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Biomedical subjects

M Bischoff

Publications and source records attributed to M Bischoff.

At least 19 recordsLinked to original sources

Strain dependence of the cell wall-damage induced stimulon in Staphylococcus aureus.

The vancomycin stress induced transcriptome of the methicillin susceptible Staphylococcus aureus (MSSA) strain Newman was determined by microarray analysis. Subsets of the induced ORFs corresponded to those previously reported to be induced by vancomycin in the methicillin resistant S. aureus (MRSA) strains N315 and JH1, and/or by other cell wall active antibiotics in RN450; while other ORFs appeared to be induced strain specifically in Newman. Northern analyses showed that the induction pathway for several of the ORFs appeared to be altered in a number of clinical NARSA isolates. Induction was found to be dependent on inhibitory concentrations of antibiotics.

Bacterial Proteins↗

Utilizing the ventriloquism-effect to investigate audio-visual binding.

Audio-visual binding - as subset of crossmodal integration - describes the combination of information across both these senses to the subjective unified perception of a bound object. We investigated audio-visual binding by using the ventriloquism-effect (localization of a sound is biased towards and by a simultaneous visual stimulus) to act as an indicator for perceived binding. Simple visual and auditory stimuli were presented synchronously or asynchronously. fMRI was recorded during task performance (n = 19 subjects) in order to reveal activation in areas discussed to be involved in multisensory processing in the literature. Contrasting trials with reported ventriloquism-effect versus the no-binding condition revealed activation in the insula, superior temporal sulcus and parieto-occipital sulcus. Implementing the ventriloquism-effect allows us to relate these activations to consciousness-related processes, which probably are different from stimulus-driven multisensory integration in subcortical areas.

Acoustic Stimulation↗

In vivo survival of teicoplanin-resistant Staphylococcus aureus and fitness cost of teicoplanin resistance.

Glycopeptide resistance, in a set of in vitro step-selected teicoplanin-resistant mutants derived from susceptible Staphylococcus aureus SA113, was associated with slower growth, thickening of the bacterial cell wall, increased N-acetylglucosamine incorporation, and decreased hemolysis. Differential transcriptome analysis showed that as resistance increased, some virulence-associated genes became downregulated. In a mouse tissue cage infection model, an inoculum of 10(4) CFU of strain SA113 rapidly produced a high-bacterial-load infection, which triggered MIP-2 release, leukocyte infiltration, and reduced leukocyte viability. In contrast, with the same inoculum of the isogenic glycopeptide-resistant derivative NM67, CFU initially decreased, resulting in the elimination of the mutant in three out of seven cages. In the four cages in which NM67 survived, it partially regained wild-type characteristics, including thinning of the cell wall, reduced N-acetylglucosamine uptake, and increased hemolysis; however, the survivors also became teicoplanin hypersusceptible. The elimination of the teicoplanin-resistant mutants and selection of teicoplanin-hypersusceptible survivors in the tissue cages indicated that glycopeptide resistance imposes a fitness burden on S. aureus and is selected against in vivo, with restoration of fitness incurring the price of resistance loss.

Animals↗

Accelerated degradation of N, N'-dibutylurea (DBU) upon repeated application.

In a recent study on the degradation of N,N'-dibutylurea (DBU), a breakdown product of benomyl [methyl 1-(butylcarbamoyl)-2-benzimidazole carbamate], the active ingredient in Benlate fungicides, degradation half-lives of 1.4-46.5 days were observed across several soils incubated at various combinations of soil moisture potential (-0.03 and -0.1 MPa) and temperature (23, 33, and 44 degrees C) for a single DBU application of 0.08 and 0.8 microg g(-1) (Lee et al. 2004). However, Benlate can be applied as often as every 7 days resulting in the repeated application of DBU likely to be present in the Benlate over a growing season. In this study, the effect of seven repeated DBU applications on mineralization rate was investigated in two soils, which encompass the range in rates previously observed. For the slower degrading soil, repeated DBU application increased mineralization from 0.029 to 0.99 day(-1) at the 0.08 microg g(-1) rate, and 0.037 to 0.89 day(-1) at the 0.8 microg g(-1) rate. For the faster degrading soil, effects on mineralization of repeated DBU applications were small to negligible. For the latter soil, the effect on mineralization of applied DBU concentrations from 0.0008 to 80 microg g(-1) was also investigated. Mineralization rates decreased from 0.43 to 0.019 day(-1) with increasing DBU concentrations. However, the amount of DBU mineralized by day 70 was similar across concentrations and averaged 83% of applied. Microbial respiration was not affected by increasing DBU concentrations. These findings support the supposition that DBU is readily degraded by soil microorganisms, thus unlikely to accumulate in agricultural soils.

Benomyl↗

[The physics of vacuum therapy].

BACKGROUND: Vacuum therapy is a routine and successful method for wound treatment and for the temporary covering of soft-tissue defects. It is an occlusive method that can be used for treating acute, chronic and infected wounds. To date, no data are available regarding secretion transit times and pressure conditions in lesions treated with vacuum therapy. The present study had as its objectives to examine the mechanisms of vacuum therapy and determine the effects of physical forces on the wound surface with the purpose of formulating recommendations for pressure settings using the various available vacuum pumps. MATERIAL AND METHODS: Using an appropriate model, we measured secretion transit times and pressures using two different vacuum therapy pads. We then conducted pressure measurements during dressing change in eight patients with wound surfaces greater than 20 cm(2). RESULTS: The secretion transit times remained unchanged with the polyvinyl alcohol (PVA) pad and a negative pressure of 40 kPa, but decreased by about 50 % when the black polyurethane (PU) pad was used. Pressure measurements showed that, at this negative pressure, there was only a slight positive external pressure of 31 mmHg on the wound surface. CONCLUSION: When the PVA pad is used, negative pressures greater than 40 kPa should be applied in order to effect a maximum transit of wound secretion and prolongation of the use of the vacuum dressing. When the PU pad is used, the applied negative pressure can be lower due to the pad's larger pores, as recommended by Argenta and Morykwas. An excessive external pressure on the wound surface does not occur.

Biophysical Phenomena↗

Generation of bioaerosols during manual mail unpacking and sorting.

AIMS: The dynamics of bioaerosol generation in specific occupational environments where mail is manually unpacked and sorted was investigated. METHODS AND RESULTS: Total number of airborne particles was determined in four different size classes (0.3-0.5, 0.5-1, 1-5 and >5 microm) by laser particle counting. Time dependent formation of bioaerosols was monitored by culturing methods and by specific staining followed by flow cytometry. Besides handling of regular mail, specially prepared letters ('spiked letters') were added to the mailbags to deliberately release powdered materials from letters and to simulate high impact loads. These letters contained various dry powdered biological and nonbiological materials such as milk powder, mushrooms, herbs and cat litter. Regarding the four size classes, particulate aerosol composition before mail handling was determined as 83.2 +/- 1.0, 15.2 +/- 0.7, 1.7 +/- 0.4 and 0.04 +/- 0.02%, respectively, whereas the composition changed during sorting to 66.8 +/- 7.9, 22.3 +/- 3.6, 10.4 +/- 4.0 and 0.57 +/- 0.27%, respectively. Mail processing resulted in an increase in culturable airborne bacteria and fungi. Maximum concentrations of bacteria reached 450 CFU m(-3), whereas 270 CFU of fungi were detected. CONCLUSIONS: Indoor particle concentrations steadily increased during mail handling mostly associated with particles of diameters >1 microm. However, it was not possible to distinguish spiked letters from nonspiked by simple particle counting and CFU determinations. SIGNIFICANCE AND IMPACT OF STUDY: The dynamics of bioaerosol generation have to be addressed when monitoring specific occupational environments (such as mail sorting facilities) regarding the occurrence of biological particles.

Air Microbiology↗

[Cost effectiveness of intraoperative three-dimensional imaging with a mobile surgical C-arm].

DRGs lead to a new definition of refunding medical treatment. The calculated DRG covers all costs of the individual hospital stay of each patient. Any revision surgery is not refunded separately. Especially in spine surgery and in articular fractures, postoperative X-ray control sometime reveals malposition of implants that later require operative revision. The latter causes additional costs that can be in the range of 50% of the whole refund as shown here for tibia plateau and calcaneus fractures. New intraoperative 3D fluoro techniques provide CT-like images of bones and joints that enable the surgeon to optimize implant positions immediately. Despite higher initial costs as compared to conventional imaging devices, these technologies help to increase process quality in the OR and clearly save costs.

Cost-Benefit Analysis↗

[Diagnostic apparatus in the shock trauma room].

Opinions vary with regard to the equipment and structural furnishings required for adequate management of the trauma patient in the dedicated shock suite. In order to assess the current situation in Germany, we conducted a survey of the 76 centers participating in the Polytrauma Registry of the DGU. Fifty-one questionnaires were returned by centers representing all levels of care. Responses revealed, for example, that not all centers possess capabilities for conventional radiography in the shock suite (7/51). Only 20 centers had a fixed table; the remaining 24 hospitals used either an image converter or a mobile X-ray unit. A dedicated ultrasound scanner was provided for the shock suite in 39 of 51 centers responding. Dedicated computed tomography scanners were provided for the shock suite in only eight centers (one dedicated trauma center, three level 3 centers, four university hospitals). All eight scanners use helical CT technology; at least three of the units are 8- or 16-slice. Of 51 shock suites, 12 are air-conditioned in compliance with sterile criteria (and are officially designated as surgical suites), while the remaining 39 are not. In acute cases, emergency surgeries can be performed in the shock suite in 37 centers, but not in the remaining 14 shock suites. According to the survey, slightly less than half of the hospitals responding are un-satisfied with the shock suite infrastructure ( n=24) and, of these, 13 centers are actively planning changes (the necessary financial resources have been guaranteed in 10 centers). Fourteen centers desire changes but do not currently have the required money. Information provided by Philips and Siemens suggests that the cost of furnishing a new shock suite ranges between 1.4 and 1.7 million euros. Responses to our survey show that a large gap remains between wishes and reality in the technical infrastructure in many shock suites in Germany.

Diagnostic Equipment↗

Vacuum-sealed mesh graft transplantation in chronic cutaneous ulcers of the lower leg.

BACKGROUND: The covering of defects caused by chronic ulcers on limbs affected by peripheral arterial disease or chronic venous insufficiency is often difficult due to extensive secretion and edema, while chronic bacterial contamination of the wound bed further compromises the conditions for successful healing. PATIENTS AND METHODS: Vacuum-sealed dressing (VSD) offers the option of a closed dressing system for moist wound care that assures firm contact with the wound surface and protection against contamination with nosocomial microbes and decontamination of existing bacteria by means of constant drainage of secretion independent of gravity. VSD is particularly useful in difficult wounds featuring extensive secretion and unfavorable localization and offers many advantages over conventional dressing techniques in terms of improved healing of skin transplants. A total of 35 patients with chronic leg ulcers were treated with vacuum-sealed mesh graft transplantation. RESULTS: Complete healing of the mesh graft transplant was observed in 20 patients (57%). Twelve patients (34%) experienced partial healing (75-90%) of the transplant, while three patients exhibited less than 75% healing of the graft and therefore required a second mesh graft transplantation. CONCLUSIONS: VSD is a simple, quick and inexpensive technique that promotes excellent healing of skin transplants. It is particularly useful in difficult wounds with extensive secretion and/or contamination or infection.

Aged↗

[Flat rate reimbursement system for minimally invasive management of unstable vertebral fractures. An analysis of costs and benefits].

Some 30% of unstable vertebral fractures of the thoracic and lumbar spine involve a destruction of the ventral column and thus of the supporting structures of the spine. This requires extensive surgical reconstruction procedures, which are carried out using minimally invasive techniques. The disadvantages of the minimally invasive methods are the high cost, the technical equipment and the expenditure of time required in the initial phase for the performance of the surgical procedure. With the structural reform of the health care system in the year 2000, the private-sector regulatory bodies were called upon to introduce a flat-rate compensation system for hospital services according to section 17b of the Hospital Law (KHG). The previous financing system which involved per-diem operating cost rates has thus been abolished. Calculations of individual entities are now required. Considering the case values to date, a contribution margin deficit of EUR 4628.45 has been calculated for our patients with fractures of the thoracic and lumbar spine without neurological defunctionalization symptoms. An economically efficient medical care is thus no longer possible. Consequently, an adjustment of the German relative weights must urgently be demanded in order to guarantee a high-quality medical care of patients.

Cost Control↗

[Analysis of the incidence and causes of mass casualty events in a southern Germany medical rescue area].

UNLABELLED: The growing number of mass casualty events during the early 1990s led, in January 1996, to the foundation of an honorary group of specially trained emergency physicians for dealing primarily with the management of large-scale emergency events and mass casualties. The incidence and quantity of these casualties was analysed in order to be better prepared for such events in the future. METHODS: All calls prospectively registered by the Augsburg Rescue Co-ordination Centre (ARCC) in the 5 years from July 1997 to June 2002 were analysed, distinguishing between the different types of damage, number of patients involved, and time of occurrence (time of day/season). The area served by the ARCC includes the city of Augsburg with its surrounding counties. An estimated 850,000 inhabitants live in this area of 4,100 square kilometers (1,600 square miles). Since 1998, more than 145,000 calls a year have been dealt with of which 28,000 were covered by emergency physicians. In the 5 year period discussed here, 75 large-scale-calls were registered, giving an average incidence of 1.25 calls/month. Most of the calls were fire alarms, followed by car accidents. In total, we were able to serve more than 800 patients. The lowest number per event was two people during an emergency landing of a sport aircraft; the largest number was about 150 patients during a large open-air event in the city. While there was no difference in the time of day at which the event happened, most occurred in November and December. Taking these results into account, the authors, supported by the members of the emergency physician team of the German Trauma Society, developed an algorithm describing the optimal procedure for mass casualty events. This is presented here. In mass casualty or large-scale emergency events, an experienced emergency physician is necessary to co-ordinate the rescue brigades on site.

Algorithms↗

Association of microbial community composition and activity with lead, chromium, and hydrocarbon contamination.

Microbial community composition and activity were characterized in soil contaminated with lead (Pb), chromium (Cr), and hydrocarbons. Contaminant levels were very heterogeneous and ranged from 50 to 16,700 mg of total petroleum hydrocarbons (TPH) kg of soil(-1), 3 to 3,300 mg of total Cr kg of soil(-1), and 1 to 17,100 mg of Pb kg of soil(-1). Microbial community compositions were estimated from the patterns of phospholipid fatty acids (PLFA); these were considerably different among the 14 soil samples. Statistical analyses suggested that the variation in PLFA was more correlated with soil hydrocarbons than with the levels of Cr and Pb. The metal sensitivity of the microbial community was determined by extracting bacteria from soil and measuring [(3)H]leucine incorporation as a function of metal concentration. Six soil samples collected in the spring of 1999 had IC(50) values (the heavy metal concentrations giving 50% reduction of microbial activity) of approximately 2.5 mM for CrO(4)2- and 0.01 mM for Pb2+. Much higher levels of Pb were required to inhibit [14C]glucose mineralization directly in soils. In microcosm experiments with these samples, microbial biomass and the ratio of microbial biomass to soil organic C were not correlated with the concentrations of hydrocarbons and heavy metals. However, microbial C respiration in samples with a higher level of hydrocarbons differed from the other soils no matter whether complex organic C (alfalfa) was added or not. The ratios of microbial C respiration to microbial biomass differed significantly among the soil samples (P < 0.05) and were relatively high in soils contaminated with hydrocarbons or heavy metals. Our results suggest that the soil microbial community was predominantly affected by hydrocarbons.

Bacteria↗

First steps in the phytochrome phototransformation: a comparative femtosecond study on the forward (Pr --> Pfr) and back reaction (Pfr --> Pr).

The primary light-induced events in the reversible Pr right harpoon over left harpoon Pfr phototransformation are investigated by femtosecond absorption spectroscopy using a pump-probe technique. After the selective electronic excitation of Pr and Pfr with pulses at 610 and 730 nm, respectively, the transient absorption spectra were measured as a function of the delay time and subjected to a global fit analysis. As a result of this analysis, the decay-associated spectra of the kinetic components involved in the formation of the first photoproducts in the forward and back reaction are obtained. These spectra provide a more detailed understanding of the primary stages in the light-induced transformations. In addition, the influence of the solvent viscosity on the initial reaction steps was studied. In each direction of reaction, a short-lifetime component is found to be strongly viscosity-dependent, indicating that the primary photochemistry encompasses intramolecular motions of the chromophore or its proximal amino acid side chains. H-D exchange has no significant effect on the kinetics of the initial photoprocesses. This suggests that the isomerization reaction in both directions is not accompanied by a rate-limiting proton transfer.

Avena↗

Involvement of multiple genetic loci in Staphylococcus aureus teicoplanin resistance.

Teicoplanin resistance was transformed from a teicoplanin-resistant Staphylococcus aureus into the susceptible strain BB255 to give strain BB938. The cell wall composition, amidation of the iD-glutamate, and peptide crosslinking were identical in BB938 as in BB255 except for a 60% increased length of the glycan chain. Transductional crosses revealed that at least two distinct loci contributed in a cumulative fashion to teicoplanin resistance. One of these loci correlated with a mutation inactivating the anti-sigma factor RsbW. This mutation must have occurred during transformation and selection for teicoplanin resistance in BB938. Genetic manipulations involving the sigB operon showed that transcription factor SigB contributed to decreased teicoplanin susceptibility.

Animals↗

[Endoprosthesis in medial femoral neck fractures].

UNLABELLED: Alloarthroplasty of the hip joint in the elderly has improved significantly the outcome of femoral neck fractures. The indication for a hip replacement is based on the biological age of the patient and the type of fracture. In our hospital in a 5-years period (1996-2000) we treated operatively 305 patients with femoral neck fractures (248 medial, 57 lateral). Of these, 239 patients received a endoprosthesis (190 total hip joint replacements, 49 hemialloarthroplasty). The other 66 patients (most of them younger patients) were treated by osteosynthesis. The complication rate of the endoprosthetic hip replacement was low; five hematoma/seroma and two deep infections had to be treated operatively. In 21 patients (8.79%) we saw hip luxation; 17 could be treated by closed and four by open reduction. Reluxation was found in nine of these 21 patients. Only two patients (both over 80 years old) died between the first 2 postoperative weeks. Eighty percent of the patients were able to walk, half of them alone or with help outside their homes. Fifteen percent of the patients could be mobilized in a wheel chair; only 5% were confined to bed. CONCLUSION: For the treatment of femoral neck fractures in older patients, the cemented hip endoprosthesis is the method of choice.

Adult↗

Feasibility and safety of peripheral blood stem cell transplantation from unrelated donors: results of a single-center study.

We compared the outcomes in patients receiving unrelated peripheral blood stem cell transplants (PBSCT) with those receiving bone marrow transplants (BMT) in a matched pair analysis. Seventy-four patients with hematological malignancies with HLA-matched (77%) and mismatched (23%) donors were analyzed in this study. Thirty-four patients (45%) were considered as high risk patients. Sixty-eight patients received standard conditioning regimens with Bu/Cy or TBI/Cy. Six patients received an intensified conditioning regimen with the addition of etoposide, thiotepa or melphalan. GVHD prophylaxis consisted of prednisolone, cyclosporine and methotrexate. Groups were matched for patient, donor, transplant characteristics and HLA compatibility. Peripheral blood stem cell collection led to the collection of a higher number of CD34+ and CD3+ cells in comparison to bone marrow collection. Leukocyte engraftment in the PBSCT group occurred in 14 days (median; range 6-26 days) and in the BMT group in 19 days (range 9-29 days; P < 0.02). The time of platelet engraftment did not differ significantly. The incidence of grades II-lV acute GVHD in the group of HLA-identical patients was 35% in the PBSCT group and 25% in the BMT group (P < 0.33, log-rank). However, there was a significant difference (P < 0.05, log-rank) in incidence and time to onset of acute GVHD II-IV comparing all patients, including the 17 mismatched transplants. Disease-free survival was 51% (19 patients) with a median of 352 days and 59% (21 patients) with a median of 760 days for PBSC and BMT transplants, respectively. In conclusion, our results indicate that allogeneic PBSCT led to significantly faster leukocyte engraftment but is associated with a higher incidence and more rapid onset of severe acute GVHD comparing all patients, including the 17 mismatched transplants. However, the incidence of severe acute GVHD in HLA-identical patients was not different between the PBSCT and BMT groups.

Adolescent↗

Molecular characterization of tomato 3-dehydroquinate dehydratase-shikimate:NADP oxidoreductase.

Analysis of cDNAs encoding the bifunctional 3-dehydroquinate dehydratase-shikimate:NADP oxidoreductase (DHQase-SORase) from tomato (Lycopersicon esculentum) revealed two classes of cDNAs that differed by 57 bp within the coding regions, but were otherwise identical. Comparison of these cDNA sequences with the sequence of the corresponding single gene unequivocally proved that the primary transcript is differentially spliced, potentially giving rise to two polypeptides that differ by 19 amino acids. Quantitative real-time polymerase chain reaction revealed that the longer transcript constitutes at most 1% to 2% of DHQase-SORase transcripts. Expression of the respective polypeptides in Escherichia coli mutants lacking the DHQase or the SORase activity gave functional complementation only in case of the shorter polypeptide, indicating that skipping of a potential exon is a prerequisite for the production of an enzymatically active protein. The deduced amino acid sequence revealed that the DHQase-SORase is most likely synthesized as a precursor with a very short (13-amino acid) plastid-specific transit peptide. Like other genes encoding enzymes of the prechorismate pathway in tomato, this gene is elicitor-inducible. Tissue-specific expression resembles the patterns obtained for 3-deoxy-D-arabino-heptulosonate 7-phosphate synthase 2 and dehydroquinate synthase genes. This work completes our studies of the prechorismate pathway in that cDNAs for all seven enzymes (including isozymes) of the prechorismate pathway from tomato have now been characterized.

3' Untranslated Regions↗