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Biomedical subjects

M Fried

Publications and source records attributed to M Fried.

At least 91 records · Page 5Linked to original sources

p53-dependent apoptosis or growth arrest induced by different forms of radiation in U2OS cells: p21WAF1/CIP1 repression in UV induced apoptosis.

Following exposure to DNA damaging agents the p53 tumour-suppressor gene induces either a growth arrest (primarily in G1) or apoptosis. The factors governing which response a cell undertakes, however, are unclear. We find that the osteosarcoma cell line, U2OS, (wild-type for p53) is capable of undergoing either p53 dependent apoptosis or cell cycle arrest in response to distinct forms of radiation. Following exposure to UVC, the majority of U2OS cells were apoptotic within 2 days and cells continued to cycle even as viability was being lost. In contrast, after X-ray treatment, U2OS cells exhibited a cell cycle arrest. Western analysis showed that p53 protein was stabilized to a greater extent by UVC than X-ray. Treatment with X-rays induced p21WAF1/CIP1 whereas p21WAF1/CIP1 expression was specifically repressed at the post-transcriptional level after exposure to UVC. Ectopic expression of high levels of p21WAF1/CIP1, which arrested U2OS cells in G1 and G2, initially conferred considerable protection against UVC-induced apoptosis. Ultimately, however, cells underwent apoptosis indicating that a high level of p21WAF1/CIP1 delays but does not block apoptosis. Taken together, these results show that cell cycle arrest and apoptosis can occur in the same cell type in response to different forms of radiation and that the repression of p21WAF1/CIP1 after UVC may contribute to the efficient induction of apoptosis in response to this particular insult.

Apoptosis↗

[The first decade of routine laparoscopic surgery].

Common use of laparoscopic surgery was extended during the last ten years worldwide, as well as in our Republic. The contribution of laparoscopy to surgery is compared sometimes with the contribution of ether anesthesia. Despite this, discussions persist on the advantages and disadvantages of this method among surgeon as well as physicians from other disciplines, in particular those who indicate patients for laparoscopic operations. The ten-year use of laparoscopy in surgery should be a sufficiently long period for certain general evaluations of the asset of this method. The submitted paper compares some evaluating criteria of laparoscopic surgery and "classical" laparotomic operations. It is obvious that there can be many evaluating aspects and that each aspect has its specific weight. In the submitted paper some of these aspects are compared and discussed with regard to their possible contributions to laparoscopic and laparotomic surgery.

Cholecystectomy, Laparoscopic↗

[New perspectives in 3D MR colonography].

Filling the colon lumen with contrast allows for 3D-MR-colonography. The 3D data set can be postprocessed to multiplanar reconstruction, surface shaded displays as well as virtual colonoscopy. The latter facilitates the differentiation between haustra and polyps and enables detection of polyps down to 6 mm in size. Multiplanar reconstructions provide the assessment of the inner wall contour. The morphology of the colonic wall itself can be assessed on T1- or T2-weighted images. T1-weighted sequences performed before and after i.v. contrast administration and T2-weighted sequences depict pathologies based on their contrast uptake respectively on their tissue water content. This concept of colonic imaging practicable in less than 15 minutes is useful for the assessment of inflammatory disease, for polyp detection as well as for tumour staging.

Colonic Diseases↗

Assessment of gastric motor function during the emptying of solid and liquid meals in humans by MRI.

Gastric emptying and motility have previously been assessed by magnetic resonance imaging (MRI) using liquid test meals. The aim of this study was to extend the applicability of our MRI method to the assessment of gastric emptying and motility of solid meals. Gastric emptying and motility of a liquid and a solid meal, of similar chemical properties, were studied in eight volunteers. The MRI protocol combined a multislice turbo spin-echo (TSE) sequence (volume scan, resolution: 1.5 mm) and a dynamic FFE sequence (motility scan, 1 sec/image, resolution: 3.1 mm). Gastric emptying of the liquid meal was faster than emptying of the solid meal when considering half-times of emptying. However, during the first 15 minutes after ingestion, the liquid meal emptied more slowly. This was related to reduced motility with the liquid meal. In conclusion, with our MRI method it is feasible to assess gastric emptying and motility of liquid and solid meals.

Adult↗

5'-Cytosine DNA-methyltransferase mRNA levels in hereditary colon carcinoma.

DNA methylation plays an important part in the regulation of gene expression. Alterations in DNA methylation in tumours have been reported and have been used to generate hypotheses about mutagenesis and silencing of tumour suppressor genes. However, the underlying mechanism is still poorly understood, and conflicting data on the levels of overexpression of 5'-cytosine DNA methyltransferase in sporadic colon carcinoma have been published. We used a competitive RT-PCR assay for quantification of mRNA of 5'-cytosine DNA methyltransferase in colon biopsies obtained from patients with hereditary colon carcinoma syndromes and compared the results with those obtained in a control group. No significant difference was found between the flat mucosa of FAP patients and the mucosa of the control group. In FAP and HNPCC patients, the 5'-cytosine DNA methyltransferase mRNA levels of adenomas were significantly higher (P<0.05) than of flat mucosa in the same group, but both showed great variability from patient to patient. Our findings suggest that the mRNA levels of methyltransferase cannot be used as predictive marker for screening in families affected by hereditary colon carcinoma.

Adenomatous Polyposis Coli↗

Phenotypic diversity in Lewis expression of Helicobacter pylori isolates from the same host.

Populations of Helicobacter pylori cells show a stable expression of Lewis surface antigens, although phase variation may occur among individual organisms grown in vitro. We searched for variation in Lewis phenotypes among H. pylori cells of minimally in vitro-passaged isolates. Lewis expression in 180 clonal H. pylori populations from the primary culture of 20 gastric biopsy samples from 12 patients, and that in 160 isolates from primary cultures from 16 experimentally infected rodents, were examined by enzyme immunoassays. Substantial differences in Lewis expression were found among the isolates from 9 (75%) of 12 patients. These differences were unrelated to overall genetic diversity as determined by polymerase chain reactions for random amplified polymorphic DNA or cagA status, and they persisted during subsequent in vitro passage. In contrast, Lewis expression was highly uniform in H. pylori isolates from different rodents infected for up to 20 weeks. Variation in H. pylori Lewis expression in genetically closely related organisms in human subjects may provide a pool of bacterial phenotypes for the continuous selection of optimally host-adapted populations suitable for persistence.

Animals↗

Gastric pouch acid secretion in response to physiologic digestive function.

OBJECTIVES: To evaluate acid secretion and histologic features of the gastric segment used for bladder replacement in bladder cancer. METHODS: Nine patients were investigated a mean of 36 months after gastric pouch surgery with modified shamfeeding and feeding. We determined urinary acidity, urinary pH, serum gastrin, and serum pancreatic polypeptide values and tried to find a relationship between feeding and acid secretion in the gastric pouch. In 6 patients, biopsy and histopathologic examination were performed. RESULTS: In 8 patients, urinary acidity increased after feeding following the rise of gastrin; in 1 patient no increase of gastrin or acidity was observed. In 7 patients, urinary acidity did not change after modified shamfeeding, indicating vagal denervation after surgery. This group showed a minimal urinary pH of above 4 after feeding. On the other hand, in 2 patients an increased acid secretion was observed after modified shamfeeding, indicating the possible presence of residual vagal innervation. In this group, the acid secretion in the pouch was higher, reaching the minimal pH level earlier after feeding. Histopathologic examination showed no major structural changes of gastric mucosa. CONCLUSIONS: Most patients are vagally denervated after gastric pouch surgery, and the gastric segment continues its original gastrointestinal function by a hormonal pathway. Our data indicate, however, that in some patients, the gastric pouch keeps a residual vagal innervation. We therefore suggest that nerve fibers present in the blood supply of the gastric segment be interrupted to avoid the complications associated with increased acid secretion of the gastric pouch.

Aged↗

Malaria during pregnancy: parasites, antibodies and chondroitin sulphate A.

CSA-binding forms of P. falciparum appear uncommonly in non-pregnant hosts but are selected by the human placenta for growth. Parasites are presumably selected by adherence to CSA within the vascular compartment of the placenta, allowing IRBCs to sequester and multiply to high density. Chondroitin sulphate appears on the surface of placental syncytiotrophoblasts, and CSA is a component of PGs found in the placenta [42], but the identification of the CSA-containing PG(s) mediating IRBC adhesion in vivo requires further study. Anti-adhesion antibodies against CSA-binding parasites are associated with protection from maternal malaria, but these antibodies develop only over successive pregnancies, accounting for the susceptibility of primigravidas to infection. PfCSA-L, the parasite ligand mediating adhesion to CSA, has not yet been identified but is known to be antigenically conserved among isolates from around the world. An anti-adhesion vaccine delivered to women before first pregnancy could confer protection from maternal malaria and might be globally effective.

Cell Adhesion↗

Endoscopic ultrasonography in the diagnosis, staging, and follow-up of anal carcinomas.

BACKGROUND AND STUDY AIMS: Endoscopic ultrasonography (EUS) is a technique that is well established in gastroenterology for tumor staging, but so far very few data have been reported concerning the staging of anal carcinomas using EUS. The aim of this study is to underline the value of EUS in the staging and follow-up of anal carcinoma. PATIENTS AND METHODS: In this retrospective study, 30 consecutive patients with carcinoma of the anal canal (nine men, 21 women) were examined using EUS, and the tumors were classified according to the 1985 TNM classification. EUS was carried out either before the start of treatment (15 patients); after the initial treatment in order to plan further treatment; or during follow-up examinations (15 patients). The treatment given was based on the results of the EUS examination. RESULTS: The following tumor stages were diagnosed: four lesions in stage uT0, seven in stage uT1, seven in stage uT2, nine in stage uT3, and three in stage uT4. In seven patients, suspect lymph nodes were also detected by EUS. In all but three of the patients (lost to follow-up), EUS had a direct impact on the treatment selected. Depending on the tumor stage, patients either underwent surgery (four patients: one uT1, one uT2, two uT3); received radiotherapy alone (five patients: three uT2, two uT3); combined chemoradiotherapy (eight patients: three uT2, three uT3, two uT4); interstitial booster radiotherapy (four patients: three uT1, one uT3); or no therapy at all (six patients: four uT0, one uT3, one uT4), respectively. In two patients, the tumor was understaged at EUS: in one, a uT1 tumor proved to be a pT2 tumor, and in the other, a uT3 tumor proved to be a pT4 tumor. CONCLUSIONS: The advantage of EUS in the staging of anal cancer is that it allows precise assessment of the depth of infiltration and tumor spread into adjacent tissue, facilitating the choice of stage-dependent treatment decisions-particularly in determining the extent of interstitial booster radiotherapy needed. It also allows follow-up examinations after the initial treatment, with fine-needle aspiration biopsies of suspicious areas. Wider acceptance of this method might further decrease the performance of extensive surgery, with the impaired quality of life associated with rectal amputation. In addition, it might allow improved quality control of the various treatment modalities.

Aged↗

Extensive gene order differences within regions of conserved synteny between the Fugu and human genomes: implications for chromosomal evolution and the cloning of disease genes.

The suitability of the Fugu genome to facilitate the identification of candidate human disease genes using comparative positional cloning is dependent upon the extent to which synteny and gene order are conserved between the two species. We have cloned seven Fugu genes which are closely linked to Surfeit genes in two regions of the Fugu genome and have mapped and ordered their human homologues both by PCR analysis of the Genebridge 4 panel of radiation hybrids and by fluorescence in situ hybridization. All seven human genes map to a 3 Mb region of chromosome band 9q34.1, approximately 2-4 Mb proximal to the human Surfeit genes. Although both Fugu regions are syntenic with human chromosome band 9q34, the relative order of the genes differs greatly in the two species. Indeed, some of the genes that are adjacent in the Fugu genome are separated by at least 2-4 Mb in the human genome. This suggests that intra-chromosomal rearrangements, most probably inversions, have been common during the 900 million years of divergent evolution separating Fugu and human. The utility of Fugu to facilitate human disease gene identification by comparative positional cloning is questioned in light of these results.

Animals↗

Evaluation of gastric emptying and motility in diabetic gastroparesis with magnetic resonance imaging: effects of cisapride.

OBJECTIVE: The motor mechanisms that underlie both slow gastric emptying in diabetic gastroparesis and its acceleration by cisapride are poorly understood. We have recently shown that magnetic resonance imaging (MRI) allows concurrent evaluation of both gastric emptying and regional gastric motility. METHODS: Emptying and motility were measured in eight diabetic patients with previously demonstrated delayed gastric emptying using a rapid MRI technique during oral administration of cisapride and placebo. Studies were performed in a double blind fashion and each patient acted as his own control. Subjects were studied supine for 120 min in a 1.5 Tesla MRI scanner after ingestion of 500 ml of 10% Intralipid. Gastric emptying corrected for the volume of secretions was determined every 15 min using transaxial scans. Each transaxial scan was followed by 120 coronal scans at 1 s intervals. Coronal scans were angled to provide simultaneous imaging of the proximal and distal stomach. MRI studies were also performed in seven diabetic patients with normal emptying who served as disease controls. RESULTS: Emptying was slower in the gastroparetic patients (t(1/2): 124 +/- 10 min) compared to patients with normal emptying (81 +/- 9 min, p < 0.05). Cisapride accelerated gastric emptying (74 +/- 5 vs 124 +/- 10 min) in patients with gastroparesis. The contraction amplitudes in the proximal stomach of gastroparetic patients were increased during cisapride treatment (17.2% +/- 1.8% vs 13.2% +/- 0.6%; p < 0.02), whereas antral contraction frequency, amplitude, and velocity were unchanged. CONCLUSIONS: We conclude that cisapride-induced acceleration of liquid gastric emptying in diabetic gastroparesis does not appear to result from changes in antral contractility, but may be related to changes in proximal gastric tone or gastric outlet resistance.

Adult↗

Scintigraphic validation of a magnetic resonance imaging method to study gastric emptying of a solid meal in humans.

BACKGROUND: We have previously used a magnetic resonance imaging (MRI) method to study gastric emptying of liquids. So far, however, it has not possible to assess solid gastric emptying with this technique. AIMS: To validate scintigraphically MRI as a method for measuring emptying of a mixed solid/liquid meal. METHODS: In eight healthy subjects, gastric emptying of a solid/liquid (SM) and a liquid meal (LM) of identical energy content and macronutrient composition was studied by scintigraphy and MRI for 120 minutes. RESULTS: MRI and scintigraphy agreed with respect to emptying profiles (intraclass correlation coefficient (RI) SM: 0.988, RI, LM: 0.917), t1/2 (SMMRI: 129 (9), SMScinti: 123 (11) minutes, NS; LMMRI: 100 (7), LMScinti: 110 (8) minutes, NS) and AUC (SMMRI: 8999 (232), SMScinti: 8788 (277) min%, NS; LMMRI: 8819 (368), LMScinti: 8891 (321) min%, NS). CONCLUSIONS: MRI can be used to measure reliably gastric emptying not only of liquid but also of mixed solid/liquid meals in humans.

Adult↗

Octreotide in the treatment of refractory diarrhea.

Refractory chronic diarrhea that does not respond to specific antimicrobial therapy or standard unspecific medication may present a challenging and serious clinical problem. Octreotide is a candidate drug for the treatment of these patients as it inhibits gastrointestinal motility, pancreatic secretion and inhibits intestinal absorption. Only few mostly uncontrolled studies in small patient groups were published evaluating the efficacy of octreotide in the treatment of patients with chemotherapy-induced diarrhea, short-bowel syndrome, AIDS-associated diarrhea and other conditions with chronic diarrhea not responding to standard treatment. Most of these studies are not conclusive as they yielded either negative or controversial results. Octreotide may be tried in the treatment of refractory diarrhea, in particular AIDS-associated diarrhea if patients do not respond to conventional treatment strategies. Well-designed controlled trials in large patient groups are needed in order to define the place of octreotide in the treatment of patients with refractory diarrhea.

Acquired Immunodeficiency Syndrome↗

Some complications after laparoscopic nonadjustable gastric banding.

BACKGROUND: Bariatric surgery is the only currently available, effective, long-term method for controlling morbid obesity. Gastric banding as one of the possible surgical treatments was repeatedly described during the last 10 years. It is a reversible surgical procedure which is primarily performed laparoscopically. METHODS: From 1993 to 1998 at the 1st Surgical Department Faculty General Hospital Charles University in Prague we performed nonadjustable gastric banding laparoscopically in 487 patients with morbid obesity (body mass index [BMI] 34 to 49 kg/m2). There were 429 females and 58 males in this group. RESULTS: In 487 patients who underwent laparoscopic nonadjustable gastric banding (LNGB): early postoperative complications occurred in 29 cases (5.9%)-swelling of the gastric mucosa at the site of the nonadjustable band. In three cases (0.6%)--gastric perforations, and in two patients (0.4%)--bleeding from gastric ulceration at the site of the band. Swelling was treated conservatively with a nasogastric tube and antisecretory and antiedematic drugs. Bleeding was treated by gastrofibroscopy and gastric perforation by open suture of the lesion. Late complications after LNGB occurred in eight patients (1.7%)--gastritis or esophagitis (but at the site of the band in only two patients [0.4%]), and in 13 patients (2.7%)--small upper pouch dilatation. In 24 cases (4.9%), we discovered slippage of the anterior stomach wall above the band. In three patients (0.6%), the band migrated through the gastric wall in 6-12 months following surgery. In the majority of cases, treatment of these complications was conservative. In eight patients we removed the band by laparoscopy, and in three patients we removed the migrating band from the stomach by open gastrotomy. Other complications have been treated conservatively by correcting the diet, prokinetic drugs, and antisecretory treatment. CONCLUSIONS: According to our long-term results, LNGB by experienced bariatric and laparoscopic surgeons is a viable method with low morbidity. In our 487 patients, there were major complications (necessitating reoperation) in 3.2% and minor complications (treated conservatively) in 10.4%.

Adolescent↗

Influence of some hereditary factors on weight loss following conservative and surgical treatment of obese female monozygotic twins.

BACKGROUND: The important role of hereditary factors in the etiology of obesity has been demonstrated by various authors in last few years. The possible influence of some genetic factors on weight reduction or maintenance following conservative and/or surgical treatment was studied in 14 pairs of obese female monozygotic twins. METHODS: 12 pairs of twins underwent a weight reduction regimen initiated by short-term inpatient treatment; two pairs were treated by nonadjustable gastric banding. Some factors that may be genetically influenced and that can predict, to some extent, success or failure in long-term weight loss were followed up in obese pairs. RESULTS: The most valuable predictors of long-term outcome in this group of patients were initial weight loss, fat mass, respiratory quotient, waist circumference, and sagittal abdominal diameter. CONCLUSION: Hereditary factors cause significantly higher risk of treatment failure in some obese subjects. There is a need to pay special attention to these factors in order to achieve successful long-term weight loss.

Diseases in Twins↗

[Long-term results of ileo-rectal anastomosis in familial polyposis].

The authors present their experience with 93 patients operated at the First Surgical Clinic of the General Faculty Hospital and First Medical Faculty, Charles University Prague on account of familial adenomatous polyposis (FAP) assembled during 36 year starting in 1962. They analyze 91 patients followed up in collaboration with the First Medical Clinic of the General Faculty Hospital and First Medical Clinic Charles University Prague. Seventy-two of the patients were operated and in 55 of them an ileorectoanastomosis was made following subtotal colectomy. Two important findings were made. From the group of 91 patients incl. primary patients who suffered already from advanced malignant disease of the large bowel a total of 38.5% died. In the rectal stump after ileorectoanastomosis on average within 16 years after operation in 16.4% of the patients a malignant tumour was found. This leads to the belief that patients should be recommended colectomy with ileoanoanastomosis with an ileal reservoir. This operation was performed during the last five years in nine patients with this condition, using a one-stage or two-stage procedure with temporary ileostomy.

Adenomatous Polyposis Coli↗