A subtractive hybridisation analysis of genomic differences between the uropathogenic E. coli strain 536 and the E. coli K-12 strain MG1655.

Suppression subtractive hybridisation (SSH) was performed to identify genomic differences between the uropathogenic Escherichia coli strain 536 and the non-pathogenic E. coli K-12 strain MG1655. In total, 22 DNA fragments were isolated which were specific for strain 536. Five of these fragments showed homology to known virulence determinants and four fragments matched genes for lipopolysaccharide (LPS) or capsule biosynthesis and a siderophore receptor. Seven fragments did not show any homology to known genes. These fragments may represent parts of putative pathogenicity islands (PAIs). Whereas two fragments were highly specific for uropathogenic E. coli (UPEC), the other fragments could also be detected among the other tested wild-type strains.

Virulence patterns from septicemic Escherichia coli O78 strains.

Several septicemic Escherichia coli O78 strains, isolated from different sources, were characterized phenotypically and genotypically. Two avian isolates, one of which is known to carry the AC/I fimbriae, hybridized with the sfa determinant in colony dot-blot assay. Southern hybridizations with specific sfa probes, following pulsed-field gel electrophoresis (PFGE), showed positive hybridization to the same fragment in each of these strains. Determination of the N-terminal amino acid sequence of the AC/I major subunit gene revealed high similarity to the sequence of the SfaA-II protein. These data suggest that the adhesin gene cluster, coding for AC/I fimbriae, belongs to the S-fimbrial adhesin family.

New state markers for alcoholism. Comparison of carbohydrate deficient transferrin (CDT) and alcohol mediated (triantennary) transferrin (AMT).

Carbohydrate deficient transferrin (CDTect-RIA, Pharmacia) was compared with an Immunoluminometric assay for isotransferrin separated by a short column Con-A sepharose which we have called alcohol mediated triantennary transferrin (AMT). 101 in-patients with alcohol dependency syndrome (alcohol consumption of more than 60 g/day) were grouped according to the time of abstinence A1 (0-7 days), A2 (8-14 days), A3 (> or = 15 days). Serum samples were obtained at admission (U0) and under abstinent conditions after 10-20 days (U1). All groups were controlled for AMT, CDT, GGT, MCV. Control groups were 30 in-patients with non alcoholic liver disease (NALD) and 31 healthy volunteers (alcohol consumption of less than 20g/day). Results showed for CDT and AMT highly significant differences between short abstinence period (group A1) and more than two weeks abstinence (group A3) alcoholics and between group A1 and healthy controls. In group A1 CDT was significantly elevated (P < or = .001) compared to NALD group whereas AMT showed no differences. CDT (cut off 22 mg/l) showed a high diagnostic specificity (A1/controls 97%, A1/NALD 83%, A1/A3 78%) but only a diagnostic sensitivity of 61%. AMT (cut off 260 mg/l) revealed a diagnostic test sensitivity of 74%. The diagnostic test specificity of AMT was inferior to CDT (A1/controls 74%, A1/NALD 50%, A1/A3 70%). Initial CDT and AMT values in alcoholics were highly correlated (P < or = .001) with time of abstinence. CDT and AMT decline was correlated with time of abstinence. CDT was proved for high significant (P < or = .001) decline over a longer period of abstinence (11-30 days) while AMT decline was significant (P = .008) only in early abstinence (0-10 days). Presence of a withdrawal syndrome was highly correlated (P < or = .01) with CDT values above 22 mg/l and AMT values above 260 mg/l. Furthermore in selected follow up cases it was shown that AMT seemed to be a more sensitive indicator for short alcoholic relapses than CDT.

[Ectopic gastric mucosa in the duodenal bulb]. / Ektope Magenschleimhaut im Bulbus duodeni.

The radiological and clinical findings of 12 patients with ectopic gastric mucosa in the duodenal bulb are presented. This is a defined disease with characteristic radiological features: multiple small nodular defects of the contrast medium of 1-3 mm diameter. Histology shows complete heterotopia. Pathogenesis and clinical significance are discussed with reference to the literature on this subject.

Prognostic significance of the hepatitis B virus-DNA concentration in patients after orthotopic liver transplantation.

Hepatitis B virus-DNA was detected by polymerase chain reaction in 9 out of 10 patients after orthotopic liver transplantation. Three of these patients were at the same time positive for hepatitis B virus-DNA by dot-blot hybridization (hepatitis B virus-DNA > 1.5 pg/ml). In these three patients HBs-antigen (HBsAg) reappeared within a mean time of 12 weeks after orthotopic liver transplantation (range 7-18 weeks). Only two of the six polymerase chain reaction-positive and dot-blot-negative patients (hepatitis B virus-DNA between 0.4 fg/ml and 1.5 pg/ml) had recurrence of HBsAg within a mean time of 54 weeks (range 52-56 weeks). Passive immunoprophylaxis with anti-HBs antibodies (serum titers > 100 IU/l) did not prevent infection of the graft in the five reinfected patients. We conclude that a low concentration of serum hepatitis B virus-DNA after orthotopic liver transplantation, which is detectable only by polymerase chain reaction, indicates a delayed infection of the graft.

[Liver transplantation--preparing patients, early postoperative care and occupational rehabilitation]. / Májtranszplantáció--a betegek elökészítése, korai posztoperatív gondozása és foglalkozási rehabilitációja.

Authors summarize the results of liver transplantation first of all in the view of rehabilitation. Role of rehabilitation experts is discussed in the period before and after transplantation. The necessity of information for the patients is specially underlined already from the first raise of the possibility of liver transplantation. They express that after successful operation it is needed for the patients to return gradually to the used activities of everyday life. All the questions of immunosuppressive treatment, hygienic rules, physical activities, patient care at home and work place rehabilitation are discussed.

[Social-medical aspects of chronic liver diseases]. / Sozialmedizinische Aspekte chronischer Lebererkrankungen.

In our country liver diseases are frequent and have many different causes. They can often develop into cirrhosis of the liver with mortality beetween 13.5% and 24.5%. Hepatitis B and C-viral infections frequently play a significant role in the recognition of an occupational disease in the case of medical staff, with histological criteria of major importance in this respect. A consequence of cirrhosis of the liver may be the development of hepatoencephalopathia of varying degrees of severity. As it is then likely that a patient will no longer be able to drive motor vehicles, it is important that attending physicians inform their patients accordingly. Liver transplants are an acknowledged method of treatment in the therapy of advanced liver cirrhosis. Rehabilitation shortly after transplantation is highly important to help ensure a speedy return to work. Surprisingly, reintegration is more difficult in patients suffering from alcohol related liver disease than in those with non-alcohol-related liver disease.

[Drug therapy of pulmonary embolism]. / Die medikamentöse Therapie der Lungenembolie.

Heparin is indicated in pulmonary embolism suspicion, in minor and a part of submassive embolism. The dose is 15,000-20,000 U (acute) and 40,000 U/day subsequently. Fibrinolytic therapy with streptokinase or urokinase is indicated in massive embolism. Submassive embolism is treated by fibrinolysis if no contraindications against fibrinolysis are to be registered.