Search PubMed⌕ Search

Biomedical subjects

M Müller

Publications and source records attributed to M Müller.

At least 379 records · Page 21Linked to original sources

Rapid and sensitive detection of enhanced green fluorescent protein expression in paraffin sections by confocal laser scanning microscopy.

Various forms of green fluorescent protein (GFP) have become important reporters of gene transfer and expression after transfection or infection of cells in cell culture. Frequently, molecular biological assays (Northern blots, PCR) are applied to detect reporter gene expression in target organs. However, these methods are not suitable for evaluation of tissue- or cell-specific expression which would be of great interest especially in case of using tissue-specific promoters. Therefore, organs of transgenic mice with the enhanced green fluorescent protein (EGFP) gene under control of the cytomegalovirus (CMV) promoter were processed for histology by formaldehyde fixation and embedding in paraffin. Sections were deparaffinized, mounted and evaluated for fluorescence in a confocal laser scanning microscope. This method combines the advantages of direct exploitation of tissue sections without further staining procedures with evaluable tissue-, cell-, and even subcellular-specific distribution patterns of EGFP expression in tissues. Results obtained by direct evaluation of EGFP fluorescence in paraffin sections were confirmed by immunohistochemical staining with anti-EGFP. In the present report, we demonstrate that application of confocal microscopy on routinely processed histological preparations is very suitable for determining gene transfer efficiency and promotor activities.

Animals↗

Relationship between in vivo drug exposure of the tumor interstitium and inhibition of tumor cell growth in vitro: a study in breast cancer patients.

A novel approach is described to simulate effect site pharmacodynamics of anticancer drugs. This approach is based on (i) the in vivo measurement of unbound, interstitial drug pharmacokinetics (PK) in solid tumor lesions in patients and (ii) a subsequent pharmacodynamic (PD) simulation of the time versus drug concentration profile in an in vitro setting. For this purpose, breast cancer cells (MCF-7) were exposed in vitro to the time versus interstitial tumor concentration profiles of 5-fluorouracil (5-FU) and methotrexate (MTX) from primary breast cancer lesions in patients. This led to a maximal reduction in the viable cell count of 69% on day 4, and of 71% on day 7 for 5-FU and MTX, respectively. This effect was dependent on the initial cell count and was characterized by a high interindividual variability. For 5-FU there was a significant correlation between the maximum antitumor effect and the intratumoral AUC (r = -0.82, p = 0.0005), whereas no correlation could be shown for MTX (r = 0.05, p = 0.88). We conclude, that the in-vivo-PK / in-vitro-PD model presented in this study may provide a rational approach for describing and predicting pharmacodynamics of cytotoxic drugs at the target site. Data derived from this approach support the concept that tumor penetration of 5-FU may be a response-limiting event, while the response to MTX may be determined by events beyond interstitial fluid kinetics.

Antimetabolites, Antineoplastic↗

Concomitment spread of a renal cell carcinoma beyond the kidney and a transitional cell carcinoma beyond the bladder.

We report the case of a 61-year-old man, with a rare combination of two advanced urological tumors: a concomitant spread of an adenocarcinoma beyond the kidney and a urothelial carcinoma beyond the bladder. We simultaneously performed a primary curative prostatovesiculectomy and a nephroureterectomy on the right with ileal neobladder. To our knowledge, a case report of concomitant spread of an adenocarcinoma beyond the kidney (pT3 pN0 M0 G3) and a urothelial carcinoma beyond the bladder (pT3a pN0 M0 G3) with subsequent curative therapy has thus far not been published. A combination of the two diseases described here is obviously a remarkable rarity.

Carcinoma, Renal Cell↗

[Advanced and continuing education is an important indicator of professional satisfaction in nursing].

The subject of this quantitative study is the job-satisfaction of nursing staff at the Freiburg Tumorbiology Clinic. The aim was to identify factors which influenced job-satisfaction. Originally 127 questionnaires were distributed and the final evaluation was based on 89 completed returns. With the information, using factor analysis, we identified nine factors. One of the factors, continuing education was interpreted and evaluated in detail. The results showed that in general women including managers and supervisors have a more positive attitude toward further training than men. The data could not confirm if a positive attitude toward training positively influenced job-satisfaction or that a prior satisfaction with the job leads to a positive attitude towards training. What is clear is that continuing education enables employees to be more competent and handle more responsibility. From the point of view of both the employees and employers it is necessary to have constantly updated knowledge to ensure highest quality of nursing care.

Education, Nursing, Continuing↗

Effects of dopexamine and volume loading on hemodynamics and oxygenation parameters in patients undergoing pulmonary resection.

BACKGROUND: Pulmonary resection may result in a reduction in arterial oxygen pressure as well as in cardiac output. Since cardiac index, oxygen delivery, and oxygen consumption are considered as important determinants of patients' outcome, we evaluated the effects of dopexamine and volume loading on cardiopulmonary variables in patients undergoing pulmonary resection. METHODS: Forty adult patients undergoing pulmonary resection for lung or bronchial tumors were included in an open placebo-controlled study. The patients were selected according to a randomized sequence to group A (n=20) or group B (n=20). Dopexamine (2 microg x kg(-1) x min(-1)) was started when steady state conditions were achieved after induction of anesthesia in group A. Saline 0.9% was given as control (group B). Hemodynamic monitoring was performed using a pulmonary artery catheter. RESULTS: Dopexamine increased heart rate, cardiac output and oxygen delivery compared with control without increasing oxygen consumption during anesthesia and surgery. Furthermore, dopexamine was found not to alter the course of PaO2/FiO2 values. CONCLUSION: In patients undergoing pulmonary resection, dopexamine can be used perioperatively to increase cardiac index without decreasing the PaO2/FiO2 ratio.

Aged↗

Cognitive outcome after bacterial meningitis.

OBJECTIVE: To evaluate long-term cognitive deficits in unselected patients with previously diagnosed meningitis and to compare these deficits to neurologic and psychopathologic impairment. PATIENTS AND METHODS: Twenty-two unselected patients (mean age 52.5 +/- 17.1 years) were examined neurologically, psychiatrically, and psychometrically 30 +/- 11 months after the acute stage of bacterial meningitis. Results of psychometric tests were compared with clinical long-term deficits. Psychometric tests were additionally applied on 17 healthy controls (mean age 49.2 +/- 14.2 years). RESULTS: Neurologic or psychopathologic symptoms were found in 16 patients. Psychometrically, the speed of cognitive processes and psychomotor performance, concentration, visuoconstructive capacity, and memory functions were reduced significantly in patients as compared to controls. Verbal intelligence was less affected than performance efficiency. Patients with pneumococcal meningitis had significantly lower test results than patients with other pathogens. The psychometric test results were only slightly related with clinical findings of the follow-up examination. CONCLUSION: Psychometric deficits are frequent after bacterial meningitis, and their relation with neurologic and psychopathologic symptoms is loose. The pattern of neuropsychologic impairment accentuates psychomotor slowing combined with memory disturbances, and resembles features observed in subcortical cognitive impairment.

Acute Disease↗

New controlled environment vitrification system for cryo-transmission electron microscopy: design and application to surfactant solutions.

A newly designed controlled environment vitrification system for cryo-transmission electron microscopy of vitrified samples (cryo TEM) is presented. It significantly reduces the lag-time from blotting to vitrification by means of an optimized blotting procedure. Furthermore, a modified transfer system allows rapid transfer of the vitrified sample into the microscope and reduces the equilibration time. The practicable throughput of samples is thereby markedly increased. This new equipment is used to determine the overall size of individual polymer-like mixed lecithin-bile salt micelles, which very critically depends on the composition of the sample. The quantitative agreement with the results from independent light scattering experiments on the same sample supports the validity and performance of the presented sample preparation and handling procedures. In addition, these experiments demonstrate that cryo TEM experiments not only provide direct structural information, but furthermore permit a quantitative determination of micellar properties.

Bile Acids and Salts↗

Eosinophil granule proteins in serum and urine of patients with helminth infections and atopic dermatitis.

Eosinophil cationic protein (ECP) and eosinophil-derived neurotoxin (EPX) are cytotoxic molecules involved in helminth infections and allergic reactions. Hitherto most clinical chemical studies have been concerned with the analysis of serum ECP in allergic diseases. The aim of this study was to examine whether serum as well as urine levels of these proteins are useful clinical chemical parameters in helminthiases and allergic diseases such as atopic dermatitis. Comparing these diseases under the same methodological conditions, levels of ECP and EPX were generally higher in helminthiases than in atopic dermatitis and non-helminth, non-allergic diseases. The highest levels of both proteins occurred in tropical worm diseases, in particular hookworm disease and onchocerciasis. When comparing helminthiases with allergic disorder, only hookworm disease (ECP and EPX) and onchocerciasis (EPX) exhibited significantly higher eosinophil cationic protein serum levels than atopic dermatitis. In patients with schistosomiasis mansoni and egg loads of > 1000-10 000 eggs/g stool (epg) EPX serum levels were significantly higher than in patients exhibiting loads < 1000 epg. Urinary analyses revealed only EPX to be present in measurable amounts. Levels of this protein were much higher in urine of patients with hookworm disease and onchocerciasis than in those with atopic dermatitis and in healthy controls. The results suggest that besides serum EPX, urinary EPX may be a useful clinical chemical parameter in eosinophilia of helminth and allergic aetiology.

Adolescent↗

Regulation of multidrug resistance 2 P-glycoprotein expression by bile salts in rats and in primary cultures of rat hepatocytes.

Biliary phospholipid secretion is tightly coupled to the secretion of free cholesterol and bile salts. The secretion of phospholipids across the canalicular membrane of hepatocytes occurs via the multidrug resistance 2 (mdr2) P-glycoprotein (Pgp). The mechanism underlying the coupling of bile salt and phospholipid secretion has not been elucidated. The aims of this study were to determine the effects of bile acid structure on the expression of mdr2 in vitro and in vivo. Under optimal culture conditions, taurine-conjugated bile acids (50 micromol/L) increased mdr2 messenger RNA (mRNA) levels in the following order: taurocholate (TCA) (288 +/- 36%, P <. 005) = taurodeoxycholate (TDCA) (276 +/- 36%, P <.025) > taurochenodeoxycholate (TCDCA) (216 +/- 34%, P <.025) > tauroursodeoxycholate (TUDCA) (175 +/- 28%, P <.05) of control levels. The increase in mdr2 mRNA levels by TCA was both time and concentration dependent. Cholate feeding to rats with intact enterohepatic circulation increased mdr2 transcriptional activity by 4-fold and protein mass by 1.9-fold. Chronic biliary diversion (CBD) decreased mdr2 mRNA levels to 66 +/- 9% (P <.025) of sham-operated controls. Intraduodenal infusion of TCA for 48 hours in CBD rats caused a significant increase in mdr2 mRNA levels (224%) as compared with CBD controls. A diet high in cholesterol (4%) decreased mdr2 mRNA levels to 57% +/- 2 (P <.001) of pair-fed controls. Squalestatin (1 micromol/L), an inhibitor of cholesterol biosynthesis, increased mdr2 mRNA levels by 8.8-fold (P <.005) in hepatocyte cultures after 24 hours. In conclusion, in the rat, bile acids up-regulated mdr2 transcriptional activity whereas cholesterol decreased mdr2 mRNA both in vitro and in vivo.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

Deficient activation of CD95 (APO-1/Fas)-mediated apoptosis: a potential factor of multidrug resistance in human renal cell carcinoma.

The pronounced resistance of human renal cell carcinoma (RCC) to anticancer-induced apoptosis has primarily been related to the expression of P-glycoprotein and effective drug detoxification mechanisms. Because the CD95 system has recently been identified as a key mediator of anticancer drug-induced apoptosis, we analysed the contribution of the CD95 system to chemotherapy-induced apoptosis in four newly established RCC cell lines. Here, we demonstrate that all RCC cell lines expressed CD95-receptor and -ligand. Exposure to agonistic anti-CD95 antibodies resulted in induction of apoptosis and significant (P < 0.05) reduction of cell number in three out of four cell lines, indicating that the essential components for CD95-mediated apoptosis were present and functionally intact in the majority of these RCC cell lines. Moreover, treatment of cultures with bleomycin or topotecan, a novel topoisomerase I inhibitor with little substrate affinity for P-glycoprotein, led to induction of apoptosis and significant (P < 0.05) dose-dependent reduction of cell number in all RCC cell lines. Both anticancer drugs also induced upregulation of CD95 ligand expression in all cell lines. Additionally, augmentation of CD95 receptor expression was found in three RCC cell lines, including one p53-mutated cell line, whereas another p53-mutated cell line showed no or only a weak CD95 receptor upregulation after exposure to topotecan or bleomycin, respectively. Despite this upregulation of CD95 receptor and ligand, antagonistic antibodies directed against CD95 receptors or ligands could not inhibit induction of apoptosis by topotecan and bleomycin in any cell line. Thus, although a functionally intact CD95 signalling cascade is present in most RCC cell lines, the anticancer drugs topotecan and bleomycin that induce upregulation of CD95 receptor and ligand fail to effectively activate CD95-mediated apoptosis. This deficient activation of CD95-mediated apoptosis might be an important additional factor for the multidrug resistance phenotype of human RCCs.

Antineoplastic Agents↗

[Recovery of balanced anesthesia with various inhalation anesthetics in comparison to intravenous anesthetics: a retrospective analysis of 20,060 patients].

BACKGROUND: The aim of this investigation was to compare routine balanced anaesthesia with different inhalation agents to intravenous anaesthesia (IVA) using an Anaesthesia-Information-Management-System (AIMS) with regard to time of recovery from anaesthesia, the time of discharge from the postanaesthesia care unit (PACU) and postoperative nausea as well as postoperative therapy with analgesics. METHODS: In 1997 and 1998 all relevant data of each anaesthesia procedure have been recorded using the online documentation Software NarkoData. These data sets have been stored into a relational database during each anaesthesia procedure. For evaluation the information has been exported from the database to a statistics program via 'Structured Query Langvage' (SOL). Balanced anaesthesia has been performed using isoflurane, halothane, and sevoflurane, respectively, supplemented with or without nitrous Oxide (N2O). The intravenous based anaesthesia-groups included propofol-fentanyl or propofol-remifentanil. RESULTS: The fastest recovery was seen in patients of the isoflurane group (11.2 +/- 7.7 minutes), and the longest time for extubation was observed in patients wich halothane anaesthesia (12.8 +/- 9.3 minutes); the overall mean difference was 1.7 minutes. The earliest patient admitted to the PACU had received sevoflurane (7.0 +/- 6.3 minutes) and propofol-remifentanil (7.0 +/- 7.4 minutes) whereas patients of the halothane group (9.5 +/- 7.5 minutes) took more. The shortest stay in PACU was seen in patients of the sevoflurane and isoflurane groups (105.13 +/- 35.7 and 108.4 +/- 60.5 minutes), whereas propofol-remifentanil (126.2 +/- 89.1 minutes) and halothan (120.0 +/- 86.1 minutes) anaesthetised patients had the longest stay in PACU. No difference was noted in the incidence of postoperative nausea and vomiting nor in the amount of postoperatively given analgesics. CONCLUSION: Results achieved in routine correspond only in part to results from studies. In our investigation balanced anaesthesia with isoflurane and sevoflurane correspond with the shortest stay in PACU compared to balanced anaesthesia with halothane and IVAs with propofol-fentanyl or propofol-remifentanil. One reason for this could be the intraoperatively administered opioide piritramide in IVAs. Furthermore we conclude that an AIMS may provide additional information about overall costs-effectiveness. However this information depends largely on local factors, e.g. patient case mix, staffing, policy of discharge from the PACU etc.

Adolescent↗

[3D-spectrogram of the doppler signal in real time].

AIM: Doppler signals are normally displayed as an x/y-graph. The frequency is plotted in the y-direction, and the intensity is represented by the brightness. This represents less information than is contained in the acoustic signal: often one can hear more one can see. We are investigating the question as to whether it is feasible to render the complete information visible without the use of expensive additional equipment. METHOD: The sound card (SB16 P&P value edition) in a Pentium-PC (200 MHz 32 MB RAM) was used as a 16 bit dual channel a/d converter and connected to the ultrasound system Sonoline Elegra (Siemens, Erlangen, Germany). We used a standard 32 bit dual channel real-time FFT-software (SpectraPro, Sound Technology, California) to display a 3D-spectrogram on the PC-screen in real-time mode. This system was first tested on a flow model both with laminar steady flow and with pulsatile flow. Following this, measurements were made of the arteries and veins in healthy volunteers. RESULTS: In the 3D-Spectrogram the character of the flow can easily be seen. The quantitative parameters of velocity (Doppler frequency), direction and intensity of flow can be readily determined. Additional information about quality of flow, erythrocyte clusters and changes occurring in areas of slight stenoses can be used for diagnostic evaluation. The orthograde and retrograde flow are displayed separately using the dual channel technique. The arterial and venous flow in small and closely neighbouring vessels, such as the central retinal artery and vein, can easily be differentiated. The venous flow in particular is more turbulent in the 3D-spectrogram than would be expected from the normal display mode. CONCLUSION: The 3D-spectrogram provides much additional information in comparison with the normal Doppler spectrogram of the ultrasound system. This 3D-spectrogram can be easily obtained using inexpensive standard hard- and software.

Arteries↗

Transcriptional control of hepatocanalicular transporter gene expression.

Transport processes for larger organic solutes at the canalicular membrane are mainly driven by members of the superfamily of ATP-binding cassette (ABC) transporters. The functions of these transporters range from bile component secretion to xenobiotica and phase II-conjugate export. The transcriptional control of the expression of their respective genes differs, and this may be to guarantee tissue specificity, effective response to stress, or changes in substrate concentrations. Inside the nucleus, the concentration of competing and specifically activated transcription factors determines the transcriptional activation in transporter gene expression. Some transcription factors function as sensors for metabolites (LXR, FXR, CAR, SREBP, PPARs), xenobiotics (PPARs, PXR), oxidative stress (NF-kappa B, AP-1), or DNA damage (p53). Changes in their nuclear concentrations and activity will influence the transcription rates of the respective target genes that contain specific responsive elements in their 5'-promoter/enhancer DNA sequences. Until now little was known about the transcriptional control of most ABC transporter proteins. However, due to the enormous progress in molecular biology, many tools have become recently available to study and understand the "battle inside the nucleus" with respect to hepatic transporter gene expression.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

Target site concentrations after continuous infusion and bolus injection of cefpirome to healthy volunteers.

BACKGROUND: Recent data indicate a higher level of effectivity of beta-lactam antibiotics if serum concentrations are kept above the minimal inhibitory concentration (MIC) of the pathogen. This concept would favor continuous infusion over bolus dosing. However, it is usually not the serum concentration but the free interstitial concentration in the target tissue that determines antibiotic activity. We therefore set out to measure effective drug concentrations in the interstitial space of muscle and subcutaneous adipose tissue and to compare trough levels and times above the MIC after bolus versus continuous infusion of cefpirome. METHODS: Twelve healthy volunteers received a single dose of 2 g cefpirome as an intravenous bolus or as a continuous infusion over 8 hours in a crossover design, and the resulting free interstitial tissue concentrations were measured with use of microdialysis. RESULTS: After bolus injection, mean interstitial trough concentrations were 3.0 +/- 1.9 microg/mL and 2.1 +/-1.0 microg/mL for muscle and subcutaneous tissue, respectively; continuous infusion resulted in trough levels of 10.1 +/- 6.8 microg/mL and 10.1 +/- 4.6 microg/mL for muscle and subcutaneous tissue, respectively. This resulted in significantly longer times above the MIC with continuous infusion for Staphylococcus epidermidis and Enterobacter cloacae. Bacteria with an MIC < or =1 would be covered by either method, whereas higher doses seem to be necessary for Pseudomonas aeruginosa. CONCLUSION: Although susceptible organisms will usually be covered sufficiently with standard dosing regimens, soft tissue infections with bacteria that have MIC values of 2 to 8 may profit from continuous application. Coverage of P aeruginosa, however, would be inadequate with conventional daily doses of 4 g cefpirome regardless of the method of application.

Adult↗