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Biomedical subjects

K Richter

Publications and source records attributed to K Richter.

At least 109 records · Page 6Linked to original sources

Technology assessment of medical devices at the Center for Devices and Radiological Health.

We reviewed the Food and Drug Administration's regulatory process for medical devices and described the issues that arise in assessing device safety and effectiveness during the postmarket period. The Center for Devices and Radiological Health (CDRH), an organization within the Food and Drug Administration, has the legal authority and responsibility for ensuring that medical devices marketed in the United States are both reasonably safe and effective for their intended use. This is an enormous challenge given the diversity of medical devices and the large number of different types of devices on the market. Many scientific and regulatory activities are necessary to ensure device safety and effectiveness, including technology assessment, albeit in a manner quite different from that of conventional technology assessment. The basic approach taken at the CDRH to ensure device safety and effectiveness is to develop an understanding of the way in which a medical device works and how it will perform in clinical situations.

Device Approval↗

DAFS experiments with non-centrosymmetric single crystals.

Diffraction anomalous fine structure (DAFS) experiments were applied to an epitaxially grown (Ga,In)P layer on a [001] GaAs substrate as a single-crystalline model substance. The requirements for the reliable measurement of reflection intensities as a function of photon energy, as well as the quantitative DAFS analysis resulting in the complex-valued fine-structure function of the scattering factor, are described. In the case of single crystals, effort had to be put into performing the DAFS measurements in order to hold the position of the Bragg reflection exactly during the energy scan. Using the zinc-blende-type structure as an example, it is shown for the first time that, similar to single-crystal structure analysis, the lack of inversion symmetry has a significant impact on the DAFS signal, so that DAFS may contribute to structure analysis as well.

Journal Article↗

Bassoon, a novel zinc-finger CAG/glutamine-repeat protein selectively localized at the active zone of presynaptic nerve terminals.

The molecular architecture of the cytomatrix of presynaptic nerve terminals is poorly understood. Here we show that Bassoon, a novel protein of >400,000 Mr, is a new component of the presynaptic cytoskeleton. The murine bassoon gene maps to chromosome 9F. A comparison with the corresponding rat cDNA identified 10 exons within its protein-coding region. The Bassoon protein is predicted to contain two double-zinc fingers, several coiled-coil domains, and a stretch of polyglutamines (24 and 11 residues in rat and mouse, respectively). In some human proteins, e.g., Huntingtin, abnormal amplification of such poly-glutamine regions causes late-onset neurodegeneration. Bassoon is highly enriched in synaptic protein preparations. In cultured hippocampal neurons, Bassoon colocalizes with the synaptic vesicle protein synaptophysin and Piccolo, a presynaptic cytomatrix component. At the ultrastructural level, Bassoon is detected in axon terminals of hippocampal neurons where it is highly concentrated in the vicinity of the active zone. Immunogold labeling of synaptosomes revealed that Bassoon is associated with material interspersed between clear synaptic vesicles, and biochemical studies suggest a tight association with cytoskeletal structures. These data indicate that Bassoon is a strong candidate to be involved in cytomatrix organization at the site of neurotransmitter release.

Amino Acid Sequence↗

High-performance liquid chromatographic determination of propiverine and its N-oxide in human serum.

A high-performance liquid chromatographic method has been developed for the determination of propiverine hydrochloride (P4) and its main metabolite, propiverine N-oxide (P4NO) in human serum. P4 has been shown to be efficacious in those patients who have either idiopathic bladder instability, or neurogenic bladder (detrusor hyperflexia) resulting from spinal cord injuries. In the present method, the analytes were extracted from serum (1 ml, pH 8) into methyl tert.-butyl ether. The separation was performed on a reversed-phase C8 (RP-select B) column using phosphate buffer-acetonitrile (30:70, v/v). UV absorption was used for measuring the analytes, with a limit of quantitation of about 10 ng/ml, which is appropriate for pharmacokinetic studies.

Benzilates↗

Identification of fucose alpha(1-2) galactose epitope-containing glycoproteins from rat hippocampus.

Fucosylation of terminal galactose residues of brain glycoproteins in the alpha(1-2) position has been shown to be crucial for neuronal plasticity, including phenomena such as long-term potentiation and long-term memory formation. We raised antibodies against the plasticity-relevant fucalpha(1-2)gal epitope and used them to determine the distribution of the epitope in adult rat hippocampus. To identify proteins bearing fucalpha(1-2)gal glycostructures antibodies against known synaptic fucoglycoproteins were used in combination with the fucalpha(1-2)gal antibodies. The NMDA receptor subunit NR1 and fractions of gp65 and cadherin were found to carry the epitope, while fucosylation of NCAM180 and NCAM140 obviously occurs via different linkages to the glycan chains.

Animals↗

Determination of drugs in biological fluids by high-performance liquid chromatography with on-line sample processing.

An automated two column HPLC system with the new packing material LiChrospher RP-18 ADS (alkyl-diol-silica) was tested for the determination of several drugs and metabolites (talinolol, celiprolol, metoprolol, oxprenolol, triamterene, trimethoprim, tiracizine, articaine, detajmium, ajmaline, lamotrigine) in various biological fluids (serum, urine, intestinal aspirates, supernatants of cell cultures and supernatants after protein denaturation). The method allows the direct injection of biological fluids into a reversed-phase HPLC system and on-line clean-up and sample enrichment by a column-switching technique. Precision, accuracy and sensitivity were similar to conventional assays as described in the literature. With this new method it was possible to measure drug concentrations in various biological fluids without changing the sample preparation procedure. In some cases an additional sample preparation like protein denaturation or solid-phase extraction was advantageous to enhance the sensitivity of the method and the life-time of the ADS column.

Autoanalysis↗

Eukaliuric natriuresis and diuresis in response to disprocynium24: studies on the tubular site of action.

We previously described that 1,1'-diisopropyl-2,4'-cyanine (disprocynium24, DP24) exerts an eukaliuric diuresis and natriuresis in the anesthetized rat. The purpose of the present study was to localize the tubular site of action of DP24. Employing micropuncture experiments in anesthetized rats, we first tested the effect of systemic application of DP24 (300 microg/kg + 300 microg/kg h, i.v.) on whole kidney excretion rates as well as on fluid, sodium and potassium ion delivery to the early distal tubule (V(ED), Na+(ED), K+(ED)). It was found that the eukaliuric diuresis and natriuresis in response to DP24 was accompanied by a substantial increase in V(ED) and Na+(ED), suggesting a predominant tubular site of action upstream to the early distal tubule, most likely in the proximal tubule. DP24 caused a comparable fractional, although minor absolute increase in K+(ED) as compared to Na+(ED). Second, application of DP24 into the first surface loop of the proximal tubule significantly increased V(ED) and Na+(ED) at a concentration of about 10(-7) M, indicating that DP24 may act from the intratubular site. Third, microperfusion of tubular segments revealed that effects of DP24 on the proximal convoluted tubule and the loop of Henle accounted for about 70 and 30%, respectively, of its diuretic and natriuretic action upstream to the early distal tubule. With regard to the loop of Henle, the quantitative effect of DP24 on fluid and Na+ reabsorption proposed a predominant effect on the straight part of the proximal tubule rather than the thick ascending limb. Intratubular DP24 did not affect reabsorption in the distal tubule. In summary, the present findings indicate that: (1) the diuretic and natriuretic effect of DP24 resides predominantly in the proximal tubule, and (2) DP24 may act from the intratubular site. Since DP24 increased V(ED) and Na+(ED) without apparently affecting sodium or potassium ion transport in the distal tubule, the mechanism of the eukaliuric response remains unclear.

Animals↗

Anterior specification of embryonic ectoderm: the role of the Xenopus cement gland-specific gene XAG-2.

In a search for novel developmental genes expressed in a spatially restricted pattern in dorsal ectoderm of Xenopus we have identified XAG-2, a cement gland-specific gene with a putative role in ectodermal patterning. XAG-2 encodes a secreted protein, which is expressed in the anterior region of dorsal ectoderm from late gastrula stages onwards. Activation of XAG-2 transcription is observed in response to organizer-secreted molecules including the noggin, chordin, follistatin and cerberus gene products. Overexpression of XAG-2 but not of the related cement gland marker XAG-1 induces both cement gland differentiation and expression of anterior neural marker genes in the absence of mesoderm formation. Further, we show that XAG-2 signaling depends on an intact fibroblast growth factor (FGF) signal transduction pathway and that XAG-2-induced anterior neural fate of ectodermal cells can be transformed to a more posterior character by retinoic acid. Based on these findings we propose a role for XAG-2 in the specification of dorsoanterior ectodermal fate, i.e. in the formation of cement gland and induction of forebrain fate of Xenopus.

Amino Acid Sequence↗

Is the prevalence of atopic diseases in East and West Germany already converging?

Studies comparing respiratory health of residents in the areas of former East and West Germany have shown higher rates of asthma and allergies in children and young adults in former West Germany. It has been speculated that some factors associated with western lifestyle may be related to higher rates of atopic diseases among residents of former West Germany. We examined if the prevalence rates of self-reported asthma and nasal allergies in adults converged between the areas of former East and West Germany five years after re-unification. During the years 1990-1992 and 1994-1995 two independently drawn random samples of more than 3,000 subjects between the ages of 20 to 44 years answered a screening questionnaire of the European Community Respiratory Health Survey in Erfurt (East Germany) and in Hamburg (West Germany). The prevalence rates of asthma attacks, asthma medication use, allergic rhinitis, and wheezing remained stable in Hamburg but increased significantly in Erfurt approaching those of Hamburg. The data indicate that there is a tendency for the prevalence rates of self-reported allergic rhinitis and asthma-related respiratory symptoms in the eastern part of Germany to increase to West-German levels. It is not yet clear if this is due to a true increase in morbidity or only to a higher awareness for these diseases among doctors and the public.

Adult↗

Are chronic obstructive pulmonary disease (COPD) and asthma different diseases?

In the past it has been hypothesized that asthma and chronic obstructive pulmonary disease (COPD) are related diseases. As both show high prevalences and as smoking may occur in both groups of patients the simultaneous presence of both diseases in the same subject may well occur. The most characteristic features of asthma are short-term changes in airway caliber, reversible airflow limitation, bronchial hyperresponsiveness as well as eosinophilic and lymphocytic airway inflammation. The common definition of COPD implies long-term changes in airway calibre, less or irreversible airflow obstruction, no or less common bronchial hyperresponsiveness and neutrophilic airway inflammation. By analysing the results of epidemiology, risk factors, airway morphology, lung function and markers of airway inflammation in both diseases, it becomes clear that asthma and COPD share some similarities. However, their pathological presentations differ considerably and this provides evidence that the two syndromes are, in fact, different diseases. Furthermore, the analysis of data on lung volumes, diffusion capacity and aerosol-derived airway morphology shows important differences between asthma and COPD. It is suggested that the specific type of airway inflammation in both diseases is responsible for the peculiar pattern of lung function abnormalities.

Asthma↗

[Automated mammary sonography and mammography: the differentiation of benign and malignant breast lesions].

PURPOSE: A prospective study on the differentiation of breast lesions was carried out using experimental combination schemes of mammography and automatic sonography. MATERIALS AND METHODS: X-ray mammograms and a B image from automatic sonography of 39 malignant and 41 benign lesions as well as 40 cases without lesions were separately examined by four experienced diagnosticians. The observers differentiated the findings mammographically and by measurement in the B images. RESULTS: For two examiners the combination of mammography and automatic sonography gave with regard to the differentiation of breast lesions an improvement in sensitivity of 3 or 5% and in specificity of 31 and 18%, respectively, as compared to mammography alone while for the other two examiners an improved specificity of 21 and 36%, respectively, was accompanied by an 8 and 10% decrease in sensitivity as compared to mammography alone. CONCLUSIONS: The differentiating criteria from automatic sonography and mammography can, in principle, be used to evaluate the dignity of breast lesions. However, an optimization is necessary since the improvement in specificity does not compensate the loss in sensitivity.

Adult↗

[7-D-ALA]-angiotensin 1-7 blocks renal actions of angiotensin 1-7 in the anesthetized rat.

Exogenous angiotensin (Ang) 1-7 affects renal function, but the receptor(s) involved in this response remain(s) to be determined. In an in vitro preparation of proximal tubules, Ang 1-7 was shown to act on Ang II AT1 receptors (minor component), but also on a non-AT1, non-AT2 Ang receptor (major component) to inhibit reabsorption. In brain, Ang 1-7 also exerts effects mediated by a non-AT1, non-AT2 binding site; these effects are inhibited, however, by the angiotensin analog [7-D-Ala]-Ang 1-7. Therefore we tested the effect of Ang II AT1-receptor antagonist losartan and [7-D-Ala]-Ang 1-7 on the renal response to exogenous Ang 1-7 in standard renal-clearance experiments in the anesthetized rat. We found that Ang 1-7 (100 pmol/kg/min, i.a.) increased glomerular filtration rate (GFR), urinary flow rate (UV), and urinary sodium excretion (UNaV) without affecting mean arterial blood pressure (MAP) or urinary potassium excretion (UKV), confirming previous reports. Losartan (10 mg/kg, i.v.) blocked the pressor effect of exogenous Ang II (100 pmol/kg/min, i.a.), but did not significantly affect the renal response to Ang 1-7. Conversely, pretreatment with [7-D-Ala]-Ang 1-7 (5 nmol/kg/min) did not affect the pressor effect of Ang II, but abolished the renal response to Ang 1-7. Application of [7-D-Ala]-Ang 1-7 in the absence of exogenous Ang 1-7 did not alter MAP or GFR, but increased UNaV (by 52%). Our data indicate that similar to the response in brain, the renal response to exogenous Ang 1-7 may be mediated predominantly by a distinct non-AT1 binding site, which is sensitive to blockade by [7-D-Ala]-Ang 1-7. Furthermore, ambient endogenous Ang 1-7 acting on this distinct binding site may not contribute significantly to control of MAP or GFR, but exerts an antinatriuretic influence in the anesthetized rat.

Anesthesia↗

Procedural and follow up results with a new balloon expandable stent in unselected lesions.

OBJECTIVE: To assess the clinical and angiographic results of the first clinical application of a new balloon expandable stent, the NIR stent, characterised by high longitudinal flexibility and low profile before expansion, and by high radial support and minimal recoil and shortening after expansion. DESIGN: Single centre survey of unselected lesions in consecutive patients. SETTING: Tertiary referral centre. PATIENTS AND LESIONS: 93 stents of various length (9, 16, and 32 mm) were implanted in 64 lesions in 41 patients. Twenty lesions (31%) were longer than 15 mm, and 17 lesions (27%) were located in vessels with a diameter smaller than 2.5 mm. Extreme tortuosity of the proximal vessel was present in 15 lesions (23%). All patients were treated with aspirin and ticlopidine. All lesions were evaluated before and after treatment by quantitative angiography, and in 47 lesions (75%) the stent expansion was also controlled by intracoronary ultrasound. Clinical follow up was available in all patients and angiographic follow up was performed in 53 lesions (84%), at a mean (SD) interval of 5.4 (1.7) months. RESULTS: Deployment of the stent failed in two lesions (3%). Minimum lumen diameter increased from 1.01 (0.54) mm to 2.94 (0.49) mm, and diameter stenosis decreased from 66(15)% to 7(11)%. There was one in-hospital non-Q wave myocardial infarction, one sudden death after 40 days, and 17 target lesion revascularisations (27%). Angiographic restenosis (> or = 50% diameter stenosis) was documented in 19 lesions (36% of all lesions with angiographic follow up), with an average residual diameter stenosis of 43(21)% and minimum lumen diameter of 1.63 (0.74) mm. Restenosis was more common in vessels with a reference diameter < 2.5 mm (45%) and for lesions longer than 15 mm (46%). CONCLUSIONS: The NIR stent could be used successfully in most lesions, achieving optimal angiographic results with very few in-hospital or subacute cardiac events. The angiographic restenosis rate and need for target lesion revascularisation remained high in this unfavourable lesion subset, especially in small vessels and long lesions.

Catheterization↗

Changes in sputum composition between two inductions performed on consecutive days.

BACKGROUND: Sputnum induction is a non-invasive method for obtaining cellular and biochemical material from the airways and appears to be particularly suited for repeated testing. However, it has not been clarified whether repeated inductions lead to a change in sputum composition. The aim of this study was to compare induced sputum results between two inductions performed 24 hours apart. METHODS: Ten subjects with mild asthma and 19 healthy subjects were included. Sputum was obtained during three consecutive 10 minute periods of hypertonic saline inhalation. Samples were analysed separately for the three inhalation periods. Corresponding pooled values were computed, taking into account total cell numbers of each inhalation period. RESULTS: In the three consecutive inhalation periods mean (SE) percentages of neutrophils increased from 29.2 (4.2)%, 22.0 (4.6)% and 14.5 (2.9)% on day 1 to 43.1 (5.3)%, 34.8 (5.5)% and 25.7 (5.3)% on day 2 in healthy subjects and from 21.3 (4.3)%, 24.1 (5.9)% and 15.9 (3.7)% to 35.9 (6.9)%, 30.7 (7.1)% and 31.8 (6.5)% in asthmatic subjects. This parallel shift corresponded to a mean (95% CI) increase in the pooled percentages of neutrophils of 17.4 (11.6) to 23.3)% in healthy and 14.6 (1.2 to 28.0)% in asthmatic subjects. In contrast to neutrophils, the percentage of macrophages decreased from day 1 to day 2, while eosinophil and lymphocyte percentages did not change significantly. CONCLUSION: These results suggest that the induction procedure itself causes a change in the composition of sputum detectable after 24 hours. This effect has to be taken into account when repeated sputum induction is performed.

Adult↗