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Biomedical subjects

W Klein

Publications and source records attributed to W Klein.

At least 271 records · Page 15Linked to original sources

[Females in performance sports from the sports medicine viewpoint].

Especially in the endurance disciplines, the performance of women went up considerably in the course of the past few decades. This seems to be peculiar to the female sex and can be taken as a hint to a higher adaptability of the female organism with respect to the various motor capacities required for strength and endurance. During the past 10 years, however, the rate, with which the performance gap in the endurance disciplines narrowed, has slowed down distinctly. Thus, it seems, that the era during which the women vigorously caught up on the men, is coming to an end in the endurance sports. The different capacity of the sexes with respect to strength is rooted in the differently dimensioned cross sections of the muscle fibres and in the higher activation capability of the skeletal muscles of men. No differences exist with respect to the relative proportions of the ST-, FTa- and FTb-fibres and with respect to the biochemistry of the muscles. Just as in case of men, the adaptation of the cardiovascular system to endurance training manifests in a uniform enlargement of all of the heart's cavities. It is true, that women have a smaller heart volume and lower values for the maximum oxygen uptake, but these differences or by no means related to sex alone. Very often, they are produced by the fact that the endurance training of the women did not go that far. As regards the energy substrates, there is the hypothesis that women have better utilization of free fatty acids under conditions of prolonged and intensive physical work.(ABSTRACT TRUNCATED AT 250 WORDS)

Bone Density↗

[Initial experiences with a new wrist joint fixator in treatment of distal radius fractures].

Between January 1989 and October 1991, 56 patients with 57 distal radius fractures were treated with the new Orthofix wrist fixator. This review of 43 patients consists of cases with follow-ups of at least 12 months. One patient had died, and 38 (90.5%) of the remaining 42 fractures were examined 20.3 months after surgery, on average. Radiological findings were classified according to Lidström, and the functional results according to Gartland and Werley in the Sarmiento modification. Functional analysis demonstrated excellent and good results in 73% of the fractures. Although the number of cases studied is too small for statistical analysis, the results do show a trend emphasizing the importance of subtle anatomical restoration, particularly of the radial length. Since this cannot always be obtained by external fixation alone, supplementary Kirschner-wires, screws and bone-grafting can be necessary. The main advantages of the new Orthofix fixator are its light-weight design, simple application, and the possibility of fracture reduction even after the device has been mounted. Early mobilisation has not been evaluated sufficiently, so no general recommendations can be made yet.

Adolescent↗

Developmental profiles of arylsulfatases A and B in rat cerebral cortex and spinal cord.

Arylsulfatases A (EC 3.1.6.1) and B (EC 3.1.6.12) are lysosomal enzymes that can remove sulfate groups from sulfatides and sulfo-glycosaminoglycans, respectively. The activities of these enzymes in cerebral cortex and in spinal cord of developing rat pups were measured. The tissues were homogenized and the arylsulfatases A and B in the soluble fraction were separated from each other by anion exchange chromatography on DE-52 cellulose. Subsequently, the enzyme activities were assayed with p-nitrocatechol sulfate as substrate at 37 degrees C and pH 5.6. We observed a developmental profile of arylsulfatase A, similar to that previously reported for cerebroside sulfatase (EC 3.1.6.8; (Van der Pal et al. (1990) Biochim. Biophys. Acta 1043, 91-96]. The activity of arylsulfatase A increased gradually during development, whereas arylsulfatase B rose more steeply, peaked around day 15 and declined thereafter. As a consequence the ratio between B and A forms of arylsulfatase dropped from about 4 in 1-week-old pups to 2.2 (cortex) and 0.7 (cord) in 7-week-old rat pups.

Animals↗

Acute effects of the ACE inhibitor lisinopril on cardiac electrophysiological parameters of isolated guinea pig hearts.

Angiotensin-converting enzyme (ACE) inhibitors are of benefit in life-threatening ventricular arrhythmias in patients with congestive heart failure and ventricular tachycardia caused by the onset of myocardial ischemia as well as by reperfusion of an ischemic area. The aim of the present study was to investigate whether direct electrophysiological effects are responsible for these observations. Therefore, we investigated the electrophysiological effects of lisinopril on the whole cardiac conduction and pacemaker system in isolated guinea pig hearts perfused by the method of Langendorff at concentrations of 0.01, 0.1, 1, and 10 microM. Lisinopril did not affect heart rate, atrioventricular, His bundle, or intraventricular conduction at any of the concentrations tested. Likewise the frequency-dependent QT duration was unchanged. At a concentration of 10 microM, lisinopril prolonged effective refractory period evaluated by premature beats (46 +/- 15%, n = 8, p less than 0.01) as well as the rate-dependent effective refractory period (31 +/- 12, n = 8, p less than 0.01) of the atrioventricular conduction. These effects can be explained by lisinopril's action as a minor calcium antagonist at a toxic concentration of 10 microM. The present results show that electrophysiological parameters are not substantially altered by lisinopril. Therefore, several other mechanisms such as the unloading of the left ventricle and/or the suppression of noradrenalin release and the electrolyte (potassium and magnesium) repletion and/or regression of left ventricular hypertrophy as long-term effects may play a major role in the antiarrhythmic efficacy of ACE inhibitors.

Angiotensin-Converting Enzyme Inhibitors↗

Perforated ventricular aneurysm in a male suffering from pneumonia.

In a 49-year-old male with fever, dyspnea, and chest pain, thoracic x-ray revealed pneumonia with enlarged heart silhouette. Antibiotics were successful, pneumonia healed and complaints disappeared. Yet, during the following 3 months, echocardiography showed mild persistent pericardial effusion while in ECG both sinus tachycardia and ST-T changes were found suggesting chronic pericarditis. Magnetic resonance imaging, however, revealed an extensive posterobasal aneurysm with pericardial effusion substantiated by ventriculography. Coronary angiography showed diffuse three-vessel disease. Surgery revealed aneurysm with distinct perforation of the left ventricle and pericardial thrombi, thus aneurysmectomy as well as bypass grafts were performed. One year postoperatively, magnetic resonance imaging confirmed the absence of aneurysm with only a small irreversible posterobasal perfusion defect remaining as shown by thallium scintigraphy.

Adult↗

Traumatic dislocation of the hip in young children.

Traumatic dislocation of the hip joint is an uncommon injury in children. The present report on this traumatic emergency is based on the authors' own observations of three cases and a review of the literature. The main problem is the possible development of avascular necrosis of the femoral head. The crucial therapeutic intervention to avoid this serious complication seems to be immediate, usually closed, reduction under general anaesthesia. A management protocol is presented.

Accidental Falls↗

Predictive QSAR models for estimating biodegradation of aromatic compounds.

The development of valid structure biodegradation relationships (SBRs) is restricted by the lack of reproducible published data and by the considered endpoint of degradation data. A classification scheme is required for comparative evaluation of degradation data obtained by different test methods. SBRs based on substructure indicators are available for application to most compounds, but the reliability is still uncertain. SBRs based on physico-chemical parameters are only available for a few classes of compounds based on specific test methods. A combination of several SBRs covering the various transformation pathways provides a promising tool for predicting biodegradability. Two models describing biodegradation are introduced.

Biodegradation, Environmental↗

Predictive QSAR models for estimating ecotoxic hazard of plant-protecting agents: target and non-target toxicity.

Quantitative structure-activity relationships (QSARs) are evaluated for predicting pesticides' effects on non-target and target organisms: aquatic biota, mammals, soil micro-organisms, and plants. Satisfactory estimates of pesticides' fish toxicity are obtained from log POW-dependent QSARs derived using chemicals of similar polarity and reactivity. Algal toxicity of herbicidal compounds reflects interactions with the electron transport chain in photosystem II and can be modelled by QSARs describing the Hill reaction inhibition. The ranking in effects on soil micro-organisms is evaluated from models derived using in-vitro bacteria systems. Mammalian toxicity can be estimated by QSARs using the partition coefficient log POW and electronic terms derived by MNDO quantum mechanical calculations. In general, the targets are more susceptible than the non-target species towards phenylurea herbicides. Plants and algae constitute the most sensitive populations, corresponding to the same mode of action. Differences in mode of action towards bacteria, rats, and fish, which are similarly sensitive organisms, are revealed by QSAR analyses.

Animals↗

Abnormal epidermal changes after argon laser treatment.

A 26-year-old woman with a congenital port-wine stain on the forehead was treated three times at 2-month intervals with an argon laser. Six months after the last treatment, moderate blanching and mild scaling confined to the treated area was observed. A biopsy specimen of the treated area revealed a significant decrease in ectatic vessels. However, epidermal changes similar to those of actinic keratosis with disorganized cell layers and marked cytologic abnormalities were seen. Analysis of peripheral blood lymphocytes for a defect in DNA repair was negative. Multiple, argon laser-induced photothermal effects may be responsible for the changes observed in our case and may lead to premalignant epidermal transformation.

Adult↗

The repression of trehalose transport and metabolism in Escherichia coli by high osmolarity is mediated by trehalose-6-phosphate phosphatase.

Trehalose transport and metabolism in Escherichia coli are induced by trehalose in the growth medium but only at low osmolarity. In contrast, synthesis of internal trehalose as an osmoprotectant occurs only at high osmolarity, independent of the carbon source. The synthesis of internal trehalose proceeds via the UDP-glucose-mediated transfer of glucose to glucose-6-phosphate, forming trehalose-6-phosphate, which is then hydrolysed to trehalose. We demonstrate that the inducer for the synthesis of the trehalose transport system as well as of amylotrehalase, the key enzyme in trehalose metabolism at low osmolarity, is trehalose-6-phosphate. We found that the inability to induce these proteins at high osmolarity is primarily due to activity of trehalose-6-phosphate phosphatase, the enzyme responsible for the final step in the synthesis of internal trehalose under these conditions. A gene, otsP, necessary for the synthesis of the biosynthetic trehalose-6-phosphate phosphatase, is located at min 42 closely linked to otsA/B the structural genes for the trehalose-6-phosphate synthase. There is another gene locus near 84 min on the chromosome, that we termed otsR, which is involved in the regulation of otsA/B and possibly otsP. The nature of this regulatory gene is unclear at present.

Biological Transport↗

A 6-week double-blind comparison of amlodipine and placebo in patients with stable exertional angina pectoris receiving concomitant beta-blocker therapy.

This study was a multicenter, double-blind comparison of the antianginal efficacy and safety of amlodipine and placebo as adjunctive therapy with constant recommended maintenance doses of beta-blockers. Patients with stable exertional angina pectoris were randomized to placebo or amlodipine at a starting dose of 5 mg once daily. The amlodipine dose was adjusted to 10 mg daily after 2 weeks if angina attacks were not abolished. Antianginal efficacy was assessed throughout the study with angina diaries, investigators' and patients' global evaluations, and with bicycle exercise tests during a placebo run-in period (baseline) and after 2 and 6 weeks of double-blind treatment. On baseline-final analysis, the exercise time to angina onset increased by 13% with amlodipine compared to 6% with placebo (p < 0.05). The total exercise time increased by 11% on amlodipine compared with 2% on placebo, though this difference did not reach statistical significance. Angina attack frequency and nitroglycerin consumption were both reduced by adding amlodipine to beta-blocker treatment. Amlodipine in combination with beta-blocker therapy was well tolerated, with a low incidence of side effects and laboratory test abnormalities. The study showed clearly that addition of amlodipine to beta-blocker therapy in patients with stable angina pectoris was well tolerated and gave improved antianginal efficacy.

Adolescent↗

Trehalose synthesis genes are controlled by the putative sigma factor encoded by rpoS and are involved in stationary-phase thermotolerance in Escherichia coli.

The rpoS (katF) gene of Escherichia coli encodes a putative sigma factor (sigma S) required for the expression of a variety of stationary phase-induced genes, for the development of stationary-phase stress resistance, and for long-term starvation survival (R. Lange and R. Hengge-Aronis, Mol. Microbiol. 5:49-59, 1991). Here we show that the genes otsA, otsB, treA, and osmB, previously known to be osmotically regulated, are also induced during transition into stationary phase in a sigma S-dependent manner. otsA and otsB, which encode trehalose-6-phosphate synthase and trehalose-6-phosphate phosphatase, respectively, are involved in sigma S-dependent stationary-phase thermotolerance. Neither sigma S nor trehalose, however, is required for the development of adaptive thermotolerance in growing cells, which might be controlled by sigma E.

Adaptation, Physiological↗

Circadian blood pressure pattern in patients with treated hypertension and left ventricular hypertrophy.

Left ventricular hypertrophy in hypertensives is an important determinant of prognosis. In the present study 45 patients with treated essential hypertension were divided into two groups: 23 patients had normal left ventricular dimension and 22 patients had echocardiographic signs of left ventricular hypertrophy (LVH). All patients were adequately treated during daytime, but ambulatory blood pressure monitoring showed a distinct abnormal pattern in the LVH group characterized by a lack of blood pressure reduction during the night; 16 of 22 patients with LVH had no blood pressure decline during the night, whereas 17 of 23 patients without hypertrophy showed this reduction (P less than 0.01). In conclusion, patients with hypertension and LVH often reveal a lack of blood pressure decline during the night, which may be the reason for the development of left ventricular hypertrophy (and thus should be managed by a different circadian blood pressure therapy) or which may be the consequence of progressive structural changes in the resistance vessels, along with the development of left ventricular hypertrophy. It is suggested that patients with hypertension and left ventricular hypertrophy should have ambulatory twenty-four hour blood pressure monitoring.

Antihypertensive Agents↗

New concepts in ischemia prevention.

Transient myocardial ischemia may result from obstruction to flow in the large epicardial coronary arteries or diminished flow reserve due to small vessel disease or left ventricular hypertrophy. In patients with coronary heart disease, calcium blockers have proven to reduce stress induced ischemia in patients with normal left ventricular function and in those with ischemic cardiomyopathy. However, recent studies indicate a need for caution when giving calcium antagonists to patients with postinfarction left ventricular systolic dysfunction. Moreover, calcium antagonists that reduce heart rate (diltiazem) are able as a monotherapy to reduce total ischemic burden. Calcium antagonists that may increase rate (dihydropiridines) have to be combined with beta-blockers to achieve this goal. For 24-h control of ischemia the ischemic threshold should be determined for a differentiated therapy in the individual patient. Is the ischemic threshold of the majority of episodes lower than the exercise threshold, a calcium blocker should work. Angiotensin-converting enzyme (ACE) inhibitors are not effective in stress-induced ischemia, but may reduce total ischemic burden, although this effect is not significant. In patients with left ventricular hypertrophy and/or small vessel disease, calcium blockers and ACE inhibitors are probably effective in regression of left ventricular hypertrophy and vascular hypertrophy. However, it remains to be shown that ischemia is reduced by these drugs.

Angiotensin-Converting Enzyme Inhibitors↗

[Silent myocardial ischemia. Current concepts of pathophysiology and diagnosis].

Silent myocardial ischemia (SMI) is divided into 3 groups: type I: completely asymptomatic patients, type II: patients after acute myocardial infarction with SMI, type III: patients with angina pectoris (AP) and SMI. Pathophysiology on the lack of pain-perception and the cause for high tolerance against pain in SMI-patients has not yet been cleared up. It is most likely that more than one mechanism is involved in every patient, e.g. generally lower pain-perception in SMI-patients, physically counter-regulation in pain, duration and strength of myocardial ischemia. Diagnosis of SMI can be made by exercise- and long-term-ECG, thalliumszintigraphy and coronary angiography, in doing so the pros and cons of the 4 established methods have to be noted. The summary of the findings together with the lack of pain leads to the diagnosis of SMI.

Angina Pectoris↗