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Biomedical subjects

A Prokop

Publications and source records attributed to A Prokop.

At least 37 records · Page 2Linked to original sources
PubMed2002

[Treatment of metacarpal fractures].

Conservative treatment of metacarpal fractures is recommended if there is no joint displacement, malrotation, displacement of over 30 degrees ad axim and shortening of over 5 mm. Surgery should be performed in open fractures and serial fractures of metacarpal bone. Early functional treatment should be carried out in stable, not displaced fractures. A cast can be used for a short period in full extended position of fingers and flexion in metacarpo-phalangeal joint in 60 - 90 degrees. Twin-tape fixation allows functional treatment after soft-tissue swelling has disappeared. Closed reduction of displaced fractures of the fifth metacarpal bone (boxer's fracture) is not successful. Cases with displacement of over 30 degrees may be treated surgically by intramedullary stabilisation.

Adult↗
PubMed2002

[Minimal invasive biological osteosynthesis of the clavicle with a titanium nail].

Until December 2001 84 midclavicular fractures in 80 patients were treated with intramedullary nailing. Postoperatively there was a significant decrease of pain and a significant increase of mobility compared to the situation preoperatively. 6 months after hardware removal the mean Constant-Score was 97.4 points. There was one none union. In one patient there was a loss of reduction with shortening of 1.5 cm. In 5 patients a shortening of the proximal end of the nail had to be performed, due to painful skin irritation. Intramedullary nailing of midclavicular fractures is a safe and minimally invasive operation technique. It should be offered to the patient as an alternative to conservative treatment.

Adult↗
PubMed2002

[LISS versus condylar plate].

Up to the seventies the surgical treatment of supra- and bicondylar femoral fractures was difficult and showed a lot of complications. In most studies a conservative treatment was recommended. In the least 30 years the clinical outcome after surgical treatment improved. This was a result of the development of new implants and improved surgical techniques. However, today the primary surgical treatment is the therapy of choice. We reviewed from 1986 to 2001 n = 121 distal femoral fractures which were in 32 cases treated with a Condylar Blade Plate and in 10 cases with a less invasive stabilisation system (LISS). The final results after condylar blade plating were rated using the system that was described by Neer. The averaged follow up time was 9 years. Low postoperative infection rates and in 75% excellent and satisfactory results combined with low cost are the reference for the evaluation of the LISS results. While in our owen series according to the literature there were no significant better functional results for the LISS group than for the Condylar Blade Plate group there were only few autologous bone grafts necessary. Due to the angle-stable self-drilling and self-cutting screws and the Internal-Fixater Principle the LISS has some mechanical and biological edge on the condylar blade plate.

Bone Plates↗
PubMed2002

[Intramedullary fixation of pediatric bone shaft fractures].

Intramedullary stabilisation (Prévot-nailing) of shaft fractures in childhood allows full weight bearing without cast. Early fracture healing is seen by respecting soft tissue around fracture and by using distal or proximal approaches. Good indications of femoral shaft osteosynthesis are recommended in oblique- and transverse-fractures. Intramedullary stabilization seems to be a good alternative methode instead of casting calf-shaft-fractures. An instable fracture of forearm may be treated intramedullary to avoid often observed displacement ad axim and rotation. Humoral fractures primary have to be treated conservatively. Only in displaced fractures or in cases with additional injuries an intramedullary procedure with free range of motion is recommended.

Adolescent↗
PubMed2002

[Conservative treatment of metacarpal fracture].

Conservative treatment of meatacarpale fracture is recommended if there are no joint displacement, rotation failures, displacement over 30 degrees ad axim and shortening over 5 mm. Operative procedures should be done in open fractures and serial of fractures of metacarpale bones. Early functionally treatment should be done in stable, not displaced fractures. Cast can be used only for a short time in full extended position of fingers and flexion in metacarpo-phalangeal joint in 60-90 degrees. Twin-tapes after reduction of edema allowed free range of motion by fixed rotation. Closed reduction of displaced fractures of fifth metacarpal bone (boxer's fracture) isn't successful. Cases with displacement over 30 degrees may be operatively treated by intramedullary stabilization.

Adult↗
PubMed2002

[Stabilizing intramedullary pediatric shaft fractures].

Intramedullary stabilisation (Prévot-nailing) of shaft fractures in childhood allows full weight bearing without cast. Early fracture healing is seen by respecting soft tissue around fracture and by using distal or proximal approaches. Good indications of femoral shaft osteosynthesis are recommended in oblique and transverse fractures. Intramedullary stabilization seems to be a good alternative method instead of casting calf-shaft fractures. An unstable fracture of forearm may be treated intramedullary to avoid often observed displacement ad axim and rotation. Humoral fractures primary have to be treated conservatively. Only in displaced fractures or in cases with additional injuries an intramedullary procedure with free range of motion is recommended.

Adolescent↗
PubMed2001

Water-based nanoparticulate polymeric system for protein delivery.

This article features a new production technology for nanoparticles comprised of multicomponent polymeric complexes that are candidates for delivery vehicles of biological molecules such as proteins and drugs. Biocompatible and mostly natural polymers are fabricated into thermodynamically stable nanoparticles insoluble in water and buffered media, in the absence of organic solvents, using two types of processing: batch and continuous. Careful choice of construction materials and the superposition of several interacting principles during their production allow for the customization of the physicochemical properties of the structures. Detailed experiments in batch and continuous systems allowed time-dependent stoichiometric characterization of the production process and an understanding of fundamental assembly principles of such supramolecular structures. Continuous-flow production is shown to provide more consistent data in terms of product quality and consistency, with further possibility of process development and commercialization. The development of nanoparticles using the described methodology is expected to lead to a flexible nanoparticle drug delivery system for medical applications, which has particular bearing to the slow release of drugs, antigens (for vaccine design), and genes (for gene therapy). Several chemistries of particles are presented.

Animals↗
PubMed2001

Activation of caspase-8 in drug-induced apoptosis of B-lymphoid cells is independent of CD95/Fas receptor-ligand interaction and occurs downstream of caspase-3.

The activation of caspase-8, a crucial upstream mediator of death receptor signaling, was investigated in epirubicin- and Taxol-induced apoptosis of B-lymphoma cells. This study was performed because the CD95/Fas receptor-ligand interaction, recruitment of the Fas-associated death domain (FADD) adaptor protein, and subsequent activation of procaspase-8 have been implicated in the execution of drug-induced apoptosis in other cell types. Indeed, active caspase-8 was readily detected after treatment of mature and immature B-lymphoid cells with epirubicin or Taxol. However, neither constitutive nor drug-induced expression of the CD95/Fas ligand was detectable in B-lymphoma cells. Furthermore, overexpression of a dominant-negative FADD mutant (FADDdn) did not block caspase-8 processing and subsequent DNA fragmentation, indicating that drug-induced caspase-8 activation was mediated by a CD95/Fas-independent mechanism. Instead, caspase-8 cleavage was slightly preceded by activation of caspase-3, suggesting that drug-induced caspase-8 activation in B-lymphoma cells is a downstream event mediated by other caspases. This assumption was confirmed in 2 experimental systems-zDEVD-fmk, a cell-permeable inhibitor of caspase-3-like activity, blocked drug-induced caspase-8 cleavage, and depletion of caspase-3 from cell extracts impaired caspase-8 cleavage after in vitro activation with dATP and cytochrome c. Thus, these data indicate that drug-induced caspase-8 activation in B-lymphoma cells is independent of death receptor signaling and is mediated by postmitochondrial caspase-3 activation.

Adaptor Proteins, Signal Transducing↗
PubMed2001

[Diagnosis of intra-articular fracture of the head of the tibia. A prospective comparative study].

Complete visualization of the joint surface is essential for correct assessment of tibial head fractures. Conventional tomography, computed tomography (CT), and magnetic resonance imaging (MRI) are compared in this prospective study. We examined 27 patients (19 suffering from B fractures and 8 from C fractures) from 1 January 1995 to 11 November 1998. Conventional tomography underestimated the fractures in 3 of the 19 cases of B fractures. Computed tomography underestimated two of these cases. MRI could not exactly depict the essential structures in three of the eight cases of C fractures because of edema and effusions. MRI identified complete cruciate ligament rupture in 6 of the 27 cases (18%) and 10 meniscal ruptures in 9 cases (33%: 6 medial meniscus, 4 lateral meniscus). Complete ruptures of the lateral collateral ligament were detected in five cases and medial collateral ligament ruptures in two cases. According to this, 63% of the patients suffered from relevant accompanying soft tissue injuries. The rate of soft tissue injuries increased up to 92% including the partial collateral ligament ruptures. Local hospital conditions permitting, X-ray-loaded conventional tomography should no longer be used in tibial head fractures. X-ray-free MRI is most efficient in cases of B fractures, which can in most cases be treated with a minimum of invasive techniques. Computed tomography is to be used in cases of C fractures that are regularly managed by open surgery accompanied by direct visualization of the inside of the knee joint.

Adult↗
PubMed2001

[Treatment errors of metacarpal fractures. An analysis of expert testimony of the "Committee for Medical Malpractice" of the North Rhine Physician's Council].

A large number of publications notwithstanding, there are no clear guidelines regarding the treatment of metacarpal fractures. Some authors believe that even severely dislocated fractures should not be surgically fixated. This paper analyzes the forensic problem on the basis of court rulings in Germany. Seventeen evaluations of metacarpal fractures conducted by the commission on medical malpractice of the physicians' council in North Rhein were analyzed and common mistakes were listed. The average age of the eight male and nine female patients was 41.9 years. The fifth metacarpal bone (MB) was affected eight times, the fourth MB four times, and the first MB twice. The second MB and third MB were affected once each. Surgery was performed in nine cases, while the conservative approach was taken eight times. An independent expert determined medical malpractice in 13 cases (76%). In 10 of these 13 cases, the symptoms the patients exhibited were linked to medical malpractice. In the 13 cases of medical malpractice there were 5 cases with technically insufficient osteosynthesis, 4 cases of uncorrected dislocation, 2 false diagnoses, and 2 false immobilizations. An independent expert identified a link to the symptoms in three of the four cases of uncorrected dislocation. These were an anatomically nonreduced fracture with joint involvement, a fracture with a dislocation of 50 degrees, and a fracture with rotation dislocation. Cases where fractures healed with severe dislocation or immobilization in a wrong position or for a too long a period are common but avoidable mistakes in the treatment of metacarpal fractures.

Adult↗
PubMed2001

Piceatannol, a hydroxylated analog of the chemopreventive agent resveratrol, is a potent inducer of apoptosis in the lymphoma cell line BJAB and in primary, leukemic lymphoblasts.

The stilbene phytochemicals resveratrol and piceatannol have been reported to possess substantial antitumorigenic and antileukemic activities, respectively. Although recent experimental data revealed the proapoptotic potency of resveratrol, the molecular mechanisms underlying the antileukemic activity have not yet been studied in detail. In the present study, we show that resveratrol, as well as the hydroxylated analog piceatannol, are potent inducers of apoptotic cell death in BJAB Burkitt-like lymphoma cells with an ED50 concentration of 25 microM. Further experiments revealed that treatment of BJAB cells with both substances led to a concentration-dependent activation of caspase-3 and mitochondrial permeability transition. Using BJAB cells overexpressing a dominant-negative mutant of the Fas-associated death domain (FADD) adaptor protein to block death receptor-mediated apoptosis, we demonstrate that resveratrol- and piceatannol-induced cell death in these cells is independent of the CD95/Fas signaling pathway. To explore the antileukemic properties of both compounds in more detail, we extended our study to primary, leukemic lymphoblasts. Interestingly, piceatannol but not resveratrol is a very efficient inducer of apoptosis in this ex vivo assay with leukemic lymphoblasts of 21 patients suffering from childhood lymphoblastic leukemia (ALL).

Adolescent↗
PubMed2001

Towards retrievable vascularized bioartificial pancreas: induction and long-lasting stability of polymeric mesh implant vascularized with the help of acidic and basic fibroblast growth factors and hydrogel coating.

We seek to improve existing methodologies for allogenic grafting of pancreatic islets. The lack of success of encapsulated transplanted islets inside the peritoneal cavity is presently attributed to poor vascularization of the implant. A thick, fibrotic capsule often surrounds the graft, limiting survival. We have tested the hypothesis that neovascularization of the graft material can be induced by the addition of proper angiogenic factors embedded within a polymeric coat. Biocompatible and nonresorbable meshes coated with hydrophilic polymers were implanted in rats and harvested after 1-, 6-, and 12-week intervals. The implant response was assessed by histological observations on the degree of vascularity, fibrosis, and inflammation. Macrostructural geometry of meshes was conducive to tissue ingrowth into the interstitial space between the mesh filaments. Hydrogel coating with incorporated acidic or basic FGF in an electrostatic complex with polyelectrolytes and/or with heparin provided a sustained slow release of the angiogenic growth factor. Anti-factor VIII and anti-collagen type IV antibodies and a GSL I-B4 lectin were used to measure the extent of vascularization. Vigorous and persistent vascularization radiated several hundred microns from the implant. The level of vascularization should provide a sufficient diffusion of nutrients and oxygen to implanted islets. Based on our observations, stable vascularization may require a sustained angiogenic signal to allow for the development of a permanent implant structure.

Animals↗
PubMed2001

Bioartificial pancreas: materials, devices, function, and limitations.

The term "bioartificial endocrine pancreas" (BEP) was introduced by Anthony Sun in 1980. It was in 1968, however, that Thomas Chang proposed the use of microencapsulated islets as artificial beta-cells. By applying a semipermeable membrane on the top of microcapsules, a system can be produced that is impermeable to viable islet cells and large effector molecules of the immune system, thus providing a protection for transplanted islets against rejection. Since then, the term BEP has not often appeared in papers. Instead, the term "bioartificial pancreas" (BAP) has gained widespread use. In a broader sense, BAP would include an application of suitable endocrine cells and protective polymeric vehicles, but not necessarily providing a filtration barrier of precisely defined properties (e.g., cells injected into a gel of hyaluronate).

Animals↗
PubMed2001

Bioartificial organs in the twenty-first century: nanobiological devices.

Bioartificial organs involve the design, modification, growth and maintenance of living tissues embedded in natural or synthetic scaffolds to enable them to perform complex biochemical functions, including adaptive control and the replacement of normal living tissues. Future directions in this area will lead to an abandonment of the trial-and-error implant optimization approach and a switch to the rational production of precisely formulated nanobiological devices. This will be accomplished with the help of three major thrusts: (1) use of molecularly manipulated nanostructured biomimetic materials; (2) application of microelectronic and nanoelectronic interfacing for sensing and control; and (3) application of drug delivery and medical nanosystems to induce, maintain, and replace a missing function that cannot be readily substituted with a living cell and to accelerate tissue regeneration. Biomimetics involves employment of microstructures and functional domains of organismal tissue function, correlation of processes and structures with physical and chemical processes, and use of this knowledge base to design and synthesize new materials for health applications. Nanostructured materials should involve biological materials (rather then synthetic ones) because their prefabricated structure is suitable for modular control of devices from existing materials. Nanostructured tools should encompass surface patterned molecular arrays, nanoscale synthetic scaffolding mimicking the cell-extracellular matrix microenvironment, precise positioning of molecules with specific signals to provide microheterogeneity, composites of bioinorganic and organic molecules, molecular layering (coating), and molecular and supramolecular self-assembly and self-organization (template-directed) assembly. The nanoelectronic interface includes electronic or optoelectronic biointerfaced devices based on individual cells, their aggregates and tissues, organelles, and molecules, such as enzyme-based devices, transport and ion-channel membrane proteins, and receptor-ligand structures, including nanostructured semiconductor chips and microfluidic components. Delivery nanosystems encompass both water and lipid core vehicles (for hydrophilic and lipophilic components) of various geometries: liposomes, micelles, nanoparticles, lipid shells (as imaging and contrasting agents), solid nanosuspensions, lipid nanospheres, and coated film surfaces (molecular layering), all for use in delivering drugs, proteins, cell modifiers, and genes. Nanoelectronic interface and delivery nanosystems will be used for sensing, feedback, control, and analysis of function of bioartificial organs.

Bioartificial Organs↗
PubMed2001

Measurement of bubble size distribution in protein foam fractionation column using capillary probe with photoelectric sensors.

Bubble size is a key variable for predicting the ability to separate and concentrate proteins in a foam fractionation process. It is used to characterize not only the bubble-specific interfacial area but also coalescence of bubbles in the foam phase. This article describes the development of a photoelectric method for measuring the bubble size distribution in both bubble and foam columns for concentrating proteins. The method uses a vacuum to withdraw a stream of gas-liquid dispersion from the bubble or foam column through a capillary tube with a funnel-shaped inlet. The resulting sample bubble cylinders are detected, and their lengths are calculated by using two pairs of infrared photoelectric sensors that are connected with a high-speed data acquisition system controlled by a microcomputer. The bubble size distributions in the bubble column 12 and 1 cm below the interface and in the foam phase 1 cm above the interface are obtained in a continuous foam fractionation process for concentrating ovalbumin. The effects of certain operating conditions such as the feed protein concentration, superficial gas velocity, liquid flow rate, and solution pH are investigated. The results may prove to be helpful in understanding the mechanisms controlling the foam fractionation of proteins.

Chemical Engineering↗
PubMed2001

Effect of a natural contaminant on foam fractionation of bromelain.

Foam fractionation is a simple, inexpensive method for separating and purifying proteins. Typically, a dilute bromelain solution with a pH ranging from 2.0 to 7.0 foams very well when bubbles are introduced into a foam fractionation column. It was observed, however, that the dilute enzyme solution only foamed between approximately pH 2.0 and 3.0 when the inner wall of the fractionation column was coated with a natural contaminant (okra residue). We studied the separation ratio and the protein mass recovery to explore the effect of a natural antifoaming agent on the foam fractionation of a dilute bromelain solution. The control variables used in this process were the initial bulk solution pH, which ranged from 2.0 to 7.0, and the superficial air velocity, which varied between 1.7 and 6.2 cm/s.

Abelmoschus↗
PubMed2000

Relapse in childhood acute lymphoblastic leukemia is associated with a decrease of the Bax/Bcl-2 ratio and loss of spontaneous caspase-3 processing in vivo.

Dysfunction of the p53/Bax/caspase-3 apoptosis signaling pathway has been shown to play a role in tumorigenesis and tumor progression, ie the development of acquired drug resistance. Low expression of the apoptosis inducer Bax correlates with poor response to therapy and shorter overall survival in solid tumors. In the present study, we analyzed the p53/Bax/caspase-3 pathway in a paired and an unpaired sample series of children with acute lymphoblastic leukemia (ALL) at initial diagnosis and relapse. The data demonstrate that both Bax expression levels and the Bax/Bcl-2 ratio are significantly lower in samples at relapse as compared with samples at initial diagnosis (P=0.013, Wilcoxon signed rank test (paired samples); P=0.0039, Mann-Whitney U test (unpaired samples)). The loss of Bax protein expression was not a consequence of Bax frameshift mutations of the G8 tract and could not be attributed to mutations of the p53 coding sequence (exons 5 to 8) which were detected to a similar extent in de novo ALL samples and at relapse. Analysis of the downstream effector caspase-3 showed loss of spontaneous caspase-3 processing at relapse. Whereas nine out of 14 (64%, paired samples) or 37 out of 77 (48%, unpaired samples) ALL patients at initial diagnosis displayed spontaneous in vivo processing of caspase-3, this was completely absent in patients at relapse (paired samples) or detected in only one out of 34 patients at relapse (2.9%, unpaired samples). We therefore conclude that in ALL relapse a severe disturbance of apoptotic pathways occurs, both at the level of Bax expression and caspase-3 activation.

Adolescent↗