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  • 1
    ISSN: 1520-4995
    Source: ACS Legacy Archives
    Topics: Biology , Chemistry and Pharmacology
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1831
    Keywords: Key wordsTrypanosoma cruzi ; Interferon-γ ; Interleukin-4 ; T cell-mediated immunity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Interferon-γ (IFN-γ) is the most important mediator of inhibition of intracellular replication of Trypanosoma cruzi in vitro and has a protective effect against this parasite if administered in vivo. Here we have analyzed the importance of IFN-γ for resistance against a lethal infection with T. cruzi in a mouse model system. Resistant B6D2 mice survived the infection with a virulent strain of T. cruzi, whereas susceptible BALB/c mice died within 3 weeks. Both strains produced large amounts of IFN-γ after infection. Surprisingly, susceptible mice had higher serum concentrations of IFN-γ and showed, using in situ hybridization a stronger increase in IFN-γ mRNA-producing cells in their spleens than resistant mice. Moreover, this pattern was also found when immune spleen cells were stimulated with parasite antigens in vitro. However, a marked difference between these mice was found in the production of IL-4, which was much higher in susceptible mice in vivo and in vitro. No difference was found for IL-10. These data show that, at least in the mouse strain/parasite combination used, production of IFN-γ is not the decisive factor determining resistance or susceptibility to T. cruzi. Rather, it is possible that the balance between protective (e.g., IFN-γ) and exacerbative cytokines (e.g., IL-4) may decide over disease control or progression.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1831
    Keywords: Key words  Infant rat ; Bacterial meningitis ; Cerebrospinal fluid ; Blood contamination ; Sangur test strips
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract   The infant rat model is widely used to study the pathogenesis of meningitis caused by a variety of gram-positive and gram-negative bacteria. However, the interpretation of published results concerning meningitis is difficult in many records because the fact that blood contamination of the cerebrospinal fluid (CSF) cannot be avoided during the traumatic puncture procedure has not been taken into consideration. Since bacterial invasion of the central nervous system develops following bacteremia in this model, blood contamination of the CSF leads to a falsification of the CSF bacterial counts. Here we present an evaluation of a rapid and quantitative test for CSF blood contamination using Sangur test strips. The procedure requires minimal amounts of CSF and allows direct calculation of the CSF bacterial load due to blood contamination and, thus, provides refined criteria for the presence of bacterial meningitis in the infant rat model. It is superior to the detection of erythrocytes using a hemocytometer since it is less time consuming. Furthermore, we demonstrate the value of this method for the experimental infection of rats with Neisseria meningitis.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1831
    Keywords: Key wordsNeisseria meningitidis ; Infant rat ; Sialic acid ; Capsule ; Lipooligosaccharide sialylation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We investigated the contribution of the polysialic acid capsule and of terminal lipooligosaccharide (LOS) sialylation to the pathogenicity of Neisseria meningitidis in vivo using a set of defined isogenic mutants of the N. meningitidis strain B 1940 deficient in either capsule synthesis or LOS sialylation. Furthermore a spontaneous capsule-deficient variant was investigated, which was capable of switching on the capsule synthesis at a frequency of 3×10–3 in vitro. Infection of infant rats with the wild-type strain revealed a high potential to cause bacteremia. This potential was attenuated in the capsule-phase variable mutant (LOS sialylation+). However, using a mutant irreversibly deficient in capsule synthesis, but expressing a sialylated LOS, bacteremia could only be achieved using 106 times higher numbers of bacteria when compared to the wild-type. The unencapsulated bacteria were located extracellularly upon examination of blood smears, suggesting that defense mechanisms, i. e. phagocytosis, directed against unencapsulated meningococci were exhausted using very high infecting doses. Interestingly, when infant rats were infected with encapsulated meningococci which were unable to sialylate the LOS, bacteremia could never be achieved, even with an infective dose as high as 108 colony forming units (CFU). Despite the presence of capsular polysaccharide this mutant was phagocytosed by peritoneal phagocytes, as was the unencapsulated, LOS-sialylated mutant, suggesting that the inability to cause bacteremia was due to a higher susceptibility to the action of the complement system, which is virtually unsaturable. We conclude that in the infant rat model of meningococcal infection both forms of sialic acid on the bacterial cell surface are indispensable for systemic survival.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Good clinical practice ; „Null-Arm” ; Arzt-Patienten-Zusammenarbeit ; Key words Good clinical practice ; ”No treatment group” ; Doctor-patient-interaction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Guidelines of good clinical practice regulate controlled clinical studies. Goal of the study, type of treatment and possible side effects have to be explained. The physician faces problems, if the study includes a ”no treatment group”. Referring to the literature and based on our own experience with tumor patients, several criteria are proposed to optimize the recruitment of patients. Important points are:  Explanations should be given by an experienced doctor. He must be informed about the study and therapeutic alternative treatments. • The atmosphere for the talk must be quiet. The participation of a person whom the patient trusts is desirable. • The necessity of the study must be explained. Randomization in different study groups should be discussed without any preference. • Prognosis should be explained without any detailed statistical data. • Form of treatment, possible side effects and control examinations have to be discussed. The family physician’s cooperation should be stressed. • Personal autonomy in the patient’s decision to participate in the study must be emphasized. Enough time for reflection must be granted before the final decision. It must be assured that the patient receives the same medical attention even after rejecting the study. These recommendations might help to avoid major mistakes which are harmful for the doctor-patient-relationship and further tumor therapy. A good initial discussion forms the basis for effective cooperation during tumor treatment. It may counteract the personal fear and negative reports in media of being ”a guinea pig”. The patient will appreciate the efforts of the doctor to provide optimal therapy. Furthermore, he will realize that such studies are necessary to improve future therapies.
    Notes: Zusammenfassung Bei der Durchführung von klinischen Studien nach den Richtlinien der Good Clinical Practice (GCP) muß der Patient umfassend über Studienziel, Art der Behandlung und mögliche Nebenwirkungen aufgeklärt werden. Der aufklärende Arzt stößt auf Schwierigkeiten, wenn es sich dabei um randomisierte Studien mit einem sog. „Null-Arm” handelt (keine Therapie, Placebo, nur Operation ohne zusätzliche medikamentöse Therapie). Die Autoren haben aufgrund der Literatur und ihrer eigenen Erfahrungen mit Tumorpatienten Kriterien erarbeitet, die dieses Aufklärungsgespräch effektiver gestalten sollen. Wesentliche Punkte sind: • Die Aufklärung sollte durch einen erfahrenen Arzt, der nicht nur über die Studie, sondern auch über therapeutische Alternativen informiert ist, erfolgen. • Eine ruhige Gesprächsatmosphäre unter Hinzuziehung einer Vertrauensperson des Patienten ist wünschenswert. • Die Notwendigkeit der Studie muß eingehend erläutert werden. Bei mehreren Studienarmen sollte der aufklärende Arzt keine Präferenz erkennen lassen. • Die Prognose ist zu erläutern, ohne jedoch primär exakte statistische Zahlen zu nennen. • Verabreichung der Studienmedikation, mögliche Nebenwirkungen und begleitende Kontrolluntersuchungen sind detailliert zu erklären. Die Kooperation mit dem Hausarzt bei der Durchführung der Studie ist zu besprechen. • Dem Patienten ist die Entscheidungsautonomie zu verdeutlichen. Für die Entscheidung muß ausreichend Bedenkzeit eingeräumt werden. Dem Patienten sollte klar sein, daß er jederzeit seine Entscheidung rückgängig machen kann, und trotzdem die gleiche aufmerksame ärztliche Fürsorge erhalten bleibt. Durch Beachtung dieser Grundsätze können gravierende Fehler vermieden werden, die das Arzt-Patienten-Verhältnis in der Tumortherapie beeinträchtigen. Ein gutes Aufklärungsgespräch als Grundlage für die weitere Zusammenarbeit von Arzt und Patient kann auch dem möglichen Empfinden und Pressemitteilungen entgegenwirken, daß„der Patient ein Versuchsobjekt” sei. Das Bemühen des Arztes um die optimale Therapie wird transparent und der Patient wird verstehen, daß die Studienplanung in seinem Sinne und im Sinne der zukünftigen Therapieverbesserung angeboten wird.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Der Hautarzt 49 (1998), S. 556-559 
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Tumoren ; Schwenklappenplastik ; Kosmetische Chirurgie ; Key words Tumors ; Rotating flaps ; Cosmetic surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The closure of large circular defects on the scalp is technically difficult and cosmetically often not satisfying, if a free transplant is necessary. Following the technique of Tillmann described first in 1908, several flaps shaped like a windmill can be combined. We report on 14 patients (ages 41–88 years) where large defects resulting from the excision of various tumors (5 melanomas, 5 basal cell carcinomas, 1 keratoacanthoma, 1 trichilemmal cyst, 1 squamous cell carcinoma, 1 skin metastasis) were successfully closed by this method. The diameter of the defect ranged between 4 and 8 cm (mean 5,7 cm). Size and number of the rotating flaps (3 or 4) was varied according to the size of the defect and the mobility of the surrounding tissue. The procedure was performed with local anesthesia in all cases. Wound healing occurred without complications except in 3 cases. 2 patients (63 years, 70 years) developed small necrotic areas on the tips of the flaps. In a 74 year old man with a very large defect of 8 cm diameter, one flap of four underwent total necrosis. The cosmetic result was rated ”very good” in 71,4% and ”good” in 14,3%. The preservation of the terminal hair turned out to be of special advantage. The ”windmill procedure” is an important addition to the surgical approaches for closure of large defects on the scalp, particularly in young patients.
    Notes: Zusammenfassung Der Verschluß von großen zirkulären Defekten auf dem behaarten Kopf ist technisch schwierig und kosmetisch oft unbefriedigend, wenn ein freies Transplantat verwendet werden muß. Bei der von Tillmann 1908 erstmals beschriebenen Technik werden mehrere Schwenklappen in Form eines Windmühlenmusters kombiniert. Wir berichten über 14 Patienten (Alter 41–88 Jahre), bei denen große Defekte nach Exzision verschiedener Tumoren mit dieser Methode erfolgreich verschlossen werden konnten (5 Melanome, 5 Basaliome, 1 Keratoakanthom, 1 Tricholemmalzyste, 1 Spinaliom, 1 Hautmetastase). Der Defektdurchmesser variierte zwischen 4 und 8 cm (Mittelwert 5,7 cm). Größe und Anzahl der Schwenklappen (3 oder 4) wurden jeweils der Größe des Hautdefektes bzw. der Mobilisationsreserve der Defektumgebung angepaßt. Der Eingriff konnte in allen Fällen in Lokalanästhesie durchgeführt werden. Die Wundheilung war komplikationslos bis auf 3 Fälle: Zwei Patienten (63 Jahre, 70 Jahre) entwickelten umschriebene Lappenspitzennekrosen. Bei einem 74jährigen mit sehr großem Defekt von 8 cm ∅ zeigte ein Lappen von vieren eine vollständige Nekrose. Das kosmetische Ergebnis wurde in 71,4% als „sehr gut” und in 14,3% als „gut” eingestuft. Die Erhaltung des Terminalhaares erwies sich als besonderer Vorteil. Die „Windmühlenplastik” ist eine wichtige Ergänzung der Operationstechniken zum Verschluß großer Defekte auf dem Kapillitium, insbesondere bei jüngeren Patienten.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Experimental brain research 128 (1999), S. 200-204 
    ISSN: 1432-1106
    Keywords: Key words Eye-hand coordination ; Human ; Saccade ; Vision ; Bimanual coordination
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Two different drawer tasks were investigated with the aim of assessing the role of eye movements in well-coordinated hand movements. In an unimanual step-tracking task, which had a predictive and an unpredictive movement, a two-way repeated-measures ANOVA showed a significant effect of prediction on the onset of grip-force (GF) rate (300±39 ms for the predictive condition versus 394±53 ms for the non-predictive condition, P〈0.0001). Correlation coefficients, computed from the eye and the hand movements were low for the right and the left hand. The saccade was more coupled with the visual step change than with the action of the hand per se. In a second bimanual pull-and-pick task, the instruction was to pull a drawer with the left hand from a closed position to a LED-cued open position and then to grasp and reinsert a small peg in the drawer with the right hand. Correlation coefficients, computed from the latencies of saccades and of the leading left hand or of the right hand, were significant in four of five subjects. Intermanual correlations were significant in all five subjects. In conclusion, we found that the initial saccade in the unimanual task was best related with the visual step change, but was poorly correlated with the pulling/pushing hand. In the bimanual task, a moderate, but significant temporal coupling between the eyes and hand events was observed. This coupling was, however, less tight than that between both hands.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 139 (1997), S. 845-850 
    ISSN: 0942-0940
    Keywords: Apoptosis ; astrocytic neoplasms ; bcl-2 ; immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Apoptosis is a form of programmed cell death characterized by specific morphologic and biochemical properties. Tumorgenesis is the consequence not only of cell proliferation but also the loss of the ability to undergo apoptosis [2]. Bcl-2 is a protooncogene which has the ability to block apoptosis in many cell types. Astrocytic neoplasms are very aggressive tumors which many times fail to respond to surgery, radiation or chemotherapy. They frequently overexpress wild-type p53 which is associated with the expression of bcl-2, and thus they may have evolved a mechanism to subvert apoptosis and allow continued growth. We examined the apoptotic index in fifty-nine astrocytic tumors of various histological grades (Oncor ApopTag PlusIn Situ Detection Kit) and compared this with the level of bcl-2 expression. Low grade astrocytomas (0.21 ±0.05; range 0.0–0.9) and anaplastic astrocytomas (0.27 ±0.13; range 0.0–2.6) had significantly less apoptosis than glioblastomas (0.70 ± 0.13; range 0.0–2.1; Kruskal-Wallis test, P ≤0.01). In contrast, bcl-2 expression was similar in all grades of astrocytic tumors and did not correlate with the apoptotic index. Cells of low grade and anaplastic astrocytomas are less likely to undergo apoptosis; however, this does not seem to be a direct consequence of the regulation of bcl-2 expression. The difference in growth potential despite differences in apoptotic index is likely to be attributed to differences in mitotic not apoptotic activity.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: This article describes the results of an EECDRG multicentre study on contact allergy to corticosteroids. A total of 7238 patients were investigated: 6238 in 13 centres in the course of 1993, and 1000 patients in 1 centre in 1993 and 1994. The 5 corticosteroids tested were budesonide 0.1% pet., betamethasone-17-valerate 1% pet., clobetasol-17-propionate 1% pet., hydrocortisone-17-butyrate 1% eth., and tixoeortol-21-pivalate 1%., pet.; 189 (2.6%) gave a positive patehtest reaction (+, ++, +++)to at least 1 of the corticosieroids. The data regarding the corticosteroid-sensitive patients, as well as the patchtest results, were recorded on a standardized form.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Worldwide, there are 3 major standard series of patch tests, the European, North American and Japanese, together presenting 32 allergens, the differences between them being the result of regional variation in allergen distribution as well as differences in dermatological opinion. We propose a “minimal” international standard series of 20 allergens, together with an “extended” international standard series of 14 allergens.
    Type of Medium: Electronic Resource
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