Biomedical subjects

H Brunner

Publications and source records attributed to H Brunner.

At least 19 recordsLinked to original sources

PubMed2005

Colonic spread and serum pharmacokinetics of budesonide foam in patients with mildly to moderately active ulcerative colitis.

BACKGROUND: Local treatment with foams in patients suffering from ulcerative proctitis or proctosigmoiditis is considered a rational treatment option. AIMS: To investigate colonic spread, safety, tolerability and acceptance of a newly developed budesonide foam formulation. METHODS: Twelve patients (four females, eight males) with acute proctosigmoiditis or left-sided ulcerative colitis were rectally administered a single dose of [99Tcm]-labelled budesonide foam (Budenofalk; Dr Falk Pharma GmbH, Freiburg, Germany) containing 2 mg budesonide in 20 mL foam after diagnostic colonoscopy. Thereafter, the colonic spread was assessed by means of gamma-scintigraphy for 6 h. Serum samples were taken simultaneously. RESULTS: Budesonide foam spread with a maximum between 11 and 40 cm, thus reaching the sigmoid colon in all patients. In some patients, the foam even extended into the distal third and the middle of the descending colon with maximum radioactivity at 4 h. Systemic budesonide absorption was rapid and pharmacokinetic data were comparable with published data on marketed budesonide enemas, with mean serum C(max) and AUC(0-8 h) values of 0.8 +/- 0.5 ng/mL and 3.7 +/- 1.9 ng h/mL, respectively. The new formulation was well accepted by all patients, who could retain the foam for at least 4 h. CONCLUSIONS: In the majority of patients, budesonide foam effectively spread up to the left-sided colon and thus qualifies for the local treatment of proctosigmoiditis.

Administration, Rectal↗

PubMed2005

Comprehensive MR angiography of the lower limbs: a hybrid dual-bolus approach including the pedal arteries.

The purpose of this study was to include the pedal vasculature into the coverage of peripheral multistation magnetic resonance angiography (3DceMRA). A total of 216 patients suffering from peripheral vascular disease were examined with a modified hybrid dual-bolus technique. The cruropedal arteries were acquired first with two sagittal slabs and time-resolved 3D sequences. Then the aortofemoral vessels were visualized using the bolus-chase technique and a second contrast injection. Interventional procedures were performed in 104 patients, and in 69 of those, the cruropedal vessels were also examined with digital subtraction angiography (iaDSA). Using 3DceMRA, the cruropedal arteries were displayed with both excellent and good quality in 95% (205/216 cases), and without any venous overlay in 94% (203/216 cases). The aortofemoral vessels were not jeopardized by the first contrast injection. With iaDSA as the standard of reference, observed sensitivity of 3DceMRA was found in ranges from 80% (29%, 99%) to 100% (86%, 100%) for assessing significant stenoses, and observed specificity ranged between 93% [80%, 98%] and 100% (82%, 100%). In conclusion, hybrid dual-bolus 3DceMRA significantly reduces the limitations of standard single-bolus 3DceMRA in anatomic coverage and temporal resolution of the cruropedal arteries, thus providing high-quality images of the entire peripheral vasculature.

Aged↗

PubMed2005

[Nightmares in patients with Alzheimer's disease caused by donepezil. Therapeutic effect depends on the time of intake].

Dementia of the Alzheimer type (DAT) has been linked to losses of cholinergic function in the brain. The acetylcholinesterase inhibitors donepezil, rivastigmine and galantamine improve cognitive performance in manifest dementia. These substances, however, also influence the quality of sleep, and particularly the quality and amount of dreams. We therefore investigated the influence of the time point of donepezil intake on the occurrence of nightmares. We observed a clear-cut relationship between the occurrence of nightmares and an evening dose of donepezil in eight patients with DAT. None of these patients reported nightmares when donepezil was taken in the morning. We suggest that the activation of the visual association cortex during REM sleep is enhanced by donepezil, a mechanism most likely facilitating the development of nightmares in patients with DAT.

Aged↗

PubMed2005

[Differential diagnosis of the signal-compromised lunate in MRI].

PURPOSE: To define both the underlying pathology and diagnostic criteria in lunates presenting with conspicuous signal pattern in MRI. MATERIALS AND METHODS: The retrospective evaluation of 2940 MRI examinations revealed 203 patients with signal alterations of the lunate. All MRI examinations were performed on 1.5-Tesla platforms using dedicated surface coils and an intravenous contrast agent. To establish a definitive diagnosis, a total of 252 MRI examinations (49 follow-ups), 22 CT examinations and 4 arthroscopic studies were obtained in addition to the obligatory conventional radiographs. RESULTS: Incorporating all clinical data, radiographs and MRI examinations succeeded in assigning a diagnosis in 136 signal-compromised lunates (67.0 %), whereas additional diagnostic procedures or follow-up examinations were required for the definitive diagnosis in 57 cases (33.0 %). The most frequent entities were 51 cases of Kienbock's disease (25.1 %), 47 cases of ulnolunate-(triquetral) impaction syndromes (23.2 %) and 44 cases of intra-osseous ganglion cysts (21.7 %). Other pathologies included 23 degenerative, 19 traumatic and 10 inflammatory changes as well as 9 congenital conditions. For MRI assessment of the altered lunate, the most important parameters were location and morphology as well as involvement of the articular and osseous structures of the carpus. CONCLUSION: The lunate may be affected by different pathological states of the wrist. In total, only one quarter of the signal-compromised lunate represented Kienboeck's disease.

Adolescent↗

PubMed2005

Identification and characterization of Cor33p, a novel protein implicated in tolerance towards oxidative stress in Candida albicans.

We applied two-dimensional gel electrophoresis to identify downstream effectors of CPH1 and EFG1 under hypha-inducing conditions in Candida albicans. Among the proteins that were expressed in wild-type cells but were strongly downregulated in a cph1Delta/efg1Delta double mutant in alpha-minimal essential medium at 37 degrees C, we could identify not-yet-characterized proteins, including Cor33-1p and Cor33-2p. The two proteins are almost identical (97% identity) and represent products of allelic isoforms of the same gene. Cor33p is highly similar to Cip1p from Candida sp. but lacks any significant homology to proteins from Saccharomyces cerevisiae. Strikingly, both proteins share homology with phenylcoumaran benzylic ether reductases and isoflavone reductases from plants. For other hypha-inducing media, like yeast-peptone-dextrose (YPD) plus serum at 37 degrees C, we could not detect any transcription for COR33 in wild-type cells, indicating that Cor33p is not hypha specific. In contrast, we found a strong induction for COR33 when cells were treated with 5 mM hydrogen peroxide. However, under oxidative conditions, transcription of COR33 was not dependent on EFG1, indicating that other regulatory factors are involved. In fact, upregulation depends on CAP1 at least, as transcript levels were clearly reduced in a Deltacap1 mutant strain under oxidative conditions. Unlike in wild-type cells, transcription of COR33 in a tsa1Delta mutant can be induced by treatment with 0.1 mM hydrogen peroxide. This suggests a functional link between COR33 and thiol-specific antioxidant-like proteins that are important in the oxidative-stress response in yeasts. Concordantly, cor33Delta deletion mutants show retarded growth on YPD plates supplemented with hydrogen peroxide, indicating that COR33 in general is implicated in conferring tolerance toward oxidative stress on Candida albicans.

Alleles↗

PubMed2004

[The importance of a careful examination of all persons in close contact with newly diagnosed infectious tuberculosis].

The diagnosis of infectious pulmonary tuberculosis was made in a 53-year-old Macedonian man. A careful examination of all persons in close contact with him according to the guidelines of the Swiss respiratory society was performed. Pulmonary tuberculosis was diagnosed in his 22-year-old son, in his 20-year-old daughter and in his 3-year-old granddaughter. Seven persons had isoniazid preventive treatment for latent tuberculosis. These data shows very clearly that a careful examination of all persons in close contact with contagious tuberculosis is very important.

Adult↗

PubMed2004

[Diagnostic angiography using multi-slice spiral CT in acute obstruction of the basilar artery].

OBJECTIVE: To evaluate the diagnostic efficiency of CT angiography in case of clinical signs of acute brainstem infarction for the therapeutic management of catheter-based local thrombolysis. MATERIAL AND METHODS: 3 patients (2 males, 1 female) suffering from an acute onset of brainstem symptoms and being suspicious of an occluded basilar artery were included into this report. 1 patient underwent selective vertebral arteriography. 2 patients were initially examined with CT angiography using a 4-row scanner and 100 ml intravenous contrast agent. RESULTS: In one patient, an occlusion of the basilar artery was excluded with catheter-based angiography. Subsequently, the patient was treated with systemic thrombolysis using r-tPA because of a thalamus infarction seen in MRI. 2 patients who have been initially examined with CT angiography presented with complete occlusions of the basilar arteries. These patients underwent r-tPA thrombolysis by means of superselective micro-catheter approaches of the vertebrobasilar vessels. CT angiography was very useful for determinating the occlusion length of the basilar artery pre-therapeutically, and in 1 case for ruling out an occluded vertrebral artery for catheterization. All patients recovered well under thrombolytic therapy applied systemically or selectively. CONCLUSION: Cerebral multi-slice CT angiography is a fast and save technique for detecting or ruling out an acute basilar artery occlusion. Thus, in cases of equivocal clinical signs CT angiography is recommended before the decision of thrombolytic therapy is made.

Adult↗

PubMed2003

Identification of cell surface determinants in Candida albicans reveals Tsa1p, a protein differentially localized in the cell.

To identify cell surface proteins of Candida albicans, the predominant fungal pathogen in humans, we have established an approach using a membrane impermeable biotin derivative in combination with affinity purification. We were able to identify 29 different proteins under two distinct conditions. Among mannoproteins, heat shock proteins and glycolytic enzymes we found thiol-specific antioxidant-like protein 1 (Tsa1p) to be differentially localized depending on the conditions applied. Only in hyphally grown cells Tsa1p was localized to the cell surface whereas in blastospores no surface but mainly nuclear localization was found. This indicates that cell surface expression of at least some proteins is mediated by differential translocation.

Biotinylation↗

PubMed2003

Spectral composition of NREM sleep in healthy subjects with moderately increased daytime sleepiness.

OBJECTIVE: This study addressed the relationship between daytime sleepiness and spectral composition of the preceding NREM sleep. METHODS: Nineteen healthy volunteers (mean age: 36.5 years; SD: 10.1) underwent polysomnography during two consecutive nights and the multiple sleep latency test (MSLT) on the following day. Daytime sleepiness was also assessed by the Epworth sleepiness scale (ESS). The sleep recordings were visually scored according to standard criteria. The quantitative sleep EEG analysis was performed using a fast Fourier transform routine. The sleep parameters were compared between subjects with short and long MSLT sleep latencies (cut-off=10 min) and between subjects with low and high ESS scores (cut-off=6 points). RESULTS: Subjects with short MSLT sleep latencies showed a reduced theta EEG activity. There was no evidence of reduced synchronization of sleep EEG in subjects with high ESS scores. CONCLUSIONS: Moderately increased daytime sleepiness as indicated by MSLT sleep latency less than 10 min is accompanied by decreased power of theta activity during NREM sleep indicating a deficit of sleep EEG synchronization.

Adult↗

PubMed2003

Capgras syndrome--out of sight, out of mind?

OBJECTIVE: Recent theoretical approaches emphasize a disorder of face processing in the pathogenesis of the Capgras syndrome. We report a patient with the Capgras syndrome developing in the physical absence of the person who is believed to be replaced and thus a limited role for a disorder of face processing. METHOD: The clinical phenomenology of a case of the Capgras syndrome is explored. RESULTS: A disorder of face processing might not be a sufficient explanation of the course of the disorder in this patient. CONCLUSION: Face processing accounts, of the Capgras delusion, have to be supplemented by additional assumptions.

Antipsychotic Agents↗

PubMed2003

EFG1 is a major regulator of cell wall dynamics in Candida albicans as revealed by DNA microarrays.

Cell wall dynamics in Candida albicans, the most common fungal pathogen in man, underlie regulatory processes during the yeast-to-hyphae transition. To analyse this regulation at the transcriptional level, we have established a DNA microarray representing genes implicated in cell wall biogenesis. Using these microarrays, we were able to identify YWP1 and HWP2 that are specifically transcribed in the yeast or hyphal growth form respectively. Cluster analysis revealed at least two major clusters of genes: cluster I comprised genes that were upregulated under at least one hyphae-inducing condition. Three as yet not further characterized genes were attributed to cluster II. These genes were transcribed in the yeast form of C. albicans and were downregulated in an EFG1-dependent manner under specific hyphae-inducing conditions. We show further that, in contrast to CPH1, EFG1 plays a major role in the transcriptional regulation of cell wall proteins under the conditions investigated. EFG1 was essential for the transcription of both hyphae-specific genes such as HWP1 and HWP2 as well as the yeast form-specific gene YWP1. Moreover, we found that, under various conditions, EFG1 also can act as a strong repressor for the transcription of RBE1, another not yet characterized cell wall protein. Overall, our data show that EFG1 plays a major role in the induction and repression of cell wall genes, not only in the hyphal form but also in the yeast form of C. albicans.

Candida albicans↗

PubMed2003

A screen in Saccharomyces cerevisiae identified CaMCM1, an essential gene in Candida albicans crucial for morphogenesis.

Morphogenesis in Saccharomyces cerevisiae and the pathogenic yeast Candida albicans is governed in part by the same molecular circuits. In S. cerevisiae, FLO11/MUC1 expression has been shown to be modulated by multiple signalling pathways required for pseudohyphal development. We have established a screen in S. cerevisiae to identify regulators of fungal development in C. albicans based on FLO11::lacZ expression as a reporter. This screen identified both known components of the mitogen-activated protein kinase (MAPK) cascade and the cAMP cascade that are important for hyphal development in C. albicans, as well as genes not yet known to be involved in morphogenesis. The Candida homologue of MCM1 is one of the novel factors identified in this screen as being important for morphogenesis. CaMcm1p levels do not vary significantly in different cell types and respond to an autoregulatory feedback mechanism, arguing that CaMcm1p activity is regulated by post-translational modifications. Both overexpression and repression of this essential gene led to the induction of hyphae. Moreover, we found that the expression of HWP1, a hyphae-specific gene, was induced by repression of CaMCM1. The changes in morphology and HWP1 expression were not the result of a change in expression levels of NRG1 or TUP1, known repressors of hyphal development. Thus, CaMcm1p is a component of a hitherto unknown regulatory mechanism of hyphal growth.

Base Sequence↗

PubMed2003

Child-Pugh versus MELD score in predicting survival in patients undergoing transjugular intrahepatic portosystemic shunt.

BACKGROUND: In patients undergoing transjugular intrahepatic portosystemic shunt (TIPS), prognostic scores may identify those with a poor prognosis or even those with a clear survival benefit. The Child-Pugh score (CPS) is well established but several drawbacks have led to development of the model of end stage liver disease (MELD). AIM: The aim of the study was to compare the predictive power of CPS and MELD, to validate the original MELD formula, and to assess the predictive value of the determinants used in the two prognostic scores outside of a study setting. PATIENTS: A total of 501 patients underwent elective TIPS placement and 475 patients fulfilled the inclusion criteria. METHODS: Data of all patients undergoing elective TIPS in one university hospital and four community hospitals in Vienna, Austria, between 1991 and 2001, were analysed retrospectively. The main statistical tests were Cox proportional hazards regression model, the log rank test, Kaplan-Meier analysis, and concordance c statistics. RESULTS: Median follow up was 5.2 years and median survival was 4.6 years. During follow up, 230 patients died, 75 within three months after TIPS placement. In stepwise proportional hazards analyses, independent predictors of death were creatinine level, bilirubin level, age, and refractory ascites. MELD was better in predicting survival in a stepwise Cox model but both scores were equally predictive in c statistics for one month, three month, and one year survival. Renal function was the strongest independent predictor of survival. CONCLUSIONS: Although MELD was the primary predictor of overall survival in multivariate analysis, c statistics showed that both scores can be used for patients undergoing TIPS with equal accuracy. For assessing prognosis in patients undergoing TIPS implantation, there seems little reason to replace the well established Child-Pugh score.

Adult↗

PubMed2003

New 5-aminolevulinic acid esters--efficient protoporphyrin precursors for photodetection and photodynamic therapy.

Photodetection (PD) and photodynamic therapy (PDT) with 5-aminolevulinic acid (ALA)-induced protoporphyrin IX (PPIX) accumulation are approaches to detect and treat dysplasia and early cancer in the gastrointestinal tract and in the urinary bladder. Because ALA-induced PPIX production is limited, we synthesized ALA ester hydrochlorides 3-22 and tested them in two different in vitro models (gastrointestinal tract: HT29-CCD18; urinary bladder: J82-UROTSA). PPIX accumulation after incubation with 0.12 mmol/L for 3 h and PPIX accumulation as a function of different incubation times were measured using flow cytometry. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assays were performed to check cellular dark toxicity. Phototoxicity after irradiation was tested. ALA nonafluorohexylester hydrochloride 11, ALA thiohexylester hydrochloride 13 and ALA dibenzyldiester dihydrochloride 19 induced appreciably increased PPIX levels and showed improved phototoxicity compared with the references ALA hydrochloride 1, ALA hexylester hydrochloride 3 and ALA benzylester hydrochloride 4. Thus, the new compounds 11, 13 and 19 are promising compounds for PD and PDT.

Aminolevulinic Acid↗

PubMed2002

Ghrelin promotes slow-wave sleep in humans.

Ghrelin, an endogenous ligand of the growth hormone (GH) secretagogue (GHS) receptor, stimulates GH release, appetite, and weight gain in humans and rodents. Synthetic GHSs modulate sleep electroencephalogram (EEG) and nocturnal hormone secretion. We studied the effect of 4 x 50 microg of ghrelin administered hourly as intravenous boluses between 2200 and 0100 on sleep EEG and the secretion of plasma GH, ACTH, cortisol, prolactin, and leptin in humans (n = 7). After ghrelin administration, slow-wave sleep was increased during the total night and accumulated delta-wave activity was enhanced during the second half of the night. Rapid-eye-movement (REM) sleep was reduced during the second third of the night, whereas all other sleep EEG variables remained unchanged. Furthermore, GH and prolactin plasma levels were enhanced throughout the night, and cortisol levels increased during the first part of the night (2200-0300). The response of GH to ghrelin was most distinct after the first injection and lowest after the fourth injection. In contrast, cortisol showed an inverse pattern of response. Leptin levels did not differ between groups. Our data show a distinct action of exogenous ghrelin on sleep EEG and nocturnal hormone secretion. We suggest that ghrelin is an endogenous sleep-promoting factor. This role appears to be complementary to the already described effects of the peptide in the regulation of energy balance. Furthermore, ghrelin appears to be a common stimulus of the somatotropic and hypothalamo-pituitary-adrenocortical systems. It appears that ghrelin is a sleep-promoting factor in humans.

Adrenocorticotropic Hormone↗

PubMed2002

In vitro reconstructed human epithelia reveal contributions of Candida albicans EFG1 and CPH1 to adhesion and invasion.

The individual and synergistic contributions of two transcription factors, EFG1 and CPH1, have been characterized with regard to adhesion to, and invasion of, human epithelia by Candida albicans. For this purpose two in vitro reconstructed tissue models were developed. A multi-layered model of human epidermis was used to simulate superficial infections of the skin, whereas a reconstructed human intestinal model was used to mimic the first steps of systemic infections. It was shown that C. albicans deleted for both transcription factors CPH1 and EFG1, in contrast to the congenic clinical isolate Sc5314, was neither able to adhere to, nor to penetrate, either of the model systems. A strain deleted for EFG1 alone showed significant reduction in adhesion and was not able to penetrate through the stratum corneum. However, strains deleted for CPH1 showed phenotypes paralleling the phenotypes of the clinical isolate Sc5314. Using different types of multi-layered human tissues reconstructed in vitro the individual contributions of Efg1p and Cph1p to two important virulence factors of C. albicans, namely adhesion and invasion, could be defined.

Candida albicans↗

PubMed2001

Standardized measurements and differential spectroscopy in microplates.

Microplates (MPs) are excellent devices for the parallel processing of multiple samples for the spectroscopic analysis of chromophores and turbidity, for luminometric measurements, for cell culture applications, or simply for sample storage, library organization, and other high-throughput (HTP) processes. Disadvantages include an ill-defined pathlength, meniscus formation, evaporation, and cross-contamination. Here, we have developed a novel MP and lid system which can serve to minimize these drawbacks. Cup-like lids are inserted into MP wells. Thereby, liquid is pushed aside. The flat bottoms of the cup-like lids guarantee a planar interface and a defined pathlength. In addition, the devised MP system allows for differential spectroscopic analysis of multiple samples comparable to measurements in tandem cuvettes. This was shown by the investigation of the binding of reduced nicotinamide adenine dinucleotide to dihydrolipoamide dehydrogenase. The MP lid system described offers a low-cost solution for standardized spectrophotometric quantitations in any solvent compatible with the MP/lid material. In addition to the system's suitability for routine MP application, it should be advantageous as a simple and noninvasive method, i.e., no labeling and immobilization of analytes is required for detection of the interaction of molecules, for various HTP applications and drug screening purposes.

Binding Sites↗

PubMed2001

Structural rearrangements in triple-decker-like complexes with mixed group 15/16 ligands: synthesis and characterization of the redox couple.

The reaction of As4Se4 with stoichiometric amounts of [Cp*Fe2(CO)4] (Cp* = C5Me5) in boiling toluene forms [Cp2*Fe2As2Se2] (1) in good yield. X-ray crystallography shows 1 to have a triple-decker structure which comprises a tetraatomic mu,eta4:4-As2Se2 ligand. Density functional theory (DFT) and extended Hückel molecular orbital (EHMO) calculations confirm that the As2Se2 ligand behaves as a four-electron pi donor. Oxidation of 1 with equimolar amounts of [(C5H5)2Fe]PF6, Br2 and I2, respectively, gave compounds 2-4. According to X-ray crystallographic investigations that were carried out on 2 and 4, the oxidation state has a considerable influence on the structure of the Fe2As2Se2 core: significant shortening of the Fe-Fe distance (deltad(Fe-Fe)> 0.3 A) and weakening of the As-As bond length ((deltad(As-As) > 0.3 A) suggests the formal presence of two diatomic AsSe ligands and a Fe-Fe bond. DFT and EHMO calculations confirm that an electron is removed from an occupied Fe-Fe orbital of antibonding character during oxidation. All molecular orbitals lower their energies upon oxidation, but the energy drop is relatively small for those involving the As-As bond. An additional structural feature in 4 consists of an electronic interaction of the iodide with both As atoms which suggests a formally neutral ion pair. Electrochemical studies confirm that the oxidation of 1 is a reversible one-electron process with E(1/2)= +0.07 V (in THF). These studies also reveal that 4 dissociates in polar solvents, such as THF, into [1]+ and I-, which is followed by transformation into 1 and I3.

Journal Article↗