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Biomedical subjects

F Koch

Publications and source records attributed to F Koch.

At least 37 records · Page 2Linked to original sources

Perioperative care of environmentally sensitive patients.

In today's complex environment, with an increasing number of chemicals and environmental contamination, some individuals have developed sensitivities to their surroundings. Surgical intervention for environmentally sensitive patients provides an opportunity to reach beyond the boundaries of the OR. These patients require highly individualized perioperative nursing assessments and care planning on a multidisciplinary level. Presbyterian Hospital of Dallas has developed a protocol to initiate collaborative planning for these patients and has had the opportunity to successfully care for these patients.

Environment, Controlled↗

Entry into afferent lymphatics and maturation in situ of migrating murine cutaneous dendritic cells.

An important property of dendritic cells (DC), which contributes crucially to their strong immunogenic function, is their capacity to migrate from sites of antigen capture to the draining lymphoid organs. Here we studied in detail the migratory pathway and the differentiation of DC during migration in a skin organ culture model and, for comparison, in the conventional contact hypersensitivity system. We report several observations on the capacity of cutaneous DC to migrate in mouse ear skin. (i) Upon application of contact allergens in vivo the density of Langerhans cells in epidermal sheets decreased, as determined by immunostaining for major histocompatibility complex class II, ADPase, F4/80, CD11b, CD32, NLDC-145/DEC-205, and the cytoskeleton protein vimentin. Evaluation was performed by computer assisted morphometry. (ii) Chemically related nonsensitizing or tolerizing compounds left the density of Langerhans cells unchanged. (iii) Immunohistochemical double-staining of dermal sheets from skin organ cultures for major histocompatibility complex class II and CD54 excluded blood vessels as a cutaneous pathway of DC migration. (iv) Electron microscopy of organ cultures revealed dermal accumulations of DC (including Birbeck granule containing Langerhans cells) within typical lymphatic vessels. (v) Populations of migrating DC in organ cultures upregulated markers of maturity (the antigen recognized by monoclonal antibody 2A1, CD86), but retained indicators of immaturity (invariant chain, residual antigen processing function). These data provide additional evidence that during both the induction of contact hypersensitivity and in skin organ culture, Langerhans cells physically leave the epidermis. Both Langerhans cells and dermal DC enter lymphatic vessels. DC mature while they migrate through the skin.

Animals↗

Detection of vascular endothelial growth factor and tumor necrosis factor alpha in epiretinal membranes of proliferative diabetic retinopathy, proliferative vitreoretinopathy and macular pucker.

PURPOSE: To evaluate epiretinal membranes in proliferative eye disease for the presence of vascular endothelial growth factor (VEGF) and tumor necrosis factor alpha (TNF-alpha). METHODS: Membranes were surgically removed from 66 patients with proliferative diabetic retinopathy (PDR), proliferative vitreoretinopathy (PVR) and macular pucker (MP). Cytokine concentrations were determined by ELISA (VEGF) and bioassay (TNF-alpha). RESULTS: VEGF was detected in all 66 membranes investigated. The highest VEGF values were found in patients with type I diabetes (mean = 5,994 pg/mg protein). In patients with type II diabetes, the values were at a mean of 1,242 pg/mg protein. When coagulation therapy was performed for longer than 3 months prior to surgery, VEGF was significantly (p < 0.05) reduced. Intermediate levels of VEGF were found in PVR membranes (mean = 1,417 pg/mg protein). The lowest activity was found in MP (mean = 216 pg/mg protein). In contrast, TNF-alpha was present in 16 PDR membranes, 9 PVR membranes and 8 MP membranes. CONCLUSION: The presence of VEGF in all membranes investigated indicates that this cytokine plays an important role in angiogenesis in ischemic retinal disease and in membrane growth in proliferative disorders.

Diabetic Retinopathy↗

Granulocyte-macrophage colony-stimulating factor induces a unique set of STAT factors in murine dendritic cells.

Cytokine-mediated signaling pathways were studied in mouse dendritic cells (DC) by analysis of the activation pattern of STAT factors. Electrophoretic mobility shift assays were performed to detect STAT isoform-specific complexes. Granulocyte-macrophage colony-stimulating factor (GM-CSF) simultaneously induced complexes containing STAT1, STAT3, STAT5A, STAT5B and STAT6. In non-DC, a similar broad activation pattern of STAT factors by GM-CSF or other cytokines has not been observed so far. By comparison, in peritoneal macrophages, GM-CSF induced a complex with the properties of a truncated form of STAT5. Other cytokines tested on DC either failed to induce STAT factors [interleukin (IL)-1 beta, IL-2, IL-15], or activated the same STAT factors as observed in peritoneal macrophages (IL-4, IFN-gamma). Our results implicate a specific effect of GM-CSF on STAT signaling in DC which might account for the cell type-specific effect of this cytokine on development and function.

Animals↗

Maturation and migration of murine dendritic cells in situ. Observations in a skin organ culture model.

Dendritic cells reside in tissues such as skin in an immature state. Upon antigenic challenge they begin to mature and migrate to the draining lymph nodes. These processes are still poorly understood. One way to study in situ aspects of maturation and migration are skin organ culture models. In an attempt to learn more about the relationship between maturation and migration we investigated the expression of several marker molecules by immunohistochemistry. Sheets from normal murine ear skin and from skin that had been cultured for three days were compared. During culture the numbers of epidermal Langerhans cells decreased and accumulations of strongly MHC class II-positive cells ("cords") were found in the dermis. As compared to untreated skin, the few Langerhans cells remaining in the epidermal sheets after 2-3 days expressed increased levels of MHC class II and had also upregulated B7-2 (CD86) as described. They did not express the antigen recognized by mAb 2A1, a marker for mature dendritic cells. Double-staining of dermal sheets after 3 days of culture showed that dendritic cells in the "cords" expressed high levels of MHC class II and CD86 but were also reactive with mAb 2A1. This pattern is identical to those dendritic cells that had emigrated into the culture medium over the period of 3 days. Invariant chain (mAb In1) was detected at all stages of culture as opposed to isolated epidermal Langerhans cells in suspension where invariant chain expression disappears after 3 days of culture. We conclude that the up- (class II, B7-2, 2A1) and down-regulation (invariant chain) of dendritic cell molecules during migration does not happen in a synchronized manner. The molecule recognized by mAb 2A1 seems to appear late in maturation.

Animals↗

Detection of eicosanoids in epiretinal membranes of patients suffering from proliferative vitreoretinal diseases.

AIM: Arachidonic acid is metabolised via lipoxygenase to 15-HETE (15-hydroxyeicosatetraenoic acid) and 15-HPETE (15-hydroperoxyeicosatetraenoic acid), which are believed to influence proliferation in tissue culture. 15-HETE is the reduction product of 15-HPETE. Cell proliferation is believed to be decreased by 15-HPETE and increased by 15-HETE. The aim of this study was to investigate epiretinal membranes for the presence of these lipoxygenase products and to compare membranes from different disease processes. METHODS: Epiretinal membranes of 15 patients suffering from proliferative vitreoretinopathy (PVR, n = 7) and proliferative diabetic retinopathy (PDR; n = 8) were removed during vitrectomy and analysed by means of thin layer chromatography. The plates were evaluated by digital image analysis. RESULTS: Both 15-HETE and 15-HPETE were identified in membranes from eyes of patients with PVR and PDR with HETE values significantly higher (p < 0.05) than HPETE values (HETE/HPETE ratio = 5.2). CONCLUSION: This study demonstrates that eicosanoids are present in the epiretinal membrane tissue of patients with PVR and PDR. Considering that HETE increases cell proliferation while HPETE inhibits it, it is conceivable that eicosanoids are an additional factor contributing to the regulation of membrane growth in proliferative retinal disorders. Thus, inhibition of lipoxygenase could be a therapeutic approach in these diseases.

Biomarkers↗

Cardiovascular costs.

Cardiovascular procedures have been identified as an area of great potential savings. Costs per surgeon per procedure must be identified and communicated. Surgeon buy-in is critical for change to occur and standardization is key to the success of cost savings initiatives. Gains must be monitored to assure success.

Cardiovascular Diseases↗

High level IL-12 production by murine dendritic cells: upregulation via MHC class II and CD40 molecules and downregulation by IL-4 and IL-10.

We have shown previously that dendritic cells (DC) produce IL-12 upon interaction with CD4+ T cells. Here we ask how this IL-12 production is induced and regulated. Quantitative PCR and in situ hybridization for IL-12 p40 and an ELISA specific for the p70 heterodimer were used to determine IL-12 production. We demonstrate that ligation of either CD40 or MHC class II molecules independently trigger IL-12 production in DC, and that IL-12 production is downregulated by IL-4 and IL-10. The levels of bioactive IL-12 that can be released by triggering with an anti-CD40 mAb or with a T cell hybridoma are high (range 260-4700 pg/ml from 1 X 10(6) DC in 72 h). The CD40-mediated pathway indicates that IL-12 production is induced in DC upon interaction with activated, CD40 ligand-expressing helper T cells, even in the absence of cognate antigen recognition. Side-by-side comparison of IL-12 production, and blocking experiments employing an anti-CD40 ligand mAb, suggest that the CD40-mediated pathway is quantitatively more significant than induction via the MHC class II molecule. The importance of the CD40/CD40 ligand interaction for IL-12 induction in DC likely contributes to the recent finding that mice lacking the CD40 ligand are impaired in mounting Th1 type cell-mediated immune responses.

Animals↗

An improved isolation method for murine migratory cutaneous dendritic cells.

Dendritic cells are highly specialized accessory cells for the initiation of primary immune responses. They occur as trace populations in non-lymphoid and lymphoid organs. Therefore, the isolation and enrichment of primary dendritic cells is difficult and time-consuming. This applies also to dendritic cells from skin, i.e. epidermal Langerhans cells and dermal dendritic cells. Recently introduced skin organ cultures serve as a convenient source for primary cutaneous dendritic cells. We report here a refinement of such cultures in which cutaneous dendritic cells emigrate spontaneously into the culture medium. Murine ear skin is cultured for a total of 3 days in three sequential 24 h steps. This simple modification doubles or triples the yields of dendritic cells that can be obtained and up to 30,000 dendritic cells can be recovered from one ear half. This represents 50-70% (range 30-80%) of all viable cells. The cells are mature dendritic cells that possess potent T cell stimulatory function. Compared to the classical methods of preparing epidermal Langerhans cells by trypsinization this technique is easier and quicker; it does not require enzymes such as trypsin, and it yields similar numbers of mature dendritic cells. It should prove useful for further studies of dendritic cells of the skin.

Animals↗

Interleukin-12 is produced by dendritic cells and mediates T helper 1 development as well as interferon-gamma production by T helper 1 cells.

Interleukin-12 (IL-12), a 70-kDa heterodimeric cytokine composed of covalently linked p35 and p40 chains, is to date the most critical factor for skewing the immune response towards a T helper 1 (Th1) of cytokine profile [high interferon-gamma (IFN-gamma), low IL-4]. Established sources of IL-12 are stimulated macrophages, neutrophils and B cells. As dendritic cells (DC) process antigen in the periphery and then migrate to lymphoid organs to sensitize T cells and induce cell mediated immunity, we reasoned that DC should constitute a critical source of IL-12. The criteria used to detect IL-12 in DC were the demonstration of p40 and p35 mRNA (semiquantitative polymerase chain reaction, northern blotting, and in situ hybridization) as well as IL-12 protein (p70 enzyme-linked immunosorbent assay, p70 antigen capture followed by IFN-gamma bioassay, free p40 chain radioimmunoassay or immunoprecipitation). We found that conventional stimuli such as Staphylococcus aureus induced production of IL-12 by murine as well as human DC in amounts comparable to spleen cells, peritoneal macrophages or peripheral mononuclear cells. DC exhibited, however, features that had not been seen with other antigen-presenting cells: they produced bioactive IL-12 upon antigen-specific interaction with T cells without any other stimuli; in an allogeneic mixed leukocyte reaction model, neutralizing anti-IL-12 antibodies showed that DC-derived IL-12 was critical for optimal proliferation and IFN-gamma production by activated Th1 blasts; and finally, the priming of resting, naive allogeneic T cells by DC, followed by restimulation of primed T blasts by DC, skewed the response to Th1 without the need for any exogenous cytokines or stimuli such as microorganisms. This skewing to Th1 cytokine production, which depended on DC-derived IL-12, but did not require anti-IL-4, exogenous IL-12, or microbes, might be a major function of DC.

Animals↗

[Incident light microscopic characterization of vascular patterns in skin tumors].

The search for vascular structures in skin tumors by incident light microscopy has revealed a surprisingly high proportion of vascularized tumours. Characteristic vascular patterns, in some cases highly tumour-specific, have been defined. The vascular structure is a valuable feature for characterization and differentiation of skin tumours, especially for amelanotic malignant melanoma. We propose a flowchart procedure for analysis and diagnosis of skin tumours using incident light microscopy, which appears to be valuable for advanced image analytic techniques.

Capillaries↗

Optical emission spectroscopy in reactive hollow cathode arc discharge plasmas - Local distribution of active species during the deposition of hard carbon films.

A low pressure arc plasma discharge from a hollow LaB(6)-cathode with up to 100 A discharge current is used to create plasmas of high density. Typical values for the electron density and temperature in PETRA ( Plasma Engineering and Technology Research Assembly) are n(e)=10(12)-10(13) cm(-3) and T(e)=5-20 eV. The ionization ratio is typically 1-10%. Optical emission spectroscopy has been applied to investigate the processes within the plasma which lead to the deposition of thin carbon films. In these experiments hydrogenated carbon films (a-C:H) have been deposited on Si-substrates by introducing hydrocarbon gases (CH(4), C(2)H(2)) into He- and Ar-plasmas. Space resolved optical emission spectroscopy using an in-situ translation mechanism of the optical fibre has been performed to measure the local concentrations of CH-radicals, carbon ions and of the excitation of He-neutrals. In addition the hydrogen liberated by the dissociation of the hydrocarbon molecules has been measured. The dissociation of the hydrocarbon molecules takes place as a localized process in the vicinity of the reactive gas inlet.

Journal Article↗

Local optical emission spectroscopy of excited species effused from an evaporation cell and a sputter source into dense plasmas - Basic studies for the deposition of thin gradient films.

Space resolved optical emission spectroscopy has been applied to determine the distribution of excited species in dense plasmas which are used for the deposition of thin coatings. Typical electron densities and electron temperatures in the plasma facility PETRA ( Plasma Engineering and Technology Research Assembly) are in the range of n(e) = 10(12) cm(-3) and T(e) = 10 eV. During the deposition process material (Al) is evaporated from a vapour cell under controlled conditions. The vapour stream is guided into a dense plasma which is composed of inert gas, Ar or He, and hydrocarbon species produced from the dissociation of C(2)H(2). The evaporated Al-stream which travels with thermal velocity into a plasma of high electron density, is nearly completely ionized due to the short mean free path for electron impact ionization in the above mentioned parameter range. Optical emission spectroscopy has been applied to investigate the interaction processes between the vapour stream and the plasma as well as the transport of the ionized Al along the applied magnetic field. For the measurements space resolved optical emission spectroscopy with an in-situ translation mechanism of the optical fibre has been used to measure the local concentrations of excited Al neutrals and ions as well as the concentration of the background plasma species.

Journal Article↗

Effects of allopurinol and steroids on inflammation and oxidative tissue damage in experimental lens induced uveitis: a biochemical and morphological study.

AIMS: To evaluate the effects of allopurinol in lens induced uveitis (LIU) by morphological methods and to compare these effects with those of steroids and a combination of both drugs biochemically and morphologically. METHODS: Lipid peroxides (LPO) of the retinal tissue were determined by two different methods (thiobarbituric acid assay (TBA) and high performance liquid chromatography expressed as malondialdehyde-like substances). Myeloperoxidase (MPO) activity in the iris/ciliary body complex was analysed spectrophotometrically. Histological changes on three morphological levels of LIU eyes were evaluated. RESULTS: Both allopurinol and the combination of allopurinol/prednisolone led to a significant reduction in the increaed retinal LPO values. Prednisolone only revealed significant effects on retinal LPO when being measured with the TBA method. MPO activity in iris and ciliary body was significantly reduced in all therapy groups. The morphological evaluation of the sections by two masked investigators revealed a significant reduction (p < 0.05) in the inflammation score in all therapy groups. Morphometric studies using the QUANTIMED system (Leica, Cambridge) showed significantly reduced values (p < 0.05) in the allopurinol group and in the group receiving prednisolone and allopurinol. Prednisolone alone did not lead to a significant reduction in the values. CONCLUSIONS: The findings show that both allopurinol and steroids exert positive effects on the variables determined in LIU. The effects of steroids are believed to be mostly due to their direct action on inflammatory cells. The recently reported scavenging effects of methylprednisolone should play a minor role in this disease model. Allopurinol and oxypurinol act as direct scavengers of free radicals and hypochlorous acid, which is produced via MPO catalysis, thus leading to a reduction in tissue inflammation and tissue damage.

Allopurinol↗

Neuroborreliosis with retinal pigment epithelium detachments.

Borreliosis or Lyme disease, a tick-borne infection with the spirochete Borrelia burgdorferi, can cause various ocular and neurological symptoms. A 41-year-old man had been repeatedly bitten by ticks in June 1992; 6 months later, the patient complained of blurred vision in both eyes of 1-week duration, bifrontal headache that was more pronounced on the right side, and neck pain that had appeared months earlier and was becoming more severe. On ophthalmoscopy, clover-shaped retinal pigment epithelium detachments around the optic disc were observed in both eyes. The patient's visual acuity was reduced to 0.5 in his left eye. Liquor cells and total protein were significantly increased; however, a hemagglutination inhibition test revealed only moderately increased immunoglobulin values. After 2 weeks of daily application of 4 g ceftriaxone disodium, ophthalmological and neurological symptoms disappeared. Even though the immunoglobulin values remained unchanged, neuroborreliosis with involvement of the retinal pigment epithelium was the most probable diagnosis, considering the history of tick bites and headache. The authors assume that the tissue around the optic nerve head, which does not have an effective blood-brain barrier, allowed the spirochetes to spread from the central nervous system into the subpigment-epithelium space, thus causing the observed parapapillary pigment epithelium detachments.

Adult↗