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Biomedical subjects

C Weiss

Publications and source records attributed to C Weiss.

At least 109 records · Page 6Linked to original sources
PubMed1998

[High frequency current ablation of ectopic atrial tachycardia. Different mapping strategies for localization of right- and left-sided origin].

UNLABELLED: Ectopic atrial tachycardia (EAT) is a rare form of supraventricular tachycardia and often drug-resistant. Radiofrequency catheter (RFC) ablation offers an alternative therapy suggesting a high efficacy rate. Localization of the EAT origin is proposed to be efficacious by various mapping strategies. We analyzed the efficacy of different mapping strategies for localization of right and left sided EAT foci. METHODS AND PATIENTS: In a cohort of 48 patients (25 female: age 35 +/- 18 years) RFC ablation of 40 right and 12 left sided EAT foci was performed. Mapping of the right atrium was achieved with 2 ablation catheters using the "encircling" technique (Figure 1). We looked for an early bipolar local electrogram in relation to the onset of the P-wave and a QS-complex in the unipolar electrogram. The bipolar local electrogram was retrospectively analyzed for a fragmented morphology and duration of more than 50 ms (Figure 3). In case of mechanical block of the EAT during mapping P-wave pace mapping over the mapping catheter was performed (Figure 4). RESULTS: RFC ablation succeeded in 44 patients with 46 EAT foci (Figure 5). Left sided EAT origin was in 40% in the region of the pulmonary veins. Two left sided foci were abladed within the coronary sinus. An anteroseptal location in vicinity to the bundle of His was found in 4 cases (Figure 6). There were no differences between left and right sided origin regrading session duration (304 +/- 131 vs 241 +/- 101 min) and fluoroscopic time (39 +/- 29 vs 31 +/- 19 min). The activation time related to the onset of the P-wave was at successful ablation site for left sided origin significantly earlier compared to a right sided origin (45 +/- 22 vs 30 +/- 18 ms). Fragmenation of the bipolar local electrogram was found before successful RFC application in 86% in the left and in 65% in the right atrium. The unipolar electrogram showed in 87% of all cases a QS-complex before the successful RFC pulse. In 16% a beat to beat change of the unipolar electrogram could be found at successful ablation site (Figure 7). Both criteria had a low specify and sensitivity. Mechanical block could be induced during mapping in 10 patients (20%). In these cases RFC application at a site with a perfect match of P-wave pace mapping succeeded in 8 patients. In 2 patients the same EAT occurred within the following 24 hours. During a follow-up of 4 to 58 months there were additionally recurrence of EAT in 3 patients (3 to 6 months after ablation). No influence of the AV nodal conduction was observed after ablation of anteroseptal EAT foci. Other acute or chronic complications were not observed. CONCLUSIONS: 1. RFC ablation of right and left sided EAT foci is a safe and efficacious treatment. There were no differences regarding session duration and fluoroscopic time between right and left sided foci. 2. Activation mapping showed an earlier activation time for left sided origin compared to right sided. 3. Mechanical block could be induced in 20% of cases. P-wave pace mapping might offer a strategy to localize the focus during mechanical block.

Adolescent↗
PubMed1998

Whole-body hyperthermia combined with ifosfamide and carboplatin causes hypotension and nephrotoxicity.

It was previously postulated on the basis of clinical data that the cardiovascular sequelae of extracorporeal whole-body hyperthermia (e-WBH), i.e., hypotension (which requires catecholamine support) results in unique nephrotoxicity in combination with select chemotherapeutic agents. In an attempt to explain this phenomenon, we mimicked e-WBH physiological conditions in a rat model. Animals were treated with and without ifosfamide (IFO) and/or carboplatin (CBDCA) at 37 degrees C or 41.5-41.8 degrees C, with blood pressure monitoring and catecholamine support comparable to the clinical setting. Ex vivo post-treatment data (24 h) from artificially perfused kidneys (i.e., histology, urine volume, perfusion rate, glomerular filtration rate, and the reabsorption of sodium, glucose, and water) demonstrated unique toxicity including proximal tubular necrosis for the combination of WBH and IFO, for WBH and CBDCA and for WBH and IFO plus CBDCA, but not for IFO and CBDCA without WBH. These data, considered together with results derived from a subsequent clinical trial and the laboratory work of others were consistent with the hypothesis.

Animals↗
PubMed1998

Structural analysis of GroE chaperonin complexes using chemical cross-linking.

In this chapter, we have shown how chemical cross-linking with a bifunctional reagent, GA, can be used to investigate the structure of large oligomeric complexes such as GroEL14GroES7 and GroEL14(GroES7)2. Cross-linking, followed by denaturing electrophoresis, confirmed the number and arrangement of GroEL and GroES subunits within each individual oligomer, which was previously known from EM analysis. Furthermore, cross-linking permitted a close examination of the effect of regulatory factors, such as nucleotides and free divalent cations, on the molecular structure of GroEL14, GroEL14GroES7, and GroEL14GroES7. Finally, cross-linking analysis permitted characterization and quantitation of various chaperonin heterooligomeric complexes, GroEL14, GroEL14GroES7, and GroEL14GroES7 in solution, under conditions that also supported protein folding and ATP hydrolysis. It was shown that GA does not induce the artifactual association or the dissociation of GroES7 from the chaperonin. On the contrary, chemical cross-linking is an obligatory procedure when the subsequent analysis is carried out using methods that can displace the equilibrium.

Adenosine Triphosphate↗
PubMed1998

Protein and mRNA analysis of myosin heavy chains in the developing avian pectoralis major muscle.

While the existence of post-hatch and adult myosin heavy chain isoforms in the large, avian type IIB pectoralis major muscle has been clearly established, the number and nature of fast myosin heavy chains during in ovo development and the perihatch period have not been resolved. In the present study, developmental fast heavy chain proteins purified by high resolution anion-exchange have been characterized by sequence analysis of a unique CNBr peptide and by complementary mRNA analysis. The four proteins present at 15/16 days in ovo are shown to differ uniquely in primary structure. They correlate with heavy chains II, IV, VI and VII, characterized recently as major or minor species in adult fast muscles using similar methods. These four heavy chains are expressed in a time-dependent fashion from 8 to 16 days in ovo. At the mRNA level, heavy chain VI predominates until 12 days in ovo. Heavy chain IV mRNA is upregulated dramatically at 16 days in ovo preparatory to its protein's predominance in the peri-hatch period. Heavy chains II, IV and V (the post-hatch isoform which replaces heavy chain IV) have major roles in adult fast muscles.

Animals↗
PubMed1998

Proteolytic processing of chromogranin B and secretogranin II by prohormone convertases.

Two experimental approaches were used to study the processing of chromogranin B and secretogranin II by prohormone convertases. In GH3 cells various prohormone convertases were overexpressed together with the substrate chromogranin B by use of a vaccinia virus infection system. PC1 appeared to be by far the most active enzyme and converted chromogranin B to several smaller molecules, including the peptide PE-11. In brain this peptide is cleaved physiologically from chromogranin B. Some processing of chromogranin B and formation of free PE-11 were also observed with PC2 and PACE4. Furin produced larger fragments, whereas PC5-A and PC5-B had negligible effects. As a second model, PC12 cells were stably transfected with PC1 or PC2 to investigate the processing of endogenous chromogranins. Both enzymes effectively cleaved chromogranin B and secretogranin II, liberating the peptides PE-11 and secretoneurin, respectively. However, in transfection experiments the ability to generate the free peptides was more pronounced with PC2 than with PC1. The extent of proprotein processing achieved by prohormone convertases apparently differed depending on the experimental system applied. This suggests that in vivo mechanisms to support and fine-tune the activity of the processing enzymes exist, which might be overlooked by using only one methodological approach.

Animals↗
PubMed1998

Acute effects of haemodialysis on cutaneous microcirculation in patients with peripheral arterial occlusive disease.

BACKGROUND: Peripheral arterial occlusive disease (PAOD) is an increasing problem in patients on maintenance haemodialysis. Alterations in microvascular perfusion accompany and complicate arteriosclerosis of large vessels and might contribute to the disease process. The aim of the study was to investigate the acute effects of haemodialysis on the cutaneous microcirculation in 26 patients with and without intermittent claudication. METHODS: Cutaneous perfusion was assessed by measuring transcutaneous oxygen pressure (tcPO2) and skin temperature at the dorsum of the foot. After standardized cooling to 15 degrees C of a 2cm2 skin area, the time to reach baseline skin temperature was evaluated as an indirect parameter of reactive hyperaemia. RESULTS: During haemodialysis, tcPO2 dropped significantly in both groups. The decrease in tcPO2 was more pronounced in patients with PAOD (20% vs 15% n.s.). The reactive hyperaemia response was reduced significantly in patients with intermittent claudication indicated by a prolonged time to reach baseline skin temperature after cooling. Values of tcPO2 and reactive hyperaemia did not reach baseline values at the end of haemodialysis in either group. CONCLUSIONS: Nutritive skin perfusion is impaired during haemodialysis. These changes are more pronounced in patients with PAOD and persist after dialysis. These findings are relevant for the treatment of patients with vascular disease on maintenance haemodialysis.

Adult↗
PubMed1998

Coagulation and fibrinolysis after moderate and very heavy exercise in healthy male subjects.

To examine the relationship between exercise intensity and activation of coagulation and fibrinolysis, we measured markers of thrombin, fibrin, and plasmin formation in 12 male subjects (mean 24+/-4 yr (SD)) before and after running on a treadmill for 1 h at two different intensities corresponding to moderate (82% maximal heart rate (HR), 68% VO2max) and very heavy (94% maximal HR, 83% VO2max) exercise. During moderate exercise plasma levels of tissue plasminogen activator (t-PA) antigen rose from 3.7+/-0.5 (mean+/-SE) to 14.6+/-1.8 ng x mL[-1] (P < 0.01) and of plasmin-alpha-antiplasmin (PAP) complexes from 2.1+/-0.3 to 4.2+/-0.7 nmol x L[-1] (P < 0.01), whereas prothrombin fragment 1+2 (PTF1+2), thrombin-antithrombin III (TAT) complexes and fibrinopeptide A (FPA) did not change significantly. In response to very heavy exercise, mean plasma levels of t-PA antigen and PAP complexes exceeded the upper limit of normal values 2.5- (P < 0.01) and two-fold (P < 0.01), respectively, while significant increases of plasma levels of PTF1+2 (P < 0.01), TAT (P < 0.05), and FPA (P < 0.01) occurred within the range of normal. We conclude that in healthy young individuals, exercise-induced activation of coagulation is well balanced by activation of the fibrinolytic system, since moderate exercise results in increased plasmin formation only, while at very heavy exercise generation of plasmin seems to exceed that of thrombin and fibrin.

Adult↗
PubMed1998

Coagulation and thrombomodulin in response to exercise of different type and duration.

PURPOSE: The present study was conducted to evaluate the role of the duration of exercise and the impact of the exercise type for exercise-induced activation of coagulation. METHODS: Eleven male triathletes were subjected to stepwise maximal (17 min) and 1-h maximal exercise in swimming, cycling, and running. Changes of hemostatic variable sand of plasma thrombomodulin, a marker of endothelial cell activation, were monitored. RESULTS: Irrespective of the type of exercise, alterations in markers of thrombin (prothrombin fragment 1 + 2, thrombin-antithrombin III complexes) and fibrin formation (fibrinopeptide A) were more pronounced after 1-h exercise than after stepwise maximal exercise. Hemostatic parameters rose to the highest levels after running resulting in substantial fibrin formation as indicated by fibrinopeptide A increasing from 1.33 ng.mL-1 to 2.25 ng.mL (P < 0.05) after 1-h exercise testing. Significant changes of plasma thrombomodulin were detected exclusively after running with increases from 38.2 ng.mL-1 to 44.2 ng.mL-1 (1 h, P < 0.01). CONCLUSIONS: The data demonstrated that prolonged exercise is necessary for exercise-induced activation of coagulation resulting in thrombin and fibrin formation and suggested that endothelial cell activation possibly due to mechanical factors associated with running might play a role.

Adult↗
PubMed1998

Interleukin-9 promotes allergen-induced eosinophilic inflammation and airway hyperresponsiveness in transgenic mice.

Human atopic asthma is a complex heritable inflammatory disorder of the airways associated with clinical signs of allergic inflammation and airway hyperresponsiveness. Recent studies demonstrate that the degree of airway responsiveness is strongly associated with interleukin (IL)-9 expression in murine lung. To investigate the contribution of IL-9 to airway hyperresponsiveness, and to explore directly its relationship to airway inflammation, we studied transgenic mice overexpressing IL-9. In this report we show that IL-9 transgenic mice (FVB/N-TG5), in comparison with FVB/NJ mice, display significantly enhanced eosinophilic airway inflammation, elevated serum total immunoglobulin E, and airway hyperresponsiveness following lung challenge with a natural antigen (Aspergillus fumigatus). These data support a central role for IL-9 in the complex pathogenesis of allergic inflammation.

Allergens↗
PubMed1998

Neutrophil function in peripheral arterial occlusive disease: the effects of prostaglandin E1.

The role of polymorph nuclear neutrophils (PMN) in limb ischemia and reperfusion has been recognized only in recent years. The present study aimed to investigate the systemic and local (in femoral venous blood) effects of intra-arterially or intravenously applied prostaglandin E1 (PGE1) on systemic and ischemia-induced local changes in neutrophil function. Thirty patients with intermittent claudication were randomly assigned to intra-arterial or intravenous infusion of prostaglandin E1 (10 microg i.a. or 15 microg i.v. over 30 min). Prior to infusion femoral arterial and venous blood samples were obtained from the predominantly affected leg under resting conditions and immediately after a 3-min period of ischemia induced by suprasystolic thigh compression. After 24 h additional blood samples were obtained at baseline, following infusion of prostaglandin E1, and again after another 3-min period of ischemia following the prostaglandin E1 infusion. Intra-arterially administered prostaglandin E1 caused an increase in the PMN count by 3.5 +/- 2% (p<0.05) and a decrease in free oxygen radical production by 13 +/- 8% (p<0.05) measured by whole blood chemiluminescence. Additionally, a trend for lower PMN filterabilities (9 +/- 12%, NS) was observed. Intra-arterially infused prostaglandin E1 significantly reduced the ischemia-induced decrease in neutrophil filterability (arterial and venous blood difference after ischemia -- control: 22 +/- 17% (p<0.05); IA PGE1: 8 +/- 11% (NS), each compared to baseline). Intravenously administered prostaglandin E1 showed similar systemic effects as the intra-arterial application, but did not affect the ischemia-induced changes in neutrophil filterability. In conclusion, prostaglandin E1 reduces PMN activation in patients with peripheral arterial occlusive disease.

Aged↗
PubMed1998

[Electrophysiologic study and endocardial ECG mapping in the detection of causes of heart rhythm disorders].

Accessory pathways and ectopic heart focuses tachycardias are often cause of tachycardias. AV reentry tachycardias are great diagnostic and therapeutic problems. Using the electrophysiological investigation and ECG mapping, there is possibility to find out abnormal pathways and ectopic atrial and ventricular focuses. In electrophysiological investigations we can use bipolar, threepolar and multipolar electrodes and mapping electrodes, as well. The ablation catheter is introduced by transveins way in electrophysiological investigation of right atrium and ventricle, and via the femoral artery to the left atrium and ventricle. We investigated 45 patients, who are hospitalised at the Cardiology clinic Ependorf, of the University in Hamburg Accessory pathways were found out in 37 (82.22%) patients. Successful RF catheter ablation was done in 34 (91.89%) patients and unsuccessful in 3 (8.10%). Ectopic focuses were found out in patients with left ventricle aneurysm. It was indication for aneurysmectomia in two cases and for implantation of antitachycardia pacemaker in one case.

Adult↗
PubMed1998

[The Richard classic nail (intramedullary hip screw, IMHS) as unreamed intramedullary nail in osteosynthesis treatment of pertrochanteric fractures].

The treatment of 85 patients with pertrochanteric femoral fractures (average age 82.3 years) with the Richards classic nail allowed full weight-bearing in 94.1% and unreamed implantation in 91.8%. In the follow-up period (11.2 months post-operatively) few complications (1.2% infections, 1.2% cutting out) could be documented. The Sanders and Regazzoni score revealed that 66% of the patients reached their preoperative status again. Statistical analysis showed a negative influence of patient age and fracture type on the postoperative walking ability.

Aged↗
PubMed1997

Attenuated progression of coronary artery disease after 6 years of multifactorial risk intervention: role of physical exercise.

BACKGROUND: It was the aim of this study to assess the long-term effects of physical exercise and low-fat diet on the progression of coronary artery disease. At the beginning of the study, 113 male patients with coronary artery disease were randomized to an intervention group (n=56) or a control group (n=57); 90 patients (80%) could be reevaluated after 6 years. METHODS AND RESULTS: Patients in the intervention group (n=40) showed a reduction in total serum cholesterol (6.03+/-1.03 versus 5.67+/-1.01 mmol/L; P<.03) and triglyceride levels (1.94+/-0.8 versus 1.6+/-0.89 mmol/L; P<.005) and maintained their initial body mass index (26+/-2 versus 27+/-2 kg/m2; P=NS), but results were not statistically different from the control group (n=50) (total serum cholesterol, 6.05+/-1.02 versus 5.79+/-0.88 mmol/L; triglycerides, 2.25+/-1.28 versus 1.85+/-0.96 mmol/L [both P=NS]; body mass index, 26+/-2 versus 28+/-3 kg/m2 [P<.0001]). In the intervention group, there was a significant 28% increase in physical work capacity (166+/-59 versus 212+/-89 W; P<.001), whereas values remained essentially unchanged in the control group (165+/-51 versus 170+/-60 W; P=NS; between groups, P<.05). In the intervention group, coronary stenoses progressed at a significantly slower rate than in the control group (P<.0001). Energy expenditure during exercise was assessed in a subgroup; patients with regression of coronary stenoses spent an average of 1784+/-384 kcal/wk (approximately 4 hours of moderate aerobic exercise per week). Multivariate regression analysis identified only physical work capacity as independently contributing to angiographic changes. CONCLUSIONS: After 6 years of multifactorial risk intervention, there is significant and persistent improvement in lipoprotein levels and physical work capacity, which results in a significant retardation of disease progression. These beneficial effects appear to be largely due to chronic physical exercise.

Adult↗
PubMed1997

[Resuscitation in ventricular fibrillation as the first manifestation of Bland-White-Garland syndrome in adulthood].

CASE REPORT: This case presents a 31-year-old male patient with anomalous origin of the left coronary artery from the pulmonary trunc. First symptom of the disease was a survived sudden cardiac death. Subsequent angiographic and echocardiographic studies demonstrated the anomalous origin of the left coronary artery from the pulmonary artery. There were no signs of prior myocardial infarction. After reimplantation of the anomalous originating left coronary artery no myocardial ischemia could be detected in the thallium-201 myocardial imaging, which was present before surgical correction. In this case myocardial ischemia was the only potential triggering mechanism responsible for the sudden cardiac death, which was no longer detectable after surgical correction. Therefore no additional pharmacological and nonpharmacological antiarrhythmic treatment was initiated. CONCLUSION: In rare cases the first manifestation of Bland White Garland syndrome in the adult patient could be sudden cardiac death due to ventricular fibrillation.

Adult↗