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Biomedical subjects

J Hentschel

Publications and source records attributed to J Hentschel.

At least 19 recordsLinked to original sources
PubMed2006

[Changes in shape and size of the foot during pregnancy].

Many women report an increase in foot size during their pregnancy. Our objective was to verify this anecdotal evidence. In an initial survey of 21 mothers in 2 Münster nursery schools we found a tendency towards an increase in foot size during pregnancy. We therefore developed a measuring system to measure changes in foot length, width, height and volume. A total of 40 women recruited from the antenatal clinic of the University Hospital of Münster and a participating practice were seen three times during their pregnancy. The results were analysed using the Wilcoxon test. We found a statistically significant increase in foot length, width and volume, whereas foot height decreased slightly. This difference was, however, not significant. Especially in diabetic women with polyneuropathy it is important to pay attention to shoe size to prevent pressure sores.

Anthropometry↗
PubMed2006

Caudal regression sequence: vascular origin?

Caudal regression sequence (CRS) is a rare congenital defect of the lower spinal segments and the neural tube. Motor symptoms as well as neurological deficits and loss of bladder and bowel function are usually present. CRS is also associated with anomalies in other systems such as the gastrointestinal and genitourinary tract. Etiology and pathogenesis are poorly understood.A newborn presented with anomalies of the spinal column (lumbosacral) with absence/hypoplasia of the 12th thoracic and first lumbar vertebral anomaly body. Bladder and bowel initially were functional. MR-angiography exhibited an anomaly of the unpaired vessels originating from the aorta, a likely relict of a persisting vitelline artery. These findings indicate a potential vascular genesis of CRS, much as in sirenomelia.

Abnormalities, Multiple↗
PubMed2005

Prospective surveillance of nosocomial infections in a Swiss NICU: low risk of pneumonia on nasal continuous positive airway pressure?

BACKGROUND: This study assessed the rate of invasive nosocomial infections in very low birth weight (VLBW) </= 1,500 g infants in a Swiss university hospital neonatal intensive care unit (NICU). Device-association and devicerelated infection rates were prospectively evaluated. PATIENTS AND METHODS: From October 1999 to September 2000, 76 hospitalized neonates with VLBW were included, plus 60 neonates > 1,500 g, who had received a central venous or umbilical catheter, or assisted ventilation. Nosocomial infections (sepsis, pneumonia, necrotizing enterocolitis [NEC]) were defined according to Centers for Disease Control (CDC) recommendations with slight modifications and their rates measured longitudinally. RESULTS: Among VLBW neonates, 16 nosocomial infections for an overall infection rate of 6 per 1,000 patient days were found. Infants with infection were of lower birth weight, a greater proportion was male, received lipid infusions, and on average had a higher severity of illness (CRIB) score. Interestingly, the ventilator-associated pneumonia (VAP) rate (12.5/1,000 ventilator days) seemed significantly higher than the pneumonia rate during nasal continuous positive airway pressure (NCPAP) treatment (1.8/1,000 NCPAP days; p = 0.04). The sepsis rate associated with peripheral catheters almost equaled the central line-associated rate, although numbers for both device-related infections were small. CONCLUSION: Further studies are needed to confirm the observation that the NCPAP-associated pneumonia rate might be lower than the VAP rate in VLBW infants, as well as to confirm the second observation that the sepsis rates on peripheral catheters compared to central venous catheters might be almost equal in VLBW infants. Reducing the exposure to ventilation via endotracheal tube, but not using peripheral as opposed to central catheters, might reduce the incidence of device-associated infection in this patient population.

Catheters, Indwelling↗
PubMed2003

Refilling of cortical calcium stores in Paramecium cells: in situ analysis in correlation with store-operated calcium influx.

This is the first thorough study of refilling of a cortical calcium store in a secretory cell after stimulation in which we combined widely different methodologies. Stimulation of dense-core vesicle ("trichocysts") exocytosis in Paramecium involves a Ca(2+) -influx" superimposed to Ca(2+) -release from cortical stores ("alveolar sacs" (ASs)). In quenched-flow experiments, membrane fusion frequency rose with increasing [Ca(2+)](o) in the medium, from approximately 20-25% at [Ca(2+)](o) < or = 0.25 microM to 100% at [Ca(2+)](o) between 2 and 10 microM, i.e. close to the range of estimated local intracellular [Ca(2+)] during membrane fusion. Next, we analyzed Ca(2+)-specific fluorochrome signals during stimulation under different conditions. Treatment with actin-reactive drugs had no effect on Ca(2+) -signaling. In double trigger experiments, with BAPTA in the second secretagogue application (BAPTA only for stimulation and analysis), the cortical Ca(2+) -signal (due solely to Ca(2+) released from cortical stores) recovered with t(1/2) approximately 65 min. When ASs were analyzed in situ by X-ray microanalysis after different trigger times (+Ca(2+)(o)), t(1/2) for store refilling was similar, approximately 60 min. These values are similar to previously measured 45Ca(2+) -uptake by isolated ASs. In sum we find, (i) exogenous Ca(2+) increases exocytosis/membrane fusion performance with EC(50)=0.7 microM, (ii) Ca(2+) -signaling in this system is not sensitive to actin-reactive drugs, and (iii) refilling of these cortical calcium stores goes on over hours and thus is much slower than expected.

Actins↗
PubMed2002

Functional and fluorochrome analysis of an exocytotic mutant yields evidence of store-operated Ca2+ influx in Paramecium.

A non-discharge mutant of Paramecium tetraurelia (nd12-35 degrees C, lacking exocytotic response upon stimulation with the nonpermeable polycationic secretagogue aminoethyldextran, AED), in the pawnA genetic context (d4-500r, lacking ciliary voltage-dependent Ca2+ influx), was shown to lack (45)Ca2+ entry from outside upon AED stimulation. In contrast, cells grown at 25 degrees C behave like the wildtype. To check the functional properties in more detail, fluorochrome-loaded 35 degrees C cells were stimulated, not only with AED (EC(100) = 10(-6) M in wildtype cells), but also with 4-chloro-meta-cresol, (4CmC, 0.5 mM), a permeable activator of ryanodine receptor-type Ca2+ release channels, usually at extracellular [Ca2+] of 50 microM, and eventually with a Ca2+ chelator added. We confirm that pwA-nd12(35 degrees C) cells lack any Ca2+ influx and any exocytosis of trichocysts in response to any stimulus. As we determined by x-ray microanalysis, total calcium content in alveolar sacs (subplasmalemmal stores) known to be mobilized upon exocytosis stimulation in wild-type cells, contain about the same total calcium in 35 degrees C as in 25 degrees C cells, and Ca2+ mobilization from alveoli by AED or 4CmC is also nearly the same. Due to the absence of any AED-induced Ca2+ influx in 35 degrees C cells and normal Ca2+ release from stores found by x-ray microanalysis one can exclude a "CICR"-type mechanism (Ca2+-induced Ca2+ release) and imply that normally a store-operated Ca2+ ("SOC") influx would occur (as in 25 degrees C cells). Furthermore, 35 degrees C cells display a significantly lower basal intracellular [Ca2+], so that any increase upon stimulation may be less expressed or even remain undetected. Under these conditions, any mobilization of Ca2+ from stores cannot compensate for the lack of Ca2+ influx, particularly since normally both components have to cooperate to achieve full exocytotic response. Also striking is our finding that 35 degrees C cells are unable to perform membrane fusion, as analyzed with the Ca2+ ionophore, A23187. These findings were corroborated by cryofixation and freeze-fracture analysis of trichocyst docking sites after AED or 4CmC stimulation, which also revealed no membrane fusion. In sum, in nd12 cells increased culture temperature entails multiple defects, notably insensitivity to any Ca2+ signal, which, moreover, cannot develop properly due to a lower basal [Ca2+] level and the lack of Ca2+ influx, despite normal store activation.

Animals↗
PubMed2001

Role of erythromycin for treatment of incipient chronic lung disease in preterm infants colonised with Ureaplasma urealyticum.

Ureaplasma urealyticum is frequently isolated from tracheal aspirates of very low birthweight infants who go on to develop chronic lung disease. The use of erythromycin has been advocated in ventilated very low birthweight infants who are colonised with U. urealyticum, although the association between U. urealyticum and chronic lung disease remains controversial. There are only two randomised, controlled trials involving a total of 37 U. urealyticum-positive very low birthweight infants. Both trials failed to demonstrate a reduction in the incidence of chronic lung disease after 7 or 10 days of erythromycin. On the other hand, there are reports of rare but serious adverse effects of erythromycin in newborn infants including sudden cardiovascular compromise and hypertrophic pyloric stenosis. We conclude that, at present, there is insufficient evidence to support the use of erythromycin for the treatment of incipient chronic lung disease in very low birthweight infants colonised with U. urealyticum.

Anti-Bacterial Agents↗
PubMed2000

Liver support by extracorporeal blood purification: a clinical observation.

Liver failure associated with excretory insufficiency and jaundice results in an endogenous accumulation of toxins involved in the impairment of cardiovascular, kidney, and cerebral function. Moreover, these toxins have been shown to damage the liver itself by inducing hepatocellular apoptosis and necrosis, thus creating a vicious cycle of the disease. We report a retrospective cohort study of 26 patients with acute or chronic liver failure with intrahepatic cholestasis (bilirubin level > 20 mg/dL) who underwent a new extracorporeal blood purification treatment. A synthetic hydrophilic/hydrophobic domain-presenting semipermeable membrane (pore size < albumin size, 100-nm thick) was used for extracorporeal blood detoxification using dialysis equipment. The opposite side was rinsed with ligandin-like proteins as molecular adsorbents that were regenerated online using a chromatography-like recycling system (molecular adsorbent recirculating system [MARS]). Bile acid and bilirubin levels, representing the previously described toxins, were reduced by 16% to 53% and 10% to 90% of the initial concentration by a single treatment of 6 to 8 hours, respectively. Toxicity testing of patient plasma onto primary rat hepatocytes by live/dead fluorescence microscopy showed cell-damaging effects of jaundiced plasma that were not observed after treatment. Patients with a worsening of Child-Turcotte-Pugh (CTP) index before the treatments showed a significant improvement of this index during a period of 2 to 14 single treatments with an average of 14 days. After withdrawal of MARS treatment, this improvement was sustained in all long-term survivors. Ten patients represented a clinical status equivalent to the United Network for Organ Sharing (UNOS) status 2b (group A1), and all survived. Sixteen patients represented a clinical status equivalent to UNOS status 2a, and 7 of these patients survived (group A2), whereas 9 patients (group B) died. We conclude that in acute excretory failure caused by a chronic liver disease, this treatment provides a therapy option to remove toxins involved in multiorgan dysfunction secondary to liver failure.

Adult↗
PubMed1999

Neonatal nosocomial infection surveillance: incidences by site and a cluster of necrotizing enterocolitis.

Nosocomial infection (NI) was prospectively studied in hospitalized neonates during a 10-month period. The Centers for Disease Control (CDC) criteria (some specified for neonates) were used for surveillance. Forty-nine of 677 infants experienced 73 episodes of NI. The overall incidence was 10.8 NI/100 patients and 6.5 NI/1,000 patient days. The average monthly NI number did not correlate with patient load. Very low birth weight (VLBW) infants showed a higher NI incidence (81.8 NI/100 patients and 11.1 NI/1,000 patient days), also elevated if adjusted for their inherently longer neonatal intensive care unit (NICU) stay. The most common NI sites in the VLBW stratum were sepsis and necrotizing enterocolitis (NEC), the latter occurring in a seasonal cluster. It can be concluded that surveillance for NIs should focus on VLBW infants and include the evaluation of NEC, as it behaves like a nosocomial disease.

Anti-Bacterial Agents↗
PubMed1999

[1H-MR spectroscopy in anorexia nervosa: the characteristic differences between patients and healthy subjects].

PURPOSE: The neurophysiological and neuromorphological changes in patients with anorexia nervosa (AN) are well-known but the reason of both is still unknown. We have evaluated the usefulness of hydrogen (H1) magnetic resonance spectroscopy in anorexia nervosa. METHOD: We investigated 15 patients with clinically diagnosed AN (ICD F50.0) and 17 controls without eating disorders. The body mass index (BMI) was 15.8 and 21, respectively. The spectroscopy was recorded on two voxels in the parieto-occipital white matter or in the thalamus with a water-suppressed STEAM-sequence. The metabolites were recorded with respect to phosphocreatine (PCr). RESULTS: The ratio of NAA/PCr in both voxels were not significantly different when comparing patients vs. controls. Patients showed significantly higher ratios of choline-containing components (Cho) or, respectively Cho/PCr and NAA/PCr in the white matter. Distinct, but not significant differences were detected both for m-Ino and m-Ino/PCr in the parieto-occipital region and for the Cho- and m-Ino contained ratios in the thalamus. CONCLUSION: AN is not associated with neuronal damage. The ratio of Cho/PCr and NAA/Cho may reflect the disturbance of membrane-turnover. It is possible that the increase of membrane catabolism leads to a hyperosmolar state. The change of m-Ino/PCr ratio may reflect the regulation of osmolarity.

Anorexia Nervosa↗
PubMed1998

Device-associated nosocomial infection surveillance in neonatal intensive care using specified criteria for neonates.

Agreement on criteria for defining nosocomial infections is essential when surveillance is intended for quality assurance. The CDC criteria for patients < 12 months old were compared with locally developed criteria for neonates in a 10-month study of nosocomial infections in a Berlin University hospital. Six hundred and seventy-seven neonates were observed prospectively for 11,936 patient days. The overall nosocomial infection incidence rate was 13.2%. Because of the observed strength of agreement between the CDC and local criteria for central line-associated primary bloodstream infections and for ventilator-associated pneumonias (recommended by the NNIS system for inter-hospital comparisons) and the preference of the clinicians for the local criteria, we decided to use the latter for an ongoing surveillance system which nonetheless would retain the possibility for comparison with NNIS-data.

Bacteremia↗
PubMed1998

Staphylococcal scalded-skin syndrome complicating wound infection in a preterm infant with postoperative chylothorax.

The course of infection in a 3-week-old premature newborn suffering from extensive dermatitis with flaccid blisters is described. Staphylococcus aureus was recovered from a local wound infection around a chest tube inserted to drain a postoperative chylothorax. The strain isolated tested positive for the eta gene for exfoliative toxin A, the causative agent of staphylococcal scalded-skin syndrome (SSSS). In this case, prematurity and loss of chylus with consecutive lymphopenia may have contributed to development of SSSS.

Chylothorax↗
PubMed1998

Predicting chronic lung disease in very low birthweight infants: comparison of 3 scores.

AIM: To evaluate 3 scores in their ability to predict Chronic Lung Disease (CLD) in very low birthweight (VLBW) infants. METHODS: The records of 188 VLBWs admitted to neonatal intensive care within two years were retrospectively reviewed. Two mortality scores -the CRIB (clinical risk index for babies) score and the Berlin admission score- and one morbidity score developed to predict CLD (Sinkin score) were assigned to each infant. Areas (AUC) under receiver operating characteristic (ROC) curves were used for comparison. RESULTS: The Sinkin score and the Berlin admission score had AUCs of 89.0 and 85.8% to predict CLD ("alive in oxygen at 28 days of life"). The AUCs were 87.7 and 81.2%, respectively, using the CLD definition "alive in oxygen at 36 weeks gestational age", the CRIB had an AUC of 77.0%. CONCLUSION: To enroll patients in trials aimed at early interference with the course of CLD, the Berlin admission score or the Sinkin score could be used.

Aging↗
PubMed1997

Facilitation of membrane fusion during exocytosis and exocytosis-coupled endocytosis and acceleration of "ghost" detachment in Paramecium by extracellular calcium. A quenched-flow/freeze-fracture analysis.

We had previously shown that an influx of extracellular Ca2+ (Ca2+e), though it occurs, is not strictly required for aminoethyldextran (AED)-triggered exocytotic membrane fusion in Paramecium. We now analyze, by quenched-flow/freeze-fracture, to what extent Ca2+e contributes to exocytotic and exocytosis-coupled endocytotic membrane fusion, as well as to detachment of "ghosts"-a process difficult to analyze by any other method or in any other system. Maximal exocytotic membrane fusion (analyzed within 80 msec) occurs readily in the presence of [Ca2+]e > or = 5 x 10(-6) M, while normally a [Ca2+]e = 0.5 mM is in the medium. A new finding is that exocytosis and endocytosis is significantly stimulated by increasing [Ca2+]e even beyond levels usually available to cells. Quenching of [Ca2+]e by EGTA application to levels of resting [Ca2+]i or slightly below does reduce (by approximately 50%) but not block AED-triggered exocytosis (again tested with 80 msec AED application). This effect can be overridden either by increasing stimulation time or by readdition of an excess of Ca2+e. Our data are compatible with the assumption that normally exocytotic membrane fusion will include a step of rapid Ca(2+)-mobilization from subplasmalemmal pools ("alveolar sacs") and, as a superimposed step, a Ca(2+)-influx, since exocytotic membrane fusion can occur at [Ca2+]e even slightly below resting [Ca2+]i. The other important conclusion is that increasing [Ca2+]e facilitates exocytotic and endocytotic membrane fusion, i.e., membrane resealing. In addition, we show for the first time that increasing [Ca2+]e also drives detachment of "ghosts"-a novel aspect not analyzed so far in any other system. According to our pilot calculations, a flush of Ca2+, orders of magnitude larger than stationary values assumed to drive membrane dynamics, from internal and external sources, drives the different steps of the exo-endocytosis cycle.

Animals↗
PubMed1997

Routine registration of deviations from the norm in cardiac surgery: a potent clinical research tool and quality assurance measure.

UNLABELLED: The surveillance and monitoring of deviations from normality is an often used quality assurance weapon in private industry. In cardiac surgery, complications have often been monitored and reported, but mostly one at a time and in conjunction with a scientific study. METHODS: Using the clinic's data network including operating theatre, intensive care unit and ward, deviations from a normal postoperative course are registered by the patient's nurses. The deviations are registered by answering questions on all organ systems in front of a PC. Suitable definitions are available to the nurse. When the patient is discharged, the surgeon in charge will review the deviations noted and make a formal diagnosis on the patient's chart if appropriate. RESULTS: The data system has now been in use for 6 months. It was easily adopted by the nurses. The doctor's work is facilitated as relevant data are available to him when discharging the patient and making the discharge note. 58% of the patients have some kind of deviation from the norm, most commonly in the cardiovascular system (30% of the patients), respiratory system (22%), and surgically complicated postoperative course (17%). During the first months of registration it became apparent that too many patients had postoperative thrombophlebitis. By changing routines, the incidence of thrombophlebitis decreased from 5 to < 1%. CONCLUSION: Only about 40% of our patients go through a cardiac operation with a totally normal postoperative course. The registration system has turned out to be easily handled by our nurses and able to detect complications not immediately noticed in everyday clinical practice. A registry of this kind is highly dependent on its definitions and on the general 'norm' prevailing. Findings from such registries cannot therefore be immediately compared with those of other institutions. The research potentials of the registry as well as its role in quality assurance seem large.

Data Collection↗
PubMed1996

Annexins in Paramecium cells. Involvement in site-specific positioning of secretory organelles.

Annexins were isolated from Paramecium cell homogenates by standard ethylene glycol tetraacetic acid (EGTA) extraction and 100 000-g centrifugation. Two different antibodies (Abs) against synthetic peptides were used, Call-15 and B15, which in mammalian cells recognize a sequence of annexin II or a common sequence occurring in several annexins (except for annexin II), respectively. With anti-Call-15 Abs, western blots from EGTA extracts showed strongly reactive bands of 44.5 and 46 kDa and of higher values. Some of these bands bound to the 100 000-g pellet fraction when Ca(2+) was added. Immuno- and affinity labelling revealed selective, Ca(2+)-dependent labelling of the cell cortex, with enrichment around trichocyst docking sites (facing subplasmalemmal Ca(2+) stores). Cortical fluorescence labelling decreased in wild-type (7S) cells when trichocyst ghosts were detached after synchronous exocytosis. Similarly, cortical labelling was reduced when intact trichocysts were detached from the cell surface of non-discharge mutant cells (nd9-28 degrees C, showing identical bands on blots), which then contained numerous heavily labelled phagolysosomes. This strongly suggests annexin downregulation. All together, the dynamic labelling of cortical structures we observed strongly supports involvement of calpactin-like annexins in trichocyst docking. Anti-B15 Abs recognized a band of 51 kDa and some of higher values. These Abs selectively labelled the outlines of the cytoproct, the site of spent phagolysosome exocytosis. In conclusion, our data indicate involvement of specific sets of annexins in site-specific positioning and attachment of widely different secretory organelles at the cell surface in Paramecium cells.

Animals↗
PubMed1994

Immortalization of rat hepatocytes by fusion with hepatoma cells. I. Cloning of a hepatocytoma cell line with bile canaliculi.

Hepatocytoma (HPCT) hybrid cells were obtained by fusion of cultured rat hepatocytes with Fao Reuber hepatoma cells H35 by polyethylene glycol treatment. Surviving cells were cloned in HAT (hypoxanthine-aminopterine-thymidine)/ouabain medium and propagated in cell lines over 80 passages. Morphological criteria were chosen to allow differentiation of the clones into two types of cells: 1) Type I cells which formed irregular cell layers, lacked contact inhibition and resembled the parental Fao hepatoma cells and 2) type II cells, which proliferated in monolayer cultures, exhibited contact inhibition during growth in culture plates and formed bile canaliculi thereby resembling cultured hepatocytes by phenotype. Bile canaliculi were absent in type I clones and Fao cells. One particular type II clone 1E3 was studied in detail. These cells formed bile canaliculi sealed by tight junctions and were comparably polarized as cultured hepatocytes. They expressed canalicular antigen B10, canalicular aminopeptidase N, and even secreted the fluorescent bile acid derivative NBD-cholate into the canalicular lumen. This type of HPCT cells lacked malignancy by tests in vivo and in vitro, and contained 110 +/- 5 chromosomes. The cells were considered to represent an immortalized hepatocyte-like cell line.

Animals↗
PubMed1993

Detection of Ureaplasma urealyticum by polymerase chain reaction in the urogenital tract of adults, in amniotic fluid, and in the respiratory tract of newborns.

On the basis of the nucleotide sequence of the urease genes of Ureaplasma urealyticum serotype 8, polymerase chain reaction (PCR) primers were selected, evaluated for specificity and sensitivity, and tested for their ability to detect U. urealyticum in the adult urogenital tract, amniotic fluid, and endotracheal aspirates of newborns. All 14 reference serotypes of U. urealyticum were detected with equal sensitivity (1-10 cfu), whereas multiple strains of 12 other mycoplasma species found in humans as well as eukaryotic DNA were not detected. A total of 638 clinical specimens was evaluated. Results indicate that PCR is equal to if not more sensitive than culture for detection of U. urealyticum. Faster detection of U. urealyticum by PCR (< 24 h) compared to culture (2-5 days) will be particularly important in management of very low birth-weight infants in whom this organism has been shown to be a significant cause of meningitis, respiratory disease, and death. This method of detection will also be helpful in further determining the role of this organism in intraamniotic infection and premature birth.

Adult↗