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1.
Exp Eye Res ; 173: 113-120, 2018 08.
Article in English | MEDLINE | ID: mdl-29746818

ABSTRACT

Tissues of the central nervous system (CNS), including the optic nerve (ON), are considered a-lymphatic. However, lymphatic structures have been described in the dura mater of human ON sheaths. Since it is known that lymphatic markers are also expressed by single non-lymphatic cells, these results need confirmation according to the consensus statement for the use of lymphatic markers in ophthalmologic research. The aim of this study was to screen for the presence of lymphatic structures in the adult human ON using a combination of four lymphatic markers. Cross and longitudinal cryo-sections of human optic nerve tissue (n = 12, male and female, postmortem time = 15.8 ± 5.5 h, age = 66.5 ± 13.8 years), were obtained from cornea donors of the Salzburg eye bank, and analyzed using immunofluorescence with the following markers: FOXC2, CCL21, LYVE-1 and podoplanin (PDPN; lymphatic markers), Iba1 (microglia), CD68 (macrophages), CD31 (endothelial cell, EC), NF200 (neurofilament), as well as GFAP (astrocytes). Human skin sections served as positive controls and confocal microscopy in single optical section mode was used for documentation. In human skin, lymphatic structures were detected, showing a co-localization of LYVE-1/PDPN/FOXC2 and CCL21/LYVE-1. In the human ON however, single LYVE-1+ cells were detected, but were not co-localized with any other lymphatic marker tested. Instead, LYVE-1+ cells displayed immunopositivity for Iba1 and CD68, being more pronounced in the periphery of the ON than in the central region. However, Iba1+/LYVE-1- cells outnumbered Iba1+/LYVE-1+ cells. PDPN, revealed faint labeling in human ON tissue despite strong immunoreactivity in rat ON controls, showing co-localization with GFAP in the periphery. In addition, pronounced autofluorescent dots were detected in the ON, showing inter-individual differences in numbers. In the adult human ON no lymphatic structures were detected, although distinct lymphatic structures were identified in human skin tissue by co-localization of four lymphatic markers. However, single LYVE-1+ cells, also positive for Iba1 and CD68 were present, indicating LYVE-1+ macrophages. Inter-individual differences in the number of LYVE-1+ as well as Iba1+ cells were obvious within the ONs, most likely resulting from diverse medical histories of the donors.


Subject(s)
Biomarkers/metabolism , Chemokine CCL21/metabolism , Forkhead Transcription Factors/metabolism , Lymphatic Vessels/metabolism , Membrane Glycoproteins/metabolism , Optic Nerve/metabolism , Vesicular Transport Proteins/metabolism , Aged , Aged, 80 and over , Female , Fluorescent Antibody Technique, Indirect , Humans , Macrophages/metabolism , Male , Microscopy, Fluorescence , Middle Aged , Skin/metabolism , Young Adult
2.
Exp Eye Res ; 159: 30-39, 2017 06.
Article in English | MEDLINE | ID: mdl-28315338

ABSTRACT

Only few tissues lack lymphatic supply, such as the CNS or the inner eye. However, if the scleral border is compromised due to trauma or tumor, lymphatics are detected in the eye. Since the situation in the optic nerve (ON), part of the CNS, is not clear, the aim of this study is to screen for the presence of lymphatic markers in the healthy and lesioned ON. Brown Norway rats received an unilateral optic nerve crush (ONC) with defined force, leaving the dura intact. Lesioned ONs and unlesioned contralateral controls were analyzed 7 days (n = 5) and 14 days (n = 5) after ONC, with the following markers: PDGFRb (pericyte), Iba1 (microglia), CD68 (macrophages), RECA (endothelial cell), GFAP (astrocyte) as well as LYVE-1 and podoplanin (PDPN; lymphatic markers). Rat skin sections served as positive controls and confocal microscopy in single optical section mode was used for documentation. In healthy ONs, PDGFRb is detected in vessel-like structures, which are associated to RECA positive structures. Some of these PDGFRb+/RECA+ structures are closely associated with LYVE-1+ cells. Homogenous PDPN-immunoreactivity (IR) was detected in healthy ON without vascular appearance, showing no co-localization with LYVE-1 or PDGFRb but co-localization with GFAP. However, in rat skin controls PDPN-IR was co-localized with LYVE-1 and further with RECA in vessel-like structures. In lesioned ONs, numerous PDGFRb+ cells were detected with network-like appearance in the lesion core. The majority of these PDGFRb+ cells were not associated with RECA-IR, but were immunopositive for Iba1 and CD68. Further, single LYVE-1+ cells were detected here. These LYVE-1+ cells were Iba1-positive but PDPN-negative. PDPN-IR was also clearly absent within the lesion site, while LYVE-1+ and PDPN+ structures were both unaltered outside the lesion. In the lesioned area, PDGFRb+/Iba1+/CD68+ network-like cells without vascular association might represent a subtype of microglia/macrophages, potentially involved in repair and phagocytosis. PDPN was detected in non-lymphatic structures in the healthy ON, co-localizing with GFAP but lacking LYVE-1, therefore most likely representing astrocytes. Both, PDPN and GFAP positive structures are absent in the lesion core. At both time points investigated, no lymphatic structures can be identified in the lesioned ON. However, single markers used to identify lymphatics, detected non-lymphatic structures, highlighting the importance of using a panel of markers to properly identify lymphatic structures.


Subject(s)
Blood Vessels/pathology , Lymphatic Vessels/pathology , Membrane Glycoproteins/biosynthesis , Optic Nerve Injuries/diagnosis , Optic Nerve/blood supply , Receptors, Cell Surface/biosynthesis , Animals , Biomarkers/metabolism , Cell Count , Disease Models, Animal , Female , Immunohistochemistry , Male , Microscopy, Confocal , Microscopy, Immunoelectron , Optic Nerve Injuries/metabolism , Rats
3.
Bull Exp Biol Med ; 161(1): 11-4, 2016 May.
Article in English | MEDLINE | ID: mdl-27270940

ABSTRACT

We analyzed the dynamics of neuropathic pain development and changes in catalase and superoxide dismutase (SOD) activities in the brain, liver, and skeletal muscles of male Wistar rats with 1-month streptozotocin-induced diabetes mellitus. A decrease in mechanical nociceptive threshold was revealed that progressed during the disease progress. Insulin treatment restored nociceptive threshold in diabetic animals to the control values. Catalase activity in the liver and skeletal muscles of diabetic rats increased by 1.5 and 2 times, respectively, in comparison with the control, while insulin treatment reduced enzyme activity to the control level. In the brain, catalase activity was reduced by 1.5 times and insulin therapy did affect this parameter. SOD activity in the studied tissues remained unchanged during diabetes and was not affected by insulin therapy. A strong negative correlation between nociceptive threshold in rats and catalase activity in their liver and skeletal muscles was found.


Subject(s)
Antioxidants/metabolism , Pain/enzymology , Animals , Catalase/metabolism , Diabetes Mellitus, Experimental , Glutathione Peroxidase/metabolism , Liver/enzymology , Male , Muscle, Skeletal/enzymology , Oxidative Stress/physiology , Rats , Rats, Wistar , Stress, Mechanical , Superoxide Dismutase/metabolism
4.
Exp Eye Res ; 136: 59-71, 2015 Jul.
Article in English | MEDLINE | ID: mdl-26001526

ABSTRACT

Glaucoma is a group of neurodegenerative diseases characterized by the progressive loss of retinal ganglion cells (RGCs) and their axons, and is the second leading cause of blindness worldwide. Elevated intraocular pressure is a well known risk factor for the development of glaucomatous optic neuropathy and pharmacological or surgical lowering of intraocular pressure represents a standard procedure in glaucoma treatment. However, the treatment options are limited and although lowering of intraocular pressure impedes disease progression, glaucoma cannot be cured by the currently available therapy concepts. In an acute short-term ocular hypertension model in rat, we characterize RGC loss, but also microglial cell activation and vascular alterations of the retina at certain time points. The combination of these three parameters might facilitate a better evaluation of the disease progression, and could further serve as a new model to test novel treatment strategies at certain time points. Acute ocular hypertension (OHT) was induced by the injection of magnetic microbeads into the rat anterior chamber angle (n = 22) with magnetic position control, leading to constant elevation of IOP. At certain time points post injection (4d, 7d, 10d, 14d and 21d), RGC loss, microglial activation, and microvascular pericyte (PC) coverage was analyzed using immunohistochemistry with corresponding specific markers (Brn3a, Iba1, NG2). Additionally, the tightness of the retinal vasculature was determined via injections of Texas Red labeled dextran (10 kDa) and subsequently analyzed for vascular leakage. For documentation, confocal laser-scanning microscopy was used, followed by cell counts, capillary length measurements and morphological and statistical analysis. The injection of magnetic microbeads led to a progressive loss of RGCs at the five time points investigated (20.07%, 29.52%, 41.80%, 61.40% and 76.57%). Microglial cells increased in number and displayed an activated morphology, as revealed by Iba1-positive cell number (150.23%, 175%, 429.25%,486.72% and 544.78%) and particle size analysis (205.49%, 203.37%, 412.84%, 333.37% and 299.77%) compared to contralateral control eyes. Pericyte coverage (NG2-positive PC/mm) displayed a significant reduction after 7d of OHT in central, and after 7d and 10d in peripheral retina. Despite these alterations, the tightness of the retinal vasculature remained unaltered at 14 and 21 days after OHT induction. While vascular tightness was unchanged in the course of OHT, a progressive loss of RGCs and activation of microglial cells was detected. Since a significant loss in RGCs was observed already at day 4 of experimental glaucoma, and since activated microglia peaked at day 10, we determined a time frame of 7-14 days after MB injection as potential optimum to study glaucoma mechanisms in this model.


Subject(s)
Blood-Retinal Barrier/pathology , Disease Models, Animal , Microglia/pathology , Ocular Hypertension/pathology , Retinal Ganglion Cells/pathology , Acute Disease , Animals , Antigens/metabolism , Biomarkers/metabolism , Blood-Retinal Barrier/metabolism , Calcium-Binding Proteins/metabolism , Female , Fluorescent Antibody Technique, Indirect , Intraocular Pressure , Male , Microfilament Proteins/metabolism , Microglia/metabolism , Microscopy, Confocal , Ocular Hypertension/etiology , Ocular Hypertension/metabolism , Proteoglycans/metabolism , Rats , Rats, Inbred BN , Real-Time Polymerase Chain Reaction , Retinal Ganglion Cells/metabolism , Time Factors , Transcription Factor Brn-3A/metabolism
5.
Histochem Cell Biol ; 142(6): 601-17, 2014 Dec.
Article in English | MEDLINE | ID: mdl-25138677

ABSTRACT

Doublecortin (DCX) is predominantly expressed in neuronal precursor cells and young immature neurons of the developing and adult brain, where it is involved in neuronal differentiation, migration and plasticity. Moreover, its expression pattern reflects neurogenesis, and transgenic DCX promoter-driven reporter models have been previously used to investigate adult neurogenesis. In this study, we characterize dsRed2 reporter protein-expressing cells in the adult retina of the transgenic DCX promoter-dsRed2 rat model, with the aim to identify cells with putative neurogenic activity. Additionally, we confirmed the expression of the dsRed2 protein in DCX-expressing cells in the adult hippocampal dentate gyrus. Adult DCX-dsRed2 rat retinas were analyzed by immunohistochemistry for expression of DCX, NF200, Brn3a, Sox2, NeuN, calbindin, calretinin, PKC-a, Otx2, ChAT, PSA-NCAM and the glial markers GFAP and CRALBP, followed by confocal laser-scanning microscopy. In addition, brain sections of transgenic rats were analyzed for dsRed2 expression and co-localization with DCX, NeuN, GFAP and Sox2 in the cortex and dentate gyrus. Endogenous DCX expression in the adult retina was confined to horizontal cells, and these cells co-expressed the DCX promoter-driven dsRed2 reporter protein. In addition, we encountered dsRed2 expression in various other cell types in the retina: retinal ganglion cells (RGCs), a subpopulation of amacrine cells, a minority of bipolar cells and in perivascular cells. Since also RGCs expressed dsRed2, the DCX-dsRed2 rat model might offer a useful tool to study RGCs in vivo under various conditions. Müller glial cells, which have previously been identified as cells with stem cell features and with neurogenic potential, did express neither endogenous DCX nor the dsRed2 reporter. However, and surprisingly, we identified a perivascular glial cell type expressing the dsRed2 reporter, enmeshed with the glia/stem cell marker GFAP and colocalizing with the neural stem cell marker Sox2. These findings suggest the so far undiscovered existence of perivascular associated cell with neural stem cell-like properties in the adult retina.


Subject(s)
Luminescent Proteins/genetics , Microtubule-Associated Proteins/genetics , Neuropeptides/genetics , Retina/cytology , Animals , Doublecortin Domain Proteins , Doublecortin Protein , Female , Immunohistochemistry , Luminescent Proteins/metabolism , Male , Microtubule-Associated Proteins/metabolism , Neuropeptides/metabolism , Rats , Rats, Transgenic , Red Fluorescent Protein
7.
J Eur Acad Dermatol Venereol ; 25(2): 227-31, 2011 Feb.
Article in English | MEDLINE | ID: mdl-20579227

ABSTRACT

BACKGROUND: The pathogenic role of nasal carriage as a source for cutaneous and soft-tissue Staphylococcus aureus (SA) infections, and Staphylococcal scalded skin syndrome (SSSS) in particular, is unclear. OBSERVATION: We herein describe a nosocomial outbreak of SSSS in three orthopaedic patients who received intra-articular injections by a single orthopaedic surgeon. Bacteriological samples from the index patients and medical personnel involved in their care were assessed by phage typing, polymerase chain reaction for exfoliative toxin genes, SmaI macro-restriction analysis and molecular spa-typing. These studies first revealed SA cultural growth in synovial fluid of all three patients as well as nasal mucosa of one medical assistant. Moreover, all SA isolates had the same phage typing and antibiotic susceptibilities and were positive for exfoliative toxin ETa by polymerase chain reaction. SmaI macro-restriction and spa-typing further confirmed all proband isolates to be identical. CONCLUSION: These findings provide evidence that SA nasal colonization of otherwise healthy carriers is a risk factor for SA infections, including SSSS, in predisposed individuals.


Subject(s)
Adrenal Cortex Hormones/administration & dosage , Cross Infection/diagnosis , Cross Infection/transmission , Injections, Intra-Articular/adverse effects , Staphylococcal Scalded Skin Syndrome/diagnosis , Staphylococcal Scalded Skin Syndrome/transmission , Adrenal Cortex Hormones/therapeutic use , Aged , Anti-Bacterial Agents/therapeutic use , Cross Infection/drug therapy , Female , Humans , Hygiene/standards , Male , Nasal Mucosa/microbiology , Osteoarthritis/drug therapy , Risk Factors , Skin/microbiology , Staphylococcal Scalded Skin Syndrome/drug therapy , Staphylococcus aureus/isolation & purification , Treatment Outcome
8.
Klin Monbl Augenheilkd ; 228(2): 98-103, 2011 Feb.
Article in German | MEDLINE | ID: mdl-21328168

ABSTRACT

A thorough understanding of intraocular pressure homeostasis is the biological foundation for the development of new strategies to treat patients with elevated intraocular pressure or glaucoma. However, investigations on the physiology of intraocular pressure homeostasis are also important to gain more comprehensive insights into the pathogenesis of glaucoma and other diseases with associated alterations of intraocular pressure. The present review intends to give alternative insights into the biological and physical aspects of intraocular pressure regulation. The pressure-volume as well as the hydraulic model of intraocular pressure and also the relationship between ciliary blood flow and aqueous humor production, which has moved into the centre of interest because of its possible clinical relevance for glaucoma patients, will be explained. The authors Have attempted to interrelate the different aspects of intraocular pressure genesis and regulation in a comprehensive but understandable way.


Subject(s)
Aqueous Humor , Glaucoma/physiopathology , Intraocular Pressure , Models, Biological , Humans
9.
Microbiology (Reading) ; 156(Pt 12): 3710-3721, 2010 Dec.
Article in English | MEDLINE | ID: mdl-20817646

ABSTRACT

Staphylococcus aureus is a human pathogen of growing clinical significance, owing to its increasing levels of resistance to most antibiotics. Infections range from mild wound infections to severe infections such as endocarditis, osteomyelitis and septic shock. Adherence of S. aureus to human host cells is an important step, leading to colonization and infection. Adherence is mediated by a multiplicity of proteins expressed on the bacterial surface, including clumping factor B. In this study, we aimed to identify new targets of clumping factor B in human keratinocytes by undertaking a genome-wide yeast two-hybrid screen of a human keratinocyte cDNA library. We show that clumping factor B is capable of binding cytokeratin 8 (CK8), a type II cytokeratin. Using a domain-mapping strategy we identified amino acids 437-464 as necessary for this interaction. Recombinantly expressed fragments of both proteins were used in pull-down experiments and confirmed the yeast two-hybrid studies. Analysis with S. aureus strain Newman deficient in clumping factor B showed the clumping factor B-dependence of the interaction with CK8. We postulate that the clumping factor B-CK8 interaction is a novel factor in S. aureus infections.


Subject(s)
Adhesins, Bacterial/metabolism , Keratin-8/metabolism , Staphylococcal Infections/metabolism , Staphylococcus aureus/metabolism , Virulence Factors/metabolism , Adhesins, Bacterial/genetics , Amino Acid Sequence , Cell Line , Humans , Keratin-8/genetics , Keratinocytes/metabolism , Keratinocytes/microbiology , Molecular Sequence Data , Protein Binding , Staphylococcal Infections/genetics , Staphylococcal Infections/microbiology , Staphylococcus aureus/genetics , Staphylococcus aureus/pathogenicity , Two-Hybrid System Techniques , Virulence Factors/genetics
11.
Assay Drug Dev Technol ; 4(6): 709-19, 2006 Dec.
Article in English | MEDLINE | ID: mdl-17199509

ABSTRACT

The yeast two-hybrid (Y2H) method is capable of delivering vast amounts of interacting positive yeast colonies from a single library screen, particularly if a multifunctional protein is used as bait. However, the selection of definitive colonies for further molecular analysis is limited by both technical practicality and high costs. Here we demonstrate a cost-effective and simple method for the rapid selection and ranking of those Y2H-positive interaction clones that are suitable for further analysis. We performed a Y2H screen for the identification of human transforming growth factor beta2- interacting proteins in a human skin keratinocyte library. The identified clones were ranked by the amount of beta-galactosidase enzyme produced, as well as by the interaction strength of the positive colonies. The combination of high-throughput microplate fluorescence readers and specific fluorescence assays can be utilized for relative quantitation of protein-protein interaction strength of Y2H-positive colonies in crude yeast-cell lysates. We demonstrate here that the high sensitivity of the fluorescence approach can bypass cumbersome conventional methods of cell lysis used in beta-galactosidase assays, and still deliver accurate values for analysis of protein interaction data. Finally, we also achieved a better understanding of general aspects of beta-galactosidase measurements in the Y2H system, such as protein normalization, the influence of yeast culture incubation time on optimal beta-galactosidase detection, and the linearity of beta-galactosidase detection in crude cell lysates.


Subject(s)
Protein Interaction Mapping/methods , Two-Hybrid System Techniques , Yeasts/genetics , beta-Galactosidase/metabolism , Cost-Benefit Analysis , False Positive Reactions , Fluorescence , Gene Library , Humans , Keratinocytes/enzymology , Organic Chemicals , Sensitivity and Specificity
12.
Ross Fiziol Zh Im I M Sechenova ; 102(2): 176-87, 2016 Feb.
Article in Russian | MEDLINE | ID: mdl-29671969

ABSTRACT

Diabetic peripheral neuropathy (DPN) is one of the most common complications of the type 1 diabetes mellitus (DM1). The aim of the work was to study the dynamics of a painful DPN and functional state of the hormone-sensitive ACSS in the skeletal muscles of rats with the models of acute and mild DM1, as well as the study of impact on them of insulin therapy with different ways of hormone delivery - intranasal and peripheral. In both models of DM1, the level of nociceptive threshold in rats decreased and the stimulatory effects of guanine nucleotides (GppNHp) and adrenergic agonists (isoproterenol, BRL-37344) on adenylyl cyclase (AC) activity were attenuated. The AC stimulating effect of relaxin decreased in animals with acute DM1, but in mild DM1, the decrease was insignificant. Peripheral administration of insulin in rats with acute DM1 increased the nociceptive threshold and partially restored the AC effect of ß 3-agonist BRL-37344. Intranasal administration of insulin in rats with DM1 also increased the nociceptive threshold and partially restored the basal and BRL-37344-stimulated AC activity in the skeletal muscles of diabetic animals. Thus, in the skeletal muscles of rats with acute and mild DM1 the nociceptive sensitivity and the functions of ACSS were disturbed, and they were partially restored by the treatment with peripheral (acute DM1) or intranasal (mild DM1) insulin.


Subject(s)
Adenylyl Cyclases/metabolism , Diabetes Mellitus, Type 1/physiopathology , Muscle, Skeletal/physiopathology , Neuralgia/physiopathology , Nociception , Acute Disease , Administration, Cutaneous , Administration, Intranasal , Animals , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 1/drug therapy , Hypoglycemic Agents/administration & dosage , Insulin/administration & dosage , Male , Muscle, Skeletal/drug effects , Muscle, Skeletal/enzymology , Neuralgia/etiology , Neuralgia/prevention & control , Pain Threshold , Rats, Wistar
13.
Mech Ageing Dev ; 131(5): 346-53, 2010 May.
Article in English | MEDLINE | ID: mdl-20403371

ABSTRACT

Keratin filaments form obligatory heterodimers consisting of one type I and one type II keratin that build the intermediate filaments. In keratinocytes, type II keratin 6 (K6) interacts with type I keratin 16 (K16). We previously showed that the intermediate filament protein K16 is up-regulated in aged human skin. Here, we report that there is an obvious imbalance of K16 to K6 mRNA in in vivo and in vitro aging, which possibly leads to cellular effects. To unveil a possible biological function of K16 overexpression we investigated the migration potential of keratinocytes having up-regulated K16 expression in vitro. Two cell lines were established by transfection of human keratinocytes (HaCaT cells) with K16 or control vectors and subsequent fluorescence-activated cell sorting. By performing migration assays we were able to show a 90% reduction in the migration ability of the K16-overexpressing keratinocytes. In addition, a delay in wound closure associated with K16-overexpressing cells was shown by scratch assays. Transient overexpression of K6A in K16-overexpressing keratinocytes partially corrected the cell-migration defect. By real-time PCR we excluded co-regulation of the annotated interaction partner, K6, in the K16 cell line. Finally, we observed a decreased level of tyrosine phosphorylation in K16-overexpressing cells. Taken together, these data highlight the possibility of a physiological role for K6/K16 heterodimers in keratinocyte cell migration, in addition to the heterodimer's known functions in cell differentiation and mechanical resilience.


Subject(s)
Cell Movement , Cellular Senescence , Keratin-16/metabolism , Keratin-6/metabolism , Keratinocytes/physiology , Cell Line , Humans , Keratin-16/genetics , Keratin-6/genetics , Keratinocytes/metabolism , Phosphorylation , Protein Multimerization , RNA, Messenger/metabolism , Tyrosine/metabolism
19.
Fortschr Med ; 100(5): 190-4, 1982 Feb 04.
Article in German | MEDLINE | ID: mdl-7042501

ABSTRACT

In a prospective randomized double blind study, prophylactic cefamandol therapy was compared to placebos before appendectomy. 25 of 220 patients had to be excluded. The overall infection rate was reduced from 13,1% (1977/78) to 7,6% (1979/80). The infection rate differed in both groups (antibiotic and placebo) only for perforated appendices significantly. If there was a wound infection, the hospital stay of the treatment group was significantly reduced to the placebo group (p less than 0,0005). Predisposing factors for wound infection are leucocytosis greater than 12 000, anamnesis greater than 24 hours, operation time greater than 45 minutes.


Subject(s)
Appendectomy/adverse effects , Cefamandole/therapeutic use , Cephalosporins/therapeutic use , Premedication , Surgical Wound Infection/prevention & control , Clinical Trials as Topic , Double-Blind Method , Humans , Povidone-Iodine/therapeutic use , Prospective Studies
20.
Chir Forum Exp Klin Forsch ; (1978): 1-5, 1978.
Article in German | MEDLINE | ID: mdl-37053

ABSTRACT

At the University Surgical Clinic Köln-Lindenthal 5 different methods were employed for assessment of gastro-esophageal reflux between 1975 - 1976 in 283 patients with and without reflux disturbances. Clinically, a gastro-esophageal reflux was found in 72% of the cases. The measurement of intra-esophageal pH with reflux-provocation was the most sensitive, and at the same time the most specific (83, 3%). Significant differentiation betwen patients with and without reflux who had an axial hiatus-hernia could not be made, using x-ray examination and counting of the number of times swallowed in the acid-clearing test. The most suitable procedure in proving the presence of gastro-esophageal reflux was esophagoscopy, intra-esophageal pH-measurement and acid-clearing-and-pH determination, in all of which the results correlated with each other to a high degree.


Subject(s)
Gastroesophageal Reflux/diagnosis , Diagnosis, Differential , Esophagitis, Peptic/diagnosis , Esophagoscopy , Evaluation Studies as Topic , Gastroesophageal Reflux/diagnostic imaging , Hernia, Hiatal/diagnosis , Humans , Hydrochloric Acid , Hydrogen-Ion Concentration , Manometry/methods , Radiography
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