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Biomedical subjects

D Bauer

Publications and source records attributed to D Bauer.

At least 91 records · Page 5Linked to original sources
PubMed2000

Telerehabilitation: managed care's new opportunity.

Recent advances in telecommunications technology are leading to new developments in postacute and rehabilitative care. For about $400 per patient and a telephone hookup, physicians and therapists can provide ongoing, direct care to patients at remote clinics or in their homes. The lack of large-scale randomized controlled trials demonstrating clinical and cost effectiveness in rehabilitation and telemedicine has precluded many payers from reimbursing for services. Guidelines for best use do not currently exist, yet the benefits for payers, providers, and patients could be substantial. Telerehabilitation could become an important modality to MCOs seeking to extend the continuum of postacute care to nonclinical settings.

Aged↗
PubMed1999

CD4+ T-cell type 1 and type 2 cytokines in the HSV-1 infected cornea.

PURPOSE: It has been previously shown that CD4+ T-lymphocytes are critical mediators in HSV-1 stromal keratitis (HSK). CD4+ T cell subpopulations (type 1, type 2) can be defined by their capabilities of producing different sets of cytokines. This study was performed to determine the role of type 1 and type 2 cytokines in murine HSK. METHODS: BALB/c mice (n = 20) were inoculated with 10(5) PFU of HSV-1 (KOS strain) and were followed clinically. At various time points post-infection (p.i.), the conjunctival and corneal tissues were analyzed histologically (n = 2 each time point), and immunohistochemically (n = 5 each time point) for the presence of interleukin-1alpha (IL-1alpha), type 1 cytokines (IL-2, interferon-gamma) and a type 2 cytokine (IL-4). The expression of cytokine mRNA was tested in eye samples by reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: Stromal keratitis clinically progressed after day 9. In 15% of the mice, disease regressed until day 14 p.i. Polymorphonuclear neutrophils, lymphocytes and other mononuclear cells infiltrated the conjunctiva by day 2 and rapidly expanded to the central cornea between days 7 and 14. IL-1alpha, IFN-gamma and IL-2 mRNA were found in the eyes at days 1 and 2 p.i. IL-1alpha protein was detected in the conjunctiva, limbus and corneal epithelium at day 2. The IL-1alpha staining intensities increased with disease progression. This was paralleled by IL-2 and IFN-gamma staining intensities. In contrast, IL-4 mRNA and protein were detected at days 7 through 14 after HSV-1 infection; compared to IL-2 and IFN-gamma, IL-4 staining intensities were lower. CONCLUSIONS: The findings suggest that the lymphocytic infiltrate during the development of HSV-1 keratitis is predominantly composed of type 1 cells expressing IL-2 and IFN-gamma. Type 2 cytokines participate in the late stage of inflammation and might be useful to improve the course of the disease.

Animals↗
PubMed1999

Clinical significance of sleep-related breathing disorders in patients with implantable cardioverter defibrillators.

The prevalence and clinical significance of sleep-related breathing disorders (SRBDs) in patients with cardiac disease and a history of life-threatening ventricular tachyarrhythmias is unclear. Forty consecutive recipients of implantable cardioverter defibrillators (ICDs) with cardiac disease and a documented history of spontaneous, life-threatening, ventricular tachyarrhythmias underwent full night polysomnography. SRBDs were diagnosed if the apnea/hypopnea index was > 10. SRBD were diagnosed in 16 of 40 patients (40%): central sleep apnea (CSA) was present in 9 of these 16 patients (56%), 8 of whom had associated Cheyne-Stoke respiration. Seven of the 16 patients with SRBD (44%) had obstructive sleep apnea (OSA). Patients with and without SRBDs were comparable with respect to left ventricular ejection fraction, NYHA classification, underlying heart disease, ICD indications, and concomitant antiarrhythmic drug and beta-blocker therapy. Patients were followed prospectively for 2 years. ICD-treated ventricular tachyarrhythmias occurred in 10 of 24 patients (42%) without SRBD, in 4 of 9 patients (44%) with CSA, and in 3 of 7 patients (44%) with OSA (NS). The numbers and circadian distributions of episodes recorded during follow-up in patients without SRBD versus with CSA or OSA were not significantly different (14 +/- 25, median = 4 vs 4 +/- 5, median = 2.5 vs 15 +/- 15, median = 7, respectively). The 2-year mortality, which was entirely attributable to nonsudden cardiac events, was highest in patients with CSA (4/9 [44%], vs 0/7 [0%] with OSA, vs 3/24 patients (12.5%) without SRBD; P < 0.05).

Aged↗
PubMed1998

Endogenous hormones and the risk of hip and vertebral fractures among older women. Study of Osteoporotic Fractures Research Group.

BACKGROUND AND METHODS: In postmenopausal women, the serum concentrations of endogenous sex hormones and vitamin D might influence the risk of hip and vertebral fractures. In a study of a cohort of women 65 years of age or older, we compared the serum hormone concentrations at base line in 133 women who subsequently had hip fractures and 138 women who subsequently had vertebral fractures with those in randomly selected control women from the same cohort. Women who were taking estrogen were excluded. The results were adjusted for age and weight. RESULTS: The women with undetectable serum estradiol concentrations (<5 pg per milliliter [18 pmol per liter]) had a relative risk of 2.5 for subsequent hip fracture (95 percent confidence interval, 1.4 to 4.6) and subsequent vertebral fracture (95 percent confidence interval, 1.4 to 4.2), as compared with the women with detectable serum estradiol concentrations. Serum concentrations of sex hormone-binding globulin that were 1.0 microg per deciliter (34.7 nmol per liter) or higher were associated with a relative risk of 2.0 for hip fracture (95 percent confidence interval, 1.1 to 3.9) and 2.3 for vertebral fracture (95 percent confidence interval, 1.2 to 4.4). Women with both undetectable serum estradiol concentrations and serum sex hormone-binding globulin concentrations of 1 microg per deciliter or more had a relative risk of 6.9 for hip fracture (95 percent confidence interval, 1.5 to 32.0) and 7.9 for vertebral fracture (95 percent confidence interval, 2.2 to 28.0). For those with low serum 1,25-dihydroxyvitamin D concentrations (< or =23 pg per milliliter [55 pmol per liter]), the risk of hip fracture increased by a factor of 2.1 (95 percent confidence interval, 1.2 to 3.5). CONCLUSIONS: Postmenopausal women with undetectable serum estradiol concentrations and high serum concentrations of sex hormone-binding globulin have an increased risk of hip and vertebral fracture.

Aged↗
PubMed1998

[Clinical significance of sleep apnea disorders after implantation of a cardioverter-defibrillator in patients with cardiac disease and sustained ventricular tachyarrhythmia].

The purpose of our study was to determine the prevalence of sleep related breathing disorders (SRBD) in patients with an implantable cardioverter-defibrillator (ICD) and to evaluate prospectively the possible influence of SRBD on arrhythmia recurrence and circadian arrhythmia variation as well as on cardiac mortality during long-term follow-up. Forty consecutive ICD recipients with cardiac disease and a documented history of spontaneous, life-threatening, ventricular tachyarrhythmias underwent full-night polysomnography and were followed for 2 years. In 16 of 40 patients (40%), SRBD were diagnosed (Apnea/Hypopnea Index (AHI) > 10); in 9 of these 16 patients (56%) central sleep apneas (CSA) occurred (in 8 of these 9 patients in combination with Cheyne-Stokes respiration). Seven of the 16 patients with SRBD (44%) revealed obstructive sleep apneas (OSA). AHI was 32 +/- 15 (12-60) in patients with CSA and 32 +/- 27 (11-86) in patients with OSA. Patients with and without SRBD were comparable concerning left ventricular ejection fraction, NYHA classification, cardiac disease, ICD indication, and concomitant medication. ICD registered ventricular tachyarrhythmias occurred in 10 of 24 patients (42%) without SRBD, in 4 of 9 patients (44%) with CSA, and in 3 of 7 patients (44%) with OSA. The numbers and circadian variation of episodes registered during follow-up in patients without SRBD, with OSA or CSA were comparable (14 +/- 25, median 4 vs 15 +/- 15, median 7 vs 4 +/- 5, median 2.5). The 2-year cardiac mortality was highest in patients with CSA (4/9 (44%) vs. 0/7 patients (0%) with OSA vs 3/24 patients (12.5%) without SRBD. Thus, the prevalence of SRBD in patients with chronic heart failure and a history of malignant ventricular tachyarrhythmias is high (40%) and the occurrence of CSA seems to be predictive for cardiac mortality in these patients. An influence of moderate SRBD on arrhythmia recurrence and circadian variation of spontaneous sustained tachyarrhythmic events could not be demonstrated.

Aged↗
PubMed1998

Hodgkin's disease occurring in a child after liver transplantation.

Here we describe the case of a 14-year-old boy who underwent liver transplantation for post-Kasai biliary atresia when aged 4. Antirejection treatment consisted of prednisone and cyclosporine. At the age of 11 years the patient developed left cervical lymphadenopathy; the biopsy showed classical Hodgkin's disease(HD) of the mixed cellularity (MC) type. Neoplastic cells expressed CD30 and CD15, and were negative for CD45, CD20, CD3, CD43, and CD79a. Furthermore, they carried the EBV-related products LMP1 and EBER1/2. Treatment consisted of three cycles of adriamycin, bleomycin, vinblastine and DTIC (ABVD), followed by radiotherapy (2,000 cGys) on involved fields. At present, 42 months after the diagnosis of HD, the patient is still in complete remission. This is, to the best of our knowledge, the first reported case of classical HD following liver transplantation. The positivity of neoplastic cells for LMP1 and EBER1/2 indicates a possible role for immunosuppression in the development of the tumor, and whether a reduction in immunosuppression might have influenced the course of the disease is open to question.

Adolescent↗
PubMed1998

Alcohol-related words are distracting to both alcohol abusers and non-abusers in the Stroop colour-naming task.

AIM: To compare alcohol abusers' and non-abusers' distraction for alcohol-related and emotional words, controlling for emotional valence of those words. DESIGN AND METHOD: The experiment compared 20 alcohol abusers and 20 non-abusers in terms of performance on a computerized Stroop colour-naming test using alcohol-related and non-alcohol-related words. FINDINGS: Abusers rated the alcohol stimuli greater in emotional valence than the emotional stimuli. Therefore, differences in emotional-valence ratings between the two groups were statistically controlled. Against expectation, both alcohol abusers and non-abusers were more distracted by alcohol stimuli than by positive or negative emotional stimuli. CONCLUSIONS: The results indicate that alcohol words are distracting for drinkers in general, and this may indicate a high level of salience for these kinds of stimuli.

Adult↗
PubMed1998

Activity of secreted Kunitz domain 1 variants of tissue factor pathway inhibitor.

Tissue factor pathway inhibitors (TFPI and TFPI-2) are Kunitz domain-type serine protease inhibitors which inhibit factor VIIa/tissue factor (VIIa/TF) complexes in a factor Xa-dependent manner. The VIIa/TF and Xa inhibitory activity has been localized to the first two Kunitz domains, respectively. Unlike TFPI, TFPI-2 has been reported to exhibit significant Xa-independent VIIa/TF inhibitory activity, perhaps due to an arginine at the P1 residue in the first Kunitz domain of TFPI-2 as opposed to a lysine at the comparable residue in TFPI. Two domain TFPI variants, differing in the first Kunitz domain but containing the second Kunitz domain of TFPI, were constructed and secreted by Saccharomyces cerevisiae in order to test the possibility that a TFPI first Kunitz domain with a P1 lysine to arginine change or a hybrid containing the TFPI-2 first Kunitz domain may represent more potent VIIa/TF inhibitors. When yeast supernatants were analyzed for specific activity in the Xa-dependent inhibition of VIIa/TF, neither variant was as active as the truncated TFPI.

Aprotinin↗
PubMed1997

Analysis of leukocyte activation during acute rejection of pulmonary allografts in noninfected and cytomegalovirus-infected rats.

After human lung transplantation acute rejection and cytomegalovirus (CMV) infections may occur, probably contributing to the development of chronic rejection. We established a model of subacute allograft rejection in rats to analyze leukocyte activation and effects of a CMV infection. Histoincompatible lung transplants (BN/LEW) without immunosuppression (group A) and lungs of initially immunosuppressed animals (group B) were analyzed. The production of inflammatory mediators (interleukin-6, tumor necrosis factor alpha, nitric oxides) and the expression of MHC class II antigens by alveolar and lung tissue macrophages were significantly enhanced during the alloresponse. In recipients without immunosuppression (group A) allograft necrosis was detected by day 6, whereas group B allografts were fully rejected by day 25. In allografts of immunosuppressed, CMV-infected animals (group C) the CMV infection was clearly aggravated and the number of activated lung tissue macrophages was increased when compared with noninfected allografts or isografts. The subacute model provides the advantage of allowing us to study mechanisms of acute rejection without the effects of reperfusion injury. Furthermore these findings underline the role of inflammatory mediators produced by macrophages during rejection.

Acute Disease↗
PubMed1997

Macrorestriction analysis (PFGE) of serologically cross-reactive serovars of Acinetobacter baumannii and genospecies 3.

Forty-two serovar reference strains of Acinetobacter baumannii and genospecies 3, which yielded major or minor, one-way or two-way (reciprocal) serological cross-reactions, were subjected to macrorestriction (SmaI, ApaI) analysis with the aid of pulsed-field gel electrophoresis (PFGE). The PFGE patterns of serovars 3 and 21 of genospecies 3 differed by 3 (SmaI) and 2-4 (ApaI) DNA fragments and thus were closely/possibly related in their genotype. Serovars 13 and 26 of genospecies 3 differed by only 2 DNA fragments (SmaI), suggesting close genetic relatedness; however, these two particular serovars of genospecies 3 appeared to be genotypically indistinguishable following restriction with ApaI. Serovars 2, 4, and 12 of genospecies 3 appeared to be unrelated to serovar 13 of genospecies 3 (SmaI); however, restriction with ApaI indicated a possible relatedness. Genospecies 3 serovars 2 and 26 differed by 5 DNA fragments (SmaI and ApaI), implying a possible relatedness. All other cross-reactive serovars examined proved to be genotypically unrelated, i.e., differed by > or = 7 DNA fragments (SmaI restriction).

Acinetobacter↗
PubMed1997

Human renin binding protein: complete genomic sequence and association of an intronic T/C polymorphism with the prorenin level in males.

The role of renin binding protein (RnBP) in human (patho)physiology, despite its biochemical characterization, is as yet unclear. RnBP has been shown to bind and inactivate renin, a key player of the blood pressure regulating renin-angiotensin system. This renders the RnBP gene a promising candidate gene in human hypertension. Herein, a molecular genetic approach was employed to investigate if RnBP might affect renin, prorenin and/or blood pressure levels. Sequencing of the human Xq28 chromosomal region provided the precise chromosomal location and full genomic sequence of the RnBP gene. All 11 exons, adjacent intronic splice sites and the promoter region were sequenced in 20 patients with essential hypertension of early onset and possible X-linked inheritance and in four normotensive individuals. The only variant found was a single base exchange polymorphism 61 base pairs upstream of the intron 6/exon 7 boundary (T61C). Several cardiovascular parameters, the renin, and prorenin levels and the T61C allele status were determined in 505 Caucasian individuals. Male individuals without medication who were hemizygous for the C allele were characterized by lower prorenin levels (196 +/- 15 versus 256 +/- 12 mU/l, P = 0.05) and a significantly higher renin/prorenin ratio (10.7 +/- 1.5 versus 7.7 +/- 0.3%, P = 0.002), whereas no variations in circulating renin, blood pressure, heart rate and left ventricular mass index were associated with the C allele. No significant association was observed in women. The data do not exclude a role of RnBP in essential hypertension. The complete genomic structure of the RnBP gene, including the identified repetitive sequence elements, provides an essential tool for further studies of the RnBP gene in hypertensive patients with a different genetic background.

Base Sequence↗
PubMed1997

Ataxia-telangiectasia locus: sequence analysis of 184 kb of human genomic DNA containing the entire ATM gene.

Ataxia-telangiectasia (A-T) is an autosomal recessive disorder involving cerebellar degeneration, immunodeficiency, chromosomal instability, radiosensitivity, and cancer predisposition. The genomic organization of the A-T gene, designated ATM, was established recently. To date, more than 100 A-T-associated mutations have been reported in the ATM gene that do not support the existence of one or several mutational hotspots. To allow genotype/phenotype correlations it will be important to find additional ATM mutations. The nature and location of the mutations will also provide insights into the molecular processes that underly the disease. To facilitate the search for ATM mutations and to establish the basis for the identification of transcriptional regulatory elements, we have sequenced and report here 184,490 bp of genomic sequence from the human 11q22-23 chromosomal region containing the entire ATM gene, spanning 146 kb, and 10 kb of the 5'-region of an adjacent gene named E14/NPAT. The latter shares a bidirectional promoter with ATM and is transcribed in the opposite direction. The entire region is transcribed to approximately 85% and translated to 5%. Genome-wide repeats were found to constitute 37.2%, with LINE (17.1%) and Alu (14.6%) being the main repetitive elements. The high representation of LINE repeats is attributable to the presence of three full-length LINE-1s, inserted in the same orientation in introns 18 and 63 as well as downstream of the ATM gene. Homology searches suggest that ATM exon 2 could have derived from a mammalian interspersed repeat (MIR). Promoter recognition algorithms identified divergent promoter elements within the CpG island, which lies between the ATM and E14/NPAT genes, and provide evidence for a putative second ATM promoter located within intron 3, immediately upstream of the first coding exon. The low G+C level (38.1%) of the ATM locus is reflected in a strongly biased codon and amino acid usage of the gene.

Ataxia Telangiectasia↗
PubMed1997

SICONA: the development of signal conditioning communication aids for the severely hearing impaired.

Project SICONA endeavours to satisfy the specific needs of the severely hearing impaired. A complex system is introduced, consisting of several speech processing modules to achieve an improvement of the communication ability within the target group. The basic methods are improving the S/N-ratio by multichannel wireless FM transmission, enhancing weak consonants and second formant information and transposing the unvoiced fricative /s/ into the residual hearing area. Single case studies indicate the effectiveness of the proposed methods; improved reception of speech features within the F2 range and successful integration of the replacement /s/ could be shown. Practical useability is achieved by introducing wireless coupling between the miniaturized (SMD technology, ASIC) system components.

Conditioning, Psychological↗
PubMed1996

The genomic organization of a human creatine transporter (CRTR) gene located in Xq28.

During the course of a large-scale sequencing project in Xq28, a human creatine transporter (CRTR) gene was discovered. The gene is located approximately 36 kb centromeric to ALD. The gene contains 13 exons and spans about 8.5 kb of genomic DNA. Since the creatine transporter has a prominent function in muscular physiology, it is a candidate gene for Barth syndrome and infantile cardiomyopathy mapped to Xq28.

Base Sequence↗
PubMed1996

[The prevalence of sleep-related breathing disorders in patients with implanted cardioverter-defibrillators. The effect on the incidence and circadian distribution of malignant ventricular tachyarrhythmias].

OBJECTIVE: To determine the prevalence of sleep-related breathing disorders (SRBD) on patients who, because of malignant ventricular tachyarrhythmias associated with cardiac disease, have an implanted cardioverter-defibrillator (ICD). It was also investigated whether the frequency and circadian distribution of spontaneous ventricular tachycardia and (or) fibrillation (VTF) can be influenced by SRBD. PATIENTS AND METHODS: 29 consecutive ICD patients (28 men, one woman; mean age 64 +/- 8 years) were investigated by multifunction recordings. 22 patients had coronary heart disease, and seven dilated cardiomyopathy. For each patient the number of VIF episodes per month were recorded, as well as the percentage distribution of the episodes during the day per hour and after grouping into four time periods. RESULTS: SRBDs were recorded in 13 of the 29 patients (45%) (apnoea-hypopnea index [AHI] > 10). The other 16 patients had normal findings (AHI < or = 10). Mean frequency of the registered VTF attacks was similar in both groups (0.41/month with AHI < or = 10 vs 0.44/month with AHI > 10; difference not statistically significant). Averaged percentage distribution pattern showed a maximum frequency in both groups between 6 o'clock and 12 o'clock a.m. There was no significant increase of VTF during the night (10 o'clock p.m.-6 o'clock a.m.) in the group with SRBD (19% with AHI > 10 vs 18.2% with ATF < or = 10; difference not significant). CONCLUSION: There was a high prevalence of SRBD in the patients with ICD and underlying cardiac disease. No influence of SRBD on frequency and circadian distribution of VTF was demonstrated in patients with ICD during long-term observation.

Aged↗
PubMed1996

Enhancement of cytomegalovirus infection and acute rejection after allogeneic lung transplantation in the rat.

A possible mechanism of the induction of lung transplant rejection by cytomegalovirus (CMV) infection is the inflammatory upregulation of adhesion ligand molecules on transplant endothelia by the viral infection leading to leukocyte activation. To study this question a rat model of rat cytomegalovirus (RCMV) infection and acute lung transplant rejection was established to study: (1) the influence of RCMV infection on the course of rejection, (2) the influence of rejection on the course of RCMV infection, and (3) the influence of RCMV on adhesion molecule expression and leukocyte infiltration. For this Lew (RT1l) rats received either syngenic (n=25) or allogeneic (BN, RT1n; n=38) left lateral lung transplants. Postoperatively, CsA 25mg/kg was given on days 1-3 and triple drug (CsA, Aza, Pred) immunosuppression was given from days 4-10 to induce systemic RCMV infection and acute rejection developed from postoperative day (POD) 15-25 in allogeneic transplants. In RCMV-positive animals the rejection grade was gradually increased at POD 15 and 18. Furthermore, after allogeneic transplantation an enhanced viral infection of the lung transplant as early as POD 11 was found and increased salivary gland PFU titers on days 20 and 25. In the absence of rejection infiltration a maximal induction of ICAM-1 adhesion molecules was found on lung endothelia in RCMV+ allogeneic animals as compared with noninfected controls. This induction was found to lesser degree for VCAM-1 and MHC class II adhesion ligand molecules. This was accompanied by a significantly increased CD11a+ and CD49d+ leukocyte infiltration into the alveolar interstitium on day 11 and 15 in infected transplants. The results show an enhancement of RCMV infection after allogeneic lung transplantation leading to endothelial activation and recruitment of CD11a/CD49d+ leukocytes. This mechanism may strongly influence transplant inflammation and the long-term course of lung transplant rejection.

Animals↗
PubMed1996

Phenotypic and genotypic characterization of clinically recovered presumptive Acinetobacter baumannii isolates which failed to grow at 44 degrees C.

Eleven clinical isolates of Acinetobacter, which exhibited an identical biochemical profile compatible with genospecies 3 and failed to grow at 44 degrees C, were not agglutinated by polyclonal rabbit immune sera against 26 serovars of genospecies 3. Rather, all 11 isolates reacted strongly with antiserum against serovar 18 of A. baumannii. Macrorestriction (SmaI) analysis of genomic DNA revealed that only one isolate was genotypically different, whereas the remaining ones were either closely related or identical. However, the genomic DNA of the A. baumannii serovar 18 reference strain proved to be genotypically unrelated.

Acinetobacter↗