Biomedical subjects

R Wagner

Publications and source records attributed to R Wagner.

At least 145 records · Page 8Linked to original sources

PubMed1998

[An ophthalmologic image databank on the Internet].

The Internet has become a powerful, international source for information, and it has shown an exponential growth because of the ease of access and the immediate availability of information. We introduced a new ophthalmological atlas including ICD coding on the World Wide Web. So far, more than 500 lantern slides of typical and interesting ophthalmological findings have been selected and digitized. These pictures were integrated in a data base, which was arranged for ease and speed of search and retrieval. In its background, the data base contains a list of over 4700 ICD-encoded diagnoses to which the picture-documented findings are linked. Comments on pictures can be added by the author or by users. The data base contains several lists, such as a list of ICD codes and diagnoses, a list of all pictures with corresponding diagnoses, a list of all diagnoses and number of pictures, a list of those diagnoses for which the corresponding picture is available, as well as a list of comments on each picture. Special program scripts handle the user's search key words for diagnoses and extract the required information out of the data base, using Windows NT. Search results are presented on an automatically built-up webpage. To provide fast speed of search all pictures initially are shown in a small format (thumbnails) with little amount of data. The related full-size picture is retrieved by a single mouse click. Moreover, the name and institution of the author, diagnostical hints and comments on pictures by the author or by users are offered for each diagnosis available. The Giessen Ophthalmological Picture Atlas can be reached under www.med.unigiessen.de in the Internet. It allows a fast search free of charge from all over the world and, therefore, offers an additional option to obtain specific ophthalmological information for various purposes.

Databases, Factual↗

PubMed1998

Effects of the Escherichia coli DNA-binding protein H-NS on rRNA synthesis in vivo.

The Escherichia coli DNA-binding protein H-NS is known to interact specifically with the upstream region of ribosomal RNA transcription units, where it causes transcriptional repression in vitro. Here, we present results demonstrating the effect of H-NS on rRNA transcription in vivo. rRNA synthesis rates were compared in cells that differ in the expression of functional H-NS or FIS molecules. We could show that in the absence of H-NS derepression of rRNA synthesis occurs at low growth rates. During the cell cycle H-NS is responsible for the rapid shut-off of rRNA synthesis at the end of the exponential phase. As it is known for FIS-dependent activation, the inhibitory function of H-NS is specific for P1, the first of the tandem rRNA promoters. The effect of H-NS on rRNA synthesis was further assessed under stress conditions. While under osmotic upshift the reduction in rRNA synthesis is clearly H-NS-dependent, no such influence could be detected at cold shock. Determination of the cellular ppGpp concentrations revealed that H-NS does not mediate its function via alterations in the synthesis of the global effector ppGpp.

Bacterial Proteins↗

PubMed1998

[Evaluation with biomechanical gait analysis of various treatment methods after rupture of the anterior cruciate ligament].

The purpose of the present study is to evaluate the rehabilitation of different treatments of ACL ruptured knees by means of gait parameters. The gait analysis results in two surgically treated patient groups (patellar tendon autograft reconstructions (n = 35) and augmented repairs (n = 15) and one non-surgically treated patient group (n = 19) are evaluated by means of gait parameters of normal controls (n = 30). The technical equipment included an optoelectronic system for recording the kinematics of gait (Primas, NL) and two force plates for measuring the ground reaction forces (Kistler, CH). The moments acting on joints can be determined experimentally with both systems. It can be shown from special gait tests that the derived quantitative evaluation parameters are independent from the gait analysis conditions. One year after surgery, both the patellar tendon autograft reconstruction group and the augmented repair group show clear deficiencies in gait parameters compared with the controls. In particular this concerns the midstance extension motion of the knee (p < = 0.01) and the extension moments acting on the knee joint during the stance phase (sagittal plane, p < = 0.01). The deficiencies of both surgically treated groups are approximately the same. However, one year after occurrence of the disruption the non-surgically treated group cannot be distinguished from the controls. From this and from additional pre-surgical measurements, it can be concluded, that operating has an important influence on gait parameters. The role of the gait analysis results has been discussed.

Adult↗

PubMed1998

[Anesthesia in cesarean section in the FRG in 1997. Results of a nationwide survey].

A survey of all German hospitals providing obstetric anaesthesia in 1997 (n = 1061, recovery rate 82% comprising 115,000 Caesarean sections revealed that most Caesarean sections (CS) are performed under general anaesthesia (GA). For elective CS, the average was 63%, and 82% for urgent (non-emergency) section. Succinylcholine is the standard neuromuscular blocker for intubation. Of the regional techniques, epidural continuous anaesthesia (ED) is preferred for elective CS (59%) over subarachnoid (SA, 10%) and combined epidural and subarachnoid anaesthesia (CSE). In urgent CS, SA is used more often (56%) than ED (42%) and CSE. With increasing number of births per year, the use of regional techniques is more common.

Anesthesia, General↗

PubMed1998

[Use of mechanical autotransfusion in maxillofacial surgery in the mouth, jaw and face].

OBJECTIVE: In maxillofacial surgery considerable blood loss is not uncommon. However, the use of autologous blood collected from the site of surgery is controversial. METHODS: Bacterial contamination of blood collected for autologous retransfusion was studied by standard microbiological methods in 25 patients undergoing elective non-malignant maxillofacial surgery. Swabs were taken from the pharynx and from the collected blood before and after routine treatment. The autologous blood was not used for transfusion. Preoperative antibiotic treatment consisted in amoxicilline plus clavulanic acid. RESULTS: The blood prepared for retransfusion was free of bacteria in only one case, while 24 samples contained up to five different bacterial species including some strains not preexistent in the pharyngeal swabs. CONCLUSION: Blood collected from the site of operation is not suitable for retransfusion in maxillofacial surgery.

Adult↗

PubMed1998

Altered serum amino acid profiles in head and neck cancer.

Patients who develop squamous cell carcinoma of the head and neck (SCCHN) are often malnourished because of poor dietary habits, excessive alcohol consumption, local tumor effects, tumor-induced cachexia, and the effects of various therapies. The composition of the diet may be a risk factor for the development of head and neck cancer as well as tumor progression. This study compares the amino acid profiles in the banked serum of patients with and without SCCHN. In comparison to the control group, patients with SCCHN had significantly decreased preoperative serum levels of alanine (p = 0.006), asparagine (p = 0.002), aspartic acid (p = 0.0001), glycine (p = 0.0002), histidine (p = 0.002), 3-methylhistidine (p = 0.001), ornithine (p = 0.001), phenylalanine (p = 0.002), serine (p = 0.002), taurine (p < 0.0001), and threonine (p = 0.001). Levels of cystine were significantly elevated in the group of cancer patients (p < 0.0001). No significant differences were noted on the basis of T stage, N stage, or nutritional status. Serum levels increased postoperatively for the majority of the amino acids tested. Postoperative histidine levels were associated with tumor recurrence (p = 0.04). Serum amino acid levels may prove to be useful markers of disease status and provide prognostic information.

Adult↗

PubMed1998

Glucose metabolism of the thyroid in Graves' disease measured by F-18-fluoro-deoxyglucose positron emission tomography.

The radiolabeled glucose surrogate F-18-fluoro-deoxyglucose (F-18-FDG) and positron emission tomography (PET) were used to measure glucose metabolism of the thyroid in vivo. We evaluated patients with Graves' disease before therapy with radioiodine in comparison to patients with normal thyroids. Thirty-six patients with Graves' disease underwent scanning the day before radioiodine therapy. Twenty patients with head tumors and normal thyroids were the controls. Overall F-18-FDG uptake was determined for all thyroids and modeling of glucose metabolism was performed in order to differentiate between glucose concentration in the fractional blood volume, glucose transport, and glucose utilization. F-18-FDG uptake was significantly higher in Graves' disease patients compared with controls. In these patients F-18-FDG uptake increased with increasing antithyroid antibodies and shorter radioiodine half-life. Modeling of glucose metabolism revealed substantial differences in thyroid F-18-FDG utilization constants (k3 values) corresponding to enhanced local metabolic rates in Graves' disease. No significant differences in the remaining rate constants and the fractional blood volume were detected. These results indicate that glucose metabolism is enhanced in the thyroid of Graves' disease patients not only due to enhanced fractional blood volume but to enhanced utilization. Whether a lymphocytic infiltration or thyroid epithelial cells utilize this surplus of glucose cannot be determined using in vivo PET measurements in humans. Still, the correlation of radioiodine half-life and glucose hypermetabolism suggests direct or nondirect connections of glucose metabolism and hormone synthesis in thyroid cells.

Adult↗

PubMed1998

A high-conductance solute channel in the chloroplastic outer envelope from Pea.

The pea chloroplastic outer envelope protein OEP24 can function as a general solute channel. OEP24 is present in chloroplasts, etioplasts, and non-green root plastids. The heterologously expressed protein forms a voltage-dependent, high-conductance (Lambda = 1.3 nS in 1 M KCl), and slightly cation-selective ion channel in reconstituted proteoliposomes. The highest open probability (P open approximately 0. 8) is at 0 mV, which is consistent with the absence of a transmembrane potential across the chloroplastic outer envelope. The OEP24 channels allow the flux of triosephosphate, dicarboxylic acids, positively or negatively charged amino acids, sugars, ATP, and Pi. Structure prediction algorithms and circular dichroism spectra indicate that OEP24 contains seven amphiphilic beta strands. The primary structure of OEP24 shows no homologies to mitochondrial or bacterial porins on a primary sequence basis, and OEP24 is functionally not inhibited by cadaverine, which is a potent inhibitor of bacterial porins. We conclude that OEP24 represents a new type of solute channel in the plastidic outer envelope.

Amino Acid Sequence↗

PubMed1998

Circadian plasma leptin levels in patients with anorexia nervosa: relation to insulin and cortisol.

In anorexia nervosa, underweight results from a loss of body mass due to a restricted energy intake. Circulating leptin levels have been shown to be low in the acute stage of the disorder. We studied diurnal secretion characteristics of leptin, insulin and cortisol in a study group of anorectic patients prior to refeeding, a second study group of anorectic patients after initiation of refeeding and study groups of healthy underweight and normal-weight controls. Spontaneous secretion of leptin, insulin and cortisol was measured by drawing blood samples every 2 h for 24 h. The temporal relationships between the diurnal secretion patterns of the three hormones were assessed by cross-correlation analysis in every study group. Plasma levels of leptin and cortisol were secreted with a specific circadian rhythmicity and displayed an intricate temporal relationship in anorectic patients. Semistarvation in the non-refed patients was associated with (1) exceedingly low plasma leptin levels, (2) a qualitative alteration in the circadian rhythm of leptin and cortisol levels and (3) an alteration in the temporal coupling between cortisol and leptin. In contrast, in the patients who had gained weight, leptin levels were higher; furthermore, the diurnal pattern of leptin and the temporal relationship between leptin and cortisol were similar to controls. Increments in insulin secretion preceded those of leptin by 4-6 h in both anorectic patients and in controls. Leptin levels increased 4 h prior to those of cortisol in controls and in refed patients, whereas in the non-refed patients cortisol increased prior to leptin. Thus, anorexia nervosa leads to pronounced, albeit reversible changes in the secretion dynamics of leptin and cortisol.

Adult↗

PubMed1998

Comorbidity of diabetes and eating disorders. Does diabetes control reflect disturbed eating behavior?

OBJECTIVE: This multicenter study was designed to explore the prevalence of clinical and subclinical eating disorders (EDs), the extent of intentional omission of insulin and oral antidiabetic agents, and its relationship to glycemic control in an inpatient and outpatient population of men and women with type 1 and type 2 diabetes. RESEARCH DESIGN AND METHODS: Data have been collected from 12 diabetes medical centers in two German cities. In a questionnaire and interview-based study, a sample of male and female patients (n = 341 type 1, n = 322 type 2) was assessed for the following eating disorders: anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorder not otherwise specified. For lack of interview data of several patients meeting the screening criteria, prevalence ranges were calculated. RESULTS: The overall prevalence range of current EDs was 5.9-8.0% (lifetime prevalence 10.3-14.0%). When patients were stratified according to type 1 and type 2 diabetes, there was no difference in prevalence of EDs. However, the distribution of the EDs was different in both types of diabetes, with a predominance of binge eating disorder in the type 2 diabetes sample. Type 1 (5.9%) and type 2 (2.2%) diabetic patients reported deliberate omission of hyperglycemic drugs (insulin or oral agents) in order to lose weight. Compared with control subjects, neither the presence of EDs nor insulin omission influenced diabetic control. CONCLUSIONS: There seems to be no difference in prevalence rates of EDs in both types of diabetes; however, distribution of EDs is different. The findings suggest that neither EDs nor insulin omission are necessarily associated with poor control of glycemia. Binge eating disorder seems to precede type 2 diabetes in most patients and could be one of the causes of obesity that often precedes type 2 diabetes.

Adolescent↗

PubMed1998

Discovery of ascomycin analogs with potent topical but weak systemic activity for treatment of inflammatory skin diseases.

Drug therapy for the major inflammatory skin diseases, which include atopic dermatitis, psoriasis and allergic contact dermatitis, is often inadequate due to poor efficacy, toxicity, or both. Much research has focused on the macrolactam T cell inhibitors as a promising new class of agents for immunotherapy, and medicinal chemistry efforts to design novel ascomycin analogs have produced clinically promising agents. A synthetic program to modify the ascomycin nucleus to alter its physicochemical properties and promote systemic clearance is described. A biologic screening strategy to identify analogs with reduced systemic activity and rapid pharmacokinetic elimination led to identification of the clinical candidate, ABT-281. A swine contact hypersensitivity model was used as a stringent indicator of skin penetration as human doses of topical corticosteroids produced inhibition only in the 50% range and ED50 values were 100-fold less potent than in rat. Also, cyclosporine was confirmed to be topically inactive in swine, as seen in human. ABT-281 had topical potency equal to tacrolimus (FK506) despite a severalfold lower potency for inhibiting swine T cells in vitro, consistent with superior skin penetration. ABT-281 was found to have a shorter duration of action after i.v. dosing in monkeys using an ex vivo whole blood IL-2 production assay. Systemic potency was reduced by 30-fold or more in rat popliteal lymph node hyperplasia and contact hypersensitivity assays. Following i.v. or i.p. administration in the swine contact hypersensitivity model, ABT-281 was 19- and 61-fold less potent, respectively, than FK506. Pharmacokinetic studies showed that ABT-281 had a shorter half life and higher rate of clearance than FK506 in all three species. The potent topical activity and reduced systemic exposure of ABT-281 may thus provide both efficacy and a greater margin of safety for topical therapy of skin diseases.

Administration, Topical↗

PubMed1998

p27Kip1 is expressed transiently in developing myotomes and enhances myogenesis.

Vertebrate skeletal muscle development is characterized by tight coupling of muscle differentiation with cell cycle arrest in G1/G0. Key regulators of G1 progression are the G1 cyclin-dependent kinases, their positive regulators, the G1 cyclins, and their negative regulators, the cyclin-dependent kinase inhibitors (CDIs). Here we show that p27Kip1 protein, a G1 CDI, is expressed in a prominent but transient wave in the developing myotomes of the mouse embryo. We relate its expression to expression of MyoD and myogenin proteins, which are determination and differentiation class myogenic regulatory factors, respectively. Functional assays showed that ectopic p27 expression can powerfully enhance the efficiency of MyoD-initiated muscle differentiation in cell culture. When considered together with the myotomal expression patterns of p18, p21, and p57, these results suggest a model in which p27 acts as a "trigger" CDI while myoblasts are exiting the cell cycle and initiating differentiation. At later times, when p27 protein has been down-regulated, it is proposed that accumulation of p18, p21, and p57 maintain the differentiated myocytes in a postmitotic state.

Animals↗

PubMed1998

[Quality-related education in general medicine].

On the basis of depth interviewing we obtained detailed qualitative data about opinions, experiences and needs of general practitioners (GP) concerning continuing medical education. Two main topics were health promotion and psychosocial aspects of the GP's daily work. Following a broad discussion of the results--comprehensively considering international research--we developed a modern conception for a worth-while and independent continuing medical education leading to a more individualised learning and teaching.

Curriculum↗

PubMed1998

[F-qi-FDG PET of the thyroid gland in Graves' disease].

AIM: This study evaluates F-18-FDG PET of the thyroid in Graves' disease. METHODS: Thirty patients were investigated the day before radioiodine therapy, 15 patients 3-10 days after radioiodine therapy. Twenty patients with cancer of the head or neck and normal thyroid function served as controls. RESULTS: F-18-FDG uptake was higher in Graves' disease patients than in controls. Negative correlations of F-18-FDG uptake with half-life of radioiodine and absorbed radiation dose due to radioiodine therapy were found along with a positive correlation to autoantibody levels. CONCLUSION: Thus F-18-FDG PET is likely to give information on the biological activity of Graves' disease as well as on early radiation effects.

Adult↗

PubMed1997

Reconstitution of a chloroplast protein import channel.

The chloroplastic outer envelope protein OEP75 with a molecular weight of 75 kDa probably forms the central pore of the protein import machinery of the outer chloroplastic membrane. Patch-clamp analysis shows that heterologously expressed, purified and reconstituted OEP75 constitutes a voltage-gated ion channel with a unit conductance of Lambda = 145pS. Activation of the OEP75 channel in vitro is completely dependent on the magnitude and direction of the voltage gradient. Therefore, movements of protein charges of parts of OEP75 in the membrane electric field are required either for pore formation or its opening. In the presence of precursor protein from only one side of the bilayer, strong flickering and partial closing of the channel was observed, indicating a specific interaction of the precursor with OEP75. The comparatively low ionic conductance of OEP75 is compatible with a rather narrow aqueous pore (dporeapproximately equal to 8-9 A). Provided that protein and ion translocation occur through the same pore, this implies that the environment of the polypeptide during the transit is mainly hydrophilic and that protein translocation requires almost complete unfolding of the precursor.

Chloroplasts↗

PubMed1997

Primary congenital pulmonary lymphangiectasia--a case report.

We report on a 22 year-old women with recurrent pleural effusions and shadowing of the right lower lobe, which was refractory to antibiotic treatment. Histologic examination (open lung biopsy) was interpretated as indicating an early stage of lymphangioleiomyomatosis. Because of progression of the pulmonary changes and development of a pericardial effusion in spite of antiestrogen treatment to achieve pharmacological castration, and in view of the atypical findings in high resolution computed tomography (lack of cysts) a second open lung biopsy was performed, confirming the diagnosis of pulmonary lymphangiectasia. The patient was given oral corticosteroids postoperatively and showed almost complete resolution of the pleural and pericardial effusions.

Adult↗

PubMed1997

QT dispersion is determined by the extent of viable myocardium in patients with chronic Q-wave myocardial infarction.

BACKGROUND: QT dispersion is lower in patients with successful thrombolysis after acute myocardial infarction, suggesting that QT dispersion may be determined by the extent of viable and scarred myocardium. METHODS AND RESULTS: To test this hypothesis, QT dispersion was measured in a 12-lead resting ECG in 44 patients with chronic Q-wave myocardial infarction. To assess the extent of viable and scarred myocardium, all patients underwent F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET). In addition, all patients had revascularization of the infarct-related artery and repeated angiography 4 months later. QT dispersion was lower (53+/-20 versus 94+/-24 ms, P<.0001) in patients with evidence of a substantial amount of viable myocardium in the infarct region as demonstrated by PET (average FDG uptake > or = 50% of normalized, maximum FDG uptake) than in patients with only minimal residual viability. Average FDG uptake of the infarct region and FDG defect size were significantly related to QT dispersion (r=.64, P<.0001; r=.67, P<.0001), whereas ejection fraction was not (r<.1, P=NS). QT dispersion of < or = 70 ms had a sensitivity of 85% and a specificity of 82% to predict viable myocardium in the infarct region. QT dispersion was also lower in patients with improvement of left ventricular function 4 months after revascularization (54+/-21 versus 88+/-30 ms, P=.0003). QT dispersion of < or = 70 ms had a sensitivity of 83% and a specificity of 71% to predict improvement of left ventricular function. CONCLUSIONS: QT dispersion is determined by the amount of viable myocardium in the infarct region and may serve as a novel, rapidly available marker of substantial viability in the infarct region of patients with chronic Q-wave myocardial infarction.

Angioplasty, Balloon, Coronary↗

PubMed1997

Allele identification using immobilized mismatch binding protein: detection and identification of antibiotic-resistant bacteria and determination of sheep susceptibility to scrapie.

A novel method for detection and identification of specific alleles has been developed utilizing immobilized mismatch binding protein (IMBP). The assay involves the use of biotin-labeled probes, which are prepared by PCR amplification of cloned fragments with known sequence. The use of probes avoids many of the problems associated with the extreme sensitivity of IMBP assays to errors in PCR amplification. The method can be used to monitor PCR fidelity and to genotype both diploid and haploid organisms and has been used to distinguish rifampicin-sensitive and -resistant strains of Mycobacterium tuberculosis and to detect and distinguish two alleles of the sheep prion protein gene involved in susceptibility to scrapie.

Alleles↗