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  • 1
    Electronic Resource
    Electronic Resource
    In Vitro Stimulation with Glutamic Acid Decarboxylase (GAD65) Leads to an Oligoclonal Response of Peripheral T-Cells in an IDDM Patient (1995)
    Oxford, UK : Blackwell Publishing Ltd
    Scandinavian journal of immunology 42 (1995), S. 0 
    Details
    ISSN: 1365-3083
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The enzyme glutamic acid decarboxylase (GAD65) is a major autoantigen in insulin-dependent diabetes mellitus (IDDM). To study T-cell reactivity towards GAD, peripheral blood leucocytes from seven patients with IDDM and five control subjects were stimulated in vitro with recombinant GAD. All diabetics studied were heterozygous for diabetes-associated HLA alleles, i. e. HLA-DRB1*03, *04-DQBl*0302, *0201. A single IDDM subject (no. GAD65.05) revealed a strong response against GAD65. After stimulation, his T-cell receptor β (TCRBV) usage was found to be oligoclonal. The sequence analysis of the putative peptide binding region of the T-cell receptor (CDR3 region) of 37 GAD-reactive T-cell clones revealed no common CDR3 motif. The stimulation of GAD-reactive T-cells could be inhibited with anti-class II monoclonal antibodies, indicating a class II restricted T-cell response. In addition, GAD65-responsive T-cells revealed a Thl cytokine response pattern. The author's data suggest that GAD-reactive T-cells of Thl phenotype can be obtained after in vitro stimulation of peripheral blood leucocytes from an HLA-DRBl*03/*04 heterozygous IDDM patient. The lack of a common CDR3 motif suggests the absence of an immunodominant T-cell epitope in that patient, or may indicate receptor repertoire spreading of peripheral T-lymphocytes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-3083.1995.tb03710.x
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  • 2
    Electronic Resource
    Electronic Resource
    Therapy of osteoporosis in patients with Crohn's disease: a randomized study comparing sodium fluoride and ibandronate (2003)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 17 (2003), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background : Osteoporosis is a frequent complication in Crohn's disease. Although the efficacy of both sodium fluoride and aminobisphosphonates in postmenopausal osteoporosis has been investigated in long-term therapy studies, no long-term results are available regarding the effect of these agents in the management of osteoporosis in patients with Crohn's disease.Methods : Eighty-four patients with Crohn's disease and pathological bone mineral density findings were randomized to receive either vitamin D3 (1000 IU) and calcium citrate (800 mg) daily (group A) or sodium fluoride (25 mg b.d., group B) or intravenous ibandronate (1 mg every 3 months, group C) in addition to daily calcium/vitamin D substitution. On admission to the study and after 12 and 27 months, patients underwent dual-energy X-ray absorptiometry and radiological examination of the spine.Results : Sixty-eight patients completed the 1-year observation period and were available for the intention-to-treat analysis. No new vertebral fractures were diagnosed. In group A, lumbar bone density increased by 2.6% (P = 0.066, N.S.), in group B by 5.7% (P = 0.003) and in group C by 5.4% (P = 0.003). Therapy with sodium fluoride was associated with an increase in osteocalcin (N.S.), whereas administration of ibandronate was associated with a decrease in the resorption parameter, carboxy-terminal cross-linked type-I collagen telopeptide (P 〈 0.05). Both sodium fluoride and ibandronate resulted in significant decreases in the serum concentration of osteoprotegerin after 9 months (P 〈 0.001).Conclusions : The findings of the present study show that both sodium fluoride and ibandronate are effective in combination with calcium and vitamin D substitution in the management of osteopenia and osteoporosis in patients with Crohn's disease. Both agents are safe and well tolerated, and induce continuous increases in lumbar bone density.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.2003.01448.x
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  • 3
    Electronic Resource
    Electronic Resource
    Does methodic long-term follow-up affect survival after curative resection of colorectal carcinoma? (1993)
    Springer
    Diseases of the colon & rectum 36 (1993), S. 280-286 
    Details
    ISSN: 1530-0358
    Keywords: Colorectal carcinoma ; Follow-up ; Recurrences
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Records of 487 patients in long-term follow-up after R0 resection of colorectal carcinomas between January 1, 1980 and December 31, 1989 were analyzed. Every patient underwent regular examinations according to a defined schedule after curative resection of colorectal carcinoma. The date of evaluation was June 31, 1991. During a median observation time of 48 months (range, 15–132 months), tumor recurrence was observed in 149 patients (30.6 percent), with 56.4 percent of these suffering from tumor-associated symptoms. As the primary manifestation of tumor recurrence, only distant metastases (DM) were found in 76 patients (51 percent), only local recurrence (LR) in 46 patients (30.9 percent), and both DM and LR in 27 patients (18.1 percent). Patients with rectal carcinoma developed LR more frequently (P 〈0.05) (19.5 percent) than patients with colon carcinoma (11.8 percent). The probability of developing distant metastases was not different (P 〈0.05) for colon or rectal carcinoma but depended on primary tumor stage (P 〈0.05). Only 36 patients (24.2 percent) with recurrence could undergo further curative resection. Fifty patients (33.5 percent) were given palliative therapy, and 63 patients (42.3 percent) were given no oncologic treatment. Only 9 of the 36 patients (6 percent of all recurrence patients) undergoing R0 resection were free of tumor for more than two years. In no case was a third R0 resection possible. The survival time of these patients was increased significantly after R0 resection of tumor recurrence (P =0.03). Our study suggests that only a very few patients may live longer as a result of regular follow-up programs after curative resection for colorectal carcinoma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02053511
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  • 4
    Electronic Resource
    Electronic Resource
    Intermittent sequential compression of the lower limbs prevents venous stasis in laparoscopic and conventional colorectal surgery (1997)
    Springer
    Diseases of the colon & rectum 40 (1997), S. 1056-1062 
    Details
    ISSN: 1530-0358
    Keywords: Colorectal resection ; Laparoscopic surgery ; Pneumoperitoneum ; Intermittent sequential compression ; Thrombosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: This study was designed to evaluate the influence of intraoperative intermittent sequential compression (ISC) on venous blood return from the lower limbs during laparoscopic and conventional colorectal colectomy. METHODS: Fifty patients undergoing laparoscopic (n=25) or conventional (n=25) colorectal surgery were included in a prospective study. Peak venous flow (PFV) and the cross-sectional area (CSA) of the femoral vein were assessed by Doppler ultrasound examination intraoperatively. RESULTS: Age, gender, and body mass index were comparable between both groups. Baseline PFV was 21±6.6 cm/s in the conventional and 18.4±6.4 cm/s in the laparoscopic group (P=0.2). ISC increased PFV to 156±29 percent of the baseline value in the conventional group and to 161±29 percent in the laparoscopic group. PFV decreased after abdominal insufflation to 127±19 percent of the baseline value in the laparoscopic group and after laparotomy to 134±27 percent in the conventional group (P=0.3). PFV decreased slightly in both groups during surgery but remained well above the baseline value. Baseline CSA was 1.02±0.17 cm 2 in the conventional group and 1±0.23 cm 2 in the laparoscopic group. ISC decreased CSA to 0.91±0.18 cm 2 (conventional) and 0.85±0.18 cm 2 (laparoscopic) after initiation of ISC. CSA was 0.92±0.18 cm 2 after abdominal insufflation in the laparoscopic group, and it was 0.93±0.18 cm 2 after laparotomy in the conventional group (P=0.4). During surgery, there were no differences in absolute CSA or CSA changes compared with the baseline value in both groups. Postoperative circumference of the calf and thigh were not different between both groups. Postoperative thromboembolic complications did not occur. CONCLUSION: ISC effectively increases venous blood flow from the lower limbs during conventional and laparoscopic colorectal resections and may decrease the risk of postoperative deep vein thrombosis. Therefore, ISC is strongly recommended in every prolonged laparoscopic procedure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02050929
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  • 5
    Electronic Resource
    Electronic Resource
    A system of demand equations for Austria (1980)
    Springer
    Empirical economics 5 (1980), S. 129-142 
    Details
    ISSN: 1435-8921
    Source: Springer Online Journal Archives 1860-2000
    Topics: Economics
    Notes: Abstract This paper presents results of parameter estimations of a small system of demand equations for Austria. The functional form of the equations follows the log-linear specification well known as the “Rotterdam”-System. Using annual data from 1954 to 1977 we estimate the absolute price version for a rather aggregated system consisting of four sectors of consumption expenditures. Aitken estimation with and without linear restrictions is the adopted estimation method. Tests for the validity of the general linear restrictions axe performed employing the usual criteria. Relations among the test statistics are discussed. Taking into accountBeaton's [1972] argument of the appropriate use of likelihood ratio tests we present results also after iterating on the restricted error-covariance matrix. The question of negative semidefiniteness of the matrix of price coefficients is examined by inspection of its characteristic roots and the calculation of their approximated asymptotic covariance matrix. Finally, our results are confronted with such of other comparable studies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01848047
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  • 6
    Electronic Resource
    Electronic Resource
    Der Wert der farbkodierten kontrastmittelgestützten Duplexsonographie bei der Erfassung von Endoleckagen nach Aortenstentimplantation im mittleren Nachuntersuchungszeitraum von 15 Monaten (2000)
    Springer
    Gefässchirurgie 5 (2000), S. 225-231 
    Details
    ISSN: 1434-3932
    Keywords: Schlüsselwörter Aortenstent ; Aortenaneurysma ; Kontrastmittelgestützte farbkodierte Duplexsonographie ; Keywords Aortic endografting ; Aortic aneurysm ; Contrast-enhanced color duplex ultrasound scan
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Purpose The treatment of aortic aneurysms with endovascular stent graft prostheses is receiving increasing attention. Concerns still remain regarding the long-term results of endovascular aortic endografting. The most troublesome problems have been blood leakages around the graft system with continued risk of aneurysm rupture. The shrinkage of the aneurysm sack as a good sign of excluded aneurysm is discussed controversially. The aim of our study was to evaluate contrast-enhanced color duplex ultrasound scans (CECDU) in detecting endoleaks. Material and methods Between October 1996 and December 1998, 32 patients underwent endovascular treatment of abdominal aortic aneurysm. Results Six primary leaks occurred. Of these, two sealed spontaneously, two were treated interventionally, and two have been waiting for further treatment. All primary leaks were documented with CECDU, whereas one primary leak was missed both with computer tomography (CT) and color duplex ultrasound scan (CDU). After a mean follow-up of 15.1 months, three secondary leaks occurred. CT failed to detect one endoleak. Sensitivities of CECDUs as compared with CDUs and CTs were 100%, 96%, and 92%, respectively. Conclusion For detection of endoleaks, CECDU is superior to CT and CDU. It is a reliable and economical surveillance method after endovascular aortic endografting.
    Notes: Zusammenfassung  Ziel Zentrales Problem bei der Implantation von Aortenstents bei infrarenalen Bauchaortenaneurysmen ist das Auftreten von Endoleckagen mit folgender Größenprogredienz bis zur Aneurysmaruptur. Ziel der Untersuchung war die frühzeitige direkte Erfassung von Endoleckagen mittels Computertomographie (CT), farbkodierter Duplexsonographie (FKDS) und kontrastmittelgestützter farbkodierter Duplexsonographie (KFKDS). Material und Methoden Zwischen Oktober 1996 und Dezember 1998 sind 32 Stentimplantationen durchgeführt worden. Der mittlere Nachuntersuchungszeitraum war 15,1 Monate. Alle Patienten wurden postoperativ mit der CT, FKDS sowie der KFKDS auf eine mögliche Endoleckage untersucht. Ergebnisse Von 6 primären Leckagen sind 2 spontan thrombosiert, 2 behandelten wir interventionell, 2 weitere distale Leckagen sind zur Stentverlängerung geplant. Alle primären Leckagen wurden mit der KFKDS erkannt, während CT und FKDS in einem Fall unauffällig waren. Nach 15,1 Monaten traten 3 sekundäre Leckagen auf, wobei einmal die CT die Endoleckage nicht zur Darstellung brachte. Die Sensitivität für CT, FKDS und KFKDS beträgt im eigenen Krankengut 92, 96 und 100%. Schlussfolgerungen Die KFKDS als zentraler Bestandteil im Nachsorgeprotokoll ist der CT sowie der alleinigen FKDS bei der Erfassung von kleinen Endoleckagen überlegen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00010599
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  • 7
    Electronic Resource
    Electronic Resource
    Endoscopic Surgery: Fit for Malignancy? (1999)
    Springer
    World journal of surgery 23 (1999), S. 808-815 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Neither experimental nor clinical data confirm the repeatedly published opinion that video-endoscopic surgery promotes tumor growth or the occurrence of implantation metastases in cancer patients. On the contrary, alterations due to pneumoperitoneum by the application of different gases, pressures, and temperatures might provide the basis for a new therapeutic approach to cancer surgery. Oncologically adequate resections defined by such terms as “no touch isolation” and “monobloc resection” can be performed video-endoscopically in a variety of intraabdominally or intrathoracically located cancers if a standardized technique is used. The benefit of video-endoscopic surgery is limited in large tumors, especially if they have reached the organ surface. There is still a major deficit in the clinical evaluation of video-endoscopic interventions in most oncologic diseases. Randomized studies comparing video-endoscopic and conventional surgery have been reported only for the resection of colorectal carcinoma. They show that laparoscopic resections can be performed with a minimum of postoperative complications to the same extent as conventional resections and offer several advantages during the early postoperative period. No reliable data from comparative trials are as yet available on the long-term results.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002689900584
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  • 8
    Electronic Resource
    Electronic Resource
    Prevalence of HLA-DQ beta chain non-asp alleles in type I (insulin-dependent) diabetics with young and older ages of onset (1991)
    Springer
    Journal of molecular medicine 69 (1991), S. 687-689 
    Details
    ISSN: 1432-1440
    Keywords: Adult-onset diabetes ; HLA-DQβ ; Polymerase chain reaction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Particular HLA-DQβ chain alleles were reported as immunogenetic markers of type I diabetes mellitus with young onset of the disease. In a homogenous German population, we studied HLA-DR specificities and HLA-DQβ chain alleles in young-onset (〈21 years of age;n=185) and adult-onset (〉40 years of age;n=48) insulin-dependent diabetics. In both cohorts of type I diabetics, the HLA-DR3 and -DR4 specificities were significantly increased. The presence of an HLA haplotype with an amino acid other than aspartic acid at position 57 of the DQβ chain was significantly associated with type I diabetes in both cohorts (etiologic fraction:93% and 73%). We conclude that the presence of DNA sequences coding for an amino acid other than aspartic acid at the 57th position of the DQβ chain provides a molecular risk marker for type I diabetes of both and adult onset.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01649437
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  • 9
    Electronic Resource
    Electronic Resource
    Insulin autoantibodies as determined by competitive radiobinding assay are positively correlated with impaired beta-cell function — The Ulm-Frankfurt population study (1991)
    Springer
    Journal of molecular medicine 69 (1991), S. 736-741 
    Details
    ISSN: 1432-1440
    Keywords: CIAA ; CF-ICA ; Beta-cell function ; IVGTT ; HLA
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Out of a random population of 4208 non-diabetic pupils without a family history of Type I diabetes 44 (1.05%) individuals had islet cell antibody (ICA) levels greater or equal to 5 Juvenile Diabetes Foundation (JDF) units. 39 of these ICA-positives could be repeatedly tested for circulating insulin autoantibodies (CIAA) using a competitive radiobinding assay. The results were compared with the insulin responses in the intravenous glucose tolerance tests (IVGTT) and with HLA types. Six pupils were positive for CIAA. All of them had complement-fixing ICA, and 5 of them were HLA-DR4 positive. Three of the 6 showed a first-phase insulin response below the first percentile of normal controls. Our data indicate that in population-based studies CIAA can be considered as a high risk marker for impaired beta-cell function in non-diabetic ICA-positive individuals.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01797611
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  • 10
    Electronic Resource
    Electronic Resource
    HLA-DR3 and HLA-DR5 confer risk for autoantibody positivity against the thyroperoxidase (mic-TPO) antigen in healthy blood donors (1993)
    Springer
    Journal of molecular medicine 71 (1993), S. 221-225 
    Details
    ISSN: 1432-1440
    Keywords: Autoantibodies ; Autoimmune thyroid diseases ; Human leukocyte antigen ; Microsomal thyroid antigen ; Thyroid autoimmunity ; Thyroid peroxidase
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The prevalence of circulating autoantibodies against thyroperoxidase (mic-TPO) was determined in 3,000 healthy blood donors (age range: 23 to 60 years) from the Hamburg area. Of the blood donors, 153 (5.1 %) were found to have high titer of mic-TPO (〉 350 IU/ml). Only two auto-antibody positive subjects (0.06%) were chemically hyper- and hypothyroid, respectively. Analysis of HLA-DR specificities revealed that HLA-DR specificities DR3 and DR5 were significantly increased when compared to controls (n=1,863). Comparison of the autoantibody-positive probands with a group of disease controls, i.e., Graves' patients and patients with lymphocytic thyroiditis, revealed a higher prevalence of HLA-DR3-positive HLA haplotypes in the disease controls when compared to autoantibody positives. Individuals with a mic-TPO level greater than 2,000 IU/ml were almost exclusively found to have one HLA-DR3 or HLA-DR5 positive HLA haplotype. We conclude that a high prevalence of hightiter mic-TPO can be found in healthy blood donors. Circulating signs of thyroid autoimmunity were associated with HLA specificities also found to be associated with autoimmune thyroid diseases.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00180105
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