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Biomedical subjects

M Kern

Publications and source records attributed to M Kern.

At least 91 records · Page 5Linked to original sources
PubMed1998

[Palliative medicine].

Palliative medicine is the care and the study of that care for patients, with an active, progressive, and advanced disease, where life expectancy is relatively short. The goal is achievement of the best possible quality of life for patients and their families. Pain therapy, control of other physical symptoms and of psychological, social and spiritual problems are cornerstones of palliative medicine. Skilled empathetic communication and ethical issues are essential to many of the aspects of palliative care. Education and training of professional health workers involved in the care of dying patients is important.

Ethics, Medical↗
PubMed1998

Simultaneous lowering of serum phosphate and LDL-cholesterol by sevelamer hydrochloride (RenaGel) in dialysis patients.

The aim of the current investigation was to study the effects of sevelamer hydrochloride (RenaGel) on serum phosphate, intact parathyroid hormone levels (iPTH), and lipid profiles in stable hemodialysis patients. Hemodialysis patients maintained on calcium containing phosphate binders were enrolled in this study. Following two weeks of washout of the phosphate binders, serum phosphate rose from 6.4 +/- 0.6 to 10.5 +/- 0.7 mg/dl (p <0.001). After 8 weeks of titration with sevelamer hydrochloride, serum phosphate fell by 4.5 +/- 0.3 to 6.3 +/- 0.7 mg/dl (p <0.0001). Serum calcium levels fell during washout (9.8 +/- 0.4 to 8.9 +/- 0.3 mg/dl, p <0.004) and were unaffected by sevelamer hydrochloride. Sevelamer hydrochloride administration was associated with a 23.0 +/- 3.1% fall in total cholesterol, a 35.9 +/- 3.0% fall in LDL cholesterol, and a 35.2 +/- 5.3% fall in the LDL:HDL cholesterol ratio (p <0.001). There was no change in HDL cholesterol, triglycerides or the concentration of fat soluble vitamins. Sevelamer hydrochloride is a well tolerated alternative to calcium or aluminum containing phosphate binders and may offer an advantage to patients who become hypercalcemic on calcium-containing antacids and vitamin D supplementation. Furthermore, sevelamer hydrochloride lowers LDL cholesterol without affecting HDL cholesterol. The potential usefulness of the lipid lowering effects of sevelamer hydrochloride needs to be determined in additional prospective studies.

Administration, Oral↗
PubMed1997

Modulation of neurite branching by protein phosphorylation in cultured rat hippocampal neurons.

The control of branching of axons and dendrites is poorly understood. It has been hypothesized that branching may be produced by changes in the cytoskeleton [F.J. Diez-Guerra, J. Avila, MAP2 phosphorylation parallels dendrite arborization in hippocampal neurones in culture, NeuroReport 4 (1993) 412-419; P. Friedrich, A. Aszodi, MAP2: a sensitive cross-linker and adjustable spacer in dendritic architecture, FEBS Lett. 295 (1991) 5-9]. The assembly and stability of microtubules, which are prominent cytoskeletal elements in both axons and dendrites, are regulated by microtubule-associated proteins, including tau (predominantly found in axons) and MAP2 (predominantly found in dendrites). The phosphorylation state of tau and MAP2 modulates their interactions with microtubules. In their low-phosphorylation states, tau and MAP2 bind to microtubules and increase microtubule assembly and/or stability. Increased phosphorylation decreases these effects. Diez-Guerra and Avila [F.J. Diez-Guerra, J. Avila, MAP2 phosphorylation parallels dendrite arborization in hippocampal neurones in culture, NeuroReport 4 (1993) 412-419] found that protein phosphorylation correlates with neurite branching in cultured rat hippocampal neurons, and hypothesized that increased protein phosphorylation stimulates neurite branching. To test this hypothesis, we cultured rat hippocampal neurons in the presence of specific modulators of serine-threonine protein kinases and phosphatases. Inhibitors of several protein kinases, which would be expected to decrease protein phosphorylation, reduced branching. KT5720, an inhibitor of cyclic AMP-dependent protein kinase, and KN62, an inhibitor of Ca(2+)-calmodulin-dependent protein kinases, inhibited branching of both axons and dendrites. Calphostin C and chelerythrine, inhibitors of protein kinase C, inhibited branching of axons but not dendrites. Treatments that would be expected to increase protein phosphorylation, including inhibitors of protein phosphatases (okadaic acid, cyclosporin A and FK506) and stimulators of PKA (SP-cAMPS) or PKC (phorbol 12-myristate 13-acetate), increased dendrite branching. Only FK506 and phorbol 12-myristate 13-acetate stimulated axon branching. A subset of these agents was tested to confirm their effects on protein phosphorylation in this preparation. Okadaic acid, FK506 and SP-cAMPS all increased protein phosphorylation; KT5720 and KN62 decreased protein phosphorylation. On Western blots, the position of MAP2c extracted from cultures exposed to okadaic acid was slightly shifted toward higher molecular weight, suggesting greater phosphorylation, while the position of MAP2c from cultures exposed to KT5720 and KN62 was slightly shifted toward lower molecular weight, suggesting less phosphorylation. We conclude that protein phosphorylation modulates both dendrite branching and axon branching, but with differences in sensitivity to phosphorylation and/or dephosphorylation by specific kinases and phosphatases.

Animals↗
PubMed1997

Induction of aldose reductase and xylitol dehydrogenase activities in Candida tenuis CBS 4435.

In this study the ability of various sugars and sugar alcohols to induce aldose reductase (xylose reductase) and xylitol dehydrogenase (xylulose reductase) activities in the yeast Candida tenuis was investigated. Both enzyme activities were induced when the organism was grown on D-xylose or L-arabinose as well as on the structurally related sugars D-arabinose or D-lyxose. Mixtures of D-xylose with the more rapidly metabolizable sugar D-glucose resulted in a decrease in the levels of both enzymes formed. These results show that the utilization of D-xylose by C. tenuis is regulated by induction and catabolite repression. Furthermore, the different patterns of induction on distinct sugars suggest that the synthesis of both enzymes is not under coordinate control.

Aldehyde Reductase↗
PubMed1997

Pharmacologic stress-induced regional myocardial blood flow heterogeneity and left ventricular wall thickening abnormality: comparison of intravenous adenosine with dipyridamole in a model of critical coronary stenosis.

Variations in reported sensitivity of myocardial perfusion scans or wall motion abnormalities during pharmacologic stress with intravenous adenosine and dipyridamole may be caused by differences in myocardial oxygen demand or myocardial blood flow redistribution induced by each agent. To investigate the physiologic correlates of functional abnormalities during pharmacologic stress testing, regional myocardial blood flow (radiolabeled microsphere technique) and left ventricular segmental wall thickening (quantitative two-dimensional echocardiography) were measured in 9 dogs with an open chest model of critical stenosis of the left circumflex coronary artery. Data were obtained at baseline and peak drug infusion for intravenous adenosine (0.42 mg/kg over a 3-minute period) and for intravenous dipyridamole (0.56 mg/kg over a 4-minute period). Adenosine and dipyridamole induced regional flow abnormality in 7 (77%) of 9 dogs. Myocardial segments with decreased endocardial/epicardial flow ratio were similar for both agents (2.9 +/- 1.8 vs 2.7 +/- 1.3, p = [NS]). Segments with myocardial flow heterogeneity (ratio of endocardial flow to control left anterior descending/left circumflex endocardial flow) were similar for both agents (2.7 +/- 0.9 vs 2.3 +/- 1.0, p = NS). Adenosine-induced wall thickening abnormality (77% vs 55% with dipyridamole) correlated with regional flow abnormality. Significantly lower mean arterial pressure (53 +/- 1.7 mm Hg vs 64 +/- 1.9 mm Hg, p < 0.01) and more prolonged drug effect (18 +/- 6.4 min vs 3 +/- 1.4 min, p < 0.001) were seen for dipyridamole compared with adenosine. Adenosine induces regional flow abnormality similar to dipyridamole but with less hemodynamic perturbation, and adenosine-induced wall thickening abnormality more closely parallels regional flow abnormality.

Adenosine↗
PubMed1997

Donor work-up and transport of bone marrow--recommendations and requirements for a standardized practice throughout the world from the Donor Registries and Quality Assurance Working Groups of the World Marrow Donor Association (WMDA).

In October 1995 the World Marrow Donor Association (WMDA) was restructured in order to facilitate its primary function of establishing guidelines in relation to international bone marrow and blood stem cell transplants -- transplants in which the donor is in one country and the patient is in another country. Five new working groups were established -- Donor Registries, Ethics, Quality Assurance, Finances, and Stem Cells. This paper, prepared by members of the Donor Registries Working Group, in consultation with the Quality Assurance Working Group, provides recommendations for the 'donor work-up'. This term covers events that start when the definitive donor has been identified, includes the harvesting (collection) and transportation of the stem cell product and ends when the product reaches the transplant centre. The paper includes examples of the documentation intended to ensure compliance with the recommendations at all key points in the sequence.

Bone Marrow Transplantation↗
PubMed1997

Augmentation of deglutitive upper esophageal sphincter opening in the elderly by exercise.

Earlier studies have shown that the cross-sectional area of the deglutitive upper esophageal sphincter (UES) opening in healthy asymptomatic elderly individuals is reduced compared with healthy young volunteers. The aim of this study was to determine the effect of a head-raising exercise on swallow-induced UES opening and hypopharyngeal intrabolus pressure in the elderly. We studied a total of 31 asymptomatic healthy elderly subjects by videofluoroscopy and manometry before and after real (19 subjects) and sham (12 subjects) exercises. A significant increase was found in the magnitude of the anterior excursion of the larynx, the maximum anteroposterior diameter, and the cross-sectional area of the UES opening after the real exercise (P < 0.05). These changes were associated with a significant decrease in the hypopharyngeal intrabolus pressure studied in 12 (real-exercise) and 6 (sham-exercise) subjects (P < 0.05). A similar effect was not found in the sham-exercise group. In normal elderly subjects, deglutitive UES opening is amenable to augmentation by exercise aimed at strengthening the UES opening muscles. This augmentation is accompanied by a significant decrease in hypopharyngeal intrabolus pressure, indicating a decrease in pharyngeal outflow resistance. This approach may be helpful in some patients with dysphagia due to disorders of deglutitive UES opening.

Aged↗
PubMed1997

Correlation of electrical and contractile activities of the cricopharyngeus muscle in the cat.

We correlated the electrical and contractile activities of the cricopharyngeus (CP) to better understand the function of the CP and the upper esophageal sphincter (UES). In 40 decerebrate cats, we recorded resting and active tension of the CP and CP force and electromyographic (EMG) activity simultaneously during electrical stimulation of the pharyngoesophageal (PE) nerve, esophageal distension, or swallowing. In six intact cats, the change in diameter of the UES during food swallows was determined in two planes using videofluoroscopy. We found that resting tension of the CP developed quickly with stretch, and the strain-energy function, y = 6.5e3.4(z-1), fit (r = 0.94 +/- 0.06) this relationship. Active tension peaked at 1.68 +/- 0.03 times resting length, which is greater than the maximum distension during swallowing. Activation and relaxation of the CP occurred in approximately 50 and 120 ms, respectively. PE nerve stimulation bilaterally caused a force equal to approximately 90% of the summed force generated by separate stimulation of each PE nerve. The magnitude of the EMG response of the contralateral CP was approximately 18% of the ipsilateral response to unilateral PE nerve stimulation. We conclude that the CP exhibits tension throughout its physiological range of stretch. The CP functions more like a bilateral than a single contiguous muscle, and more like cardiac than striated muscle with regard to its passive elastic properties.

Animals↗
PubMed1996

Clinical comparison of postoperative sensitivity for a glass ionomer and a zinc phosphate luting cement.

In 60 patients, 120 partial and full-coverage restorations were cemented on vital abutment teeth with either a glass ionomer or a zinc phosphate luting cement. A split-mouth design and a patient blind data acquisition protocol were used. During an average observation period of 17.3 months there were no differences between the two types of luting cements in regard to subjective and clinical parameters. A high incidence of postoperative hypersensitivity, which is often said to accompany the use of glass ionomer luting cements, was not observed. With the cementation method used in this study, the glass ionomer cement Ketac-Cem Maxicap was an acceptable alternative to conventional zinc phosphate cement. Capsule systems make the clinical handling of glass ionomer luting cements safe and easy and should be used routinely in dental practice.

Adult↗
PubMed1996

Previous physical activity relates to bone mineral measures in young women.

Exercise may increase accretion of bone, potentially reducing the risk of osteoporosis. Previous physical activity was assessed in 204 minimally active young women (18-31 yr). Bone mineral content (BMC) and bone mineral density (BMD) for the total body, femoral neck, and spine were assessed by a dual x-ray absorptiometer, and the radius by a single photon absorptiometer. Self-reported occupation and leisure activity for the 5 yr before enrollment in the study, as well as high school and college sports participation, were assigned energy expenditure (EE) values. From this information, EE variables were created as follows: 1) occupation EE + leisure EE + high school sport and/or college sport EE if within prior 5 yr (5-yr EE); 2) occupation EE + leisure EE (occupation + leisure EE); and 3) high school sport EE (high school EE). These variables were correlated with bone mineral measures and significant results follow (P < 0.05). Five-year EE and occupation + leisure EE correlated with all measures of bone health (r from 0.13 to 0.39). High school EE correlated with total body BMD (r = 0.25) and BMC (r = 0.28), femoral neck BMD (r = 0.28), radius BMC (r = 0.20), as well as spine BMD (r = 0.20) and BMC (r = 0.27). When weight was controlled, 5-yr EE and occupation + leisure EE remained correlated with all BMC measures (r from 0.14 to 0.22). When controlled for weight, high school EE remained associated with femoral neck BMD (r = 0.24), total body BMD (r = 0.20) and BMC (r = 0.26), and spine BMC (r = 0.17). To partially control for selection bias, data were also controlled for total body BMD. Five-year EE and occupation + leisure EE remained positively correlated with all measures of BMC. High school EE remained correlated both with femoral neck BMD and total body BMC. In multiple regression analyses, 5-yr EE or occupation + leisure EE were significant predictors of all measures of bone health, except femoral neck BMD. High school EE was a significant predictor for total body BMD and BMC, femoral neck BMD, and spine BMC.

Adolescent↗
PubMed1996

Histology and histochemistry of intervertebral discs of rats participated in spaceflight.

The qualitative and quantitative histological and histochemical changes in the structure and macromolecular composition of lumbar intervertebral discs of rat during a 12.5-day space flight (Cosmos 1887 biosatellite) were determined using light and polarization microscopy. Semiquantitative histochemical, topo-optical reactions were measured and evaluated by retardation values of birefringence. (a) Lateral expansion and accumulation of the notochordal cells in the nucleus pulposus was observed in contrast with the vivarium control, where the chondroid cells dominated. (b) The cartilage and plate showed a swelling, which consisted mainly of hypertrophied cells sometimes with mild extracellular mineralization. (c) In the external zone of annulus fibrosus and cartilage end plate a mild decrease of orientation of collagen fibers was found. (d) A significant increase of orientation of hyase sensible glycosaminoglycans in the internal zone of annulus fibrosus and nucleus pulposus was observed. (e) In the external and internal zones of annulus fibrosus an increase of orientation of glycoproteids was revealed. The alterations of macromolecular components of intervertebral discs, cartilage end plates, and the osteoporotic changes of the lumbar vertebral bodies producing the looser structure of vertebral column after 12.5 day space flight suggest the necessity of the common evaluation of these structures, and may explain the heavy spinal pains of astronauts.

Animals↗
PubMed1996

Ten-year clinical and microscopic evaluation of resin-bonded restorations.

A clinical recall was conducted for 103 patients who were functioning with resin-bonded restorations for approximately 10 years. The purpose of this study was to evaluate marginal adaptation of the cast metal retainers. Following clinical evaluations, replicas of incisal and occlusal margins were examined in the scanning electron microscope to determine marginal separation and microscopic patterns of the resin composite interface between metal and tooth. Anterior abutments exhibited better clinical adaptation and fewer voids and debonds than did posterior abutments. Larger microscopic marginal separations were associated with those retainers that had clinically detectable voids or defects.

Chi-Square Distribution↗
PubMed1995

Inorganic lead may inhibit neurite development in cultured rat hippocampal neurons through hyperphosphorylation.

Inorganic lead inhibits neurite initiation in cultured rat hippocampal neurons at concentrations as low as 100 nM. Conflicting reports suggest that Pb2+ may stimulate or inhibit protein kinase C, adenylyl cyclase, phosphodiesterase, and calmodulin, or increase intracellular free Ca2+ concentrations. Therefore, Pb2+ may alter the activities of Ca2+/calmodulin-dependent protein kinase (CaM kinase) or protein kinases C or A. We cultured rat hippocampal neurons in 100 nM PbCI2 alone or in combination with kinase or calmodulin inhibitors. Inhibiting protein kinase C with calphostin C exacerbated the inhibition of neurite initiation caused by PbCI2, but inhibiting protein kinase A with KT5720, CaM kinase with KN62, or calmodulin with calmidazolium completely reversed the effects of PbCI2. These results indicate that Pb2+ may inhibit neurite initiation by inappropriately stimulating protein phosphorylation by CaM kinase or cyclic AMP-dependent protein kinase (PKA), possibly by stimulating calmodulin. This hypothesis is supported by findings that other treatments that should increase protein phosphorylation (okadaic acid, a protein phosphatase inhibitor, and Sp-cAMPS, a PKA activator) also reduced neurite initiation. Whole-cell intracellular free Ca2+ ion concentrations were not significantly altered by 100 nM PbCI2 at 4, 12, 24, or 48 hr. Therefore, the hypothesized stimulatory effects of Pb2+ exposure on calmodulin, CaM kinase, or PKA are probably not caused by increases in whole-cell intracellular free Ca2+, but may be attributable either to intracellular Pb2+ or to localized increases in [Ca2+]in that are not reflected in whole-cell measurements.

Animals↗
PubMed1995

Durability of resin bonds to a cobalt-chromium alloy.

Common nickel-chromium-beryllium alloys used for resin-bonded fixed partial dentures have possible health hazards due to leaching of nickel and beryllium. For resin-bonded restorations corrosion resistant cobalt-chromium alloys (CoCr) are a suitable alternative material without sacrificing physical properties. This study evaluated the bond strength and bond durability of new adhesive systems to a CoCr alloy. Plexiglas (acrylic) tubes filled with composite were bonded to CoCr alloy discs. Groups of 24 samples were bonded using six different bonding systems. Subgroups of eight bonded samples were stored in an isotonic artificial saliva solution (37 degrees C) either for 1 day, 30 days or 150 days. In addition the 30- and 150-days samples were subjected to 7500 or 37,500 thermal cycles, respectively. The bond strength of a conventional BisGMA composite (Twinlook) to sandblasted CoCr was significant lower than when using chemomechanical bonding systems and decreased continuously during the storage time of 150 days. The additional use of silane on the sandblasted alloy resulted in an insignificant increase in bond strength. Statistically significant higher and more durable bonds to CoCr alloy were achieved either with the combination of silica coating and use of the conventional BisGMA composite or with the combination of sandblasting and the use of a composite modified with a phosphate monomer (Panavia EX). In the latter systems, the bond strengths were mainly limited by the cohesive strength of the resin composites: partial adhesive failures were only observed for a tribochemical silica coating system. A new composite also containing the active phosphate monomer (Panavia TPN-S) exhibited a significant decrease in cohesive strength over time.

Adhesiveness↗
PubMed1995

Bonding to glass infiltrated alumina ceramic: adhesive methods and their durability.

Resin bonding to a glass-infiltrated aluminum oxide ceramic (In-Ceram) cannot be achieved by the methods commonly used for conventional silica-based dental ceramics. This study evaluated the durability of alternative methods of adhesive bonding to In-Ceram ceramic. The tensile bond strength of six bonding systems to In-Ceram ceramic was tested after up to 150 days of storage in isotonic artificial saliva solution and thermal cycling. Sandblasting alone or additional use of a silane did not result in a durable bond of a conventional BIS-GMA composite resin to In-Ceram ceramic. A durable bond to In-Ceram ceramic was achieved with a combination of tribochemical silica coating and conventional BIS-GMA composite resin or with the combination of sandblasting and a composite resin modified with a phosphate monomer. These two chemomechanical bonding methods appeared suitable for clinical bonding of In-Ceram ceramic restorations. A delayed degradation in bond strength was recorded for the combination of thermal silica coating and a conventional BIS-GMA composite resin; no reduction was found after 30 days, but there was a pronounced decrease after 150 days. This degradation indicated that extended storage in a wet environment was needed in laboratory tests to evaluate the durability of chemical bonds.

Aluminum Oxide↗
PubMed1995

Durability of resin bonds to pure titanium.

PURPOSE: This study evaluated the bond strength and bond durability of new adhesive systems to pure titanium. MATERIALS AND METHODS: Plexiglass tubes filled with composite were bonded to titanium discs. Groups of 24 samples were bonded using six different bonding systems. Subgroups of eight bonded samples were stored in an isotonic artificial saliva solution (37 degrees C) for 1, 30, or 150 days. In addition, the 30- and 150-day samples were thermal cycled for 7,500 or 37,500 cycles between 5 degrees C and 55 degrees C, respectively. After these storage conditions, all samples were debonded in tension. RESULTS: The bond strength of a conventional bisphenol-A glycidyl methacrylate composite to sandblasted titanium was significantly lower than using chemomechanical bonding systems and decreased slightly during the storage time of 150 days. The additional use of a silane on sandblasted titanium resulted in an insignificant increase in bond strength and decreased over storage time to the same level as on sandblasted-only titanium. Statistically significant higher bond strengths were achieved either with the combination of silica coating and use of a conventional bisphenol-A glycidyl methacrylate composite or with the combination of sandblasting and the use of composites modified with a phosphate monomer. In the latter systems, the bond strengths were only limited by the cohesive strength of the composite resins. A new phosphate monomer containing composite showed a tendency to lose cohesive strength over time (statistically not significant). CONCLUSIONS: Using chemomechanical bonding systems, ie, silica-coating systems or modified composites with adhesive monomers, resulted in 2 to 2.5 times increased bond strength to titanium compared with the bond strength of a conventional bisphenol-A glycidyl methacrylate composite. With chemomechanical bonding systems, the resin bond to titanium was durable over 150 days, even after being stored in water and thermal cycled.

Adhesiveness↗