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Biomedical subjects

T Schwarz

Publications and source records attributed to T Schwarz.

At least 55 records · Page 3Linked to original sources

The molecular determinants of sunburn cell formation.

Sunburn cell (SBC) formation in the epidermis is a characteristic consequence of ultraviolet radiation (UVR) exposure at doses around or above the minimum erythema dose. SBC have been identified morphologically and biologically as keratinocytes undergoing apoptosis. There is evidence that SBC formation is a protective mechanism to eliminate cells at risk of malignant transformation. The level of DNA photodamage is a major determinant of SBC induction by a process controlled by the tumor suppressor gene p53. However, extra-nuclear events also contribute to SBC formation, such as the activation of death receptors including CD95/Fas. UVR triggers death receptors either by direct activation of these surface molecules or by inducing the release of their ligands such as CD95 ligand or tumor necrosis factor. Oxidative stress also appears to be involved, probably via mitochondrial pathways, resulting in the release of cytochrome C. Pathways which modify SBC formation are now extensively studied given the importance of apoptosis in eliminating irreparably damaged cells. A greater understanding of the mechanisms that induce and prevent UVR-induced apoptosis will contribute to our understanding of mechanisms relevant in genomic integrity.

Animals↗

Interleukin-6-resistant melanoma cells exhibit reduced activation of STAT3 and lack of inhibition of cyclin E-associated kinase activity.

Development of cytokine resistance is an important feature of melanoma cells during tumor progression. To study the mechanisms of interleukin-6 resistance, we examined an interleukin-6 sensitive (WM35) and an interleukin-6 unresponsive cell line (WM9). Interleukin-6 treatment resulted in rapid inhibition of cyclin-dependent kinase 2/cyclin E activity and accumulation of the hypophosphorylated retinoblastoma protein in WM35 but not in WM9 cells. In contrast to previous reports, no differences in the expression of the cyclin-dependent kinase 2 inhibitor p21Cip1/WAF1 upon interleukin-6 treatment were found in both cell lines. Interleukin-6-induced inhibition of cyclin-dependent kinase 2 was also not due to changes in protein expression of cyclin-dependent kinase 2, cyclin E, p27Kip1 and cdc25A, a phosphatase positively regulating cyclin-dependent kinase 2 activity. As it is established that interleukin-6 resistance of WM9 cells is not caused by differential interleukin-6 receptor expression, we studied whether this is due to defective interleukin-6 signaling in which activation of signal transducer and activator of transcription 3 is a critical step. WM9 cells showed reduced tyrosine phosphorylation, DNA binding, and delayed nuclear translocation of signal transducer and activator of transcription 3 as compared with WM35 cells. The kinase upstream of signal transducer and activator of transcription 3, Janus kinase 1, was constitutively tyrosine-phosphorylated in WM9 cells and did not respond to interleukin-6 with increased phosphorylation. As compared with WM35 cells, interleukin-6 treatment of WM9 cells was not paralleled by reduced activity of the mitogen-activated protein kinase kinase-1, which suppresses activation of signal transducer and activator of transcription 3. Our data suggest that resistance of advanced melanoma cells to interleukin-6 is associated with reduced inhibition of cyclin-dependent kinase 2, which appears to be a consequence of a complex alteration in interleukin-6 signal transduction.

CDC2-CDC28 Kinases↗

Reduction of pacing output coupling capacitance for sensing the evoked response.

Sensing of the intracardiac evoked response (ER) after a pacing stimulus has been used in implantable pacemakers for automatic verification of capture. Reliable detection of ER is hampered by large residual afterpotentials associated with pacing stimuli. This led to the development of various technological solutions, like the use of triphasic pacing pulses and low polarizing electrode systems. This study investigated the effect of reducing the coupling capacitance (CC) in the pacemaker output circuitry on the magnitude of afterpotential, and the ability to automate detection of ventricular evoked response. A CC of 2.2 microF and four different blanking and recharge time settings were clinically tested to evaluate its impact on sensing of the ventricular ER and pacing threshold. Using an automatic step-down threshold algorithm, 54 consecutive patients, aged 70 +/- 10 years with acutely (n = 27) or chronically (n = 27) implanted ventricular pacing leads were enrolled for measurement testing. Routine measurements, using a standard pacing system analyzer (PSA), were (mean +/- SD) impedance 569 +/- 155 omega, R wave amplitude baseline to peak 9.8 +/- 3.7 mV and threshold 0.9 +/- 0.7 V at 0.4-ms pulse width. This new capture verification scheme, based on a CC of 2.2 microF and recharge/blanking timing setting of 10/12 ms, was successful in 52 patients which is equivalent to a success rate of 96%. In a subgroup of 26 patients implanted with bipolar ventricular leads (10 chronic, 16 acute), data were collected in unipolar (UP) and bipolar (BP) pace/sense configurations. Also, ER signals were recorded with two different band-pass filters: a wider band (WB) of 6-250 Hz and a conventional narrow band (NB) of 20-100 Hz. WB sensing from UP lead configuration yielded statistically significant larger signal to artifact ratios (SAR) than the other settings (P < 0.01). A dedicated unipolar ER sensing configuration using a small output capacitor and a wider band-pass filter enables adequate automatic capture verification, without any restrictions on pacing lead models or pacing/sensing configurations.

Aged↗

A directed approach to the selection of bacteria with enhanced catabolic activity.

AIMS: This study was aimed at selecting catabolicly-improved bacteria by in vitro evolution using a specially designed fermentor system. METHODS AND RESULTS: To facilitate this objective, genetic variation was induced by ultraviolet irradiation, and a selective pressure was subsequently exerted by gradual increases in the concentration of organic toxins. During a pilot experiment, a culture was forced to tolerate and catabolize a mixture of phenol and formaldehyde. The population developed a high resistance against formaldehyde and the specific degradation rate increased rapidly. Biochemical analysis of the mutants revealed an increase in the expression of enzymes involved in the pathway oxidizing formaldehyde. CONCLUSIONS: The fermentor system described is, in general, suitable for the selection of bacteria with enhanced catabolic activities. SIGNIFICANCE AND IMPACT OF THE STUDY: The procedure is an alternative to conventional genetic engineering, providing efficient and genetically stable strains suitable for applications in the field of environmental biotechnology.

Bacteria↗

Dual-coil vs single-coil active pectoral implantable defibrillator lead systems: defibrillation energy requirements and probability of defibrillation success at multiples of the defibrillation energy requirements.

AIMS: The aim of the study was to compare the defibrillation energy requirements and the probability of successful defibrillation at multiples of the minimum defibrillation energy requirements in active pectoral implantable defibrillators with single- and dual-coil lead systems. METHODS AND RESULTS: Eighty-three consecutive patients undergoing implantation of an active pectoral cardioverter-defibrillator were randomized to receive a dual- or single-coil lead system. Defibrillators of two manufacturers with a fixed tilt biphasic defibrillation waveform were used. Defibrillation energy requirements were determined using a step-down defibrillation testing protocol. According to the randomization protocol, the patients were assigned to three additional consecutive defibrillation attempts during device implantation and during pre-discharge testing of either 1.0, 1.5 or 2.0 times the determined defibrillation energy requirement. Patients presenting defibrillation energy requirements > 15 J were excluded from analysis. Eighty of 83 patients (96%) completed the study protocol. Three patients were excluded due to elevated defibrillation energy requirements. The defibrillation energy requirements in the dual- and single-coil patient groups were 8.0 +/- 3.6 J and 8.4 +/- 3.7 J (ns), respectively. A comparable percentage of study patients showed defibrillation energy requirements <10 J (dual-coil: 88% vs single-coil: 83%). Defibrillation impedance was significantly different (dual-coil: 50 +/- 5.8 Ohm; single-coil: 39.8 +/- 4.2 Ohm). Regarding the probabilities of successful defibrillation, there were no significant differences between the two patient groups. The probabilities of defibrillation at the three multiples of the defibrillation energy requirement using a dual- and single-coil lead system were 82, 89.7 and 93.6 and 77.8, 94.1 and 95.8%, respectively (P=0.88, P=0.42, P=0.62, respectively). CONCLUSIONS: Dual- and single-coil active pectoral defibrillator systems show no difference in defibrillation energy requirements and no difference in the probability of successful defibrillation at multiples of the minimum defibrillation energy requirement. The use of more simplified defibrillator lead systems may contribute to a future lead design focusing on improvement in lead durability.

Aged↗

Segmental mandibular reconstruction by microincremental automatic distraction osteogenesis: an animal study.

We investigated the reconstruction of a surgically created critical size mandibular defect in sheep using a newly developed automatic distraction device. The device has an implantable component, which is fixed to the mandible to allow the transfer of the transport disc across the created defect, and an external component which is mounted on the activation pump and secured away from the site of bone distraction. Compression of the bellows in the external component causes fluid to be forced through the connecting tube into the distraction component. Distraction at a rate of 1 mm over 24 h was achieved in six sheep. New bone generated at the site of the created defects both anterior (compression side) and posterior (tension side) to the transport disc and had similar radiodensity to the adjacent mandibular bone eight weeks after the completion of distraction.

Angiography↗

[Breast cancer recurrence versus scar. Ultrasonographic differentiation using Levovist as the contrast medium].

AIM: To determine the scope of improving the distinction between a postoperative scar and the recurrence of a breast carcinoma through the use of the ultrasound echo enhancer Levovist? METHOD: In 23 patients with 26 lesions a colour-coded duplex sonography examination before and after administration of Levovist was performed. The parameters investigated were: degree of enhancement, number of tumour vessels and the pattern of vascular morphology and anatomy. RESULTS: Recurrences (n = 15) demonstrated a greater number of vessels and a stronger enhancement after administration of Levovist. Individual vessels were also visible in scars (n = 11). Further evaluations with respect to the pattern of the tumour vascularization are therefore necessary with the exception of one false positive and one negative result a clear distinction was possible. CONCLUSION: The administration of the ultrasound echo enhancer clearly improved the otherwise difficult distinction between a scar and a tumour recurrence through sonography and mammography. Further studies with larger number of patients are necessary to establish the value of the method.

Adult↗

Eligibility for home treatment of deep vein thrombosis: a prospective study in 202 consecutive patients.

PURPOSE: Home treatment of deep vein thrombosis (DVT) has been shown to be safe and effective. However, this conclusion has been drawn from studies with predefined patient selection criteria. Eligibility for home treatment has never been properly assessed. METHODS: In a 9-month period, we prospectively evaluated the possible reasons for hospital treatment in consecutive patients with acute DVT by using a check list that included medical reasons, home care situation, preferences, and hospital service logistics. Treatment consisted of low-molecular-weight heparin and concomitant oral vitamin K antagonists and compression therapy. A 3-month follow-up examination included assessment of recurrent venous thromboembolism (VTE), bleeding events, and mortality. RESULTS: A total of 202 patients were included in the study; 117 patients (58%) were outpatients and 85 patients (42%) were hospitalized before DVT diagnosis. Of the 117 outpatients, 95 (81%) were considered eligible for home treatment. Only two patients (1.7%) were admitted to the hospital for DVT-related morbidity, one (0.85%) because of comorbidity, 11 (9.4%) for home care reasons, and eight (6.83%) because of hospital service logistics. Of the hospitalized patients, 79 (92.94%) remained inpatients, and six (7.05%) could be discharged within 48 hours. The only reason for hospitalization was pre-existing comorbidity. In outpatients, the outcome after 3 months showed a 4% rate of recurrent VTE, no major bleeding, and an 8% mortality rate; 75% of deaths were caused by cancer. No patient died of VTE. In inpatients, a statistically significant higher mortality rate was found (8% vs 19%; P < .02). CONCLUSION: Less than 3% of patients with DVT who were outpatients had to be hospitalized because of DVT morbidity. For the entire DVT population, the main reason for hospital treatment is comorbidity, rather than management issues or DVT morbidity.

Adult↗

Activation of Gi-coupled receptors releases a tonic state of inhibited platelet aggregation.

Single-receptor pharmacology does not satisfactorily explain the physiology of the ADP-induced platelet aggregation response. It has been shown that, in addition to Gq-coupled receptor activation, one Gi-coupled receptor, either the ADP P2T or the alpha2-adrenoceptor, is required for elicitation of aggregation. The underlying mechanism of this action, however, has not been elucidated. By systematically assaying the entire time course of the aggregation and its fade using two methods of aggregometry, we have investigated the role of graded activation of these two Gi-coupled receptors. We demonstrate that constant activation of either of two Gq-coupled receptors, the ADP P2Y1 or the 5-HT2A, and incremental activation of either of the two Gi-coupled receptors, tightly regulates the aggregation response in vitro, through the apparent release of a tonic inhibition of platelet aggregation. This tightly regulated release of inhibition, which appears analogous to the phenomena of disinhibition observed in the central nervous system, may be instrumental for the continuous adaptation of the aggregation response to variable physiological conditions.

Adaptation, Physiological↗

The balance of concurrent aggregation and deaggregation processes in platelets is linked to differential occupancy of ADP receptor subtypes.

Deaggregation, the partial reversal of the initial aggregation of platelets is observed following low, but not higher, micromolar ADP concentrations. This study tested the hypothesis that deaggregation results from a balance between concurrent, opposing, aggregation and deaggregation processes which are ADP (adenosine 5'-diphosphate) receptor occupancy-dependent. Aggregation of human platelet-rich plasma (PRP) prepared in r-hirudin was assayed in a 96-well plate reader over 20 min by measurement of the optical density (OD) at 580 nm. Aggregation and the time to reach peak aggregation were directly proportional to ADP receptor occupancy. The magnitude and time course of the response to ADP were comparable to those previously reported with standard aggregometry. The rate constant of platelet deaggregation, as assessed by a four-compartment kinetic model, was inversely proportional to agonist concentration. The ratio of the rate constants of aggregation and deaggregation was receptor occupancy-dependent and directly proportional to aggregation. Consequently, platelet aggregation was proportional, and deaggregation inversely proportional, to ADP receptor occupancy. We propose that the response of PRP to ADP and to 2-MeS-ADP (2-methylthioadenosine-diphosphate), in vitro, consists of at least two active, concurrent processes, aggregation and deaggregation. Incremental occupancy of the P2T ADP receptor subtype attenuates deaggregation and governs the balance between these two processes.

Adenosine Diphosphate↗

Deaggregation is an integral component of the response of platelets to ADP in vitro: kinetic studies of literature and original data.

Adenosine diphosphate (ADP) is recognized as an important mediator of platelet aggregation. Transient aggregation at low (< or =1 microM), and sustained aggregation at higher ADP concentrations are consistently observed. Dissociation of platelet aggregates has been described and may explain the reversible component of the aggregation response. We hypothesized that the net aggregation response to ADP in vitro results from the concurrent activation of two opposing processes, aggregation and deaggregation. Different purinergic receptor subtypes may mediate these effects. To test this hypothesis and its generalizability, we performed a kinetic analysis of representative published ADP-induced aggregation responses supplemented with original data from our laboratory. A four-compartment kinetic model was used to estimate k(3), a rate constant of deaggregation. Two model-independent parameters, the magnitude of the aggregation response (DeltaOD) and the time to reach maximal aggregation (t(peak)) were also assessed. Greater sustained aggregation at higher ADP concentrations was consistently associated with increased DeltaOD and t(peak) but decreased k(3) values. These relationships were independent of type of platelet preparation or experimental conditions and not due to ADP receptor desensitization. Conversely, blockade of the P2Y(12) receptor subtype (ticlopidine, clopidogrel or 2-MeS-AMP) decreased DeltaOD and t(peak) but increased k(3) values. This supports the presence of active deaggregation which is decelerated by activation of the P2Y(12) receptor subtype.

Adenosine Diphosphate↗

Activation of the alpha(2A)-adrenoceptor mediates deceleration of the deaggregation component of the response to ADP or 5-HT in human platelets in vitro.

Platelet aggregation requires the concomitant activation of at least one G(i)- and one G(q)-coupled receptor. Epinephrine (EPI) amplifies the response elicited by a number of agonists for platelet aggregation. This study tested the hypothesis that platelet alpha(2A)-adrenoceptor activation causes deceleration of the deaggregation component of the platelet aggregation response when activated concomitantly with the G(q)-coupled adenosine diphosphate (ADP) P2Y(1) or 5-hydroxytryptamine(2A) receptor. The time course of the aggregation response of human platelet-rich plasma following activation of combinations of two or three receptors was assessed by turbidometry using lepirudin anticoagulation. Simultaneous activation of specific two- and three-receptor combinations was achieved using selective antagonists for the P2Y(12) and P2Y(1) receptor subtypes. Steady-state and kinetic parameters, obtained using a four-compartment kinetic model, were used to assess the effects on the net aggregation response. Graded alpha(2A)-adrenoceptor activation was associated with a concentration-dependent decrease of the rate constant of deaggregation. Activation of both ADP receptor subtypes and the alpha(2A)-adrenoceptor produced a concentration-dependent, mutual amplification of the aggregation response. In addition, when three receptors were simultaneously activated, mutual amplification of the aggregation response was observed at physiologically relevant concentrations of epinephrine or norepinephrine (NE) and ADP. We propose that similar to the P2Y(12) receptor, activation of the alpha(2A)-adrenoceptor decelerates the deaggregation component shifting the balance toward increased net aggregation. The effects of EPI and NE on the aggregation response may contribute to the mechanism of increased thrombotic risk present in certain pathophysiological and disease states.

Adenosine↗

Therapy of isolated calf muscle vein thrombosis with low-molecular-weight heparin.

There are no data from prospective studies concerning the treatment of isolated calf muscle vein thrombosis (soleal and gastrocnemial muscle veins), found in 20-40% of patients with lower extremity thrombosis of the calf. We investigated the outcome in two cohorts of consecutive patients, the first receiving low-molecular-weight heparin for 10 days at therapeutic doses and compression therapy; the second cohort, compression therapy alone. In patients on therapeutic heparin (n = 52), no progression to deep vein thrombosis occurred [0%; 95% confidence interval (CI), 0-6.8%]. Patients without anticoagulation (n = 32) showed a statistically significant higher percentage of progression into the deep calf veins (25%; 95% CI, 11.5-43.4%) as well as recurrent muscle vein thrombosis. No symptomatic pulmonary embolism or bleeding event occurred; one patient died in each group, both related to malignancy. The data suggest a need for short-term anticoagulation in such patients to prevent further thromboembolic complications. Randomized prospective studies are now warranted in a larger study population.

Adolescent↗

Investigation of genotype-dependent differences in factor V activity as well as response to activated protein C by application of different methods.

Coagulation factor V has been at the centre of investigation for several years. In addition to factor V Leiden, various other polymorphisms are becoming the object of interest. Different results have been published about the association of the HR2 haplotype with decreased factor V levels and with reduced response to activated protein C (APC). Due to the central position of factor V in the clotting process, its activity can be determined in both thromboplastin-based and activated partial thromboplastin time (aPTT)-based assays. A multitude of assays are known for the determination of APC response. The aim of our study was to investigate whether different methods disclose genotype-dependent differences in factor V activity as well as APC response. Three wild-type carriers, three carriers homozygous for the R2 allele (4070G), and three carriers homozygous for the G allele (2391G, 2663G, 2684G, 2863G) were investigated. For each individual plasma sample, the factor V activity was determined using 12 different reagent combinations of three different thromboplastins, three different aPTT reagents, and two different factor V deficient plasma sources. The determination of factor V activity in the thromboplastin system revealed differences between the genotypes. These differences were independent of the thromboplastin reagent and the factor V-deficient plasma. The aPTT system exhibited a dependency on the aPTT reagent and the factor V-deficient plasma. Analysis of APC response disclosed genomic differences in specific test systems only. One type of assay could be more appropriate than other types in dependence of the position of genomic variations. Therefore, the applied assay is an important influential factor in investigations of functional consequences of genomic variations.

Alleles↗

Diagnosis of bone infection using 99m Tc-HMPAO labelled leukocytes.

In order to evaluate the importance of 99mTc-hexamethylpropylene amine oxime (99mTc-HMPAO) leukocyte scintigraphy in the diagnosis of bone infection, we retrospectively reviewed 324 patients. Abnormal findings were seen in 221 patients. In the other 103 cases acute pathological inflammation could be ruled out. The patients with pathological findings were divided into four groups according to the location of the infection. This method showed the localizations of skeletal disorders and its differences to other diagnostic imaging modalities. The underlying abnormalities causing the inflammation were determined. In conclusion, 99mTc-HMPAO leukocyte scintigraphy is still a very sensitive method for either whole body screening or local detection of acute or exacerbated chronic osteomyelitis. The advantages of this method over other diagnostic imaging methods are shown.

Acute Disease↗

Fatal pulmonary fat embolism during humeral fracture repair in a cat.

An 11-month-old cat was referred following a road traffic accident with non-weightbearing forelimb lameness and tachypnoea. A diaphragmatic rupture was repaired two days after trauma. Six days post trauma, a further operation was performed to repair the fractured humerus. As an intramedullary pin was advanced into the bone to achieve stabilisation, acute respiratory arrest occurred. Manual extrathoracic cardiopulmonary resuscitation was immediately instigated, but the cat did not recover. Postmortem examination identified a high degree of embolic fat occluding pulmonary capillaries. A massive embolic shower was established as the cause of death.

Acute Disease↗