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Biomedical subjects

H Watzke

Publications and source records attributed to H Watzke.

At least 19 recordsLinked to original sources

Lipase-catalyzed reactions at different surfaces.

Starting from gold chips, we have tailor-made three surfaces by the self-assembly monolayer technique: one entirely hydrophobic, one hydrophobic with dispersed carboxyl groups, and one hydrophilic, containing hydroxyl groups. Rhizomucor miehei lipase has been adsorbed to the hydrophobic and the hydrophilic surfaces and covalently bound to the surface containing carboxyl groups. The adsorption of two substrates-capric acid (decanoic acid) and monocaprin-on the lipase-covered surfaces was monitored by the surface plasmon resonance (SPR) technique. Biocatalysis was also performed in the SPR instrument by circulating a solution of the substrate, dissolved in an 85:15 water-glycerol mixture at a(w) = 0.81, through the instrument, thus exposing the capric acid or the monocaprin to the lipase-covered surfaces. The product composition was found to depend on the type of surface used. Lipase adsorbed at the hydrophilic surface favored hydrolysis, and capric acid was the main product formed when monocaprin was used as substrate. Lipase adsorbed at a hydrophobic surface and, in particular, lipase covalently bound to a hydrophobic surface favored condensation. More dicaprin than capric acid was formed in experiments with monocaprin as the substrate. Reactions performed outside the SPR instrument showed that small amounts of triglyceride were also formed under these conditions. We believe that this work constitutes the first example of the SPR instrument being used for in-situ biotransformation.

Adsorption↗

Reversibility and irreversibility of adsorption of surfactants and proteins at liquid interfaces.

It is shown experimentally that the desorption of sodium decyl sulphate from the liquid/air interface is purely diffusion controlled, while the desorption of higher surface active surfactants such as the non-ionic surfactants Triton X-100 and tridecyl dimethyl phosphine oxide obeys a mixed mechanism. The desorption kinetics of beta-lactoglobulin (BLG) and beta-casein is, however, determined by a barrier mechanism. From the analysis of the BLG and beta-casein desorption kinetics at different temperatures the activation energy of desorption is calculated. The values obtained are rather close to the free energy of adsorption. The theoretical model of desorption kinetics predicts that these two energetic parameters are similar if the adsorption activation energy is low. This explains why substances with a higher adsorption activity have a lower desorption rate. Adsorption kinetics studies for beta-casein with and without forced convection show the same equilibrium surface tension values. This leads to the conclusion that the protein adsorption at liquid interfaces is thermodynamically reversible, although the slow desorption kinetics would allow to assume it to be an irreversible process.

Adsorption↗

Influence of prothrombin complex concentrates on plasma coagulation in critically ill patients.

OBJECTIVE: To evaluate thrombogenicity of prothrombin complex concentrates (PCCs) in critically ill patients. DESIGN: Prospective clinical study. SETTING: Medical intensive care unit at a university hospital. PATIENTS: 16 consecutive patients suffering from acquired deficiencies of coagulation factors and with either overt bleeding from any site or a planned invasive procedure. INTERVENTIONS: 2000 factor IX units of PCCs intravenously. MEASUREMENTS AND RESULTS: Prothrombin time (PT), activated partial prothrombin time, fibrinogen, platelet count, plasma levels of coagulation factors II, V, VII, VIII, IX, X, antithrombin, protein C, thrombin-antithrombin complex (TAT), prothrombin fragment F(1+2), and the fibrin degradation product D-dimer were measured prior to and 1, 3, and 24 h after administration of PCCs. PT as well as coagulation factors II, VII, IX, and X, TAT, and F(1+2) showed a significant increase after administration of PCCs. All other parameters remained unchanged. CONCLUSIONS: Administration of PCCs induces thrombin generation. No evidence for induction of disseminated intravascular coagulation in biochemical terms could be found. When rapid correction of acquired coagulation factor disturbances is warranted, the use of PCCs seems reasonable, but the elevated risk of intravascular thrombus formation should be kept in mind.

Adult↗

Systemic activation of coagulation and fibrinolysis during varicose vein stripping.

BACKGROUND: Elevation of activation markers of blood coagulation (thrombin-antithrombin complex [TAT], prothrombin fragment 1 + 2 [F1 + 2], D-Dimer] has not only been found in clinically overt thrombosis but also reflects a prethrombotic state. OBJECTIVE: The purpose of our study was to evaluate whether varicose vein stripping, an operative procedure with an extremely low risk of postoperative thromboembolism, induces a prethrombotic state by activation of the hemostatic system. METHODS: In a prospective, observational study we compared the baseline and postoperative values of TAT, F1 + 2, and D-Dimers in 15 patients undergoing varicose vein stripping and in 11 control patients undergoing surgical procedures associated with only minor soft tissue trauma. RESULTS: A highly significant postoperative elevation of TAT (P < 0.001), F1 + 2 (P = 0.006), and D-Dimer (P < 0.001) was observed in the varicose vein stripping group. No significant postoperative change of the respective parameters was detected in the control group. CONCLUSION: We therefore conclude that varicose vein stripping induces a significant hemostatic system activation although postoperative thrombotic events are rare.

Adolescent↗

Varicose vein stripping--a prospective study of the thrombotic risk and the diagnostic significance of preoperative color coded duplex sonography.

Insufficiency of epifascial veins promotes venous ulceration and increases thromboembolic risk in general surgery patients. Epifascial varicose vein stripping is therefore considered the most effective prophylactic procedure. Thromboembolic risk of patients undergoing this surgical procedure has not yet been prospectively evaluated but appears to be lower than in general surgery patients. The gold standard of preoperative assessment of varicose surgery patients is ascending pressure phlebography, but this technique is invasive, time consuming and costly. We prospectively investigated 100 consecutive varicose vein surgery patients for postoperative thrombosis. Ascending pressure phlebography (APP) and colour coded duplex sonography (CCDS) were performed before and 10 to 21 days after the stripping operation in 100 and 70 patients, respectively. APP revealed no postoperative deep vein thrombosis in all 100 limbs investigated (0 percent; 95 percent confidence interval: 0 to 2.95). With regard to epifascial vein reflux there was good agreement between APP and CCDS (quadratic weighted kappa: 0.76). In 67 out of 73 superficial veins investigated excellent agreement of diagnostic accuracy was found for both diagnostic procedures (91.78 percent; 95 percent confidence interval: 82.96 to 96.92). We conclude that thrombotic risk of varicose vein surgery is low in properly selected patients. CCDS provides a high degree of accuracy in diagnosis of reflux and regular vein morphology and should therefore replace APP; however, APP does remain essential in the preoperative workup of atypical anatomical variants.

Adolescent↗

Subacute toxicity testing of ochratoxin A and citrinin in swine.

Fourteen pigs were fed ochratoxin A and citrinin through a stomach tube at daily doses of 0.02 and 0.01 mg/kg body mass for 57 days. These toxin doses correspond to the average toxin contamination level of feeds in Central Europe. The clinical status of the pigs was monitored and clinical laboratory, haematological and mycotoxin-analytical examinations were performed throughout the trial. At the end of the experiment gross and histopathological examinations were carried out. The results of ochratoxin A and citrinin determination in the blood, obtained by high-performance liquid chromatography (HPLC), are important from the food hygienic point of view. The sensitivity of the method was 2 and 10 ng/ml for ochratoxin A and citrinin, respectively. The recovery rate of the mycotoxins was above 60%.

Animals↗

Thromboembolic risk factors in patients undergoing maxillofacial surgery for malignancies.

Venous thromboembolism is a common complication in patients undergoing major surgery. We studied blood coagulation profiles in 16 patients undergoing extensive maxillofacial surgery for oral malignant diseases. Activity of coagulation factor V and levels of antithrombin III were significantly reduced on the first postoperative day. Fibrinogen level showed a continuous increase throughout the observation period. However, no thromboembolic events were observed. It can be concluded that despite a severe alteration of the blood clotting system, maxillofacial surgery does not seem to be associated with postoperative thromboembolism.

Blood Coagulation Factors↗

Bacterial contamination of dialysate in dialysis-associated endotoxaemia.

Bacteriological investigations and endotoxin (ET) determinations were performed during a routine haemodialysis session for six patients. The glucose free dialysate was prepared with untreated tap water. All patients were dialysed for 5 h. Pseudomonas aeruginosa was regularly isolated in numbers up to 10(7) cfu ml-1 from samples of the dialysate inflow, the dialysate site and the dialysate outflow. ET levels in the plasma of the patients increased continuously during haemodialysis and were always higher in the blood outflow line of the dialyzer than in the blood inflow. Despite the high bacterial counts in the dialysate and the increasing ET levels in the patients plasma neither bacteraemia nor fever was observed. The former is due to the impermeability of the dialyzer membrane for bacteria, the latter is explained by low pyrogenicity of P. aeruginosa endotoxin. Inspection of the dialyzer machines revealed that air-traps and heater-unit for the incoming (untreated) tap water before mixing with the dialysate concentrate were the only sites where high bacterial release was feasible, as this part of the machine escaped disinfection due to the construction of these devices. We recommend the regular disinfection of all parts of a dialyzer machine, including heating units, air traps and valves.

Dialysis Solutions↗

Effects of somatostatin and oral potassium administration on terbutaline-induced hypokalemia.

Terbutaline, a beta 2-adrenergic agonist, has been shown to cause hypokalemia and an increase of plasma glucose and serum insulin concentrations. We considered that terbutaline-induced hypokalemia may be due to the insulin-induced shift of potassium (K+) from the extracellular to the intracellular space. If so, then inhibition of insulin secretion by somatostatin would prevent terbutaline-induced hypokalemia. Further, we wondered whether oral potassium pretreatment could prevent terbutaline-induced hypokalemia. Therefore, 10 healthy volunteers (5 men, 5 women; mean age, 23 yr +/- 3 SD) received either sodium chloride (NaCl) or somatostatin intravenously together with 0.25 mg terbutaline subcutaneously in a double-blind crossover design. On a third test day, they received 39 mval of K+ powder orally before terbutaline injection in an open trial. Terbutaline caused a significant decrease of K+ (from 3.96 +/- 0.08 to 3.3 +/- 0.13 mmol/L +/- SEM; p less than 0.0005), accompanied by a significant increase in plasma glucose (from 83 +/- 3.6 to 101 +/- 4.4 mg/dl +/- SEM; p less than 0.01) and serum insulin concentrations (from 11.7 +/- 0.9 to 19.9 +/- 1.1 microU/ml +/- SEM; p less than 0.001), confirming earlier data. Somatostatin pretreatment inhibited the terbutaline-induced hypokalemia; the small fall of K+ (from 3.7 +/- 0.08 to 3.5 +/- 0.2 mmol/L) was no longer significant. Insulin secretion was completely blocked by somatostatin, leading to an even more pronounced increase of blood glucose. Hypokalemia after terbutaline injection was not prevented by oral potassium pretreatment. In summary, the present findings confirm that terbutaline-induced hypokalemia is associated with increased plasma glucose and insulin levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗

Molecular characterization of human factor XSan Antonio.

Enzymatic amplification technique was used to isolate all eight exons and sequences around the splice junctions, putative promoter, and polyadenylation sites of human factor X DNA from a patient with factor X deficiency. Two genetic changes in factor X have been observed in this patient. The patient is most likely a compound heterozygote since there is only 14% activity associated with factor X. A point mutation that resulted in the substitution of cysteine (TGC) for arginine (CGC) at amino acid 366 was found in exon VIII of one allele of the factor X gene. This mutation, which occurs in the catalytic domain, can affect the formation of a disulfide bridge and thus could result in a reduction in factor X activity. Sequencing all the regions revealed a second mutation: a deletion of one nucleotide (TCCT to TCT) in exon VII that would cause a frame shift at amino acid 272 followed by termination. We have also shown that the point mutation in exon VIII creates an ApaL1 restriction site and destroys the HinP1 site. Enzymatic DNA amplification followed by restriction digestion provides a quick, reliable, and sensitive method for carrier detection and antenatal diagnosis in affected kindreds. This is the first characterization of factor X deficiency at the molecular level. We propose to name this mutation Factor XSan Antonio.

Alleles↗

Low total protein S antigen but high protein S activity due to decreased C4b-binding protein in neonates.

Protein S, a vitamin K-dependent cofactor for activated protein C, exists in normal adult plasma in a free anticoagulantly active form and in an inactive form complexed to C4b-binding protein. Immunologic and functional levels of protein S and C4b-binding protein in plasma were determined for 20 newborn infants and compared with adult normal pooled plasma. Total protein S antigen levels averaged 23%, similar to other vitamin K-dependent plasma proteins. However, the protein S anticoagulant activity was 74% of that of adult normal plasma. This apparent discrepancy of activity to antigen was shown to be due to low or undetectable levels of C4b-binding protein, which results in the presence of most if not all of protein S in its free and active form. The relatively high level of anticoagulantly active protein S in infants may enhance the potential of the protein C pathway, thereby minimizing risks of venous thrombosis in this group.

Antigens↗

A permissive effect of cyclosporin on the development of isohaemagglutinins of graft origin in ABO-mismatched organ transplantation.

Acquired immunhaemolytic anemia is a rare but potentially hazardous phenomenon in ABO-mismatched allograft recipients. We report on a further patient, in whom severe haemolytic anemia developed due to a highly specific anti-A1 'auto' antibody of IgG class, after receiving an ABO-mismatched kidney graft. The possible role of immunosuppressive medication in the generation and limitation of this immune disease is discussed.

ABO Blood-Group System↗

Coagulation factors of contact phase of haemostasis are normal in well-controlled type-I diabetic patients despite presence of diabetic retinopathy.

Alterations of plasma coagulation factors have been reported in diabetic patients with severe microangiopathy and metabolic derangement. No information is available, however, for well-controlled type-I diabetic patients. Thus, we studied coagulation factors of the contact phase and inhibitors in 80 fairly well-controlled diabetics (42 female, 38 male, age 28 +/- 11 SD years). Mean HbA1c in these patients was 6.6 +/- 1.0 SD, duration of diabetes ranged from 6 months to 30 years, and 36% had retinopathy shown by fluorescein angiography. The well-controlled diabetic patients did not differ from controls in terms of the activity of prekallikrein, factor XII, high molecular weight kininogen, kallikrein inhibitor, C-1-esterase inhibitor and antithrombin III. Only alpha-2-macroglobulin, an inhibitor of the contact phase of blood coagulation, was elevated significantly in these patients (p less than 0.05). Diabetics with retinopathy had similar activities of prekallikrein, factor XII, high molecular weight kininogen, kallikrein inhibitor, c-1-esterase inhibitor and antithrombin III when compared with patients without retinopathy and controls respectively. alpha-2-macroglobulin did not differ in patients with and without diabetic retinopathy but were significantly elevated in both groups compared with controls. Correlation analysis showed significant positive correlation between HbA1c and the activity of high molecular weight kininogen, kallikrein inhibitor and alpha-2-macroglobulin. In patients with poor metabolic control (n = 11; 6 female, 5 male; age 25 +/- 5 SD years; HbA1C 10.7 +/- 0.9) prekallikrein (p less than 0.05), kallikrein inhibitor (p less than 0.005) and alpha-2-macroglobulin (p less than 0.005) were significantly elevated compared to the controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Fibronectin during thyroid hormone replacement therapy.

Hemostasis may be affected by thyroid function in various ways. We studied plasma concentration of Fibronectin in 13 untreated patients after total thyroidectomy due to thyroid carcinoma. Fibronectin levels were significantly decreased compared to an equal numbered group of healthy volunteers (p 0.0005). The same patients were studied again after an oral thyroid replacement of 200 micrograms L-thyroxine/d over at least six weeks. Fibronectin had increased significantly, compared to untreated patients and controls resp. Furthermore, a significant positive correlation was found between plasma concentrations of Fibronectin and total T4 (r = 0.92; y = 6.617 + 0.52x). In contrast Factor V activity was low in untreated patients but normal during high dose replacement therapy. No correlation was found between Factor V and thyroid hormone concentrations. We discuss the relation between fibronectin plasma levels and thyroid hormones.

Factor V↗

[Clinical value of endotoxin determination in infection. Comparison of the Limulus amebocyte lysate test with detection of bacterial pathogens].

To evaluate usefulness of Limulus amoebocyte lysate test and blood culture in the diagnosis of septicemia both tests were performed in 27 intensive care patients. Test results were compared with a clinical sepsis score. Ten (62%) out of 16 patients with clinical diagnosis of septicemia showed a positive endotoxin test and 11 (69%) a positive blood culture. In 14 patients (87%) either endotoxin test or blood culture revealed a positive result. Two out of 11 patients (20%) classified by the sepsis score as non-septic showed positive blood cultures as well as positive endotoxin tests. 4 patients with gram-positive bacteria in the blood cultures showed a positive endotoxin test. Due to lack of sensitivity and specificity the Limulus amoebocyte lysate test is of rather low value in the diagnosis of septicemia. Simultaneous performance of Limulus amoebocyte lysate test and blood culture is able to improve the sensitivity, which then over-rules the one obtained when only blood cultures are performed.

Bacteria↗