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Biomedical subjects

M Ludwig

Publications and source records attributed to M Ludwig.

At least 73 records · Page 4Linked to original sources
PubMed2001

Responses of magnocellular neurons to osmotic stimulation involves coactivation of excitatory and inhibitory input: an experimental and theoretical analysis.

How does a neuron, challenged by an increase in synaptic input, display a response that is independent of the initial level of activity? Here we show that both oxytocin and vasopressin cells in the supraoptic nucleus of normal rats respond to intravenous infusions of hypertonic saline with gradual, linear increases in discharge rate. In hyponatremic rats, oxytocin and vasopressin cells also responded linearly to intravenous infusions of hypertonic saline but with much lower slopes. The linearity of response was surprising, given both the expected nonlinearity of neuronal behavior and the nonlinearity of the oxytocin secretory response to such infusions. We show that a simple computational model can reproduce these responses well, but only if it is assumed that hypertonic infusions coactivate excitatory and inhibitory synaptic inputs. This hypothesis was tested first by applying the GABA(A) antagonist bicuculline to the dendritic zone of the supraoptic nucleus by microdialysis. During local blockade of GABA inputs, the response of oxytocin cells to hypertonic infusion was greatly enhanced. We then went on to directly measure GABA release in the supraoptic nucleus during hypertonic infusion, confirming the predicted rise. Together, the results suggest that hypertonic infusions lead to coactivation of excitatory and inhibitory inputs and that this coactivation may confer appropriate characteristics on the output behavior of oxytocin cells. The nonlinearity of oxytocin secretion that accompanies the linear increase in oxytocin cell firing rate reflects frequency-facilitation of stimulus-secretion coupling at the neurohypophysis.

Animals↗
PubMed2001

Dependence of enantioselectivity on the distribution of a chiral hydrogenation catalyst between an aqueous and a micellar phase: investigations using pulsed field gradient spin echo NMR spectroscopy.

The enantioselectivity obtained from rhodium complex catalyzed hydrogenations conducted in water can often be increased considerably by the addition of amphiphiles. At present the reasons for this increase in selectivity are not fully understood. The application of pulsed field gradient spin echo NMR (PGSE-NMR) spectroscopy to determine the average diffusion coefficients of the catalysts in both known and novel examples of asymmetric hydrogenation shows definitively that the increase in enantioselectivity is coupled with an aggregation of the catalyst to the micelles. This aggregation or solubilization of the catalyst in the micelles leads to the formation of a new colloidal phase in the aqueous solution. This phase has stronger hydrophobic properties, and thus the hydrogenation is more comparable to those conducted in a hydrophobic or less polar organic solvent. In the case of anionic amphiphiles, which form amphiphilic salts with the cationic catalyst, the embedment of the catalyst complex into the micelle is generally complete. The whole hydrogenation then takes place exclusively inside the micelles, leading to high enantioselectivity. If the catalyst is not completely embedded into the micelle, for example in the cases of nonionic or cationic surfactant solutions, the solubility of the substrate plays an important role. For soluble substrates the hydrogenation of the substrate occurs predominately in the aqueous phase itself, leading to very poor enantioselectivities. In these cases, only the use of a large excess of amphiphile, far above the critical micelle concentration (cmc), will lead to higher enantioselectivities due to a shift of the equilibrium towards the micellar bonded forms of catalyst and substrate. In contrast, poorly soluble substrates exhibit a high tendency to be incorporated into micelles, which leads to much higher enantioselectivities if the cmc of the surfactant is small enough. Changes in the cmc of amphiphiles caused by their aggregation with catalysts could also be estimated. The variation in selectivity observed for the catalysts containing seven-membered, flexible chelate rings is apparently due to changes in their conformation in the less polar micellar medium, and this effect is also seen in organic solvents. As expected, catalysts containing smaller chelate rings show this effect to a considerably lower extent since they are conformationally more rigid.

Journal Article↗
PubMed2001

Somatic mosaicism in hemophilia A: a fairly common event.

Mutations in the large gene of clotting factor VIII (FVIII) are the most common events leading to severe human bleeding disorder. The high proportion of de novo mutations observed in this gene raises the possibility that a significant proportion of such mutations does not derive from a single germ cell but instead should be attributed to a germline or somatic mosaic originating from a mutation during early embryogenesis. The present study explores this hypothesis by using allele-specific PCR to analyze 61 families that included members who had sporadic severe hemophilia A and known FVIII gene defects. The presence of somatic mosaicisms of varying degrees (0.2%-25%) could be shown in 8 (13%) of the 61 families and has been confirmed by a mutation-enrichment procedure. All mosaics were found in families with point mutations (8 [25%] of 32 families). In the subgroup of 8 families with CpG transitions, the percentage with mosaicism increased to 50% (4 of 8 families). In contrast, no mosaics were observed in 13 families with small deletions/insertions or in 16 families with intron 22 inversions. Our data suggest that mosaicism may represent a fairly common event in hemophilia A. As a consequence, risk assessment in genetic counseling should include consideration of the possibility of somatic mosaicism in families with apparently de novo mutations, especially families with the subtype of point mutations.

Alleles↗
PubMed2001

Cross-linked poly(vinyl alcohol) as permanent hydrophilic column coating for capillary electrophoresis.

A fast method for the generation of permanent hydrophilic capillary coatings for capillary electrophoresis (CE) is presented. Such interior coating is effected by treating the surface to be coated with a solution of glutaraldehyde as cross-linking agent followed by a solution of poly(vinyl alcohol) (PVA), which results in an immobilization of the polymer on the capillary surface. Applied for capillary zone electrophoresis (CZE) such capillaries coated with cross-linked PVA exhibit excellent separation performance of adsorptive analytes like basic proteins due to the reduction of analyte-wall interactions. The long-term stability of cross-linked PVA coatings could be proved in very long series of CZE separations. More than 1000 repetitive CE separations of basic proteins were performed with stable absolute migration times relative standard deviation (RSD > 1.2%) and without loss of separation efficiency. Cross-linked PVA coatings exhibit a suppressed electroosmotic flow and excellent stability over a wide pH range.

Chymotrypsinogen↗
PubMed2001

[Symptoms of prostatitis in German. The Giessen Prostatitis Symptom Score].

In cases of chronic prostatitis, a systematic case history of subjective complaints is crucial. In addition to the urological diagnosis, a special symptom questionnaire can be utilized. The objective of this study was to develop a standardized and valid questionnaire to assess prostata-specific complaints in an economic way. Independently from the evaluation of this questionnaire, a similar instrument (CPSI) was developed in the United States with several similar items. The Giessener prostatitis symptom score (GPSS) comprises 12 items. Thirty-three patients suffering from prostatitis and 770 representatively selected German males filled in the questionnaire. A sum score of 6 points proved to best suited to differentiate between the patient and the representative group. Values of 6 and above indicate the corresponding diagnosis, i.e., it can be assumed that prostata-specific symptoms occur at least occasionally. In the representative sample, 7.8% of the males showed prostata-specific complaints with a score of 6 or above. A comparison between the GPSS and the CPSI concerning their diagnostic validity has not yet been performed. This comparison will show which of the instruments is better suited for prostatitis screening.

Adolescent↗
PubMed2001

[Prostatitis syndrome. Changes in the ejaculate and effects on fertility].

Inflammation and infections of the male reproductive tract represent an important factor in male infertility that is potentially responsive to successful therapy. A standardized diagnostic procedure is a prerequisite for the exact evaluation of alterations of ejaculate specimens, especially in cases of the different forms of the prostatitis syndrome. Several alterations in ejaculate due to inflammation and infection have been identified that have a negative impact on the quality of sperm. Besides the influence of leuko- and bacteriospermia, the effect of inflammatory mediators, such as cytokines and reactive oxygen species (ROS), are being discussed as relevant pathomechanisms. These parameters just recently were incorporated into the conventional range of diagnostic criteria. Clinical studies that investigate the quality of ejaculate in the different forms of the prostatitis syndrome yielded contradictory results. Only antimicrobial therapy has been sufficiently described as a therapeutic option. In the future, it will be decisive to include novel functional and molecular parameters to define an interaction of urogenital infection and male infertility.

Bacterial Infections↗
PubMed2001

Influence of CYP2D6 genotype and medication on the sparteine metabolic ratio of psychiatric patients.

OBJECTIVE: To investigate the influence of CYP2D6 genotype and medication on the reliability of phenotyping in a naturalistic setting of psychiatric inpatients. METHODS: The phenotype of 160 psychiatric inpatients was estimated by taking the urinary metabolic ratio (MR) of the concentrations of sparteine to 2- and 5-dehydrosparteine. Genotyping identified CYP2D6*1, *3, *4, *5 and *6 alleles as well as duplication of the CYP2D6 gene. All subjects underwent detailed drug history including drug dose and therapeutic drug monitoring to control compliance and abuse of other psychotropic drugs. These data were compared with those of 195 unmedicated healthy Germans. RESULTS: The cumulative distribution of the MR in patients showed a significant shift to higher MR when compared with that of healthy subjects (P < or = 0.001). Patients medicated either with selective serotonin reuptake inhibitors (SSRIs, P < or = 0.001), antipsychotic drugs (P= 0.002) or other drugs known to be substrates or inhibitors of CYP2D6 (P < or = 0.001) showed a significantly higher mean MR than unmedicated patients. However, there was no significant effect of tricyclic antidepressants on the MR. Healthy subjects with CYP2D6 deficiency were separated by a MR of greater than 20 from those who expressed functional CYP2D6. Seven patients carrying at least one functional CYP2D6 allele revealed a MR of greater than 20, indicating the occurrence of phenocopying. CONCLUSION: The results of phenotyping may be falsified by drugs known to be substrates or inhibitors of CYP2D6; thus, this method is not sufficiently reliable. However, since we observed the phenomenon of phenocopying only in patients treated with a SSRI such as fluoxetine, fluvoxamine or paroxetine, we conclude that sparteine phenotyping of medicated patients detects CYP2D6 deficiency correctly, provided that patients treated with these SSRIs are excluded.

Adult↗
PubMed2001

Alternative splicing of the p15 cdk inhibitor in glioblastoma multiforme.

Thirty-four to fifty-six percent of malignant gliomas harbor homozygous co-deletions of the INK4a(p16-p14ARF) and INK4b(p15) tumor suppressor genes. Recently, an alternatively spliced form of p15 has been cloned and termed p10 based on the presumed molecular weight of the protein. In this study, we have investigated the role of p10 expression in human glioblastomas. Both, wild-type p15 and p10 were detected in three of nine glioblastoma cell lines. Sixteen of twenty-nine (55%) glioblastoma tumor samples contained INK4b transcripts, but only nine (31%) tumors expressed p15 protein. Three p15 protein-negative tumors expressed only p10 mRNA. Preferential expression of p10 was not due to splice site mutations. Strong suppression of tumorigenicity was seen in four glioblastoma cell lines after transfection with p15 but not with p10. Loss of p15 protein expression was almost always accompanied by loss of p16 expression. p1 6/p15-negative tumors commonly lacked p14ARF expression. These results suggest that differential splicing of the INK4b gene may result in the expression of p10 at the expense of p15, which would lead to loss of p15-mediated growth suppression. This novel mechanism of loss of p15 might complement alterations of the INK4a tumor suppressor gene in some glioblastomas, resulting in combined loss of p16, p15 and p14ARF.

Alternative Splicing↗
PubMed2001

Use of GnRH antagonists in ovarian stimulation for assisted reproductive technologies compared to the long protocol. Meta-analysis.

The use of GnRH antagonists has revolutionized ovarian stimulation for assisted reproduction. Two GnRH antagonists are clinically available, namely, cetrorelix and ganirelix. Several studies have directly compared these new stimulation protocols against the long GnRH agonist protocol. To evaluate whether there is a reduction in cases of ovarian hyperstimulation syndrome (OHSS) and/or a reduction in pregnancy rates, a meta-analysis was performed. There was a significant reduction of OHSS cases in the cetrorelix studies (odds ratio, OR, 0.23; 95% confidence interval, CI, 0.10-0.54), but no reduction for ganirelix (OR 1.13; 95% CI 0.24-5.31). The incidence of OHSS degree III cases was reduced in the cetrorelix protocols as compared to the long protocol to a nearly significant degree (OR 0.26; 95% CI 0.07-1.01). Ganirelix did not reduce the incidence of OHSS degree III at all (OR 1.08; 95% CI 0.27-4.38). The pregnancy rate per cycle was significantly lower in the ganirelix protocols than in the long protocol (OR 0.76; 95% CI 0.59-0.98). The studies using cetrorelix showed quite similar, not significantly different results for the antagonist and the long protocol groups for the pregnancy rate per cycle (OR 0.91; 95% Cl 0.68-1.22). From the data one can conclude that cetrorelix but not ganirelix will reduce the incidence of cases of OHSS and that cetrorelix but not ganirelix will result in the same pregnancy rates as the long protocol. Several possibilities to explain this phenomenon are discussed.

Chorionic Gonadotropin↗
PubMed2001

Ureteric and pulmonary endometriosis.

Pulmonary lesions and ureter involvement are rare complications of endometriosis. We describe the first case with an involvement of both sites in this condition. The radiographs showed "pulmonary metastases" together with clinical findings of a hydronephrosis, mimicing a malignant metastatic gynecologic tumor of unknown primary. A laparoscopy showed severe endometriotic lesions; therefore the findings were most likely related to the condition of endometriosis. The patient was treated with gosereline acetate for six months (Zoladex). Control radiographs showed complete regression of the pulmonary lesions and the patient is symptom free at 36 months after diagnosis.

Adult↗
PubMed2001

Neurotoxicity of 24-hydroxycholesterol, an important cholesterol elimination product of the brain, may be prevented by vitamin E and estradiol-17beta.

24-Hydroxycholesterol, the main cholesterol elimination product of the brain is increased in serum of Alzheimer patients. This oxysterol behaves neurotoxic towards the human neuroblastoma cell line, SH-SY5Y. Here we demonstrate, that 24-hydroxycholesterol-induced neurotoxicity in differentiated SH-SY5Y cells was due to apoptosis, as indicated by DNA-fragmentation, caspase-3 activation and a decrease of the mitochondrial membrane potential. Free radicals were generated, resulting in the death of 75% of the cells within 48h; neurotoxicity in differentiated SH-SY5Y cells was partially prevented by physiological concentrations of vitamin E (50-100 microM) in that 75% of the cells survived. Physiological concentrations of estradiol-17beta (1-100nM) elicited a protective effect in differentiated cells, which was not significant; however, in undifferentiated cells a significant protection was noted by this steroid hormone. Vitamin C and melatonin did not prevent 24-hydroxycholesterol-induced neurotoxicity. These in vitro data support the in vivo observed beneficial effects reported as circumstantial evidence of vitamin E and estradiol-17beta treatment in the prevention and therapy of neurodegenerative disease.

Antioxidants↗
PubMed2001

Health of 227 children born after controlled ovarian stimulation for in vitro fertilization using the luteinizing hormone-releasing hormone antagonist cetrorelix.

OBJECTIVE: To summarize data from completed phase II and III clinical trials on children born after controlled ovarian stimulation using the luteinizing hormone-releasing hormone antagonist cetrorelix. DESIGN: All children born after ovarian stimulation in patients treated for infertility who were in prospective studies until March 23, 1999. SETTING: Academic research center. PATIENT(S): Children born after IVF or IVF plus ICSI. INTERVENTION(S): Controlled ovarian stimulation with cetrorelix in a multiple-dose or single/dual-dose protocol. MAIN OUTCOME MEASURE(S): Outcome of pregnancy and, in deliveries, the date of birth, number and sex of children born, birth weight, body length, and abnormalities were recorded. At approximately 1 year of age and 2 years of age, body weight and length and abnormalities in physical and mental development were recorded. RESULT(S): Two hundred nine and 18 children were born after fresh and frozen embryo transfers, respectively. Of the pregnancies, 76.2% (179 of 234) resulted in live birth and ectopic pregnancy occurred in 3.4% (8 of 231); one heterotopic pregnancy and four induced abortions were recorded. The malformation rate among all live births, stillbirths, and aborted fetuses was 3.1%. CONCLUSION(S): Use of cetrorelix in controlled ovarian stimulation does not harm the subsequently born children.

Adult↗
PubMed2001

Preimplantation genetic diagnosis: the German situation.

Preimplantation genetic diagnosis makes it possible to detect some genetic disorders in embryos in vitro before they are transferred to the uterus. Using this technique, there is an opportunity for couples who have an increased risk of transmitting severe genetic disorders to their offspring to reduce this risk by >95%. By doing PGD, abortions at a later stage can be avoided.

Ethics, Medical↗
PubMed2001

Preoperative reduction of uterine fibroids in only 16 days by administration of a gonadotrophin-releasing hormone antagonist (Cetrotide).

Ten premenopausal women with symptomatic uterine fibroids confirmed by magnetic resonance imaging (MRI) were treated with four injections (s.c.) of 3 mg of the gonadotrophin-releasing hormone (GnRH) antagonist cetrorelix every 4 days, starting on the first day of cycle. On every fourth day, blood samples were drawn for the measurement of gonadotrophins and sex steroids. On the 17th day of treatment after a final MRI control, myomectomy was performed laparotomically, laparoscopically or hysteroscopically. All patients showed a deep and sustained suppression of gonadotrophins and sex steroids over the treatment time. In three patients, no change or even an increase in uterine fibroids volume was observed according to MRI, and in one patient MRI did not allow a reliable interpretation. However, six patients showed a mean reduction of 31% in fibroid size after only 16 days of hormonal treatment. In nine patients laparoscopic or hysteroscopic myomectomy could be performed, while laparotomy was necessary only in one non-responder. Preparation of the cleavage plane during surgery was easy and blood loss was minimal. Patient compliance was excellent. No side-effects occurred. The GnRH antagonist Cetrotide(R), acting as an intermediate depot preparation at a dose of 3 mg, opens up a new avenue for preoperative short term treatment in a subgroup of patients with uterine fibroids, minimizing treatment time and patient discomfort.

Journal Article↗
PubMed2001

Preimplantation genetic diagnosis in Germany - ethical responsibility and law.

Preimplantation diagnosis (PGD) can be judged as early or brought forward prenatal diagnosis and brings up the ethical question in Germany whether potential selection of embryos and intentional killing of a human conceptus, showing a defect not or almost not compatible with life, is reconcilable with human dignity. Whereas prenatal diagnosis and its consequences are socially accepted in Germany, PGD is not compatible with the Embryo Protection Law and is still under debate since >5 years. On the other hand abortion is not subject to prosecution because the legal status of the mother outweighs that of the embryo or fetus. Here the conflict of two legally protected rights - the embryo's worth of protection and the woman's family planning - are accepted and form the basis of the potential decision of the prospective mother to carry the fetus to term or not. An obvious and deep contradiction of assessment is present between the legal requirements for the regulation of abortions in its amendment of 1995 and the Embryo Protection Law which exists unchanged since 1991. The killing of an embryo or fetus in vivo is not subject to prosecution although it is illegal, whereas the discard of an embryo in vitro after PGD was performed, also illegal, is subject to prosecution.

Journal Article↗
PubMed2001

Evaluation of an optimal luteal phase support protocol in IVF.

SUBJECT: Luteal phase support has been shown in the past to be an essential part of ovarian stimulation protocols, especially the long protocol. It could be shown that hCG is as effective as is progesterone for luteal phase support but hCG is accompanied by a higher rate of complications. METHODS: Progesterone can be administered in several routes. The oral, intramuscular (i.m.) and vaginal routes have been chosen frequently in the past. The oral route is ineffective, since progesterone has a low oral bioavailability (<10%), and a high rate of metabolites, which may result in side effects such as somnolence etc. Intramuscular administration provides very high serum levels of progesterone and this route is effective with regard to pregnancy rates. Injection of progesterone, however, is painful and cannot be done by the patient herself. The vaginal route is also effective, progesterone can be administered by the patient herself and progesterone is delivered directly to the uterus, where high levels are achieved (first uterine pass effect). RESULTS: Several studies could show, in the past, that the vaginal administration of progesterone is effective also with regard to the downregulation of uterine contractions. Crinone 8% Vaginal Gel is especially designed for vaginal use with a special applicator and has to be administered once daily in the morning. It adheres to the vaginal epithelium, and leakage of the gel is substantially reduced as compared to other drugs like capsules or suppositories. CONCLUSIONS: Since progesterone is as effective as hCG for luteal phase support but provides a higher safety with regard to ovarian hyperstimulation syndromes, and vaginal progesterone is as effective as intramuscular progesterone, vaginal progesterone should be the standard choice for luteal phase support. Crinone 8% seems to be the most comfortable way of vaginal administration of progesterone for luteal phase support in IVF cycles.

Administration, Intravaginal↗