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Biomedical subjects

T Lang

Publications and source records attributed to T Lang.

At least 19 recordsLinked to original sources

Quantification of prolactin-releasing peptide (PrRP) mRNA expression in specific brain regions of the rat during the oestrous cycle and in lactation.

Real-time Taqman RT-PCR was used to make quantitative comparisons of the levels of PrRP mRNA expression in micropunch brain samples from rats at different stages of the oestrous cycle and in lactation. The nucleus of the solitary tract and ventrolateral reticular nuclei of the medulla oblongata contained significantly (P<0.05) greater levels of PrRP mRNA than any hypothalamic region. Within the hypothalamus, the highest level of PrRP expression was localised to the dorsomedial aspect of the ventromedial hypothalamus. All other hypothalamic regions exhibited significantly (P<0.05) lower levels of expression, including the rostral and caudal dorsomedial hypothalamus. Very low levels of PrRP expression were observed in the arcuate nucleus, paraventricular nucleus, medial preoptic nucleus and ventrolateral aspect of the ventromedial hypothalamus. No significant changes in PrRP expression were noted in any sampled region between proestrus, oestrus or dioestrus. Similarly, PrRP expression in hypothalamic regions did not differ between lactating and non-lactating (dioestrous) animals. During validation of RT-PCR techniques we cloned and sequenced a novel splice variant of PrRP from the hypothalamus. This variant arises from alternative splicing of the donor site within exon 2, resulting in an insert of 64 base pairs and shift in the codon reading frame with the introduction of an early stop codon. In the hypothalamus and brainstem, mRNA expression of the variant was restricted to regions that expressed PrRP. These results suggest that PrRP expression in the hypothalamus may be more widespread than previously reported. However, the relatively low level of PrRP in the hypothalamus and the lack of significant changes in expression during the oestrous cycle and lactation provides further evidence that PrRP is unlikely to be involved in the regulation of prolactin secretion.

Animals↗

How psychiatric patients perceive the public's stereotype of mental illness.

BACKGROUND: It is well established that the general public has devaluating attitudes towards psychiatric patients. In order to avoid rejection, many of these patients develop coping strategies, such as withdrawal and concealing their treatment history. These efforts are in themselves stressing, which might have negative consequences for the course of the disorder. It is not clear, however, how many and which patients do actually perceive the public's stereotype as threatening and, therefore, expect rejection. METHOD: Ninety psychiatric patients and a sample of 1042 persons of the Austrian general population were asked whether they agreed with five devaluating statements about mental patients contained in a questionnaire developed by Link et al. Matched pairs comparisons and multiple logistic regression were employed in order to find out whether patients agreed with these statements to the same extent as the general population did. RESULTS: For the statements that most people believe that psychiatric patients are "less intelligent", "less trustworthy" and "taken less seriously", patients thought significantly less often than the general population that most people devalue mental patients. For two statements ("personal failure", "think less of") no difference was found. CONCLUSIONS: It seems that some psychiatric patients are less convinced than the general population that most people devalue psychiatric patients in specific respects; these patients might fear rejection less than other patients do. Those who actually fear rejection might need antistigma assistance more urgently than the first group.

Adult↗

Isolated systolic hypertension: data on a cohort of young subjects from a French working population (IHPAF).

Elderly patients with isolated systolic hypertension (ISH)--systolic blood pressure (SBP) > or =140 mmHg and diastolic blood pressure (DBP) <90 mmHg--have increased mortality and morbidity. The aim was to study the incidence of ISH in a younger population of between 15 and 60 years of age, and to measure pulse pressure (PP), mean arterial pressure (MAP) and heart rate (HR) in these subjects. The study population consisted of 27 783 subjects, aged 15-60 years, untreated for hypertension (HT) from a cohort of employees formed to study the incidence of HT in the French working population (AIHFP). BP and HR were measured with a validated, automatic device after 5, 6 and 7 min at rest. The prevalence of ISH was 6.9% in men, 2.3% in women. This prevalence was over 5% in young men and increased at 40-44 years; it was negligible in young women, but increased at 50-54 years to about 10% (ie to the same level as in men of the same age): PP in subjects with ISH (46.9 mmHg) was significantly higher than in the normotensive group (NT-40.9 mmHg); it was comparable in both young men (65.5 mmHg) and older men (66 mmHg); it was higher in men (63.1 mmHg) than in women (61.5 mmHg). HR was higher in ISH than in NT and it was higher in women ( approximately 5 bpm) in whom it decreased with age. The prevalence of ISH is not negligible in HT (30% men, 25% women), with a high prevalence in young subjects and elevated PP, MAP and HR values. These data should be taken into account as elevated ISH, PP and HR are considered as cardio-vascular risk factors.

Adolescent↗

Imaging SNAREs at work in 'unroofed' cells--approaches that may be of general interest for functional studies on membrane proteins.

When cultured cells are subjected to a brief ultrasound pulse, their upper parts burst, but the basal plasma membranes with their embedded membrane-protein complexes remain intact. Such two-dimensional, paraformaldehyde-fixed plasma membrane sheets have been used in the past to visualize the morphology of the inner plasmalemmal leaflet by electron or light microscopy. More recently, fluorescence microscopy of unfixed native membranes has been applied to study SNARE (soluble N-ethylmaleimide-sensitive factor attachment protein receptor) function. For instance, biochemical reactions of the plasmalemmal SNAREs with soluble fluorescent SNAREs, patching of SNARE and raft domains, and online monitoring of SNARE-mediated membrane fusion has been performed. The results obtained with the membrane sheet system have added some novel aspects to our understanding of the regulation of neuronal exocytosis. Surprisingly, SNAREs are concentrated in cholesterol-dependent microdomains that are different from membrane rafts. SNAREs in such domains are highly reactive, and define sites for vesicle exocytosis. Secretory granules that fuse on the membrane sheets are retrieved intact in a dynamin-dependent process, suggesting that the 'kiss-and-run' mechanism is not a reversed SNARE reaction, but is driven by a biochemically different mechanism. So far, studies of this type have focused on neuronal exocytosis; however, the method might be widely applicable. Data obtained with this system are derived from a 100% pure plasma membrane preparation that is only several seconds old, and membrane proteins are studied in their natural microenvironment that is defined by local lipid composition and putative bound proteins. Hence this approach yields results that most probably reflect the situation in a live cell.

Cell Membrane↗

Congenital atresia of the portal vein and extrahepatic portocaval shunt associated with benign neonatal hemangiomatosis, congenital adrenal hyperplasia, and atrial septal defect.

A rare case of congenital atresia of the portal vein and ductus venosus, extrahepatic portocaval shunt, benign neonatal hemangiomatosis, congenital adrenal hyperplasia, and an atrial septal defect is reported. Twenty-two cases of congenital extrahepatic end-to-side shunts have been described before. Although additional anomalies are common in this type of shunt, hemangiomatosis has been described only once. Adrenal hyperplasia has never been reported in this anomaly.

Abnormalities, Multiple↗

Suprascapular nerve entrapment. A meta-analysis.

We performed a review of the literature between 1959 and 2001. We found 88 cases of suprascapular nerve entrapment, which fulfilled our inclusion criteria. Suprascapular nerve entrapment is rare and mainly occurs in patients under 40 years of age. Males are more likely to suffer from a ganglion compressing the nerve than females. If the patient's history reveals a trauma, it is more likely that the ligament is compromising the nerve. Ganglions usually cause isolated infraspinatus atrophy, whereas a combined atrophy of the supra- and infraspinatus muscles is more common in cases in which the nerve is compressed by the ligament.

Humans↗

Quantitative computed tomography of the lumbar spine, not dual x-ray absorptiometry, is an independent predictor of prevalent vertebral fractures in postmenopausal women with osteopenia receiving long-term glucocorticoid and hormone-replacement therapy.

OBJECTIVE: To determine which measurement of bone mineral density (BMD) predicts vertebral fractures in a cohort of postmenopausal women with glucocorticoid-induced osteoporosis. METHODS: We recruited 114 subjects into the study. All had osteopenia of the lumbar spine or hip, as demonstrated by dual x-ray absorptiometry (DXA), and were receiving long-term glucocorticoids and hormone replacement therapy (HRT). Measurements of BMD by DXA of the lumbar spine, hip (and subregions), and forearm (and subregions), quantitative computed tomography (QCT) of the spine and hip (n = 59), and radiographs of the thoracolumbar spine were performed on all subjects to assess prevalent vertebral fractures. Vertebral fracture prevalence, as determined by morphometry, required a >or=20% (or >or=4-mm) loss of vertebral body height. Demographic information was obtained by questionnaire. Multiple regression and classification and regression trees (CART) analyses were used to assess predictors of vertebral fracture. RESULTS: Twenty-six percent of the study subjects had prevalent fractures. BMD of the lumbar spine, total hip and hip subregions, as measured by QCT, but only the lumbar spine and total hip, as measured by DXA, were significantly associated with prevalent vertebral fractures. However, only lumbar spine BMD as measured by QCT was a significant predictor of vertebral fractures. CART analysis showed that a BMD value <0.065 gm/cm(3) was associated with a 7-fold higher risk of fracture than a BMD value >or=0.065 gm/cm(3). CONCLUSION: In postmenopausal women with osteoporosis induced by long-term glucocorticoid treatment who are also receiving HRT, BMD of the lumbar spine as measured by QCT, but not DXA, is an independent predictor of vertebral fractures.

Absorptiometry, Photon↗

[Intra- and perioperative complications in the stabilization of per- and subtrochanteric femoral fractures by means of PFN].

In the period from 2/98 up to 6/99, fractures of the proximal femur of 70 patients (phi 79.2 a), were treated with a proximal femur nail (PFN((R))). The aim of this retrospective analysis was to evaluate intra- and perioperative complications. The reports of the operation and the anaesthesia documentation sheets have been worked out, all X-rays have been measured, and evaluated along exactly defined parameters. Problems or complications were found in 18 cases (25,7%). In 7 cases (10,0%) these problems could be solved during operation. The "Z-effect" seen in 5 cases (7,1%) and the "cut-out" of the sliding-hip-screw in 6 cases (8,6%) were the most frequent complications. The main reason was a bad primary reposition in varus with a CCD-Angle less than 125 degrees.

Bone Nails↗

[Social and professional factors, occupational environmental strain and cardiovascular diseases].

In addition to conventional risk factors, environmental and occupational strain is an actor of the development and evolution of cardiovascular diseases. In industrialised countries, cardiovascular mortality is inversely correlated with the socio-economic level and type of occupation. In the French Ihpaf study, systemic hypertension and obesity were correlated with the socio-economic level. Among possible explanations for the importance of occupational environment, psychological stress at work, sedentary jobs, passive smoking and shift working may all play a role. Thus, beyond the conventional approach to individual risk factor management, it appears necessary to consider cardiovascular prevention through collective actions taking into account occupational environment.

Cardiovascular Diseases↗

The prediction of visceral fat by dual-energy X-ray absorptiometry in the elderly: a comparison with computed tomography and anthropometry.

INTRODUCTION: Effective methods for assessing visceral fat are important to investigate the role of visceral fat for the increased health risks in obesity. Techniques for direct measurement of soft tissue composition such as CT or MRI are expensive, time-consuming or require a relatively high radiation dose. Simple anthropometric methods, such as waist-to-hip ratio, waist circumference or sagittal diameter are widely used. However, these methods cannot differentiate between visceral and subcutaneous fat and are less accurate. The aim of the present study is to investigate whether the dual-energy X-ray absorptiometry (DXA) method, possibly combined with anthropometry, offers a good alternative to CT for the prediction of visceral fat in the elderly. METHODS: Subjects were participants in the Health ABC-study, a cohort study of black and white men and women aged 70-79, investigating the effect of weight-related health conditions on disablement. Total body fat and trunk fat were measured by DXA using a Hologic QDR 1500. A 10 mm CT scan at the L4-L5 level was acquired to measure visceral fat and total abdominal fat. Weight, height, sagittal diameter and waist circumference were measured using standard methods. Fat in a manually defined DXA subregion (4 cm slice at the top of iliac crest) at the abdomen was calculated in a sub-group of participants (n=150; 50% male; 45.3% Afro-American/54.7% Caucasian, age 70-79 y). This subregion, the standard trunk region and total fat were used as indicators of visceral fat. RESULTS: Total abdominal fat by DXA (subregion) was strongly correlated with total abdominal fat by CT (r ranging from 0.87 in white men to 0.98 in black women). The DXA subregion underestimated total abdominal fat by 10% compared to the CT slice. The underestimation by DXA was seen especially in people with less abdominal fat. The association of visceral fat by CT with the DXA subregion (r=0.66, 0.78, 0.79 and 0.65 for white and black men and women, respectively) was comparable with the association of the CT measure with the sagittal diameter (r=0.74, 0.70, 0.84 and 0.68). Combining DXA measurements with anthropometry gave only limited improvement for the prediction of visceral fat by CT compared to univariate models (maximal increase of r(2) 4%). CONCLUSION: DXA is a good alternative to CT for predicting total abdominal fat in an elderly population. For the prediction of visceral fat the sagittal diameter, which has a practical advantage compared to DXA, is just as effective.

Abdomen↗

Effect of low protein concentration on serum sodium measurement: pseudohypernatraemia and pseudonormonatraemia!

BACKGROUND: The effect of high concentrations of protein or lipid on the measurement of plasma sodium by indirect ion selective electrode (ISE) causing pseudohyponatraemia and pseudonormonatraemia is well described. The effect of a low total protein concentration, however, has not been described. METHODS: In order to examine this, over a 2-week period the total protein concentration was measured on all samples received for urea and electrolyte measurement. All samples with a low (<50 g/L) or a high (> 80 g/L) total protein concentration had sodium measured by both direct and indirect ISE. RESULTS: There were approximately equal numbers of samples with a protein concentration less than 50 g/L (1.3%) as samples with a protein concentration greater than 80 g/L (1.3%). The frequency of erroneous sodium results owing to the use of an indirect ISE was less in hypoproteinaemic (2%) than in hyperproteinaemic (20%) samples.

Blood Proteins↗

The LDH ratio as a marker for response to plasma exchange in HUS/TTP of the adult.

BACKGROUND: Plasma exchange improved the outcome of thrombotic thrombocytopenic purpura (TTP)/hemolytic uremic syndrome (HUS) of the adult markedly, but a high number of non-responders remain. Identifying these patients at an early stage would help to optimize therapy. AIM: determine the value of serologic measures in predicting the response to plasma exchange. MATERIAL AND METHODS: We performed a retrospective chart review of 30 patients with HUS/TTP of the adult treated with plasma exchange. According to the treatment protocol, a mean of 42 +/- 8.2 ml plasma per kilogram of body weight was exchanged daily for 3 days and continued every second day thereafter. Prior to each session, clinical status and serologic markers for hemolysis and kidney function were obtained. To assess the early individual response to plasma exchange, the decline of LDH from the first to the third cycle was calculated as: LDH concentration before the third session/LDH concentration before the first session (LDH ratio). RESULTS: During the observation period (median 195, range 6-1500 days), 80% of the patients responded to therapy with plasmapheresis. None of the serologic measures or clinical signs obtained before initiation of plasma exchange showed a significant correlation with the outcome. After 2 sessions of plasma exchange, only LDH and platelet level had improved markedly in responding patients. The LDH ratio was the best predictive marker for the individual response. An LDH ratio < 0.6 predicted a favorable outcome with a sensitivity of 0.96 and a specificity of 0.83. CONCLUSION: The LDH ratio might be a useful marker for separating patients responding to plasma exchange from those not responding at an early stage.

Adult↗

Psychosocial factors at work, personality traits and depressive symptoms. Longitudinal results from the GAZEL Study.

BACKGROUND: An association between stressful job conditions and depressive symptoms has been reported. This association could be explained by personality traits. AIMS: To examine the relationship between psychosocial factors at work and changes in depressive symptoms, taking into account personality traits. METHOD: The role of occupational characteristics, psychosocial stress and personality traits in predicting an increase of depressive symptoms was evaluated in 7729 men and 2790 women working at the French National Electricity and Gas Company, with a 3-year follow-up. RESULTS: In men, high decision latitude was predictive of a decrease in the Centre for Epidemiologic Studies - Depression scale (CES-D) scores. In both genders, high job demands and low social support at work were predictive of increased scores, irrespective of personality traits and covariates. CONCLUSIONS: Adverse psychosocial work conditions are predictors of depressive symptom worsening, independent of personality traits.

Depressive Disorder↗

In vivo neutralization of TNF-alpha promotes humoral autoimmunity by preventing the induction of CTL.

Neutralization of TNF-alpha in humans with rheumatoid arthritis or Crohn's disease has been associated with the development of humoral autoimmunity. To determine the effect of TNF-alpha neutralization on cell-mediated and humoral-mediated responses, we administered anti-TNF-alpha mAb to mice undergoing acute graft-vs-host disease (GVHD) using the parent-into-F(1) model. In vivo neutralization of TNF-alpha blocked the lymphocytopenic features characteristic of acute GVHD and induced a lupus-like chronic GVHD phenotype (lymphoproliferation and autoantibody production). These effects resulted from complete inhibition of detectable antihost CTL activity and required the presence of anti-TNF-alpha mAb for the first 4 days after parental cell transfer, indicating that TNF-alpha plays a critical role in the induction of CTL. Moreover, an in vivo blockade of TNF-alpha preferentially inhibited the production of IFN-gamma and blocked IFN-gamma-dependent up-regulation of Fas; however, cytokines such as IL-10, IL-6, or IL-4 were not inhibited. These results suggest that a therapeutic TNF-alpha blockade may promote humoral autoimmunity by selectively inhibiting the induction of a CTL response that would normally suppress autoreactive B cells.

Acute Disease↗

SNAREs are concentrated in cholesterol-dependent clusters that define docking and fusion sites for exocytosis.

During exocytosis, SNARE proteins of secretory vesicles interact with the corresponding SNARE proteins in the plasmalemma to initiate the fusion reaction. However, it is unknown whether SNAREs are uniformly distributed in the membrane or whether specialized fusion sites exist. Here we report that in the plasmalemma, syntaxins are concentrated in 200 nm large, cholesterol-dependent clusters at which secretory vesicles preferentially dock and fuse. The syntaxin clusters are distinct from cholesterol-dependent membrane rafts since they are Triton X-100-soluble and do not co-patch with raft markers. Synaptosomal-associated protein (SNAP)-25 is also clustered in spots, which partially overlap with syntaxin. Cholesterol depletion causes dispersion of these clusters, which is associated with a strong reduction in the rate of secretion, whereas the characteristics of individual exocytic events are unchanged. This suggests that high local concentrations of SNAREs are required for efficient fusion.

Animals↗

The revised CONSORT statement for reporting randomized trials: explanation and elaboration.

Overwhelming evidence now indicates that the quality of reporting of randomized, controlled trials (RCTs) is less than optimal. Recent methodologic analyses indicate that inadequate reporting and design are associated with biased estimates of treatment effects. Such systematic error is seriously damaging to RCTs, which boast the elimination of systematic error as their primary hallmark. Systematic error in RCTs reflects poor science, and poor science threatens proper ethical standards. A group of scientists and editors developed the CONSORT (Con solidated S tandards o f R eporting T rials) statement to improve the quality of reporting of RCTs. The statement consists of a checklist and flow diagram that authors can use for reporting an RCT. Many leading medical journals and major international editorial groups have adopted the CONSORT statement. The CONSORT statement facilitates critical appraisal and interpretation of RCTs by providing guidance to authors about how to improve the reporting of their trials. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the CONSORT statement. The meaning and rationale for each checklist item are presented. For most items, at least one published example of good reporting and, where possible, references to relevant empirical studies are provided. Several examples of flow diagrams are included. The CONSORT statement, this explanatory and elaboration document, and the associated Web site ( http://www.consort-statement.org ) should be helpful resources to improve reporting of randomized trials. Throughout the text, terms marked with an asterisk are defined at end of text.

Algorithms↗

Evaluation of the logistic organ dysfunction system for the assessment of organ dysfunction and mortality in critically ill patients.

OBJECTIVES: To evaluate the performance of the logistic organ dysfunction (LOD) system for the assessment of morbidity and mortality in multiple organ dysfunction/failure (MOD/F) in an independent database and to evaluate the use of sequential LOD measurements for the prediction of outcome. DESIGN AND SETTING: Prospective, multicentric cohort study in 13 adult medical, surgical, and mixed intensive care units (ICUs) in Austria. PATIENTS: A total of 2,893 consecutive admissions to the ICUs. MEASUREMENTS AND MAIN RESULTS: Patient vital status at ICU and hospital discharge was recorded. Univariate analysis showed that the LOD was able to distinguish between survivors and nonsurvivors (2 vs. 6 median score). Within organ systems, higher levels of the severity of organ dysfunction were consistently associated with higher mortality. For the prediction of hospital mortality, the original prognostic LOD model did not perform well in our patients, as indicated by the goodness-of-fit C statistic. Using multiple logistic regression we developed a prognostic model with a satisfactory fit in our patients. The integration of further measurements during the ICU stay increased discrimination but not calibration. CONCLUSIONS: The LOD system is well correlated well with the numbers and levels of organ dysfunctions and discriminates well between survivors and nonsurvivors. It can thus be used to quantify the baseline severity of organ dysfunction. Moreover, after customization of the predictive equation the LOD predicted hospital mortality in our patients with high precision. It thus provides a combined measure of morbidity and mortality for critically ill patients with MOD/F.

Aged↗