Search PubMed⌕ Search

Biomedical subjects

T Sommer

Publications and source records attributed to T Sommer.

At least 37 records · Page 2Linked to original sources
PubMed2002

Accuracy and precision of bone mineral density and bone mineral content in excised rat humeri using fan beam dual-energy X-ray absorptiometry.

The aim of this study was the evaluation of fan beam dual-energy X-ray absorptiometry (DXA) for measuring bone mineral density (BMD) and bone mineral content (BMC) of isolated rat humeri. Defleshed rat humeri from male Lewis rats were examined with a Hologic QDR 4500 A (Hologic, Inc., Bedford, MA) high-resolution densitometer both in water and 0.9% saline solution. The small animal scan protocol with the regional high-resolution mode was used. BMC measured by DXA was compared with bone dry weight, ash weight, and bone calcium content. Furthermore, DXA BMD and BMC precision were determined. We also evaluated the effect of salinity of the water bath in which the bones were measured. Correlations (r(2)) of BMC, as determined by DXA with dry weight, ash weight, and bone calcium content, were 0.978, 0.988, and 0.890, respectively. DXA overestimated ash weight by 5%-9%. Precision errors for BMC (BMD) were 0.90% (0.76%) without and 1.3 (0.86) with repositioning. Changes in the salinity of the water bath had a significant influence on the DXA results: At the 0.9% physiological level, BMC (-4.4%) and area (-4.1%), but not BMD, values were significantly lower (p < 0.005) compared with measurements in tap water. Fan beam DXA is a highly accurate and precise technique for measuring BMC and BMD in excised small animal bones. A physiological saline concentration in the water bath had a significant impact on BMC and area, but not on BMD, and should therefore be strictly controlled to avoid an underestimation of BMC.

Absorptiometry, Photon↗
PubMed2002

Intensified microbiological investigations in adult patients admitted to hospital with lower respiratory tract infections.

The objective of this study was to investigate the diagnostic yield of a programme with intensified microbiological investigations in immunocompetent adult patients with lower respiratory tract infections (LRTI). Patients in the study group were included prospectively and consecutively from September 1st 1997 to May 31st 1998 and were compared with a control group from the preceding year. A total of 67 adult patients were included in the study group and they were compared with 122 adult patients in the control group. The study group underwent fibre-optic bronchoscopy (FOB) with bronchoalveolar lavage (BAL). Only 7% in the historic control group were discharged with an aetiological diagnosis of their infections; while the diagnostic yield in the study group increased to 51% of patients. In the study group the presence of new infiltrates on chest X-ray increased the detection of a microbiological aetiology from 37% with no infiltrates to 62% with infiltrates and recent antibiotic therapy reduced the detection of a microbiological cause of infection from 61% in 36 patients who had not received antibiotic therapy to 39% in 31 patients who had received recent antibiotic therapy prior to microbiological sampling. Patients in the study group with known aetiology had higher values of inflammatory markers than patients with unknown aetiology. For Streptococcus pneumoniae infection culture and urine antigen detection were complimentary depending on recent antibiotic therapy since seven of eight culture-positive patients had not received antibiotic therapy within 72 h prior to investigation, while all four patients positive for urine antigens from S. pneumoniae had received antibiotic therapy within 72 h of urine sampling. In conclusion intensified microbiologic investigations increase the diagnostic yield from 7% to 51% of patients in the study group with an aetiologic diagnosis. Routine FOB with BAL had no apparent effect on clinical outcome and seems only justified in selected patients with severe LRTI with infiltrates on chest X-ray and signs of severe inflammation where a high diagnostic yield is achieved.

Aged↗
PubMed2002

[Social characteristics influencing the mortality of male members of an insurance company in the years 1989 to 2000 -- A longitudinal study for the birth cohorts 1940-1949 of the Gmuend statutory insurance body].

The study goal is to analyse the association between social and occupational characteristics and mortality. Data are from a longitudinal register for the members of a statutory insurance body 'Gmuender Ersatzkasse' (GEK) for the period 1989 to 2000. Included are males, born 1940 - 1949, who were GEK-members on January 1, 1989 (n = 58 705). The dependent variable is defined as 'reason for end of health insurance: deceased' (n = 2283). Independent variables are: age, occupational group, family status, nationality and insurance status. The statistical analysis was performed with the software package 'Transitional Data Analysis' (TDA). It included cumulative mortality rates based on the Kaplan-Meier method and the multivariate analysis in order to assess hazard rates (maximum likelihood estimation). Statistically significant increased mortality rates for the 12-year observation period were found for non-married persons, for persons with less qualified occupations, and for mandatory health insurance members. No significant difference was observed between study subjects with and without German nationality. The observed strong social gradient in the overall mortality rates for male members of the GEK underline the challenge to reduce the social inequities in health chances which has recently been placed on the political agenda for the German health insurance companies.

Cause of Death↗
PubMed2002

[Submillimeter 3D coronary MR angiography with real-time navigator correction in 107 patients with suspected coronary artery disease].

PURPOSE: To evaluate the clinical value of high-resolution coronary MR angiography (coronary MRA) in a large group of patients with suspected coronary artery disease. METHODS AND MATERIAL: 107 patients with suspected coronary artery disease underwent free-breathing coronary MRA (Intera, 1.5 T, Philips Medical Systems). To compensate for artefacts due to respiratory motion, a right hemidiaphragmatic navigator with real time-time slice correction was used. An ECG-gated, fat-suppressed, 3D segmented-k-space gradient echo sequence (in plane resolution 0.70 x 0.79 mm(2)) was used. Cardiac catheterization with selective coronary angiography was performed in all patients. Visualization of the coronary arteries (CA) was qualitatively assessed using a four-point grading scale. RESULTS: Image quality of grade 1 was achieved in 24 %, grade 2 in 48 %, grade 3 in 24 % and grade in in 4 % of patients. Based on an evaluation of the coronary MRAs of all patients (n = 107) sensitivity and specificity for the detection of stenoses > 60 % in the proximal and middle main coronary arteries were 74 % and 63 %, respectively. In coronary MRAs with good quality [grade 1 and 2, n = 77/107 (72 %)] sensitivity and specificity for the detection of coronary stenoses were 88 % and 91 %, respectively. CONCLUSION: Submillimeter 3D coronary MRA with real-time navigator correction allows high quality imaging of the proximal and middle main coronary arteries with good sensitivity and specificity for detection of stenoses > 50 % in selected patients. However, in about 28 % of patients image quality is severely impaired.

Adult↗
PubMed2002

[Stress cine MRI for detection of coronary artery disease].

Stress testing is the cornerstone in the diagnosis of patients with suspected coronary artery disease (CAD). Stress echocardiography has become a well-established modality for the detection of ischemia-induced wall motion abnormalities. However, display and reliable interpretation of stress echocardiography studies are user-dependent, the test reproducibility is low, and 10 to 15 % of patients yield suboptimal or non-diagnostic images. Due to its high spatial and contrast resolution, MRI is known to permit an accurate determination of left ventricular function and wall thickness at rest. Early stress MRI studies provided promising results with respect to the detection of CAD. However, the clinical impact was limited due to long imaging time and problematic patient monitoring in the MRI environment. Recent technical improvements - namely ultrafast MR image acquisition - led to a significant reduction of imaging time and improved patient safety. Stress can be induced by physical exercise or pharmacologically by administration of a beta1-agonist (dobutamine) or vasodilatator (dipyridamole and adenosine). The best developed and most promising stress MRI technique is a high-dose dobutamine/atropine stress protocol (10, 20, 30, 40 microgram/kg/min; optionally 0.25-mg fractions of atropine up to maximal dose 1 mg). Severe complications (myocardial infarction, ventricular fibrillation and sustained tachycardia, cardiogenic shock) may be expected in 0.25 % of patients. Currently, data of three high-dose dobutamine stress MRI studies are available, revealing a good sensitivity (83 - 87 %) and specificity (83 - 86 %) in the assessment of CAD. The direct comparison between echocardiography and MRI for the detection of stress-induced wall motion abnormalities yielded better results for dobutamine-MRI in terms of sensitivity (86.2 % vs. 74.3 %; p < 0.05) and specificity (85.7 % vs. 69.8 % p < 0.05) as compared to dobutamine stress echocardiography. The superior results of MRI can mainly be explained by the better image quality with sharp delineation of the endocardial and epicardial borders. Currently, stress MRI is already a realistic clinical alternative for the non-invasive assessment of CAD in patients with impaired image quality in echocardiography.

Adenosine↗
PubMed2001

Sec61p-independent degradation of the tail-anchored ER membrane protein Ubc6p.

Tail-anchored proteins are distinct from other membrane proteins as they are thought to insert into the endoplasmic reticulum (ER) membrane independently of Sec61p translocation pores. These pores not only mediate import but are also assumed to catalyze export of proteins in a process called ER-associated protein degradation (ERAD). In order to examine the Sec61p dependence of the export of tail-anchored proteins, we analyzed the degradation pathway of a tail-anchored ER membrane protein, the ubiquitin-conjugating enzyme 6 (Ubc6p). In contrast to other ubiquitin conjugating enzymes (Ubcs), Ubc6p is naturally short-lived. Its proteolysis is mediated specifically by the unique Ubc6p tail region. Degradation further requires the activity of Cue1p-assembled Ubc7p, and its own catalytic site cysteine. However, it occurs independently of the other ERAD components Ubc1p, Hrd1p/Der3p, Hrd3p and Der1p. In contrast to other natural ERAD substrates, proteasomal mutants accumulate a membrane-bound degradation intermediate of Ubc6p. Most interestingly, mutations in SEC61 do not reduce the turnover of full-length Ubc6p nor cause a detectable accumulation of degradation intermediates. These data are in accordance with a model in which tail-anchored proteins can be extracted from membranes independently of Sec61p.

Carrier Proteins↗
PubMed2001

Genes and attention deficit hyperactivity disorder.

The initial molecular genetic studies of attention deficit hyperactivity disorder (ADHD) evaluated two candidate genes (DAT and DRD4) suggested by dopamine theories of this common disorder and its treatment with stimulant medication. The initial reports of weak associations with ADHD have been replicated by many (but not all) investigators, as is expected for genes with small effects. This literature is reviewed, along with emerging literature generated by active research groups investigating additional genes that might contribute to the genetic basis of this complex disorder.

Attention Deficit Disorder with Hyperactivity↗
PubMed2001

Interference with cardiac pacemakers by magnetic resonance imaging: are there irreversible changes at 0.5 Tesla?

The safety and feasibility of magnetic resonance imaging (MRI) in patients with cardiac pacemakers is an issue of gaining significance. The effect of MRI on patients' pacemaker systems has only been analyzed retrospectively in some case reports. Therefore, this study prospectively investigated if MRI causes irreversible changes in patients' pacemaker systems. The effect of MRI at 0.5 Tesla on sensing and stimulation thresholds, lead impedance and battery voltage, current, and impedance was estimated during 34 MRI examinations in 32 patients with implanted pacemakers. After measurements at baseline and with documentation of intrinsic rhythm and modification of the pacing mode, patients underwent MRI. The rest of the function time of the pacemaker was calculated. Measurements were again performed after 99.5 +/- 29.6 minutes (mean +/- SD), immediately after MRI examination, and 3 months later. Lead impedance and sensing and stimulation thresholds did not change after MRI. Battery voltage decreased immediately after MRI and recovered 3 months later. Battery current and impedance tended to increase. The calculated rest of function time did not change immediately after MRI. MRI affected neither pacemaker programmed data, nor the ability to interrogate, program, or use telemetry. Surprisingly, in the gantry of the scanner, temporary deactivation of the reed switch occurred in 12 of 32 patients when positioned in the center of the magnetic field. Missing activation of the reed switch through the static magnetic field at 0.5 Tesla is not unusual. MRI at 0.5 Tesla does not cause irreversible changes in patients' pacemaker systems.

Contraindications↗
PubMed2001

Quantitative culture of bronchoalveolar lavage fluid in community-acquired lower respiratory tract infections.

To evaluate the diagnostic value of quantitative bacterial culture of bronchoalveolar lavage (BAL) fluid obtained by fibreoptic bronchoscopy, 67 consecutive immunocompetent adult patients admitted to hospital with community-acquired lower respiratory tract infections from September 1997 to May 1998 were investigated. Results were compared to the findings in eight healthy control persons investigated in February 1998. There was no difference between study patients and control persons when quantitative culture of total cumulative bacterial findings or bacteria categorized as members of the oropharyngeal normal flora were compared. The culture of normal flora in bronchial washings probably reflects contamination of the lower airways with secretions from upper arways by the fibreoptic procedure itself, as fractionated sampling showed a 10-fold reduct on in quantitative culture results when a primary bronchial washing was compared to a secondary sampling from the same bronchus in the control group. Twenty-four (36%) of 67 patients were cultured as positive in the study group while all control persons were cultured as negative for bacteria categorized as potential pathogens. With a threshold value for positive culture of 10(4) cfu ml(-1) the specificity of lavage culture of potential pathogenic bacteria in relation to actual lower airway infection was 100%. Therefore, quantitative bacterial culture of potential pathogenic bacteria in BAL fluid is very specific but only positive in about one-third of unselected immunocompetent adult patients with a lower respiratory tract infection.

Adult↗
PubMed2000

Ubiquitin-mediated proteolysis of a short-lived regulatory protein depends on its cellular localization.

In this study we demonstrate that the Deg1 degradation signal of the transcriptional repressor Matalpha2 confers compartment-specific turnover to a reporter protein. Rapid degradation of a Deg1-containing fusion protein is observed only when the reporter is efficiently imported into the nucleus. In contrast, a reporter that is constantly exported from the nucleus exhibits an extended half-life. Furthermore, nuclear import functions are crucial for both Deg1-induced degradation as well as for the turnover of the endogenous Matalpha2 protein. The conjugation of ubiquitin to a Deg1-containing reporter protein is abrogated in mutants affected in nuclear import. Obviously, the Deg1 signal initiates rapid proteolysis within the nucleoplasm, whereas in the cytosol it mediates turnover via a slower pathway. In both pathways the ubiquitin-conjugating enzymes Ubc6p/Ubc7p play a pivotal role. These observations imply that both the cellular targeting of a substrate and the compartment-specific activity of components of the ubiquitin-proteasome system define the half-life of naturally short-lived proteins.

Carrier Proteins↗
PubMed2000

[Standardisation of surgical mesh implantation in incisional hernia].

PURPOSE: To describe the relation between risk factors, postoperative complications, recurrence rates and satisfaction before and after the introduction of Stoppas technique in patients operated for incisional hernia with implantation of a surgical mesh. MATERIAL AND METHODS: The records of 27 patients undergoing an incisional hernia repair using a surgical mesh in the period 1.1.1993-30.6.1998 were reviewed, and 18 living patients were examined. RESULTS: Among the eight patients operated using Stoppas technique there were no postoperative complications but one recurrence, and among the ten patients operated without using a specific standard technique there were five with complications and four with recurrence. CONCLUSION: Operation for incisional hernia using implantation of a surgical mesh seems to require a standard surgical technique and care must be taken in patients with risk factors.

Adult↗
PubMed2000

[Surgical mesh implantation in incisional hernia. A historical follow up study].

AIM OF STUDY: To describe risk factors, recurrence rates, morbidity and satisfaction in patients operated for incisional hernia with implantation of a surgical mesh. MATERIAL AND METHODS: The records of 60 patients undergoing an incisional hernia repair using a surgical mesh in the period 1.1.1993-30.6.1998 were reviewed, and 49 living patients were examined. RESULTS: During a mean follow-up of 27 months, patients with preoperative risk factors had more complications and recurrences. Overall recurrence rate was 14%. Ninety-six percent were satisfied with the operation and 90% wanted the same operation in case of recurrence. CONCLUSION: Operation for incisional hernia using implantation of a surgical mesh is a safe and well tolerated procedure, care must be taken in patients with risk factors.

Follow-Up Studies↗
PubMed2000

[Secondary hypertrophic osteoarthropathy. Differential diagnosis of post-traumatic ossification of the interosseous crural membrane].

The case of a 48-year-old patient is presented, suffering from persisting pain in the right lower leg for more than a year following a distortion of the ankle. The patient was known to have a history of severe asthmatic disease. Conventional X-rays showed a periostitis of the lower tibia and fibula. To exclude a malignant process, an open biopsy was performed. Neither tumor nor any histological signs of chronic inflammation were found. The patient claimed to have a similar pain in the contralateral lower leg 5 months after initial biopsy. X-rays again showed signs of a periostitis of the tibia and fibula. Furthermore, an increase in isotopes in this area was found in a performed bone scan. Diagnosis of osteoarthropathia hypertrophicans was confirmed 2 years after onset of the first symptoms. Pathogenetic variables both of the primary and secondary forms of hypertrophic osteoarthropathy (HOA) are as yet not completely clarified. Secondary hypertrophic osteoarthropathy (SHOA) may be defined as a syndrome of the long bones with clubbing of the fingers and toes, and occurs in the process of chronic lung and mediastinal disease. We conclude that HAO detection may contribute to early detection of lung disease, especially bronchopulmonary cancer, before it becomes clinically and radiographically manifest.

Diagnosis, Differential↗
PubMed2000

A regulatory link between ER-associated protein degradation and the unfolded-protein response.

Ubiquitin conjugation during endoplasmic-reticulum-associated degradation (ERAD) depends on the activity of Ubc7. Here we show that Ubc1 acts as a further ubiquitin-conjugating enzyme in this pathway. Absence of both enzymes results in marked stabilization of an ERAD substrate and induction of the unfolded-protein response (UPR). Furthermore, basic ERAD activity is sufficient to eliminate unfolded proteins under normal conditions. However, when stress is applied, the UPR is required to increase ERAD activity. We thus demonstrate, for the first time, a regulatory loop between ERAD and the UPR, which is essential for normal growth of yeast cells.

Carboxypeptidases↗