomonas aeruginosa during 169 admissions (119 patients) was 17 %. Twelve genotypically distinct strains were found among 18 colonized and/or infected individuals. Three of these strains were recovered from more than one patient, suggesting a certain risk of nosocomial transmission ofPseudomonas aeruginosa and cross-infection. Genotypic comparison showed identical restriction patterns in multiple isolates from single patients, and also in colonizing and subsequently infecting strains. Genotyping distinguished isolates with similar O serotypes and established the identity between isolates with differing susceptibility to agents used for antibacterial prophylaxis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01968056
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  • 4
    Electronic Resource
    Electronic Resource
    Bacteremia due to fluoroquinolone-resistantEscherichia coli in two immunocompromised patients (1994)
    Springer
    European journal of clinical microbiology & infectious diseases 13 (1994), S. 161-165 
    Details
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Two patients with acute leukemia developedEscherichia coli bacteremia while receiving oral ofloxacin for antibacterial prophylaxis during profound neutropenia. The isolates were resistant to ofloxacin (MIC 25 and 12.5 µg/ml respectively), other fluoroquinolones and several unrelated agents. Whole cell drug accumulation studies with four different fluoroquinolones suggested major differences between drugs but only minor alterations in individual drug permeability in the two resistant isolates compared with a susceptible control strain. In a supercoiling assay using the purified DNA gyrase and plasmid pBR322, high concentrations (≥250 µg/ml) of both ofloxacin and ciprofloxacin were needed for visible inhibition of enzyme activity suggesting mutations in the DNA gyrase gene as the significant mechanism of resistance in both strains.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01982191
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  • 5
    Electronic Resource
    Electronic Resource
    The Shapley value for cooperative games under precedence constraints (1992)
    Springer
    International journal of game theory 21 (1992), S. 249-266 
    Details
    ISSN: 1432-1270
    Keywords: Cooperative Game ; Shapley Value ; Precedence Constraint ; Marginal Contribution
    Source: Springer Online Journal Archives 1860-2000
    Topics: Mathematics , Economics
    Notes: Abstract Cooperative games are considered where only those coalitions of players are feasible that respect a given precedence structure on the set of players. Strengthening the classical symmetry axiom, we obtain three axioms that give rise to a unique Shapley value in this model. The Shapley value is seen to reflect the expected marginal contribution of a player to a feasible random coalition, which allows us to evaluate the Shapley value nondeterministically. We show that every exact algorithm for the Shapley value requires an exponential number of operations already in the classical case and that even restriction to simple games is #P-hard in general. Furthermore, we outline how the multi-choice cooperative games of Hsiao and Raghavan can be treated in our context, which leads to a Shapley value that does not depend on pre-assigned weights. Finally, the relationship between the Shapley value and the permission value of Gilles, Owen and van den Brink is discussed. Both refer to formally similar models of cooperative games but reflect complementary interpretations of the precedence constraints and thus give rise to fundamentally different solution concepts.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01258278
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  • 6
    Electronic Resource
    Electronic Resource
    Corynebacterium jeikeium bacteremia at a tertiary care center (1991)
    Springer
    Infection 19 (1991), S. 201-204 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In einer Universitätsklinik wurde während eines Zeitraumes von sechs Jahren bei 23 PatientenCorynebacterium jeikeium aus Blutkulturen isoliert.C. jeikeium-Bakteriämien traten weder zeitlich noch örtlich gehäuft auf. Die retrospektive Analyse der Patientendaten zeigte, daß in den meisten Fällen eine maligne hämatologische Grunderkrankung mit Neutropenie vorlag, ein zentral-venöser Katheter implantiert und eine antibiotische Therapie vorausgegangen war. Die Patientenpopulation mit nur einer positiven Blutkultur unterschied sich in wichtigen Aspekten von derjenigen mit mehreren positiven Blutkulturen. So waren Patienten mit nur einer positiven Blutkultur seltener an akuter Leukämie erkrankt, hatten signifikant höhere neutrophile Granulozytenkonzentrationen im peripheren Blut und waren zuvor über einen kürzeren Zeitraum antibiotisch behandelt worden. Weiterhin fanden sich in dieser Patientengruppe in allen Fällen andere mögliche Ursachen der Fieberepisoden. Auch die Mortalität war deutlich geringer. Trotz des zunehmend häufigeren Nachweises vonCorynebacterium jeikeium in Blutkulturen bleiben schwere Infektionen durch diesen Erreger weiterhin meist auf die Patientenpopulation mit hämatologischer Grunderkrankung und Neutropenie beschränkt.
    Notes: Summary During a six-year period 23 patients with isolation ofCorynebacterium jeikeium (formerly known asCorynebacterium group JK) from one or more blood cultures at a university hospital were identified. Cases occurred sporadically without time- or ward-related clustering. Review of the cases showed that most infections were nosocomial, that most of the patients had underlying malignant disease, had a chronic intravascular catheter implanted, had been pretreated with antibiotics, and were neutropenic at the time the blood cultures were drawn. Patients with only one versus those with more than one positive blood culture differed in some important aspects. Patients with only one positive blood culture were less likely to have acute leukemia, had significantly higher neutrophil counts and a shorter duration of preceding antibiotic treatment, and all had other probable causes of infection and fever. The mortality also appeared to be lower in these patients. Despite the possibility of increasing frequency of blood cultures positive forC. jeikeium, severe infections due to this organism continue to be largely confined to neutropenic patients with hematologic malignancy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01644945
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  • 7
    Electronic Resource
    Electronic Resource
    Bacteremia caused byStomatococcus mucilaginosus: Report of seven cases and review of the literature (1992)
    Springer
    Infection 20 (1992), S. 213-220 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In zwei Universitätskliniken wurde während eines Zeitraumes von drei Jahren bei acht PatientenStomatococcus mucilaginosus aus Blutkulturen isoliert. Der zentral-venöse Katheter eines Patienten war mit diesem Organismus ohne Zeichen einer Infektion kolonisiert, zwei Patienten hatten eine passagere Bakteriämie ohne eindeutige Beziehung zur Grunderkrankung, während die übrigen fünf Patienten unter klinisch bedeutsamen Infektionen litten. Von diesen letzteren Patienten war bei einem Patienten ein chirurgischer Eingriff im Kopf-Halsbereich durchgeführt worden, vier Patienten wiesen maligne hämatologische Erkrankungen mit milder bis schwerer Neutropenie auf; zwei dieser Patienten entwickelten die Infektion im Anschluß an einen zahnärztlichen Eingriff. Neben oropharyngealen Schleimhautläsionen und Neutropenie könnte eine antibakterielle Prophylaxe mit Chinolonen ein zusätzlicher Risikofaktor für das Entstehen derS. mucilaginosus- Bakteriämie bei diesen Patienten gewesen sein. Eine gründliche Literaturübersicht belegte, daß zusätzlich zu unseren Beobachtungen, Endokarditiden und Fremdkörperinfektionen weitere typische Krankheitsmanifestationen sind. Obgleich die Antibiotikaempfindlichkeit insgesamt der von Streptokokken ähnelt, ist zu unterstellen, daß Penicillin G nicht das Mittel der ersten Wahl bei besonders schwerwiegenden Infektionen ist.S. mucilaginosus kann leicht von anderen grampositiven Bakterien differenziert werden, wenn bestimmte Schlüsselkriterien (z.B. Adhärenz zu Agaroberflächen, schlechtes Wachstum auf Mueller-Hinton Agar, Kapseldarstellung) sowie eine Reihe von biochemischen Tests, einschließlich kommerziell erhältlicher Identifizierungssysteme, Anwendung finden. Unsere eigenen und publizierte Daten unterstreichen, daß Mikrobiologen und Kliniker diesem opportunistischen Erreger verstärkt Beachtung schenken sollten.
    Notes: Summary During a three-year period eight patients with blood cultures positive forStomatococcus mucilaginosus were identified at two university hospitals. One patient without any signs of infection had a central venous catheter that was colonized with this organism, two patients had transient bacteremia without definite relationship to underlying disease, whereas the remaining five patients suffered from clinically significant infections. Of these last five patients, one had undergone prior head and neck surgery and four had hematologic malignancy with mild to severe neutropenia; two of the latter patients developed the infection subsequent to dental surgery. Besides neutropenia and mucosal damage in the oropharynx, quinolone antibacterial prophylaxis may have been an additional risk factor for the development ofS. mucilaginosus bacteremia in these patients. A thorough review of the literature revealed that in addition to our findings, endocarditis and foreign body infections are further typical clinical manifestations. Although the overall antibiotic susceptibility pattern ofS. mucilaginosus resembles that of streptococci, it is suggested that penicillin G may not be the drug of choice for initial therapy of particularly severe infections.S. mucilaginosus can be easily differentiated from other gram-positive bacteria when certain key criteria (e.g. adherence to agar surfaces, poor growth on Mueller-Hinton agar, presence of a capsule) as well as an array of biochemical tests, including commercially available identification systems, are applied. Our own and published data emphasize that both microbiologists and clinicians should be increasingly aware of this opportunistic pathogen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02033062
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  • 8
    Electronic Resource
    Electronic Resource
    Ofloxacin versus trimethoprim-sulfamethoxazole for prevention of infection in patients with acute leukemia and granulocytopenia (1991)
    Springer
    Infection 19 (1991), S. 73-80 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In einer prospektiven, randomisierten Studie wurden die Wirksamkeit und Verträglichkeit von Ofloxacin (dreimal 200 mg täglich) im Vergleich mit Trimethoprim-Sulfamethoxazol (dreimal 960 mg täglich) als antibakterielle Prophylaxe bei Patienten mit akuter Leukämie geprüft. Beurteilbar waren 128 Patienten, die eine aggressive cytostatische Chemotherapie erhielten, mit einer medianen Granulozytopeniedauer von 30 Tagen. In der Ofloxacin-Gruppe wurde eine Kolonisierung mitEnterobacteriaceae (13% gegenüber 90%, p〈0.001) undPseudomonas aeruginosa (3% gegenüber 14%, p=0.025) wesentlich seltener beobachtet als in der Trimethoprim-Sulfamethoxazol-Gruppe. Patienten, die Ofloxacin erhielten, entwickelten auch weniger gram-negative Infektionen (4% gegenüber 26%, p=0.002), während die Inzidenz von gram-positiven bakteriellen (19% gegenüber 22%) und von Pilzinfektionen (7% gegenüber 14%) in beiden Gruppen vergleichbar war. Ofloxacin war besser verträglich und verkürzte die Feiberdauer (p=0.02) sowie die Dauer der parenteralen antimikrobiellen Behandlung von vermuteten oder dokumentierten erworbenen Infektionen (p=0.01). In der Prophylaxe gramnegativer Infektionen bei Patienten mit akuter Leukämie erscheint Ofloxacin daher eine wirksamere und besser verträgliche Alternative zu Trimethoprim-Sulfamethoxazol zu sein. Möglichkeiten einer gezielten Prophylaxe gegen grampositive Infektionen sollten jedoch weiterhin überprüft werden.
    Notes: Summary In a prospective randomized study we evaluated the efficacy and safety of oral ofloxacin (dosage: 200 mg three times daily) versus trimethoprim-sulfamethoxazole (dosage: 960 mg three times daily) as antibacterial prophylaxis in 128 patients with acute leukemia who received aggressive cytotoxic chemotherapy and were granulocytopenic for a median duration of 30 days. Fewer patients receiving ofloxacin were colonized byEnterobacteriaceae (13% versus 90%, p〈0.001) andPseudomonas aeruginosa (3% versus 14%, p=0.025), and developed gram-negative bacterial infection (4% versus 26%, p=0.002), whereas the incidence of gram-positive bacterial (19% versus 22%) and fungal (7% versus 14%) infections was similar in both groups. Ofloxacin was significantly better tolerated than trimethoprim-sulfamethoxazole, and shortened the duration of fever (p=0.02) and of parenteral antimicrobial therapy for presumed or documented acquired infection (p=0.01). Ofloxacin appears to be a safe, effective, well-tolerated alternative to trimethoprim-sulfamethoxazole for preventing gram-negative infection in acute leukemia, but more effective prophylaxis of gram-positive infections is still needed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01645571
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  • 9
    Electronic Resource
    Electronic Resource
    Infectious diseases as a clinical specialty in germany — Fact or fancy? (1991)
    Springer
    Infection 19 (1991), S. 1-6 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01643746
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  • 10
    Electronic Resource
    Electronic Resource
    Streptococcal bacteremia in adult patients with leukemia undergoing aggressive chemotherapy. A review of 55 cases (1990)
    Springer
    Infection 18 (1990), S. 138-145 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die vorliegende Arbeit analysiert 55 Fälle von Streptokokken-Bakteriämie bei erwachsenen Patienten nach aggressiver antileukämischer Chemotherapie. Vergrünende Streptokokken waren die häufigsten Erreger (45 Isolate). Beta-hämolysierende Streptokokken (vier Isolate), Pneumokokken (drei Isolate) und Enterokokken (drei Isolate) waren dagegen eher selten. Klinisch waren die Infektionen gekennzeichnet durch Fieber, Beteiligung des oberen und unteren Respirationstrakts, Weichteilinfektion, durch Atemnotsyndrom und septischen Schock. 40 Patienten, bei denen ausschließlich Streptokokken in der Blutkultur nachgewiesen wurden, wurden verglichen mit 36 Patienten (ausgewählt nach denselben Kriterien) mit gramnegativer bakteriämischer Infektion. Die Gegenüberstellung ergab, daß Patienten mit Streptokokken-Bakteriämien häufiger hochdosiertes Cytosin-Arabinosid erhalten hatten (17 versus fünf Tage), eine längere Fieberdauer hatten (11 versus sieben Tage, P〈0.01), etwas länger antibakterielle Therapie benötigten (15 versus zwölf Tage, P=0.07, nicht signifikant) und häufiger mit Fluorochinolonen zur Infektprophylaxe behandelt waren (30 versus acht). Beide Gruppen unterschieden sich nicht hinsichtlich Alter, Grunderkrankung, Dauer der Granulozytopenie und Häufigkeit von Superinfektionen. Die Letalität betrug 18% bei Streptokokken-Bakteriämie und 17% bei Gram-negativer Bakteriämie. Die Untersuchung zeigt, daß Streptokokken, besonders vergrünende Streptokokken, ungewöhnlich häufig unerwartet schwere Infektionen bei Patienten nach antileukämischer Chemotherapie verursachen können.
    Notes: Summary We reviewed 55 cases of streptococcal bacteremia in adult patients who received cytotoxic chemotherapy for treatment of acute leukemia. Viridans group streptococci were the most frequent species isolated (45 isolates). Hemolytic streptococci (four isolates), pneumococci (three isolates), and enterococci (three isolates) were infrequent. Clinical features of streptococcal bacteremia included fever, upper and lower respiratory infection, respiratory distress syndrome, soft tissue infection, and septic shock. Forty patients who had only streptococci, but no other organisms isolated from their blood, were compared with 36 cases of gram-negative bacillary bacteremia that occurred during the same study period within the same population at risk. The comparison showed that patients with streptococcal bacteremia had more often received high dose cytosine arabinoside as part of their chemotherapy (17 vs. five), had a longer mean duration of fever (11 vs. seven days, p〈0.01) needed slightly more days of antibacterial therapy (15 vs. 12 days, p=0.07, not significant), and were more likely to have been treated with newer quinolones for infection prevention (30 vs. eight). No differences between both groups were found for age, underlying disease, remission status, duration of severe granulocytopenia, and number of superinfections. The overall mortality was 18% in streptococcal bacteremia and 17% in gram-negative bacillary bacteremia. Streptococci, especially viridans group streptococci, should now be regarded as frequent causes of serious life-threatening infections following aggressive chemotherapy in patients with hematologic malignancies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01642101
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