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Biomedical subjects

M Braun

Publications and source records attributed to M Braun.

At least 37 records · Page 2Linked to original sources
PubMed2005

Increased pentosidine, an advanced glycation end product, in serum and synovial fluid from patients with knee osteoarthritis and its relation with cartilage oligomeric matrix protein.

BACKGROUND: Pentosidine, an advanced glycation end product, increasingly accumulates in articular cartilage with age, and contributes to the pathogenesis of osteoarthritis (OA). Increased pentosidine concentrations are associated with inflammatory disorders-for example, rheumatoid arthritis. OBJECTIVE: To compare pentosidine serum concentrations in patients with knee OA and in healthy volunteers and to determine a relationship between pentosidine and cartilage oligomeric matrix protein (COMP)-a marker of articular cartilage destruction. METHODS: Paired serum and synovial fluid samples were obtained by arthrocentesis from 38 patients with knee OA and from 38 healthy volunteers. Pentosidine concentration was measured by reverse phase high performance liquid chromatography with fluorescent detection and COMP was determined by sandwich ELISA. RESULTS: Significantly increased serum pentosidine (p<0.01) and COMP (p<0.05) levels were detected in the patients with OA compared with the control group. Serum pentosidine correlated significantly with synovial fluid pentosidine (p<0.001). Pentosidine in synovial fluid (p<0.05) and in serum (p<0.05) correlated significantly with synovial fluid COMP. Pentosidine and COMP concentrations did not correlate significantly with the radiological stage of the disease. CONCLUSION: Increased pentosidine serum concentration in patients with OA and its correlation with the cartilage destruction marker COMP in synovial fluid suggests that pentosidine may be important in OA pathology and is a new potential OA marker.

Aged↗
PubMed2005

Advanced glycoxidation end products in patients with multiple sclerosis.

Advanced glycoxidation end products (AGEs) play an important role in the pathogenesis of neurodegenerations and we studied if AGEs could represent a useful marker in patients with multiple sclerosis (MS). AGE-products were assessed in cerebrospinal fluid (CSF) and serum of 31 patients with MS and 8 controls. We did not find any statistically significant differences in patients with MS and controls either in CSF or in serum. We have observed a significant association between pentosidine and total AGEs as well as a relationship of both to the protein content in CSF in MS patients. Despite of the involvement of both oxidative stress and RAGE (receptor for AGEs) in the pathogenesis of MS and its experimental model, neither pentosidine nor total AGE were shown as useful markers in this indication. Other compounds and ligands of RAGE are probably of higher significance in MS.

Adult↗
PubMed2004

Crystal structure of the catalytic domain of MMP-16/MT3-MMP: characterization of MT-MMP specific features.

Membrane-type matrix metalloproteinases (MT-MMPs) have attracted strong attention, because four of them can activate a key player in the tumor scenario, proMMP-2/progelatinase A. In addition to this indirect effect on the cellular environment, these MT-MMPs degrade extracellular matrix proteins, and their overproduction is associated with tumor growth. We have solved the structure of the catalytic domain (cd) of MT3-MMP/MMP-16 in complex with the hydroxamic acid inhibitor batimastat. CdMT3-MMP exhibits a classical MMP-fold with similarity to MT1-MMP. Nevertheless, it also shows unique properties such as a modified MT-specific loop and a closed S1' specificity pocket, which might help to design specific inhibitors. Some MT-MMP-specific features, derived from the crystal structures of MT-1-MMP determined previously and MT3-MMP, and revealed in recent mutagenesis experiments, explain the impaired interaction of the MT-MMPs with TIMP-1. Docking experiments with proMMP-2 show some exposed loops including the MT-loop of cdMT3-MMP involved in the interaction with the proMMP-2 prodomain in the activation encounter complex. This model might help to understand the experimentally proven importance of the MT-loop for the activation of proMMP-2.

Amino Acid Sequence↗
PubMed2004

Spontaneous malignant transformation of conventional giant cell tumor.

Spontaneous malignant transformation of conventional giant cell tumor (GCT) of bone is exceedingly rare. We report on a case of GCT of the iliac crest in a 35-year-old woman with malignant change into a high-grade osteosarcoma 10 years after the first appearance of GCT on a radiograph. Since the patient refused therapy for personal reasons the tumor remained untreated until sarcomatous transformation occurred. Image cytometry showed DNA aneuploidy and a suspiciously high 2c deviation index (2cDI) in the primary bone lesion. A thorough review of the world literature revealed only seven fully documented cases of secondary malignant GCT which matched the definition of a "sarcomatous growth that occurs at the site of a previously documented benign giant cell tumor" and not treated by radiotherapy. These cases as well as the current one suggest that a spontaneous secondary malignant GCT presents as a frankly sarcomatous tumor in the form of an osteosarcoma or malignant fibrous histiocytoma. It usually appears at sites of typical GCTs-often without any recurrent intermediate state-and is diagnosed 3 or more years after the primary bone lesion. The prognosis is poor.

Adult↗
PubMed2004

[Erectile dysfunction. Are interdisciplinary diagnosis and therapy necessary?].

OBJECTIVE: The last few decades have seen a marked increase in mean life expectancy in Central Europe. This has made elderly people and their quality of life a matter of ever-increasing medical concern. Besides the lack of population based studies in Central Europe, the identifying risk factors for the development of erectile dysfunction (ED) is crucial. METHODS AND MATERIAL: A newly developed and validated questionnaire on male erectile dysfunction was mailed to a representative population sample of 8000 men 30 to 80 years of age in the Cologne urban district. RESULTS: The response included 4489 analysable replies (56,1 %). The median age was 51,8 years. Prevalence of ED was estimated at about 19.2 %, with a steep age-related increase (2,3 - 53,4 %) Therapeutic necessity (defined by co-occurrence of ED and dissatisfaction with sex life), also increases with age. The overall number of ED sufferers seeking therapy was 6,8 %. The following illnesses where seen in the ED group: heart failure (14,7 %), pelvic surgery (18,8 %), diabetes mellitus (20,2 %), peripheral arterial circulatory disorders (21,5 %), herniated disc (23,2 %) and hypertension (32,0 %). Although the pathogenetic pathway remains unclear with a prevalence of 72 % "lower urinary tract symptoms" (LUTS) seems to be an age independent risk factor. In contrast, the prevalence of ED in healthy men was around 6,6 %. CONCLUSIONS: ED is a common disorder, contributing to dissatisfaction with sex life in a considerable proportion of men. ED is frequently associated with chronic diseases. For this reason adequate interdisciplinary diagnostic workup is essential, to offer patients individually adapted treatment.

Adrenergic beta-Antagonists↗
PubMed2004

[Visual acuity, quality of life, and patient satisfaction after PDT treatment in AMD patients].

BACKGROUND: The efficacy of PDT to prevent the progression of AMD has been established. This study now assesses the patients' quality of life and self-reported satisfaction after PDT. MATERIAL AND METHODS: All patients who underwent PDT during 2000 and 2001 at the University Eye Hospital of Mainz were interviewed using an AMD-specific modification of a standardized 82-item questionnaire on quality of life and satisfaction in ophthalmological patients. Different aspects of those parameters were derived as scores, which were then related to clinical outcome parameters. RESULTS: During the period of PDT treatment, the median decrease in visual acuity was three stages in the patients examined. Patients who reported a subjective increase in visual function during this period showed for example a median "private flexibility" score of 1.86, and patients with the subjective impression of a decrease in visual function a median score of 2.71. CONCLUSION: The established clinical efficacy of PDT treatment to prevent AMD progression coincides with an encouraging patient satisfaction after the treatment.

Activities of Daily Living↗
PubMed2004

Transcatheter closure of patent foramen ovale (PFO) in patients with paradoxical embolism. Periprocedural safety and mid-term follow-up results of three different device occluder systems.

AIMS: Interventional PFO closure has previously been reported to reduce the risk for recurrent thromboembolic events. The aim of the present study was to evaluate three different occluder systems in respect to (a) the safety and practicability and (b) the mid-term risk of recurrent thromboembolic events. METHODS AND RESULTS: Since 08/98 until 12/02, 307 consecutive patients (138 women, 169 men, mean age 43 years) with a symptomatic PFO underwent PFO closure using the PFO-Star ( n=177), Amplatzer PFO occluder ( n=69) and CardioSeal/Starflex ( n=61 ). Implantation was successful in all patients. Periinterventional complications occurred in 9 patients (5x ST-segment elevations, 1x arteriovenous fistula, 2x TIA, 1x device dislodgement). All of them were reversible and not associated with a specific type of device. During the median follow-up of 24 months (25/75th percentiles: 14/37 months), the annual risk of recurrence was 0.6% for TIA, 0% for stroke and 0.2% for peripheral embolism (PFO-Star: 0.8%, Amplatzer PFO occluder: 0.7% and CardioSeal/Starflex: 1.0%). CONCLUSION: Interventional PFO closure appears to be safe and a promising technique in symptomatic PFO patients with a low incidence of periinterventional complications and recurrent thromboembolic events using three different devices (PFO-Star, Amplatzer PFO occluder or the CardioSeal/Starflex).

Adult↗
PubMed2004

Radiation therapy after breast-conserving surgery; first results of a randomised clinical trial in patients with low risk of recurrence.

To study the role of radiotherapy and tamoxifen after breast-conserving surgery (BCS) in patients with a favourable prognosis, a clinical trial was initiated by the German Breast Cancer Study Group. Between 1991 and 1998, 361 patients (pT1pN0M0, aged 45-75 years, receptor positive, grade I-II) were randomised to radiotherapy (yes/no) and tamoxifen for 2 years (yes/no) in a 2x2 factorial design; the exclusion of seven centres (14 patients) left 347 patients in the analysis. After a median follow-up of 5.9 years, 77 events concerning event-free survival have been observed. Since a strong interactive effect between radiotherapy and tamoxifen has been established, the results are presented in terms of the treatment effects for all four treatment groups separately. Mainly due to the presence of local recurrences, the event rate was about three times higher in the group with BCS only than in the other three groups. No difference could be established between the four treatment groups for distant disease-free survival rates. It is concluded that even in patients with a favourable prognosis, the avoidance of radiotherapy and tamoxifen after BCS increases the rate of local recurrences substantially.

Aged↗
PubMed2004

Hyaluronic acid levels may have predictive value for the progression of knee osteoarthritis.

STUDY OBJECTIVES: To study prognostic value of different biochemical markers for morphological progression of early knee osteoarthritis. DESIGN: A total of 89 patients with knee osteoarthritis (OA) were enroled into the study. The follow-up period was 2 years. Radiological OA progression was evaluated by measuring joint space width. Pentosidine was detected using the HPLC method described earlier, cartilage oligomeric matrix protein (COMP) using the method published by our team. MMP-9, tissue inhibitors of metalloproteinases (TIMP), YKL-40 and hyaluronic acid were detected using commercially available kits. RESULTS: In the group of patients suffering from knee OA, higher serum levels of pentosidine (P=0.04), MMP-9 (P=0.02), TIMP (P=0.04) and COMP (P=0.05) were detected compared with healthy control subjects. Using a correlation analysis method, it has been found that the patients with higher basic serum levels of hyaluronic acid had a faster radiological progression (r=0.56, P<0.005), as well as the patients with higher basic serum pentosidine levels (r=0.30, P<0.005). Other biochemical markers had no statistically significant prognostic value. CONCLUSIONS: In our study, serum levels of hyaluronic acid and pentosidine had a predictive value for further development of knee OA in that further joint space narrowing was detected in the patients with knee OA in the next 2 years.

Adipokines↗
PubMed2004

[Acute, isolated and reversible paralysis of the soft palate in childhood].

INTRODUCTION: Unilateral spinal and accessory palsy is uncommon in children. The main problem is the extensive exploration undertaken to achieve etiological diagnosis. OBSERVATION: We report two cases of transitory, unilateral, spinal and accessory palsy, associated in one case with homolateral hemi-pharyngeal palsy, that occurred in two previously healthy children. RESULTS: Few reports have been published in the literature to date. From those two cases and data of the literature, we suggest that the clinical presentation results from idiopathic peripheral nerve palsy. CONCLUSION: Further case reports would be useful to confirm the benign nature of this syndrome so that complementary investigations may be limited in future cases with a similar presentation.

Accessory Nerve Diseases↗
PubMed2004

TARC and RANTES, but not CTACK, are induced in two models of allergic contact dermatitis. Effects of cilomilast and diflorasone diacetate on T-cell-attracting chemokines.

BACKGROUND: Skin-infiltrating T cells play a predominant role in allergic and inflammatory skin diseases such as atopic dermatitis and allergic contact dermatitis. These T cells are attracted by chemotactic factors, e.g. RANTES (regulation on activation, normal T cell expressed and secreted; CCL5), TARC (thymus and activation regulated chemokine; CCL17) and CTACK (cutaneous T-cell attracting chemokine; CCL27). OBJECTIVES: To investigate which T-cell-attracting chemokines are involved in allergic contact dermatitis in mice. METHODS: Allergic contact dermatitis was induced by application of dinitrochlorobenzene (DNCB) or toluene-2,4-diisocyanate (TDI), and chemokine concentrations were determined by enzyme-linked immunosorbent assay. The effects on chemokine concentrations of the highly selective phosphodiesterase 4 inhibitor cilomilast and the glucocorticoid diflorasone diacetate were studied in mouse ears. RESULTS: RANTES and TARC were elevated in both models of allergic contact dermatitis 24 h after challenge, whereas CTACK remained unchanged. The increase in RANTES was diminished in mouse ears pretreated with cilomilast or diflorasone diacetate. TARC was reduced by diflorasone diacetate in the DNCB model but was highly induced in the TDI model; in contrast, TARC was not influenced by cilomilast. CONCLUSIONS: TARC and RANTES, but not CTACK, are involved in these two models of allergic contact dermatitis.

Animals↗
PubMed2004

Treatment of benign prostatic hyperplasia through transurethral needle ablation (TUNA). Review of the literature and six years of clinical experience.

Following FDA clearance and the establishment of Medicare coverage, transurethral needle ablation (TUNA) has become an established and widely-adopted treatment method for BPH in the USA. Germany is lagging behind at present, though a change can also be recognized there. The lack of long-term data has often been criticized. This review presents an overview of clinical outcomes of TUNA, long-term results and patient selection criteria.

Clinical Trials as Topic↗
PubMed2004

Surgical anatomy of the turbinal wall of the ethmoidal labyrinth.

The upper part of the lateral nasal wall is formed by a common structure or conchal lamina that is attached all along the junction between the ethmoidal roof and the cribriform plate. From this continuous conchal lamina, the different ethmoidal turbinates take their origin. All these structures form a well defined wall that encloses the ethmoidal cells medially and that deserves the name of "turbinal wall of the ethmoidal labyrinth". The objectives of this paper were: 1) to precisely define the anatomical landmarks of the turbinal wall of the ethmoidal labyrinth, and 2) to study, from an anatomical point of view, the consequences of the surgical resection of the middle turbinate. We performed an anatomic study on 12 frozen human heads, cut in a median-sagittal plane, and then photographed with a millimetre scale in order to perform several measurements. The surface of the turbinal wall of the ethmoidal labyrinth can range from 6.1 to 11.3 cm2. The resection of the middle turbinate preserves approximately half of the turbinal wall, this being around 4.3 cm2 (range 2.6 to 6.3 cm2). The conchal lamina appears as the noble sensorial element of the turbinal wall. It can be described as a continuous bone plate, grossly rectangular in shape, measuring approximately 1 cm in height and 3.5 cm in length that forms the lateral wall of the olfactory groove. The anatomic study shows that its dimensions can vary from simple to double in different individuals. It seems to us that instead of considering the difference of height between the cribriform plate and the ethmoidal roof (Keros classification), we should consider the vertical height of the conchal lamina as a potential risk factor in ethmoidal surgery.

Adult↗
PubMed2003

Bite mark documentation and analysis: the forensic 3D/CAD supported photogrammetry approach.

Bite mark identification is based on the individuality of a dentition, which is used to match a bite mark to a suspected perpetrator. This matching is based on a tooth-by-tooth and arch-to-arch comparison utilising parameters of size, shape and alignment. The most common method used to analyse bite mark are carried out in 2D space. That means that the 3D information is preserved only two dimensionally with distortions. This paper presents a new 3D documentation, analysis and visualisation approach based on forensic 3D/CAD supported photogrammetry (FPHG) and the use of a 3D surface scanner. Our photogrammetric approach and the used visualisation method is, to the best to our knowledge, the first 3D approach for bite mark analysis in an actual case. The documentation has no distortion artifacts as can be found with standard photography. All the data are documented with a metric 3D measurement, orientation and subsequent analysis in 3D space. Beside the metrical analysis between bite mark and cast, it is possible using our method to utilise the topographical 3D feature of each individual tooth. This means that the 3D features of the biting surfaces and edges of each teeth are respected which is--as shown in our case--very important especially in the front teeth which have the first contact to the skin. Based upon the 3D detailed representation of the cast with the 3D topographic characteristics of the teeth, the interaction with the 3D documented skin can be visualised and analysed on the computer screen.

Bites, Human↗
PubMed2003

Analysis of patterned injuries and injury-causing instruments with forensic 3D/CAD supported photogrammetry (FPHG): an instruction manual for the documentation process.

Forensic 3D/CAD supported photogrammetry (FPHG) is a method of recording and documenting the surface of small objects, thus enabling a three-dimensional image of these objects in virtual space. With this representation on the computer screen the course of forensically relevant events can be reconstructed. The procedure allows for examining patterned injuries of skin, soft tissue or bones for matching potentially incriminated instruments in shape, size and angle.3D recording of objects to be examined requires taking series of photographs. A computer system then calculates the position in space of certain points on the surface of the objects and subsequently produces 3D data models of the objects. Using a 3D/CAD program these data models are used to generate graphic true-to-object volume models. The objects in question can then be moved against each other arbitrarily on the screen-depending on the questions to be answered-in order to compare them and possibly establish their congruence. This article covers the state of the art in FPHG procedures in the form of a step-by-step instruction. It also illustrates the wide range of FPHG applications.

Forensic Medicine↗
PubMed2003

[Does the digital signature of the DICOM standard meet the requirements of German law?].

The DICOM standard offers the possibilities to generate electronic signatures, valid according to German laws. This enhances the reliability of the correlation between image and patient data. However, only so called qualified electronic signatures--conveniently issued by an accredited supplier--are permissible and not rejectable as evidence in German jurisdiction and are completely equivalent to the handwritten signatures. These qualified electronic signatures can be executed only by individuals, whereas the former are not applicable to technical apparatus like image generating modalities. In consequence, a modality is able to provide its pictures with a "common or advanced signature" solely. This limits the use of the digital signature of the DICOM standard for further applications, e.g. the verifiability within the teleradiology.

Algorithms↗