Search PubMed⌕ Search

Biomedical subjects

M Weber

Publications and source records attributed to M Weber.

At least 397 records · Page 22Linked to original sources
PubMed1996

[Evaluation of the mortality related to nosocomial infections. An approach by a homogeneous group of patients, from bacteriology and data of hospitalization (1989-1993)].

We cross matched the informations from the medical records of the PMSI (French Program of Medicalisation of the Information System) with those from the bacteriology data base. The hospitalisation summaries provide the length of hospital stay, the mortality and the pathology defined by DRG (Diagnosis Related Group). Bacteriological data allow the diagnosis of nosocomial infections (NI) when using an appropriate methodology ("doubles" and early samples are not taken in account). Then it is possible to estimate the mortality when there are NI and No. 4499 stays NI were compared with 140,463 stays without NI. Mortality is 14.4% in NI group (17.5% in medecine and 8.6% in surgery) against 2.1% in the group without NI (2.5% in medecine and 0.8% in surgery). Among the 58 DRG's studied (more than 19 cases with NI), mortality and relative risk varie a lot. Results are estimations because they are many bias.

Cross Infection↗
PubMed1996

Case report. Microcephalic osteodysplastic primordial dwarfism type II: a child with unusual symptoms and clinical course.

UNLABELLED: We report on a 13-month old boy with microcephalic osteodysplastic primordial dwarfism (MOPD), whose radiographic signs correspond with type II of this entity. Some of his clinical signs, such as the anomalies of the external genitalia and the urinary tract, are common to this subgroup of MOPD, but he also shows unusual clinical signs including bilateral knee dislocation and hypoplasia of the anterior corpus callosum. His clinical course was unusual with several episodes of breathing difficulties and increased intracranial pressure secondary to craniosynostosis at the age of 16 months. After front-orbital advancement for the treatment of brachycephaly, his psychomotor development improved remarkably. CONCLUSION: MOPD type II may have a wider range of expression than previously delineated.

Abnormalities, Multiple↗
PubMed1996

Adenovirus-mediated gene transfer into kidney glomeruli using an ex vivo and in vivo kidney perfusion system - first steps towards gene therapy of Alport syndrome.

In order to develop gene therapy for Alport syndrome, we have examined the efficiency of adenovirus-mediated transfer of the beta-galactosidase gene into cultured cells and intact glomeruli in vitro, and developed an organ perfusion system for gene transfer into kidney ex vivo and in vivo. Human endothelial and mesangial cells, as well as isolated human glomeruli, were readily infected and exhibited expression of the reporter gene. Single or multiple injections of the virus solution into the renal artery of pig in vivo did not lead to significant gene transfer and expression of the reporter gene in kidney cells. To increase the exposure time of kidney cells to the virus we perfused kidneys ex vivo and in vivo for up to 12 and 2 h, respectively. The perfusion system consisted of a perfusate container, a peristaltic pump and an artificial membrane lung gassed with carbogen. Using this system, intense expression of the reporter gene could be achieved in up to about 85% of the glomeruli after perfusion of an explanted kidney ex vivo and about the same efficiency of gene transfer could be obtained in glomerular cells after 2-h perfusion in vivo. Some expression was observed in other vascular endothelial cells following the perfusion, but no expression was observed in cells of the Bowman's capsule or epithelial cells of the tubuli. The X chromosome-linked form of Alport syndrome is caused by defects in the gene for the type IV collagen of alpha5 chain, which is primarily expressed in the kidney in glomerular cells. The present results demonstrated that efficient gene transfer can be achieved into glomerular cells, a prerequisite for gene therapy of this disease. The organ perfusion method developed in this study might also be applicable for gene therapy of other diseases.

Adenoviruses, Human↗
PubMed1996

[2 steps forward and one back?--Response of child welfare to sexual abuse experiences of girls and boys].

What has been changed in the system of social help since sexual abuse became a public topic? Is social work capable of providing adequate help and support for the survivors? The article presents the results of a three-year-lasting research project. In three different regions the authors have scrutinized 1. the institutions offering help, 2. the knowledge of and the attitude towards sexual violence of the professionals and 3. the conceptional assumptions leading social work. The results show that the situation for survivors of sexual abuse has definitely improved, because there are more helping institutions and the professional awareness has increased. But for a profound reorganization of help, restrictive financial politics, internalized prejudices and institutional concepts need to be changed.

Attitude of Health Personnel↗
PubMed1996

[Inadequate therapies with implantable cardioverter-defibrillators--incidence, etiology, predictive factors and preventive strategies].

Patients with implantable cardioverter defibrillators (ICD) often suffer inappropriate ICD-therapies. The incidence, causes and risk factors of ICD-therapies for a rhythm other than ventricular tachyarrhythmias (VT) were determined retrospectively in 462 consecutive patients (pts). Inappropriate ICD-therapies were identified based on stored R-R intervals and/or electrograms. Eighty-two pts (18%) had inappropriate ICD-therapies. Actuarial rates for inappropriate ICD-therapies were 13%, 20%, 24% and 29% at 1, 2, 3 and 4 years after ICD-implantation, respectively. Atrial fibrillation with rapid ventricular response was the most common cause (34 pts, 39%). In 26 pts (30%), sinus tachycardia triggered inappropriate ICD-therapies, in 21 pts (24%) overseeing, mostly due to fractures and insulation failures of the leads, in three pts atrial flutter, in two pts non-sustained VT, in one pt supra-ventricular tachycardia and in another pt T-wave double sensing caused inappropriate ICD-therapies. In order to prevent recurrences of inappropriate ICD-therapies due to atrial fibrillation or sinus tachycardia, a rate stability (n = 19) or onset (n = 15) criterion was programmed, 41 pts additionally received beta-blocking agents and/or digoxin. In pts with overseeing an operative revision of lead system was performed. During further follow-up (15 +/- 13 months), 15 pts had recurrences of inappropriate ICD-therapies (eight pts due to atrial fibrillation, three due to sinus tachycardia and four due to overseeing). On multivariate analysis (Cox regression), history of atrial fibrillation, maximum heart rate during exercise and low cut-off rate for VT-detection were predictors of inappropriate ICD-therapies. Thus, inappropriate ICD-therapies are frequent, especially in the first year after implantation. Additional detection criteria, beta-blocking agents and/or digoxin prevent recurrences in most patients. In patients with a history of atrial fibrillation, high heart rate during exercise or a low cut-off rate for VT-detection, activation of additional detection criteria should be considered directly after ICD-implantation.

Adult↗
PubMed1995

Parathyroid hormone induces protein kinase C but not adenylate cyclase in adult cardiomyocytes and regulates cyclic AMP levels via protein kinase C-dependent phosphodiesterase activity.

Adult ventricular cardiomyocytes have been identified as target cells for parathyroid hormone (PTH) but little is known about its signal transduction in these cells. In the present study the influence of PTH on cyclic AMP accumulation and the activity of protein kinase C (PKC) in cardiomyocytes was evaluated. A mid-regional synthetic fragment of PTH, PTH-(28-48), which exerts a hypertrophic effect on cardiomyocytes, increased the activity of membrane-associated PKC in a dose-dependent manner (1-100 nM). Activated membranous PKC was dependent on Ca2+ and sensitive to an inhibitor of Ca(2+)-dependent isoforms of PKC. When adenylate cyclase was stimulated by the addition of isoprenaline, a beta-adrenoceptor agonist, PTH-(28-48) antagonized cyclic AMP accumulation. This antagonistic effect of PTH-(28-48) could be mimicked by activation of PKC with a phorbol ester and inhibited by isobutylmethylxanthine, a phosphodiesterase inhibitor. An N-terminal synthetic fragment, PTH-(1-34), which includes an adenylate cyclase-activating domain, did not stimulate the accumulation of cyclic AMP in cardiomyocytes. The results demonstrate that in adult cardiomyocytes PTH (1) is able to stimulate PKC, (2) is not able to cause accumulation of cyclic AMP and (3) functionally antagonizes the effect of beta-adrenoceptor stimulation to increase cellular cyclic AMP concentrations via PKC-dependent phosphodiesterase activity.

Adenylyl Cyclases↗
PubMed1995

[Autonomic failure as the cause of vertigo and syncope].

BACKGROUND: Vertigo and syncope often occur during orthostatic conditions. A possible cause is asympathicotonic dysregulation with a fall of blood pressure and no increase in heart rate. After the exclusion of secondary disturbances of autonomic innervation. g. in diabetes mellitus, and pharmacological side effects, e.g. tricyclic antidepressants, primary reasons must be considered. We present 2 cases of primary autonomic failure. PATIENTS: Patient 1 had Parkinson-syndrome, impaired bladder function and orthostatic dysregulation with a maximal drop of blood pressure to 60/40 mm Hg. Patient 2 showed orthostatic dysregulation with a minimal blood pressure of 70/30 mm Hg without further symptoms, in a tilt table examination catecholamines were measured during orthostatic conditions. Patient 1 had normal, and patient 2 very low resting catecholamine plasma levels. Neither patient reacted with a rise of plasma catecholamines when tilted to an upright position. These findings are diagnostic of multiple system atrophy (MSA) in patient 1 and pure autonomic failure (PAF) in patient 2. DISCUSSION: In PAP only dysautonomic symptoms are found. It has a favourable prognosis. MSA consists of an autonomic dysregulation in combination with parkinsonism, cerebellary and bulbar symptoms, prognosis quo ad vitam is poor. Diagnosis is often established by a tilt table examination and radiology findings, and is often late. Treatment of both diseases consists of pharmacological, e.g. fludrocortisone, vasopressin analogues and ergotamine tartrate as well as non-pharmacological blood pressure stabilizing measures.

Adult↗
PubMed1995

[A high serum creatine kinase picture due to too much or too little exercise].

In case I, a 31-year-old man who had undergone unusual high-performance training, painful swellings occurred in the left arm and creatine kinase activity was raised (28,644 U/l), as well as that of the transaminases. A rapid urine test for blood was positive, but the sediment was free of red blood cells. There were no other pathological findings. Fluid intake was increased to 31 daily and on the third day he was symptom-free and creatine kinase activity had fallen to 6475 U/l, reaching normal values on the 15th day. Case 2 concerned a 28-year-old woman with paranoid schizophrenia who had taken several tablets of clozapine and then remained in bed for 3 days. She complained of pain in the region of the gluteus maximus muscles, exacerbated on pressure but otherwise unremarkable. Creatine kinase was raised to 21,492 U/l, creatine to 186 mumol/l, and the transaminases were likewise increased. The urine strip-test for blood was twice positive. She was treated with frusemide (80 mg daily) and infusions of electrolyte solution (21 daily). She became pain-free on the second day and the various enzyme activities rapidly fell to normal.

Adult↗
PubMed1995

IL-8 is expressed by human peripheral blood eosinophils. Evidence for increased secretion in asthma.

Eosinophils possess the capacity to synthesize various cytokines. We demonstrate that IL-8 mRNA and protein are constitutively expressed by freshly isolated resting human eosinophils. Most of the patients with bronchial asthma or atopic dermatitis show evidence for up-regulated IL-8 protein expression in eosinophils but not in neutrophils, suggesting that an eosinophil-specific cytokine may act in these patients. To investigate whether the intracellular IL-8 can be released, eosinophils were stimulated by different cytokines and platelet-activating factor. Priming with granulocyte-macrophage CSF and a subsequent 25-min stimulation with RANTES or platelet-activating factor resulted in release of IL-8 from highly purified human eosinophils in vitro. As the eosinophil is the predominant cell in asthmatic inflammation, we determined IL-8 concentrations in bronchoalveolar lavage fluids from normal individuals and asthmatic patients. Bronchoalveolar lavage fluids from patients with bronchial asthma consistently demonstrated high IL-8 concentration compared with the controls. This suggests that IL-8 is released in vivo by inflammatory bronchial cells in asthma.

Asthma↗
PubMed1995

Monocyte chemotactic protein MCP-2 activates human basophil and eosinophil leukocytes similar to MCP-3.

It has been shown that CC chemokines activate basophil and eosinophil leukocytes with different selectivities and patterns of activity. The most effective are monocyte chemotactic protein-1 (MCP-1), a potent stimulus of mediator release in basophils without effects on eosinophils, RANTES, a weak stimulus of release and strong chemoattractant for basophils and eosinophils, and MCP-3, which combines the activities of MCP-1 and RANTES. We have now compared MCP-2, which has 62 and 60% of sequence identity with MCP-1 and MCP-3, respectively, with the other CC chemokines. MCP-2 induced mediator release by human basophils with lower efficacy and potency than MCP-1 and MCP-3. It promoted transient changes of cytosolic-free calcium concentration ([Ca2+]i) and chemotactic responses in both basophils and eosinophils, however somewhat less efficiently than MCP-3 and RANTES. Desensitization studies indicate that MCP-2 interacts with receptors recognizing MCP-1 as well as RANTES. These results demonstrate that MCP-2 and MCP-3 exert qualitatively similar biologic activities on basophils and eosinophils. In basophils that had not been treated with IL-3, MCP-2 induced minimal exocytosis only, but desensitized the cells toward MCP-1 and MCP-3, suggesting that MCP-2 may act as a functional inhibitor of CC chemokine actions. The results of this study further indicate that MCP analogues display partially distinct, partially overlapping bioactivities toward eosinophils and basophils, and may thus regulate inflammatory processes involving these effector cell types.

Basophils↗
PubMed1995

Association of intermediate uveitis with HLA-A28: definition of a new systemic syndrome?

BACKGROUND: Endogenous posterior uveitis (PU) can be associated with systemic diseases, and certain forms have strong association with HLA antigens. Much less is known regarding intermediate uveitis (IU). The purpose of this study was to determine whether IU is associated with the HLA system and whether it can be associated with systemic symptoms. METHODS: In 179 consecutive patients consulting for uveitis, a detailed history was obtained and a physical examination performed. HLA typing for 71 HLA-A, B, DR and DQ antigens, laboratory tests, and radiography of the chest, sinuses, and sacroiliac joints were systematically performed. RESULTS: Thirty-two patients (18%) had IU; 51 (28.5%) had PU and constituted our internal control group. Nine of the patients with IU (28%) had the HLA-A28 antigen, compared with 8.1% of a healthy control population and 8.6% of the patients with PU (P < 0.001). An associated disease was found in four patients with IU (12.5%) (none was HLA-A28) and in 45% of the patients with PU (P < 0.01). Some 67% of HLA-A28 patients with IU had arthralgias affecting the knee(s), compared with 17% of non-HLA-A28 patients and 18% of patients with PU (P < 0.05 and P < 0.01 respectively); 55% had gonalgias and hypocomplementemia compared with 9% and 2% respectively (P < 0.01 and P < 0.001). CONCLUSIONS: IU is significantly associated with HLA-A28; patients having this antigen may represent a subset of the disease characterized by an increased prevalence of arthralgias and hypocomplementemia.

Adolescent↗
PubMed1995

Protective role of excitatory amino acid antagonists in experimental retinal ischemia.

BACKGROUND: Excitatory amino acids and their analogues (NMDA, kainate and AMPA) are implicated in the pathogenesis of ischemic brain injury. In order to fully understand their involvement in the pathogenesis of retinal ischemic injury, we studied the electrophysiological and histopathological effects of two excitatory amino acid antagonists, cis-PDA and MK 801, in an experimental retinal ischemia model. METHODS: The two antagonists were injected intravitreously 15 min before ischemia was induced by elevatory intraocular pressure caused by external compression. Electrophysiological and histopathological evaluation was made 48 h after 45 min transient ischemia. RESULTS: The excitatory amino acid antagonists cis-PDA and MK 801 can partially protect against retinal ischemic injury; whereas the mean post-ischemic b-wave amplitude corresponded to 41% of the pre-ischemic value in the control group, it was 64% (P = 0.003) and 59% (P = 0.005) following administration of cis-PDA and MK 801 respectively. Histopathological study corroborated these data, showing significant differences for morphometric parameters (P = 0.011 and P = 0.007 respectively). CONCLUSION: These preliminary results suggest the possibility of limiting excito-toxicity, one of the lesion-forming mechanisms in ischemic retinal injury.

Animals↗
PubMed1995

Long-term follow up to patients with frozen shoulder after mobilization under anesthesia, with special reference to the rotator cuff.

UNLABELLED: In order to evaluate the efficacy of mobilization under anesthesia as a therapy for frozen shoulder, 43 patients with a mean age of 52.8 years were examined after an average time of 4.7 years. Since some authors have been concerned about rotator cuff tears, special attention--using sonography--was paid to rotator cuff lesions. RESULTS: Clinical and sonographic examinations were very similar and showed a perfect recovery in 27 of 37 patients (73.0%). The average time off work after mobilization was 6.2 weeks compared with expected spontaneous recovery of about 30 months. Outcome was worse in patients with previous trauma to their shoulder. In 2 patients (5.4%) the sonography revealed a slight rotator cuff tear, which is not uncommon in 60-year-old persons. Two additional patients (5.4%) underwent shoulder surgery two years after mobilization due to a persistent impingement syndrome and to a supraspinatus-tear. We conclude, that mobilization under anesthesia for frozen shoulder is an effective treatment modality causing little harm.

Adult↗