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  • 1
    Electronic Resource
    Electronic Resource
    Serum neopterin levels as predictor of AIDS (1988)
    Springer
    Journal of molecular medicine 66 (1988), S. 1015-1018 
    Details
    ISSN: 1432-1440
    Keywords: Neopterin ; HIV infection ; AIDS prognosis ; Laboratory parameters
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The reliability of laboratory parameters for the prediction of impending manifestion of AIDS in HIV-1 infected patients was investigated. Over a mean observation period of approximately 1 year (5 to 33 months) 56 patients were studied. Eleven patients progressed to AIDS (group 1) and 45 remained free of AIDS-defining disease (group 2). Eight candidate-predictor variables were measured on each patient at the beginning of the observation period: neopterin, hemoglobin, lymphocytes, CD4 counts, CD8 counts, platelets, gammaglobulins, and erythrocyte sedimentation rate. In a linear discrimination analysis, a stepwise entry of these parameters into the discriminant function was effected according to which variable added most to the separation into groups 1 and 2. Neopterin proved to be most discriminating with no improvement of separation when adding further variables. Thus, a final allocation rule was computed using neopterin alone. This rule assigns neopterin levels above 21.9 nmol/l to group 1 and levels below to group 2. We conclude, tentatively, that in HIV-infected patients neopterin levels of 22 nmol/l and over may indicate the manifestation of AIDS in the year to come.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01733445
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  • 2
    Electronic Resource
    Electronic Resource
    Endothelin-1 immunoreactivity in plasma is elevated in HIV-1 infected patients with retinal microangiopathic syndrome (1994)
    Springer
    Journal of molecular medicine 72 (1994), S. 288-293 
    Details
    ISSN: 1432-1440
    Keywords: HIV-1 ; Endothelins ; Endothelin-1 ; Cytokine ; Retinal microangiopathic syndrome ; Vascular disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Endothelin-1 is a recently identified cytokine with potent vasoconstrictor activity which is associated with various diseases involving blood vessels. HIV-1 related retinal microangiopathic syndrome is a frequent finding in patients with AIDS or AIDS-related complex, presenting predominantly with retinal cotton-wool spots. We investigated 55 HIV-1 infected patients by ophthalmoscopy and for endothelin-I immunoreactivity in plasma and an additional 76 HIV-1 infected patients only for endothelin-1 levels. For reference values 13 age-matched healthy subjects were studied. In 18 of 55 patients (33%) investigated ophthalmoscopically we found evidence of microangiopathic syndrome. Overall, the mean endothelin-1 immunoreactivity in plasma of HIV-1 infected patients was significantly elevated as compared to controls (4.28 ± 3.62 versus 2.72 ± 0.67 fmol/ml, P 〈 0.0001). HIV-1 infected patients with retinal microangiopathic syndrome had significantly higher plasma levels of endothelin-1 immunoreactivity (4.59 ± 1.38 fmol/ ml) compared to HIV-1 infected patients without microangiopathic syndrome (3.18 ± 1.64 fmol/ml, P = 0.003). Correlation analysis revealed that endothelin-1 immunoreactivity in plasma had no significant association with disease progression, CD4 cell count, β2-mi-croglobulin, neopterin, or age. Endothelin-1 immunoreactivity in plasma was correlated exclusively with retinal microangiopathic syndrome in one or both eyes (r = 0.45, P = 0.0006) and with the number of cotton-wool spots (r = 0.50, P = 0.0001). In conlusion, HIV-1 related retinal microangiopathic syndrome is associated with elevated plasma levels of endothelin-1. By virtue of its potent vasoconstrictor activity endothelin-1 may be involved in the pathogenesis of HIV-1 related vascular disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00180042
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  • 3
    Electronic Resource
    Electronic Resource
    Chronic pentamidine aerosol prophylaxis does not induce QT prolongation (1993)
    Springer
    Journal of molecular medicine 71 (1993), S. 319-322 
    Details
    ISSN: 1432-1440
    Keywords: Pentamidine ; Arrhythmias ; QT interval ; Long-QT syndrome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Intravenous administration of pentamidine is known to cause long-QT syndrome (Torsade de pointes tachycardias and large QT prolongation) in rare cases and to cause small QT prolongation regulary. A similar pattern is seen with other drugs known to cause a long-QT syndrome. Pentamidine aerosol prophylaxis is commonly used to prevent Pneumocystis carinii pneumonia in HIV-infected persons. The goal of this study was to clarify whether pentamidine aerosol prophylaxis induces QT prolongation. We examined 100 patients receiving pentamidine aerosol prophylaxis at a rather high dose (300 mg biweekly) for at least 1 month (range 1–24) by determinating the QT interval corrected for heart rate (QTc), blind for treatment. In a cross-sectional study, QTc was not different in 50 HIV-infected patients with chronic pentamidine aerosol prophylaxis (413 ms), 50 similar HIV-infected patients without pentamidine (407 ms), and 50 similar patients without HIV-infection and without pentamidine (407 ms). In a longitudinal study in another 50 HIV-infected patients, QTc was the same before (414 ms) and on long-term (median 9-month) pentamidine aerosol prophylaxis (414 ms). In contrast to the case with intravenous pentamidine, we found no QT prolongation and thereby no risk of long-QT syndrome with pentamidine aerosol prophylaxis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00184735
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  • 4
    Electronic Resource
    Electronic Resource
    Lymphocyte subsets as surrogate markers in antiretroviral therapy (1991)
    Springer
    Infection 19 (1991), S. S103 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Beurteilung der Effektivität einer antiretroviralen Therapie geschieht überwiegend anhand der Krankheitsprogredienz und der Überlebenszeit. Es besteht Interesse an Surrogatmarkern, die eine Aussage zu Wirksamkeit der Therapie ermöglichen, bevor es zu einer Progredienz kommt und solange ein asymptomatisches Stadium vorliegt. Gerade während asymptomatischer Stadien bieten sich Parameter, welche die Immunantwort auf die HIV-Infektion widerspiegeln, hierfür an, da eine Virämie meist noch nicht vorliegt. Die einzigen derzeit etablierten Surrogatmarker unter den Lymphozyten-Subsets sind CD4+ und CD8+ Lymphozyten. Anhand eigener Ergebnisse und Diskussion der Literatur wird auf die Möglichkeit neuer Subset-Untersuchungen eingegangen: Die Aufgliederung der CD8+ Zellen mit Markern für Aktivierung und Zytotoxizität (HLA/DR, CD38, CD57) ermöglicht eine stadienabhängige Beurteilung der Beeinflussung von zytotoxischer Immunantwort als Auswirkung der HIV-Immunpathogenese. Andere Subsets, wie beispielsweise B-Lymphozyten, CD3+4-8-Lymphozyten und Killerzellen eignen sich theoretisch weniger gut als Surrogatmarker.
    Notes: Summary Efficacy of antiretroviral treatment is evaluated usually according to reduction of serious events (e.g. opportunistic infections while on therapy) and improvement of survival time. In stages of asymptomatic disease treatment trials have to cover very long time periods to fulfil these requirements. In asymptomatic stages, when viremia is commonly absent, monitoring the host's immune response is an indirect means of measuring antiviral efficacy. CD4+ lymphocyte counts are generally accepted as surrogate in all major trials. The subsets of the CD8+ compartment reflect early and late activation and cytotoxic immune response. CD38+, CD57, CD8+ HLA/DR+ subsets reflect the host's vigorous cellular immune response even in early stages. These subsets are candidate surrogate markers in early and late stages of HIV infection. On the other hand, CD3+ CD4− CD8−, CD19/20 (B lymphocytes) and CD16+ (natural killer cells) do not exhibit any properties of candidate surrogate markers. Established and experimental cellular surrogate markers are discussed including own data and a review of the literature.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01644477
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  • 5
    Electronic Resource
    Electronic Resource
    Kombinationsbehandlung der HIV-Infektion (1997)
    Springer
    Der Internist 38 (1997), S. 1146-1153 
    Details
    ISSN: 1432-1289
    Keywords: Schlüsselwörter HIV-Infektion ; Kombinationstherapie ; Reverse-Transkriptase-Hemmer ; Protease-Inhibitoren ; Virus-Suppression
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Zum Thema Derzeit gilt methodisch nicht nur die Messung der Anzahl von CD4-Zellen sondern auch der quantitative Nachweis retroviraler RNA als Aktivitätsindikator einer HIV-Infektion. Dabei kommt dem RNA-Nachweis eher noch größere diagnostische Bedeutung zu. Bei symptomatischen Patienten ist die Indikation zur antiretroviralen Dreierkombination, heute Goldstandard der Therapie, unabhägnig von CD4-Zellzahl und HIV-RNA gegeben. Bei asymptomatischen Patienten richtet sich die Indikation zum Therapiebeginn nach der HIV-RNA im Plasma. Therapieindikationen sind: 〉5000–10000 RNA-Kopien/ml, CD4-Zahl unter 350/μl oder CD4-Zahl 〈500/μl bei meßbarer HIV-RNA und der CD4-Zellzahl. Alle Aspekte der HIV-Therapie werden hier eingehend erläutert, z.B. auch die HIV-Infektion in der Schwangerschaft und die mögliche Nadelstichinfektion durch HIV-infiziertes Material bei medizinischem Personal (Konsequenz: sofortige Behandlung!). Diese Arbeit richtet sich also keineswegs nur an Spezialisten sondern wendet sich an eine breite ärztliche Leserschaft.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001080050126
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  • 6
    Electronic Resource
    Electronic Resource
    Duplexsonography in the diagnosis of renovascular hypertension (1990)
    Springer
    Journal of molecular medicine 68 (1990), S. 830-834 
    Details
    ISSN: 1432-1440
    Keywords: Duplexsonography ; Renal artery stenosis ; Hypertension ; DSA
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Duplexsonography (DS) has become a well established method for diagnosing peripheral vascular diseases. Technical developments (higher resolution of transducer and deeper penetration) have made also abdominal and retroperitoneal vessels, including renal arteries, accessible for duplexsonography. This method provides the opportunity to recognize renal artery stenoses causing renovascular hypertension without invasive procedures. We therefore examined 86 hypertensive patients with a high likelihood of renovascular hypertension. Due to technical problems (bowel gas, adipositas) we excluded 7 patients. 79 patients (17–79 years) were included in our study. Flow patterns of several renal vascular areas were evaluated while the renal artery was demonstrated on a B-scan. A spectrumanalysis included the evaluation of the frequency pattern (widening of the frequency band and loss of a frequency free window below the systolic rise?), the sloping of the diastolic shoulder, and the calculation of different parameters like accelerationindex, decelerationindex, resistanceindex, accelerationtime, and systolic peak velocity. The accuracy of DS in diagnosing renal artery stenoses was compared with arterial digital substraction angiography (DSA). Renal artery stenoses was diagnosed in 21 out of 158 renal arteries (13%). Except for the systolic peak velocity no significant correlations could be found of any of the indices from spectrumanalysis with hemodynamically significant stenoses (〉50%). However, the following 3 criteria proved to be valuable signs of a hemodynamically significant stenoses: 1) Maximal systolic accelaration 〉3 m/s, 2) Steep sloping diastolic shoulder, and 3) Turbulence of all frequency ranges without a frequency free window below the systolic rise. Compared with DSA the sensitivity of DS was 84,0%, the specificity was 98,5%, and the predictive value 91% in significant stenoses. Abdominal DS seems to be a potent noninvasive method in diagnosing renal artery stenoses with a good sensitivity and a high specifity and a high predictive value.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01796273
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  • 7
    Electronic Resource
    Electronic Resource
    Reversible Raumforderung der Niere bei HIV Infektion (1990)
    Springer
    Journal of molecular medicine 68 (1990), S. 1032-1035 
    Details
    ISSN: 1432-1440
    Keywords: HIV ; Kidney ; Renal abscess ; Cirrhosis ; Hepatitis C
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In January 1990 a 32 year old nurse was admitted with fever, weight loss of 9 kilogramms and pain of her right flank. HIV infection due to intravenous drug abuse had been diagnosed in 1986. Ultrasonic imaging revealed a solid tumor of low echogenicity in the cranial part of the right kidney. This finding could be confirmed with computed tomography and magnetic resonance imaging. Angiographic study showed a missing of blood vessels in the same area. A transcutaneous puncture with a thin needle resulted histologically in unspecific findings like detritus, lymphoid cells and neutrophils. Antibiotic treatment with amoxicilline and cefuroxim was without success. Symptoms as well as ultrasonic findings completely disappeared following oral administration of ofloxazine. The clinical course and the successful treatment support the diagnosis of an atypical renal abscess. As a second diagnosis a histologically proven cirrhosis of the liver could be established. Hepatitis C serology proved to be positive.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01646551
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  • 8
    Electronic Resource
    Electronic Resource
    Erythrocyte antibodies in AIDS are associated with mycobacteriosis and hypergammaglobulinemia (1990)
    Springer
    Journal of molecular medicine 68 (1990), S. 1050-1053 
    Details
    ISSN: 1432-1440
    Keywords: Erythrocyte antibody ; Direct antiglobulin test ; Coombs' test ; AIDS ; Transfusion ; Mycobacteriosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Positive direct antiglobulin results prior to transfusion in some of our AIDS patients, as well as some reports in the literature on red cell antibodies in AIDS patients, prompted us to investigate the prevalence of erythrocyte antibodies in AIDS patients with transfusion requiring anemia. In addition we studied the question of relevant correlations with clinical diagnosis and with hematological and immunological laboratory parameters. Of 145 consecutive hospitalized AIDS patients (CDC criteria), 34 (23%) presented with anemia requiring transfusion. With each cross-match a routine antibody screening was performed. In cases of positive reaction additional antibody differentiation was done. Diagnoses, hematologic parameters, and therapy were studied retrospectively. Agglutination was positive in at least one test for 41% (14/34) (group 1). C3d, anti I, cold agglutinins, and IgG occurred most frequently (n=9/8/7/6 out of 14). Seventyfive per cent (12/14) had leukopenia (〈4000/μl), 57% (8/14) had thrombocytopenia (〈150000/μl), and 43% (6/14) showed both. Average values for leukocytes, thrombocytes, and CD4-positive lymphocytes did not differ significantly in patients with (group 1) and without (group 2) erythrocyte antibodies. Average gamma globulin levels were significantly increased in group 1 (23.2 g/l versus 16.9 g/l;p〈0.001). In group 1, 64% (9/14) had proven mycobacteriosis (6 atypical), in contrast to only 15% (3/20) in group 2 (p〈0.05). There were no significant differences between the two groups in prevalence of other opportunistic infections, malignant lymphoma, and Kaposi's sarcoma. Autoimmune versus infectious pathogenesis of pathologic erythrocyte antibodies in AIDS has been discussed in the literature. Our results show an association of mycobacteriosis with positive direct antiglobulin test, suggesting that autoimmunological features might be triggered by certain pathogens.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01649303
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  • 9
    Electronic Resource
    Electronic Resource
    Expansion of activated T lymphocytes (CD3+HLA/DR+) detectable in early stages of HIV-1 infection (1990)
    Springer
    Journal of molecular medicine 68 (1990), S. 393-396 
    Details
    ISSN: 1432-1440
    Keywords: T lymphocytes ; T lymphocytes, activated ; T lymphocytes, cytotoxic ; HIV ; AIDS ; Flow cytometry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The phenotypic characterization of lymphocyte subsets in relation to different clinical stages of HIV infection has mainly focussed on CD4 and CD8 cells. Some reports focus on expansion of activated T lymphocytes in AIDS patients. Yet there is no detailed knowledge whether such changes occur also in earlier stages of HIV infection. In order to describe the kinetics and possible pathogenetic meaning of this subset when related to all distinct chronologic stages, we performed two-color flow cytometric lymphocyte differentiation in 173 HIV-infected patients and 30 healthy controls. All subjects were classified according to the Walter Reed (WR) system. Our results show that a significant increase of activated T lymphocytes (CD3+HLA/DR+) occurs early, in WR1 and WR2, thus preceding the clinically relevant CD4 depletion. This increase is paralleled by an expansion of CD 8+Leu7+cytotoxic cells. We conclude, thatearly changes of lymphocyte subsets are detectable in addition to inversion of the CD4/ CD8 ratio. The possible pathogenetic meaning including the question of possible autoimmune mechanisms is discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01648577
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  • 10
    Electronic Resource
    Electronic Resource
    Chylothorax as fatal complication in fulminating Kaposi's sarcoma in a patient with AIDS (1991)
    Springer
    Journal of molecular medicine 69 (1991), S. 134-134 
    Details
    ISSN: 1432-1440
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Kaposi's sarcoma (KS) is one of the earliest and most frequent manifestations of the acquired immunodeficiency syndrome. About 20 percent of all German AIDS patients present with KS as their first sign of AIDS. Visceral involvement occurs in up to 40% percent of patients with disseminated KS [1, 2, 3]. Fatal complications are known in pulmonary and gastrointestinal KS. They include respiratory failure and fatal bleeding [1, 2]. To our knowledge an arrosion of the thoracic duct with chylothorax has not yet been reported.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01795958
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