p16ink4a expression decreases during imiquimod treatment of anal intraepithelial neoplasia in human immunodeficiency virus-infected men and correlates with the decline of lesional high-risk human papillomavirus DNA load.

Background: Human papillomavirus (HPV)-associated anogenital cancers and their precursor lesions occur in excess in human immunodeficiency virus (HIV)-infected patients despite the initiation of highly active antiretroviral therapy. In this context, a drastically increased relative risk for anal intraepithelial neoplasia (AIN) exists in HIV-infected men having sex with men (MSM). In a pilot study, imiquimod, a topical immune response modifier, has been reported to be beneficial in the treatment of AIN.

MR characterization of cardiac abnormalities in HIV+ individuals with increased BNP levels.

Objective: To characterize cardiac abnormalities in HIV+ patients with increased serum B-type natiuretic peptide (BNP) by contrast-enhanced cardiac magnetic resonance imaging (MRI).

Design: Non-blinded prospective consecutive cohort evaluation.

Methods: More than 400 HIV+ patients were screened for potential BNP alterations.

In Vitro Comparison of Physical Parameters, Enzyme Activity, Acid Resistance, and pH Dissolution Characteristics of Enteric-Coated Pancreatic Enzyme Preparations: Implications for Clinical Variability and Pharmacy Substitution.

OBJECTIVE Pancreatic enzyme products were available before the 1938 passage of the Federal Food, Drug, and Cosmetic Act and have to date been marketed without required safety and efficacy testing. Despite a lack of demonstrated bioequivalence, they are often substituted for each other without physician or patient consent or monitoring. We investigated the in vitro variability of key performance parameters among a representative group of currently available pancreatic enzyme formulations.

Steroid treatment for severe acute cryptogenic hepatitis.

Objective: Acute cryptogenic hepatitis may represent both a self-limited disease as well as the onset of chronic hepatitis. The aim of this analysis was to evaluate the effect of steroid treatment in patients with acute cryptogenic hepatitis.

Methods: We retrospectively analyzed four patients with acute cryptogenic hepatitis.

[HIV-related symptoms].

The course of HIV-infection has changed dramatically since the beginning of the epidemic. Opportunistic infections and AIDS-defining tumors are diagnosed less frequently since the introduction of antiretroviral therapy and the time of survival has increased. According to German-Austrian therapy guidelines highly active antiretroviral therapy (HAART) should be started on the onset of HIV-related symptoms and/or when the CD4 cell count is lower than 350/microl.

Improved outcome of chronic hepatitis B after heart transplantation by long-term antiviral therapy.

Chronic hepatitis B progresses to cirrhosis in the majority of immunosuppressed patients. The outcome of long-term antiviral therapy in HBV-infected organ transplant recipients is unknown. In 1996, we included 20 heart transplant (HT) recipients in a pilot trial to treat chronic hepatitis B with famciclovir.

[HIV-associated tumors].

In the beginning of the HIV epidemic, Kaposi sarcoma was a common stigma in AIDS patients and one of the leading causes of death. While Kaposi sarcoma is seen less frequently since the introduction of antiretroviral therapy, lymphoma and other malignancies are an increasing therapeutic challenge. The incidence of HPV-related anal carcinoma and its precursor lesions is rising so dramatically that screening programs as they are already established for cervical carcinoma should be implemented.

Hepatitis A virus infection suppresses hepatitis C virus replication and may lead to clearance of HCV.

Background/aims: The significance of hepatitis A virus (HAV) super-infection in patients with chronic hepatitis C had been a matter of debate. While some studies suggested an incidence of fulminant hepatitis A of up to 35%, this could not be confirmed by others.

Methods: We identified 17 anti-HCV-positive patients with acute hepatitis A from a cohort of 3170 anti-HCV-positive patients recruited at a single center over a period of 12 years.

Uridine supplementation enhances hepatic mitochondrial function in thymidine-analogue treated HIV-infected patients.

Supplementation with uridine offers the possibility of a new and promising approach to nucleoside analogue reverse transcriptase inhibitor-associated mitochondrial toxicity. We investigated the metabolic effects of short-course treatment with the uridine-enriched food supplement NucleomaxX on hepatic mitochondrial function in thymidine-analogue treated HIV-infected patients. Mitochondrial function was assessed by a recently introduced non-invasive C-methionine breath test.

GNB3 C825T polymorphism and response to anti-retroviral combination therapy in HIV-1-infected patients--a pilot study.

Methods: Analyses were based on a cohort of 55 HIV infected patients whose treatment was changed due to therapy failure. Viral load, CD4+ and CD8+ cell counts were determined before therapy and after 8 weeks and 16-32 weeks, respectively. GNB3 genotyping was performed using Pyrosequencing.

[Status of HIV-infections 2005].

The course of HIV infection has changed dramatically since the beginning of the epidemic. In Germany, 19 antiretrovirally active substances are available. They prevent viral penetration into the cell, inhibit the reverse transcriptase or the protease that are necessary to release infectious viral particles.

[Aspects of rehabilitation in HIV and AIDS].

Medical treatment of HIV infection has changed dramatically since 1997. The uncontrollable threat became a chronic disease. On the other hand, many HIV-infected people suffer from high psychological distress and multiple physical complaints.

Superiority of standard interferon-alpha2b compared to pegylated interferon-alpha2b (12 kDa) in a hemodialysis patient with chronic hepatitis C?

Introduction: Hepatitis C virus (HCV) infection represents an important problem for hemodialysis patients. Interferon-alpha (IFN-alpha) three times per week has been shown to clear HCV RNA in a substantial proportion of renal transplant candidates, and may thereby prevent the deleterious effect of immunosuppressive treatment on progression of liver disease in HCV-positive patients after renal transplantation. Data on the efficacy of the new pegylated interferons in hemodialysis patients are limited and general recommendations are absent.

Spontaneous resolution of chronic hepatitis C virus infection after antiviral treatment and relapse.

Clearance of acute hepatitis C virus (HCV) infection is associated with strong and multi-specific cellular immune responses which are often weak in chronic hepatitis C. We here report a case of spontaneous and sustained resolution of chronic hepatitis C virus infection in the absence of apparent HCV-specific immunity. The patient received standard antiviral therapy for chronic HCV infection and was HCV-RNA negative at the end of treatment but relapsed between follow-up week 4 and 12.

[Syphilis and HIV infection. Characteristic features of diagnosis, clinical assessment, and treatment].

The incidence of syphilis has increased dramatically in Germany since 2001. Homosexual men have been particularly afflicted. Several characteristic features should be taken into account in the diagnosis and treatment of HIV patients with concomitant syphilis.

Effect of H. pylori on the expression of TRAIL, FasL and their receptor subtypes in human gastric epithelial cells and their role in apoptosis.

Background And Aims: In the human stomach expression of TNF-related apoptosis inducing ligand (TRAIL) and its receptors and the modulatory role of Helicobacter pylori are not well described. Therefore, we investigated the effect of H. pylori on the expression of TRAIL, FasL and their receptors (TRAIL-R1-R4, Fas) in gastric epithelial cells and examined their role in apoptosis.

Significance of the caspase family in Helicobacter pylori induced gastric epithelial apoptosis.

Background And Aims: H. pylori infection results in an increased epithelial apoptosis in gastritis and duodenal ulcer patients. We investigated the role and type of activation of caspases in H.

Rational design of Rhizopus oryzae lipase with modified stereoselectivity toward triradylglycerols.

The binding site of sn-1(3)-regioselective Rhizopus oryzae lipase (ROL) has been engineered to change the stereoselectivity of hydrolysis of triacylglycerol substrates and analogs. Two types of prochiral triradylglycerols were considered: 'flexible' substrates with ether, benzylether or ester groups, and 'rigid' substrates with amide or phenyl groups, respectively, in the sn-2 position. The molecular basis of sn-1(3) stereoselectivity of ROL was investigated by modeling the interactions between substrates and ROL, and the model was confirmed by experimental determination of the stereoselectivity of wild-type and mutated ROL.

Randomised placebo-controlled trial of ritonavir in advanced HIV-1 disease. The Advanced HIV Disease Ritonavir Study Group.

Background: Ritonavir is a potent, orally bioavailable inhibitor of HIV-1 protease. We undertook an international, multicentre, randomised, double-blind, placebo-controlled trial of ritonavir in patients with HIV-1 infection and CD4-lymphocyte counts of 100 cells/microL or less, who had previously been treated with antiretroviral drugs.

Methods: 1090 patients were randomly assigned twice-daily liquid oral ritonavir 600 mg (n = 543) or placebo (n = 547) while continuing treatment with up to two licensed nucleoside agents.

Inhibition of lipases from Chromobacterium viscosum and Rhizopus oryzae by tetrahydrolipstatin.

Tetrahydrolipstatin is known as an inhibitor for pancreatic lipase but not for microbial lipases. In this paper we demonstrate that in the presence of water-insoluble substrates like tributyrin or olive oil, tetrahydrolipstatin inhibits the lipases of Chromobacterium viscosum and Rhizopus oryzae, although with different potency. In contrast to porcine pancreatic lipase, which forms an irreversible and covalent enzyme-inhibitor complex with tetrahydrolipstatin, the inhibition of the microbial lipases is reversible as the inhibitor can be removed from the enzyme-inhibitor complex by solvent extraction.

Acquired myasthenia gravis and cholangiocellular carcinoma in a dog.

Acquired myasthenia gravis and cholangiocellular carcinoma were diagnosed in a 7-year-old English Setter referred because of forelimb lameness, exercise-induced weakness, and fever. Three months earlier, the dog had had a pleuropulmonary infection caused by a Fusobacterium sp. The concurrent development of myasthenia gravis and cholangiocellular carcinoma in this dog may be explained by a paraneoplastic syndrome, although it is unproven.

Neuronal-visceral GM1 gangliosidosis in Portuguese water dogs.

Three female siblings in a litter of seven Portuguese Water dogs (PWDs) showed clinical signs of ataxia and/or lameness at 5 months of age. Signs of cerebellar dysfunction (intention tremors, ataxia, widebased stance, dysmetria, and/or nystagmus) and mild limb weakness developed rapidly. Results of hemograms (three dogs), blood chemistry profiles (two dogs), urinalyses (two dogs), electroencephalograms (two dogs), and radiographs of the limbs or pelvis (three dogs), vertebrae (two dogs), and skull (one dog) were unremarkable except for an absolute lymphocytosis in one dog.

[Condition and satisfaction of patients after gynecologic surgery].

The effects of gynaecological operations on the well-being and satisfaction of patients can be viewed as important supplements to quality assurance which is mainly based on clinical parameters and medical ratings. In the present study 215 patients undergoing gynaecological operations assessed different components of their subjective health status at times of admission to the hospital, at discharge and six weeks after discharge. Additionally, the patients gave satisfaction ratings at discharge.

Increased alcohol intake induced by chronic stimulants: is "orality" involved?

One should be able to mimic aspects of chronic stress using pharmacological stimulants administered continuously. Alcohol preference can be selectively increased by the continuous administration of two stimulants: D-amphetamine (which works well), and nicotine (which is extremely potent). This effect does not occur with continuous administration of a variety of other psychoactive compounds such as hallucinogens and tranquilizers, nor does it occur if stimulants are administered chronically but in an intermittent fashion.