Molekulare Aspekte und diagnostische Wertigkeiten von Pilzallergenen

Zusammenfassung. Die Klonierung, Sequenzierung und Produktion von hochreinen Allergenen bietet die Möglichkeit, perfekt standardisierte Allergenpräparate herzustellen. Die Entwicklung eines neuen Klonierungssystems, das auf filamentösen Phagen basiert, führte zu einer schnellen Isolierung und Charakterisierung von Aspergillus fumigatus-Allergenen. Die auf diesem Weg rekombinant hergestellten Proteine wurden serologisch und klinisch geprüft und ihr routinemä-ßiger Einsatz im ImmunoCAP-System evaluiert. Es gelang eine quantitative Übereinstimmung zwischen Hauttestergebnissen und Serologie nachzuweisen, welche das Potential rekombinanter Allergene in der Diagnostik allergischer Krankheiten aufzeigt. Darüber hinaus trägt die Charakterisierung der Pilzallergene wesentlich zum Verständnis der moiekularen Natur der allergieauslösenden Komponenten bei Zum jetzigen Zeitpunkt können, abgesehen von Proteinen mit unbekannten biologischen Funktionen, die Pilzallergene in zwei Klassen eingeteilt werden: 1. Spezies-spezifische sezcrnierte Allergene und 2. cytoplasmatische, hoch konservierte Proteine. Diese letztgenannten Pilzallergene zeigen auch zu Proteinen aus phylogenetisch weit entfernten Organismen weitreichende Sequenzhomologien. Neben der daraus zu erwartenden IgE-Kreuzreaktivität findet man in einigen Fällen auch eine Kreuzreaktivität mit den homologen humanen Proteinen, was auf Autoimmunreaktionen, bei Pilzalleigien hindeutet. Summary. Cloning, sequencing and production of highly pure recombinant allergens allows to produce perfectly standardised allergen preparations. The development of a new cloning system based on filamentous phage allowed the fast isolation and characterisation of allergens from the fungus Aspergillus fumigatus. The produced recombinant allergens were tested in serological and clinical studies as well as for their performance for routine assessments in the ImmunoCAP-system. Thereby, a perfect correlation between skin test results and serology was found showing the potential of recombinant allergens for the diagnosis of allergic diseases. Moreover, the characterisation of fungal allergens substantially contributes to our understanding of the molecular nature of proteins involved in the elication of allergic reactions. Apart from allergenic proteins with unknown biological function, fungal allergens can be subdivided into two classes: 1. Species-specific, secreted proteins and 2. cytoplasmic, even in phylogenetically distant organisms, well conserved proteins. These fungal allergens show extended sequence similarity, a high level of IgE cross-reactivity and in some cases also cross-reactivity with homologous human proteins indicating autoimmune reactions involved in fungal allergy.     

医疗设备管理信息系统的应用

医疗设备管理信息系统是现在医院管理不可缺少的部分,将其合理的开发和应用形成动态的全程的管理。     

Age-dependency of alpha- and beta-adrenoceptors on thrombocytes and lymphocytes of asthmatic and nonasthmatic children

Among the possible mechanisms which may cause wheezing or asthmatic episodes a genetically determined -adrenoceptor blockade and a hyperresponsiveness of -andrenoceptors has been postulated. Evidence to support this hypothesis stems from an increased bronchial sensitivity to -blockers, a reduced formation of cyclic AMP in response to -adrenergic stimulation and enhanced -adrenergic responses in asthmatic subjects. The recent development of techniques for measuring the specific, high-affinity binding of radiolabeled -and -adrenergic antagonists made it possible to study - and -adrenoceptors in vitro. Based upon the assumption that a change in the number and/or affinity of adrenergic receptors might be a general phenomenon, we have performed - and -receptor binding studies on lymphocytes and platelets from wheezing infants and asthmatic children as well as of infants, children, and adults not suffering from these diseases.Using ¹²⁵[I]-cyanopindolol (ICYP) and ³[H]-yohimbine (HYOH) as highly specific ligands for - and -adrenoceptors, the following results were obtained: (1) Lymphocytes and platelets from control subjects and asthamatics bound similar amounts of ICYP and HYOH and thus showed no differences either in the number or the affinity of - and -adrenoceptors. Lymphocytes and platelets of wheezing and nonwheezing infants also bound the same amounts of the radioligands. (2) In asthmatic children receiving 4×2 puffs salbutamol -adrenoceptor were down-regulated and this may mimic -adrenoceptor blockade. (3) When subjects were divided into four categories according to age (0–5, 5–10, 10–20 years, adults) the number of -adrenoceptor binding sites showed an age-dependent increase. The number and affinity of -adreneceptor binding sites on platelets was neither influenced by age nor disease.It is concluded that the - and -adrenoceptors of wheezing infants and asthmatic children at least on blood cells are normal. However the -adrenoceptors show an age-dependent maturation process, which may account for an unresponsiveness to -adrenoceptor agonists in wheezing infants.Supported by a grant from the Ministerium für Wissenschaft und Forschung, NRWPresented at the 19th Workshop for Pediatric Research, University of Göttingen, March 10–11, 1983     

Erforschung der psychosozialen Aspekte der HNO-Tumorchirurgie (exklusiv Laryngektomie): 4teilige Analyse der Literatur Teil 3: Forschungsergebnisse

Zusammenfassung In einer vierteiligen Literaturstudie wird die Fachliteratur zu den psychosozialen Aspekten der HNO-Tumorchirurgie – exklusiv Laryngektomie – zwischen 1950 und 1995 analysiert. Im ersten Teil (HNO 45: 360–366) wurde die Geschichte der Erforschung der psychosozialen Aspekte der HNO-Tumorchirurgie dargestellt. Der zweite Teil (HNO 45: 433–441) diente der Analyse der empirischen Arbeiten. Im vorliegenden 3. Teil werden die Ergebnisse der bisherigen Forschung unter 4 synchronen Aspekten dargestellt: 1. Durch Krankheit und Behandlung verursachte Einschr?nkungen (Dysfunktionen, Mutilationen, emotionale und soziale Reaktionen); 2. Bew?ltigungsverhalten (Coping); 3. Verlauf von Krankheit und Behandlung (Behandlungsverz?gerung, pr?operative Phase, Hospitalisation, frühe und sp?tere Rehabilitation, Rezidive, terminale Phase); 4. Beziehung zwischen Patient und beruflichen Helfern (Arzt-Patient-Beziehung, Gegenübertragung). Eingegangen am 12. September 1996 Angenommen am 18. Dezember 1996     

Experimental and Analytical Research on Flexural Behavior of Concrete-Filled High-Strength Steel Tubular Members

Using high-strength steel (yield strength f_y ≥ 460 MPa) in concrete-filled steel tubes is expected to provide a superior bearing capacity by achieving light weight and efficient construction, but the existing design limitation on diameter-to-thickness (D/t) ratios for concrete-filled high-strength steel tubular (CFHST) members inevitably obstructs its wide application. In this study, aiming at the application of circular CFHST members using Q690 steel (f_y ≥ 690 MPa), a total of 15 CFHST beams were examined using a three-point loading test to investigate the failure mode, bearing capacity and plasticity evolution. Subsequently, finite element models (FEMs) were established to analyze the full-range curves, composite effect, failure mechanism and influences of key parameters including material strengths, D/t ratios, and shear-span ratios. A simplified calculation method for bearing capacity was finally proposed and verified. The results indicate that the full-range performance of tested CFHST members with out-of-code D/t ratios have ductile behavior, though they fail through the mode of steel fracture and concrete cracks in the tension zone as well as through local buckling in the compression zone; out-of-code CFHST members (e.g., D/t = 120) can perform reasonable composite behavior because of contact pressure larger than 2.5 MPa, where a thin-walled steel tube experiences an arch failure mechanism similar to core concrete at a trussed angle of 45°; the simplified bearing capacity model achieves a mean value of 0.97, and can be accepted as a primary tool to perform structural design and performance evaluation.     

131Ⅰ治疗分化型甲状腺癌的单病种临床路径优化

目的探讨^131I治疗分化型甲状腺癌的临床诊疗程序,优化单病种临床路径。方法使用放射性核素^131I治疗14例分化型甲状腺癌患者,观察患者的治疗反应及对症处理,优化临床路径。结果对分化型甲状腺癌^131I治疗的术前准备、常规医嘱、临床观察、疗效评估、护理、治疗注意事项等方面进行优化。结论^131I治疗分化型甲状腺癌疗效肯定,在满足条件的医院,可广泛开展。     

胰岛素壳聚糖纳米粒的制备

 目的制备胰岛素壳聚糖纳米粒。方法采用酶水解和超滤膜分离技术，得到不同相对分子质量的壳聚糖，由凝胶渗透色谱法测定其相对分子质量；采用溶剂扩散法制备纳米粒，研究纳米粒的空间结构，测定其粒径、表面电位(zeta电位)、模型药物胰岛素包封率及体外释放。结果通过控制酶水解条件，经超滤分离得到3种不同相对分子质量的壳聚糖，凝胶渗透色谱法测得的重均相对分子质量(MW)分别为10 289，41500和101 870。经溶剂扩散法制备得到的壳聚糖纳米粒，呈类圆形球体，粒径分布较窄，且随制备工艺中乙醇加入量的增加、分散用超声次数的增多，以及壳聚糖分子量的降低，粒径变小。壳聚糖纳米粒带正电荷，zeta电位值大于+30 mV。放射免疫法测得的药物包封率为72.66%。在壳聚糖酶存在条件下，前1 h体外释放药物较快，1 h后趋于平稳，并能持续释放6 h。结论选用合适相对分子质量壳聚糖制备胰岛素壳聚糖纳米粒，方法简便，药物包封率高，并有一定的缓释作用。     

PegIFN-α2a for the treatment of chronic hepatitis B and C: a 10-year history

Chronic HBV and HCV are progressive diseases leading to cirrhosis and liver transplantation. Persistent viral eradication or suppression can positively affect the natural course of the infection, by preventing disease progression. Since its introduction more than 30 years ago, IFN-α has represented the foundation of HBV and, lately, anti-HCV treatment. Pegylation of the IFN-α molecule (PegIFN-α2a) has provided improvements in both efficacy and administration schedule, thus becoming part of the standard-of-care regimen for HCV and HBV therapy in the last 10 years. Currently, treatment of finite duration with PegIFN-α2a may achieve a sustained virological response off-treatment and HBsAg seroconversion. PegIFN-α2a will most likely remain the backbone of HCV treatment for the next few years, despite the availability of direct-acting antivirals that are expected to improve cure rates. However, many efforts are concentrated on developing new compounds, with the goal of administrating all oral regimens and eliminating PegIFN from anti-HCV treatment.     

肝移植术后早期脂肪乳剂支持治疗对移植肝功能影响的临床研究

目的　研究含脂肪乳剂的肠外营养 (TPN)对肝移植受体肝脏功能的影响。方法　选择2 0 0 1年 9月～ 2 0 0 4年 6月期间在我所肝移植中心住院行肝移植手术治疗的患者 ,取符合标准的 30例作为研究对象 ,随机分组 ,进行前瞻性的临床研究。肝移植术后 6h开始给予单糖或脂肪乳剂和单糖联合功能的TPN(分别为Glu对照组和MCT/LCT组 ) ,TPN期为 7d ,期间严格禁食。于TPN后第 1、4、7、10、30、90及 180天收集标本 ,检测血ALT、AST、GGT、TBil及DBil。结果　TPN支持后MCT/LCT和Glu组ALT、AST、GGT、TBil及DBil水平均呈现下降趋势 ,与单糖组相比 ,脂肪乳组降低迅速。结论　含脂肪乳的TPN较单糖TPN更有利于促进移植肝早期功能恢复