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Biomedical subjects

A Neumann

Publications and source records attributed to A Neumann.

At least 37 records · Page 2Linked to original sources
PubMed2003

A Systemic Hyperthermia Oncologic Working Group trial. Ifosfamide, carboplatin, and etoposide combined with 41.8 degrees C whole-body hyperthermia for metastatic soft tissue sarcoma.

BACKGROUND: Based on earlier clinical and preclinical studies, we conducted a phase II trial in metastatic sarcoma patients of the combination of 41.8 degrees C (x60 min) radiant heat (Aquatherm) whole-body hyperthermia (WBH) with 'ICE' chemotherapy. The ICE regimen consists of ifosfamide (5 g/m(2)), carboplatin (300 mg/m(2)) and etoposide (100 mg/m(2)), concurrent with WBH, with etoposide also on days 2 and 3 post-WBH. METHODS: Therapy was delivered every 4 weeks for a maximum of 4 cycles. All patients received filgrastim or lenograstim. RESULTS: Of 108 patients enrolled as of September 2001, 95 are evaluable for response. Of the evaluable patients (mean ECOG performance status approximately 1; mean age 42.3; 58% male) 33 had no prior therapy for metastatic disease, and 62 were pretreated (mean: 1.5 prior regimens). The overall response rate was 28.4% (4 complete remissions and 23 partial remissions) with stable disease (SD) in 31 patients. For no prior therapy, the response rate was 36%; in pretreated patients it was 24%. The median overall survival by Kaplan-Meier estimates was 393 days (95% CI 327, 496); the median time to treatment failure was 123 days (95% CI 77, 164). The major toxicity (287 cycles) was grade 3 or 4 neutropenia and thrombocytopenia seen in 79.7 and 60.6% of treatments respectively; there were 7 episodes of infection (grade 3/4) with 2 treatment-related deaths, bot involving disease progression and ureteral obstruction. CONCLUSION: These results are consistent with continued clinical investigation of this combined modality approach.

Adolescent↗
PubMed2002

[Morphological and functional results of Palisade Cartilage Tympanoplasty].

BACKGROUND AND OBJECTIVE: The application of cartilage in tympanoplasty has been generally accepted, because cartilage as a bradytrophic tissue allows stable and functionally reliable reconstruction of the eardrum even in difficult pathological conditions (such as subtotal defects, tympanosclerosis etc.). A special surgical technique using small cartilaginous chips for the reconstruction of the eardrum has been developed by J. Heermann, who introduced it as Palisade Cartilage Tympanoplasty (PCT). Although being increasingly applied in otosurgery, this technique has to date neither been evaluated regarding morphological and hearing results nor regarding its combination with titanium ossicular reconstruction prostheses. PATIENTS AND METHODS: Therefore we reviewed 84 of 94 ears (92 patients, 58 female, 34 male) 12 to 36 months after PCT. RESULTS: A recurrent defect was seen in 2 ears (1 adhesive otitis, 1 subtotal defect). There were no extrusions of prostheses. Preoperatively an ear-bone-gap of 0-10 dB was seen in 2 ears, 11-30 dB in 48 and 31-59 dB in 34 ears. Postoperatively the corresponding numbers were 25, 50 and 9 ears. CONCLUSIONS: The low rate of recurrent tympanic membrane defects (2.4%) shows that palisade cartilage tympanoplasty is particularly appropriate for the management of difficult indications in middle ear surgery. Further, it could be demonstrated that the PCT can be combined safely with titanium ossicular reconstruction prostheses. Regarding postoperative hearing results the negative preselection of pathological conditions has to be considered.

Adolescent↗
PubMed2002

Effects of taurolidine and octreotide on port site and liver metastasis after laparoscopy in an animal model of pancreatic cancer.

Port site metastasis is a dreadful event following laparoscopy; however, the exact pathomechanism is still unknown. In order to prevent trocar metastasis we determined the effects of intraperitoneal lavage with either taurolidine or octreotide on port site and liver metastasis after laparoscopy in a chemically induced, solid pancreatic adenocarcinoma. Pancreatic adenocarcinoma was induced in 60 Syrian hamsters by weekly injection of 10 mg/kg body weight N-nitrosobis-2-oxopropylamine s.c. for 10 weeks. Six weeks later, a laparoscopic pancreatic biopsy was performed by the use of a pneumoperitoneum with carbon dioxide (12 mm Hg), followed by an abdominal irrigation with 5 ml normal saline (group 1, n = 20), 5 ml 0.5% taurolidine (group 2, n = 20) or 5 ml octreotide (20 mg/ml) (group 3, n = 20). After 8 weeks, all hamsters were sacrificed and histopathologically examined. There was only one macroscopic visible primary tumor in the taurolidine group (5.9%), compared to 42.1% in the saline group and 62.5% in the octreotide group (P < 0.05). The size of carcinomas was smaller in the saline group than after octreotide irrigation (median 6, range 2-25 vs. median 70, range 40-160 mm2, P < 0.05). The number of liver metastases per animal was increased after saline irrigation (median 4, range 2-6), compared to taurolidine (median 2, range 1-3) or octreotide (median 2.5, range 2-4) (P < 0.05). Port site metastases were found in 36.8% after saline, in 37.5% after octreotide and in 0% after taurolidine irrigation (P < 0.05). Thus port site metastasis was effectively prevented by taurolidine irrigation after staging-laparoscopy in pancreatic cancer.

Animals↗
PubMed2001

Characterization of a hyperdynamic murine model of resuscitated sepsis using echocardiography.

A small animal model of sepsis that reproduces the vasodilation, hypotension, increased cardiac output, and response to treatment seen in patients with septic shock would be useful for studies of pathophysiology and treatment, but no current models replicate all of these features. Mice were made septic by cecal ligation and puncture and resuscitated with fluids and antibiotics every 6 h. Blood pressure was measured in anesthetized mice with manometric catheters, and echocardiography was performed in these animals every 6 h. Survival in treated septic mice was improved compared with untreated mice (44% versus 0%, p < 0.01). In control mice, heart rate (HR, 420 +/- 31 beats/min), mean arterial pressure (Pa, 100 +/- 8 mm Hg), stroke volume (SV, 26 +/- 4 microl), and cardiac output (12.5 +/- 6.6 ml/min) were unchanged over 48 h. In septic mice Pa was significantly decreased (102 +/- 14 to 65 +/- 19 mm Hg, p < 0.02), starting at 12 h. HR and cardiac output increased significantly (HR, 407 +/- 70 to 524 +/- 76 beats/min, cardiac output, 11.6 +/- 2.0 to 17.1 +/- 1.5 ml/min, p < 0.01). SV (24 +/- 5 microl) remained constant. This fluid-resuscitated, antibiotic-treated model replicates the mortality, hypotension, and hyperdynamic state seen in clinical sepsis. Precise determination of serial hemodynamics in this model may be useful to elucidate pathophysiologic mechanisms and to evaluate new therapies for septic shock.

Animals↗
PubMed2001

Feasibility and low toxicity of early radiotherapy after high-dose chemotherapy and autologous stem cell transplantation for patients with high-risk stage II-III and locally advanced breast carcinoma.

BACKGROUND: This prospective trial examined the feasibility, toxicity, and effectiveness of early locoregional radiotherapy after high-dose chemotherapy and autologous stem cell transplantation in patients with high-risk American Joint Committee on Cancer (AJCC) Stage II-III and locally advanced breast carcinoma. METHODS: One hundred forty-seven consecutive patients with high-risk and locally advanced breast carcinoma were included in the current study. All patients received induction chemotherapy with a doxorubicin-based therapy, which was consolidated with high-dose cyclophosphamide, carboplatin, and thiotepa followed by autologous stem cell support. Within 50 days of the transplant, the patients were treated with locoregional radiotherapy that included the chest wall or breast, the axilla and supraclavicular area, and the internal mammary chain. The volume of lung included in the treatment volume was kept to a minimum. The central lung distance of the tangential fields ranged from 0.6-2.0 cm (mean, 1.1 cm). Tamoxifen was given based on receptor status. RESULTS: One hundred forty-six of 147 patients received the planned treatment. Only six patients had a delay in the initiation of radiotherapy, and another 16 patients had delays during radiotherapy. Leukocyte and platelet toxicities during radiotherapy were not life-threatening and blood counts thereafter returned to normal. Grade 2 (according to National Cancer Institute Common Toxicity Criteria) skin toxicity occurred in 22% of patients and Grade 3 skin toxicity occurred in 6% of patients. Radiation pneumonitis was reported to occur in 5 patients (< 4%). After a median follow-up of 36 months from diagnosis (range, 6-64 months), there were no long-term organ toxicity and no secondary malignancy reported. No treatment-related deaths were reported. Three patients (< 3%) developed locoregional recurrence. CONCLUSIONS: Locoregional radiotherapy after high-dose chemotherapy and autologous stem cell transplantation appears to be feasible and can be delivered safely within 10 weeks of transplantation. The short-term and long-term toxicity are reported to be low, with good local control.

Adult↗
PubMed2001

[Use of the Appropriateness Evaluation Protocol in inpatient ENT practice].

BACKGROUND AND OBJECTIVE: Determination of inappropriate hospital use is of increasing importance due to limited resources in health care. The Appropriateness Evaluation Protocol (AEP) serves as an instrument to identify this inappropriate hospital use. It was designed in the USA in 1981 for use in Internal Medicine and General Surgery and consists of criteria items to assess the appropriateness of hospital admissions and days of care. PATIENTS/METHODS: The present study aims to examine the practicability of the AEP in Otorhinolaryngology. The charts of all patients hospitalized in the ENT Department at that particular day were surveyed on 4 consecutive Wednesdays. Three reviewers each reviewed 196 charts. RESULTS: The overall level of inappropriate use was 41.5%. Presuming that the day preoperative to elective surgery was appropriate, the level was 23.1%. CONCLUSIONS: The critical comparison between this result and the actual reasons for hospital admissions and days of care showed, that the present German version of the AEP is less suitable for use in Otorhinolaryngology. Based on the experiences with the AEP an AEP adjusted to Otorhinolaryngology (AEP-ENT) is proposed.

Germany↗
PubMed2001

[Clinical aspects of tracheopathia osteoplastica].

Tracheopathia osteoplastica is a rare condition of the tracheobronchial tree characterized by the formation of multiple osseous or cartilaginous submucosal nodules which protrude into the lumen. Clinical features, pathological-anatomical, and radiological findings are described and discussed on the basis of three recent cases and a literature review.Two female patients (age 56 and 62 years) and one male (age 44 years) presented with recurrent tracheobronchitis, a "difficult intubation" at the time of an emergency situation requiring tracheostomy. The diagnosis was confirmed by tracheoscopy. CT scans showed radiodense nodular thickening of the tracheal wall compromising the lumen in all patients, whereas plain chest radiography revealed scalloped linear calcification in only one case. Histologically the nodules consisted of lamellar-type bone covered by normal mucosa. None of the patients needed therapeutic measures as there was no impairment of ventilatory function. The long-term observations (>15 years) of a few authors suggest that the disease is of benign course and does not deteriorate.

Adult↗
PubMed2001

[Ocular myositis. A rare differential diagnosis of sinus-induced orbital complications].

Orbital myositis is an uncommon subgroup of the nonspecific orbital inflammatory syndromes (previously termed orbital pseudotumor) and presents with eyelid swelling and redness, conjunctival chemosis, pain, proptosis, and diplopia. The disease is to date of unknown origin; autoimmune processes are suspected for the etiology. In the case of an otherwise healthy young male patient (age 28 years), the coexistence of chronic sinusitis primarily led to the diagnosis of sinugen orbital cellulitis. Despite antibiotic drug administration and surgical drainage of the paranasal sinuses the symptoms persisted. A second computed tomography revealed fusiform, inflammatory enlargement of the m. rectus lateralis. This muscle showed a restrictive paresis so that initially the m. rectus medialis was suspected to be paretic. The patient responded dramatically to administration of prednisolone within 2 days. The differential diagnosis between a sinugen orbital complication and orbital myositis is significant because corticosteroids are contraindicated for orbital cellulitis whereas they remain the therapy of choice for orbital myositis.

Adult↗
PubMed2001

[Early surgical pharyngostoma in therapy of postoperative pharyngeal fistulas].

BACKGROUND: Postoperative salivary fistulas after laryngectomy occur in 2-65% of cases according to the literature. They are not only inconvenient but also dangerous, as the permanent leakage of saliva prevents wound healing and may cause a life threatening arrosion hemorrhage from the jugular vein or carotid artery. Spontaneous closure of such fistulas is unlikely unless the leakage of saliva can be reduced sufficiently by suction and wound compression. However, about 50% of these patients develop a mucocutaneous pharyngostome after several weeks or even months, then requiring extensive flap reconstruction. In order to shorten this long rehabilitation process and to protect the patient from the danger of hemorrhage the commonly recommended therapeutic concept was modified in that the saliva was completely drained from the wound by creation of a submental epithelialized pharyngostome. In this paper our 10 year experience with this concept is reported. PATIENTS AND METHOD: During the period from 1991 to 1999 postoperative salivary fistulas were seen in 9 of 94 consecutive patients after total laryngectomy. Right after diagnosis a meticulous surgical wound debridement was performed and a submental pharyngostome was created in each case. After healing of the mucocutaneous lining the pharyngostome itself was closed with regional skin flaps. RESULTS: In 7 of the 9 patients a quick and permanent closure of the fistula was achieved by the treatment described. The sooner after diagnosis of the fistula the pharyngostome was created, the earlier the closure of the fistula was obtained. In 1 patient the pharyngeal reconstruction was complicated by nosocomial infections, 1 patient died in the course of treatment due to non fistula related concomitant disease. CONCLUSIONS: In case of postoperative salivary fistulas following laryngectomy the immediate creation of a mucocutaneous pharyngostome can reduce the duration of treatment and at the same time protect the patient from the danger of vascular arrosion.

Adult↗
PubMed2001

[Posterior crus stapedectomy: an obsolete method in otosclerosis surgery?].

BACKGROUND: Stapedectomy and stapedotomy with interposition of prostheses are the methods of choice for surgical treatment of otosclerosis. For the present study we resumed and reevaluated the posterior crus stapedectomy, a method based on the principal of renouncing a prosthesis by cutting the posterior crus of the stapes close to the footplate and the anterior crus close to the stapes head. METHODS: The posterior crus is temporarily transposed with the incudostapedial joint remaining intact. After performance of platinectomy and sealing of the oval window with fascia it is repositioned onto the center of the window. RESULTS: 19 of 20 ears operated on applying this technique showed good results (closure of air bone gap) after a mean follow up of 24.6 months. One patient showed persistence of air bone gap of 32.5 dB. Revision surgery revealed that the posterior crus had migrated to the posterior rim of the oval window. No inner ear affection, perilymph fistula or sensorineural hearing loss were observed. CONCLUSIONS: The major advantage of this technique is the avoidance of incus necrosis and foreign body reactions related to the material of the prosthesis. Disadvantages are technical plus the longer duration of the procedure.

Adult↗
PubMed2001

Comparison of MPEG-1 digital videotape with digitized sVHS videotape for quantitative echocardiographic measurements.

Digital format is rapidly emerging as a preferred method for displaying and retrieving echocardiographic studies. The qualitative diagnostic accuracy of Moving Pictures Experts Group (MPEG-1) compressed digital echocardiographic studies has been previously reported. The goals of the present study were to compare quantitative measurements derived from MPEG-1 recordings with the super-VHS (sVHS) videotape clinical standard. Six reviewers performed blinded measurements from still-frame images selected from 20 echocardiographic studies that were simultaneously acquired in sVHS and MPEG-1 formats. Measurements were obtainable in 1401 (95%) of 1486 MPEG-1 variables compared with 1356 (91%) of 1486 sVHS variables (P <.001). Excellent agreement existed between MPEG-1 and sVHS 2-dimensional linear measurements (r = 0.97; MPEG-1 = 0.95[sVHS] + 1.1 mm; P <.001; Delta = 9% +/- 10%), 2-dimensional area measurements (r = 0.89), color jet areas (r = 0.87, p <.001), and Doppler velocities (r = 0.92, p <.001). Interobserver variability was similar for both sVHS and MPEG-1 readings. Our results indicate that quantitative off-line measurements from MPEG-1 digitized echocardiographic studies are feasible and comparable to those obtained from sVHS.

Echocardiography↗
PubMed2001

Advanced glycation endproducts: activators of cardiac remodeling in primary fibroblasts from adult rat hearts.

BACKGROUND: Cardiovascular diseases are the leading cause of death in the Western world, especially in the elderly. Myocardial fibrosis induced by activated cardiac fibroblasts is thought to play a key role in the pathogenesis of cardiovascular disease. Accumulation of advanced glycation endproducts (AGEs), products of nonenzymatic glycation of proteins, correlate with the stiffness of the heart and large vessels. To elucidate a potential role of AGEs as a trigger of fibrosis, the effects of AGEs on primary fibroblasts from hearts of adult rats were investigated. MATERIAL AND METHODS: The activation of intracellular signaling pathways was shown by Western blotting. In addition, the expression of genes of the extracellular matrix proteins, metalloproteases (MMPs), their inhibitors, and TGF-beta were analyzed by semiquantitative PCR. Activation of MMPs were controlled by Zymography. RESULTS: It was shown that treatment of cardiac fibroblasts with AGEs leads to an activation of different signaling molecules, such as the p38MAP-kinase, the extracellular regulated kinases (ERKs), the jun kinase (JNK), as well as transcription factors like ATF-2 and NF-kappaB. In addition, the expression and activation of MMP-2, MMP-9, and MMP-13 were induced, which may be responsible for tissue remodeling followed by fibrosis. CONCLUSION: Due to their effects on the expression and activation of metalloproteases, AGEs should be regarded as a potential therapeutic target for the prevention of pathologic remodeling.

Animals↗
PubMed2000

Induction of primary NY-ESO-1 immunity: CD8+ T lymphocyte and antibody responses in peptide-vaccinated patients with NY-ESO-1+ cancers.

Cancer-testis antigen NY-ESO-1 is one of the most immunogenic tumor antigens defined to date. Spontaneous humoral and CD8+ T-cell responses to NY-ESO-1 are detected in 40-50% of patients with advanced NY-ESO-1-expressing tumors. A clinical trial was initiated to study the immunological effects of intradermal vaccination with 3 HLA-A2-binding NY-ESO-1 peptides in 12 patients with metastatic NY-ESO-1-expressing cancers. Seven patients were NY-ESO-1 serum antibody negative, and five patients were NY-ESO-1 serum antibody positive at the outset of the study. Primary peptide-specific CD8+ T-cell reactions and delayed-type hypersensitivity responses were generated in four of seven NY-ESO-1 antibody-negative patients. Induction of a specific CD8+ T-cell response to NY-ESO-1 in immunized antibody-negative patients was associated with disease stabilization and objective regression of single metastases. NY-ESO-1 antibody-positive patients did not develop significant changes in baseline NY-ESO-1-specific T-cell reactivity. However, stabilization of disease and regression of individual metastases were observed in three of five immunized patients. These results demonstrate that primary NY-ESO-1-specific CD8+ T-cell responses can be induced by intradermal immunization with NY-ESO-1 peptides, and that immunization with NY-ESO-1 may have the potential to alter the natural course of NY-ESO-1-expressing tumors.

Amino Acid Sequence↗
PubMed2000

Adenomatous polyposis coli I1307K mutation in Jewish patients with different ethnicity: prevalence and phenotype.

BACKGROUND: A new mutation, I1307K, recently was reported in the adenomatous polyposis coli (APC) gene. This mutation was found to be predominant in Ashkenazi Jews, creating a hypermutable area and predisposing the development of carcinoma. The objective of the current study was to estimate the prevalence of this mutation in several of the ethnic groups that comprise the Israeli population and to elucidate the clinical features of the mutation carriers with colorectal carcinoma (CRC). METHODS: A total of 111 consecutive CRC patients were evaluated and their medical history and clinical data recorded. The general population (298 Ashkenazim and 189 Yemenites) also was tested for the presence of this mutation. Mutation screening was performed using both the polymerase chain reaction-based amplification refractory mutation system and a commercial APC kit. RESULTS: Of the total of 111 CRC patients, 15 (13.5%) carried the I1307K mutation and 26 of 487 subjects from the general population (5.3%) carried the I1307K mutation (P = 0.004). Among the 71 Ashkenazi CRC patients there were 12 carriers (16.9%) whereas 17 of the 298 Ashkenazi Jewish general population (5.7%) carried the mutation (P = 0.004). Of the 4 CRC patients of Yemenite origin, 3 carried the mutation and 9 carriers were found among 189 subjects in the general Yemenite population (4.7%) (P = 0.0007). None of the 34 Sepharadic or 2 Arab CRC patients carried the APC I1307K allele. Late age at diagnosis (64.6 years +/- 10.0, which is similar to that of the noncarriers), mostly right-sided tumors, and moderate to good differentiation constituted the phenotype of the mutation carriers. CONCLUSIONS: The authors believe the findings of the current study broaden the known spectrum of ethnic groups in which the APC I1307K mutation is prevalent. The phenotype of the mutation carrier CRC patients does not conform to the expected familial pattern of germline mutations. The phenotype and the differential incidence rate of CRC among APC I1307K carriers of various ethnic groups suggest low penetrance.

Adenomatous Polyposis Coli↗
PubMed2000

[Management of complications after prosthetic voice rehabilitation].

The growing popularity of prosthetic voice restoration after total laryngectomy confronts ENT specialists with an increasing number of prosthesis-related complications. The ENT specialist should be familiar with the management of these complications in order to maintain the patients speech and social rehabilitation. In a retrospective study on 108 consecutive patients, complications were encountered in 30%. The incidence was not related to the factors age or primary vs. secondary insertion of the prosthesis. Complications consisted of formation of granulation tissue (15.7%), shunt dilatation (5.5%), loss of prosthesis (3.7%), local cellulitis (2.8%), extrusion (1.9%), ingrowth of prosthesis (1.9%) and formation of excessive scar tissue with dislocation of prosthesis (0.9%). Permanent removal of the prosthesis due to complications was necessary in 3 cases (2.8%). Therapeutic measures for the management of complications are described and evaluated. The treatment of complications was well tolerated by all patients and led to satisfying results in most cases. Our observations show that prosthetic voice rehabilitation is associated with various difficulties and complications, but that these can be handled quite easily and successfully in the majority of cases.

Adult↗
PubMed2000

A lipid A analog, E5531, blocks the endotoxin response in human volunteers with experimental endotoxemia.

BACKGROUND: Endotoxin (lipopolysaccharide [LPS]) has been associated with sepsis and the high mortality rate seen in septic shock. The administration of a small amount of LPS to healthy subjects produces a mild syndrome qualitatively similar to that seen in clinical sepsis. We used this model to test the efficacy of an endotoxin antagonist, E5531, in blocking this LPS-induced syndrome. METHODS: In a placebo-controlled, double-blind study, we randomly assigned 32 healthy volunteers to four sequential groups (100, 250, 500, or 1000 microg of E5531). Each group of eight subjects (six assigned to E5531, two assigned to placebo) received a 30-min intravenous infusion of study drug. LPS (4 ng/kg) was administered to all subjects as an intravenous bolus in the contralateral arm at the midpoint of the infusion. Symptoms, signs, laboratory values, and hemodynamics (by echocardiogram) were evaluated at prospectively defined times. RESULTS: In subjects receiving placebo, LPS caused headache, nausea, chills, and myalgias. E5531 led to a dose-dependent decrease in these symptoms that was statistically significant (p < .05) except for myalgias. The signs of endotoxemia (fever, tachycardia, and hypotension) were consistently inhibited at the three higher doses (250, 500, and 1000 microg, p < .05). Tumor necrosis factor-alpha and interleukin-6 blood levels were both lower in those who received E5531 (p < .0001). The C-reactive protein level and white blood cell count response were decreased at all doses (p < .0001). The hyperdynamic cardiovascular state (high cardiac index and low systemic vascular resistance) associated with endotoxin challenge was significantly inhibited at the higher doses of E5531. CONCLUSIONS: E5531 blocks the symptoms and signs and cytokine, white blood cell count, C-reactive protein, and cardiovascular response seen in experimental endotoxemia. This agent is a potent inhibitor of endotoxin challenge in humans and may be of benefit in the prevention or treatment of sepsis and septic shock.

Adolescent↗
PubMed1999

High molecular weight hyaluronic acid inhibits advanced glycation endproduct-induced NF-kappaB activation and cytokine expression.

Advanced glycation endproducts (AGEs), which accumulate on long-lived proteins and protein deposits (amyloids), induce the expression of proinflammatory cytokines through NF-kappaB-dependent pathways. Hyaluronic acid with a molecular weight above 1.2 MDa (HMW-HA) inhibits the AGE-induced activation of the transcription factor NF-kappaB and the NF-kappaB-regulated cytokines interleukin-1alpha, interleukin-6 and tumor necrosis factor-alpha. Since the molecular weight of hyaluronic acid in humans decreases with age and under conditions of oxidative stress, it is likely that the protective effect of HMW-HA against AGE-induced cellular activation is lost at sites of chronic inflammation and in older age.

Animals↗