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Biomedical subjects

I Hofmann

Publications and source records attributed to I Hofmann.

At least 37 records · Page 2Linked to original sources

Prospective, randomized trial of Microvisc and Healon in routine phacoemulsification.

PURPOSE: To compare the safety and efficacy of the new sodium hyaluronate viscoelastic, Microvisc, with those of Healon in routine phacoemulsification. SETTING: York Finch Eye Associates and York Finch General Hospital, Toronto, Ontario, Canada. METHODS: An unmasked, prospective, randomized clinical trial of 100 eyes in 100 patients having routine phacoemulsification and intraocular lens implantation was conducted to compare the safety and efficacy of Microvisc with those of Healon. Visual acuity, corneal thickness, and intraocular pressure were assessed preoperatively and at 6 hours, 1 and 5 days, and 1 and 6 months postoperatively. RESULTS: There were no statistically significant differences between the two treatment groups at any follow-up CONCLUSION: Based on the parameters assessed, both viscoelastic products were safe and provided comparable outcomes.

Adult↗

Heterotypic interactions and filament assembly of type I and type II cytokeratins in vitro: viscometry and determinations of relative affinities.

We have determined relative affinities of type I and type II human non-epidermal cytokeratin (CK) polypeptides synthesized in Escherichia coli from cDNA, using the method of surface plasmon resonance, and have compared the influence of ionic strength and ion quality on the assembly to intermediate filaments (IFs) by viscometry and electron microscopy. By surface plasmon resonance (total internal reflection) we determined the real-time relative binding of various type I CKs to the type II CK8. Surprisingly, the various type I CKs examined (i.e., CKs 13, 18, 19 and 20) differed markedly in their relative binding rate: For example, CK18 and CK13 displayed much higher resonance signals than CK19 and CK20. In addition, soluble complexes of type II CK8 with various type I cytokeratins were reconstituted at slightly alkaline pH and low ionic strength. Subsequent IF assembly was induced by simultaneous shifting to neutral pH and increasing the ionic strength. Both mono- and divalent ions as well as tris (hydroxymethyl)-aminomethane (Tris) alone were able to induce IF assembly. When we compared the time course of viscosity increase of CK8 in combination with either CK13, CK18, CK19 or CK20, we found that the cytokeratin pairs 8:18 and 8:20 attained the highest viscosity values, whereas the cytokeratin pair 8:19 displayed a relatively low value. Significantly lower values of specific viscosity were also observed in competition experiments when CK18 was gradually replaced by CK19. The observed differences in relative affinities and assembly kinetics of certain CK combinations allow quantitations of the interactions between different CKs and are discussed in relation to IF stability and cell differentiation.

Base Sequence↗

[Truth in dealing with sick people].

One of the most difficult problems for many nurses and physicians is the question of truthful information, especially for seriously ill and dying people. Talking about the problem of truth from an ethical point of view there are three essential aspects to consider: First the concept of truth from an anthropological point of view has to be defined and compared to the truth in the natural sciences, second, how the concept of "Truth at the sick bed" and its effect on nurses are treated in the medical literature, third, the psychological conditions we have to consider in relating to seriously ill and dying people. It is the declared aim of this paper to describe and summarize these three theoretical aspects, which in everyday work are inseparably connected, and to show some possible solutions.

Anthropology↗

[Quantitative determination of fetal fibronectin in cervical smears: a new marker for evaluating the risk of premature labor].

There is a well-known correlation between ascending infection and preterm labour. Nevertheless, up to now an exact method to identify patients which are at high risk for preterm labour does not exist. Fetal fibronectin is an extracellular matrix protein, which is produced by fetal membranes. High concentrations are present in amniotic fluid, but not in cervical secretions in uncomplicated pregnancies (only in 3-4%). If there is an inflammatory mediated damage to fetal membranes (amnion/chorion) or a mechanical disruption caused by preterm contractions, fetal fibronectin should be released into the cervix and vagina. A prospective clinical study measuring quantitatively the content of fFN in cervicovaginal secretions in patients with preterm labour (n = 43), preterm rupture of membranes (n = 15) and 20 controls was undertaken. In 16 patients frequent specimen could be obtained over a period of several weeks. 14 of the 34 patients with preterm labour, which could be observed until delivery, delivered before term (< 37. WOP). In 13 fFN was present in a concentration > 75 ng/ml (sensitivity: 92.4%). 13 patients were negative for fFN and only one of these patients delivered before term (92% chance of term delivery in absence of fFN in cervicovaginal fluids). In 8 patients with beta-adrenergic treatment fFN was present. All patients delivered before term. The 15 patients with PROM had very high concentrations of fFN with a medium concentration of 967.3 ng/ml. 18 of the 20 control patients were negative for fFN (< 75 ng/ml), 2 had a slightly elevated concentration of 84 and 85 ng/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

Chorioamnionitis↗

Identification of a nonapeptide motif in the vimentin head domain involved in intermediate filament assembly.

The assembly of soluble vimentin subunits into intermediate filaments (IFs) is dependent on information located in the amino-terminal domain. Using site-directed mutagenesis of a Xenopus laevis vimentin cDNA and an Escherichia coli production system to obtain pure mutated protein, we have identified, in the head domain, a nine amino acid motif (SSYRRIFGG), evolutionarily conserved from amphibia to man, which plays an important role in the orderly formation of IFs. Exchanges in the central di-arginine and in the two aromatic residues interfere with IF assembly of vimentin in vitro: on assembly under standard assembly conditions (160 mM-NaCl) most of the protein is included in dense aggregates, with a variable and minor proportion of IFs, whereas at lower ionic concentrations short and incomplete IF-like structures are formed. The deletion of the whole motif results in a protein that under standard assembly conditions (e.g. 160 mM-NaCl) predominantly and rapidly precipitates into large aggregates of non-IF material, whereas at lower ionic strength (e.g. 50 mM-NaCl) both IFs and dense aggregates are formed simultaneously. Our results show that the mutated protein can assume different forms at the same time and under the same conditions. This motif alone is insufficient for the formation of normal IFs as demonstrated by a mutant in which the motif has been brought closer to the alpha-helical rod domain by deletion of 55 internal amino acid residues. Corresponding observations have been made, by immunofluorescence microscopy, upon transfection of cultured epithelial cells lacking vimentin IFs. The importance of the head domain motif for the assembly and higher-order arrangement of IFs is discussed.

3T3 Cells↗

Interference in vimentin assembly in vitro by synthetic peptides derived from the vimentin head domain.

The importance of the amino-terminal domain ("head") of type III intermediate filament (IF) proteins in IF assembly has been examined by testing the influence of synthetic peptides representing a highly conserved decameric motif, KSSSYRRIMFGG, located near the amino terminus of vimentin. When added to soluble vimentin subunits this peptide induces, at fourfold molar excess or slightly above, the appearance of short, regular rod-like structures as determined by electron microscopy of negatively stained and rotary-shadowed preparations as well as by viscometry. At higher peptide concentrations large, irregularly shaped aggregates of mostly non-IF structures formed, but this aggregation was reversible by prolonged dialysis against low ionic strength buffer. The aggregating effect of this peptide was highly sequence-specific and was not seen with point-mutated sequences such as RR----TR or with unrelated peptides containing a central diarginine, indicating that it is not simply ionic. When different hexapeptides representing different "head" positions were compared, only the central sequence, SYRRXF, was as effective as the decamer. The addition of peptide during IF assembly did not prevent filament formation, although 50-fold molar excess of peptide resulted in a drastic increase (up to 40 nm) in the width of the filaments, which also appeared less regular, thus reflecting some interference with assembly. In contrast to the effects on soluble vimentin, the decameric peptide did not disturb IFs, indicating that the binding domain is "masked" or stabilized in the filaments. To identify the domain to which the peptide binds, three different binding assays using vimentin fragments and genetically engineered vimentin deletion mutants were employed. The results indicate that the binding domain of the near-amino-terminal peptide is located at the start of the alpha-helical "rod" domain of the protein. Possible mechanisms of interaction of these two portions of vimentin during IF assembly are discussed.

Amino Acid Sequence↗

Assembly and structure of calcium-induced thick vimentin filaments.

Using a viscometric assay and various electron microscopic procedures (negative staining, rotary shadowing, ultrathin sectioning) we have determined the influences of different kinds of ions and of ionic strength on the structures formed by assembly of soluble subunits of vimentin from bovine lens tissue or from Escherichia coli transformed with Xenopus vimentin cDNA. In contrast to the assembly of typical, i.e., 8 to 14-nm, intermediate-sized filaments (IFs) at elevated (e.g., 160 mM) concentrations of monovalent cations and at millimolar Mg2+ concentrations, filaments formed in the presence of Ca2+ ions (e.g., 5 mM) appeared at a lower rate, attained lower viscosity and were considerably thicker and shorter. The largest diameter measured was that for the recombinant amphibian protein: 24.2 +/- 8.5 nm in negative staining, 28.7 +/- 5.6 nm in sections. These thick Ca(2+)-induced filaments, however, revealed the same approximately 2 nm protofilament composition and approximately 20 nm cross-striation pattern as typical IFs, indicative of a similar molecular arrangement. The significance of this unusual structural IF protein assembly is discussed.

Animals↗

[Sequential alternating chemotherapy of highly malignant non-Hodgkin's lymphomas with VIM-Bleo and CHOP. Initial results].

54 patients with high grade malignant NHL (stage II 19, stage III 10, stage IV 25 patients, medium age 56 years) were treated in an ongoing study with the VIM-Bleo/CHOP-regimen: Etoposide 100 mg/m2 i.v. days 1-3, Ifosfamide 1.5 g/m2 i.v. days 1-5 with Mesna for prophylaxis of cystitis, Methotrexate 30 mg/m2 i.v. day 3, Bleomycin 10 mg i.v. days 8 and 15, Cyclophosphamide 750 mg/m2 day 22, Adriamycin 50 mg/m2 day 22, Vincristine 1.4 mg/m2 day 22 and prednisolone 100 mg po days 1-5 and 22-26. Cycles were repeated on day 43. After completion of therapy (4 cycles of VIM-Bleo/CHOP), 27 out of 35 patients (77%) were in complete remission. 6 patients (17%) had a partial remission and 2 (6%) progressive disease. After a median follow up of 8 months so far, 6 relapses occurred. Probability of survival at 12 months is 82%. Toxicity of treatment was very low with leukopenia being the main side effect. Only in 2 cycles (3%), major infections were observed. Nausea and vomiting were severe only in 4% of patients. We conclude that VIM-Bleo/CHOP is a well tolerated regimen with good remission rates in high grade malignant NHL. However, longer follow up is necessary for a final evaluation.

Adult↗

Ovarian carcinoma: increase in clinical validity by simultaneous determination of SRA and CA 125.

Ovarian carcinomas are distinguished by their polyclonality, i.e., heterogeneity and polymorphism of their tissue. There is no marker available complying with the clinical demands in the case of ovarian carcinoma regarding satisfactory sensitivity and specificity. Therefore, we have simultaneously determined two entirely distinct tumor markers, serum ribonuclease activity (SRA) and cancer antigen 125 (CA 125), recommended in the literature with respect to ovarian carcinoma. After evaluation by logistic regression analysis, we found a specificity of 93% together with a sensitivity of 97% for the simultaneous determination of SRA and CA 125 (37 ovarian carcinomas, 11 cases without pathological findings after treatment, 11 benign tumors of the ovary, 61 controls). The patients are not exposed to increased stress by this simultaneous determination method compared to the determination of a single marker. The increased clinical validity justifies the recommendation of routine simultaneous determinations of SRA and CA 125 for diagnosis and monitoring of patients with ovarian carcinoma.

Antibodies, Monoclonal↗

[Follow-up in patients with chronic obstructive lung diseases with special reference to the pressure behavior in the pulmonary artery].

The study demonstrates the results of 203 patients with COLD in a follow-up of 4-6 years. The investigations include the clinical state, lung function tests, blood gas analyses and measurements of pulmonary arterial pressure (PAP). One hundred and six of these 203 patients were investigated 3 times within 4-6 years. Clinical state, oxygen partial pressure and airways' resistance showed the best correlation with the PAP at rest and under exercise. In 54 patients (= 51%) the pulmonary arterial pressure increased up to a pulmonary hypertension. In 37 patients (= 35%) it decreased, out of them in 13 to normal values. Only in 15 patients (= 14%) the PAP did not change. We conclude, that a single measurement of the pulmonary arterial pressure can only be a marker of the general prognosis in COLD, but not of the individual prognosis. So we need further follow-up studies for the correct assessment of the individual prognosis dependent on the clinical state in each case.

Adolescent↗

[Follow-up studies and special cardiologic diagnosis in patients with suspected heart sarcoidosis].

During a retrospective analysis of 1236 patients with pulmonary sarcoidosis who showed electrocardiographic disturbances or cardiomegaly the existence of a possible heart sarcoidosis was suspected. It was tried to confirm this suspected diagnosis in subsequent examinations of these patients by support of modern non-invasive and invasive cardiological methods. Thereby the differential diagnosis to the coronary heart disease is especially difficult in elderly. This problem represents a permanent diagnostic challenge because of the therapeutic chance in case of heart sarcoidosis.

Adult↗

[Contribution to the assessment of physical fitness in patients with pulmonary diseases on the basis of cardiopulmonary and ergometric parameters (author's transl)].

In 270 patients with COLD, bronchial asthma, exogenic allergic alveolitis or fibrosis of the lung measurements of VC, FEV 1,0, Rt, RV, DL CO, CL, PO2 and PAP (by means of floating catheter) were made. Results of measurements at rest and during exercise were compared after statistical treatment in the above groups and their value with regard to the determination of physical fitness was appreciated.

Adolescent↗