Search PubMed⌕ Search

Biomedical subjects

M Frey

Publications and source records attributed to M Frey.

At least 73 records · Page 4Linked to original sources
PubMed2000

The influence of the donor nerve on the function and morphology of a mimic muscle after cross innervation: an experimental study in rabbits.

In the present study we used the scutuloauricularis muscle in the rabbit to investigate the functional and morphometric alterations in the mimic-muscle system after cross-reinnervation. The scutuloauricularis muscle is the first experimental model that allows functional assessment of a mimic muscle by force measurements. A total of 36 rabbits were separated into three groups. In group 1 the scutuloauricularis nerve was cut and re-sutured to itself to achieve self-reinnervation; in group 2 the buccal nerve was used to cross-reinnervate the fast scutuloauricularis muscle and in group 3 the slow buccinator muscle was cross-reinnervated by the scutuloauricularis nerve. After a period of 6 months the maximal tetanic tensions of the reinnervated scutuloauricularis muscles were determined and histomorphometric examinations of muscle and nerve biopsies were carried out. Force measurements showed no loss of muscle force after self- and cross-reinnervation. The normal scutuloauricularis muscle contained 33%, and the buccinator muscle 46%, slow type I fibres. After self-reinnervation of the scutuloauricularis muscle the fibre-type composition remained unchanged. After cross-reinnervation we saw a significant fast-to-slow transformation of the scutuloauricularis muscle and a significant slow-to-fast transformation of the buccinator muscle. The number of myelinated nerve fibres in the scutuloauricularis nerve increased after cross-reinnervation from 1531 to 4077 (group 2) and to 3813 (group 3). The number of nerve fibres in the buccal nerve (3209) was unchanged after cross-reinnervation. The results of the present study might be relevant in the treatment of irreversible facial palsy by functional muscle transplantation and cross-face nerve grafting. The facial nerve branch used for cross-reinnervation seems to determine the functional outcome.

Animals↗
PubMed2000

[The current role of endoscopy within the scope of the German Speaking Study Group of Microsurgery of Peripheral Nerves and Blood Vessels--results of a survey].

PURPOSE: The present survey among the members of the DAM deals with the application of endoscopic methods in plastic and reconstructive procedures. Special interest is focussed upon endoscopically assisted microsurgery. METHODS: A questionnaire was sent to all members of the DAM. It contained questions about the application of endoscopic techniques, the types of operations performed with the endoscope, the advantages, disadvantages, and complications of endoscopic operations. RESULTS: In 26 of 40 cases the question about the application of endoscopic techniques was answered positively. The most frequent indications were carpal tunnel release, wrist arthroscopy, the harvesting of flaps, breast reconstruction, and implantation of expanders. Incomplete release of the flexor retinaculum and partial lesions of the median nerve in patients referred from other departments were listed as complications. CONCLUSION: Endoscopic techniques have found acceptance among the DAM-members, but are restricted to traditional indications such as arthroscopy, carpal tunnel release, and aesthetic procedures. Future attempts must attract the interest of industrial companies for the development of high-resolution endoscopes for microsurgery.

Attitude of Health Personnel↗
PubMed2000

Evaluation of transmyocardial laser revascularization by following objective parameters of perfusion and ventricular function.

BACKGROUND: Does transmyocardial laser revascularization (TMLR), a new surgical technique for treating patients with otherwise intractable angina pectoris, improve myocardial perfusion, metabolism, and, consequently, function? METHODS: Patients referred for TMLR, alone or with coronary artery bypass grafting (CABG), were preoperatively evaluated clinically and by treadmill stress testing, echocardiography, ventriculography, radionuclide assessment of perfusion and metabolism, and hemodynamic assessment. Intraoperatively it was decided that some patients only required CABG. Follow-up evaluations were repeated after 6 (n = 40) and 12 months (n = 23) and compared with preoperative values. RESULTS: CABG only was performed in 35 cases, TMLR + CABG in 17, TMLR only in 45. 1-year mortality was 11% in the TMLR, zero in the TMLR + CABG, and 11% in the CABG groups. In all groups a significantly improved CCS angina- and NYHA class was observed immediately after operation and after 6 and 12 months. In all study groups treadmill tolerance (p<0.05) improved, but regional and global function, perfusion at rest, and metabolism were not significantly changed at 6 and 12-months follow-ups. Perfusion studies under stress demonstrated an improvement only in the CABG group after 12 months (p<0.05), whereas in both TMLR groups the lasered ischemic segments remained unchanged. CONCLUSIONS: TMLR significantly improves long-term clinical status and treadmill stress tolerance, but appears to have little if any effect upon regional and global function, perfusion, and metabolism.

Aged↗
PubMed2000

A redox-dependent interaction between two electron-transfer partners involved in photosynthesis.

Ferredoxin:NADP+:reductase (FNR) catalyzes one terminal step of the conversion of light energy into chemical energy during photosynthesis. FNR uses two high energy electrons photoproduced by photosystem I (PSI) and conveyed, one by one, by a ferredoxin (Fd), to reduce NADP+ to NADPH. The reducing power of NADPH is finally involved in carbon assimilation. The interaction between oxidized FNR and Fd was studied by crystallography at 2.4 A resolution leading to a three-dimensional picture of an Fd-FNR biologically relevant complex. This complex suggests that FNR and Fd specifically interact prior to each electron transfer and disassemble upon a redox-linked conformational change of the Fd.

Anabaena↗
PubMed2000

Functional and morphometric evaluation of end-to-side neurorrhaphy for muscle reinnervation.

This study was undertaken to quantify the effect of motor collateral sprouting in an end-to-side repair model allowing end organ contact. Besides documentation of the functional outcome of muscle reinnervation by end-to-side neurorrhaphy, this experimental work was performed to determine possible downgrading effects to the donor nerve at end organ level. In 24 female New Zealand White rabbits, the motor nerve branch to the rectus femoris muscle of the right hindlimb was dissected, cut, and sutured end-to-side to the motor branch to the vastus medialis muscle after creating an epineural window. The 24 rabbits were divided into two groups of 12 each, with the second group receiving additional crush injury of the vastus branch. After a period of 8 months, maximum tetanic tension in the reinnervated rectus femoris and the vastus medialis muscles was determined. The contralateral healthy side served as control. The reinnervated rectus femoris muscle showed an average maximum tetanic force of 24.9 N (control 26.2 N, p = 0.7827), and the donor- vastus medialis muscle 11.0 N (control 7.3 N, p = 0.0223). There were no statistically significant differences between the two experimental groups (p = 0.9914). The average number of regenerated myelinated nerve fibers in the rectus femoris motor branch was 1,185 +/- 342 (control, 806 +/- 166), and the mean diameter was 4.6 +/- 0.6 microm (control, 9.4 +/- 1.0 microm). In the motor branch to the vastus medialis muscle, the mean fiber number proximal to the coaptation site was 1227 (+/-441), and decreased distal to the coaptation site to 795 (+/-270). The average difference of axon counts in the donor nerve proximal to distal regarding the repair site was 483.7 +/- 264.2. In the contralateral motor branch to the vastus medialis muscle, 540 (+/- 175) myelinated nerve fibers were counted. In nearly all cross-section specimens of the motor branch to the vastus medialis muscle, altered nerve fibers could be identified in one fascicle distal and proximal to the repair site. The results show a relevant functional reinnervation by end-to-side neurorrhaphy without functional impairment of the donor muscle. It seems to be evident that most axons in the attached segment were derived from collateral sprouts. Nonetheless, the present study confirms that end-to-side neurorrhaphy is a reliable method of reconstruction for damaged nerves, which should be applied clinically in a more extended manner.

Anastomosis, Surgical↗
PubMed2000

Multiple primary tumors as an indicator for p16INK4a germline mutations in pancreatic cancer patients?

Multiple primary tumors in pancreatic cancer patients might indicate a genetic predisposition to the development of malignancies. In this study we evaluated whether the mutation rate of the TP53 and p16INK4a genes of pancreatic cancers differs in pancreatic cancer patients with and without multiple primaries. Furthermore, we investigated whether pancreatic cancer patients with multiple primaries carry germline mutations in either p16INK4a, TP53, or BRCA2 tumor suppressor genes to detect a genetic alteration that predisposes to the development of different primaries. Fourteen (23%) of 60 pancreatic cancer patients developed histologically verified additional primaries during their lifetimes. Normal constitutional and tumor DNA of the 14 patients with a positive cancer history, but negative family history, were analyzed for p16INK4a, TP53, and BRCA2 mutations by single-strand conformational variant (SSCV) analysis and direct sequencing. Hypermethylation of the p16INK4a promoter region in pancreatic cancers was identified by methylation-specific polymerase chain reaction (PCR; MSP). Four of 14 pancreatic carcinomas carried somatic intragenic p16INK4a mutations, and another four tumors revealed hypermethylation of the p16INK4a promoter region. Somatic intragenic TP53 mutations were identified in six of 14 tumors. None of the pancreatic cancer patients carried TP53 or BRCA2 germline mutations. In contrast, one of 14 pancreatic cancer patients with multiple primaries carried the p16INK4a mutation A68V in his germline. This mutation was localized in the conserved second ankyrin repeat of p16INK4a and did not occur in 100 control patients. The frequency of somatic TP53 and p16INK4a mutations in pancreatic cancer is similar in patients with and without multiple primaries. TP53 and BRCA2 germline mutations seem not to be significantly associated with the occurrence of multiple primaries in pancreatic cancer patients. However, p16INK4a germline mutations might be causative for tumor development in some pancreatic cancer patients with multiple primaries. The genetic investigation of patients with accumulation of different cancers even without a positive family history may be a new approach for the understanding of the relation of different cancers.

Adult↗
PubMed2000

An improved gas chromatography assay for topiramate monitoring in pediatric patients.

An improved micromethod involving capillary gas chromatographic assay with liquid-liquid extraction and nitrogen phosphorus detection (GC/NPD) was developed and validated for the determination of topiramate (TPM) in human body fluids. The galactopyranose analog of TPM was used as the internal standard. Capillary gas chromatographic conditions yielded typical retention times of 6.8 min for TPM and 7.2 min for the internal standard. Calibrations were linear between 1.0 and 32 microg/mL. Between-day precision (n = 17) for three serum controls (3.0, 10, and 24.5 microg/mL) resulted in coefficients of variation of 6.9%, 7.3%, and 4.9%, respectively. The limit of detection was 0.42 microg/mL. There was an excellent linear correlation between the fluorescence-polarization immunoassay (FPIA) and GC/NPD determinations of 56 patient specimens (r2 = 0.981). Chromatograms showed no interfering peaks with the respective blank human samples or from many commonly prescribed drugs. Because of improved specificity and decreased sample volume requirements, this micromethod should be particularly useful for monitoring TPM therapy in pediatric patients, for patients with impaired renal function, and for research studies.

Anticonvulsants↗
PubMed2000

Crystallographic studies of the interaction between the ferredoxin-NADP+ reductase and ferredoxin from the cyanobacterium Anabaena: looking for the elusive ferredoxin molecule.

Ferredoxin-NADP(+) reductase (FNR) and its physiological electron donor ferredoxin (Fd) from the cyanobacterium Anabaena PCC7119 have been co-crystallized. The unit-cell parameters are a = b = 63.72, c = 158.02 A and the space group is P2(1)2(1)2(1). The crystal structure has been solved with 2.4 A resolution synchrotron data by molecular replacement, anomalous dispersion and R(min) search methods. For the computations, the crystal was treated as a merohedral twin. The asymmetric unit contains two FNR molecules and one ferredoxin molecule. The packing of the FNR molecules displays a nearly tetragonal symmetry (space group P4(3)2(1)2), whereas the ferredoxin arrangement is orthorhombic. This study provides the first crystallographic model of a dissociable complex between FNR and Fd.

Anabaena↗
PubMed2000

The "forgotten" cross-tolerance between phenobarbital and primidone: it can prevent acute primidone-related toxicity.

PURPOSE: We report on the effect that pretreating patients with phenobarbital has on averting adverse events when primidone is introduced. METHODS: Thirty patients with intractable partial epilepsy were pretreated with phenobarbital before starting primidone. Therapy with primidone was started at a dosage of 500 mg/day, and the phenobarbital was stopped. The primidone dose was then increased by 125 to 250 mg every 3 weeks until adverse events or a seizure-free state was reached. All previous antiepileptic medications were tapered down to yield a primidone monotherapy regimen. RESULTS: Twenty-six patients (87%) tolerated the introduction of primidone with minimal or no adverse events. Only one patient had to discontinue primidone during the initial 4 weeks because of severe dizziness. This was the only patient in whom primidone monotherapy could not be reached because of adverse events. Three other patients experienced dizziness severe enough to interfere with their activities. This symptom disappeared in two patients after the dose was lowered; in the other patient, primidone was stopped and phenobarbital was restarted for another 4 days. No symptoms recurred when primidone was reintroduced on the fifth day. CONCLUSIONS: Pretreatment with phenobarbital can minimize the occurrence of intolerable adverse events associated with the introduction of primidone.

Adolescent↗
PubMed1999

Refined X-ray structures of the oxidized, at 1.3 A, and reduced, at 1.17 A, [2Fe-2S] ferredoxin from the cyanobacterium Anabaena PCC7119 show redox-linked conformational changes.

The chemical sequence of the [2Fe-2S] ferredoxin from the cyanobacterium AnabaenaPCC7119 (Fd7119) and its high-resolution X-ray structures in the oxidized and reduced states have been determined. The Fd7119 sequence is identical to that of the ferredoxin from the PCC7120 strain (Fd7120). X-ray diffraction data were collected at 100 K with an oxidized trigonal Fd7119 crystal, at 1.3 A resolution, and with an orthorhombic crystal, previously reduced with dithionite and flash frozen under anaerobic conditions, at 1.17 A resolution. The two molecular models were determined by molecular replacement with the [2Fe-2S] ferredoxin from the strain PCC7120 (Rypniewski, W. R., Breiter, D. R., Benning, M. M., Wesenberg, G., Oh, B.-H., Markley, J. L., Rayment, I., and Holden, H. M. (1991) Biochemistry 30, 4126-4131.) The final R-factors are 0. 140 (for the reduced crystal) and 0.138 (for the oxidized crystal). The [2Fe-2S] cluster appears as a significantly distorted lozenge in the reduced and oxidized redox states. The major conformational difference between the two redox forms concerns the peptide bond linking Cys46 and Ser47 which points its carbonyl oxygen away from the [2Fe-2S] cluster ("CO out") in the reduced molecule and toward it ("CO in") in the oxidized one. The "CO out" conformation could be the signature of the reduction of the iron atom Fe1, which is close to the molecular surface. Superposition of the three crystallographically independent molecules shows that the putative recognition site with the physiological partner (FNR) involves charged, hydrophobic residues and invariant water molecules.

Amino Acid Sequence↗
PubMed1999

Purification of the human apical conjugate export pump MRP2 reconstitution and functional characterization as substrate-stimulated ATPase.

The multidrug resistance protein MRP2 (ABCC2) acts as an ATP-dependent conjugate export pump in apical membranes of polarized cells and confers multidrug resistance. Purified MRP2 is essential for the detailed functional characterization of this member of the family of ATP-binding cassette (ABC) transporter proteins. In human embryonic kidney cells (HEK293), we have permanently expressed MRP2 containing an additional C-terminal (His)6-tag. Immunoblot and immunofluorescence analyses detected the MRP2-(His)6 overexpressing clones. Isolated membrane vesicles from the MRP2-(His)6-expressing cells were active in ATP-dependent transport of the glutathione S-conjugate leukotriene C4 and were photoaffinity-labelled with 8-azido-[alpha-32P]ATP. MRP2-(His)6 was solubilized from membranes of MRP2-(His)6-cells and purified to homogeneity in a three-step procedure using immobilized metal affinity chromatography, desalting, and immunoaffinity chromatography. The identity of the pure MRP2-(His)6 was verified by MS analysis of tryptic peptides. The purified MRP2-(His)6 glycoprotein was reconstituted into proteoliposomes and showed functional activity as ATPase in a protein-dependent manner with a Km for ATP of 2.1 mM and a Vmax of 25 nmol ADP x mg MRP2-1 x min-1. This ATPase activity was substrate-stimulated by oxidized and reduced glutathione and by S-decyl-glutathione. Future studies using pure MRP2 reconstituted in proteoliposomes should allow further insight into the molecular parameters contributing to MRP2 transport function and to define its intracellular partners for transport and multidrug resistance.

ATP Binding Cassette Transporter, Subfamily B↗
PubMed1999

Psychiatric and neurologic predictors of psychogenic pseudoseizure outcome.

OBJECTIVE: To investigate the patterns of occurrence of psychogenic pseudoseizures (PPS) of 45 consecutive patients during a 6-month period after diagnosis, and to determine whether psychiatric and neurologic variables identified previously in PPS patient series can predict their recurrence after diagnosis, and whether any of these variables are associated with a particular outcome pattern. METHOD: Postdiagnosis PPS recurrence was assessed twice: during the first month and during a period ranging from the second to the sixth month. Outcome was categorized as follows: class I, complete cessation of PPS; class II, PPS only during one of the two observation periods; and class III, persistent PPS during the two observation periods. The authors used a logistic regression model to identify predictors of PPS recurrence (versus no PPS) among four neurologic and nine psychiatric variables, and compared their frequency among the three outcome classes. RESULTS: Class I, n = 13 (29%); class II, n = 12 (27%); and class III, n = 20 (44%). The presence of an abnormal MR image predicted PPS recurrence during the second observation period with a 75% accuracy. The presence of all nine psychiatric variables predicted PPS recurrence during both the first and second observation periods with a 93% and an 89% accuracy respectively. Patients with a class III outcome had a markedly higher frequency of recurrent major depression, dissociative and personality disorders, and a history of chronic abuse. Patients with a class II outcome displayed a notably higher frequency of denial of stressors and psychosocial problems, refusal of treatment recommendations, and new somatic symptoms after disclosure of diagnosis. Conversely, one episode of major depression was the one common diagnosis in patients with a class I outcome. CONCLUSIONS: PPS outcome after disclosure of diagnosis can be predicted by the presence of certain psychiatric characteristics. More than one psychopathogenic mechanism appears to operate in PPS.

Adult↗
PubMed1999

The hydroxamic acid pathway.

An important component of general defence mechanisms of plants are toxic secondary metabolites that function as natural pesticides. The cyclic hydroxamic acids DIBOA (2,4-dihydroxy-1,4-benzoxazin-3-one) and DIMBOA (2,4-dihydroxy-7-methoxy-1,4-benzoxazin-3-one) play an important role in the chemical defence of cereals against pests such as insects and pathogenic fungi and bacteria. Five genes that are clustered on chromosome four are sufficient to encode the enzymes to synthesize DIBOA. The first gene in the pathway, Bx1, encodes an enzyme resembling a tryptophan synthase alpha subunit that catalyses the formation of indole and thereby establishes the branchpoint that leads to the secondary metabolites. Four cytochrome P450-dependent monooxygenases encoded by Bx2-Bx5 catalyse consecutive hydroxylations to form DIBOA. This pathway can be generalized for grasses, since identical enzyme activities have been found in rye. The pathway is relatively short and begins with a metabolite ubiquitous to plants. Therefore DIBOA biosynthesis could be introduced into other plant species to confer improved disease resistance.

Hydroxamic Acids↗
PubMed1999

[The influence of different therapeutic approaches on the survival of elderly burn patients].

The present study analyzes the outcome of 51 patients aged more than 65 years, who were admitted between 1993 and 1997 to a specific burns unit with the possibility of intensive care medicine including respirator therapy and hemofiltration. The results were compared to an historical control group treated between 1980 and 1990. The overall survival rate was 54 %. Analyzing the patients' mortality, an increase in the number of nurses, improvement of enteral nutrition and wound monitoring had more influence on the survival rates than respirator therapy, hemofiltration and catecholamines. This is in contrast to our experience with younger individuals. The positive influence of intensive care on survival was restricted only to a small number of cases. The group of patients who died on the intensive care unit showed a relatively long median survival time of 24 days. Septic multiorgan failure was the main cause of death.

Aged↗
PubMed1999

Cytochrome P450 monooxygenases of DIBOA biosynthesis: specificity and conservation among grasses.

DIBOA and DIMBOA are secondary metabolites of grasses which function as natural pesticides. The four maize genes BX2 through BX5 encode cytochrome P450-dependent monooxygenases that catalyse four consecutive reactions in the biosynthesis of these secondary products. Although BX2-BX5 share significant sequence homology, the four enzymes have evolved into specific enzymes each catalysing predominantly only one reaction in the pathway. In addition to these natural reactions, BX3 hydroxylates 1,4-benzoxazin-3-one and BX2 shows pCMA demethylase activity. With respect to DIBOA biosynthesis, identical enzymatic reactions have been found in rye as compared to maize, indicating early evolution of the P450 enzymes in the grasses.

Benzoxazines↗
PubMed1999

Progression of burn wound depth by systemical application of a vasoconstrictor: an experimental study with a new rabbit model.

The final depth of a necrosis resulting from burn trauma is determined within 3 days. The zone of stasis has the potential for complete regeneration or there may be ischemic influences that lead to necrosis. In our model, we examined the dermal influence of vasoconstrictors with reference to the development of burn necrosis. On the backs of New Zealand white rabbits (4.0-4.5 kg) standardized lesions were made with a heated aluminum stamp at 80 degrees C, 14 s in duration. The lesions were intradermal, whereby the border zone of the coagulated tissue was found in the middle two quarters of the dermis in 100% of untreated animals after 72 h. For dermal vasoconstriction epinephrine in a dose of 0.5 microg/kg/min was used. There were two groups of seven animals each. One group received epinephrine and the dosage was dependent on the clinical state of the animal. Several cycles were administered within a 3-day period. The reduction of skin perfusion was documented by Laser-Doppler-flowmetry. After 3 days, the skin with the lesions was excised and using a hematoxylin dye, a histological examination followed. The parameter used to determine the efficacy was the thickness of the uncoagulated part of the excised dermis. Over a period of 48 h, an average of 2.3 epinephrine cycles of average of 88 min per animal in duration resulted in an average reduction of skin diffusion of 41%. The uncoagulated part of the dermis in the epinephrine group was 28.6% average; in the control group, this was 43.5%. The statistical analysis revealed significant differences with a p-value of 0.0312 (significant, when value is less than 0.05). The test results indicate that temporary reduction of skin perfusion through external administration of vasocontrictors may lead to progression of burn necrosis in our animal model. Clinically, this result indicates that for patients with burn injuries and systemic inflammatory response syndrome who have insufficient volume therapy, the administration of vasocontrictors may produce similar results in the injured area.

Administration, Topical↗