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Biomedical subjects

A Wettstein

Publications and source records attributed to A Wettstein.

At least 19 recordsLinked to original sources
PubMed1998

[Successful coping with declining objective life style by institutionalized long-term patients. Results of a follow-up analysis of quality of life in long-term care institutions with the Zurich Quality of Life Inventory].

Measurement of quality of life in institutionalized frail patients is difficult considering the high prevalence of dementia. The Zurich quality of life inventory was developed specifically for this purpose and applied to describe longitudinally 103 institutionalized long-term care patients 3-12 months after entry: 11 slow-stream-rehabilitation patients (SSR), 16 severely dependent patients (ASL), 61 moderately dependent patients (ALL), and 15 young severely dependent patients, all of whom were assessed at least twice. The objective conditions of life deteriorated in all 4 groups, significantly in the SSR and ASL, and with high significance in the whole population from 121 +/- 54 to 139 +/- 58 (P < 0.001). Well-being did not change significantly in any of the groups or overall (from 122 +/- 59 to 117 +/- 54, p = 0.90). Deteriorating life conditions were due to a decline in clinical dementia rating, (p < 0.01) and living space diameter (p < 0.001), whereas the remaining subscores of life condition, i.e., number of falls, days of sickness, life style rating, and all subscores of well-being, i.e., number of medicines, valuation of handicap and of suffering, visual self-rating of well-being and caregivers' stress did not change significantly.

Activities of Daily Living↗
PubMed1997

[The use of adenosine in the diagnosis and treatment of cardiac arrhythmias].

The authors investigated the effect of adenosine or ATP on narrow QRS tachycardia in 56 pts, 3 pts with wide QRS tachycardia 9 pts with suspected latent preexcitation and 10 pts with PVC suspected to be ventricular parasystole. After the bolus iv. administration of adenosine or ATP every SVT was stopped related to AV node (44 pts), but in the rest twelve related to atrial origin of SVT only one automatic atrial tachycardia could be stopped. From the 9 patient suspected to have concealed WPW 2 pts had delta wave during the effect of adenosine, and in four pts parasystole was demonstrated among the pts had varying coupling interval PVC. None of the pts who had wide QRS tachycardia was the tachycardia stopped, but in two cases the supraventricular origin--atrial flutter and tachycardia--was discovered. The authors emphasize the favourable effect of adenosine in narrow complex tachycardia and suggest that it can given safely in wide QRS tachycardia of unknown origin either. The diagnostic effect of adenosine can be used in sinus rhythm too if latent preexcitation or ventricular parasystole is suspected.

Adenosine Triphosphate↗
PubMed1997

[Headache as a symptom of angina].

The authors report two cases where headaches was the only manifestation of severe myocardial ischemia. They had high degree coronaria sclerosis which was demonstrated by angiocardiography in one patient and at autopsy in the second patient. These findings suggest that in the mechanism of headache angina rather the pain perception than generalized vasospasm plays an important role.

Adult↗
PubMed1997

[Medical evaluation of dementia].

A careful medical evaluation of each dementia patient from any age group is necessary. Dementia targeted questioning of the patients and their relatives should be accompanied by a quantitative dementia rating like the NOSGER-scale. The essential neuropsychological evaluation should be followed by a nosological differential diagnosis including a row of laboratory tests. Brain imaging is necessary only if one of the Dietch-criteria is met. Pharmaco-therapy should be considered for non-cognitive symptoms of dementia and a cholinergic therapy in cases of Alzheimer's disease. Considering the axiome of dementia: one dementia = two in need of help, the care-giver burden has to be eased by proposing sets of medico-social interventions, optimally at a family conference.

Aged↗
PubMed1997

[The Zurich prospective dementia study 1987-1993].

1987-1993 the Zurich prospective dementia study examined twice yearly 308 nursing-home patients: 192 with senile dementia of Alzheimer-type, 18 with Parkinsonism, 20 with Parkinson dementia and 78 controls, with the Zurich variant of the mini-mental state and rated their dementia state by CDR, activities of daily living with ADL and social behavior with an SVS-scale. At the end of the study or at death the average age was 86.2 years (range 63-103 and 159 autopsies were performed which confirmed the clinical diagnoses at least partly in 70%. Of the 62 cases with autopsies who had been studied more than two years 25 showed M.Alzheimer, 8 M, Parkinson, 7 vascular dementia and 13 a combination of those three diagnoses 40% of these Alzheimer patients exhibited no deterioration in the SVS for two years, 40% respectively 30% during one, resp. two years in the CDR, 20% resp. 40% in the ADL and 23% resp. 5% in the MMS. This demonstrates that good nursing-home care can stabilize behaviour and to a lesser extent even cognitive abilities of a large minority of patients with a pathologically confirmed progressive dementing illness.

Activities of Daily Living↗
PubMed1996

[Cost reduction in long-term nursing thanks to a memory clinic--results of a case control study].

Between 1991 and 1995, 334 persons from the city of Zurich have been investigated at the gerontologic counselling facility of the memory clinic of the nursing home Entlisberg near Zurich. 49 (14.7%) of these persons suffered from a treatable disease (16 from depression, 13 from chronic intoxication, 20 from other treatable diseases), 10 from other disturbances (debility or postapoplectic state), and 275 from dementia. In 45% of the cases dementia was moderate, in 47% moderate to severe, and in 8% severe. In most cases dementia was of Alzheimer's type (60.7%), others were of multi-infarct type (17.5%), of mixed type (13.1%), or other types (8.7%). Until march 1996, 64 (19.4%) of these 334 on the average 74-year-old persons treated in the memory clinic have been admitted to a city nursing home. They have compared to a random sample, including 312 demented persons of similar ages and similar date of admittance to the same institutions. The proportion of demented persons cared before admittance by a spouse was about 28% in both groups. On an average, the mini mental state (Zurich variant) at admittance to a nursing home was 10.95 points in patients from the memory clinic, compared to 13.43 points in the control group. Thus, patients that have formerly been advised and trained entered the nursing home in a state of dementia more advanced by 2.48 points. Based on an average yearly demelioration by about 2.4 points, this means admittance to a nursing home is delayed by 376 days. Patients for whom admittance to a nursing home could be avoided completely by the treatment proposed by the counselling were not considered in this calculation.

Aged↗
PubMed1995

T-cell-receptor repertoire in chronic plaque-stage psoriasis is restricted and lacks enrichment of superantigen-associated V beta regions.

Preferential usage of certain T-cell receptors by the lymphocytic infiltrate in psoriasis might indicate the involvement of an antigen in the pathogenesis of this disease. However, to date there are no data on the complete T-cell-receptor V alpha and V beta repertoire in psoriatic patients. We therefore compared the usage of T-cell-receptor variable regions in blood and skin of 10 patients with chronic plaque-stage psoriasis by means of semiquantitative polymerase chain reaction. Additionally, HLA class II alleles were analyzed by means of sequence-specific oligonucleotide typing. A considerable restriction of the T-cell-receptor repertoire was observed in the skin, where up to 20% of the variable regions present in the blood were not detectable. This was true for both alpha- and beta-chains. However, no interindividually constant pattern of T-cell-receptor restriction was deducible. Inconsistently, a certain preferential usage of some beta chains occurred within the cutaneous compartment. This report on the complete T-cell-receptor V alpha and V beta repertoire in psoriasis documents the restricted receptor repertoire of infiltrating T cells and a lack of enrichment of superantigen-associated V beta regions. Thus superantigens seem not to play a pathogenetically relevant role in chronic plaque-stage psoriasis.

Genetic Heterogeneity↗
PubMed1993

[Phototherapy of behavioral disorders as a sequela of disordered circadian rhythm in dementia in the elderly--difficulties in practical clinical applications].

The behavioral disturbances of 16 nursing home patients with a history of sundowning behaviour and dementia were treated with light therapy instead of psychopharmacological medication. After the withdrawal of the before established medication a very individual, heterogenous deterioration of the symptoms was noted. A significant improvement of the behaviour was not found by light therapy in any patient. The problems in practical handling and possible consequences of further investigation are discussed.

Aged↗
PubMed1992

[Falls as a side effect of drugs].

Because of the smaller functional resources, the risk for falls in elderly persons is significantly increased when they take sedative anxiolytics with long half life, antipsychotics, antidepressants and, not so well documented, antihypertensives. Nonpharmacological strategies are, therefore, the treatment of choice for insomnia, depression and agitation in the elderly.

Accidental Falls↗
PubMed1992

The regulation of the human beta myosin heavy-chain gene.

The human myosin heavy-chain (MHC) genes for cardiac and skeletal muscle exist as a multigene family with eight or more non-allelic genes. Two of them code for the cardiac alpha and beta myocin HCs. They are located on chromosome 14. The skeletal muscle myosin HC genes are on chromosome 17. The cardiac MHCs coexist in the heart, however, with a distinct distribution within cardiac tissue of the human adult. alpha-MHC is predominantly found in the atria and beta-MHC is found in the ventricles. Both genes are also expressed in certain types of skeletal muscle fibers. We have sequenced the beta-gene in its entire length and have further studied in detail its expression in muscle cells. Promoter activities were tested using DNA-mediated gene transfer in cultured chicken embryonic myoblasts. By deletion mapping of the 5' flanking region of the beta-gene a candidate signal sequence was identified in a region which stimulates the promoter in a tissue specific and differentiation dependent mode. The presumed signal was located about 210 bp 5' to the basic promoter which, by itself, is almost inactive, even in muscle cells. The sequence of the signal (CAGCTG) has homology to known E-box sequences. E-boxes (consensus sequence CANNTG) constitute a family of transcription control sites frequently found upstream of muscle genes. In nuclear extracts of cardiac and skeletal muscle (of rabbit) a protein was identified which binds to the region containing the E-box like motif of the beta-gene. Since this protein was present in both types of muscle, overlapping expression control patterns are assumed to operate in these tissues.

Base Sequence↗
PubMed1992

A new case of Zimmermann-Laband syndrome with atypical retinitis pigmentosa.

This paper reports a case study of a 10-year-old girl exhibiting symptoms of a Zimmermann-Laband syndrome (ZLS), including an ocular involvement not previously observed. In addition to the case reported, we have also discovered 21 patients described in the literature. Major clinical findings, defined as being present in more than 75% of the cases under discussion, are presented.

Child↗
PubMed1991

Failure to find a relationship between mnestic skills of octogenarians and aluminum in drinking water.

High concentrations of aluminum (greater than 80 micrograms/l) in drinking water have been related to an elevated incidence of Alzheimer's disease. Mnestic and naming skills of residents living for greater than 15 years in districts with high (98 micrograms/l) or low (4 micrograms/l) aluminum concentrations [Al] in the drinking water were evaluated in a population survey by examining 800 residents aged 81 to 85 using the mnestic subtest of the Mini Mental Status test (Zurich variant). The mnestic and naming performance of the octogenarians did not differ between the high- and low-content-areas. Since 73% of dementias are at least partly caused by Alzheimer's disease in the area examined and because the short test used discriminates demented from healthy octagenarians as well as tests involving extensive examinations, the findings of this study suggest with a high probability that the [Al] of drinking water is not an essential factor in the pathogenesis of senile dementia. The serum [Al] the urinary [Al] and the urinary [Al]/creatinine ratio were measured twice in ten clinically diagnosed Alzheimer patients and ten controls in both areas. No significant difference was found, which confirms the negative epidemiological findings.

Aged↗
PubMed1991

Aspects related to mevalonate biosynthesis in plants.

We purified and characterized a membrane-associated enzyme system from radish (Raphanus sativus L.) that is capable of converting acetyl-CoA into 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA). The enzyme system apparently comprises acetoacetyl-CoA thiolase (EC 2.3.1.9) and HMG-CoA synthase (EC 4.1.3.5). Its activity in vitro can be strongly stimulated by FeII. When ferrous ions are applied chelated with ethylenediaminetetraacetate, citrate or adenosine 5-triphosphate (ATP), the stimulation is further increased. Stimulation is due to a higher catalytic efficiency as indicated by an increase in Vmax, whereas the affinity of the enzyme towards acetyl-CoA remains constant (Km = 6 micro M). A considerable portion of HMG-CoA lyase activity is associated with the same membranes. HMG-CoA lyase (EC 4.1.3.4) is also solubilized and partially co-purified. Its activity requires comparatively high concentrations of Mg2+. The conversion of HMG-CoA to mevalonic acid is catalyzed by HMG-CoA reductase (EC 1.1.1.34) that is associated with the same membranes. By cDNA encoding the Arabidopsis HMG-CoA reductase, we isolated a corresponding gene from a cDNA library newly established from etiolated radish seedlings. This full-length cDNA, referred to as lambda cRS3, encodes a polypeptide 583 amino acids with a molecular mass of about 63 kDa. The hydropathy profile suggests the presence of two hydrophobic membrane-spanning domains within the N-terminal 165 amino acids. The carboxy-terminal part, where the catalytic site resides, is highly conserved in all eukaryotic HMG-CoA reductase genes sequenced so far.

Acetyl Coenzyme A↗
PubMed1990

Expression of catalytically active radish 3-hydroxy-3-methylglutaryl coenzyme A reductase in Escherichia coli.

Two fragments of a cDNA encoding radish 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGR) were cloned into the vector pET-8c and expressed in Escherichia coli. The large fragment, encoding both the membrane and the cytosolic domains, was expressed at low level, essentially as an insoluble protein without enzymatic activity. In contrast, the fragment encoding only the cytosolic domain was expressed at a high level in a catalytically active form. The amount of soluble active enzyme in cell-free extracts of E. coli dramatically increased when the temperature during the induction was lowered from 37 degrees C to 22 degrees C.

Cloning, Molecular↗