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Biomedical subjects

A Müller

Publications and source records attributed to A Müller.

At least 73 records · Page 4Linked to original sources
PubMed2003

[Collagen breakdown in ankylosing spondylitis-relationship to disease related parameters].

OBJECTIVE: Patients with ankylosing spondylitis (AS) often develop osteoporosis particularly of the axis skeleton. To investigate disease-related or therapeutic influence on bone catabolism, we quantified the total excretion of the collagen crosslinks (CL) pyridinoline (Pyd) and deoxypyridinoline (Dpyd) in 91 AS patients (26 f, 65 m) in relation to disease activity or stage and therapy with NSAID. METHODS: CL were determined by HPLC (High Performance Liquid Chromatography). RESULTS: The AS patients show a highly significant positive correlation between Pyd and the inflammatory activity (CrP, r = 0.36, p < 0.001: ESR, r = 0.379, p < 0.001). Also the quotient Pyd/Dpyd correlates positively to the inflammatory activity (CrP, r = 0.262, p < 0.001: ESR, r = 0.325, p < 0.002). In the case of increased inflammatory disease activity (CrP > or = 10 mg/l vs CrP < 10 mg/l or ESR > or = 10 30 mm vs ESR < 30 mm), Pyd excretion is raised significantly (p < 0.042 for CrP and p < 0.009 for ESR). Among those patients treated with NSAID therapy, significantly reduced levels for Dpyd (p < 0.001) and raised levels for the quotient Pyd/Dpyd (p < 0.002) appear. In the case of advanced radiological changes with evidence of syndesmophytes, Pyd (p = 0.014) and Dpyd (p < 0.004) were significantly raised in urine. Regarding the movement function (finger-floor distance, schober test), no significant correlation to crosslink excretion could be proven. CONCLUSION: From our investigations, we assume that osteoporosis in AS is primarily caused by an inflammatory-mediated degradation of bone.

Adolescent↗
PubMed2003

Rule learning in a serial reaction time task: an fMRI study on patients with early Parkinson's disease.

In the present study, we investigated implicit rule learning in patients with Parkinson's disease (PD) and healthy participants. Functional magnetic resonance imaging (fMRI) and a variant of the serial reaction time task were employed to examine the performance of previously learned regular sequences. Participants responded to successively appearing visual stimuli by pressing spatially corresponding keys. Unbeknownst to them, a cycling 12-item sequence was presented. In order to measure rule learning independently from initial visuomotor learning, participants were trained with the sequence prior to scanning. In the fMRI session, alternating blocks of regular and random stimuli were performed. Imaging revealed activations in the frontomedian and posterior cingulate cortex during performance of sequence blocks as opposed to random blocks. The magnitude of activations in these two areas was correlated with the behavioral index for rule learning. As has been reported earlier, the frontomedian cortex may be involved in the prediction of future stimuli and anticipation of corresponding actions, whereas the posterior cingulate activation may rather be related to memory retrieval. Additional activations of the right putamen and the inferior frontal sulcus were not related to behavioral performance. In patients with early PD, the behavioral data showed reduced training effects during pretraining, but intact rule learning during the fMRI session. Imaging revealed highly similar frontomedian and posterior cingulate activations in patients and controls, in the absence of significant striatal and inferior frontal activations in patients. Our findings support the view that in early PD, with the lateral striatofrontal dopaminergic projections being affected, medial dopaminergic projections involved in the application of previously learned rules may still be spared.

Aged↗
PubMed2003

[Miflonide/Foradil via Aerolizer compared with other anti-inflammatory and anti-obstructive therapeutic regimens].

Standard therapy of asthma consists of combined, antiinflammatory (steroids) and anti-obstructive (long acting/short acting beta-agonist) treatment via inhalation using two separate or a single inhalation device. Here, we report the results of using Miflonide (Budesonide 400 - 800 microg per day) and Foradil (Formoterol 24 - 48 microg per day) in cases of moderate and severe asthma previously treated insufficiently with another combination therapy. 80 patients with asthma previously treated insufficiently with any other combination therapy of steroid and long acting beta-agonist were included. Instead of their previous therapy all were switched to therapy with Miflonide and Foradil for eight weeks (two office visits at 4 and 8 weeks). Lung function (peak flow [l/min], FEV1 [I], FVC [I], R(tot) [kPa*s/l]) was performed at every visit. Doctors' and patients' estimation of disease severity, physical examination, drug related side-effects and the use of short acting beta-agonist aerosols were registered. Lung function parameters improved significantly compared to the run in phase prior to the change in medication (peak flow: + 18.4 %, FEV 1 : + 10.7 %, FVC: + 6.8 %, R(tot) : -18.0 %). Use of additional short acting inhalative beta-agonists was reduced. Subjectively, patients judged their general condition as improved, effectiveness as greater compared to previous medication and side effects as tolerable. The use of a combination of Miflonide/Foradil lead to an improvement in subjective and objective parameters in asthma patients that had previously been treated with a variety of other antiinflammatory and anti-obstructive therapy regimens. Reasons for this observation are beside change in medication, patients training in asthma therapy, change of application system, and increase of patients compliance.

Adrenergic beta-Agonists↗
PubMed2003

The extracorporeal perfusion of swine uterus as an experimental model: the effect of oxytocic drugs.

The objective of this study was to establish an experimental model for extracorporeal perfusion of swine uterus. In order to validate this model, we examined some biochemical parameters and determined the effect of oxytocic drugs (Oxytoxin, Prostaglandin E (2)) on extracorporeal perfused swine uteri. Thirty swine uteri were perfused with Krebs-Ringer bicarbonate-glucose buffer for a period up to eleven hours with the aim to preserve a viable organ, which should be responsive to hormones. The intrauterine pressure was recorded after administration of various concentrations of oxytocin and prostaglandin E (2). Perfusate pH, perfusate lactate, partial oxygen and carbon dioxide tensions, oxygen saturation, and hydrogencarbonate levels in the perfusate, all indicators of tissue ischemia or cell necrosis, showed good preservation of the organ for up to seven hours. We examined the relation of intrauterine pressure to oxytocin and prostaglandin E (2). Both were able to induce contractions of the uterus, whereas prostaglandin E (2) produced rhythmical contractions of smaller amplitude and a higher frequency. We could demonstrate that our perfusion system was able to preserve the swine uterus in a functional condition appropriate for the study of physiological questions.

Animals↗
PubMed2003

Cell-derived sequences in the N-terminal region of the polyprotein of a cytopathogenic pestivirus.

Efficient proteolytic release of nonstructural protein 3 (NS3) from the viral polyprotein is considered to be crucial for the cytopathogenicity of pestiviruses. Here we describe a novel cytopathogenic (cp) bovine viral diarrhea virus strain (BVDV CP8) with a complex insertion composed of viral and cell-derived sequences, including two fragments of the cellular J-domain protein Jiv (J-domain protein interacting with viral protein) located in the N-terminal region of the polyprotein. BVDV CP8 expresses a Jiv fusion protein of 513 amino acids in addition to a complete set of viral proteins. This protein has the capacity to induce NS2-3 cleavage in trans. Accordingly, CP8 is a representative of a novel type of cp pestivirus with a cp-specific mutation located outside of the NS2-3 gene.

Amino Acid Sequence↗
PubMed2003

Evaluation of free and peptide bound collagen crosslink excretion in different skeletal diseases.

OBJECTIVE: To investigate urinary fractions of free and peptide forms of collagen crosslinks in patients with rheumatoid arthritis (n=50), osteoarthrosis (n=38), psoriatic arthritis (n=38) and in healthy volunteers (33 adults, 17 children). METHODS: Pyridinoline (PYD) and deoxypyridinoline (DPD) were measured by high performance liquid chromatography. RESULTS: In rheumatoid arthritis (RA) all fractions of PYD and DPD were significantly raised compared with osteoarthritis, psoriatic arthritis, and healthy controls. PYD and DPD correlated with disease activity in RA. In RA the collagen degradation resulted in primarily peptide bound forms. CONCLUSION: The correlation between total peptide bound or free collagen crosslinks in different chronic joint diseases varies; however, this variation does not allow for a reliable differentiation between inflammatory and degenerative joint diseases.

Adult↗
PubMed2003

Contrast media effect on cerebral blood flow regulation after performance of cerebral or coronary angiography.

OBJECTIVE: The immediate hemodynamic effects of contrast agents are well documented. Less is known about their longer-lasting effects. We investigated the later effect of iopromide on the neurovascular coupling mechanism after the performance of cerebral or coronary angiography. Neurovascular coupling is a fine-tuned and reliable mechanism adapting cerebral blood flow to cortical activity. When performing a visual stimulation and measuring the resultant flow velocity change in the posterior cerebral artery transcranial Doppler has been used to determine vascular integrity. METHODS: The visually evoked blood flow velocity response in the posterior cerebral artery was measured with transcranial Doppler before, 1-2 h after and the day after angiography. The overshoot of the flow velocity response and the stable flow velocity level at the end of the stimulation phase were used to compare the different conditions. RESULTS: A significantly diminished overshoot was found 1-2 h after angiography only in patients undergoing cerebral angiography. The stable blood flow velocity levels at the end of the stimulation phase remained unchanged in all cases. CONCLUSIONS: Our finding demonstrates effects of contrast media on dynamic blood flow regulation of the cerebral vasculature 1-2 h after application of direct contrast agent suggesting a possible concentration effect of the contrast agent. However, since the relative blood flow velocity increase under stable blood flow conditions remained constant, this dynamic alteration does not cause a reduction in cerebral blood flow.

Adult↗
PubMed2003

Serum levels of total homocysteine, homocysteine metabolites and of advanced glycation end-products (AGEs) in patients after renal transplantation.

AIMS: Hyperhomocysteinemia has been described as an independent risk factor for cardiovascular diseases (CVD) influencing patient outcome. Advanced glycation end-products (AGEs) are involved in the pathogenesis of vascular damage in uremia. This study was undertaken to assess whether high serum levels of total homocysteine (tHcy) with its metabolites methylmalonic acid (MMA), methylcitric acid (MCA) and cystathionine (CYSTA) as well as elevated serum concentrations of the AGEs pentosidine and Nepsilon-carboxymethyllysine (CML) are independent risk factors for CVD, left ventricular hypertrophy (LVH) or hypertension as well as kidney dysfunction in renal transplant recipients (RTR). METHODS: Serum levels of tHCy, MMA, MCA and CYSTA were measured by a gas chromatographic-mass spectrometric assay, pentosidine by HPLC and CML using an ELISA assay. RESULTS: All measured parameters were significantly higher in RTRs than in healthy subjects (p < 0.0001). The levels of pentosidine and CML as well as of tHcy and its metabolites correlated significantly with each other, but not with those ofMMA and CYSTA. Significant correlations were also found between pentosidine and tHcy, MMA or MCA as well as between CML, MMA and MCA, respectively. Acute or chronic rejection did not influence these values. No significant differences were observed between patients with or without CVD or with hypertension. In RTRs with LVH, only the tHcy levels were significantly higher than in those RTRs without LVH (p = 0.006). Logistic regression analysis revealed an independent influence of tHcy on the presence of LVH. CONCLUSION: These results may indicate an association between high tHcy values and LVH. Further investigation is needed to determine whether a reduction of tHcy and Hcy metabolites and/or AGE serum concentrations would significantly improve patient outcome after undergoing renal transplantation.

Adult↗
PubMed2003

[Computed tomographic aspects of skull development in a child with cherubism].

The clinical picture of cherubism is similar to that of fibrous dysplasia. The initial clinical appearance involves the deformation of the maxillofacial area with orthodontic disorder. Usually it is found in the mandible giving the child a chubby-faced appearance, and it often occurs together with symmetric submandibular lymph node enlargement. This appearance reminds one of the cherubs seen in art. Only histological evidence for cherubism is inconclusive. The presence of multi-nucleated giant cells resembles fibrous dysplasia. A combination of clinical, radiographical and histological findings eventually leads to the correct diagnosis. An example is given of a patient displaying the typical disease process. Over a period of 12 years, we observed the progression of the disease from its initial appearance in a young child, through the full and characteristic display of a cherubic youth, and finally its regression. In conclusion, we advise restraint in planning surgical intervention. The diseases etiology is not entirely dear. The latest research points to genetic defects that lead to failure in the expression of matrix proteins.

Adolescent↗
PubMed2002

Experimental link of photoionization of Sc2+ to photorecombination of Sc3+: an application of detailed balance in a unique atomic system.

The principle of microscopic time reversal of physical processes, detailed balance, is widely used and depended upon in the theoretical community as a connection between photorecombination (PR) and photoionization (PI). This paper reports on a novel use of detailed balance and the comparison of experimental results obtained by two very distinct techniques to determine both the metastable fraction of an ion beam and partial Sc3+ PR cross sections and partial Sc2+ PI cross sections for the ground state and for two metastable states. The Sc2+ to Sc3+ system presents a unique opportunity to obtain comprehensive state-selective information by combining results from PR and PI experiments.

Journal Article↗
PubMed2002

Postoperative complications after laparoscopic incisional hernia repair. Incidence and treatment.

BACKGROUND: The popularity of laparoscopic repair of incisional hernias is increasing due to the apparent advantages of laparoscopy. PATIENTS AND METHODS: A group of 150 consecutive patients with incisional hernias were treated by laparoscopic IPOM technique with a Goretex Dualmesh between September 1999 and September 2001 and subsequently followed up. Some minor and major complications could clearly identify advantages as well as drawbacks of the technique. RESULTS: No primary mesh infection were observed but 4 recurrences, 3 of them due to technical mistakes, and 1 case with ileus due to a volvolus at day 4 p.o. were recorded. Further major complications included 2 early and 2 later stage trocar hernias, which needed surgical correction. Two patients developed secondary bowel perforation after thermal injury and after primary enterotomy which was closed by laparotomy. CONCLUSIONS: All complications, except one recurrence due to failure of the material, were surgical mistakes and cannot be attributed to the laparoscopic procedure. Consequently, after taking into account the surgical mistakes and possible technical errors, the low recurrence rate justifies further application of laparoscopic ventral hernia repair.

Adult↗
PubMed2002

High Rydberg resonances in dielectronic recombination of pb(79+).

Dielectronic recombination resonances of Pb (79+) associated with 2s(1/2)-->2p(1/2) excitations were measured at the heavy-ion storage ring ESR at GSI. The fine structure of the energetically lowest resonance manifold Pb (78+)(1s(2)2p(1/2)20l(j)) at around 18 eV could partially be resolved, and rate coefficients on an absolute scale were obtained. A comparison of the experimental data with results of a fully relativistic theoretical approach shows that high-angular-momentum components up to j=31/2 significantly contribute to the total resonance strength demonstrating the necessity to revise the widespread notion of negligible high-angular-momentum contributions at least for very highly charged ions.

Journal Article↗
PubMed2002

Assessment of mutagenicity and toxicity of different-size fractions of air particulates from La Plata, Argentina, and Leipzig, Germany.

Airborne particulates, especially fine particles and bound chemical compounds, are a potential mediator of adverse health effects. In this study an analysis was done of the concentration and size distribution of air particulate matter, the content of bound polycyclic aromatic hydrocarbons (PAHs), and the biological effects of organic extracts from different fractions of dust that had been influenced by urban and industrial emissions from the regions of La Plata, Argentina, and Leipzig, Germany, along with samples from control areas. Air particulate matter was sampled in summer and winter in each region using a high-volume sampler with a six-stage cascade impactor, classifying dust in six size fractions from 10-microm particles to those less than 0.49 microm in size. Organic extracts of dust were tested for mutagenicity (Ames test, Salmonella typhimurium TA98 strain, S9+) and cytotoxicity (Tetrahymena pyriformis test system, growth rate, cell respiration). The content of PAHs was analyzed by high-performance liquid chromatography (HPLC) with diode array and fluorescence detection. Mutagenic and cytotoxic effects were found to be associated with very fine (<0.49 microm) and fine (<1.5 microm) particle-bound compounds, corresponding to a higher content of PAHs. The mutagenic potency (revertants/m(3)) associated with particles less than 0.49 microm from urban areas of La Plata was about 1 order of magnitude higher than in particles in the range of 3.0 to 0.49 microm. Fine fractions from sites with an industrial burden were also found to exhibit high mutagenic potency. A similar tendency was observed in cytotoxicity tests with T. pyriformis. This cell system proved to be very sensitive to toxicants in tested dust fractions. The observed biological effects were found to be correlated significantly with concentrations of total PAH, carcinogenic PAHs, and benzo[a]pyrene.

Air Pollutants↗
PubMed2002

[Laparoscopic repair of incisional hernias].

The rationale for laparoscopic repair of incisional hernias lies in the fact that any kind of incisional hernia is caused by an intrinsic defect of wound healing. This means that the abdominal wall needs to be reinforced with foreign nonresorbable material. During laparoscopic repair a nonresorbable mesh with the characteristic feature that its two surfaces are quite different is used to completely cover the original incision. One surface is designed to ensure stable incorporation into the abdominal wall and the other, to keep adhesions between the mesh and the bowel to a minimum. Experience reported since its first description in 1993 has clearly shown that the main advantage of the laparoscopic technique over conventional methods is that it involves an extremely low risk of mesh infection. The reported recurrence rates of 1-11% are mainly attributable to technical error and demonstrate that in this way too, the laparoscopic technique is at least as good as the open techniques. Up to now, no mesh-related complications in the form of fistula or mesh migration have been described. In conclusion, then, laparoscopic repair of ventral hernia is an important addition to the surgical armamentarium, which at least in our hands has almost completely replaced conventional techniques.

Follow-Up Studies↗
PubMed2002

[Prognostic value of a screening test for difficult microlaryngoscopy].

BACKGROUND: Several screening methods for the prediction of a difficult endotracheal intubation such as the test by Patil or the Mallampati-Score have been described. The incidence of difficult microlaryngoscopic procedures and the prognostic value of those screening tests for their prediction has not been investigated. PATIENTS AND METHODS: We examined 81 patients with mainly benign conditions of the larynx in a prospective study to evaluate the maximal overview of the glottis gained during microlaryngoscopy under supraglottic jetventilation. We used a specially designed ruler to measure the length of the invisible portion of the glottis. RESULTS: The incidence of a difficult microlaryngoscopy was 4.9%. All employed screening scores did not reach a satisfactory positive predictive value (PPV). The routine indirect laryngoscopy with phonation had the highest PPV (50%) of all tests. CONCLUSION: Therefore an impossible indirect laryngoscopy can be regarded as a warning sign for a difficult microlaryngoscopic procedure. Summation-scores like the Arné Multivariate Risk Index or the use of check lists (Benumof) may improve the predictive value of preoperative screening.

Adult↗
PubMed2002

[The incidence of microlaryngoscopy associated complications].

BACKGROUND: The frequency of local and cardiovascular side effects of microlaryngoscopy is generally underestimated. There are no data available in the literature from recent and prospective clinical trials. PATIENTS AND METHODS: We examined 81 patients between 03/1998 and 03/2000 who underwent microlaryngoscopy in our department. This was done following a standard protocol before, during and after surgery. Side effects of endotracheal intubation were avoided by using supraglottic jet-ventilation. RESULTS: In 79% of our cases we encountered side effects due to the microlaryngoscopic procedure.86% of them were reversible lesions,hematomas and edemas of the mucous membranes or mild cardiovascular dysregulations. In two cases there was a dental complication (one fracture, one dislocation), and seven cases of moderate hemodynamic effects were noted. CONCLUSIONS: The incidence of tissue damage caused by microlaryngoscopic endoscopes is much higher than commonly assumed in clinical practice. This has to be explained to the patient when obtaining his written consent to a certain microlaryngoscopic procedure and to be considered during the postoperative follow up.The consequent use of tooth protection and a good control of muscle relaxation and analgesia can be effective in preventing side effects.

Adult↗
PubMed2002

[Entacapone for treatment of motor fluctuations in idiopathic Parkinson syndrome].

The treatment of idiopathic Parkinson's disease becomes rather difficult if levodopa-induced late complications such as motor fluctuations or dyskinesias occur. This prospective and open study shows that an add-on therapy with entacapone can significantly lower wearing-off and end-of-dose akinesia. This treatment is well tolerated and easy to perform.

Aged↗