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Biomedical subjects

T Zimmermann

Publications and source records attributed to T Zimmermann.

At least 73 records · Page 4Linked to original sources

Simultaneous detection of two GFP spectral mutants during in vivo confocal microscopy of migrating Dictyostelium cells.

A method is described that allows simultaneous measurement of two spectrally distinguishable green fluorescent protein (GFP) mutants with a confocal microscope. In contrast to previously described methods, neither UV excitation nor repetition of scans is required. Therefore the method is well-suited to the long-time observation of living cells in three-dimensional microscopy and time series recording, as demonstrated with GFP-expressing Dictyostelium discoideum cells.

Animals↗

[Value of locoregional chemotherapy in liver metastases of breast carcinoma].

Between 1985 and 1997, we performed a locoregional chemotherapy in 59 patients suffering from non-resectable liver metastases of breast cancer. 36 of them only had liver metastases, in 23 patients liver metastases were combined with extrahepatic tumor spread. Furthermore, in 7 patients locoregional chemotherapy was used as a adjuvant regimen after metastasectomy. The average age of our patients was 52 (32-81) years. In most of our patients, a cytostatic scheme of mitoxantron, 5-fluorouracil and doxorubicin or a scheme of vincristin, mitomycin and mitoxantron was administered. The median survival of all patients was 11 months, in the patients with no additional extrahepatic tumor spread it was 16, in the patients with extrahepatic metastases 3 months, respectively.

Adult↗

[The plasma level of the neurotoxin 1-trichloromethyl-1,2,4,5-tetrahydro-beta-carboline (TaClo) in man after oral administration of chloral hydrate].

Chloral hydrate (CAS 302-17-0) is a widely used hypnotic and sedative agent. It was recently reported in the literature that a neurotoxin, TaClo (1-trichloromethyl-1,2,3,4-tetrahydro-beta-carboline), may be formed in vitro from tryptamine (Ta) and chloral (Clo). Intraperitoneal administration of TaClo led to parkinson-like symptoms in the rat. Hence, the plasma levels of TaClo were determined at various time-points in 18 healthy volunteers in two periods each during a bioavailability study of several chloral hydrate preparations. The limit of quantitation for TaClo was 5 ng/ml. No TaClo could be determined in the plasma of the various volunteers following administration of human therapeutic doses of chloral hydrate. Hence, it is unlikely that TaClo will be formed in man after application of therapeutic doses of chloral hydrate to patients.

Adult↗

[The relative bioavailability and pharmacokinetics of chloral hydrate and its metabolites].

Two open, randomized cross-over trials were performed in 18 healthy volunteers each to evaluate the relative bioavailability and the pharmacokinetics of chloral hydrate (CAS 302-17-0), the active ingredient of Chloraldurat 500 (immediate release capsules, CH), Chloraldurat rot (immediate release capsules, CR) and Chloraldurat blau (enteric-coated modified release capsules, CB). In the first study the male subjects, aged 21 to 31 years, were randomly given one capsule of CH or 500 mg of chloral hydrate as drinking solution. In the second study the volunteers, aged 20 to 28 years, received either one capsule of CR or one capsule of CB or 250 mg of chloral hydrate as drinking solution. The time of administration was between 6:30 and 7:30 a.m. and the capsules had to be swallowed with 150 ml water. The reference medication consisted of 150 ml drinking solution. The wash out time in both studies was 4 weeks. Prior to the administration and (2, 4, 6, only for CH) 8, 10, 15, 20, 40, 60 min and 1.5, 2, 4, 6, 8, 12, 24, 36, 48, 72, 96, 144, 192, 240 (and 408 only for CR/CB) h afterwards blood samples of 4.5 ml were taken from the antecubital vein. Additional 4.5 ml were drawn before and 10, 20, 40 and 60 min after administration to detect unchanged chloral hydrate. In the second study times of blood sampling were modified up to 4 h after administration due to the estimated later onset of release from CB in comparison to CR. Blood samples were centrifuged within 20 min, the plasma was separated and immediately frozen at -20 degrees C. Due to the extremely short terminal half-life of chloral hydrate its active metabolite trichloroethanol is regarded as the pharmacokinetically relevant parameter for the assessment of the bioavailability of the parent substance. Compared to the reference formulation (drinking solution) the bioavailability of trichloroethanol was 94.8% (CH), 100.7% (CR) and 101.6 (CB), respectively. The maximum plasma concentrations (Cmax) of trichloroethanol were 5176 ng/ml after intake of CH (reference 6131 ng/ml), after intake of CR 3241 ng/ml and CB 3279 ng/ml (reference 2993 ng/ml). Maximum plasma concentrations (tmax) of trichloroethanol were reached after 0.67 h (reference) and after 0.98 (CH), 0.76 (CR) and 2.38 h (CB), respectively. The terminal half-life for trichloroethanol was calculated to be 9.3 to 10.2 h, for the inactive metabolite trichloracetic acid the half-life ranged from 89 to 94 h. Chloral hydrate itself could be detected only 8 to 60 min after application at very low concentrations in some of the plasma samples. It is justified to characterize its bioavailability by the active metabolite trichloroethanol due to the extremely short terminal half-life and high variability of the parent substance.

Adult↗

[Myrtol standardized in the treatment of acute and chronic respiratory infections in children. A multicenter post-marketing surveillance study].

This multicenter post-marketing surveillance study examined the course of characteristic signs and symptoms and the tolerability of myrtol standardized (Gelomyrtol/Gelomyrtol forte) in 511 children (4 to 12 years of age) with acute and chronic sinusitis, bronchitis and sinubronchitis. The choice of dose and formulation (120 mg or 300 mg myrtol stand) accounted for the patients' age and body weight. The following signs and symptoms were evaluated before and after 1 and 2 weeks of treatment: impaired nasal respiration (blocked-up nose), pain upon pressure on the trigeminal nerve endings, headache, sensitivity of the paranasal sinuses, presence of mucus in the pharynx. At the end of the observation period, the physicians, the patients themselves and their parents judged efficacy of the medication. In more than 90% of the children, trigeminal pain, headache, paranasal sensitivity, and mucus in the pharynx had disappeared after two weeks of treatment. In more than 60%, impaired nasal respiration and difficulty to evacuate sputum were no longer observed. The incidence of adverse drug reactions was low: less than 1%. The efficacy was judged to be very good or good by the majority of physicians, patients and parents. In spite of their young age, most children (> 80%) experienced no difficulty in swallowing the capsules.

Acute Disease↗

[Pathophysiology and clinical aspects of ischemia-reperfusion damage to skeletal muscles].

Ischemia/reperfusion-injury of skeletal muscle--pathophysiology and clinical implications. Ischemia and reperfusion of skeletal muscle occurs in acute vascular occlusion and revascularisation, in elective vascular surgery, in orthopedic surgery by means of a tourniquet, and in transplantation of muscle-containing cutaneous flaps. The ischemia sets up a cascade of events, which fully develops not prior to the moment of reperfusion. The ischemia-reperfusion-cascade is comparable to an overwhelming inflammatory reaction out of control. Depending on the duration of ischemia it prompts an injury for the muscle itself, and in some cases for the whole body. The present review discusses the main mechanisms of ischemia/reperfusion-injury in terms of cellular metabolism, endothelial function, cytokine release, and leucocyte function. Release of toxic oxygen radicals by activated leucocytes plays the pivotal role in this reaction. In addition, the clinical manifestations of ischemia/reperfusion will be reviewed as well as some of the means proposed to control this harmful reaction.

Animals↗

[Selenium administration in patients with sepsis syndrome. A prospective randomized study].

PATIENTS AND METHOD: In this study the effect of antioxidative therapy with sodium selenite was investigated in patients with systemic inflammatory response syndrome (S. I. R. S.) and multiple organ failure. 40 patients were included in this prospective randomized study. The patients were observed over a period of 28 days. The letality rate within 28 days was excepted as main criteria. The Apache-II and the MOF-Score of Goris were used as clinical parameters. 20 patients were treated with sodium selenite over a period of 28 days. RESULT: This antioxidative therapy reduced the letality rate from 40 to 15%.

Antioxidants↗

[Selenium administration in severe inflammatory surgical diseases and burns in childhood].

PATIENTS AND METHOD: Substitution of selenium was performed in the University Clinic of Paediatric Surgery in Dresden in the time from 1994 to 1996 in 34 children aged 1 to 16 years with severe inflammatory surgical diseases as well a s widespread burns. Seven further patients have been examined within this time who have not received substitution of selenium as preliminary comparison group. All these patients fulfilled the criteria of "Systemic Inflammatory Response Syndrome" (SIRS). The following paraclinical parameters were examined: white cell count, interleukin 6, C-reactive protein, fibrinogen, malondialdehyde, activity of glutathione peroxidase in plasma and level of selenium in plasma and whole blood. RESULTS: Patients with initially low level of selenium who received substitution of selenium reached normal ranges more quickly than patients without substitution. Originally partly elevated values of malondialdehyde as sign of increased peroxidation of lipids were normalized under substitution of selenium. Initially low activity of selenium level in plasma showed a clear increase under substitution of selenium as sign of increased protection of the cell membrane. CONCLUSION: The substitution of selenium in children with SIRS is a supportive therapy.

Adolescent↗

[Does selenium prevent peroxynitrite formation from NO in vascular surgery interventions? A clinical study].

Nitric oxide seems to play a protective role in the pathogenesis of arteriosclerosis. It appears to protect the tissue during reperfusion in vascular surgery. High values of NO show an inverse correlation to the severity of arteriosclerosis. In our opinion selenium should be substituted in order to enhance the activity of the glutathione peroxidase. This means an effective protection against the high production of peroxinitrite in patients with arteriosclerosis. A comparison of the corresponding redox pairs SeO3(2-)/SeO4(2-) and HOONO/HONO allows the conclusion that sodium selenite can be a direct antioxidant thereby.

Aged↗

Role of NFkappaB in the mortality of sepsis.

Binding activity for nuclear factor kappa B (NFkappaB) consensus probes was studied in nuclear extracts from peripheral blood mononuclear cells of 15 septic patients (10 surviving and 5 not surviving). Nonsurvivors could be distinguished from survivors by an increase in NFkappaB binding activity during the observation period (P < 0.001). The increase in NFkappaB binding activity was comparable to the APACHE-II score as a predictor of outcome. Intravenous somatic gene transfer with an expression plasmid coding for IkappaBalpha was used to investigate the role of members of the NFkappaB family in a mouse model of endotoxemia. In this model, increased NFkappaB binding activity was present after injection of LPS. Intravenous somatic gene transfer with IkappaBalpha given before LPS attenuated renal NFkappaB binding activity and increased survival. Endothelial cells and monocytes/macrophages were the major target cells for somatic gene transfer, transfected with an average transfection efficiency of 20-35%. Tissue factor, a gene under regulatory control of NFkappaB, was induced by LPS. Somatic gene transfer with a reporter plasmid containing the functional tissue factor promoter demonstrated NFkappaB-dependent stimulation by LPS. Intravenous somatic gene transfer with IkappaBalpha reduced LPS-induced renal tissue factor expression, activation of the plasmatic coagulation system (decrease of thrombin-antithrombin III complexes) and renal fibrin/fibrinogen deposition. Somatic gene transfer with an expression plasmid with tissue factor cDNA in the antisense direction (in contrast to sense or vector alone) also increased survival. Furthermore, antisense tissue factor decreased renal tissue factor expression and the activation of the plasmatic coagulation system.

Adult↗

[Primitive neuroectodermal tumor].

The primitive neuroectodermal tumor is a rare soft tissue neoplasm occurring in children and young adults. It derives from a carcinogeneic alteration of pluripotent neural crest cells, caused by a balanced reciprocal translocation t(11;22) (q24;q12). Treatment of this undifferentiated, extremely malignant small cell tumor is carried out in compliance with the soft tissue trail (CWS) from the German Society of Pediatric Oncology. Biopsy-proven diagnosis is followed by primary chemotherapy, which in 95% of cases leads to remission, allowing excision of the remainder of the tumor without mutilation and avoidance of intraoperative tumor cell dissemination. After excision, irradiation of the tumor site and two further sequences of chemotherapy are performed. If PNETs of the paravertebral region cause symptoms of paralysis and immediate surgery is required, postoperative chemotherapy, a second-look operation and irradiation are mandatory. Between 1986 and 1994, in cooperation with our pediatric and radiotherapy colleagues, we treated ten patients. In four patients (median age, 14 years) the PNET originated from the chest wall, in six patients from the paravertebral and retroperitoneal region. Five patients died after 20 months on average, while the remaining five patients are in full remission after 31, 46, 50, 51 and 91 months, respectively.

Adolescent↗

[Persistent chylothorax after fracture of the 12th thoracic vertebrae].

We report on a patient who suffered chylothorax 2 months after she had undergone internal fixation of a fracture of her 12th thoracic vertebral body. The pleural effusion was treated by insertion of a chest tube. The chylothorax was managed conservatively. The patient received protein-rich nutrition supplemented with medium-chain triglycerides. As the volume of chylous fluid drained from the pleura had not decreased after 2 weeks, the patient received total parenteral nutrition without any oral intake of calories. Chest X-rays documented the disappearance of the chylothorax. Reexpansion of the lungs was noted, and the costophrenic sinuses could be clearly visualised.

Chest Tubes↗

[Effects of standardized Myrtol in therapy of acute sinusitis--results of a double-blind, randomized multicenter study compared with placebo].

BACKGROUND: In the management of non-purulent acute sinusitis, alpha adrenergic substances are administered topically and secretolytics systemically. Antibiotic therapy should be restricted to purulent forms. This study was designed to demonstrate the importance of the maintenance of permanent ventilation and drainage of the sinuses as a therapeutic concept. PATIENTS/METHODS: In a multicentric trial the efficacy and safety of myrtol standardized and another essential oil were investigated in 331 patients with acute sinusitis in comparison to placebo. Three hundred thirty patients were evaluated in an intent-to-treat-analysis and 291 patients remained for statistical analysis. The study was conducted in 16 centers in a double-blind, double-dummy, randomized design versus placebo. During an observation-period of 14 days the patients were treated for 6 +/- 2 days with the respective study medication. RESULTS: With respect to efficacy, both myrtol standardized and the other essential oil proved to be significantly superior to placebo. As to the tolerance, a slight advantage of myrtol standardized was demonstrated in comparison to the other verum substance. CONCLUSION: These results which do support the value of essential oils like myrtol as an effective treatment in acute, uncomplicated sinusitis instead of antibiotics as first choice, are confirmed by the existing literature.

Acute Disease↗

Fluconazole: comparison of pharmacokinetics, therapy and in vitro susceptibility.

Fluconazole shows good penetration into the tissues and body fluids examined and a rapid equilibrium is achieved between the concentrations in the various compartments. The pharmacokinetics of fluconazole after intravenous or oral administration are proportional to the dose. This finding, together with the slow elimination of the triazole (t1/2 30 h), makes it easier to forecast the therapeutically effective dosage. Measurements of fluconazole concentration in blood can be used to predict levels in some tissues (lung, brain, gynaecological samples), body fluids (sputum, saliva, vaginal secretions) or exudates. Concentrations in cerebrospinal fluid and vitreous humour of the eye reach approximately 80% of the levels found in blood. A very high proportion of fluconazole is excreted unchanged in the urine, where concentrations of the drug are 10-20-fold higher than in blood. Whilst this pharmacokinetic profile is valuable in the treatment of fungal infections of the urinary tract, it also means that the dosage may need to be decreased in patients with renal impairment. The susceptibility of fungi to fluconazole in vitro and in vivo correlates well with the concentrations of the drug measured in various compartments of the body.

Antifungal Agents↗

["Patients with genetic diseases can, by surgical intervention, be sterilized..." Mandatory sterilization in Germany during the era of national socialism].

The ethical problem of permissibility of sterilisation for eugenic reasons is being discussed since the end of the last century. For many years restriction and rejection were the predominant opinions. A bill passed July, 1933--"Gesetz zur Verhütung erbkranken Nachwuchses" ("Act of prevention of heredopathic progeny")--imposed juridical regulations to prevent offspring with inherited diseases in National Socialist's Germany. No major protests had been made against such compulsion put upon the medical profession. Papers dealing with questions of surgical techniques had been published in Zentralblatt für Gynäkologie predominantly in 1935 and 1936. The significance of the scientific analysis of mandatory sterilisations for so-called eugenic reasons performed in almost 400,000 women and men in Germany between 1933 and 1945 has only recently began to be recognised by the scientific community in the last decade addressing predominantly the regional impact of this jurisdiction.

Eugenics↗

Pharmacokinetic and pharmacodynamic interaction study between midazolam and the macrolide antibiotics, erythromycin, clarithromycin, and the azalide azithromycin.

This report includes a recalculation of the pooled data of 2 pharmacokinetic and pharmacodynamic studies of the interaction between the hypnotic midazolam and the antibiotics erythromycin, clarithromycin (macrolides), and azithromycin (an azalide). Erythromycin and clarithromycin similarly and strikingly impaired the metabolism of midazolam and enhanced its pharmacodynamic activity; little or no effect was found with azithromycin. It was concluded that coadministration of midazolam and azithromycin involves less clinical risk than with the 2 macrolides.

Anti-Anxiety Agents↗