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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Medical microbiology and immunology 185 (1996), S. 163-170 
    ISSN: 1432-1831
    Keywords: Key words HLA B27 ; Yersinia ; Interferon-γ ; Bacterial invasion ; Persistence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To examine the role of the human HLA class I molecule B27 in the direct interaction of yersinia and human cells we performed experimental infections of constitutive HLA B27-positive and -negative human fibroblast monolayers with Yersinia enterocolitica O.3. The numbers of yersiniae invading HLA B27-positive cells were within the range of HLA B27-negative cells. Treatment of fibroblasts with interferon-γ (IFN-γ) to enhance HLA B27 expression did not alter invasion. IFN-γ reduced titers of live intracellular bacteria, but not bacterial antigens, in a dose-dependent manner. Persistent infection with yersinia could be maintained for up to 10 weeks with decreasing bacterial titers and more slowly decreasing amounts of yersinial antigens in HLA B27-positive and -negative cells. Endogenous HLA B27 does not modulate the direct interaction of yersiniae with primary human fibroblasts. This is in contrast to infection of HLA B27-transfected murine cells. The protective effect of IFN-γ for yersinia-infected cells may be important for controlling complications in patients with yersiniosis.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Medical microbiology and immunology 187 (1999), S. 157-164 
    ISSN: 1432-1831
    Keywords: Key wordsYersinia enterocolitica ; Cytokines ; Fibroblasts ; Arthritis ; Pathogenesis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Bacteria or bacterial antigen triggering reactive arthritis have been detected in inflamed joint tissue and fluid of patients. Although live yersiniae have not yet been found in joints of patients with Yersinia arthritis, early dissemination and propagation has been proposed. In this study, we investigated the influence of the proinflammatory cytokines interleukin- (IL-) 1β, tumor necrosis factor- (TNF-) α, the Th1 lymphokine interferon- (IFN-) γ, and the Th2 lymphokine IL-4 on the intracellular survival of Yersinia enterocolitica O.3 in primary human fibroblast cell monolayers as a model for joint tissue. Bacterial titers in infected cells decreased significantly and in a dose-dependent manner following treatment with IL-1β, TNF-α, or IFN-γ. The bactericidal effects of IL-1β and TNF-α were synergistic. In contrast, IL-4 significantly supported bacterial survival. In addition, IL-4 antagonized in part the bactericidal effect of TNF-α and IFN-γ. Although IL-1β, TNF-α, and IFN-γ accelerated killing of intracellular yersiniae the ratio of cells containing bacterial antigen did not differ from that in untreated cells. The differential effects of the investigated cytokines on intracellular survival of yersiniae may be of relevance for the development of Yersinia arthritis: enhanced production of IL-4 by synovial tissue may prolong the survival of yersiniae and persistence of antigen, and thus potentiate immune complex formation and inflammation. In conclusion these results show (1) that fibroblasts can take up virulent yersiniae as non-professional phagocytes and (2) that cytokines, found in the joints of patients with Yersinia arthritis, are able to affect the intracellular survival of yersiniae differentially.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 153 (1994), S. 107-109 
    ISSN: 1432-1076
    Keywords: Key words: Neurofibromatosis – Hypertension – Bowel infarction – Aneurysm – Thrombosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. In a boy with neurofibromatosis type 1 (NF-1), hypertension, septic infection of an aneurysm in the deltoid muscle, bowel infarction, multiple arterial aneurysms and venous thrombosis occurred within a period of 6 weeks. Histologically, vascular neurofibromatosis of the small vessels of the gut was found. This unusual occurrence of a multitude of clinical features within a few weeks was caused by vascular neurofibromatosis. Awareness of this condition in patients with NF-1 may help the paediatrician to avoid unnecessary diagnostic procedures and to initiate appropriate symptomatic therapy.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1076
    Keywords: Epstein-Barr virus ; Lymphoproliferative syndrome ; Inherited immunodeficiency
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report on a 30-month-old previously healthy Turkish boy who presented with fever, hepatosplenomegaly and generalized lymphadenopathy. He died 4 months after admission in spite of treatment with steroids, acycloguanosine and cyclophosphamide. Epstein-Barr virus (EBV) DNA was detected in the patient's bone marrow and in a lymph node biopsy. Cells from the lymph node biopsy showed monoclonal rearrangements of immunoglobulin heavy chain genes but no rearrangements of T-cell receptor β-chain genes or immunoglobulin kappa chain genes. Serological data indicated chronic active EBV infection. There was a slight increase of CD8 positive cells in peripheral blood and a normal response to T-cell mitogens. However, T-cell lines established with interleukin 2 from lymph node biopsy completely failed to kill autologous EBV-transformed B-cells and K 562 target cells. Moreover, in regression tests the patient's peripheral blood mononuclear cells completely failed to limit outgrowth of autologous EBV infected B-cells. We conclude that the patient's selective immunodeficiency had led to the rapid development of EBV-associated monoclonal lymphoproliferation.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1076
    Keywords: Neuroborreliosis ; Borrelia burgdorferi ; Polymerase chain reaction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Diagnosis of neuroborreliosis is often difficult since history and clinical presentation may be non-specific and serological tests may initially be negative. We therefore tested the polymerase chain reaction (PCR) for the detection of borrelial sequences in CSF and urine samples of consecutive children with neuroborreliosis seen in a single summer season. Four of eight children were negative in serum for antibodies toBorrelia burgdorferi. Two of eight children were PCR-positive in CSF and one other child was positive in urine. In two out of four children PCR was the only laboratory test confirming the clinical diagnosis. All children recovered after treatment with third generation cephalosporins. When seven of eight children were re-examined 6 months later all were healthy and antibodies toB. burgdorferi were detected in their serum. PCR may assist the paediatrician in establishing a diagnosis of neuroborreliosis; however, a negative result does not rule out neuroborreliosis. PCR is an adjunct, but no substitute for clinical judgement and serology.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-1076
    Keywords: Key words Lyme borreliosis ; Lyme ; arthritis ; Borrelia burgdorferi ; Lymphocyte proliferation assay
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To assess the contribution of the lymphocyte proliferation assay in response to borrelial antigens to establishing a diagnosis of Lyme arthritis (LA) the response to two strains of Borrelia burgdorferi was tested in peripheral blood lymphocytes of 103 children and adolescents with arthritis, among them 55 with LA and 48 control patients. Patients with LA had a significantly higher response to borrelial antigens than control patients. However, there were several patients with false positive and false negative test results. Specificity and sensitivity of the test were 78% and 77%. In patients with LA the test may turn positive after antibiotic therapy and remain positive for up to 19 months after the disappearance of arthritis. The test does not aid in prognosis or follow up. In one patient with seronegative LA specific lymphocyte proliferation and polymerase chain reaction for borrelial fla sequences in urine were positive. Conclusion Rarely the lymphocyte proliferation assay may aid in finding the correct diagnosis when clinical presentation and anti-borrelial serology do not match.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 148 (1989), S. 428-430 
    ISSN: 1432-1076
    Keywords: Aseptic meningitis ; Borrelia burgdorferi ; Lyme disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Borrelia burgdorferi (B. b.) was isolated from cerebrospinal fluid from two children with aseptic meningitis. Serology forB. b. was initially negative or borderline and became positive during the subsequent course. Children with aseptic meningitis of unknown origin should be re-evaluated within 1 month to detect possible increasing antibody titres toB. b. Aseptic meningitis may be a stage 1 manifestation of Lyme disease.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 152 (1993), S. 810-812 
    ISSN: 1432-1076
    Keywords: Borrelia burgdorferi ; Guillain-Barré syndrome ; Polymerase chain reaction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 4.5-year-old child suffered from rapidly evolving motor weakness with paresthesia and radicular pain in both legs, accompanied by an isolated elevation of protein levels in CSF. Isoelectric focusing revealed oligoclonal IgG produced in the cerebrospinal compartment only. The diagnosis of Guillain-Barré syndrome was confirmed by electrophysiological studies. High antibody titres againstBorrelia burgdorferi in the serum and specific antibodies in the CSF were demonstrable by ELISA and immunoblotting.B. burgdorferi specific DNA fragments were demonstrated in urine and CSF by means of a nested polymerase chain reaction (PCR), thus providing the borrelial aetiology and indicatingB. burgdorferi infection. Complete recovery was observed after treatment with high dose immunoglobulin and ceftriaxone and control urine specimens were PCR negative.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-1076
    Keywords: Lyme borreliosis ; Lyme arthritis ; Borrelia burgdorferi ; Lymphocyte proliferation assay
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Abstract To assess the contribution of the lymphocyte proliferation assay in response to borrelial antigens to establishing a diagnosis of Lyme arthritis (LA) the response to two strains ofBorrelia burgdorferi was tested in peripheral blood lymphocytes of 103 children and adolescents with arthritis, among them 55 with LA and 48 control patients. Patients with LA had a significantly higher response to borrelial antigens than control patients. However, there were several patients with false positive and false negative test results. Specificity and sensitivity of the test were 78% and 77%. In patients with LA the test may turn positive after antibiotic therapy and remain positive for up to 19 months after the disappearance of arthritis. The test does not aid in prognosis or follow up. In one patient with seronegative LA specific lymphocyte proliferation and polymerase chain reaction for borrelialfla sequences in urine were positive. Conclusion Rarely the lymphocyte proliferation assay may aid in finding the correct diagnosis when clinical presentation and anti-borrelial serology do not match.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-1076
    Keywords: Key words Chronic recurrent multifocal osteomyelitis ; SAPHO syndrome ; Diagnostic imaging ; Non-steroidal anti-inflammatory drugs
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Chronic recurrent, uni- or multifocal osteomyelitis (CRMO), an inflammatory disorder of unknown origin, involves mk:/night/arul/4310946m.3dultiple osseous sites and may affect the clavicle. We report on 6 children with clavicular involvement out of 11 children suffering from CRMO. The major clinical symptoms were local swelling and pain. Five children had hyperostosis of the clavicle and synovitis of adjacent joints. Histology showed chronic osteomyelitis with a predominance of lymphocytes in the inflammatory infiltrates. Cultures of biopsy tissue specimens were sterile. The patients were followed for at least 3.5 years. Three patients had up to six relapses. The most effective diagnostic tools to define CRMO were standard X-ray and bone scan in combination with biopsy and cultures. In our patients CT and MRI were misleading as they suggested the presence of malignancy. However, the sensitivity of MRI to detect involvement of bone, adjacent joints and soft tissues were better in comparison to X-ray or bone scan. Non-steroidal anti-inflammatory drugs were effective in reducing pain, swelling and limitation of motion. Reconstructive surgery was not indicated in any case. The long-term outcome of growth and function of affected bones was excellent. Conclusion Diagnosis of chronic osteomyelitis of the clavicle should be made by history and physical examination and be confirmed by standard X-ray, bone scan and open biopsy. In contrast MRI and CT can provide data on the involvement of adjacent joints, soft tissue and muscles especially in the early process of disease, but do not add information relevant to the patient's management. Treatment with non-steroidal anti-inflammatory drugs is rapidly beneficial in most patients.
    Type of Medium: Electronic Resource
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