[Bottlenecks in surgical care. Commentary].
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Career Choice↗
Biomedical subjects
H Bauer
Publications and source records attributed to H Bauer.
Intercomparison of thermal and optical measurement methods for elemental carbon and black carbon at an urban location.
Despite intensive efforts during the past 20 years, no generally accepted standard method exists to measure black carbon (BC) or elemental carbon (EC). Data on BC and EC concentrations are method specific and can differ widely (e.g. Schmid et al., 2001, ten Brink et al., 2004). In this study, a comprehensive set of methods (both optical and thermal) is compared. Measurements were performed under urban background conditions in Vienna, Austria, a city heavily impacted by diesel emissions. Filter and impactor samples were taken during 3 weeks in summer 2002 and analyzed for EC with thermal methods: a modified Cachier method (Cachier et al., 1989), a thermal-optical method (Schmid et al., 2001), and the VDI method (VDI, 1996); for BC with optical methods: a filter transmission method and the integrating sphere method (Hitzenberger et al., 1996); and for total carbon (TC) with a combustion method (Puxbaum and Rendl, 1983). The online methods aethalometer (Hansen et al., 1984) and the multiangle absorption photometer MAAP (Petzold et al., 2002) to measure BC were also used. The average values of BC and EC obtained with the methods agreed within their standard deviations. A conversion table was set up to allow comparisons between data measured elsewhere under urban background conditions (with similar source characteristics) with different instruments. An approach to estimate the absorption coefficient from attenuation data is derived so that existing records of aethalometer data in urban environments may be used to obtain also the absorption coefficients.
Air Pollutants↗
[Manifestation of diffuse proliferative lupus nephritis in a patient treated with long-term mycophenolate mofetil].
HISTORY AND ADMISSION FINDINGS: A now 34-year old female patient with long-standing systemic lupus erythematosus (SLE) had successfully been treated with mycophenolate mofetil (MMF) because of former pleuropericardial and pulmonal lupus manifestations when she was admitted with edema for the first time. INVESTIGATIONS: Laboratory investigations of urine and blood showed findings compatible with lupus nephritis. Kidney biopsy revealed lupus nephritis type IV. TREATMENT AND COURSE: Despite the initiation of cyclophosphamide bolus and corticosteroid therapy, the kidney function and renal hypertension worsened and the patient developed cerebral manifestations. Finally, synchronization of plasmapheresis with subsequent pulse cyclophosphamide led to remission of SLE. CONCLUSION: Although MMF is a promising innovative agent for induction and maintenance therapy of lupus nephritis that can be used instead of cyclophosphamide, there may be cases like the one reported here, in which MMF cannot prevent lupus flares in first manifestation of severe renal disease.
Adrenal Cortex Hormones↗
EEG evidence of gender differences in a motor related CNV study.
In the present study gender differences related to the contingent negative variation (CNV) were investigated. A series of two acoustic stimuli was presented to participants across a wide age range. The first stimulus was consistent throughout the experiment whereas the second one was either a high frequency or a low frequency tone. One of them had to be answered by a button press (go condition) the other did not require any response (nogo condition). Between the first and the second tone there was a time period of two seconds in which the CNV appeared as a slow negative potential shift. Within this episode data were analysed with respect to gender differences. Statistical analysis revealed topographical differences between men and women in go conditions for both left and right index finger movements. Differences were found over frontal regions where women showed higher brain activity than men and over temporo-parietal regions where men produced higher brain activity than women. In order to explain the fact that only in "go" conditions significant gender differences occurred we introduce the phenomenon of implicit learning. Due to implicit learning assumed predictions related to S2 might have occurred from time to time. This is so, because a 50% chance for one of two different stimuli to occur leads to reasonable assumed predictions after two or more stimuli of a kind occurring in a series. The present data now provide evidence that if such assumed prediction or expectancy is directed towards an upcoming demand to act then brain activity is subject to gender differences. Further studies providing controlled sequences of "go" conditions versus "nogo" conditions have to be done to prove this idea true.
Acoustic Stimulation↗
Human endothelial cell septins: SEPT11 is an interaction partner of SEPT5.
The septin SEPT11 is a novel member of the highly conserved septin family. Septins are cytoskeletal GTPases, which form heteropolymeric complexes. They are involved in cytokinesis and other cellular processes, such as vesicle trafficking and exocytosis. SEPT11 has strong homology to SEPT8. Previously, we identified the interaction of SEPT5 and SEPT8. Using the yeast two-hybrid system, we now demonstrate that SEPT11 partners with SEPT5. The molecular interaction of SEPT11 with SEPT5 was verified by coprecipitation of SEPT5 and SEPT11 from lysates of the human T-cell leukaemia cell line JURKAT and by fluorescence resonance energy transfer. The interaction between SEPT5 and SEPT11 requires the GTP-binding domain and the C-terminal extension. Western analysis in various mouse and human tissues revealed that expression of SEPT11 is restricted to the same tissues as those expressing SEPT5, suggesting that SEPT11 and SEPT5 are components of a cell-specific septin complex. SEPT5, which is expressed in human umbilical vein endothelial cells (HUVECs), has been reported to play an important role in exocytosis. We now report that HUVECs also express SEPT11. Given the interactivity between SEPT5 and SEPT11 as shown above and their coexpression in HUVECs, it may be that a complex formed by these two proteins is involved in the exocytosis mechanism in HUVECs.
Animals↗
["Complex treatments" in surgery. New approaches to performance adjusted DRG reimbursement of expensive treatment].
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Bacterial Infections↗
[Prevention and alternative methods for prophylaxis of recurrent urinary tract infections in women].
General recommendations to prevent recurrent urinary tract infections (rUTI) result in about one-third of patients remaining free of recurrences. Oral and parenteral immunotherapy were effective in several controlled studies for prevention of rUTI. These therapies can be combined with acute antibiotic therapy. Vaginal prophylaxis with oestriol has proven its positive effect without serious gynaecological side effects. Also there is increasing evidence that cranberries prevent rUTI. The exact mode (juice, tablets or preserved berries), dosage and duration of this therapy remain to be defined. There are also promising therapy modalities such as changing bacterial gut flora, general immune response (acupuncture, inpatient rehabilitation) and urine acidity.
Anti-Infective Agents, Urinary↗
Regulation of proteolytic activity induced by inflammatory stimuli in lung epithelial cells.
A large number of chronic lung diseases such as asthma bronchiale are associated with alveolar and/or bronchial inflammation accompanied by a damage of the alveolocapillary barrier. In this process proteolytic mechanisms may play a crucial role. The aim of the present study was to assess the role of TNF-alpha on the proteolytic activity of pulmonary epithelial cells and to find possible intracellular signaling pathways which may mediate the effect of TNF-alpha. For our studies we have used the A549 human lung epithelial cell line. Plasminogen activator and metalloproteinase activity was measured using zymography. TNF-alpha induced a time and concentration dependent activation of the urokinase type plasminogen activator (u-PA) and tissue type plasminogen activator (t-PA) activity in A549 cells. This effect could be blocked completely by dexamethasone and was reduced significantly by the Rho-kinase inhibitor Y27632. Similarly, an increased activity in the culture medium of the 72 kDa MMP-2 in response to TNF-alpha could be observed as well. This could be reduced by dexamethasone and Y27632. Our results show that TNF-alpha is at least partly responsible for an increased proteolytic activity and beside corticosteroids Rho-kinase may constitute a potential target for future therapeutical approaches.
Cell Movement↗
Magnetoencephalographic correlates of different levels in subjective recognition memory.
In our current study we employed whole-head magnetoencephalography (MEG) to identify neurophysiological correlates (event-related fields, ERFs) of different phenomenologies in human recognition memory. Words which had previously been semantically processed were presented along with previously unstudied words. Via button presses, participants provided subjective indices of three forms of memory: confident recognition, familiarity-based recognition, and misclassification of previously presented items as new (no recognition, misses). Behavioral results revealed a clear distinction between confident recognition (shortest reaction times) and familiarity-based recognition and misses, respectively, and physiological data pointed to bilateral anterior and left anterior/central regions in which magnetic field patterns were directly related to word recognition from approximately 300 ms to 500 ms after word onset. In the context of the prevalent dual process controversy on the roles of familiarity and recollection in recognition memory, we first highlight that two operationalizations of recollection need to be differentiated: We argue that a strategic search for a particular contextual feature stands in clear contrast to the fast and incidental availability of some contextual feature and derive experimental and behavioral indicators for either form of recollection. These indicators are used to select from manifold cognitive neuroscientific work on recognition memory in order to further discuss the neurocognitive characteristics of incidental recollection in contrast to other forms of episodic memory.
Adult↗
Neurocognitive correlates of incidental verbal memory encoding: a magnetoencephalographic (MEG) study.
In our current study, we applied whole head magnetoencephalography (MEG) in a subsequent memory paradigm. Magnetic fields were recorded while 20 healthy subjects (10 females, 10 males) incidentally encoded words during semantic and structural verbal processing tasks. Physiological data were then sorted according to the performance in subsequent memory tests and according to levels of processing, respectively, and analyzed for gender effects. Behavioral results show a clear advantage of semantic processing over structural processing with respect to retrieval success for both females and males. Despite alikeness of behavioral data, MEG results show considerable differences between males and females concerning both subsequent memory effects and levels of processing effects. For male subjects, we identified more distinct magnetic fields in anterior regions for subsequently remembered than for subsequently forgotten words (latency range from 300-650 ms after word onset) and for semantic processing than for structural processing, respectively. For female subjects, corresponding magnetic field differences pointed to posterior regions (subsequent memory effects from 450 ms to 750 ms after word onset). No qualitative differences were observed between subsequent memory effects during semantic processing compared to subsequent memory effects during structural processing. We try to reconcile results from male data with previous findings concerning subsequent memory effects by proposing the concept of width of processing, which holds that incidental memory formation is mediated by frontal activity on a physiological level and brought forward on a cognitive level by enhanced associating imposed by the task demands of semantic processing. Female data cannot be fully incorporated in this framework, but all the more prompt further gender-specific analyses of subsequent memory effects.
Adult↗
[Evidence based medicine. Wish and reality in routing surgical practice].
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Evidence-Based Medicine↗
In search of the astrocytic factor(s) modulating blood-brain barrier functions in brain capillary endothelial cells in vitro.
(1) The blood-brain barrier (BBB) is formed by brain capillary endothelial cells (ECs). There are various cell types, in particular astrocytes, but also pericytes and neurons, located in close vicinity to the capillary ECs which may influence formation and function of the BBB. Based on this consideration, this paper discusses various aspects of the influence of the surrounding cells on brain capillary ECs with special focus on the role of astrocytes. (2) Based on the morphology of the BBB, important aspects of brain EC functions are summarized, such as transport functions and maintenance of low paracellular permeability. Moreover, various facets are discussed with respect to the influence of astrocytes, pericytes, microglia, and neurons on the BBB. Data on the role of glial cells in the ontogenesis of the BBB are presented subsequently. The knowledge on this subject is far from being complete, however, these data imply that the neural/neuronal environment rather than glial cells may be of importance in the maturation of the barrier. (3) The role of glial cells in the induction and maintenance of the BBB is discussed under physiological as well as pathological conditions. Although the literature presents manifold evidence for a great variety of effects induced by astroglia, there are also many controversies, which may result from different cellular models and experimental conditions used in the respective studies. Numerous factors secreted by astrocytes have been shown to induce a BBB phenotype. On the molecular level, increased expression of barrier-relevant proteins (e.g., tight junction proteins) is documented in the presence of astrocyte-derived factors, and many studies demonstrate the improvement of physiological parameters, such as increased transendothelial resistance and decreased paracellular permeability, in different in vitro models of the BBB. Moreover, one has to take into account that the interaction of brain ECs and astrocytes is bi-directional, and that the other cell types surrounding the brain microvasculature also contribute to BBB function or dysfunction, respectively. (4) In conclusion, it is expected that the present and future research focused on molecular mechanisms and signaling pathways will produce new and exciting insights into the complex network of BBB regulation: the cornerstone is laid.
Animals↗
Salmonella-mediated oral DNA vaccination using stabilized eukaryotic expression plasmids.
The use of Salmonella for the delivery of plasmid-encoded heterologous antigens to eukaryotic host cells has proven successful in experimental systems, but its general applicability is still hampered by a severe instability of transformants carrying these expression plasmids. To overcome the problem of plasmid instability, new low copy number expression plasmids were constructed using different replicons. Comparative studies between transformants of the high copy number plasmid pCMVbeta and the different low copy number plasmids that contain the pMB1, p15A or pSC101 replicons on the pCMVbeta backbone, revealed a dramatic increase in plasmid stability both in vitro and in vivo. Analysis of the resulting immune responses against antigens encoded by these vectors indicated that the increased stability resulted in a strong and reproducible induction of both antigen-specific CD4(+) and CD8(+) T-cell and antibody responses even after a single application. In addition, protective immunity was induced against Listeria monocytogenes using listeriolysin as antigen, regardless of the copy number of the delivery plasmid employed. Finally, Salmonella expressing two independent antigens on compatible low copy number plasmids elicited robust responses to either antigen that is as effective as Salmonella transformed with each plasmid singly adding further versatility to this delivery system.
Administration, Oral↗
[Normalization of the Brief Repeatable Battery of Neuropsychological tests (BRB-N) for German-speaking regions. Application in relapsing-remitting and secondary progressive multiple sclerosis patients].
The Brief Repeatable Battery of Neuropsychological Tests (BRB-N) is a neuropsychological screening battery, often applied in multiple sclerosis (MS) patients. It is almost exclusively administered in trials and not in the daily practice routine because of the lack of normative values. Using a stepwise linear regression analysis, the dependence of test results on age, gender, and education of 241 healthy control subjects was investigated. Z-values of -1.68 or less were considered pathological. Based on the normative values, the proportions of cognitively impaired patients with relapsing-remitting MS (RRMS, n=43) and secondary progressive MS patients (SPMS, n=60) were calculated. The regression model explained 2.7-25.0% of the variance of test performances. Cognitive impairment occurred in 38% and in 47% of the RRMS and the SPMS groups, respectively. In both groups attention and concentration impairment was prominent, while in the SPMS group memory was also frequently affected. The proportion of cognitively impaired MS patients reflected the figures that could be found in the literature.
Adolescent↗
Increased prevalence of and gene transcription by Chlamydia pneumoniae in cerebrospinal fluid of patients with relapsing-remitting multiple sclerosis.
Microbial agents may play a role in the pathogenesis of multiple sclerosis (MS). C. pneumoniae has been recently associated with MS; however, study results are at variance. We tested the hypothesis that Chlamydia pneumoniae-specific DNA and RNA are more often detected in cerebrospinal fluid (CSF) of patients with multiple sclerosis than patients with other neurological diseases (OND). We investigated CSF samples from 84 patients with definite MS and 89 OND patients (n = 62 with normal CSF; n = 27 with pathological CSF) using a nested polymerase chain reaction (PCR) to detect ompA gene sequences of C. pneumoniae. In subjects with positive PCR, we probed for chlamydial heat shock protein 60-mRNA and 16S-rRNA by reverse transcriptase (rt)-PCR. C. pneumoniae-specific DNA was more often detected in MS patients (50 %) than in all OND patients combined (28.1%, p = 0.003) and in OND patients with normal CSF (24.2%, p = 0.003) but not than in OND patients with pathological CSF (37%, p = 0.24). In relapsing-remitting MS (n = 55), the prevalence of C. pneumoniae DNA was higher (66.7 %) than in both OND subgroups (p <or= 0.05). In MS patients (n = 20), chlamydial heat shock protein 60-mRNA (75%) and 16S-rRNA (70%) were more often detected than in OND patients (n = 16; 18.8%; p < 0.005). Although more often detected in remitting-relapsing MS, C. pneumoniae DNA in CSF is not specific for MS owing to its high prevalence in OND controls. However, the higher rate of gene transcription suggests a more active metabolism of C. pneumoniae in MS patients.
Adult↗
The Scandinavian Sarcoma Group--background, organization and the SSG Register--the first 25 years.
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Bone Neoplasms↗
Cerebral and extracerebral release of protein S100B in cardiac surgical patients.
Although several clinical studies have shown that increased serum concentrations of protein S100B predict ischaemic brain damage after cardiac surgery, S100B may also be released from the heart or other injured tissue. We therefore investigated the correlation between serum S100B levels and those of the specific cardiac marker troponin I in order to assess the cerebral vs. extracerebral origin of S100B. In 64 cardiac surgical patients, serial blood samples were drawn for the measurement of S100B and troponin I before surgery and for seven days after surgery. Neurological function was assessed before with the National Institutes of Health Stroke Scale and the Folstein Mini Mental Test. The data show that a sustained increase in serum S100B levels is associated with neurological dysfunction, as witnessed by a positive correlation between S100B values and the results of the neuropsychological tests. In contrast, the early postoperative increased levels of protein S100B derive from cardiac tissue, as shown by the positive correlation between S100B and cardiac troponin I levels.
Adult↗
Continuous assessment of right ventricular ejection fraction: new pulmonary artery catheter versus transoesophageal echocardiography.
In 25 cardiac surgical patients, right ventricular ejection fraction was continuously measured with a new pulmonary artery catheter and transoesophageal echocardiography, scanning the 'fractional area change' in a standardised transatrial cross section area. Measurements were recorded at three predefined time points (pre-, intra-, and postoperatively). Both methods were compared using the Bland-Altman analysis. Comparing right ventricular ejection fraction values obtained from the pulmonary artery catheter with those assessed by transoesophageal echocardiography, bias was -3.7%, with a precision of 30.9%. Bias and precision significantly improved when the heart rate was less than 100 beats.min(-1), pulmonary artery pressures were low and cardiac performance adequate. In conclusion, the new continuous pulmonary artery catheter system appears to be a valid and useful bedside monitoring device in the haemodynamic management of critically ill patients.
Aged↗