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Biomedical subjects

J Pfeffer

Publications and source records attributed to J Pfeffer.

At least 19 recordsLinked to original sources

[Psoriasis SCID-mouse model].

Psoriasis is characterized by a complex phenotype and pathogenesis along with polygenic determination. Several psoriasis animal models have only been able to incompletely reproduce the disease. A xenogeneic transplantation approach, grafting skin from psoriatic patients onto mice with a severe combined immunodeficiency (SCID), was the first to meet the criteria for a psoriasis model. During the last 10 years, this psoriasis SCID-mouse model not only allowed telling experiments focusing on pathogenetic aspects, but also proved being a powerful tool for drug discovery with a good predictive value.

Animals↗

Genome-wide approach to identify risk factors for therapy-related myeloid leukemia.

Using a target gene approach, only a few host genetic risk factors for treatment-related myeloid leukemia (t-ML) have been defined. Gene expression microarrays allow for a more genome-wide approach to assess possible genetic risk factors for t-ML. We assessed gene expression profiles (n=12 625 probe sets) in diagnostic acute lymphoblastic leukemic cells from 228 children treated on protocols that included leukemogenic agents such as etoposide, 13 of whom developed t-ML. Expression of 68 probes, corresponding to 63 genes, was significantly related to risk of t-ML. Hierarchical clustering of these probe sets clustered patients into three groups with 94, 122 and 12 patients, respectively; 12 of the 13 patients who went on to develop t-ML were overrepresented in the latter group (P<0.0001). A permutation test indicated a low likelihood that these probe sets and clusters were obtained by chance (P<0.001). Distinguishing genes included transcription-related oncogenes (v-Myb, Pax-5), cyclins (CCNG1, CCNG2 and CCND1) and histone HIST1H4C. Common transcription factor recognition elements among similarly up- or downregulated genes included several involved in hematopoietic differentiation or leukemogenesis (Maz, PU.1, ARNT). This approach has identified several genes whose expression distinguishes patients at risk of t-ML, and suggests targets for assessing germline predisposition to leukemogenesis.

Child↗

The Aer-O-Scope: proof of the concept of a pneumatic, skill-independent, self-propelling, self-navigating colonoscope in a pig model.

BACKGROUND AND STUDY AIMS: Considerable training is needed to enable endoscopists to use the currently available commercial colonoscopes and sigmoidoscopes effectively and safely. The aim of this study was to evaluate the safety and efficacy of the propulsion mechanism incorporated into the Aer-O-Scope (GI View Ltd., Ramat Gan, Israel)--a novel self-propelled, self-navigating colonic endoscope for diagnostic purposes. MATERIALS AND METHODS: Twenty young female pigs underwent complete bowel preparation followed by a sedated examination using the new device. Ten pigs underwent two consecutive procedures, with a wash-out period of 7 days between each procedure. The total number of procedures was 30. Two prototypes of the Aer-O-Scope, with different cable lengths and vehicle balloon sizes (n = 20 and n = 10 for prototypes I and II, respectively) were used. Each examination was followed by a standard colonoscopy for safety evaluation. The insertion length of the Aer-O-Scope was determined by fluoroscopy images. RESULTS: The colon was adequately clean in 25 procedures. Maximum insertion was achieved in 21 procedures (84%)--80% with prototype I (n = 15) and 90% with prototype II (n = 10). The time to maximum insertion averaged 8.9 +/- 4.4 min (10 +/- 4.6 and 6.6 +/- 2.9 min for prototypes I and II; P < 0.05), and the withdrawal time averaged 3.4 +/- 2.1 and 4.2 +/- 3.4 min, respectively. The driving pressures for prototypes I and II averaged 46.3 and 34.5 mbar, respectively. The follow-up conventional colonoscopy identified no mucosal tears or perforations. Minor mucosal petechiae were noted in 43% of the cases. No adverse events were noted up to 7 days after the procedure. CONCLUSIONS: The propulsion mechanism used in this novel self-propelled, self-navigating colonoscope was effective and safe in pigs.

Animals↗

New optional IVC filter for percutaneous retrieval--in vitro evaluation of embolus capturing efficiency.

PURPOSE: In-vitro evaluation of a new caval filter (Cook Celect Filter) developed for delayed percutaneous retrieval in comparison to the Gunther Tulip filter. MATERIALS AND METHODS: The new Celect filter is constructed on the basis of the Tulip filter and consists of 4 primary anchoring legs and additional 8 thinner secondary wires to stabilize the filter and to guarantee adequate filtering efficiency. The filtering wires are of the same amount and equal distribution as the filtering wires of the Tulip filter. The secondary wires are arranged in such a way that percutaneous filter retrieval should be possible even if the wires are incorporated into the caval wall. In a flow model (tube size ø15-, ø22- and ø30 mm), the filter was exposed to single and multiple emboli (blood clots) of different sizes (3 x 5, 3 x 10, 5 x 10, 3 x 20, 5 x 20, 7 x 10, 7 x 20 to 10 x 24 mm) to analyse the embolus capturing efficiency under different conditions including eccentric and concentric, horizontal and vertical positions in comparison to the Tulip filter. All testing was carried out in SPSS analytic software; statistical significance was assumed for p-values < 0.05. RESULTS: The in-vitro embolus capturing efficiency of the Celect filter proved to be equivalent to the Tulip filter. In the single-embolus test, 91.6 % of the clots were captured by the Celect filter and 87.2 % by the Tulip filter (p = 0.042). Large clots ranging from 7 x 10 to 10 x 24 mm were captured in all cases, whereas the capture rates for the 3 x 5-mm and 3 x 10-mm clots were lower. The filters captured significantly more clots in the concentric than in the eccentric location. There was no significant difference between the overall capture rates of the two filters in the multi-clot test (72.2 % vs. 75.1 %), which showed deterioration of filter function during multiple clot exposure. With the 15-mm tube, the Celect filter had a significantly higher capture rate than the Tulip filter, whereas it was lower with the ø30-mm tube. There was no significant difference between the filters in a ø22-mm tube. The pressure gradient across the filters when exposed to blood clots ranged from 4.9 - 7.4 mm Hg for the Celect filter and 5.7 - 6.8 mm Hg for the Tulip filter in the single-embolus testing. There was no significant difference in the multi-clot tests. CONCLUSION: The new Celect filter showed similar in-vitro capture properties as the Gunther Tulip filter and deserves further in-vivo testing.

Blood Flow Velocity↗

Endovascular treatment of experimentally induced aneurysms in rabbits using stents: a feasibility study.

Although Guglielmi detachable coil (GDC) systems have been generally accepted for treatment of intracranial aneurysms, primary stenting of aneurysms using porous stents or implantation of coils after stent placement remains experimental. Testing of these new methods requires an animal model which imitates human aneurysms in size, configuration and neck morphology. We assessed in detail the technical requirements of and steps for transfemoral stent treatment of experimentally induced aneurysms at the top of the brachiocephalic trunk in rabbits. We created aneurysms in ten rabbits by distal ligation and intraluminal digestion of the right common carotid artery with elastase. We treated five animals with porous stents alone, and five with stents plus coiling via the meshes of the stent, which permitted dense packing of coils. No complications related to the procedures occurred. In all animals, even in those treated solely with porous stents, total occlusion of the aneurysm was achieved. Our animal model can be suitable for testing the biocompatibility and occlusion rate of new methods and devices for the treatment of experimental aneurysms.

Aneurysm↗

Systematic assessment of difficult-to-treat asthma.

Five per cent of asthmatics remain symptomatic despite high-dose treatment. The aim of the study was to investigate how often such difficult-to-treat asthma is due to intractable asthma, misdiagnosis, non-adherence with therapy, or psychiatric problems. Difficult asthma was defined as persistence of symptoms despite treatment at step 4 of British guidelines or requirement for long-term oral glucocorticoids (step 5). One-hundred patients with a respiratory physician diagnosis of asthma were investigated in a single tertiary respiratory unit in an open and descriptive study. Twelve of the patients studied did not have asthma and a further seven had additional diagnoses. Of the remainder, 55 had an asthma diagnosis confirmed by demonstration of reversible airflow narrowing or peak flow variability, whilst 20 did not. Non-compliance with prednisolone therapy was more frequent in the 55 with confirmed asthma (nine of 18 prescribed oral prednisolone at a dose of > or = 15 mg x day(-1)) and was not detected in the "unconfirmed asthma" group. There were no other significant differences between these groups. A major psychiatric component was detected in 10 patients. Systematic evaluation of difficult asthma is useful as it can identify alternative or additional diagnoses, psychiatric illness or nonconcordance with therapy in a substantial proportion of cases (32% in the present series).

Administration, Oral↗

Bothered by abstraction: the effect of expertise on knowledge transfer and subsequent novice performance.

Although experts should be well positioned to convey their superior knowledge and skill to novices, the organization of that knowledge, and particularly its level of abstraction, may make it difficult for them to do so. Using an electronic circuit-wiring task, the authors found that experts as compared with beginners used more abstract and advanced statements and fewer concrete statements when providing task instructions to novices. In a 2nd study, the authors found that beginner-instructed novices performed better than expert-instructed novices and reported fewer problems with the instructions when performing the same task. In Study 2, the authors found that although novices performed better on the target task when instructed by beginners, they did better on a different task within the same domain when instructed by experts. The evidence suggests that the abstract, advanced concepts conveyed by experts facilitated the transfer of learning between the different tasks.

Adolescent↗

Mechanical delivery of aerosolized gadolinium-DTPA for pulmonary ventilation assessment in MR imaging.

RATIONALE AND OBJECTIVES: To evaluate a new technique with mechanical administration of aerosolized gadolinium (Gd)-DTPA for MR visualization of lung ventilation. METHODS: Ten experimental procedures were performed in six domestic pigs. Gd-DTPA was aerosolized by a small-particle generator. The intubated animals were mechanically aerosolized with the nebulized contrast agent and studied on a 1.5-T MR imager. Respiratory gated T1-weighted turbo spin-echo images were obtained before, during, and after contrast administration. Pulmonary signal intensity (SI) changes were calculated for corresponding regions of both lungs. Homogeneity of aerosol distribution was graded independently by two radiologists. RESULTS: To achieve a comparable SI increase as attained in previous trials that used manual aerosol ventilation, a ventilation period of 20 minutes (formerly 30 minutes) was sufficient. Mean SI changes of 116% were observed after that duration. Contrast delivery was rated evenly distributed in all cases by the reviewers. CONCLUSIONS: The feasibility of applying Gd-DTPA as a contrast agent to demonstrate pulmonary ventilation in large animals has been described before. The results of this refined technique substantiate the potential of Gd-based ventilation MR imaging by improving aerosol distribution and shortening the nebulization duration in the healthy lung.

Aerosols↗

Navi-ball: a new guidance device for CT-directed punctures.

RATIONALE AND OBJECTIVES: A new navigation system (Navi-Ball) for computed tomography (CT)-guided punctures was tested clinically. METHODS: The device consists of a transparent hemisphere with an angular scale. The hemisphere is fluid filled and contains a bubble indicating the angulation. The system works as a circular spirit level. Adapted to the handle of the needle, it allows needle adjustment according to the planned puncture path on the CT image. The system was tested in 36 patients who had 40 procedures. The needle deviation (in relation to the planned course of the needle) was measured in two rectangular planes. RESULTS: Without requiring preparation time, the guidance system allowed rapid and easy performance of the puncture. First-time needle placement in a double-angulated approach led to a deviation of the needle from the planned path ranging from 0.2 degrees to 4.6 degrees (mean 2.1 degrees, SD 1.4 degrees ) in the axial plane and from 0.4 degrees to 4.0 degrees (mean 2.3 degrees, SD 1.2 degrees). CONCLUSIONS: This "low-tech" system offers easy to use guidance by a single operator and provides for adequate accuracy of first-time needle placement.

Equipment Design↗

Aneuploidy frequencies in semen fractions from ten oligoasthenoteratozoospermic patients donating sperm for intracytoplasmic sperm injection.

OBJECTIVE: To determine aneuploidy frequencies in pellet and swim-up semen fractions from 10 infertile men with severe oligoasthenoteratozoospermia (OAT) who were donating sperm for intracytoplasmic sperm injection and to determine whether the swim-up isolation method would successfully separate aneuploid from haploid sperm. DESIGN: Prospective study. SETTING: Infertility clinic and molecular genetics laboratory. PATIENT(S): Ten patients with severe OAT. INTERVENTION(S): Cytogenetic analyses by fluorescence in situ hybridization to determine aneuploidy frequencies for chromosomes 1, 13, 18, 21, X, and Y in sperm from swim-up and pellet fractions. MAIN OUTCOME MEASURE(S): Gametic aneuploidy was scored in sperm fractions separated by the swim-up technique and clinical results after intracytoplasmic sperm injection were tabulated. RESULT(S): In all cases, chromosome aneuploidy levels in patients were significantly greater than in controls. The type and percentage of aneuploid sperm for all patients with OAT found in both swim-up and pellet fractions were not different, with the exception of diploid sperm, which remained in the pellet fraction. After ET, 2 (20%) of 10 couples achieved successful pregnancies. CONCLUSION(S): The data show significantly higher rates of diploidy, autosomal disomy and nullisomy, sex chromosome disomy and nullisomy, and total aneuploidy in sperm from all separated fractions obtained from all patients with OAT versus controls. This patient population with OAT may be at increased risk of producing aneuploid offspring.

Aneuploidy↗

Echocardiography-derived left ventricular end-systolic regional wall stress and matrix remodeling after experimental myocardial infarction.

OBJECTIVES: We tested the hypothesis that regional end-systolic left ventricular (ESLV) wall stress is associated with extracellular matrix remodeling activity after myocardial infarction (MI). BACKGROUND: Increased left ventricular (LV) wall stress is a stimulus for LV enlargement, and echocardiography can be used to estimate regional wall stress. A powerful validation of a noninvasive method of estimating wall stress would be predicting cellular responses after a MI. METHODS: Echocardiographic images were obtained in rats 1, 7, 14 or 21 days after coronary ligation (n = 11) or sham surgery (n = 5). End-systolic left ventricular wall stress was calculated by finite element analysis in three regions (infarcted, noninfarcted and border) from short-axis images. Matrix metalloproteinase-9 (MMP-9) and macrophage density were determined by immunohistochemistry, and positive cells were counted in high power fields (hpf). RESULTS: Average ESLV wall stress was higher in rats with MI when compared to shams irrespective of time point (p < 0.01), and ESLV wall stress in the infarcted regions increased with time (25.1 +/- 5.9 vs. 69.9 +/- 4.4 kdyn/cm2, day 1 vs. 21; p < 0.01). Matrix metalloproteinase-9 expression was higher in infarcted and border regions when compared to noninfarcted regions (22.1 vs. 25.7 vs. 0.10 cells/hpf, respectively; p < 0.01). Over all regions, ESLV wall stress was associated with MMP-9 (r = 0.76; p < 0.001), macrophage density (r = 0.72; p < 0.001) and collagen content (r = 0.67; p < 0.001). End-systolic left ventricular wall stress was significantly higher when MMP-9 positive cell density was greater than 10 cells/hpf (45+/-20 vs. 14+/-10 kdyn/cm2; p < 0.001). CONCLUSIONS: Regional increases in ESLV wall stress determined by echocardiography-based structural analysis are associated with extracellular matrix degradation activity.

Animals↗

G alpha(o) is necessary for muscarinic regulation of Ca2+ channels in mouse heart.

Heterotrimeric G proteins, composed of G alpha and G betagamma subunits, transmit signals from cell surface receptors to cellular effector enzymes and ion channels. The G alpha(o) protein is the most abundant G alpha subtype in the nervous system, but it is also found in the heart. Its function is not completely known, although it is required for regulation of N-type Ca2+ channels in GH3 cells and also interacts with GAP43, a major protein in growth cones, suggesting a role in neuronal pathfinding. To analyze the function of G alpha(o), we have generated mice lacking both isoforms of G alpha(o) by homologous recombination. Surprisingly, the nervous system is grossly intact, despite the fact that G alpha(o) makes up 0.2-0.5% of brain particulate protein and 10% of the growth cone membrane. The G alpha(o)-/- mice do suffer tremors and occasional seizures, but there is no obvious histologic abnormality in the nervous system. In contrast, G alpha(o)-/- mice have a clear and specific defect in ion channel regulation in the heart. Normal muscarinic regulation of L-type calcium channels in ventricular myocytes is absent in the mutant mice. The L-type calcium channel responds normally to isoproterenol, but there is no evident muscarinic inhibition. Muscarinic regulation of atrial K+ channels is normal, as is the electrocardiogram. The levels of other G alpha subunits (G alpha(s), G alpha(q), and G alpha(i)) are unchanged in the hearts of G alpha(o)-/- mice, but the amount of G betagamma is decreased. Whichever subunit, G alpha(o) or G betagamma, carries the signal forward, these studies show that muscarinic inhibition of L-type Ca2+ channels requires coupling of the muscarinic receptor to G alpha(o). Other cardiac G alpha subunits cannot substitute.

Acetylcholine↗

Role of psychological factors in the irritable bowel syndrome.

Our study was designed to test the hypothesis that psychoneurosis in irritable bowel syndrome (IBS) may be the secondary effects of the unsatisfactory nature of the medical transactions (diagnosis, explanation, prognosis, and therapy) in IBS rather than a primary cause of the syndrome. We carried out psychometric assessments on three groups of subjects: 10 healthy volunteers, 12 patients diagnosed as suffering from benign gastrointestinal disease, and 18 patients with IBS. We found a significantly raised incidence of psychoneurosis in IBS, but the components of this were predominantly anxiety and obsession; the incidence of depression in all 3 groups was similar. We argue that the data support our hypothesis that the psychoneurotic manifestations are secondary components of IBS; the data do not support the hypothesis that IBS is a manifestation of depression.

Adult↗

Allosteric stabilization of 3H-N-methylscopolamine binding in guinea-pig myocardium by an antidote against organophosphate intoxication.

W84 (hexamethylene-bis-[dimethyl-(3-phthalimidopropyl)-ammonium bromide]) protects overadditively against an organophosphate-intoxication when applied in combination with atropine. Further experimental evidence led to the hypothesis that W84 exerted an allosteric effect on muscarinic acetylcholine receptors. In order to investigate the action of W84 on the receptor level, binding studies with 3H-N-methylscopolamine were performed in homogenized and intact guinea-pig myocardium. For sake of comparison three bispyridinium oximes were included, i.e. Uno3 (trimethylene-bis-[4-hydroxyiminomethyl-pyridinium] dibromide mono-2,6-dichlorobenzylether), obidoxime, and TMB4. In cardiac membrane suspensions, all compounds inhibited 3H-NMS-binding after 2 hrs of incubation concentration-dependently by reducing its affinity, whereas leaving the number of binding sites unaltered. However, with increasing concentrations W84 suppressed 3H-NMS-binding less than expected for a competitive antagonist. Kinetic studies revealed that W84 did not only slow the association of 3H-NMS, but additionally retarded its dissociation over the entire range of concentrations that inhibited 3H-NMS-binding. At lmM, W84 augmented the half life time of the 3H-NMS-receptor complexes from a control value of 4 min to more than 120 min. The stabilization of the radioligand-receptor complexes is indicative of an allosteric effect of W84. Obidoxime, TMB4 and Uno3 at low concentrations acted like competitive inhibitors of 3H-NMS-binding. From 10(-5)M onwards, Uno3 retarded 3H-NMS-dissociation concentration-dependently. It is concluded that the effect of bisquaternary compounds on 3H-NMS-association and -dissociation is mediated via binding to two separate sites, i.e. the muscarinic receptor site and an allosteric effector site, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Allosteric Regulation↗

Release of N-[3H]methylscopolamine from isolated guinea pig atria is controlled by diffusion and rebinding.

This study attempts to analyze the inter-relationship between the slow fading of muscarinic antagonist action observed in isolated tissue preparations upon washout and the dissociation kinetics at the receptor level. Isolated guinea pig left atria stimulated electrically at 3 Hz were equilibrated with N-[3H]methylscopolamine ([3H]NMS) and the time course of release of [3H]NMS was studied. In parallel experiments, the fading of the antimuscarinic action of NMS was monitored by repeated determinations of the negative inotropic effect of oxotremorine. In comparison, the dissociation of [3H]NMS from muscarinic receptors was recorded in a membrane suspension of guinea pig right atria. Having been equilibrated at 10(-8) M [3H]NMS, the atria released [3H]NMS extremely slowly, when transferred into a drug-free washout bath: not even half of the initially bound [3H]NMS was lost within 3 hr. With a corresponding time course, 10(-8) M oxotremorine regained its negative inotropic action. In contrast, when 10(-4) M unlabeled NMS was present in the washout bath, it took only 5 min for the [3H]NMS binding to fall by 50%. Similarly, in a membrane-suspension of guinea pig right atria, the half-life time of the [3H]NMS receptor complexes amounted to about 5 min. It is concluded that the dissociation of NMS from its receptor sites proceeds with a half-life time of 5 min in intact atria as well as in the cardiac membrane suspension.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Comparative effects of propranolol and nadolol on renal blood flow in normal rats and rats with congestive heart failure.

Mean arterial blood pressure (MAP), heart rate (HR), renal blood flow (RBF), and renal vascular resistance (RVR) were determined before and during an infusion of propranolol (18 mg/kg/hr) or nadolol (30 mg/kg/hr) in anesthetized Munich-Wistar rats with normal cardiac function. Eight rats treated with propranolol had significant reductions in MAP (110 to 98 mm Hg; p less than 0.05) and HR (316 to 242 bpm; p less than 0.01), accompanied by a 24% decrease in RBF (5.9 to 4.5 ml/min; p less than 0.05) and a 22% increase in RVR (19.4 to 23.7 mm Hg/ml/min; p less than 0.05). Although nadolol also reduced MAP (104 to 93 mm Hg; p less than 0.01) and HR (315 to 268 bpm; p less than 0.05) in eight other rats, RBF and RVR remained unchanged from baseline levels. Thus, despite similar decrements in MAP and HR, propranolol decreased renal perfusion, whereas nadolol maintained it in animals with noninfarcted myocardium. These parameters were also evaluated in rats with congestive heart failure induced by myocardial infarction at least 3 weeks prior to their receiving either propranolol (18 mg/kg/hr; n = 6) or nadolol (30 mg/kg/hr; n = 6). In the basal state, rats with congestive heart failure had significantly (p less than 0.05) lower MAP, HR, and RBF and higher (p less than 0.01) RVR compared with control rats. Propranolol and nadolol induced comparable falls (p less than 0.05) in MAP and HR. Whereas RBF tended to fall with propranolol (3.3 to 2.4 ml/min), renal perfusion was well maintained with nadolol (3.4 to 3.8 ml/min).(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists↗