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Biomedical subjects

C Becker

Publications and source records attributed to C Becker.

At least 55 records · Page 3Linked to original sources
PubMed2003

The production of anti-inflammatory cytokines in whole blood by physico-chemical induction.

OBJECTIVE AND DESIGN: Cytokines such as interleukin-1 (IL-1) play an important role in degenerative musculo-skeletal diseases, including osteoarthritis, and a multitude of inflammatory disorders. Agents that inhibit the action of such cytokines have a high therapeutic potential in such diseases. Here we describe a new method for enhancing the production of the interleukin-l receptor antagonist (IL-1Ra) and other anti-inflammatory cytokines in whole blood. MATERIAL AND METHODS: Human venous blood was incubated in the presence of CrSO(4)-treated glass beads. Serum was recovered and the concentrations of IL-1Ra and other relevant cytokines were measured by ELISA. RESULTS: The interaction of the glass bead surface with cells in whole blood increased production of IL-1Ra and anti-inflammatory cytokines. Removal of the beads and centrifugation generated a serum preparation enriched in anti-inflammatory cytokines. This preparation is of therapeutic value in treating various inflammatory and degenerative disorders. CONCLUSIONS: The increased de novo production of anti-inflammatory cytokines by a direct physico-chemical induction of whole blood in the Orthokin system is feasible and offers an alternative, novel approach to treating mild to moderate OA and other orthopaedic conditions such as degenerative spine diseases.

Chemical Phenomena↗
PubMed2003

[Prediction of mortality, mobility and admission to long-term care after hip fractures].

INTRODUCTION: Surgical treatment, discharge planning and rehabilitation procedures are rarely based upon defined assessment procedures. It might therefore be useful to develop simple and reliable screening tools to identify patients for early discharge, intensified rehabilitation and limited treatment. PATIENTS AND METHODS: 234 patients were initially contacted. From these 217 gave informed consent. The reported study included the 134 home dwelling elderly. All patients could be contacted or died after six month. Thus,data from more than 90% could be used for the analysis. The six month mortality was 10%. A population based cohort of elderly patients referred to five local hospitals was tested. Mortality, institutionalisation and mobility were defined as major outcome criteria. Only information that was available during the first week of treatment was used in the model. Predictors expressed as odd ratios (OR) were calculated using logistic regression with variable selection. RESULTS: The most important predictors for institutionalisation were age, inability to eat without assistance, postoperative night time confusion, stroke history, cognitive deficit and fear of falling. Outdoor mobility was strongly associated to the preoperative ADL performance measured as the Barthel-Index, history of malignancy and fear of falling. Six month mortality was associated with male sex, the Barthel-Index and fear of falling. DISCUSSION: It seems feasible to improve postoperative resource allocation by predictor led stratification. This need to be tested in intervention trials under the specific condition of the German health care system.

Activities of Daily Living↗
PubMed2003

[Abilities and restrictions of nursing home residents. Evaluation with the Minimum Data Set of the Resident Assessment Instrument].

UNLABELLED: The main objective of the study was to examine the prevalence of problems and resources of an unselected cohort of nursing home residents. The sample includes residents (n=769) of an urban area in Southern Germany. The assessment definitions were used according to the Minimum Data Set of the Resident Assessment Instruments (Version 2.0). RESULTS: The mean age was 84.2 years, 608 of the residents were female. Dementia (446) and stroke (185) were the most common main diagnosis. Syndrome prevalences are reported for depressive symptoms (323), mobility impairments (608), urinary incontinence (461), decubitus (54), use of restraints (54), disruptive behavior (185), psychopharmacy (377), severe visual impairment (123) and severe hearing impairment (123).

Age Factors↗
PubMed2003

Elevated heels and adaptation to new shoes in frail elderly women.

Footwear is supposed to have influence on postural control and is a potential aspect to address in the prevention of falls in the elderly. This study aimed to show whether measurements of static balance and gait are different with habitual shoes compared to new special senior shoes with different heel height and whether these results change after adaptation. In a randomized controlled intervention study, 26 subjects (median age 87 years) were recruited from two nursing homes and one facility of assisted living. Measurements of static balance and gait were performed with habitual shoes and two types of new special senior shoes differing in heel height. Measurements were repeated after five weeks. There was no difference in static balance and gait with habitual shoes compared to either of the new footwear offered. Results of performance with higher heels were not different compared to lower heels. No further effect of adaptation after wearing a new shoe over five weeks could be demonstrated. With respect to static and dynamic balance, there seems to be a wide range of acceptable footwear as long as the heel height is below a critical value. A standardized shoe can be used in the assessment of balance because the effect of adaptation can be neglected.

Accidental Falls↗
PubMed2003

Validation of air-displacement plethysmography for estimation of body fat mass in healthy elderly subjects.

BACKGROUND: Air-displacement plethysmography (ADP) is a non-invasive method for body composition analysis that divides the body into fat-free mass (FFM) and fat mass (FM) (= 2 compartment model, 2C). It places low demands on subject performance and is therefore most convenient in the elderly. OBJECTIVE: To validate ADP against dual energy X-ray absorptiometry (DEXA) and to compare it to a four-compartment model of body composition (4C; fat mass, total body water, bone mineral content and residual mass) in the elderly. METHODS: Body composition was assessed by ADP, DEXA and bioelectrical impedance analysis (BIA) in 26 healthy elderly subjects (15 women, 11 men) aged 60-82 years. RESULTS: Despite a high correlation of %FM assessed by ADP and DEXA we observed significant differences between the results of these methods for both sexes (2.5 +/-3.4%; bias +/- SD). Deviations of %FM(ADP) from %FM(DEXA) were dependent on bone mineral content (BMC(DEXA)) fraction of FFM. A low BMC(DEXA) was related to an overestimation of DEXA-derived %FM by ADP. There was a systematic bias between results from ADP and the 4C model. 76% of its variance was explained by the assumption of a fixed density of FFM. 96% of the variance in the density of FFM was explained by water content and only 4% by BMC(DEXA) of FFM. When compared to a 4C model, overestimation of %FM(ADP) increases with increasing water fraction of FFM. CONCLUSION: Although there is a tendency for overestimation of %FM(ADP),ADP is a valid method for body composition measurement in the elderly. The bias in %FM(ADP) is mainly related to water content of FFM and indicates that a correction factor for TBW may improve the accuracy of the ADP measurements in the elderly.

Absorptiometry, Photon↗
PubMed2003

Scalp-recorded slow EEG responses generated in response to hemodynamic changes in the human brain.

OBJECTIVE: To study whether hemodynamic changes in human brain generate scalp-EEG responses. METHODS: Direct current EEG (DC-EEG) was recorded from 12 subjects during 5 non-invasive manipulations that affect intracranial hemodynamics by different mechanisms: bilateral jugular vein compression (JVC), head-up tilt (HUT), head-down tilt (HDT), Valsalva maneuver (VM), and Mueller maneuver (MM). DC shifts were compared to changes in cerebral blood volume (CBV) measured by near-infrared spectroscopy (NIRS). RESULTS: DC shifts were observed during all manipulations with highest amplitudes (up to 250 microV) at the midline electrodes, and the most pronounced changes (up to 15 microV/cm) in the DC voltage gradient around vertex. In spite of inter-individual variation in both amplitude and polarity, the DC shifts were consistent and reproducible for each subject and they showed a clear temporal correlation with changes in CBV. CONCLUSIONS: Our results indicate that hemodynamic changes in human brain are associated with marked DC shifts that cannot be accounted for by intracortical neuronal or glial currents. Instead, the data are consistent with a non-neuronal generator mechanism that is associated with the blood-brain barrier. SIGNIFICANCE: These findings have direct implications for mechanistic interpretation of slow EEG responses in various experimental paradigms.

Adult↗
PubMed2003

Non-invasive intravenous coronary angiography using electron beam tomography and multislice computed tomography.

BACKGROUND: Electron beam computed tomography (EBCT) and multislice computed tomography (MSCT) are both suitable for non-invasive identification of coronary stenoses. OBJECTIVE: To compare intravenous coronary EBCT angiography (EBCTA) and MSCT angiography (MSCTA) with regard to image quality and diagnostic accuracy. METHODS: EBCTA was done using an Imatron C-150 XP scanner in 101 patients following a standard protocol (slice thickness 3 mm, overlap 1 mm, acquisition time 100 ms, prospective ECG trigger). For MSCTA in a different set of 91 patients (using a Siemens Somatom Plus4VZ scanner), the whole volume of the heart was covered in a spiral technique by four simultaneous detector rows. Using retrospective ECG gating, the raw data were reconstructed in (mean (SD)) 215 (12) axial slices acquired in diastole (slice thickness 1.25 mm, overlap 0.5 mm, acquisition time 250 ms/slice). RESULTS: With EBCTA, 76% of predetermined coronary segments in a nine segment model could be assessed with diagnostic image quality, and with MSCTA, 82%. A low contrast to noise ratio with EBCTA, and the presence of motion artefacts with MSCTA were the main reasons for inadequate image quality. Using conventional angiography as the gold standard, 77% of stenoses of > 50% could be identified correctly with EBCTA and 82% with MSCTA. Significant stenoses were correctly ruled out in 93% of segments with EBCTA, and in 96% of segments with MSCTA. The average contrast to noise ratio was higher with MSCTA than with EBCTA (9.4 v 6.5; p < 0.001). CONCLUSIONS: EBCTA and MSCTA show similarly high levels of accuracy for determining and ruling out significant coronary artery stenoses. MSCTA is capable of providing good image quality in more coronary segments than EBCTA because of its better contrast to noise ratio and higher spatial resolution. Motion artefacts seen at heart rates of > 75 beats/min and a higher radiation exposure are the main limitations of MSCTA.

Coronary Angiography↗
PubMed2002

Dynamic gadolinium-enhanced MRI evaluation of porcine femoral head ischemia and reperfusion.

OBJECTIVE: To examine the potential of gadolinium (Gd)-enhanced dynamic MRI in the detection of early femoral head ischemia. Furthermore, to apply a three-compartment model to achieve a clinically applicable MR index for femoral head perfusion during the steady state and arterial hip joint tamponade. DESIGN AND MATERIALS: In a porcine model femoral head perfusion was measured by radioactive tracer microspheres and by using a dynamic Gd-enhanced MRI protocol. Femoral head perfusion measurements and MRI tests were performed unilaterally before, during and after the experimentally induced ischemia of one of the hip joints. Ischemia was induced by increasing intra-articular pressure to 250 mmHg. RESULTS: All pigs showed ischemia of the femoral head epiphysis under hip joint tamponade followed by reperfusion to the same level as before joint tamponade. In two cases perfusion after removal of tamponade continued to be low. In dynamic MRI measurements increases in signal intensity were seen after intravenous infusion of Gd-DTPA, followed by a slow decrease in signal intensity. The signal-intensity curve during femoral head ischemia had a minor increase. Also the coefficient determined was a helpful indicator of femoral head ischemia. CONCLUSIONS: Femoral head blood flow as measured by microspheres fell significantly under joint tamponade. Early detection of this disturbed regional blood flow was possible using a dynamic MRI procedure. A biomathematical model resulted from the evaluation of the intervals of signal intensity over time which allows detection of bone blood flow changes at a very early stage. Using this new method earlier detection of femoral head necrosis may be possible.

Animals↗
PubMed2002

A retrospectively ECG-gated multislice spiral CT scan and reconstruction technique with suppression of heart pulsation artifacts for cardio-thoracic imaging with extended volume coverage.

A method for cardio-thoracic multislice spiral CT imaging with ECG gating for suppression of heart pulsation artifacts is introduced. The proposed technique offers extended volume coverage compared with standard ECG-gated spiral scan and reconstruction approaches for cardiac applications: Thin-slice data of the entire thorax can be acquired within one breath-hold period using a four-slice CT system. The extended volume coverage is enabled by a modified approach for ECG-gated image reconstruction. For a CT system with 0.5-s gantry rotation time, images are reconstructed with 250-ms image temporal resolution. Instead of selecting scan data acquired in exactly the same phase of the cardiac cycle for each image as in standard ECG-gated reconstruction techniques, the patient's ECG signal is used to omit scan data acquired during the systolic phase of highest cardiac motion. With this approach cardiac pulsation artifacts in CT studies of the aorta, of paracardiac lung segments, and of coronary bypass grafts can be effectively reduced.

Aortic Diseases↗
PubMed2002

[Precurarization of succinylcholine with cisatracurium: the influence of the precurarization interval].

PURPOSE: To determine the influence of two different pretreatment intervals, i.e. 3 and 6 min, on the efficacy of 0.01 mg/kg cisatracurium in preventing succinylcholine-induced fasciculations and myalgia. METHODS: A total of 60 adult patients were randomized and received either 0.01 mg/kg cisatracurium (0.2*ED(95)) i.v. (Cis 3 group: pretreatment interval 3 min, Cis 6 group: pretreatment interval 6 min) or normal saline i.v. (placebo group) prior to injection of succinylcholine. The incidence and severity of fasciculations and myalgia and side-effects of precurarization were assessed. RESULTS: The incidence of muscle fasciculations was only reduced in the Cis 6 group (45%) compared with the Placebo group (85%), p<0.05. Cisatracurium was associated with a higher incidence of paralytic symptoms in both pretreatment groups (Cis 3: 75%, Cis 6: 80%) compared with the Placebo group (30%), p<0.05. CONCLUSION: Cisatracurium is only effective in preventing succinylcholine-induced fasciculations when a longer pretreatment interval, i.e. 6 min instead of 3 min, is chosen. Precurarization led to signs of paralysis in both pretreatment groups in the majority (75-80%) of patients without reducing the incidence or severity of postoperative myalgia.

Adult↗
PubMed2002

[Injury prevention in the elderly population].

Injuries in the elderly population have more considerable consequences (more difficult treatment, higher costs,worse outcome) than in the younger population. Therefore, the prevention is especially important. The majority of the injuries are caused by traffic accidents and falls. TRAFFIC ACCIDENTS: An analysis of the current injury situation in elderly road users (65 years and older) involved in road traffic accidents was intended to allow conclusions regarding future prophylaxis. FALLS: Falls are mostly caused by numerous factors. The most important predictors for falls are dementia,Parkinson-Syndrome and neurologic deficits after cerebrovascular insults. The most important symptoms, that indicate an increased risk for fall are gait abnormalities, balance lack and underweight. The most important anamnestic indications are more than one falls in the recent 90 days, need for assistance in daily living and prevailing medication. Another important factor is the residential setting (lighting, stairs, floor conditions,bath installations). The most affective protective interventions involve multiple factors. The incidence of falls could be reduced by 30%. The hip protector is an effective protection against proximal femur fractures. which is the most frequent fracture in the elderly population that requires treatment as an inpatient. Injury prevention in the elderly population is an interdisciplinary task as for example shown by the successful fall clinics in the anglo-american area.

Accident Prevention↗
PubMed2002

The cutaneo-lymph node flap of the superficial circumflex artery.

Upper limb lymphoedema and associated radiation-damaged chest wall are complications occurring after breast cancer treatment. Previous anatomical and clinical studies have demonstrated the usefulness of inguinal lymph node autotransplantation in managing lymphoedema. The present anatomical study is a complement to previous studies about the cutaneous inguinal flap. It has demonstrated the feasibility of using a free inguinal cutaneo-lymph node flap supplied by the superficial circumflex iliac artery. The useful vascularized abdominal skin area ranged from 176 to 288 cm2 and was contained within a vascularized skin area extending up to 928 cm2. However, the vascularization never extended widely beyond the abdominal midline line. Although it mainly remains unilateral, this flap combining skin and lymph nodes may help in the management of lymphoedema and chest wall damage when they occur simultaneously as complications of breast cancer treatment. The French version of this article is available in the form of electronic supplementary material and can be obtained by using the Springer LINK server located at http://dx.doi.org/10.1007/s00276-002-0024-7.

Breast↗
PubMed2002

[Detection of coronary calcinosis with multislice spiral computerized tomography: an alternative to electron beam tomography].

Electron-beam CT (EBT) has been used for years as the gold standard to quantify coronary artery calcification as a marker of coronary atherosclerosis. With the introduction of Multi-Slice Spiral CT (MSCT) technology in 1999, EBT is now challenged in the determination of coronary calcium. The aim of this study was to determine the diagnostic accuracy of MSCT for the assessment of coronary calcium, comparing this new technique to EBT. The study population consisted of 54 male patients, aged 58 +/- 11 years with suspected coronary artery disease. For EBT, 40 axial slices (scan time = 100 ms, slice thickness = 3 mm) were acquired in one breath-hold (35 +/- 5 s) using an ECG-trigger at 80% of the RR interval. For MSCT, simultaneous acquisition of four axial slices (scan time = 250 ms, slice thickness = 2.5 mm) allowed the entire heart (40 slices) to be covered in one breath-hold (25 +/- 5 s) using a prospective ECG-trigger (R--450 ms). For quantification of coronary calcium the Agatston and the Volumetric calcium score (VCS) were applied. Mean Agatston score of the study group was calculated as 88 +/- 111 (median = 45), which is between the 25th and 75th age-corrected percentile of asymptomatic patients. For the Volumetric calcium score, number of lesions, calcium mass and density, no statistical difference was found between both imaging modalities. Agatston and Volumetric calcium score were statistically different between and within both scans. Mean variability of VCS of the two methods was calculated as 24% and was in the range of repeated EBT studies (14-44.9%). The Multi-Slice Spiral CT scanner is equivalent to EBT for the determination of coronary calcium and can, therefore, be used for calcium screening. Using a prospective ECG-trigger technique, the application of the Agatston method delivers statistically different results in comparison to EBT. With the application of the spiral mode technique, retrospective ECG-trigger and thinner slice thickness, further improvement in variability can be expected, thus allowing for follow-up studies to determine progression or regression of atherosclerosis with high accuracy.

Aged↗
PubMed2002

Differential regulation of interleukin-10 production by genetic and environmental factors--a twin study.

Interleukin-10 (IL-10) has a critical role in the regulation of immune responses. The relative contribution of genetic and environmental factors to IL-10 production is under debate. We performed a twin study in 246 monozygotic and dizygotic twins to assess the heritability of IL-10 production after LPS stimulation in whole blood. In addition, the influence of promoter single nucleotide polymorphisms (-1082, -819 and -592) on transcriptional activity and their binding to nuclear factors was studied in luciferase reporter gene and electrophoretic mobility shift assays. IL-10 production showed a genetic determination with a heritability of 0.5. Decreasing body mass index (BMI), smoking and female gender lead to decreased IL-10 production. In monocytes, the -1082A allele showed higher binding affinity to the transcription factor PU.1 resulting in decreased transcriptional activity of -1082A promoter haplotypes. Genetic determination of IL-10 secretion is probably lower than that previously reported. Fifty percent of the observed variability explained by genetic factors. Female individuals produce less IL-10 than male subjects. Environmental factors like smoking and decreasing BMI exert suppressing effects on IL-10 production. Although the -1082A allele shows higher binding affinity to the PU.1 transcription factor and lower transcriptional activity, this polymorphism probably explains only a small fraction of the observed heritability.

Binding Sites↗
PubMed2002

Acute encephalopathy with parvovirus B19 infection in sickle cell disease.

A 13 year old girl with haemoglobin Sbeta(+)thalassaemia developed simultaneous aplastic crisis and encephalopathy associated with parvovirus B19 (PB19) infection. Brain magnetic resonance imaging findings were consistent with central nervous system (CNS) vasculitis and her symptoms resolved with steroid therapy. Thus, PB19 induced CNS hypersensitivity vasculitis must be considered in the differential diagnosis of encephalopathy.

Acute Disease↗