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Biomedical subjects

M Kern

Publications and source records attributed to M Kern.

At least 37 records · Page 2Linked to original sources

Stimulatory and inhibitory effects of inorganic lead on calcineurin.

Calcineurin is a phosphatase with activity dependent on both Ca(2+)/calmodulin binding to the catalytic A subunit and Ca(2+) binding to the regulatory B subunit. We have previously shown that Pb(2+) activates calmodulin with a threshold of about 100 pM free Pb(2+), and that Pb(2+) and Ca(2+) are roughly additive in calmodulin activation (Kern et al., NeuroToxicology 21, 353-364 (2000)). In the present study, we evaluated the effects of Pb(2+), with and without Ca(2+) and calmodulin, on calcineurin activity. In calmodulin-containing, Ca(2+)-free solutions, Pb(2+) activated calcineurin with a threshold of about 100 pM free Pb(2+). Maximum calcineurin activity (comparable to that induced by 10 microM Ca(2+)) was reached at about 200 pM free Pb(2+). Higher Pb(2+) concentrations reduced activity, although some activity remained even at 2000 pM free Pb(2+). Combined with subsaturating Ca(2+) concentrations, as little as 20 pM free Pb(2+) enhanced calcineurin activity, but free Pb(2+) concentrations greater than 200 pM still reduced activity below maximum. Extremely high Ca(2+) concentrations (10 microM) completely reversed the inhibition of activity by 2000 pM free Pb(2+). In the absence of calmodulin, Ca(2+) slightly stimulated calcineurin activity. Pb(2+) did not substitute for Ca(2+) in calmodulin-free activation; in fact, high concentrations of Pb(2+) inhibited Ca(2+)-mediated activation. We tentatively conclude that low concentrations of free Pb(2+) activate calcineurin by activating calmodulin. Higher concentrations reduce calcineurin activity, perhaps by binding to the B subunit.

Calcineurin↗

Effect of cholesterol-lowering therapy on coronary endothelial vasomotor function in patients with coronary artery disease.

BACKGROUND: Improved endothelial function may contribute to the beneficial effects of cholesterol-lowering therapy. METHODS AND RESULTS: In this randomized, double-blind study, we compared the effect of 6 months of simvastatin (40 mg/d) treatment with that of placebo on coronary endothelial vasomotor function in 60 patients with coronary artery disease. Simvastatin lowered LDL-cholesterol by 40+/-12% from 130+/-28 mg/dL (P<0.001). Peak intracoronary acetylcholine infusion produced epicardial coronary constriction at baseline in both the simvastatin (-17+/-13%) and placebo (-24+/-16%) groups. After treatment, acetylcholine produced less constriction in both groups (-12+/-19% and -15+/-14%, respectively, P=0.97). The increase in coronary blood flow during infusion of the peak dose of substance P was blunted at baseline in both the simvastatin (42+/-50%) and placebo (55+/-71%) groups, reflecting impaired endothelium-dependent dilation of coronary microvessels. After treatment, the flow increase was 82+/-81% in the simvastatin group and 63+/-53% in the placebo group (P=0.16). CONCLUSIONS: Six months of cholesterol-lowering therapy has no significant effect on coronary endothelial vasomotor function in the study population of patients with coronary artery disease and mildly elevated cholesterol levels. These findings suggest that the effects of cholesterol lowering on endothelial function are more complex than previously thought.

Adult↗

Identification of novel proteins associated with the development of chemoresistance in malignant melanoma using two-dimensional electrophoresis.

A model system for studying chemoresistance in human melanoma cells (MeWo) has been established utilizing the four commonly used cytotoxic drugs vindesine, cisplatin, fotemustine and etoposide to yield stable drug-resistant sublines. We analyzed phenotypical differences between MeWo cells and their chemoresistant counterparts using two-dimensional electrophoresis. Proteins that were overexpressed in chemoresistant cell lines were purified and identified using matrix assisted laser desorption/ionization-time of flight - mass spectrometry (MALDI-TOF-MS) and microsequencing. Here we show that four proteins, namely the translationally controlled tumor protein, the human elongation factor 1-delta, tetratricopeptide repeat protein and the isoform 14-3-3-gamma of the 14-3-3-family are overexpressed in chemoresistant melanoma cell lines. The significance of these findings is now being verified using transfection experiments with the aim of developing more effective chemotherapy protocols.

Drug Resistance, Neoplasm↗

Clinical evaluation of removable partial dentures 10 years after insertion: success rates, hygienic problems, and technical failures.

The aim of this retrospective study was to examine the condition and success rate of various designs of removable partial dentures 10 years after placement. Seventy-four patients treated with 101 mainly conical crown-retained dentures (CCRDs), clasp-retained removable partial dentures (RPDs), or a combination of conical crown and clasp-retained dentures (CRPDs) were reexamined. Prosthetic findings were compared to baseline values at insertion and checked for factors that may affect them. Overall, 36.6% of the prostheses were regarded as successes, 23.8% as partial successes, and 39.6% as failures. Also, only one-third of the prostheses showed neither hygienic problems nor technical failures. The statistical analysis identified no single parameter as significantly affecting the success rate of the partial dentures. Prostheses supported by several abutment teeth had improved success, and RPDs had a higher failure rate (66.7%) than CCRDs (33.3%) and CRPDs (44.8%); however, because of the limited number of RPDs these differences were not statistically significant. Although the prostheses were unsupervised in service, the 60.4% overall success rate of the dentures was somewhat higher than in other studies on precision-retained prostheses.

Chi-Square Distribution↗

Influence of design and mode of loading on the fracture strength of all-ceramic resin-bonded fixed partial dentures: an in vitro study in a dual-axis chewing simulator.

STATEMENT OF PROBLEM: In a clinical study, all-ceramic resin-bonded fixed partial dentures showed a high rate of fractures within the first years of service but remained in function as cantilevered restorations. No data are available on the fracture strength of such cantilevered restorations. PURPOSE: This in vitro study evaluated the influence of design and mode of loading on the fracture strength of all-ceramic resin-bonded fixed partial dentures. MATERIAL AND METHODS: Forty-eight frameworks were copy milled using the aluminum-oxide ceramic In-Ceram, glass-infiltrated, and circularly veneered with feldspathic porcelain to replace a maxillary incisor on a test cast. The airborne particle-abraded restorations were bonded to acid-etched human abutments using composite. Twenty-four restorations used a conventional 2-retainer design and another 24 restorations used a cantilevered single-retainer design. Subgroups of 8 specimens were subjected to a quasi-static load in the direction of the long axis of the abutments (0 degrees) or in an angle of 45 degrees. Additional subgroups were subjected to dynamic loading under 45 degrees with either 50 or 25 N in a dual-axis chewing simulator until fracture. RESULTS: Mean fracture strengths, under 45-degree quasi-static loading, were between 134 and 174 N and under 0-degree loading about 233 N. Samples subjected to dynamic loading fractured after 25 to over 200,000 loading cycles. CONCLUSION: Direction of loading exhibited a significant influence on the fracture strength, regardless of the retainer design. The applied dynamic loading force, regardless of the retainer design, had a significant influence on the loading cycles until fracture.

Aluminum Oxide↗

The French Randomized Optimal Stenting Trial: a prospective evaluation of provisional stenting guided by coronary velocity reserve and quantitative coronary angiography. F.R.O.S.T. Study Group.

OBJECTIVES: We sought to make a prospective comparison of systematic stenting with provisional stenting guided by Doppler measurements of coronary velocity reserve and quantitative coronary angiography. BACKGROUND: Despite the increasing use of stents during percutaneous transluminal coronary angioplasty, it is unclear whether systematic stenting is superior to a strategy of provisional stenting in which stents are placed only in patients with unsatisfactory results or as a bail-out procedure. METHODS: Two hundred fifty-one patients undergoing elective coronary angioplasty were randomly assigned either to provisional stenting (group 1, in which stenting was performed if postangioplasty coronary velocity reserve was <2.2 and/or residual stenosis > or =35% or as bail-out) or to systematic stenting (group 2). The primary end point was the six-month angiographic minimal lumen diameter (MLD). Major adverse cardiac events were secondary end points (death, acute myocardial infarction and target lesion revascularization). RESULTS: Stenting was performed in 48.4% of patients in group 1 and 100% of patients in group 2 (p<0.01). Six months after angioplasty, the MLD did not differ between groups (1.90+/-0.79 mm vs. 1.99+/-0.70 mm, p = 0.39), as was the rate of binary restenosis (27.1% vs. 21.4%, p = 0.37). Among patients with restenosis, 13/32 (40.6%) in group 1 but 100% (25/25) in group 2 had in-stent restenosis (p<0.01). Target lesion revascularization (15.1% vs. 14.4% in groups 1 and 2 respectively, p = 0.89) and major adverse cardiac events (15.1% vs. 16.0%, p = 0.85) were not significantly different. CONCLUSIONS: Systematic stenting does not provide superior angiographic results at six months as compared with provisional stenting.

Aged↗

The effect of medium-chain triacylglycerols on the blood lipid profile of male endurance runners.

Medium-chain triacylglycerol (MCT) oil is currently marketed for athletes as an ergogenic aid for optimal performance. Research assessing the blood lipid response of humans to MCT consumption is very limited and inconclusive. In this randomized cross-over study, male endurance runners (aged 30.5 +/- 5.5 years) were instructed to consume a low-fat diet (approximately 15% of energy) and consume either supplemental MCT oil (30 g twice each day) or long-chain triacylglycerol (LCT) oil (28 g corn oil twice each day) for 14 days. Each dietary trial was separated by at least 3 weeks. At the end of each trial, fasting blood samples were collected and analyzed for serum concentrations of total cholesterol (TC), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), and triacylglycerol (TG). Concentrations of TC (3.83 +/- 0.12 vs. 3.41 +/- 0.15 mmol/L, P = 0.004), LDL-C (1.76 +/- 0.12 vs. 1.51 +/- 0.14 mmol/L, P = 0.033), and TG (1.26 +/- 0.14 vs. 0.98 +/- 0.12 mmol/L, P = 0.006) were higher following the MCT trial than following the LCT trial, respectively. HDL-C concentration did not differ significantly between trials (MCT 1.48 +/- 0.05 mmol/L vs. LCT 1.45 +/- 0.04 mmol/L, P = 0.465). Although blood lipids remained within desirable ranges established by the National Cholesterol Education Program, these results suggest that consumption of MCT oil for 2 weeks negatively alters the blood lipid profile of athletes. Future studies should determine the effects of longer periods of MCT supplementation on serum lipids of exercisers and other groups of individuals. With little data suggesting that MCT are ergogenic, the adverse effects of MCT on blood lipid concentrations may outweigh any proposed benefits for athletes.

Journal Article↗

Bone marrow transplantation with unrelated donors: what is the probability of identifying an HLA-A/B/Cw/DRB1/B3/B5/DQB1-matched donor?

Patients transplanted with marrow from an HLA-ABDR serologically matched unrelated donor suffer from more post-transplant complications than those who are transplanted with marrow from an HLA-identical sibling. This is most likely due to either HLA-ABDR incompatibilities not resolved by standard techniques and/or HLA polymorphisms not tested for by routine tissue typing (HLA-Cw,-DQ). By resolving these incompatibilities by molecular techniques combined with the in vitro cytotoxic T lymphocyte precursor frequency (CTLpf) test, we have shown that a high degree of HLA compatibility is associated with increased patient survival. However, higher requirements for HLA matching decrease the number of available donors. We have estimated the probability of finding an HLA-A/B/Cw/DRB1/DRB3/DRB5/DQB1 compatible donor based on 104 consecutive unrelated bone marrow donor searches initiated between January 1995 and December 1997, with December 1998 as the endpoint. For 96 patients (92.3%), one or more ABDR-identical donors were listed in the Bone Marrow Donor Worldwide Registry (BMDW). After contacting the registries, we obtained at least one (mean, 5.36; range, 1-20; total, 461) blood sample for 86 patients. A highly compatible donor was identified for 33/86 patients (38.4%), after testing an average number of 4.5 donors/patients (range, 1-13). However, by accepting an HLA-DRB3 or -DQB1 or -Cw incompatibility, this number would be as high as 68.6%. Approximately half of the patients (n = 40) for whom a search had been initiated have been transplanted: 22 patients with a perfectly matched donor, 15 patients with an HLA-DRB3 or -DQB1 or -Cw mismatch and three with other mismatches. The average time needed to identify the most compatible donor was 4 months. Extremely long searches seemed to be less useful, because after testing the first seven, a more compatible donor was seldom found. These results show that even when requirements for compatibility are high, the chances of finding a donor remain considerably low.

Bone Marrow Transplantation↗

Does open access endoscopy close the door to an adequately informed patient?

BACKGROUND: The use of open access endoscopy is increasing. Its effect on the adequacy of patient informed consent, procedure acceptance and the impact on subsequent communication/transfer of procedure results to the patient have not been evaluated. The aim of our study was to compare the extent of preknowledge of procedures and test explanation, patient medical complexity, information transfer and overall patient satisfaction between a patient group referred for outpatient open access endoscopy versus a patient group from a gastrointestinal (GI) subspecialty clinic. METHODS: Information was obtained from all patients presenting for outpatient upper and lower endoscopy by using a 1-page questionnaire. Patients from the two groups who had an outpatient upper/lower endoscopic procedure were contacted by phone after the procedure to obtain information with a standardized questionnaire. RESULTS: The open access patients reported receiving significantly less information to help them identify the procedure (p < 0.01) and less explanation concerning the nature of the procedure than the group of patients referred from the subspecialty clinic (p < 0.005). There was no difference between the two groups in satisfaction scores for examinations performed under conscious sedation. For flexible sigmoidoscopy without sedation, however, the GI clinic patient group were more satisfied with their procedure. The majority of patients, regardless of access, were more likely to receive endoscopic results from a gastroenterologist than the referring physician. Furthermore, the patients in the GI clinic group who underwent colonoscopy felt significantly better at follow-up. CONCLUSIONS: Patients undergoing open access procedures are less likely to be properly informed about their endoscopic procedure. Our results indicate that with open access endoscopy, a defined mechanism needs to be in place for communication of endoscopic results to the patient.

Adult↗

Effect of a new metal primer on the bond strength between a resin cement and two high-noble alloys.

STATEMENT OF PROBLEM: With the development of new adhesive resin cements, the question of surface treatment of noble metal castings with primers has become an important issue. PURPOSE: This study compared the tensile bond strength and its durability of a new metal primer (Alloy Primer, Kuraray) to 2 noble metal alloys (Au-Ag-Cu-Pt and Au-Pt-Pd-Ag-In). MATERIAL AND METHODS: Sixty cast disk specimens of each alloy were polished, grit blasted with 50 microm Al(2)O(3), and ultrasonically cleaned in 96% isopropanol. Then, they were either nonprimed or primed only with the Alloy Primer or Alloy Primer combined with ED Primer (Kuraray). Plexiglas tubes filled with self-curing composite resin (Clearfil FII, Kuraray) were bonded to the metal samples with the use of an alignment apparatus and a self-curing luting cement (Panavia 21 Ex). The samples were stored in water, either for 3 days with no thermal cycling or for 150 days with 37,500 thermal cycles. After the different storage conditions, the tensile bond strengths of the specimens were determined. RESULTS: The mean bond strengths increased over storage time for all groups, except for the grit-blasted Au-Pt-Pd-Ag-In group. However, only in the grit-blasted and the primed groups for the Au-Ag-Cu-Pt alloy was this increase significantly different (P<.01). After 150 days of storage, the mean bond strength to Au-Ag-Cu-Pt alloy was 38.8 MPa without priming, whereas it was 40.6 to 40.8 MPa with the use of the primers. After the same time, the mean bond strength to the Au-Pt-Pd-Ag-In alloy was 20.6 MPa without priming, whereas it was 31. 9 to 37.8 MPa with the use of the primers. When comparing the different bonding methods and different storage times for the alloys, the superiority of the usage of both primers in combination was determined. Conclusion. The tested Alloy Primer significantly improved the bond strength of the dental adhesive resin cement (Panavia 21 Ex) to noble alloys. However, this effect depended on the alloy composition and was much greater for the Au-Pt-Pd-Ag-In alloy than for the Au-Ag-Cu-Pt alloy.

Analysis of Variance↗

Effect of ageing on the upper and lower oesophageal sphincters.

OBJECTIVE: To determine the effect of ageing on length and resting pressure of the upper and lower oesophageal sphincters (UOSs, LOSs). BACKGROUND: The effectiveness of upper and lower oesophageal sphincters (UOSs and LOSs, respectively) in the control of retrograde trans-sphincteric flow is influenced by sphincteric pressure and length. METHODS: Nine young and nine elderly healthy volunteers were studied. Resting UOS and LOS pressures were measured by sleeve devices and lengths were measured by the station pull-through technique. RESULTS: The length of the UOS high pressure zone in the elderly (2.1 +/- 0.7 cm posterior; 1.9 +/- 0.1 cm anterior) was significantly shorter than that of the young (2.9 +/- 0.1 cm posterior; 3.1 +/- 0.2 cm anterior) (P< 0.01). Resting UOS pressure in the elderly (42 +/- 5 mmHg) was significantly lower than that of the young (62 +/- 7 mmHg) (P< 0.05). The intersphincteric length of the oesophagus in the elderly (21 +/- 0.2 cm) was similar to that of the young (21 +/- 0.4 cm). Total length of the LOS high pressure zone in the young (4.0 +/- 0.1 cm) was similar to that of the elderly (4.1 +/- 0.1 cm). LOS resting pressure was similar between young and elderly subjects (17 +/- 5 mmHg and 15 +/- 3 mmHg, respectively). CONCLUSIONS: Ageing affects the UOS and LOS differently. With regard to resting pressure and length, ageing weakens the UOS, but has no significant effect on the LOS.

Adult↗

Disruption of primary and secondary esophageal peristalsis by afferent stimulation.

Recent studies have shown that afferent signals originating from the pharynx inhibit progression of primary esophageal peristalsis. Our aim was to further elucidate the effect of esophageal and pharyngeal afferent stimulation on primary and secondary esophageal peristalsis. We studied the effect of esophageal air distension and pharyngeal water stimulation on progression of primary and secondary peristalsis in nine healthy volunteers aged 27 +/- 2 yr (4 men, 5 women). At a threshold volume, rapid injection of water into the pharynx, directed posteriorly, resulted in complete halt of the progressing secondary and primary esophageal peristalses in both the proximal and distal esophagus. The threshold volume of injected water for inducing inhibition was similar for secondary (0.6 +/- 0.2 ml) and primary (0.5 +/- 0.1 ml) esophageal peristalsis. Progression of primary peristalsis induced by a dry swallow and secondary peristalsis induced by intraesophageal air distension were completely inhibited by intraesophageal injection of 15 +/- 2 ml of air in 70% and 75% of the trials, respectively. We conclude that afferent signals induced by esophageal air distension and pharyngeal water stimulation inhibit propagation of both primary and secondary esophageal peristalsis, suggesting a shared neural control mechanism for these types of peristalsis.

Adult↗

Upper esophageal sphincter function during gastroesophageal reflux events revisited.

Upper esophageal sphincter (UES) function during gastroesophageal reflux events is not completely elucidated because previous studies addressing this issue yielded conflicting results. We reexamined the UES pressure response to intraluminal esophageal pressure and pH changes induced by reflux events. We studied 14 healthy, asymptomatic volunteers (age 49 +/- 6 yr) and 7 gastroesophageal reflux disease patients (age 48 +/- 5 yr). UES pressure, intraesophageal pressure, and pH were monitored at the distal, middle, and proximal esophagus concurrently in the supine position 1 h before and 2 h after a 1,000-calorie meal. A total of 321 reflux events were identified by the development of abrupt reflux-induced intraesophageal pressure increase (IPI); 285 events occurred in patients and 36 in control subjects. In control subjects 33 of 36 and in patients 252 of 285 IPI events were associated with a pH drop. Among patients and control subjects, 99% and 100%, respectively, of all IPI events irrespective of pH drop were associated with abrupt increase in UES pressure (34 +/- 2 and 27 +/- 6 mmHg, respectively). The average percentage of maximum UES pressure increase over prereflux values ranged between 66% and 96% (control subjects) and 34% and 122% (patients). IPIs induced by both acidic and nonacidic reflux events evoke strong UES contractile responses.

Acids↗

Measurement of fat mass using DEXA: a validation study in elderly adults.

The accuracy of total body fat mass and leg fat mass measurements by fan-beam dual-energy X-ray absorptiometry (DEXA) was assessed in 60 healthy elderly subjects (aged 70-79 yr). Total fat and leg fat mass at four leg regions (total leg, thigh, midthigh, and calf) were measured with the QDR 4500A (Hologic, Waltham, MA). The four-compartment model and multislice computed tomography scans were selected as criterion methods for total fat and leg fat mass, respectively. Total fat mass from DEXA was positively associated with fat mass from the four-compartment model with a standard error of the estimate ranging from 1.4 to 1.6 kg. DEXA fan-beam tended to overestimate fat mass for total leg and total thigh fat mass, whereas only marginal differences in fat mass measurements at the midthigh and calf were demonstrated (</=0.08 kg, P < 0.0005). Although there were significant differences between DEXA fan beam and the criterion methods, these differences were of small magnitude, suggesting that DEXA is an accurate method for measurement of fat mass for the elderly.

Absorptiometry, Photon↗

Inorganic lead and calcium interact positively in activation of calmodulin.

Calmodulin is a ubiquitous calcium-binding protein that mediates many of the intracellular actions of Ca2+ ions. The calcium-binding sites of calmodulin consist of four EF-hand motifs; full activation of calmodulin normally occurs when all four sites are occupied by Ca2+. Inorganic lead (PY2+) has been shown to activate calmodulin at total lead concentrations similar to the concentrations of Ca2+ required for activation (Goldstein and Ar, 1983; Habermann et al., 1983), but the free Pb2+ concentrations required for calmodulin activation have not been determined. In addition, it is possible that activation may occur with different sites occupied by different divalent cations, for example Ca2+ and Pb2+. We investigated the ability of free Pb2+, alone or in combination with Ca2+, to activate calmodulin. In aqueous media, N-phenyl-1-naphthylamine (NPN) and 8-anilino-1-naphthalenesulfonate (ANS) show increased fluorescence when bound to hydrophobic regions of proteins. This increased fluorescence has been used to monitor the conformational change that occurs during calmodulin activation (LaPorte et al., 1980). In the presence of calmodulin, both Ca2+ and Pb2+ stimulated increased fluorescence of NPN and ANS. Threshold and EC50 free metal concentrations were approximately 100 nM and 450-500 nM, respectively, for Ca2+ and 100 pM and 400-550 pM, respectively, for Pb2+. Fluorescence was enhanced by combinations of low concentrations of free Ca2+ and Pb2+; for example, as little as 20 pM free Pb2+ enhanced fluorescence in combination with 200 nM free Ca2+. The activity of the PDE1 isoform of cyclic nucleotide phosphodiesterase is stimulated by Ca2+/calmodulin (Wang et al., 1990). In the presence of calmodulin, we found that Ca2+ and Pb2+ activated calmodulin-stimulated PDE activity, with threshold and EC50 free metal concentrations of approximately 200 nM and 1200 nM, respectively, for Ca2+ and 300 pM and 430 pM, respectively, for Pb2+. PDE activity was stimulated by combinations of Ca2+ and Pb2+. For example, with 100 nM free Ca2+, as little as 50 to 100 pM free Pb2+ further stimulated PDE activity; with 1000 nM free Ca2+, 20 to 50 pM free Pb2+ further stimulated PDE activity. Isobolographic analysis indicated that stimulation of PDE by Ca2+ and Pb2+ was additive. These results show that concentrations of free Pb2+ as low as 100 to 300 pM activate calmodulin and that, in the presence of physiological concentrations of free Ca2+, Pb2+ can activate calmodulin at concentrations below 50 pM. The intracellular free Ca2+ concentration in Ca2+ "hot spots," for example near sites of influx through Ca2+-permeable plasma membrane channels, can reach dozens of pM, with the free Ca2+ concentration decreasing rapidly with distance from the source of the hot spot. Our results suggest that picomolar concentrations of intracellular free Pb2+ should expand both the effective amplitude and volume of Ca2+ hot spots with respect to calmodulin activation, and thus may amplify intracellular Ca2+ signaling in lead-exposed cells.

Calcium↗

Nanomolar concentrations of inorganic lead increase Ca2+ efflux and decrease intracellular free Ca2+ ion concentrations in cultured rat hippocampal neurons by a calmodulin-dependent mechanism.

Inorganic lead (Pb2+) activates calmodulin, which in turn may stimulate many other cellular processes. The plasma membrane Ca2+ ATPase is a calmodulin-stimulated enzyme that plays the major role in regulating the "resting" intracellular free Ca2+ ion concentration, [Ca2+]i. We hypothesized that exposing neurons to low levels of Pb2+ would cause Pb2+ to enter the cytoplasm, and that intracellular Pb2+, by activating calmodulin, would stimulate plasma membrane Ca2+ ATPase activity, thereby increasing Ca2+ extrusion and reducing [Ca2+]i. We used the ratiometric Ca2+ indicator fura-2 to estimate changes in [Ca2+]i. In vitro calibrations of fura-2 with solutions of defined free Ca2+ and free Pb2+ concentrations showed that, at free Ca2+ concentrations from 10 nM to 1000 nM, adding Pb2+ caused either no significant change in the F340/F380 ratio (free Pb2+ concentrations from 100 fM to 1 pM) or increased the F340/F380 ratio (free Pb2+ concentrations from 5 to 50 pM). Therefore, fura-2 should be suitable for estimating Pb2+-induced decreases in [Ca2+]i, but not increases in [Ca2+]i. We exposed cultured embryonic rat hippocampal neurons to 100 nM Pb2+ for periods from 1 hour to 2 days and measured the F340/F380 ratio; the ratio decreased significantly by 9 to 16% at all time points, indicating that Pb2+ exposure decreased [Ca2+]i. In neurons loaded with 45Ca, Pb2+ exposure increased Ca2+ efflux for at least two hours; by 24 hours, Ca2+ efflux returned to control levels. Influx of 45Ca was not altered by Pb2+ exposure. Low concentrations (250 nM) of the calmodulin inhibitor calmidazolium had no effect on either 45Ca efflux or on the F340/F380 ratio in fura-loaded control neurons, but completely eliminated the increase in 45Ca efflux and decrease in F340/F380 ratio in Pb2+-exposed neurons. Zaldoride, another calmodulin inhibitor, also eliminated the decrease in F340/F380 ratio in Pb2+-exposed neurons. We conclude that Pb2+ exposure decreases [Ca2+]i and increases Ca2+ efflux in cultured hippocampal neurons by a calmodulin-dependent mechanism, probably by stimulating Ca2+ extrusion by the plasma membrane Ca2+ ATPase.

Animals↗

[Ambulatory palliative care--special qualities].

During the last phase of progressive cancer numerous problems may arise. Additionally to pain and other symptoms, psycho-social and spiritual considerations supervene. In such cases palliative medicine offers positive options. In Germany, these options have been made available mainly for in-patients (at palliative care units or hospices). But out-patient care must continue to be a priority, since most patients wish to remain at home as long as possible and die at home. There are various problems that also arise at a patient's home. As the possibilities of palliative medicine are still generally unknown in out-patient care, new structures of medical care have to be established. This is where home care services come in; staff, especially educated professionals supported by volunteers assist the patients at home, together with general practitioners and health and advice centres. The work of home care services focuses on supervising pain therapy and symptom control as well as psychosocial advice and support of patients and their families. The statistics of the home care service Bonn shows that in 1999 73 per cent of patients could be treated at home until the end of live. In 43 per cent physicians made the initial contact with this service organisation. This proves the necessity and acceptance of new structures in palliative out-patient care.

Germany↗

Long-term resin bond strength to zirconia ceramic.

PURPOSE: The aim of this in vitro study was to evaluate the long-term bond strength of adhesive bonding systems to yttrium-oxide-partially-stabilized zirconia ceramic (YPSZ). MATERIALS AND METHODS: Plexiglas tubes filled with resin composite were bonded to industrially manufactured zirconia ceramic disks (96% ZrO2 stabilized by 4% Y2O3). After air abrading the ceramic and ultrasonic cleansing, groups of 16 samples were bonded in an alignment apparatus using 7 different bonding methods. Subgroups of 8 bonded samples were tested for tensile strength following storage in distilled water at 37 degrees C either for 3 days or 2 years. In addition, the 2-year samples were thermocycled 37,500 times. The statistical analyses were conducted with the Kruskal-Wallis test followed by multiple pair-wise comparison of the groups using the Wilcoxon rank sum test. RESULTS: A moderate to relatively high initial bond strength was achieved by air abrasion alone, the additional use of a silane, or acrylizing the YPSZ surface in combination with a conventional bis-GMA resin composite. However, these methods failed spontaneously over storage time. The use of the bis-GMA resin composite after tribochemical silica coating of YPSZ and the use of a polyacid-modified resin composite after air abrasion of YPSZ resulted in a high initial bond strength which decreased significantly over storage time. A durable resin bond strength to YPSZ was achieved only after air abrasion of YPSZ and using one of two resin composites containing a special phosphate monomer. CONCLUSION: A durable bond strength to YPSZ was achieved only by using resin composites containing a special adhesive monomer.

Acrylates↗