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Biomedical subjects

D Meier

Publications and source records attributed to D Meier.

At least 55 records · Page 3Linked to original sources

Memory Clinics in Switzerland. Collaborative Group of Swiss Memory Clinics.

Currently, eleven Memory Clinics (MC) in Switzerland offer their services to patients, caregivers and family doctors. Their primary goal is the early diagnosis and management of dementia in elderly outpatients. Special emphasis is put on the detection of reversible causes of dementing disorders. Diagnoses and medical, pharmacological, neuropsychological and social treatment recommendations are established in a multidisciplinary consensus conference and communicated back to the referring physicians. The psychosocial therapies and supportive activities include counseling, memory training for patients, neuropsychological rehabilitation, caregiver groups, relaxation and biofeedback training, day care centers, Alzheimer's Tanzcafé, and special vacations for dementia patients. These activities vary from MC to MC according to the availability of resources. Research activities are an integral part of all MCs and range from the attempt to identify preclinical markers of Alzheimer's disease to studies of neuropathological correlates of cognitive disturbances. Moreover, patients are encouraged to participate in studies investigating new medications. MCs play an important role in the education and training of health care professionals and in raising awareness and support in the general population.

Aged↗

[Greenish discolorations of beef musculature and their assessment according the meat hygiene regulations. A case report].

In muscular tissue samples from two cows of different origin numerous greenish, spotlike tissue discolourations were diagnosed as eosinophilic myositis. Sarcosporidiosis is being suspected as the most likely cause. Factors leading to such cases of myositis due to sarcosporidiosis which is wide-spread in cattle and normally inapparent are largely unknown. According to Swiss and German meat inspection directives beef carcasses with these discolourations have to be declared as unfit for human consumption. However, during meat inspection such cases of myositis are problematic to diagnose, because the lesions are only visible on the cut end of muscle tissue. Hence, they can pass unnoticed through carcass inspection.

Animal Husbandry↗

Histomorphometric assessment of bone mass, structure, and remodeling: a comparison between healthy black and white premenopausal women.

While noninvasive studies of bone mass and turnover in blacks and whites abound, histologic evaluations are very rare. We have performed a comparative bone histomorphometric study of iliac biopsies from 55 healthy, premenopausal women including 21 blacks (mean age 33.4 + 1.2 years) and 34 whites (mean age 32.5 + 0.8 years) of comparable age, weight, body composition, education, and lifestyle. Biochemical indices of mineral metabolism: parathyroid hormone, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, serum ionized calcium, serum phosphorus, and urinary calcium/creatinine were measured in the fasting state. Blacks had lower 25-hydroxyvitamin D (315 +/- 3.36 vs. 63.21 +/- 3.79 nmol/l, p = 0.0001). Histomorphometric indices of bone volume, structure, and connectivity were not different between groups. The following indices of bone remodeling were also similar in both groups: eroded perimeter, osteoid width, mineralizing perimeter, tissue-based bone formation rate, osteoid maturation time, active formation period, and activation frequency. However, osteoid perimeter (black [B] = 15.85 +/- 1.30 vs. white [W] = 9.49 +/- 0.70%, p = 0.0002), osteoid area (B = 2.55 +/- 0.32 vs. W = 1.39 +/- 0.12%, p = 0.003), single-labeled perimeter (B = 5.46 +/- 0.54 vs. W = 4.04 +/- 0.33%, p = 0.03), mineralization lag time (B = 38.18 +/- 4.04 vs. W = 21.83 +/- 1.60 days, p < 0.009), and total formation period (B = 148.15 +/- 19.70 vs. W = 84.04 +/- 7.62 days, p = 0.0056) were higher in blacks than in whites. The quiescent perimeter (B = 76.91 +/- 1.40 vs. W = 84.25 +/- 0.91%, p = 0.0001), mineral apposition rate (B = 0.70 +/- 0.02 vs. W = 0.75 +/- 0.02 micron/day, p = 0.066), mineralizing osteoid perimeter (B = 0.49 +/- 0.04 vs. W = 0.75 +/- 0.04%, p = 0.0001) and adjusted apposition rate (B = 0.35 +/- 0.04 vs. W = 0.58 +/- 0.04 micron3/micron2/day, p = 0.0001) were all lower in blacks than in whites. These results indicate that there are no differences in bone volume, microstructure, or turnover between black and white premenopausal women. However, there are significant differences in the mechanism of bone formation between the two groups, with a lower rate of mineralized matrix apposition within each remodeling unit and a longer total formation period in blacks than in whites. The differences appear to the result of more frequent and/or longer inactive periods in the life span of the bone formation units in blacks. These differences may allow a greater overall deposition of bone mineral in black women and therefore help explain a higher bone mass and perhaps better bone quality in black than white women.

Adult↗

[A case of cutaneous epitheliotropic malignant lymphoma (mycosis fungoides) in a horse].

This article describes an eleven year old mare with apathy, fever, enlarged mandibular lymph nodes, skin lesions on the upper lip and edematous, grey-red mucous membranes in the nose, mouth and vulva. Histopathology revealed infiltrates with atypical lymphocytes forming Pautrier's microabscesses. The neoplastic cells had large, often indented nuclei. Immunohistology showed that some cells were CD3-positive (Pan T-cell-marker). The diagnosis of cutaneous epitheliotropic malignant lymphoma (Mycosis fungoides) was made. The etiology in the horse is unknown.

Animals↗

[Assessment of the quality of life].

Assessment of quality of life (qol) is becoming increasingly important, particularly as an outcome variable in assessing the impact of disease, illness and treatment. However, considerable problems exists in formulation, measurement and interpretation of qol. There is as yet no agreed-upon definition of qol nor is there a gold standard measure what complicates the selection of an appropriate assessment scale. The various aspects for the selection of a scale are described.

Activities of Daily Living↗

Detection of hidden metabolites by localized proton magnetic resonance spectroscopy in vivo.

Magnetic resonance spectroscopy (MRS) allows the assessment of chemical substances in living tissue and the detection of biochemical changes associated with certain diseases. In vivo MRS, however, is usually limited in sensitivity and spectral resolution. Many resonance lines originating from metabolites of interest are overlapped by signals of other metabolites and are therefore not visible in conventional MR spectra. In order to overcome this limitation, three localized methods, a technique making use of a spectral difference, a multiple quantum filter technique, and a two-dimensional J-resolved technique, were evaluated theoretically and experimentally for the detection of gamma-aminobutyric acid (GABA) both in vitro and in vivo. All three methods are able to produce the desired results at high metabolite concentrations in vitro. For in vivo measurements the spectral difference method proofed to be most appropriate due to its relatively high sensitivity and its short acquisition time.

Adult↗

Striatal glucose metabolism and dopamine D2 receptor binding in asymptomatic gene carriers and patients with Huntington's disease.

We used PET scans with the tracers [18F]fluorodeoxyglucose (FDG) and [11C]raclopride (RACLO) to study glucose metabolism and dopamine D2 receptor binding in the caudate nucleus and putamen of 18 carriers of the Huntington's disease gene mutation (10 asymptomatic subjects and eight untreated symptomatic Huntington's disease patients in an early disease stage). We also performed MRI scans and measured the bicaudate ratio (BCR) in the same subjects. Data were compared with those from nine mutation-negative members of Huntington's disease families and separate groups of age matched controls. The PET scans were repeated 1.5-3 years later in six of the asymptomatic gene carriers. Symptomatic Huntington's disease patients showed a marked reduction of FDG and RACLO uptake in the caudate nucleus and putamen and a significant increase of BCR. Asymptomatic mutation carriers revealed significant hypometabolism in the caudate nucleus and putamen. The RACLO binding was significantly decreased in the putamen. Decrements of caudate nucleus tracer uptake, particularly RACLO, correlated significantly with BCR increases in both symptomatic and asymptomatic gene carriers. In asymptomatic carriers, metabolic and receptor binding decreases were also significantly associated with the CAG repeat number but not with the individual's age. Discriminant function analysis correctly classified clinical and genetic status in 24 of 27 subjects on the basis of their striatal PET values (83% sensitivity and 100% specificity). Three asymptomatic mutation carriers were classified/grouped together with mutation-negative subjects, indicating that these individuals had normal striatal RACLO and FDG uptake. Follow-up PET data from gene-positive subjects showed a significant reduction in the mean striatal RACLO binding of 6.3% per year. Striatal glucose metabolism revealed an overall non significant 2.3% decrease per year. These data indicate that asymptomatic Huntington's disease mutation carriers may show normal neuronal function for a long period of life. These findings also suggest that it may be possible to predict when an asymptomatic gene carrier will develop clinical symptoms from serial PET measurements of striatal function.

Adult↗

[Cardiovascular diseases, cognitive abilities and quality of life in old age].

Dementia is the most important disorder endangering and impairing quality of life in old age. Cardiovascular diseases as well as cardiovascular risk factors raise the risk for dementia; therefore, a targeted primary and secondary prevention strategy is indicated, also in view of the maintenance of autonomy and quality of life. Consequent primary and secondary prevention comprises adequate therapy of risk factors, including pharmacotherapy, if necessary. Important general measures are regular physical and mental training, complemented by an alimentation with a favorable composition of lipids and rich in micronutrients (in particular antioxidants).

Aged↗

A fluid dynamic analysis using flow visualization of the Baylor/NASA implantable axial flow blood pump for design improvement.

The Baylor/NASA Axial Blood Flow Pump has been developed for use as an implantable left ventricular assist device (LVAD). The pump is intended as an assist device for either pulmonary or systemic circulatory support for more than 3-months' duration. To date the pump provides acceptable results in terms of thrombus formation and hemolysis (IH of 0.018 g/100 L). A fluid dynamics analysis using flow visualization was performed to investigate the flow fields and to determine areas within the pump that could be improved. These studies focused upon the inflow area in front of the pump. A prototype axial flow pump assembly was constructed to facilitate the flow visualization studies. Particle image tracking velocimetry techniques were used to measure Amberlite particles suspended in a blood analog fluid composed of 63% water and 37% glycerin. This method used a pulsed (612 Hz) laser light to determine flow velocity profiles, shear stress, Reynolds numbers, and stagnant areas within the axial pump. These studies showed that the flow straightener (a vaned assembly in the pump inflow) reduced Reynolds numbers from 4,640 to 2,540 (at 8.5 L/min) and that the flow straightener exacerbates a discontinuity found between it and the impeller. Within the inflow area, a maximum of 80 N/m2 shear stress was measured, which is well below published blood damage thresholds. Design variations were investigated resulting in a smoother flow transition between flow straightener and impeller. These variations must be investigated further to establish a correlation with hemolysis and thrombus formation.

Blood Flow Velocity↗

True myocardial motion tracking.

Myocardial tagging is a powerful tool for the assessment of in-plane cardiac motion. However, for previous myocardial tagging techniques, the imaged slice is fixed with respect to the magnet coordinate system. Thus, images acquired at different heart phases do not always represent the same slice of the myocardium. A new myocardial tagging technique is presented, which takes the through-plane motion into consideration. It involves tagging of the desired myocardial slice and applying a subtraction imaging technique to image just that part of the myocardium. The examination time can be reduced considerably by the acquisition of two one-dimensionally tagged images. To increase the signal-to-noise ratio especially at later heart phases, variable imaging RF excitation flip angles are applied. To reduce motion artifacts a repetitive breathhold scheme was applied. In vivo results demonstrate that the tags can be accurately tracked within the entire heart period with a temporal resolution of 35 ms, even at a top basal level of the heart and right ventricle.

Algorithms↗

Assessment of absolute metabolite concentrations in human tissue by 31P MRS in vivo. Part II: Muscle, liver, kidney.

Absolute metabolite concentrations were assessed in the muscle, the liver, and the kidney of healthy human volunteers by 31P MRS. Fully relaxed in vivo spectra were acquired with a surface coil and were localized with an adiabatic ISIS pulse sequence. The spectra were quantified with a subsequent measurement of a calibration phantom and were processed iteratively in the time domain. The following mean metabolite concentrations (mmol/liter) were measured in the resting male calf muscle (n = 9), in the fasting liver (n = 12), and in the orthotopic kidney (n = 5): [PME] = 2.0 +/- 0.6, 3.8 +/- 0.7, and 2.6 +/- 0.9, [Pi] = 2.9 +/- 0.3, 1.8 +/- 0.3, and 1.6 +/- 0.4, [PDE] = 3.8 +/- 0.8, 9.7 +/- 1.5, and 4.9 +/- 1.1, [PCr] = 22.0 +/- 1.2, 0, and 0, [NTP] = 5.7 +/- 0.4, 2.9 +/- 0.4, and 2.0 +/- 0.3, respectively. Several interesting findings are to be emphasized: The concentrations of Pi, PCr, and NTP were 20% lower in the muscle of women than of men. In addition, the pHi was significantly lower in female muscle (6.99 +/- 0.03) than in male muscle (7.05 +/- 0.03). The pHi in the liver (7.12 +/- 0.09) and in the kidney (7.09 +/- 0.08) were higher than in the muscle of both genders. The free magnesium concentration (mmol/liter) was higher in the liver (1.40 +/- 0.64) than in the kidney (0.79 +/- 0.39) and in the muscle (0.52 +/- 0.10).

Adult↗

Flow pattern analysis of the Baylor total artificial heart.

To obtain an optimal design of the left blood chamber of the total artificial heart (TAH), flow visualization studies were performed. Information on velocities in critical areas of the left chamber was gathered using sectional pulsed laser light. The flow patterns on the entire pumping duration were photographed frame by frame. The inflow port, the opposite of the inflow and outflow of the pump (bottom area), and the diaphragm/housing junction were the focal areas. The pump conditions, such as chamber pressure, preload and afterload pressure, pumping rate and roller screw, and displacement were recorded. Major stagnations and a low washout effect were observed in the bottom region. The closing of the inflow valve was irregular. In order to solve this problem, the inflow valve angle was changed 20 degrees. A comparison study showed a better valve closing characteristic, and no stagnation areas were observed with this new valve angle. Various velocity profiles confirmed the results. The valve closing characteristics is described in relationship to back flow.

Blood Flow Velocity↗

Changes of liver metabolite concentrations in adults with disorders of fructose metabolism after intravenous fructose by 31P magnetic resonance spectroscopy.

A novel 31P magnetic resonance spectroscopy procedure allows the estimation of absolute concentrations of certain phosphorus-containing compounds in liver. We have validated this approach by measuring ATP, phosphomonesters, and inorganic phosphate (Pi) during fasting and after an i.v. fructose bolus in healthy adults and in three adults with disorders of fructose metabolism and by comparing results with known metabolic concentrations measured chemically. During fasting, the ATP concentration averaged 2.7 +/- 0.3 (SD, n = 9) mmol/L, which, after due correction for other nucleoside triphosphates, was 2.1 mmol/L and corresponded well with known concentrations. Fructose-1-phosphate (F-1-P) could not be measured during fasting; its concentration after fructose was calculated from the difference of the phosphomonester signals before (2.9 +/- 0.2 mmol/L) and after fructose. Pi was 1.4 +/- 0.3 mmol/L and represented the one fourth of Pi visible in magnetic resonance spectra. In the three healthy controls after fructose (200 mg/kg, 20% solution, 2.5 min), the fructokinase-mediated increase of F-1-P was rapid, reaching 4.9 mmol/L within 3 min, whereas the uncorrected ATP decreased from 2.7 to 1.8 mmol/L and the Pi from 1.4 to 0.3 mmol/L. The subsequent decrease of F-1-P, mediated by fructaldolase, was accompanied by an overshooting rise of Pi to 2.7 mmol/L. In the patient with essential fructosuria, the concentrations of F-1-P, ATP, and Pi remained unchanged, confirming that fructokinase was indeed inactive. In the patient with hereditary fructose intolerance, initial metabolic changes were the same as in the controls, but baseline concentrations were not yet reestablished after 7 h, indicating weak fructaldolase activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Triphosphate↗

Age distribution and iron dependency of the T2 relaxation time in the globus pallidus and putamen.

Heavily T2-weighted spin echo sequences of the brain show age-dependent low signal intensity in many extrapyramidal nuclei. Although it has been suggested that this low intensity results from non-haem iron, the specific influence of non-haem iron on the T2 relaxation time has not been quantified and remains controversial. The T2 relaxation times of the globus pallidus and putamen were measured from MRI at 1.5T in 27 healthy patients, by using a mathematical model. They were then plotted as a function of age and compared to the curve of age-dependent iron concentration determined post mortem. The curves of T2 relaxation time in the basal ganglia are congruent with published curves of iron concentration, indicating a high probability that the changes in T2 relaxation times and the low signal in the basal ganglia result from the local, age-dependent iron deposition. Individual measurements of T2 relaxation time show less variation before than after 45 years of age, indicating the influence of a second, more individual factor.

Adolescent↗

T2 relaxation time in patients with Parkinson's disease.

Postmortem studies of patients with Parkinson's disease (PD) reveal an increase in iron concentration in the substantia nigra. Iron content in the brain is associated with decreased signal intensity on T2-weighted MRI. We measured in vivo the T2 relaxation time in 30 PD patients and 33 healthy volunteer subjects, using a 1.5-T whole-body MRI system. In comparison with healthy controls, T2 values in PD patients were reduced in the following brain regions: substantia nigra, caudate nucleus, and putamen. Due to the overlap between patients and control subjects, we could not differentiate, in a given patient, healthy from diseased state on the basis of T2 relaxation time. Our findings support the notion of increased iron deposition in the substantia nigra of patients with PD. However, the shortening of T2 values in the substantia nigra did not correlate with disease duration nor with clinical severity.

Adult↗