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Biomedical subjects

B Meyer

Publications and source records attributed to B Meyer.

At least 181 records · Page 10Linked to original sources

Heparin protects cathepsin G against inhibition by protein proteinase inhibitors.

Cathepsin G, a cationic serine proteinase present in neutrophils and monocytes, is able to cleave biologically important proteins and may thus participate in tissue destruction during inflammation. Its activity is physiologically controlled by the fast-acting serpins, alpha 1-anti-chymotrypsin (ka = 5 x 10(7) M-1 S-1) and alpha 1-proteinase inhibitor (ka = 2.7 x 10(5) M-1 S-1). We have shown that cathepsin G forms a tightly bound 1:1 complex with a 5-kDa heparin fragment (Kd = 1.9 x 10-8 M). The partial enzymatic activity retained by this complex is inhibited extremely slowly by the above 68- and 53-kDa serpins. The activity of the complex is also virtually resistant to inhibition by eglin c, and 8-kDa non-serpin inhibitor. A detailed kinetic investigation showed that the inhibition of heparin-bound cathepsin G by the three proteins proceeded via a two-step mechanism. [formula: see text] The three inhibitors have widely different Ki* values (0.18-13 microM) (Ki* = k-1/k1). Their isomerization constants k2 are, however, all in the same range and their extremely low values (0.7-3 ms-1) account for the very low rate of cathepsin G inhibition. The second-order inhibition rate constants k2/Ki* were 4300, 700, and 52 M-1 S-1 for alpha 1-antichymotrypsin, alpha 1-antitrypsin, and eglin c, respectively, indicating that, if heparin is present in vivo, the two former physiological inhibitors will be unable to prevent cathepsin G-mediated proteolysis. Neutrophil elastase binds the 5-kDa heparin fragment with an affinity identical to that of cathepsin G. alpha 1-Proteinase inhibitor reacts, however, much faster with heparin-elastase (ka = 1.8 x 10(6) M-1 S-1) than with heparin-cathepsin G (k2/Ki* = 700 M-1 S-1).

Cathepsin G↗

Sulfate detection in glycoprotein-derived oligosaccharides by artificial neural network analysis of Fourier-transform infrared spectra.

We report the use of an artificial neural network to analyze the fingerprint region of Fourier-transform infrared (ir) spectra of oligosaccharides for the presence of sulfate groups. This assay can rapidly and nondestructively detect the presence of sulfate in as little as 1 nmol (approximately 2 micrograms) of a glycoprotein-derived monosulfated decasaccharide. The neural network was trained to recognize the presence of sulfate groups by presenting it with 45 ir spectra of sulfated and nonsulfated mono- and oligosaccharides. No prior knowledge of the characteristic ir spectral features of a sulfate group was needed as input. The training process required between 3 and 10 h, while analysis of a spectrum with the trained neural network requires only 0.1 s.

Carbohydrate Sequence↗

Percutaneous needle trephination. Experience in 200 cases.

For many years percutaneous needle and classic burr-hole trephination with insertion of plastic catheters for external ventricular drainage are in use. The shortcomings of the conventional puncture needles were compensated for by the development of a modified instrument in recent years. In this prospective study we tried to define advantages and disadvantages of percutaneous ventriculostomy with this modified needle in a large number of patients. We treated and followed a total number of 200 patients with external ventricular drainage for various reasons (42% obstructive hydrocephalus, 27% haematocephalus, 11% malresorptive hydrocephalus, 11% elevated ICP and 9% infections). The ventriculostomy is performed--after percutaneous trephination with a 1.5 mm drill and 1.2 mm needle under local anaesthesia as a bedside procedure. The modified blunt needle is provided with markings and a set screw which allows insertion to a prefixed depth and a sharp guide which is withdrawn after penetration of the dura. It is then bent rostrally and fixed by a plaster cast. The mean duration of drainage was 9 days (1-30 days). Mean operating time for the whole procedure including fixation and connection to the drainage system was 20 minutes. Overall complication rate was 13% (N = 26). Two intracerebral haemorrhages (1%) occurred, of which one was caused by overdrainage. Five (3%) infections in primarily not infectious cases (N = 182) were seen. Only one case of infection occurred without loosening of the needle on day 17. In 19 patients (10%) the needles had loosened. Fifteen times this complication was repaired in time and no infection occurred.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Oral hairy leukoplakia in a patient with ulcerative colitis.

A 30-year-old man with ulcerative colitis developed oral hairy leukoplakia (OHL). Serological examination for human immunodeficiency virus (HIV)-1 and HIV-2 infection showed no abnormalities. Biopsy specimen of the lateral tongue showed ballooned prickle cells, and electron microscopy revealed herpes-type viruses. Immunologic investigation of the patient showed a marked decrease in T-helper cells as a result of immunosuppressive regimen. The present report appears to be the first well-documented case of OHL in an HIV-negative patient with ulcerative colitis. OHL may be a marker for severe immunosuppression but is not necessarily associated with HIV infection. Patients with iatrogenic immunosuppression should be monitored for OHL. Concerning the marked decrease in T-helper cells in this case, the presence of OHL may imply the examination of T-lymphocyte subsets in patients such as HIV-infected individuals or in organ transplant recipients.

Adult↗

Characterization of the relative thrombogenicity of atherosclerotic plaque components: implications for consequences of plaque rupture.

OBJECTIVES: The purpose of this study was to determine whether different components of human atherosclerotic plaques exposed to flowing blood resulted in different degrees of thrombus formation. BACKGROUND: It is likely that the nature of the substrate exposed after spontaneous or angioplasty-induced plaque rupture is one factor determining whether an unstable plaque proceeds rapidly to an occlusive thrombus or persists as a nonocclusive mural thrombus. Although observational data show that plaque rupture is a potent stimulus for thrombosis, and exposed collagen is suggested to have a predominant role in thrombosis, the relative thrombogenicity of different components of human atherosclerotic plaques is not well established. METHODS: We investigated thrombus formation on foam cell-rich matrix (obtained from fatty streaks), collagen-rich matrix (from sclerotic plaques), collagen-poor matrix without cholesterol crystals (from fibrolipid plaques), atheromatous core with abundant cholesterol crystals (from atheromatous plaques) and segments of normal intima derived from human aortas at necropsy. Specimens were mounted in a tubular chamber placed within an ex vivo extracorporeal perfusion system and exposed to heparinized porcine blood (mean [+/- SEM] activated partial thromboplastin time ratio 1.5 +/- 0.04) for 5 min under high shear rate conditions (1,690 s-1). Thrombus was quantitated by measurement of indium-labeled platelets and morphometric analysis. Under similar conditions, substrates were perfused with heparinized human blood (2 IU/ml) in an in vitro system, and thrombus formation was similarly evaluated. RESULTS: Thrombus formation on atheromatous core was up to sixfold greater than that on other substrates, including collagen-rich matrix (p = 0.0001) in both heterologous and homologous systems. Although the atheromatous core had a more irregular exposed surface and thrombus formation tended to increase with increasing roughness, the atheromatous core remained the most thrombogenic substrate when the substrates were normalized by the degree of irregularity as defined by the roughness index (p = 0.002). CONCLUSIONS: The atheromatous core is the most thrombogenic component of human atherosclerotic plaques. Therefore, plaques with a large atheromatous core content are at high risk of leading to acute coronary syndromes after spontaneous or mechanically induced rupture because of the increased thrombogenicity of their content.

Animals↗

[Respiratory effects of midazolam in patients with obstructive sleep apnea syndromes].

The administration of benzodiazepines at sleeping doses can be followed by an increased rate of upper airways obstruction episodes, especially in patients with an obstructive sleep apnea syndrome (OSAS). However, the effects of benzodiazepines at premedication doses have not yet been assessed. Therefore, fourteen patients were studied after administration of midazolam 0.08 mg.kg-1 i.m.: seven with an OSAS diagnosed previously (baseline recording) (= OSAS group) and seven without risk factors for OSAS (= Control group). The recordings were undertaken in the sleep laboratory. The airflows were assessed by nasal and oral thermistors and chest and abdominal movements by strain gauges. The electromyogram of the chin muscles was recorded, the electroencephalogram and the electro-oculogram electrodes were placed as described by RECHTSCHAFFEN and KALES. The arterial saturation in oxygen (Spo2) was monitored by pulse oximetry. All the signals were digitized and fed into a computer. The apnea was defined as a cessation of airflows for a least 10 s. The hypopnea was defined as a 10 s decrease in airflow with a drop in Spo2 of 4% or more. The respiratory event (apnea or hypopnea) was qualified as obstructive if the thoraco-abdominal movements persisted. The rate and the duration of respiratory events per sleep hour (mean +/- SEM) in OSAS group after midazolam (respectively 29.6 +/- 10 and 11.2 +/- 3.5 min) were not different from those of the baseline recording (respectively 38.4 +/- 11.6 and 12 +/- 3.5 min) and were significantly higher than in the control group (respectively 38.2 +/- 2 and 1.8 +/- 1.3 12 +/- 3.5 min) and were significantly higher than in the control group (respectively 3.8 +/- 2 and 1.8 +/- 1.3 min; p < 0.05). In the OSAS group, the percentage of sleeping time spent with a Spo2 < 90% was 1.5 +/- 1.4% during the baseline recording and 4.7 +/- 1.9% after midazolam (difference n.s.). However, a dramatic increase was observed in two patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Mitochondrial function reflected by the decarboxylation of [13C]ketoisocaproate is impaired in alcoholics.

Mitochondria of patients with alcoholic liver disease exhibit structural abnormalities, and mitochondria isolated from animals exposed to ethanol are functionally deficient when studied in vitro. To assess possible functional consequences of these ethanol-associated alterations in vivo, we measured mitochondrial function in alcoholics noninvasively with a breath test. A mitochondrial function, the decarboxylation of ketoisocaproate (KICA), was assessed by measuring the exhalation of 13CO2 following the administration of 1 mg/kg 2-keto[1-13C]isocaproic acid, the decarboxylation of which occurs in mitochondria. The results of the KICA breath test in 12 alcoholic subjects were compared with the results in healthy controls and patients with nonalcoholic liver disease. The peak exhalation of 13CO2 and the fraction of the administered dose decarboxylated in 120 min were both significantly lower in alcoholics than in healthy controls and patients with nonalcoholic liver disease. In alcoholics, KICA decarboxylation was impaired in the presence of normal quantitative liver function tests such as the aminopyrine breath test and galactose elimination capacity, indicating that KICA decarboxylation does not simply reflect a decreased functional hepatic mass. The enrichment of circulating KICA with [13C]KICA was similar in alcoholics and controls, indicating that a decreased bioavailability or an increased dilution of labeled KICA cannot account for the decreased exhalation of 13CO2. It is concluded that mitochondrial function as reflected by KICA decarboxylation is impaired in chronic alcoholics. The functional impairment is specific for ethanol abuse and not a reflection of decreased global hepatic function. KICA decarboxylation could thus be useful as a marker for excessive ethanol consumption.

Adult↗

Effect of an eccentric severe stenosis on fibrin(ogen) deposition on severely damaged vessel wall in arterial thrombosis. Relative contribution of fibrin(ogen) and platelets.

BACKGROUND: Coronary thrombosis is a dynamic process dependent on the pathological substrate, the local shear forces, and blood factors. METHODS AND RESULTS: We investigated the effect of a severe (80%) eccentric stenosis on fibrin(ogen) interaction with a deeply damaged vessel wall, its relation to platelet deposition in thrombus formation, and the influence of time on thrombus growth. Porcine 125I-fibrinogen and autologous 111In-platelets were injected into pigs instrumented for extracorporeal circulation and treated with low-dose heparin (aPTT ratio < 1.5) that has been previously shown and herein confirmed not to affect platelet and/or fibrin(ogen) attachment. Tunica media, as a model of severely injured vessel wall, was mounted in a tubular perfusion chamber containing an eccentric axisymmetric sinusoidal stenosis obstructing the lumen and exposed for 1, 5, and 10 minutes to perfusing blood. A shear rate of 424 s-1 at the laminar, parallel parabolic local flow perfused segments one to two orders of magnitude greater at the apex of the stenosis. Fibrin(ogen) deposition, its axial distribution with respect to the apex, and its relation to platelet deposition were determined by an ex vivo analysis of the test substrates. Fibrin(ogen) and platelet deposition were both significantly higher at the apex of the stenosis than at either the prestenotic or poststenotic area at all the studied perfusion times (P < .02). However, fibrin(ogen) deposition demonstrated a significantly smaller degree of increase from the prestenotic area to the apex as well as a smaller degree of decrease from the latter to the poststenotic region, compared with platelet deposition (P < .05). Although both fibrin(ogen) and platelet deposition increased over time, the ratio of fibrin(ogen) to platelets showed a progressive decrease that became significant from 5 to 10 minutes (P < .03) at either low or high shear rate. The rate of platelet deposition was relatively constant; however, fibrin(ogen) deposition progressively decreased, especially at the apex. CONCLUSIONS: On severely damaged vessel wall, fibrin(ogen) and platelet deposition is maximal at the apex of the stenosis where shear rate is extremely high and parallel streamlines are deformed. Nevertheless, fibrin(ogen) deposition is significantly less dependent on high shear rate than is platelet deposition, and the pattern is not influenced by time. Finally, fibrin(ogen) deposition appears to be predominant in the thrombus layers adjacent to a severely damaged vessel wall regardless of the local shear stress levels and flow conditions.

Animals↗

Pterional approach to the contralateral orbit.

Of a total of 80 operated intraorbital lesions, 2 were located in the posterior intraconal space, medial and inferior to the optic nerve. Because they were unfavorably located for standard surgical approaches, we operated via a contralateral pterional transsphenoidal-transethmoidal route. This technique provided excellent exposure and results in these two cases of intraorbital cavernous malformations. A brief description of the approach is presented.

Adult↗

Emergency ventriculostomy-experience with a new screw device: technical note.

Emergency situations, such as acute hydrocephalus or ventricular hemorrhage, require immediate and reliable treatment by ventriculostomy. The method used has to be standardized, applicable in a fast manner, and associated with only minimum risk of infection. We present a recently developed set for external ventriculostomy, which meets the above-standing requirements, and which consists of a screw with self-biting thread, a metal cannula, and a special screwdriver. Ventriculostomy can be performed easily within 2 minutes, and the system can be fixed rigidly to the skull of the patient for a period of up to several weeks. Exchange of the cannula is possible within 1 minute. The system has been used in 90 cases so far, with a rate of possible infection of 1.1%.

Adult↗

Efficiency of air filter sets for the prevention of airborne infections in laboratory animal houses.

Air filter sets (classes EU6 and EU9, or EU6 and S) were tested for their efficiency in protecting laboratory animals against potential airborne infections. Flexible-film isolators were used as a smaller scale model. In the first experiment, lasting 7 months, it was tested whether minute virus of mice (MVM) was able to penetrate the air filters between one isolator containing experimentally infected mice and another with MVM negative mice. In the second experiment we tested whether microorganisms in the incoming air were able to penetrate air filter sets. To assess this gnotobiotic mice in an isolator were monitored for 9 months for changes of their microbial flora. In both experiments a combination of EU6 and EU9 air filters proved to be sufficient to maintain the microbiological status of the animals. The same combination of medium efficiency filters (EU6 and EU9) is used on the air supply to 4 SPF-barrier units in which infections with MVM occurred repeatedly soon after the initial stocking. After a thorough disinfection no reinfection has been detected to date. This demonstrates that the relatively low efficiency of the air filters was not the cause of the repeated infection. The procedure for disinfection is described.

Air Conditioning↗

[Imaging of the esophagus. Normal and pathologic aspects].

Although endoscopy is the fundamental examination for exploration of the esophagus, imaging study (CT scan, barium swallow) retains numerous indications. It completes the endoscopic study in the assessment of space-occupying lesions and investigates functional disorders of the oesophagus. Barium swallow associated with the administration of glucagon has a therapeutic role in food obstruction. Endoscopic ultrasonography allows direct evaluation of the local extension of oesophageal masses. Percutaneous ultrasonography sometimes facilitates the study of the lower oesophagus in children and the cervical oesophagus.

Barium Sulfate↗

[Subtonsillar localization of a non-Hodgkin lymphoma. Apropos of a case].

Non-Hodgkin's lymphomas of the head and neck with a non-lymph node primary site represent the second commonest cause of oropharyngeal tumour, after carcinomas (5). The location in the Waldeyer's ring is classical, most frequently involving the palatine tonsil. The authors report a case of non-Hodgkin's lymphoma arising in the vestigial lymphoid tissue of the subtonsillar region. They raise the problem of the differential diagnosis, despite the contribution of CT scan.

Aged↗

[Test of electrical stimulation of the round window. Diagnostic and prognostic value of the rehabilitation of total deafness by cochlear implant].

The round window electrical stimulation (RWES) test has been performed in 708 cases of total deafness. Among them 244 have successfully benefited with a cochlear implant. Electrical Brain Stem Evoked (EBSE) potential elicited by this stimulation have been registrated in 283 cases, 113 of them during general anesthesia necessary in children. This test supplies the patient with a subjective sound sensation and/or EBSE in 93% of cases. The correlation between electrical data of this RWES test and clinical results of the cochlear implant is described. This test is discussed regarding the simple transtympanique promonotory stimulation test.

Adolescent↗

[Familial hemiplegic migraine. Localization of a responsible gene on chromosome 19].

Familial hemiplegic migraine is an autosomal dominant disorder of unknown pathogenesis in which the migrainous attacks are marked by the occurrence of a transient hemiplegia during the aura. The aim of our study was the identification of the affected gene. The first step was the chromosomal mapping of the affected gene, for which we used a "candidate gene" strategy. The first candidate gene was the gene responsible for CADASIL. While investigating CADASIL, mapped previously to chromosome 19, we observed that some patients had recurrent attacks of migraine with aura. Although the clinical and neuroimaging features of familial hemiplegic migraine differ markedly from CADASIL, we hypothesized that the same gene could be involved in the pathogenesis of both conditions. We chose two large pedigrees for linkage analysis of familial hemiplegic migraine. A maximum lodsore > 8 was found with two markers that are strongly linked to CADASIL. Multilocus linkage analysis located the affected gene within an interval of about 30 cM on chromosome 19, containing the gene responsible for CADASIL. At this step it's not possible to conclude that CADASIL and familial hemiplegic migraine are due to the same mutated gene. It will be necessary to analyse other familial hemiplegic migraine and CADASIL families in order to reduce the size of their respective interval and ultimately identify the mutated gene(s).

Chromosomes, Human, Pair 19↗

[Short anesthesia in rats: an injection or an inhalation anesthesia].

First we describe the application of an injection anaesthesia in a specific strain of rats and test its usefulness under practical conditions. Application (i.p.) of the described dose according to the animals body-weight resulted in an acceptable anaesthesia, which lasted approximately 50 minutes in male rats and 80 minutes in female rats. Next we compare the common ether anaesthesia with an other inhalation anaesthesia (Methoxyflurane) which, by using a self-made mask, could be prolonged without any problem for at least 15 minutes ("prolonging-time"). A correlation was found between the duration of the prolonging-time and the awakening time. Inhalation anaesthesia using Methoxyflurane obviously affected the animals health and well-being less than the conventional ether anaesthesia.

Anesthesia, General↗