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Biomedical subjects

S Wagner

Publications and source records attributed to S Wagner.

At least 91 records · Page 5Linked to original sources

Suboptimum hemicraniectomy as a cause of additional cerebral lesions in patients with malignant infarction of the middle cerebral artery.

OBJECT: The goal of this study was to determine the frequency of hemicraniectomy-associated lesions and their potential effect on the risk of mortality in patients suffering from malignant infarction of the middle cerebral artery MCA). METHODS: The authors evaluated serial computerized tomography scans obtained in 60 patients with complete infarction of the right MCA who were treated using hemicraniectomy. The maximum diameter of the hemicraniectomy was determined and the hemicraniectomy-associated lesions were classified as ischemic lesions or hemorrhages. The category of hemorrhages was composed of parenchymal, subdural, or epidural/subgaleal hematomas. Parenchymal hemorrhages and infarcts associated with hemicraniectomy occurred with frequency rates of 41.6% and 28.4%, respectively. The occurrence of hemicraniectomy-associated bleeding was related to the size of the hemicraniectomy performed; that is, the smaller the hemicraniectomy, the more often lesions occurred (p < 0.05). Hemicraniectomy-associated bleeding was also related to an increased risk of mortality. CONCLUSIONS: Hemicraniectomy is an effective therapy in patients with malignant infarction of the MCA. However, a hemicraniectomy that is too small in diameter may cause the formation of additional lesions and adversely affect the risk of mortality and the quality of survival. In addition, the size and shape of the edges of the bone defect are important factors relating to its efficacy.

Adult↗

Predictive value of lesions for relapses in relapsing-remitting multiple sclerosis.

BACKGROUND AND PURPOSE: Recent studies have suggested that enhancing lesions on contrast-enhanced T1-weighted MR images are predictive of impending exacerbations in cases of relapsing-remitting multiple sclerosis. We examined whether enhancing lesions, new enhancing lesions, and new hypointense lesions ("black holes") could accurately predict exacerbations in a cohort of 50 patients with relapsing-remitting multiple sclerosis within a time frame of up to 6 months. METHODS: Data were obtained from 50 patients with relapsing-remitting disease. All patients underwent monthly MR imaging and clinical examinations for a period of 12 months. Putative predictors of clinical relapse were defined from enhancing lesions, new enhancing lesions, and new black hole outcomes, and their operating characteristics were studied. RESULTS: Overall, the positive predictive values (PV+) of enhancing lesions, new enhancing lesions, or new black holes for an exacerbation did not exceed 0.25 and the negative predictive values (PV-) were all near 0.9. The best predictor for new enhancing lesions was the occurrence of new enhancing lesions in each of the previous 3 months (PV+: 0.79 [95% confidence interval, 0.651-0.900]; PV-: 0.83 [95% confidence interval, 0.751-0.887]). Similarly, new black holes were predicted best by the occurrence of new black holes in each of the previous 2 months (PV+: 0.54 [95% confidence interval: 0.372-0.697]; PV-: 0.85 [95% confidence interval, 0.790-0.896]). CONCLUSION: None of the MR markers could predict an impending relapse with any reasonable degree of precision. Rather, the absence of MR markers is associated with a more favorable clinical course (ie, fewer relapses).

Adult↗

Costs and resources associated with the treatment of overactive bladder using retrospective medical care claims data.

The objectives of this study were to determine age- and gender-specific drug treatment prevalence rates for overactive bladder (OAB), and to compare resource use and costs among MCO members receiving drug treatment for OAB. Administrative claims data from seven affiliated health plans were analyzed for 8,661 members with a diagnosis or treatment indicative of OAB during 1998. Resource use and associated costs were analyzed over a four-month follow-up. In 1998, the prevalence of OAB among plan members was 1.1%. Of the patients with OAB, 71% did not receive pharmacotherapy. After multivariate analysis, treatment with tolterodine, oxybutynin, or other OAB treatment did not significantly affect the percent change in total per patient per month (PPPM) costs compared with the group not receiving a pharmacologic agent. Although the adjusted percent change in PPPM pharmacy costs was significantly higher within the tolterodine group, medical and total PPPM costs were not.

Benzhydryl Compounds↗

Adjunctive therapies in the cath lab. Use of combination glycoprotein IIb/IIIa inhibitor and direct thrombin inhibitor drugs to support percutaneous coronary stent placement in a patient with renal insufficiency and heparin-induced thrombocytopenia.

An 81-year-old woman with a history of prior coronary artery bypass surgery, heparin-induced thrombocytopenia with "white clot" syndrome, and renal insufficiency presented with unstable angina. She was referred for cardiac catheterization. Complex percutaneous revascularization of the native circumflex coronary artery was performed using stents. A combination of tirofiban and lepirudin was used with dosing adjusted for renal insufficiency. The hospital course was uncomplicated and the patient was discharged on the fourth hospital day. This is only the second report of the combination use of direct thrombin inhibitor and glycoprotein IIb/IIIa receptor inhibitor.

Aged↗

Quantification of 5-aminolevulinic acid induced fluorescence improves the specificity of bladder cancer detection.

PURPOSE: 5-Aminolevulinic acid induced fluorescence endoscopy has outstanding sensitivity for detecting early stage bladder cancer. Nevertheless, a third of the lesions that show specific fluorescence are histologically benign. We decreased the false-positive rate of 5-aminolevulinic acid induced fluorescence endoscopy by incorporating protoporphyrin IX fluorescence quantification into the standard cystoscopy procedure. MATERIALS AND METHODS: In 25 cases (53 biopsies) of a history of or suspicion for bladder cancer 5-aminolevulinic acid induced fluorescence endoscopy and fluorescence image quantification were performed. For fluorescence image quantification images obtained with a target integrating color charge-coupled device camera were digitized and stored in a personal computer. Red-to-blue ratios were calculated from fluorescence positive lesions and results were correlated with hematoxylin and eosin histology. RESULTS: Malignant fluorescence positive lesions showed significantly stronger fluorescence intensity than fluorescing lesions with benign histology. A threshold was established that decreased the false-positive rate by 30% without affecting sensitivity. CONCLUSIONS: Fluorescence image quantification is a new endoscopic method for objectively selecting multicolor fluorescence bladder lesion images for biopsy. It has the potential of eliminating human error by different surgeons with variable experience in fluorescence endoscopy.

Adult↗

[Comparison of acute myocardial infarct in the old and new lands of unified Germany, 1996-1998. Data of the Myocardial Infarct Register (MIR)].

BACKGROUND AND OBJECTIVE: Little is known about any differences in the prevention, treatment and treatment results of myocardial infarction between the "old" (western) and "new" (eastern) Lands (OFL vs. NFL) of the now unified Federal Republic of Germany. It was the aim of this study to determine any such differences. PATIENTS AND METHODS: The Myocardial Infarction Register (MIR) is a multicentre and prospective compilation of consecutive unselected data on patients with acute myocardial infarction sustained between December 1996 and May 1998. All date collected between these dates were included in the study: there were 14,608 patients in 211 hospitals, 5618 patients and 68 hospitals of those in the eastern part (former German Democratic Republic). The median age of the entire collective was 68 years, 35% of patients were female. RESULTS: There was a higher prevalence of risk factors in the NFL than the OFL: 43.3 vs. 39.0% with regard to arterial hypertension (p = 0.002), and 28.9 vs. 22.4% with regard to diabetes mellitus (p < 0.001). The prehospital period was longer in the NFL by an average of 30 min (210 vs. 180 min; p < 0.001. Another difference concerned the lower number of diagnostic ECGs in the NFL (61.8 vs. 68.6%; p < 0.001). There were no significant differences with regard to acute and discharge medication (acetylsalicylic acid, betablockers, angiotensin-converting-enzyme inhibitors and cholesterol-synthesis inhibitors). The frequency of primary recanalization treatment (thrombolysis or percutaneous transluminal coronary angioplasty) in patients with clear-cut indications for thrombolysis was higher in the OFL (85.1 vs. 74.5%; p < 0.001). Hospital mortality was comparable (15.1 vs. 15.9%; p = 0.14). CONCLUSION: Patient characteristics and treatment in the two parts of Germany were comparable in the two parts. Treatment of acute myocardial infarction attained a similarly high standard in both. But in both parts there is room for improving the application of guidelines for treating of myocardial infarction to routine clinical practice. Greater effort should be made to inform the population, especially of the NFL, about the need for primary prevention and reduction in prehospital time.

Adrenergic beta-Antagonists↗

Coping with illness after brain diseases--a comparison between patients with malignant brain tumors, stroke, Parkinson's disease and traumatic brain injury.

PURPOSE: This study investigates coping styles in patients suffering from different brain disorders (malignant brain tumors, stroke, Parkinson's disease and traumatic brain injury). METHOD: In a combined analysis of four prospective studies we investigated 21 patients with malignant glioma at the end radiochemotherapy, 30 patients one year after ischemic stroke, 54 patients suffering from various stages of Parkinson's disease, and 58 patients 6 to 8.5 months after traumatic brain injury. The assessment of coping with illness was based on the Freiburg Questionnaire on Coping with illness. RESULTS: With few exceptions, coping styles did not differ across the various brain pathologies. Differences occurred with respect to 'active, problem-oriented coping' (decreased in stroke patients), and coping by search for religious relief or quest for sense (increased in patients with Parkinson's disease). CONCLUSION: Differences in coping styles could be mainly related to age and social factors. Individual coping strategies seem only to be little related to the type of brain pathology.

Acute Disease↗

Analysis of the subcellular distribution of protein kinase Calpha using PKC-GFP fusion proteins.

One important factor for the determination of the specific functions of protein kinase C (PKC) isoforms is their specific subcellular localization. In NIH 3T3 fibroblasts phorbol esters induce translocation of PKCalpha to the plasma membrane and the nucleus. In order to investigate PKCalpha's subcellular distribution and especially its nuclear accumulation in more detail we used fusion proteins consisting of PKCalpha and the green fluorescent protein (GFP). Purified GFP-PKCalpha from baculovirus-infected insect cells undergoes nuclear accumulation without any further stimuli in digitonin-permeabilized cells. Interestingly, permeabilization appears to be a trigger for PKCalpha's nuclear translocation, since the fusion protein also translocates to the nucleus in transiently transfected cells following permeabilization. This suggests that PKCalpha has a high nuclear binding capacity even in the case of large protein amounts. In contrast to endogenous PKCalpha, overexpressed GFP-PKCalpha as well as overexpressed PKCalpha itself translocates mainly to the plasma membrane and only to a smaller extent to the nucleus following stimulation with phorbol ester. Use of fusion proteins of GFP and different mutants of PKCalpha enabled determination of motifs involved PKCalpha's subcellular distribution: A25E and K368R point mutations of PKCalpha showed enhanced affinity for the plasma membrane, whereas sequences within the regulatory domain probably confer PKCalpha's nuclear accumulation.

3T3 Cells↗

The SCAN domain mediates selective oligomerization.

The SCAN domain is described as a highly conserved, leucine-rich motif of approximately 60 amino acids found at the amino-terminal end of zinc finger transcription factors. Although no specific biological function has been attributed to the SCAN domain, its predicted amphipathic secondary structure led to the suggestion that this domain may mediate protein-protein associations. A yeast two-hybrid screen identified members of two SCAN domain protein families that interact with the SCAN domain of the zinc finger protein ZNF202. The interacting ZNF191 protein represents the family of SCAN domain-containing zinc finger proteins, whereas the novel SDP1 protein establishes a new family of genes that encode an isolated SCAN domain. Isolated SCAN domain proteins may form asymmetric homodimers in solution. Biochemical binding studies confirmed the associations of ZNF191 and SDP1 with ZNF202 and established the SCAN domain as a selective hetero- and homotypic oligomerization domain. SCAN mediated protein associations might therefore represent a new regulatory mechanism of transcriptional activity.

Amino Acid Sequence↗

A broad role for the zinc finger protein ZNF202 in human lipid metabolism.

The ZNF202 gene resides in a chromosomal region linked genetically to low high density lipoprotein cholesterol in Utah families. Here we show that the ZNF202 gene product is a transcriptional repressor that binds to elements found predominantly in genes that participate in lipid metabolism. Among its targets are structural components of lipoprotein particles (apolipoproteins AIV, CIII, and E), enzymes involved in lipid processing (lipoprotein lipase, lecithin cholesteryl ester transferase), and several genes involved in processes related to energy metabolism and vascular disease. Based on the linkage and apparent transcriptional function of ZNF202, we propose that ZNF202 is a candidate susceptibility gene for human dyslipidemia.

Alternative Splicing↗

Modes of regulation of laminin-5 production by rat astrocytes.

Astrocytes have a prominent role in central nervous system-specific microvascular growth and function. Extracellular matrix molecules (ECMs) bind to specific adhesion molecules - integrins. These adhesion complexes are responsible for tissue integrity and cellular signalling. We have examined astrocyte-endothelial cell interactions in relation to expression of the ECM laminin-5. Astrocytes produce laminin-5 in cell culture. The production is enhanced by endothelial cells. Direct cellular contact possibly involving a beta1 integrin or an insoluble matrix compound detected by the astrocytes is responsible for the induction of astrocytic laminin production by endothelial cells. Hypoxia also influences ECM production. The described regulation goes in concert with the known effects of astrocyte-endothelial cell interaction and stresses its importance for microvascular integrity.

Animals↗

Thrombolytic properties of leukocytes from peripheral blood in healthy subjects and in patients with acute cerebral ischemia.

Polymorphonuclear leukocytes are activated in acute ischemic stroke. Activated polymorphonuclear leukocytes may contribute to thrombolysis by proteolytic degradation of fibrin and by modification of the plasminogen system. We used an in vitro thrombolysis model to investigate (1) thrombolytic properties of leukocytes in young and healthy subjects, (2) to test the hypothesis of increased polymorphonuclear leukocyte-associated thrombolysis in patients with acute cerebral ischemia, and (3) to assess plasminogen-dependent and -independent thrombolytic properties of polymorphonuclear leukocyte elastase. Coincubation of polymorphonuclear leukocytes with fibrin clots led to increased thrombolysis, a process reaching statistical significance after 8 hours [1x10(7) polymorphonuclear leukocytes/mL; 12.8+/-1.9% (mean+/-SEM), spontaneous clot lysis: 7.3+/-0.7%]. Polymorphonuclear leukocytes inside clots caused more efficient thrombolysis than polymorphonuclear leukocytes in the incubation medium. Spontaneous and polymorphonuclear leukocyte-associated lysis tended to be lower in patients with acute cerebral ischemia (n=9, 24 hours, 9.5+/-1.8% and 12.9+/-2.2%) than in age- and sex-matched control subjects (n=8; 12.2+/-2.0% and 17.4+/-1.9%). In the presence of alpha(2)-antiplasmin, thrombolysis tended to be faster with elastase-digested plasminogen (miniplasminogen) than with native plasminogen. Purified polymorphonuclear leukocyte elastase itself had no thrombolytic effect. We conclude that the thrombolytic capacity of polymorphonuclear leukocytes from peripheral blood is small and slow and may have been overestimated in previous reports. Polymorphonuclear leukocyte thrombolytic activity may not be increased in acute cerebral ischemia. Miniplasminogen may be an interesting adjunct to plasminogen activators in acute stroke models.

Aged↗

Elevated matrix metalloprotease and angiostatin levels in integrin alpha 1 knockout mice cause reduced tumor vascularization.

Integrin alpha1beta1 is a collagen receptor abundantly expressed on microvascular endothelial cells. As well as being the only collagen receptor able to activate the Ras/Shc/mitogen-activated protein kinase pathway promoting fibroblast cell proliferation, it also acts to inhibit collagen and metalloproteinase (MMP) synthesis. We have observed that in integrin alpha1-null mice synthesis of MMP7 and MMP9 was markedly increased compared with that of their wild-type counterparts. As MMP7 and MMP9 have been shown to generate angiostatin from circulating plasminogen, and angiostatin acts as a potent inhibitor of endothelial cell proliferation, we determined whether tumor vascularization was altered in the alpha1-null mice. Tumors implanted into alpha1-null mice showed markedly decreased vascularization, with a reduction in capillary number and size, which was accompanied by an increase in plasma levels of angiostatin due to the action of MMP7 and MMP9 on circulating plasminogen. In vitro analysis of alpha1-null endothelial cells revealed a marked reduction of their proliferation on both integrin alpha1-dependent (collagenous) and independent (noncollagenous) substrata. This reduction was prevented by culturing alpha1-null cells with plasma derived from plasminogen-null animals, thus omitting the source from which to generate angiostatin. Plasma from tumor-bearing alpha1-null animals uniquely inhibited endothelial cell growth, and this inhibition was relieved by the coaddition of either MMP inhibitors, or antibody to angiostatin. Integrin alpha1-deficient mice thus provide a genetically characterized model for enhanced angiostatin production and serve to reveal an unwanted potential side effect of MMP inhibition, increased tumor angiogenesis.

Angiostatins↗

Gating of segmental and transcortical reflexes to human hand muscles depends on the mode of innervation.

We investigated the influence of the innervation pattern on the transmission of reflexes to a hand muscle. Reflexes were elicited by repetitive median nerve stimulation and recorded from the abductor pollicis brevis muscle. Both H and long loop reflexes were exclusively attenuated by irregular isotonic thumb abduction. In 10 of 15 experiments the long loop reflex was blocked completely. Inhibition intercalated between the H and long loop reflexes also decreased considerably. The observed attenuation of both spinal and supraspinal reflexes is suspected to take place mainly at the spinal level. Among the possible mechanisms, reciprocal inhibition is the most likely.

Adult↗

Age-related blood half-life of particulate contrast material: experimental results with a USPIO in rats.

It has been well established in the literature that phagocytic activity in animals and humans changes with age, but this phenomenon has not yet been investigated for particulate contrast agents. The present study was therefore performed to determine the effect of age on blood half-life of a superparamagnetic iron oxide blood pool contrast agent and on the velocity of its uptake in the liver and spleen of the rat by means of magnetic resonance (MR) imaging. A total of 18 rats (group A: 214-255 g, age: 45-50 days; group B: 432-563 g, age: 100-120 days) were imaged at 1.5 T using a 3D gradient-recalled echo (GRE) sequence (TR/TE 6.6/2.3 msec; alpha 25 degrees, frontal). Images were acquired before and every 3-5 minutes for up to 30 minutes after i.v. injection of 30 micromol Fe/kg of a citrate-coated superparamagnetic iron oxide-based contrast agent (VSOP-C43). Intravenous injection of VSOP-C43 resulted in a pronounced initial signal enhancement in vessels, which decreased with a half-life of 8.4 +/- 0.9 minutes in group A and of 15.9 +/- 2. 4 minutes in group B (P < 0.01). The half-life of signal decrease was 11.6 +/- 2 minutes and 19.9 +/- 4.4 minutes in the liver (P < 0. 01) and 19.6 +/- 3.1 minutes and 26.7 +/- 5.2 minutes in the spleen (not significant). The results show that the age-related phagocytic activity has a significant effect on the circulation time and velocity of uptake of a particulate MR imaging contrast agent. This fact must be taken into consideration in both the preclinical and clinical development of particulate contrast material and in the clinical application of such agents.

Age Factors↗

New generation of monomer-stabilized very small superparamagnetic iron oxide particles (VSOP) as contrast medium for MR angiography: preclinical results in rats and rabbits.

The purpose of this study was to evaluate the signal enhancement characteristics of very small superparamagnetic iron oxide particles (VSOP)-C63, a new monomer-coated, iron oxide-based magnetic resonance (MR) blood pool contrast medium with a very small particle size and optimized physical properties. Equilibrium MR angiography (MRA) of rats (thoracic and abdominal vessels) was performed at 1.5 T with a three-dimensional gradient-recalled echo (3D GRE) technique (TR/TE 6.6/2.3 msec, flip angle 25 degrees ) before and after (every 3-5 minutes up to 50 minutes) i.v. injection of VSOP-C63 [dosages: 15, 30, 45, 60, 75, and 90 micromol Fe/kg; diameter: 8 nm; relaxivities at 0.47 T: R1 = 30 l/(mmol * s); R2 = 39 l/(mmol * s)]. First-pass MRA images (3D-GRE, TR/TE 4.5/1.7 msec, flip angle 25 degrees ) were obtained with 45 micromol Fe/kg VSOP-C63 in comparison with 0.2 mmol Gd/kg of gadolinium diethylene triamine pentaacetic acid (Gd DTPA; before and every 5 seconds p.i.). MRA (3D GRE, TR/TE 4.5/1.7 msec, flip angle 25 degrees) of coronary vessels in rabbits was performed after i.v. injection of 45 micromol Fe/kg of VSOP-C63. In rats maximal S/N ratio in thoracic and abdominal arteries directly after i.v. injection of VSOP-C63 was 25 +/- 1, 43 +/- 2, 49 +/- 4, 57 +/- 3, 64 +/- 3, and 63 +/- 3 for the different dosages. Blood half-life was dose dependent (15 +/- 2, 20 +/- 3, 29 +/- 6, 37 +/- 5, 61 +/- 16, and 86 +/- 21 minutes). At a dose of 30 micromol Fe/kg even small intrarenal arteries were sharply delineated. First-pass MRA showed no significant difference in the S/N ratio between Gd-DTPA (71.5 +/- 11.5) and VSOP-C63 (65.1 +/- 18. 3). The proximal segments of the coronary arteries in rabbits were clearly depicted at a dose of 45 micromol Fe/kg. The monomer-coated, iron oxide-based contrast medium VSOP-C63 exhibits favorable properties as a blood pool agent for both equilibrium and first-pass MRA. J. Magn. Reson. Imaging 2000;12:905-911.

Animals↗

In-hospital mortality of elderly patients with acute myocardial infarction: data from the MITRA (Maximal Individual Therapy in Acute Myocardial Infarction) registry.

BACKGROUND: Advanced age remains one of the principal determinants of mortality in patients with acute myocardial infarction (AMI). HYPOTHESIS: The aim of this study was to determine the in-hospital outcome of elderly (> 75 years) patients with AMI who were admitted to hospitals participating in the national MITRA (Maximal Individual Therapy in Acute Myocardial Infarction) registry. METHODS: MITRA is a prospective, observational German multicenter registry investigating current treatment modalities for patients presenting with AMI. All patients with AMI admitted within 96 h of onset of symptoms were included in the MITRA registry. MITRA was started in June 1994 and ended in January 1997. This registry comprises 6,067 consecutive patients with a mean age of 65 +/- 12 years, of whom 1,430 (17%) were aged > 75 years. Patients were compared with respect to patient characteristics, prehospital delays, early treatment strategies, and clinical outcome. RESULTS: In the elderly patient population, the prehospital delay was 210 min, which was significantly longer than that for younger patients (155 min, p = 0.001). Although the incidence of potential contraindications for the initiation of thrombolysis was almost equally distributed between the two age groups (8.7 vs. 8.2%, p = NS), elderly patients (> 75 years) received reperfusion therapy less frequently (35.9 vs. 64.6%) than younger patients. Mortality increased with advanced age and was 26.4% for all patients aged > 75 years. If reperfusion therapy was initiated, in-hospital mortality was 21.8 versus 28.9% in patients aged > 75 years (p = 0.001) and 29.4 versus 38.5% in patients aged > 85 years (p = 0.001). CONCLUSION: In this registry, elderly patients with AMI had a much higher in-hospital mortality than that expected from randomized trials. In MITRA, the mortality reduction with reperfusion therapy was found to be highest in the very elderly patient population.

Age Factors↗

Proinflammatory cytokines trigger MUC gene expression and mucin release in the intestinal cancer cell line LS180.

OBJECTIVES AND DESIGN: Proinflammatory cytokines and a defective mucus layer are involved in the pathogenesis of colitis. Therefore, we determined cytokine effects on MUC gene expression and mucin secretion. MATERIALS AND METHODS: LS180 cells were characterized by light and electron microscopy and subsequently exposed to interleukin 1 (IL-1, 1 ng/ml), interleukin 6 (IL-6, 10 ng/ml), or tumor necrosis factor-alpha (TNFalpha, 10 ng/ml). MUC gene (MUC2, MUC5AC, MUC5B, MUC6) mRNA expression was assessed by RT-PCR, the encoded proteins were identified by immunocytochemistry and Western blotting, and the released mucins were isolated and chromatographically characterized. RESULTS: Thirty to 40% of the cells contained intracellular mucin granules. Incubation with IL-1 transiently stimulated the mRNA expression of MUC2 and MUC5AC, whereas IL-6 induced an early response of MUC2, MUC5B and MUC6. TNFalpha upregulated the expression of MUC2 and MUC5B for 3 hours, and had no effect on the expression of MUC 5AC and MUC6. Immunocytochemistry and Western blotting confirmed TNFalpha effects on MUC2 and MUC5AC on the protein levels. All cytokines stimulated the release of less glycosylated mucins and considerably modulated their carbohydrate composition. CONCLUSION: Our data demonstrate differential cytokine effects on mucin synthesis, secretion and composition. These alterations may contribute to the defective mucus layer in colitis.

Blotting, Western↗