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Biomedical subjects

M A Kessler

Publications and source records attributed to M A Kessler.

At least 19 recordsLinked to original sources
PubMed2007

[Development of a questionnaire for patient self-assessment of shoulder function based on the Rowe score].

BACKGROUND: A questionnaire for patient self-assessment of shoulder function was designed. It was based on the internationally accepted Rowe score. METHOD: Explanations and photographs were added to the various parameters to make them easier to understand for the patients. A total of 95 patients completed the assessment form. The validity was tested by a correlation analysis comparing the questionnaire with the original score. RESULTS: The questionnaire demonstrated a reproducible and significant (p<0.001), very high correlation (r>0.9) in the overall results and a moderate to very high correlation within single parameters (r>0.68). CONCLUSION: Based on these results, it can be concluded that a valid and reproducible assessment of the original score is possible with the new questionnaire. Self-evaluation allows reliable assessment which is not dependent on the examiners or location, resulting in a higher number of patients reachable for follow-up studies.

Adolescent↗
PubMed2007

The SLAP lesion as a reason for glenolabral cysts: a report of five cases and review of the literature.

INTRODUCTION: Cysts in the spinoglenoidal or supraglenoidal incisura can be a cause of compression of the suprascapular nerve. There is agglomerated appearance of these cysts in combination with SLAP lesions. Hypothesis is SLAP lesions can lead to cysts in this region and should be repaired. MATERIAL AND METHODS: MRI of five patients (all male, four 30-40 years, one 75 years) showed cysts in the supralabral region. All were in combination with lesions of the superior glenoidal labrum (Type II or more). RESULTS: In two cases, in addition to cyst resection, the SLAP lesion was also repaired and symptoms disappeared completely and no recurrent cyst was detected in postoperative MRI. Two patients without SLAP repair showed recurrent cystic formation in MRI with similar complaints compared to their preoperative status. One patient (75 years) was treated primarily by puncture and afterwards with open resection of the cyst. His outcome was good in terms of activities of daily living without major pain. CONCLUSIONS: Our results are based on the assumption that cysts in the region of the spinoglenoidal/supraglenoidal incisura can originate from SLAP lesions. If a patient is suspected of having cysts in this region, the question of a SLAP lesion should be clarified. SLAP lesions should be repaired to avoid relapse. Arthroscopic repair of SLAP lesion can lead to the disappearance of symptoms in younger patients. In older patients puncture or resection of the ganglion alone may be an adequate therapeutic strategy.

Adult↗
PubMed2006

Tunnel placement in anterior cruciate ligament (ACL) reconstruction: quality control in a teaching hospital.

Correct placement of the femoral and tibial bone tunnels is decisive for a successful anterior cruciate ligament (ACL) reconstruction. Our method of tunnel placement was evaluated as part of quality control at a teaching hospital. The emphasis was placed mainly on investigating the influence of surgical experience on tunnel placement, and the effect of tunnel position on the clinical outcome. Seventeen surgeons with different levels of experience (between 0 and >150 ACL reconstructions) performed endoscopic ACL repair in uniform technique from August 2000 to August 2003 on 50 patients (18 women, 32 men, age range 18-43 years). The patients were available to clinical and radiological follow-up after an average of 19 months. The clinical outcome was classified according to the International Knee Documentation Committee (IKDC) standard evaluation form. The femoral tunnel was evaluated according to the quadrant method of Bernard and Hertel; the position of the tibial bone tunnel was assessed according to the criteria of Stäubli and Rauschnig. The IKDC score revealed 47 (94%) patients with a normal (A) or nearly normal (B) knee joint at follow-up. According to the quadrant method, the femoral canal was situated on average at 29% in the saggital plane. The tibial tunnel was situated on average at 43% of the a.p. diameter of the tibial condyle. Statistical analysis of our data showed no significant correlation between tunnel placement and surgical expertise. However, a highly significant correlation was found (alpha<0.01) between the femoral position of the tunnel in the sagittal plane and the IKDC score. The more anterior the femoral canal, the poorer the IKDC score. The method of tunnel placement in ACL reconstruction being investigated here only showed slight dependence on surgical experience, whereby good short-term clinical outcomes were achieved. Therefore, the method is suitable for application at a teaching hospital. A far too anterior femoral tunnel placement will probably lead to a decline in the clinical result.

Adult↗
PubMed2003

Self-organization of sorted patterned ground.

Striking circular, labyrinthine, polygonal, and striped patterns of stones and soil self-organize in many polar and high alpine environments. These forms emerge because freeze-thaw cycles drive an interplay between two feedback mechanisms. First, formation of ice lenses in freezing soil sorts stones and soil by displacing soil toward soil-rich domains and stones toward stone-rich domains. Second, stones are transported along the axis of elongate stone domains, which are squeezed and confined as freezing soil domains expand. In a numerical model implementing these feedbacks, circles, labyrinths, and islands form when sorting dominates; polygonal networks form when stone domain squeezing and confinement dominate; and stripes form as hillslope gradient is increased.

Journal Article↗
PubMed2003

[Reconstruction of big rotator cuff ruptures. A new technique of tendon refixation with the corkscrew suture anchor system].

Tendon retraction and fatty degeneration is a major problem in repair of massive rotator cuff tears. Especially in the transosseous refixation technique, a tension-free refixation cannot be obtained in all cases. The purpose of this prospective study was to evaluate the postoperative results using a new tension-free reinsertion technique with a Corkscrew suture anchor system. Thirty patients (25 males, 5 females) with complete one and two tendon tears underwent open rotator cuff repair (rupture of one tendon: n=14, 47%). The torn tendons were mobilized and reinserted medially to reduce tension. Medialization was achieved by inserting tendon near the osteochondral border in a bony trough. The number of implanted suture anchors ranged from 2 to 6 (mean: 3.56). The mean age was 56 years (39-68 years) with a follow-up of 24 months (17-33 months). In one patient physical and sonographic examination showed a complete and in two patients a partial rerupture. A temporarily frozen shoulder occurred in two cases. No infection or rejection response was seen. In no case was revision surgery necessary. No displacement or loosening of the Corkscrew anchors was noticed. The constant score improved from 45 points preoperatively to 85 points at the time of follow-up (mean). The Corkscrew suture anchor system in combination with the new suture technique offers the possibility of a stable reinsertion even in reduced calcified bone structure. This facilitates good conditions for stable fibroblastic healing. Our midterm results show good osseous union combined with a low rerupture rate.

Adult↗
PubMed2003

[SLAP lesions as a cause of posterior instability].

SLAP lesions disrupt the perilabral architecture, but so far there have been no reports about posterior instability due to SLAP lesions. In a prospective study of 30 patients with recurrent posterior instability, we found SLAP lesions as a reason for instability in three cases. The purpose of this study is to point out that SLAP lesions can be a cause of posterior instability. Thirty patients with clinical posterior shoulder instability underwent diagnostic arthroscopy before operative stabilization procedures, three of whom (three males, aged 29-51 years) showed a SLAP lesion (once case each of types II, III, and IV) as a cause of posterior instability. All three patients had a history of a fall on the outstretched arm. All patients underwent arthroscopic refixation of the labrum. After arthroscopic refixation of the SLAP lesions, two patients were completely stable (SLAP II and III), whereas one patient (SLAP IV) reported microinstability during overhead activity but complete stability during activity of daily living. The same patient complained about moderate pain in extreme external-flexion rotation with slightly reduced range of motion in external-flexion position. All other patients were free of pain and showed free range of motion. Our results demonstrate that SLAP lesions can be a cause for posterior shoulder instability. In our cases, posterior shoulder instability caused by SLAP lesions was successfully treated by arthroscopic refixation of the torn biceps anchor. When treating posterior shoulder instability, SLAP lesions should be taken into account.

Adult↗
PubMed2001

[Diagnosis of lung embolism with multislice spiral CT].

In recent years CT has been established as the method of choice for the diagnosis of central pulmonary embolism to the level of the segmental arteries. The key advantage of CT over competing modalities is the reliable detection of relevant alternative or additional disease causing the patient's symptoms. Although the clinical relevance of isolated peripheral emboli remains unclear, the alleged poor sensitivity of CT for the detection of such small clots has to date prevented the acceptance of CT as the gold standard for diagnosing pulmonary embolism. With the advent of multislice CT we can now cover the entire chest of a patient with 1-mm slices within one breath-hold. In comparison with thicker sections the detection rate of subsegmental emboli can be significantly increased with 1-mm sections. In addition the interobserver correlation which can be achieved with 1-mm sections by far exceeds the reproducibility of competing modalities. Meanwhile use of multislice CT for a combined diagnosis of pulmonary embolism and deep venous thrombosis with the same modality appears to be clinically accepted. In the vast majority of patients who receive a combined thoracic and venous multislice CT examination the scan either confirms the suspected diagnosis or reveals relevant alternative or additional disease. The therapeutic regimen is usually chosen based on the functional effect of embolic vascular occlusion. With the advent of fast CT scanning techniques, also functional parameters of lung perfusion can be non-invasively assessed by CT imaging. These advantages let multislice CT appear as an attractive modality for a non-invasive, fast, accurate and comprehensive diagnosis of pulmonary embolism, its causes, effects and differential diagnoses.

Humans↗
PubMed2001

Multislice CT imaging of pulmonary embolism.

In recent years CT has been established as the method of choice for the diagnosis of central pulmonary embolism (PE) to the level of the segmental arteries. The key advantage of CT over competing modalities is the reliable detection of relevant alternative or additional disease causing the patient's symptoms. Although the clinical relevance of isolated peripheral emboli remains unclear, the alleged poor sensitivity of CT for the detection of such small clots has to date prevented the acceptance of CT as the gold standard for diagnosing PE. With the advent of multislice CT we can now cover the entire chest of a patient with 1-mm slices within one breath-hold. In comparison with thicker sections, the detection rate of subsegmental emboli can be significantly increased with 1-mm slices. In addition, the interobserver correlation which can be achieved with 1-mm sections by far exceeds the reproducibility of competing modalities. Meanwhile use of multislice CT for a combined diagnosis of PE and deep venous thrombosis with the same modality appears to be clinically accepted. In the vast majority of patients who receive a combined thoracic and venous multislice CT examination the scan either confirms the suspected diagnosis or reveals relevant alternative or additional disease. The therapeutic regimen is usually chosen based on the functional effect of embolic vascular occlusion. With the advent of fast CT scanning techniques, also functional parameters of lung perfusion can be non-invasively assessed by CT imaging. These advantages let multislice CT appear as an attractive modality for a non-invasive, fast, accurate, and comprehensive diagnosis of PE, its causes, effects, and differential diagnoses.

Humans↗
PubMed2000

SmMAK16, the Schistosoma mansoni homologue of MAK16 from yeast, targets protein transport to the nucleolus.

The SmMAK16 gene from Schistosoma mansoni was cloned by chance when an adult worm cDNA library was probed with antiserum to affinity-purified S. mansoni GSH S-transferases. SmMAK16 encodes a hydrophilic protein of 259 amino acids with a molecular mass of 31 kDa. The protein shares 43% sequence identity and 66% similarity to the nuclear protein MAK16 of Saccharomyces cerevisiae that has been implicated both in cell cycle progression and biogenesis of 60S ribosomal subunits. Both proteins display a similar degree of sequence similar to the hypothetical protein CeMAK16 from Caenorhabditis elegans. These proteins share a number of apparent protein motifs, including two nuclear localization signals (NLS), multiple sites for phosphorylation by protein kinase CK2 and four conserved cysteine residues that resemble a zinc binding domain. SmMAK16 mRNA is more highly expressed in adult female worm than males. Recombinant SmMAK16 was phosphorylated by human protein kinase CK2. When chimeric constructs containing SmMAK16 fused the green fluorescent protein (GFP) were transiently transfected into COS-7s cells, the reporter was localized not in nuclei, but exclusively in nucleoli. The yeast and nematode homologues were likewise able to direct nucleolar accumulation of the fluorescent reporter. The high degree of sequence conservation together with the ability to direct nucleolar protein transport supports the hypothesis that MAK16 proteins play a key role in the biogenesis of 60S subunits.

Amino Acid Sequence↗
PubMed1997

Regulation of interleukin (IL)-1alpha, IL-1beta, and IL-6 expression by growth hormone and prolactin in bovine thymic stromal cells.

Growth hormone (GH) and prolactin (PRL) have been implicated in T-cell development, but relatively little is known about the mechanism(s) of their actions on the multiple cell types in this complex tissue. Here, we investigated the effects of GH and PRL on the expression of interleukin (IL)-1alpha, IL-1beta and IL-6 in thymic stromal cells (TSC). These cytokine mRNAs were increased by GH, PRL and placental lactogen (PL) in primary cultures prepared from mid-gestational fetuses in a dose-dependent manner. IL-1 receptor antagonist (IL-1ra) abolished the hormone-induced IL-6 expression, suggesting that the induction of IL-6 was secondary to IL-1 activity. To examine the effects of these hormones on an individual cell type and develop a system in which signalling mechanisms can be studied, we generated immortalized cell lines using a strategy of conditional transformation. In the cell line, TSC-936, which displayed vimentin-positive staining and morphological characteristics of mesenchymal cells, both GH and PRL increased levels of steady-state mRNAs for IL-1alpha and IL-1beta. Nuclear run-on analysis revealed that the transcription rate of the IL-1beta gene was significantly increased by GH and PRL at 30 and 60 min, respectively, but that for IL-1alpha was not significantly changed, suggesting the possibility of an alternative mechanism mediating this response. These data suggest that modulation of cytokine gene expression is one mechanism by which GH and PRL facilitate thymic development and T-cell maturation.

Animals↗
PubMed1997

Purification and properties of placental prolactin-related protein-I.

We used sucrose density gradient centrifugation, size exclusion chromatography, and high-pressure reversed-phase chromatography in the purification of bovine prolactin-related protein-I (bPRP-I) to homogeneity from a secretory granule-enriched fraction of fetal cotyledon. Amino terminal sequence was unambiguous, consistent with the nucleic acid sequence of the cDNA 50 codons distal to the initial AUG in the open reading frame, and began with the residues: RKSFTDRFMNAASLSHDFY. This is distinct from the signal peptide cleavage site predicted by the algorithm of von Heijne (1986) as well as that expected by comparison with other members of the growth hormone/prolactin family of hormones. The level of bPRP-I in uterine fluid was sufficient to detect by Western blot of unfractionated material and estimated as at least 0.65 microM. In contrast, bPRP-I was undetectable in the serum by this method. Interaction of [125I]-bPRP-I with high molecular weight serum components interfered with its measurement by radio-immunoassay, and could be replicated with purified alpha 2-macroglobulin with an apparent KD of about 0.41 microM. Thus, the bPRP-I gene product is processed secreted and distributed in a manner consistent with a paracrine action at the materno-fetal interface.

Amino Acid Sequence↗
PubMed1997

Prolactin receptor heterogeneity in bovine fetal and maternal tissues.

Study of diverse PRL actions at a variety of fetal and maternal targets during pregnancy is complicated by receptor heterogeneity and multiple ligands circulating at this time. In the present studies, we have examined PRL receptors at a variety of potential targets by reverse transcription-PCR and Western analysis. Bovine tissues contain two different transcripts for the PRL receptor; the one that encodes a short form includes an additional 39 bases at a position identical to the deviation from the long form found in rodents and sheep. Western analyses of PRL receptors in microsomal fractions from various maternal and fetal tissues revealed considerable size heterogeneity. Collectively, the larger immunoreactive moieties (apparent Mr 100 kDa or greater) and the smaller species (47-55 kDa) correlated well with the relative abundance of the transcripts for the different forms of the receptor and varied considerably among tissues. N-Glycosylation was shown to be the major, but not the only, modification of both receptor forms when transiently transfected into COS-7 and END-6.2 cells. Much of the short form could be reduced to the mobility predicted from the complementary DNA by culture with tunicamycin; this was not true of the long form, suggesting modifications specific for its cytoplasmic domain. Differences in the pattern of immunoreactive species in the COS-7 and END-6.2 cells are consistent with cell-specific modifications. The ability of these receptor forms to mediate a transcriptional response to PRL and its placental relative, placental lactogen, was evaluated with a PRL response element inserted upstream from a thymidine kinase promoter/reporter gene construct transiently transfected into CHO-K1 cells. Both hormones were able to stimulate reporter gene expression through the long form, but not the short form, of the receptor. These studies will facilitate examination of tissue-specific actions of PRL and related hormones during pregnancy.

Amino Acid Sequence↗
PubMed1997

Microalbuminuria and borderline-increased albumin excretion determined with a centrifugal analyzer and the Albumin Blue 580 fluorescence assay.

We report a new automated fluorescence assay for determination of albumin in urine. The dye Albumin Blue 580 specifically binds to albumin with exhibition of strong red fluorescence. The albumin concentration is calculated from emission intensity at 616 nm (excitation at 590 nm) and a calibration curve. Two Cobas Fara programs cover working ranges of 2-200 and 1-50 mg/L with detection limits of 1.4 and 0.4 mg/L, respectively. Within-run CVs (n = 10) ranged from 1.7% (189 mg/L) to 8.9% (7.2 mg/L) for 2-200 mg/L and from 2.9% (43.3 mg/L) to 5.7% (2.3 mg/L) for the 1-50 mg/L range. A test of urine samples (n = 100) submitted to routine analysis gave results that agreed well with those by the Behring nephelometric assay: AB 580 = 0.922 (+/-0.010) BNA + 4.16 (+/-0.78). No interference was detected from other urine components, including several proteins and 46 drugs. The high specificity and sensitivity make the method ideal for determination of microalbuminuria. In addition, the method is fast, inexpensive, and well-suited for clinical laboratory application and thus may be used instead of immunoassays.

Albumins↗
PubMed1992

Laser-induced fluorometric determination of albumin using longwave absorbing molecular probes.

A novel fluorescence assay for HSA is described. It is based on longwave-absorbing probes that selectively bind to HSA to form fluorescent complexes. The two probes reported here (Albumin Blue 633 and Albumin Blue 670) are tailored to match the lines of the 633-nm HeNe laser and the 670-nm diode laser, respectively. In both cases, the strong laser-induced fluorescence of the HSA/probe complexes makes the assay sensitive to HSA at trace levels. Detection limits of 0.2 mg/liter were obtained. In addition to its sensitivity, the assay is highly selective for HSA in that the response to other serum proteins is weaker by a factor of at least 100. It also works well on urine, and no significant interferences could be located. Potential interferents are bovine serum albumin and some detergents. Parameters of the probe--HSA interaction were obtained from a Scatchard evaluation. The high specificity and sensitivity of the assay are discussed in terms of molecular geometry of the probes. A photophysical mechanism that leads to the effect is proposed. The assay presents a promising alternative to immunological determinations of HSA since it is less expensive and much more quickly performed.

Albuminuria↗
PubMed1992

Molecular cloning of the bovine prolactin receptor and distribution of prolactin and growth hormone receptor transcripts in fetal and utero-placental tissues.

We have isolated a bovine prolactin (bPRL) receptor cDNA from an endometrial cDNA library, which predicts a 557 amino acid transmembrane protein similar to the long forms of other characterized prolactin receptors. The predicted cytoplasmic domain is slightly truncated primarily by a stop codon located 36 codons 5' from the stop utilized in the human hepatic transcript. When expressed in COS cells, this cDNA was shown to encode a protein which bound bovine placental lactogen (bPL) and bPRL with nearly equal affinity (KD for bPL, 2.03 x 10(-10) M; bPRL, 3.07 x 10(-10) M). Northern analysis demonstrated multiple transcripts, with maternal liver, corpus luteum, intestine, endometrium and fetal liver containing a major transcript of about 3.8 kb, and maternal corpus luteum and endometrium, a second sized transcript of apparently equal abundance of 4.4 kb. This difference did not appear to be within the coding region. Primer extension analysis of maternal hepatic and endometrial transcripts revealed considerable heterogeneity. Examination of the distribution of prolactin and growth hormone receptor transcripts at mid-pregnancy by semi-quantitative reverse transcriptase polymerase chain reaction showed that both are widespread in bovine fetal and placental tissues. This isolation of bovine prolactin receptor cDNA, and description of receptor distribution will facilitate study of the action of the placental and pituitary members of this gene family during pregnancy.

Amino Acid Sequence↗
PubMed1992

Nonimmunological assay of urinary albumin based on laser-induced fluorescence.

We describe the first nonimmunological assay of albumin in urine with a detection limit of 1 mg/L. The method is simple, rapid, and accurate. It is based on the probe Albumin Blue 670, which becomes highly fluorescent on binding to albumin. An inexpensive diode laser was used as the light source for measurement of laser-induced fluorescence. The assay was coupled to a flow-injection analysis system capable of running 20 samples per hour. The working range was 1-100 mg/L, which covered albumin concentrations found in nonpathological urine and in urine with slightly increased albumin. This range makes prediction of nephropathy possible at an early stage. Other serum proteins and hemoglobin do not interfere. The coefficients of variation were < 4% and < 7% within one day and from day to day, respectively. A correlation coefficient of 0.990 (n = 100) was obtained for comparison with the Behring nephelometric assay.

Albuminuria↗
PubMed1991

Structure of the bovine placental lactogen gene and alternative splicing of transcripts.

Preliminary evidence for heterogeneity among bovine placental lactogen (bPL) transcripts prompted characterization of additional cDNA clones and isolation of the bPL gene. Nucleotide replacements were detected among sequenced cDNAs isolated from different animals at a total of 11 positions. Four of these predict amino acid substitutions, which are generally conservative in nature. In addition, truncated forms of bPL are predicted by the sequences of two cDNAs in which alternative splicing is evident. In one case, exon III is deleted with no effect on reading frame. However, in the other instance, a shifted reading frame resulting in a novel carboxyl terminus is generated by use of an alternative 5' splice donor site within exon IV. Nuclease protection analysis demonstrated that these variant transcripts comprise about 13% of the total bPL mRNA present in the midgestation placenta. Characterization of the bPL gene revealed that it is similar in structure to other members of this gene family. Sequence analysis demonstrated that the 5'-flanking region of the bPL gene has diverged considerably from the bovine prolactin and growth hormone genes, but shares homology with the previously characterized gene corresponding to bovine prolactin-related cDNAI (bPRCI). Primer extension as well as nuclease protection analysis indicated that a single transcription start site was utilized in the fetal placenta at midgestation. Exact matches to the consensus sequences for response elements for thyroid hormone and transcription factor AP-2 were located 50 and 70 bp, respectively, upstream from the transcription start site in cloned genomic 5'-flanking sequences. We conclude that the bovine placenta may express more than a single placental lactogen product, raising the possibility of alternative hormones with distinct biological properties, and that the bPL gene may share regulatory elements with the gene for the distinct prolactin-related product, bPRCI, based on similarities in the 5' regions of the corresponding genes.

Amino Acid Sequence↗