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Biomedical subjects

M Scholz

Publications and source records attributed to M Scholz.

At least 109 records · Page 6Linked to original sources
PubMed2000

Transcranial magnetic-evoked potentials under total intravenous anaesthesia and nitrous oxide.

Magnetic stimulation of the cortex and recording of the motor-evoked potentials (MEPs) by electromyography (EMG) is a well proven method to assess the descending pathways of the spinal cord and detect neurological impairment. We have assessed, in 33 adult patients undergoing spinal surgery, the influence of four total i.v. anaesthesia regimens (TIVA) on this recording technique. In 20 patients, the effect of 50% nitrous oxide was also studied. MEP amplitudes, latencies and success rates of stimulation were obtained in the steady-state after induction of anaesthesia. Combinations of midazolam and ketamine, and alfentanil and etomidate had the least effect on MEPs. Propofol (in combination with alfentanil or ketamine) showed marked depression of the MEP amplitude and the lowest success rates of stimulation. The latencies did not change at all. The addition of nitrous oxide significantly depressed the registered MEPs and lowered the success rates.

Alfentanil↗
PubMed2000

Bedside assessment of cerebral blood flow by double-indicator dilution technique.

BACKGROUND: Currently, quantitative measurement of global cerebral blood flow (CBF) at bedside is not widely performed. The aim of the present study was to evaluate a newly developed method for bedside measurement of CBF based on thermodilution in a clinical setting. METHODS: The investigation was performed in 14 anesthetized patients before coronary bypass surgery. CBF was altered by hypocapnia, normocapnia, and hypercapnia. CBF was measured simultaneously by the Kety-Schmidt inert-gas technique with argon and a newly developed transcerebral double-indicator dilution technique (TCID). For TCID, bolus injections of ice-cold indocyanine green were performed via a central venous line, and the resulting thermo-dye dilution curves were recorded simultaneously in the aorta and the jugular bulb using combined fiberoptic thermistor catheters. CBF was calculated from the mean transit times of the indicators through the brain. RESULTS: Both methods of measurement of CBF indicate a decrease during hypocapnia and an increase during hypercapnia, whereas cerebral metabolic rate remained unchanged. Bias between CBF(TCID) and CBFargon was -7.1+/-2.2 (SEM) ml x min(-1) x 100 g(-1); precision (+/- 2 x SD of differences) between methods was 26.6 ml x min(-1) x 100 g(-1). CONCLUSIONS: In the clinical setting, TCID was feasible and less time-consuming than alternative methods. The authors conclude that TCID is an alternative method to measure global CBF at bedside and offers a new opportunity to monitor cerebral perfusion of patients.

Aged↗
PubMed2000

Bedside monitoring of cerebral blood flow in patients with acute hemispheric stroke.

OBJECTIVE: To test the practicability of a new double indicator dilution method for bedside monitoring of cerebral blood flow (CBF) and to assess the clinical value of CBF monitoring as a prognostic tool for outcome and in therapy of elevated intracranial pressure (ICP) in patients with acute hemispheric stroke. DESIGN: Prospective study. Clinical evaluation of a new method. SETTING: Neurological intensive care unit of a university hospital. PATIENTS: Ten patients with acute complete middle cerebral artery territory- or hemispheric infarctions. INTERVENTIONS: Two combined fiberoptic thermistor catheters were placed in the right jugular bulb and in the thoracic aorta. Central venous injections of ice-cold indocyanine green dye were performed. CBF was estimated by calculating the mean transit times of the cold bolus and dye. MEASUREMENTS AND MAIN RESULTS: A total of 104 reproducible CBF measurements were obtained. No complications associated with the method were observed. Twelve pairs of measurements were performed within 30 mins with unchanged clinical conditions. The standard deviation of repeated measurements was 2.7 mL/100 g/min; the interrater reliability was between 0.95 and 0.99. The median CBF in patients who died (n = 4) was lower (27 mL/100g/min) than in those who survived (n = 6) (45 mL/100g/ min). Patients who died more frequently had low CBF values of <30 mL/100g/min (22 of 38; 58%) than patients who survived (10 of 54; 19%). A total of 37 CBF measurements were done during ICP elevation of >20 mm Hg. In patients who survived, ICP elevations were only associated with low CBF values in 5 of 26 events; whereas in patients who died, ICP elevations were associated with low CBF values in 8 of 11 events. CONCLUSIONS: The new double indicator dilution technique may be suitable for serial bedside CBF measurement. It is easy to perform and can be rapidly repeated in the ICU environment. Validation of the method by comparison with standard methods is needed. The preliminary data indicate that bedside monitoring of CBF may give prognostic information for outcome and may guide therapy of elevated ICP in patients with malignant hemispheric infarction.

Acute Disease↗
PubMed2000

Value of free prostate-specific antigen (Hybritech Tandem-R) in symptomatic patients consulting the urologist.

INTRODUCTION: Prostate-specific antigen (PSA) is a widely used tumor marker in the detection and follow-up of adenocarcinoma of the prostate. Selection of candidates for prostate biopsies is hampered by the lack of specificity resulting in a large number of unnecessary biopsies. The intention of our study was to compare the percent free PSA (f-PSA; Hybritech Tandem-R) with total PSA and age-specific PSA reference values to evaluate the clinical benefit in detecting patients with prostate cancer (PC) in a selected group of patients consulting the urologist. The question was whether cutoff points are influenced by this selection of patients. METHODS: A total of 188 patients, 114 with benign prostate hyperplasia (BPH) and 74 with PC were selected. It is a selected group of patients consulting the urologist. Diagnosis was confirmed in the BPH and PC groups by either ultrasound-guided biopsy or transurethral resection of the prostate or suprapubic adenomectomy or cystoprostatectomy. Total PSA (t-PSA) and f-PSA of all patients were measured before any manipulation by Tandem-R assay for f-PSA and Tandem-E assay for t-PSA (Hybritech). Mean values of age, prostate volume, t-PSA, f-PSA, percent f-PSA were compared in patients with BPH and PC by Mann-Whitney U test. The sensitivity and specificity of t-PSA and age-specific PSA were compared to the sensitivities and specificities of different cutoff points of percent f-PSA. RESULTS: The mean value of t-PSA, f-PSA and percent f-PSA in patients with BPH (n = 114) and PC (n = 74) were statistically significantly different. At PSA levels between 4 and 10 ng/ml 19% of negative biopsies could be avoided by the use of percent f-PSA (cutoff point 25%). There was no additional benefit of age-specific PSA. At a PSA of <4 ng/ml 6 of 7 PCs could be diagnosed by percent f-PSA (cutoff point 25%), whereas only 1 patient would be diagnosed by age-specific PSA. CONCLUSION: Percent f-PSA seems to decrease the biopsy rate at PSA levels from 4 to 10 ng/ml without missing a relevant number of cancers and to increase the detection rate at PSA <4 ng/ml. Our data indicate that it might be necessary to choose high cutoff points (25%; Tandem-E and R assay, Hybritech) in a selected study population consulting the urologist with large glands and a high prevalence of disease. However, this situation is not comparable to testing of screening populations. No benefit of age-specific PSA could be observed in this study.

Aged↗
PubMed2000

Deconvolution of event-related fMRI responses in fast-rate experimental designs: tracking amplitude variations.

Recent developments towards event-related functional magnetic resonance imaging has greatly extended the range of experimental designs. If the events occur in rapid succession, the corresponding time-locked responses overlap significantly and need to be deconvolved in order to separate the contributions of different events. Here we present a deconvolution approach, which is especially aimed at the analysis of fMRI data where sequence- or context-related responses are expected. For this purpose, we make the assumption of a hemodynamic response function (HDR) with constant yet not predefined shape but with possibly variable amplitudes. This approach reduces the number of variables to be estimated but still keeps the solutions flexible with respect to the shape. Consequently, statistical efficiency is improved. Temporal variations of the HDR strength are directly indicated by the amplitudes derived by the algorithm. Both the estimation efficiency and statistical inference are further supported by an improved estimation of the noise covariance. Using synthesized data sets, both differently shaped HDRs and varying amplitude factors were correctly identified. The gain in statistical sensitivity led to improved ratios of false- and true-positive detection rates for synthetic activations in these data. In an event-related fMRI experiment with a human subject, different HDR amplitudes could be derived corresponding to stimulation at different visual stimulus contrasts. Finally, in a visual spatial attention experiment we obtained different fMRI response amplitudes depending on the sequences of attention conditions.

Algorithms↗
PubMed2000

Immediate localized CDKN1A (p21) radiation response after damage produced by heavy-ion tracks.

Using confocal microscopy on immunofluorescence-stained cells, we have investigated the response of CDKN1A (p21), one of the key proteins involved in the DNA damage response pathway, after irradiation with accelerated lead or chromium ions. Each traversal of an accelerated ion leads to the formation of a single, bright focus of the CDKN1A protein in the nuclei of human fibroblasts within 2 min after irradiation at 4 degrees C. This immediate, localized CDKN1A response is specific for particle irradiation with a high linear energy transfer (LET), whereas X irradiation, after a period of induction, yields a diffusely spread pattern, in line with the differences in the microscopic dose deposition pattern of both radiation types. The particle-induced CDKN1A foci persist for several hours until they become diffuse and vanish. These findings suggest that CDKN1A accumulates at the sites of primary DNA damage, possibly mediated by the interaction with proteins involved in DNA repair. Here, for the first time, an immediate biological response confined to the radial extension of low-energy particle tracks ( approximately 1 micrometer) is directly visualized and correlated to ion traversals. This indicates that particle irradiation represents an ideal tool to study the processing of biological damage induced in defined subnuclear regions.

Cells, Cultured↗
PubMed2000

Virtual image navigation: a new method to control intraoperative bleeding in neuroendoscopic surgery. Technical note.

In this neuroendoscopic study the authors tested the newly developed "red-out module" of their visual navigation system that enables the neurosurgeon to achieve hemostasis if total visualization is lost due to hemorrhage ("red out") within the visual field. An optical position measurement system connected to the endoscope guarantees that digitized endoscopic images are coupled with the accurate endoscopic position. Computerized images are simultaneously stored with their respective position data, and this creates a virtual anatomical landscape. The system was tested in in vivo bleeding conditions in a rat model. Artificial endoscopic cavities were created in the inguinal, pelvic, and jugular regions in rats to imitate the conditions of the human ventricular system. Two experimental settings were tested: Technique I, in which a computer landmark has been previously determined at the point where the vessel will be lesioned; and Technique II, in which a landmark has been previously set in the surrounding area of the vessel. Immediately after hemorrhage obscures the visual field (red out), the computer automatically displays the virtual images on a separate monitor. The previously set landmarks and the graphic overlay of the coagulation fiber enable the surgeon to navigate within the operative field based on the virtual images and to perform coagulation at the site of the lesion. A total of 175 vessels were coagulated: 43 arteries and 132 veins. In using Technique I, 130 (90.9%) of 143 vessels and in using Technique II, 26 (81.2%) of 32 arteries were successfully coagulated. The authors' data revealed that virtual image guidance has the potential to be a helpful tool in neuroendoscopy.

Animals↗
PubMed2000

[Molecular genetic analysis for taxonomic determination of fossil skull fragments of Warendorf-Neuwarendorf].

The isolation and examination DNA segments from prehistoric and fossil bone samples has become one of the biggest challenges in anthropology within the past years. By using specially developed and/or adapted genetic methods, it is possible under laboratory conditions to amplify portions of DNA from bone remains in states of good preservation by the polymerase chain reaction (PCR). DNA sequence data can provide far more specific answers to palaeanthropological questions than one would expect solely by morphologic comparison. Here we introduce an alternative approach for the classification of total ancient DNA by means of Southern hybridisation techniques.

Anthropology, Physical↗
PubMed2000

High-density vaginal Ureaplasma urealyticum colonization as a risk factor for chorioamnionitis and preterm delivery.

BACKGROUND: The aim of this case control study was to investigate the influence of genital Ureaplasma urealyticum colonization on pregnancy outcome. METHODS: One hundred and seventy-two women colonized with Ureaplasma urealyticum without co-existing other infections and 123 women with negative cultures for Ureaplasma urealyticum were enrolled. In a multivariate analysis the influence of quantitative Ureaplasma urealyticum colonization level was determined. RESULTS: Compared to the negative women increasing colonization with Ureaplasma urealyticum was associated with a significant decrease of birth weight (p<0.0001) and gestational age (p<0.0001) and with a significant increase of chorioamnionitis (p<0.0001) and preterm delivery (p<0.001). In a multivariate analysis high-density Ureaplasma urealyticum colonization was an independent risk factor for chorioamnionitis and preterm delivery, whereas low colonization levels had no effect on an adverse outcome of pregnancy. CONCLUSIONS: The degree of colonization with Ureaplasma urealyticum correlates strongly with an adverse effect on pregnancy outcome.

Adult↗
PubMed2000

[Contamination through preparation: risk of molecular genetic studies by using biological preservatives for museum collections].

In paleogenetic science, artifacts (i.e. non-authentic DNA sequences) are mainly produced by cryptic contamination with (i) edaphon DNA sequences and/or (ii) human biomolecules derived from the involved researchers and the laboratory equipment. A third, and yet underestimated source of contamination with exogenous nucleic acids is provided by (iii) conservation practices applied to old material. Bone glue has been successfully used from the beginning of the 19th century up to the middle of this century, and comprises a rich source of non-authentic nucleic acids. An unequivocal identification of treated samples remains difficult since bone and the glue used for conservatory purposes bear similar chemical properties. Since the majority of agents used for the preservation of museum collections are of biological origin, the differentiation between contaminated and non-treated samples is required.

Artifacts↗
PubMed2000

Cremation practices and the survival of ancient DNA: burnt bone analyses via RAPD-mediated PCR.

Numerous burial rites have been developed in different time periods of human cultural evolution. One of the most interesting burial practices was the ritual cremation of human bodies. Due to the respective cultural and religious background, brand graves are known where human remains had been buried together with burnt bones of animal origin. To date, burnt bone samples have been refractory to PCR-mediated amplification. D/L values of aspartic acid far greater than 80 x 10(-3) were measured in the samples thus indicating the presence of severely nicked and fragmented nucleic acids. In order to differentiate between burial gift of animal origin and burnt human specimens we established a highly sensitive protocol that addresses all the shortcomings connected to degraded ancient DNA. With the novel procedure it was possible to classify 4 specimens ranging from 2,000-5,000 BP on the basis of mitochondrial DNA sequences.

Age Determination by Skeleton↗
PubMed2000

Loss of heterozygosity and microsatellite instability as predictive markers for neoadjuvant treatment in gastric carcinoma.

We analyzed a group of gastric carcinomas treated with a cisplatin-based neoadjuvant chemotherapy regimen for microsatellite instability (MSI) and loss of heterozygosity (LOH) to determine whether there is any relation between microsatellite alterations and therapy response. Pretherapeutic endoscopic biopsies of 37 patients were studied at 11 microsatellite loci. Thirteen (35%) had a complete or partial clinical response (responders), and 24 (65%) had only a minor or no response (nonresponders). High-grade MSI was found in two tumors, both nonresponders, whereas low-grade MSI was found in five biopsies, including three non-responders and two responders. Regarding LOH, the most obvious differences between the groups were observed on chromosome 17p13, the location of the p53 gene, with 7 of 12 (58%) and 3 of 20 (15%) of the informative tumors exhibiting LOH in responders and nonresponders, respectively (P = 0.018). A statistically significant difference was also observed in the fractional allelic loss (FAL) ratio of the groups. Among the 13 responding patients, 7 (54%) tumors exhibited high FAL (>0.5-0.75), 2 (15%) showed medium FAL (>0.25-0.5), and 4 (31%) demonstrated low FAL values (0-0.25), whereas among the 22 nonresponding patients, 2 (9%) tumors showed high FAL, 5 (23%) showed medium FAL, and 15 (68%) showed low FAL (P = 0.020). These data suggest that LOH at chromosome 17p13 is associated with a good clinical response to cisplatin-based chemotherapy, suggesting that altered p53 function might render cells more sensitive to therapy. Furthermore, the association of FAL with therapy response indicates that gastric carcinomas with a high level of chromosomal alteration may be more sensitive to this type of chemotherapy.

Adult↗
PubMed2000

Adaptor-mediated amplification of minute amounts of severely fragmented ancient nucleic acids.

It has been repeatedly shown that high copy number mitochondrial DNA sequences can be recovered from ancient samples. A significant increase in the volume of information available to researchers will be observed when the amplification of nuclear DNA becomes commonplace and reproducible. To this end we established a modification of the Rapid Amplification of cDNA Ends (RACE) procedure normally used for the generation of cDNA ends from adaptor-ligated expressed sequence tag libraries. The modifications were designed to specifically address the problems associated with the highly damaged nucleic acids extracted from palaeontological specimens. For this study we used 6 human samples dating to 450 AD and approximately 6.500 BP that were refractory to reliable amplification of single copy loci by PCR. Racemate contents (ratio of D/L enantiomers) of aspartic acid, alanine, and leucine also indicated that no amplifiable DNA is present in 5 of the 6 samples. The proposed technique allowed us (i) to amplify four X-chromosomal loci from 5 human specimens, and (ii) to correct allelic drop-out phenomena at the amelogenin locus in one individual; thus showing that the threshold of 80 x 10-3 for D/Lasp as a borderline for the presence/absence of amplifiable aDNA requires reassessment. Reliability of the proposed technique (i.e. amplification of DNA sequences endogenous to the find) was validated by the application of "ancient RACE" (aRACE) to prehistoric animal samples.

Journal Article↗
PubMed1999

Antiviral and immunomodulatory effects of desferrioxamine in cytomegalovirus-infected rat liver allografts with rejection.

BACKGROUND: Cytomegalovirus (CMV) infection is associated with acute and chronic allograft rejection. We have recently shown that rat CMV increases portal inflammation and bile duct destruction in a model of rat liver allograft rejection. Desferrioxamine (DFO), an iron chelator and antioxidant, has recently been demonstrated to have antiviral as well as immunomodulatory effects in vitro. We therefore investigated whether DFO inhibits (a) CMV infection and (b) graft destruction in our rat model. METHOD: One day after liver transplantation, PVG (RT1c) into BN(RT1n), the rats were infected with rat CMV (RCMV, Maastricht strain; 10(5) plaque-forming units i.p.). The effects of 100 mg/kg body weight and 200 mg/kg body weight DFO were examined. RESULTS: In the untreated group, the grafts were uniformly RCMV culture-positive. In the group receiving 200 mg/kg DFO, RCMV replication was effectively inhibited. Inflammatory response in the graft, and especially the number of macrophages, was significantly reduced by DFO. Portal inflammation and bile duct destruction were also significantly reduced. In the untreated group, the bile duct epithelial cells were found to be strongly positive for tumor necrosis factor-alpha and this expression was clearly decreased by DFO. In addition, DFO significantly inhibited vascular cell adhesion molecule-1 expression on sinusoidal endothelial cells. CONCLUSIONS: Our in vivo transplant study strongly supports the inhibitory effects of metal chelators on CMV infection and their possible usefulness in the treatment of CMV-induced pathogenic changes.

Adjuvants, Immunologic↗
PubMed1999

Systematic search for susceptibility genes in different populations.

We analyzed the first replicate of each of the four simulated population samples from three distinct populations by linkage and association genome scans and could identify three regions with susceptibility loci for the disease: on chromosome 1, marker D1G024, with strong evidence for gene x environment interaction; or chromosome 3, around marker D3G045; and on chromosome 5, markers D5G035-D5G042. Our results were obtained without knowing the true disease model and are compared with this model in the discussion.

Alleles↗
PubMed1999

Incorporating larger families in identity-by-descent based linkage analysis.

Genome scans for alcoholism susceptibility genes were carried out using identity-by-descent-based statistics for qualitative traits. We compared the results when 1) multipoint information was used for all families, where some had to be truncated, 2) multipoint information was used only for small families while large (untruncated) pedigrees were analyzed with a single-point approach, and 3) single-point analysis was used for all pedigrees. Differences between the methods were observed, but neither method could identify regions related to the susceptibility for alcoholism.

Alcoholism↗