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Biomedical subjects

D Moser

Publications and source records attributed to D Moser.

At least 19 recordsLinked to original sources

[Ortner's syndrome and giant-cell vasculitis].

INTRODUCTION: Ortner's syndrome was first described as a left laryngeal nerve palsy caused by a dilated left atrium in mitral stenosis. Aortic aneurysm is another well-documented etiology. CASE RECORD: We report the case of a 90 year-old woman with temporal arteritis with recent onset hoarseness, and simultaneous discovery of aortic arch aneurysm and left vocal cord palsy. DISCUSSION: The occurrence of hoarseness and aortic aneurysm in Giant-cell vasculitis is discussed. We suggest to consider Horton's disease (GCA) as a possible etiology of Ortner's cardio-vocal syndrome.

Adrenal Cortex Hormones↗

[Evidence of osteocalcin expression in osteoblast cells of mandibular origin growing on biomaterials with RT-PCR and SDS-PAGE/Western blotting].

A new approach to addressing difficult tissue reconstructive or replacement problems in the oral cavity is to engineer new tissue by using selective cell transplantation on polymer scaffolds. The current study characterized the osteoblastic nature of adherent mandibular cells on biomaterials, which could have a potential use as scaffolds for tissue engineering strategies. Cells of mandibular origin from one patient were cultivated on three different biomaterials (PepGen P-15 trade mark, Frios Algipore, and OsteoGraf/LD-700) for 7 and 14 days and osteocalcin expression was demonstrated by RT-PCR and SDS-PAGE/Western blotting. In order to explicitly characterize only the adherent cells on the biomaterials, we first separated the biomaterials with adherent cells from the culture plate before trypsinization. We could demonstrate that cell growth of adherent mandibular osteoblast-like cells was significantly higher on biomaterials with an organic component (PepGen P-15 trade mark ) in comparison to Frios Algipore and OsteoGraf/LD-700, respectively. In conclusion, only the explicit study of adherent cells at the gene and protein levels gives information about the osteoconductivity of biomaterials.

Alginates↗

Immune competent cells in non-irradiated autologous jejunal grafts used for reconstruction of the oral cavity and oropharynx.

Autologous jejunal grafts used for primary reconstruction in cases of extensive soft tissue defects following tumor resection in the upper aerodigestive tract were investigated by immunohistochemistry (APAAP technique). Biopsies from eight patients were taken intra-operatively, at the time of transplantation and 2, 4, and 6 months post-operatively. A panel of monoclonal antibodies directed against surface antigens of the major subpopulations of the immune system was used. In all of the patients, a remarkable increase of all antigens investigated was detected 2 months post-operatively, which remained unchanged in the following biopsies (4 and 6 months postoperatively). Significantly higher numbers of CD45RA+ and CD45RO+ (P<0.05) leukocytes were detectable. This increase was due to both subsets of T and B cells, but only for CD19+ B cells was the increase significant. In addition, NK cells (CD16+ lymphocytic cells, P<0.01) and mature macrophages (25F9+ cells, P<0.01) increased. The first post-operative biopsy showed a significantly higher expression of activation-associated antigens (ICAM-1, VCAM, and HLA-DR) on monocytes/macrophages and endothelial cells. Our findings indicate that autologous jejunal grafts facilitate immunological function in the new microenvironment.

Aged↗

Promoting responsiveness between mothers with depressive symptoms and their infants.

PURPOSE: To test the efficacy of an interactive coaching intervention to promote responsiveness between mothers experiencing postpartum depressive symptoms (PPDS) and their infants. DESIGN: An experimental design with 117 postpartum women in the Northeastern United States. METHODS: Participants were randomly assigned either to the treatment or control group. Both groups had home visits at 4-8 weeks, 10-14 weeks, and 14-18 weeks postpartum and mother-infant interaction was videotaped and coded for responsiveness. The treatment group also received a coached behavioral intervention designed to promote maternal-infant responsiveness. Measures included the Edinburgh Postnatal Depression Scale, the Beck Depression Inventory-II, and the Dyadic Mutuality Code. FINDINGS: The hypothesis, that the treatment group would show significantly higher maternal-infant responsiveness after the intervention, was supported. No effect of the intervention on depression scores was found. A significant increase in responsiveness and a significant decrease in depression scores occurred over time for both treatment and control groups. No interaction between group and time was detected. CONCLUSIONS: The study showed that a coaching strategy had a positive effect on maternal-infant interaction in this sample. Future research is needed to test coaching interventions in conjunction with other strategies targeted to promote maternal-infant responsiveness and to reduce PPDS.

Adolescent↗

Performance on the Mattis Dementia Rating Scale in patients with vascular dementia: relationships to neuroimaging findings.

Impairment on screening measures such as the Mattis Dementia Rating Scale (MDRS) provides evidence of dementia in patients with cerebrovascular disease. However, the relationships between neuroimaging findings and performance on the MDRS in vascular dementia (VD) have not been determined. In the present study, we examined the relationships between subcortical hyperintensity (SH) volume and whole brain volume (WBV) on the subscales and total score of the MDRS. Results revealed that SH accounted for a significant amount of variance on the Initiation/Perseveration and Construction subscales, whereas WBV accounted for a significant amount of variance on the Memory subscale. The total score on the MDRS was found to be significantly related to WBV but not SH. These results suggest that subcortical damage and brain volume account for different aspects of cognitive decline in VD and that overall cognitive impairment may reflect cortical and subcortical involvement.

Aged↗

Dementia severity and pattern of cognitive performance in vascular dementia.

We evaluated the influence of dementia severity on cognitive performance in two groups of individuals with vascular dementia (VaD). Performance on the Mini-Mental State Exam (MMSE) was used to determine dementia severity. Tests of executive function, psychomotor speed, memory, language, and visuospatial function were administered. As expected, individuals with severe VaD (MMSE < 18) performed significantly more poorly than individuals with mild VaD (MMSE > or = 18) on most tests. More important, deficits were evident for both groups in each cognitive domain when compared to normative data. These results indicate that multiple cognitive domains are affected even in mild cases of VaD. Clinicians should be aware that although the presence of "patchy" cognitive deficits may indicate stroke, general cognitive dysfunction may occur in mild cases of VaD.

Aged↗

Prostaglandin E(1) is able to increase migration of leukocytes through endothelial cell monolayers.

Leukocyte interactions with endothelial cells play an important role during inflammatory processes. Leukocytes pass a monolayer of endothelial cells (ECM) to migrate into the extravascular space. The aim of the current study was to investigate whether prostaglandin E(1) (PGE(1)) influences the process of leukocyte migration. In a prospective controlled study, the influence of prostaglandin E(1) (50-5000 ng/mL) on leukocyte migration through endothelial cell monolayers (n = 7) was investigated. Human umbilical endothelial cells (HUVEC) and/or leukocytes were preincubated with clinically relevant, higher, and lower concentrations of prostaglandin E(1) and the amount of leukocyte migration after 3 h was measured. HUVEC were cultured on microporous membrane filters until achievement of a monolayer for investigation of leukocyte migration. Polymorphonuclear leukocytes (PMNL) were isolated from healthy volunteers and PMNL migration was studied under the influence of PGE(1). In clinically relevant concentrations, PGE(1) was able to increase significantly leukocyte migration through endothelial cell monolayers (205 +/- 7.8%, P < 0.05 compared to control; when treating PMNL alone, migration rate was 120 +/- 9.2% compared to control, ns; only endothelial cell monolayers treated up to 145 +/- 10.2%, P < 0.05 compared to control) showing a dose-dependent effect. In this assay, both cell types (PMNL and ECM) could be treated simultaneously, simulating the clinical situation after an iv administration. In conclusion, PGE(1) is able to increase leukocyte migration through endothelial cell monolayers when both cell types are pretreated. The treatment of either leukocytes or endothelial cell monolayers in the cell coculture showed no significant increase. These findings support the theory that prostaglandins may play a major role during inflammation. Future clinical studies are warranted to confirm this hypothesis.

Adult↗

Guided bone regeneration with titanium membranes: a clinical study.

Guided bone regeneration using barrier membranes is useful in bone augmentation. Because the commonly used polytetrafluoroethylene (PTFE, Gore-Tex (R), WL Gore, Flagstaff, AZ, USA) membranes or resorbable membranes tend to collapse, more stable membranes are desirable. A titanium membrane (FRIOS(R) BoneShield, Friatec, Mannheim, Germany) was evaluated in a clinical study of 52 patients. Most of them had particulate bone grafts or phycogene hydroxyapatite (Algipore(R), Friatec, Mannheim, Germany) or both stabilized with titanium membranes. In 78 procedures, 23 membranes (29%) became exposed, but only seven of these (9%) led to failure of the graft with a considerable loss of augmented material. The time interval between operation and possibly exposure was responsible for the result. Early exposures (within a few weeks) led to poor formation of new bone within the grafts, whereas if exposure was later, results were as good as in procedures in which the membranes did not become exposed.

Adult↗

Thrombus formation on the balloon of heparin-bonded pulmonary artery catheters: an ultrastructural scanning electron microscope study.

OBJECTIVE: To investigate heparin-bonded pulmonary artery catheters with respect to thrombus formation and platelet aggregation at the balloon and the shaft using a scanning electron microscope in critically ill patients. DESIGN: Prospective study. SETTINGS: Critical care unit and research laboratories. PATIENTS: Pulmonary artery catheters were inserted in critically ill patients (n = 10). INTERVENTIONS: Pulmonary artery catheters were removed after 24, 48, 72, or 120 hrs, and the ultrastructure was investigated in specialized research laboratories. MEASUREMENTS AND MAIN RESULTS: Balloon and shaft were investigated using a scanning electron microscopic technique. Area of thrombus formation was quantified using image analysis. Heparin release of the catheters was measured. The frequency of balloon inflations was investigated in in vitro experiments by inflating catheters different times (0, 10, 20, and 30 times). Twenty-four hours after catheter insertion, scanning electron microscopic images showed thrombus formation and platelet aggregation at the site of the balloon. Seventy-two hours after catheter insertion, a thrombus started to detach. The areas of thrombus formation did not differ, but thrombus organization changed dramatically 72 and 120 hrs after catheter insertion. The shaft was colonized by single cells only. Cracks of the balloon could be observed after 72 hrs, whereas no cracks could be found in in vitro controls. In vitro, heparin release of the pulmonary artery catheters decreased significantly after 24 hrs. CONCLUSIONS: Scanning electron microscopic images of heparin-bonded pulmonary artery catheters demonstrate thrombus formation on the balloon 24 hrs after pulmonary artery catheter insertion, increasing dramatically at 72 and 120 hrs. The shaft was colonized by single cells only. The thrombus size is not significantly different during the observation time, but the grade and quality of thrombus formation differ.

Anticoagulants↗

Comparison of psychosocial adjustment of mothers and fathers of high-risk infants in the neonatal intensive care unit.

OBJECTIVE: To compare the psychosocial adjustment of mothers and fathers to the birth of a premature or critically ill infant hospitalized in the neonatal intensive care unit (NICU). STUDY DESIGN: Using a comparative design, we studied 165 mothers and father pairs of high-risk neonates. Mothers were 29.1 +/- 6.7 and fathers were 30.7 +/- 6.8 years old. All infants were hospitalized in the NICU. Couples completed questionnaires in either English or Spanish during the infant's NICU stay. RESULTS: Mothers were more poorly adjusted and were more anxious, hostile, and depressed than fathers, but both parents experienced levels of emotional distress significantly above normative values. Mothers and fathers reported equal levels of family functioning and social support and shared similar feelings of control related to the health status of their infant. CONCLUSION: The birth of an infant who requires care in the NICU environment is highly stressful for both parents. Physicians, nurses, and other health professionals working in the NICU should assess the psychosocial adjustment in both parents, but mothers may require more intense education and counseling to reduce the distress they experience.

Adaptation, Psychological↗

Effect of anticoagulation on blood membrane interactions during hemodialysis.

BACKGROUND: Adequate anticoagulation is a precondition to prevent extracorporeal blood clotting and to improve biocompatibility during hemodialysis. In this study, we performed a morphologic analysis by using scanning electron microscopy to compare three modes of anticoagulation-conventional unfractionated heparin (UFH), low molecular weight heparin (LMWH; dalteparin sodium), or sodium citrate during hemodialysis-on membrane-associated coagulation activation. METHODS: Fifteen patients on regular hemodialysis therapy were investigated. Five patients received UFH, five patients LMWH, and five patients sodium citrate as an anticoagulant during a standardized hemodialysis protocol using a single-use polysulfone capillary dialyzer. Membrane-associated clotting was evaluated using a scanning electron microscope. A dialyzer clotting score was used for quantitative description of coagulation activation on membrane segments. RESULTS: Using UFH as an anticoagulant revealed the most pronounced cell adhesion and thrombus formation and the highest dialyzer clotting score (11.5 +/- 1.3 of a maximal 20 points). LMWH had a lower dialyzer clotting score than UFH (10.4 +/- 1.2 of 20 points). During the use of sodium citrate, a negligible thrombus formation and the lowest dialyzer clotting score (1.6 +/- 0.6 of 20 points, P < 0.05) were observed. CONCLUSION: The results of this investigation indicate that using sodium citrate as an anticoagulant during hemodialysis induces a lower activation of coagulation than both conventional and fractionated heparin, which might contribute to an improvement of biocompatibility of hemodialysis extracorporeal circulation.

Adult↗

Hydroxyethyl starch reduces the chemotaxis of white cells through endothelial cell monolayers.

BACKGROUND: Polymorphonuclear leukocytes (PMNs) play a tremendous role during inflammatory processes. PMNs have to pass a monolayer of endothelial cells to migrate into the extravascular space. Hydroxyethyl starch (HES) is frequently used as a volume expander in critically ill patients. STUDY DESIGN AND METHODS: The aim of this study was to investigate whether HES influences the chemotaxis of PMNs through endothelial cell monolayers by using a test system that allows the simultaneous treatment of both cell types. Human umbilical endothelial cells were cultured on microporous membrane filters. PMNs were isolated and PMN chemotaxis was studied. RESULTS: The number of untreated PMNs that migrated through untreated endothelial cell monolayers in response to a chemoattractant was used as a control and set as 100 percent. In clinically relevant concentrations, HES was able to significantly decrease PMN chemotaxis through endothelial cell monolayers, showing a dose-dependent effect (0.1 mg/mL: 99.6 +/- 10.9%, p = NS compared to control; 1 mg/mL: 82.4 +/- 8.3%, p<0.05 compared to control; 10 mg/mL: 62.9 +/- 11.7%, p<0.05). In this assay, both cell types (PMNs and endothelial cells in the monolayer) were treated simultaneously, which simulated the clinical situation after an intravenous injection of HES. The treatment of one cell type, PMNs (89.6 +/- 8.8%, p<0.05) or endothelial cells in the monolayer (76.2 +/- 9.4%, p<0.05), suggests that the influence on endothelial cells is greater. CONCLUSION: HES is able to significantly reduce the chemotaxis of PMNs through endothelial cell monolayers. The possible clinical consequence of a moderate reduction in endothelium-mediated PMN chemotaxis in critically ill patients remains to be evaluated.

Adult↗

Amoxycillin/clavulanic acid combinations increase transmigration of leucocytes through endothelial cell monolayers: endothelial cells play a key role.

Postoperative inflammation is still viewed as an unresolved problem. During inflammation, leucocytes play a tremendous role and migrate from intravascular spaces into the tissue to attack microorganisms. Different agents, e.g. anaesthetic drugs, are able to influence leucocyte recruitment. Previous studies have investigated the influence of amoxycillin on chemotaxis of leucocytes alone. The aim of our study was to examine the effect of amoxycillin/clavulanic acid (co-amoxiclav) on leucocyte migration through endothelial cell monolayers (ECMs). Human umbilical endothelial cells were cultured on microporous membranes, achieving a monolayer. Polymorphonuclear neutrophil leucocytes (PMNLs) were used in a migration assay. The numbers of untreated PMNLs migrating through untreated ECMs were used as control and set as 100%. PMNLs and/or ECMs were pretreated with co-amoxiclav using clinically relevant as well as higher and lower concentrations. Co-amoxiclav was able to increase PMNL migration through ECMs significantly (P<0.05) when both cell types were treated (291+/-18.7%). When PMNLs or ECMs were treated alone, it could be shown that ECMs were more affected than PMNLs. The greatest effect was shown when both cell types, PMNLs and ECMs, were treated. In conclusion, co-amoxiclav was identified as a potent drug to increase leucocyte transmigration through ECMs. ECMs were also critically involved. Co-amoxiclav also affects endothelial cells.

Amoxicillin-Potassium Clavulanate Combination↗

Propofol reduces the migration of human leukocytes through endothelial cell monolayers.

OBJECTIVE: To test propofol and the solvent of propofol on leukocyte function in the presence of endothelial cell monolayers. The interactions of leukocytes with endothelial cells play a tremendous role during inflammation. Previous studies have investigated the influence of propofol on leukocytes. DESIGN: Prospective, controlled study. SETTING: University research laboratories. SUBJECTS: Seven independent experiments were performed to investigate the influence of propofol (0.4, 4, and 40 ng/mL) on the migration of human leukocytes through human endothelial cell monolayers. Moreover, the authors tested the solvent of propofol on leukocyte migration. INTERVENTIONS: Human endothelial cell monolayers and/or human leukocytes were preincubated with clinically relevant higher and lower concentrations of propofol. The amount of leukocyte migration after 3 hrs was measured with a fluorometer. MEASUREMENTS AND MAIN RESULTS: Human endothelial cells isolated from umbilical veins were cultured on microporous membranes until they formed an endothelial cell monolayer. Leukocytes were separated by standard procedures. The migration of leukocytes through monolayers of endothelial cells using the clinically relevant concentration of propofol was reduced to 93% +- 3.8% (so; p < .05) when the leukocytes but not the endothelial cell monolayers were preincubated with propofol. Leukocyte migration was reduced to 80% - 5.9% (p < .05) when only monolayers of endothelial cells were treated with propofol, and was reduced to 73% + 10.4% (p < .05) when both leukocytes and monolayers of endothelial cells were treated with propofol. The higher and lower concentrations showed a dose-dependent effect. The solvent of propofol had no significant effect. CONCLUSION: The authors investigated the influence of propofol and its solvent on the interaction between both cell systems-leukocytes and endothelial cells. Propofol is able to reduce significantly the migration of leukocytes through endothelial cell monolayers. The use of different doses revealed a dose-dependent effect. The current model allowed treatment of one cell type: leukocyte or endothelial cell. The results of this investigation indicate that the influence of propofol on leukocyte migration affects endothelial cells more than leukocytes.

Anesthetics, Intravenous↗

Meloxicam effect on leukocyte migration under shear stress: a new perfused triple chamber (Hofbauer chamber) assay simulating an in vitro vascular wall.

BACKGROUND: Leukocyte migration plays a tremendous role during inflammation. Different drugs are able to influence migration of leukocytes. Several authors have attempted to establish methods for investigation of leukocyte migration. Migration of leukocytes under conditions simulating natural blood flow and shear stress is poorly understood. Moreover, leukocyte migration in the simultaneous presence of endothelial cells and smooth muscle cells (SMC) has not yet been examined thoroughly. The aim of the current study was to create a new three-dimensional assay investigating migration during simulated perfusion. The assay was used for investigating the effect of meloxicam on leukocyte migration under shear stress. METHODS: Different concentrations of meloxicam (0.09, 0.9, and 9.0 ng/mL) were used in a newly developed triple migration chamber system for investigation of leukocyte migration (n = 7). This new system allows inclusion of SMC-layers. Assay precision tests were done using intra-assay (within-day variability) and interassay (day-to-day variability) controls. RESULTS: Intra-assay and interassay controls showed reliable results (coefficient of variation: intra-assay 8.53%; interassay 11.39%). Meloxicam in a clinically relevant concentration of 0.9 ng/mL was able to reduce the migration of leukocytes under shear stress (71 +/- 14% SD; P < 0.05), whereas higher and lower concentrations showed a dose dependent effect. CONCLUSION: This new perfusion system allows investigation of drugs, such as meloxicam, on leukocyte migration under shear stress. Moreover, this assay may be used for studies on other cell-cell interactions, as well as on drug influences.

Adult↗

Histomorphologic findings on human bone samples six months after bone augmentation of the maxillary sinus with Algipore.

Sinus grafting, a popular and standard treatment for maxillary atrophy, uses a variety of grafting materials. In this study, specimens obtained 6 months after sinus grafting with Algipore were evaluated under light microscopy and showed osseoformation, xenograft degradation, and bone ingrowth into particles. Osteoblastic cells were embedded in the intracorpuscular bone matrix, which indicated that xenograft particles are an osseoconductive scaffold and stimulate matrix deposition. Acute inflammatory responses after insertion of Algipore did not occur. Particles were degraded during physiologic bone remodeling, and newly formed bone gradually replaced resorbed biomaterial.

Bone Substitutes↗

Muscle deoxygenation in aerobic and anaerobic exercise.

It has been generally accepted that the use of oxygen is a major contributor of ATP synthesis in endurance exercise but not in short sprints. In anaerobic exercise, muscle energy is thought to be initially supported by the PCr-ATP system followed by glycolysis, not through mitochondrial oxidative phosphorylation. However, in real exercise practice, we do not know how much of this notion is true when an athlete approaches his/her maximal capacity of aerobic and anaerobic exercise, such as during a graded VO2max test. This study investigates the use of oxygen in aerobic and anaerobic exercise by monitoring oxygen concentration of the vastus lateralis muscle at maximum intensity using Near Infra-red Spectroscopy (NIRS). We tested 14 sprinters from the University of Penn track team, whose competitive events are high jump, pole vault, 100 m, 200 m, 400 m, and 800 m. The Wingate anaerobic power test was performed on a cycle ergometer with 10% body weight resistance for 30 seconds. To compare oxygenation during aerobic exercise, a steady-state VO2max test with a cycle ergometer was used with 25 watt increments every 2 min. until exhaustion. Results showed that in the Wingate test, total power reached 774 +/- 86 watt, about 3 times greater than that in the VO2max test (270 +/- 43 watt). In the Wingate test, the deoxygenation reached approximately 80% of the established maximum value, while in the VO2max test resulted in approximately 36% deoxygenation. There was no delay in onset of deoxygenation in the Wingate test, while in the VO2max test, deoxygenation did not occur under low intensity work. The results indicate that oxygen was used from the beginning of sprint test, suggesting that the mitochondrial ATP synthesis was triggered after a surprisingly brief exercise duration. One explanation is that prior warm-up (unloaded exercise) was enough to provide the mitochondrial substrates; ADP and Pi to activate oxidative phosphorylation by the type II a and type I myocytes. In addition, transmural pressure created by the muscle contraction reduces blood flow, causing relative hypoxia.

Adult↗