Biomedical subjects
Publications and source records attributed to N Wagner.
The goal of this survey was to compare similarities and differences between two groups of pediatric nurses, a group from developing countries and a group from Israel, in confronting ethical issues and in the use of resources for support. Findings indicate similarities between the two groups in a majority of ethical situations that concern them in their work despite differences in cultural backgrounds.
PURPOSE: To clarify the expression of neurotrophins and their receptors in retinoblastoma (Rb) cells, to elucidate their potential role in the proliferation of neuroectodermal tumor cells, and to establish conditions for Rb cell differentiation. METHODS: The Rb-derived cell line Y-79 was grown in serum-free suspension or monolayer culture. Proliferating and differentiated cells were isolated and submitted to semiquantitative reverse transcription-polymerase chain reaction (RT-PCR) analysis, immunostaining, and flow cytometry. The proliferation rate of the cells was estimated by 5-bromo-2'-deoxyuridine (BrdU) incorporation, and the effects of neurotrophins and laminin on BrdU-incorporation, process outgrowth, or immunostaining were determined. RESULTS: In contrast to previously studied normal retinal precursor cells, Y-79 cells not only express nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), neurotrophin-3 (NT-3), and p75, but also the corresponding high affinity receptors TrkA, TrkB, and TrkC. Proliferation was stimulated by exogenous and endogenous neurotrophin receptor ligands. Inhibition of protein kinase phosphorylation with K252a blocked proliferation and promoted differentiation. The effect of K252a on differentiation was enhanced by the addition of soluble laminin. After 9 days of combined treatment, the fraction of differentiated cells amounted to 30%, differentiation being characterized by improved attachment, neurite outgrowth, expression of NF-68, and a loss of glial fibrillary acidic protein (GFAP) and parvalbumin immunoreactivity. These changes were accompanied by a downregulation of TrkB and TrkC, but not TrkA or p75. Differentiated cells were isolated and further grown in the absence of K252a. However, despite the high level of TrkA expression in differentiated cells, the addition of NGF had no effect on their survival. CONCLUSIONS: A mitogenic action of neurotrophins could contribute to retinal tumor growth.
Inner ear pressure reflects intracranial pressure (ICP) primarily because of the direct communication of perilymph and cerebrospinal fluid (CSF) through the cochlear aqueduct (CA). The MMS-10 tympanic displacement analyser (TDA) is a relatively new device for measuring perilymphatic pressure non-invasively, and thereby also indirectly measuring intracranial pressure. The aim of the present study was to evaluate the use of the TDA in a daily clinical setting. Other aims were to investigate changes in perilymphatic pressure from sitting to lying position in healthy volunteers in two age groups (mean age: 33 years and 50 years) and to compare the patency of the CA in these groups using the MMS-10 TDA. Tympanic membrane displacement (TMD) analyses were performed in the test subjects initially twice in sitting position (test-retest) and then in sitting and supine positions. We found that the MMS-10 TDA is easy to use, and that it gives reproducible values in repeated tests, but with large inter-subject differences. The TMD test showed curves, which, in the whole test group, were more negative in supine position, in accordance with an increasing intracranial and inner ear pressure when lying down. The change from sitting to lying position was larger in the younger group than in the older group. In 11% of the younger group (males) and in 30% of the older group (females), the CA was considered to be non-patent, although the difference was not statistically significant. However, the finding is in keeping with the hypothesis of a greater proportion of patent CA in younger than in older individuals.
350 patients attending 11 large out-patient clinics completed questionnaires evaluating attitudes to, and experience with complementary medicine. 129 (36%) respondents reported using complementary medicine. 14% of them used complementary medicine for the current medical problem for which they were attending the clinic. Pain was the most common medical problem for which complementary medicine was used, followed by respiratory problems and cancer. Common therapeutic modalities used were acupuncture, homeopathy, nutrition and herbal medicine. Women, the secular as opposed to the religious, and those with higher education were more apt to use complementary medicine. No differences were found in age, national origin, length of living in Israel, and diet (vegetarian, natural foods or regular diet) between those who used complementary medicine and those who did not. No relationship was found between the use of complementary medicine and perceived poor health status, locus of control, or satisfaction with the doctor-patient relationship.
The requirement of beta7 integrins for lymphocyte migration was examined during an ongoing immune response in vivo. Transgenic mice (OT-I) expressing an ovalbumin-specific major histocompatibility complex class I-restricted T cell receptor for antigen were rendered deficient in expression of all beta7 integrins or only the alphaEbeta7 integrin. To quantitate the relative use of beta7 integrins in migration in vivo, equal numbers of OT-I and OT-I-beta7(-/-) or OT-I-alphaE-/- lymph node (LN) cells were adoptively transferred to normal mice. Although OT-I-beta7(-/-) LN cells migrated to mesenteric LN and peripheral LN as well as wild-type cells, beta7 integrins were required for naive CD8 T cell and B cell migration to Peyer's patch. After infection with a recombinant virus (vesicular stomatitis virus) encoding ovalbumin, beta7 integrins became critical for migration of activated CD8 T cells to the mesenteric LN and Peyer's patch. Naive CD8 T cells did not enter the lamina propria or the intestinal epithelium, and the majority of migration of activated CD8 T cells to the small and large intestinal mucosa, including the epithelium, was beta7 integrin-mediated. The alphaEbeta7 integrin appeared to play no role in migration during a primary CD8 T cell immune response in vivo. Furthermore, despite dramatic upregulation of alphaEbeta7 by CD8 T cells after entry into the epithelium, long-term retention of intestinal intraepithelial lymphocytes was also alphaEbeta7 independent.
AIM: To determine the frequency of GB virus C (GBV-C)/hepatitis G virus (HGV) infection before and after switch to the use of virus inactivated concentrates in haemophiliac patients infected with human immunodeficiency virus (HIV). PATIENTS AND METHODS: Initial and follow up sera from 49 children with haemophilia were analysed for the presence of GBV-C/HGV RNA and antibodies to HGV (anti-HGV). All patients had been infected with HIV while receiving concentrates without virus inactivation before 1984 and were subsequently treated with virus inactivated concentrates. RESULTS: In the first available serum sample (1987 or later), two of 49 patients were GBV-C/HGV RNA positive and two further patients were anti-HGV positive. During follow up (mean, 6 years), 14 patients developed markers of GBV-C/HGV infection. Eleven of these had received no blood products except clotting factor concentrates that had been prepared with virus inactivation. CONCLUSIONS: Despite being treated with virus inactivated clotting factor concentrates, HIV positive patients with haemophilia are at an increased risk of manifesting GBV-C/HGV infection. We hypothesise that GBV-C/HGV is transmitted by these clotting factor concentrates. However, we cannot rule out the emergence of markers of GBV-C/HGV infection as a result of the progression of immune impairment in the course of HIV infection.
Lymphocyte migration into lymphoid organs is regulated by adhesion molecules including L-selectin and the beta7 integrins. L-selectin and alpha4beta7 are predominantly hypothesized to direct the selective migration of lymphocytes to peripheral lymph nodes and the gut-associated lymphoid tissues, respectively. To further characterize interactions between L-selectin and beta7 integrins during lymphocyte recirculation, mice deficient in both receptors (L-selectin/beta7 integrin-/-) were generated. The simultaneous loss of L-selectin and beta7 integrin expression prevented the majority of lymphocytes (>95% inhibition) from attaching to high endothelial venules (HEV) of Peyer's patches and other lymphoid tissues during in vitro binding assays. Moreover, the inability to bind HEV eliminated the vast majority of L-selectin/beta7 integrin-/- lymphocyte migration into Peyer's patches during short-term and long-term in vivo migration assays (>99% inhibition,p < 0.01). The lack of lymphocyte migration into Peyer's patches correlated directly with the dramatically reduced size and cellularity (99% reduced) of this tissue in L-selectin/beta7 integrin-/- mice. High numbers of injected L-selectin/beta7 integrin-/- lymphocytes remaining in the blood of wild-type mice correlated with markedly increased numbers of circulating lymphocytes in L-selectin/beta7 integrin-/- mice. Loss of either L-selectin or the beta7 integrins alone resulted in significant but incomplete inhibition of Peyer's patch migration. Collectively, the phenotype of L-selectin/beta7 integrin-/- mice demonstrates that these two receptors primarily interact along the same adhesion pathway that is required for the vast majority of lymphocyte migration into Peyer's patches.
Lymphocyte trafficking into Peyer's patches requires beta 7 integrins and L-selectin. Here, we use intravital microscopy to examine leukocyte rolling and adhesion in Peyer's patch high endothelial venules (HEV) of wild-type, L-selectin-deficient (L-/-), beta 7 integrin-deficient (beta 7-/-), and beta 7/L(-/-) mice. Although the leukocyte rolling flux fraction was reduced by 70%, Peyer's patches in L-/- mice were of normal size and cellularity. In beta 7-/- mice, the rolling flux fraction was normal, but the number of adherent leukocytes in HEV was greatly reduced. The median leukocyte rolling velocity was reduced in L-/- mice and increased in beta 7-/- mice, suggesting that beta 7 integrins and L-selectin mediate rolling in Peyer's patch HEV at different velocities. beta 7/L(-/-) exhibited both a low rolling flux fraction and low adhesion and had severely reduced Peyer's patch size and cellularity. The residual rolling in these mice was completely blocked by a P-selectin mAb. A significant P-selectin component was also detected in the other genotypes. Twenty-six percent of B and T lymphocytes isolated from Peyer's patches of wild-type mice expressed functional ligands for P-selectin, and this fraction was increased to 57% in beta 7/L(-/-) mice. Peyer's patch HEV were found to express P-selectin under the conditions of intravital microscopy, but not in situ. Our data suggest a novel P-selectin dependent mechanism of lymphocyte homing to Peyer's patches. In situ, beta 7 integrins and L-selectin account for all lymphocyte homing to Peyer's patches, but P-selectin-dependent rolling, as induced by minimal trauma, may support trafficking of effector T lymphocytes to Peyer's patches.
Mesenteric lymph nodes (MLN) drain the gut where nutritive antigens and pathogens are encountered by lymphocytes of the gut-associated lymphoid tissue. We sought to determine how lymphocytes enter the MLN by studying mice double deficient for beta7 integrins and L-selectin. beta7/L-selectin double-deficient lymphocytes did not migrate into MLN. Most importantly, MLN formation was drastically impaired in beta7/L-selectin double-deficient mice. Lymphocyte numbers in MLN from beta7/L-selectin double-deficient mice were tenfold reduced compared to control mice. A high percentage of the few lymphocytes still detected in MLN from beta7/L-selectin double-deficient mice were CD44hi CD18hi, suggesting alternate migration pathways independent of L-selectin and beta7 integrin for these cells. We conclude that the combination of both molecules, L-selectin and beta7 integrin, is indispensable for MLN formation and that these molecules may mediate lymphocyte migration to MLN in a sequential and synergistical manner.
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A 7 year old boy presented with linear and whorled nevoid hypermelanosis (LWNH). This entity, delineated in 1988, is characterized by streaked or whorled, frequently reticulate hyperpigmented lesions following the lines of Blaschko without preceding inflammation and without atrophy. The age of onset is usually within the first 2 years of life. Histologically, there is a mild basal cell hyperpigmentation with prominent melanocytes. In contrast to earlier reports, we observed some melanophages in the upper dermis. Associated abnormalities have been reported in a few patients, but were absent in our case. We present the clinical features, diagnostic criteria and differential diagnosis of this rare entity. Apparently, our patient represents the first case of LWNH in the German literature.
A national ethics survey was conducted of all registered nurses participating in post-basic specialisation nursing courses in Israel over a one-year period (1994-95) to identify ethical situations which confront Israeli nurses caring for patients of different age groups and in different clinical settings. This study compares the responses of those nurses caring for elderly patients (60 years or older) with those caring for adult patients in other age groups. Nurses caring for the elderly reported encountering ethical dilemmas in 16 out of 37 situations presented to them, more than in the other adult patient age groups. The most frequent dilemmas were concerning mistaken or questionable treatment, patient-family conflict, patient referral to an institution or discharge to the home where the family is incapable of caring for him, offensive behaviour by caregivers and physical restraint of the patient for staff convenience. It is recommended that nursing ethics intervention programmes be established to promote ethical decision making and patients' rights.
Adapalene is a stable naphthoic acid derivative that displays a strong retinoid agonist pharmacology. This drug controls cell proliferation and differentiation, and possesses significant anti-inflammatory action. The retinoid action of adapalene are mediated by the ligand-activated gene transcription factors retinoic acid receptors RAR beta and RAR gamma. We describe here how an aqueous gel containing adapalene was selected for the topical treatment of acne.
Maternal lymphocytes having a large and granulated morphology accumulate at healthy implantation sites in normal mice. Insight into the functions of these cells has come from a previous study of two independent lines of mice deficient in natural killer (NK) cells. In pregnant Tg epsilon 26 mice, vascular pathology was found that led to the major complications of either fetal death or intrauterine growth retardation. In pregnant p56lck null x IL-2R beta null mice, extensive distension of the decidua was observed that separated the placenta from the myometrium and appeared to be interstitial edema. To strengthen assignment of uterine large granulated lymphocytes to the NK cell lineage and to understand which aspects of NK cell biology may be important for a uterine-based, pregnancy-associated subset, mid-gestation implantation sites from a new series of mice having gene deletions which alter NK cells (IL-2R gamma null, Stat4 null, IL-12 p40 null, beta 7 integrin null and Muc-1 null) have been examined histologically. The findings support the assignment of pregnancy-associated large granulated cells of mice to the NK cell lineage and suggest that the primary functions of these tissue-based NK cells are to support normal development of the decidua and/or its vasculature using pathways that involve IL-12 mediated signal transduction.
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BACKGROUND: The formulation of topical dermatologic products must take into account efficacy, safety, and patient compliance. OBJECTIVE: We describe how an aqueous gel containing adapalene, a novel naphthoic acid derivative was selected for the topical treatment of acne. METHODS AND RESULTS: Dose selection was made using established in vivo models. In the Rhino mouse the comedolytic effect of adapalene 0.1% gel was similar or superior to that of a reference formulation containing 0.025% tretinoin. Qualitative distribution of adapalene after topical application was assessed on cryosections of human skin. They showed rapid penetration of adapalene into the pilosebaceous unit. A liberation/penetration study demonstrated that significant quantities of adapalene were present in epidermis and dermis, but only 0.01% of the applied dose penetrated through the skin. CONCLUSION: This formulation should result in effective and well-tolerated treatment of acne vulgaris with good patient compliance.
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