PubMed Health⌕ Search

Biomedical subjects

M Müller

Publications and source records attributed to M Müller.

At least 73 records · Page 4Linked to original sources

Needlelike and spherical polyelectrolyte complex nanoparticles of poly(l-lysine) and copolymers of maleic acid.

We report on the bulk and surface properties of dispersions consisting of nonstoichiometric polyelectrolyte complex (PEC) nanoparticles. PEC nanoparticles were prepared by mixing poly(l-lysine) (PLL) or poly(diallyldimethylammonium chloride) (PDADMAC) with poly(maleic acid-co-alpha-methylstyrene) (PMA-MS) or poly(maleic acid-co-propylene) (PMA-P). The monomolar mixing ratio was n-/n+ = 0.6, and the concentration ranged from 1 to 6 mmol/L. Subsequent centrifugation enabled the separation of the excess polycation, resulting in a stable coacervate phase further used in the experiments. The bulk phase parameters turbidity and hydrodynamic radius (R(h)) of the PEC nanoparticles showed a linear dependence on the total polymer content independently of the mixed polyelectrolytes. This can be interpreted by the increased collision probability of the polyelectrolyte chains when the overlap concentration is approached or exceeded. Different morphologies of the cationic PEC nanoparticles, which were solution-cast onto Si supports, were obtained by atomic force microscopy (AFM). The combinations of PLL/PMA-MS and PDADMAC/PMA-MS revealed more or less hemispherical particle shapes, whereas that of PLL/PMA-P revealed an elongated needlelike particle shape. Circular dichroism and attenuated total reflection Fourier transform infrared (ATR-FTIR) measurements proved the alpha-helical conformation for the PEC PLL/PMA-P and the random coil conformation for the PEC PLL/PMA-MS. We conclude that stiff alpha-helical PLL induces anisotropic elongated PEC nanoparticles, whereas randomly coiled PLL forms isotropic spherical PEC nanoparticles.

Circular Dichroism↗

[Teaching methods in anesthesia and intensive care medicine. The new legislation and its possibilities for the specialty].

BACKGROUND: As of October 1, 2003, a new government-initiated legislative basis for undergraduate medical education was initiated in Germany which resulted in substantial changes to the structure of the medical curriculum and in a heightened teaching load. METHODS: The Medical Faculty of the University of Dresden established an interdisciplinary reform curriculum in 1998. Since then a hybrid model of traditional lectures, seminars, practical and problem-based learning courses has been implemented for all courses in undergraduate medical training (Dresdener Integrated Problem-based Learning: DIPOL). RESULTS: Examplarly for all other DIPOL courses, the 2003 evaluation results of the "Emergency medicine-Injuries-Intensive care medicine" are presented and show that the course was very well received by students and tutors, and that 95% of the students passed the exams. CONCLUSIONS: The DIPOL anesthesiology course conforms with the new German federal law. A continuous further evaluation is an essential part of quality control and is necessary for the further development of a new curriculum.

Anesthesiology↗

[Dynamic decision making in emergency medicine. Example of paraplegia after a traffic accident].

Dynamic decision making is one of the key skills in crew resource management training in aviation. In emergency medicine it is important to practice this skill as a prerequisite for effective treatment of patients. We report a case of paraplegia after a road traffic accident and cervical spine injury. During the prehospital treatment the patient's state was re-evaluated at different times. Although the patient was initially unconscious the physician at the scene decided not to intubate the trachea as the level of consciousness improved during resuscitation. In the emergency room a C5 fracture and a prolapsed intervertebral disc were diagnosed and immediate decompression and stabilisation of the cervical spine were performed. Dynamic decision-making has been in practise for a long time in aviation, similarities to decisions in medicine and the psychological background are described on the basis of the case report.

Accidents, Traffic↗

[New concept minimizes bleeding in radical retropubic prostatectomy].

BACKGROUND: Radical retropubic prostatectomy is an intervention known to be associated with severe bleeding. Even experienced surgeons report a blood transfusion rate of up to 20%. The perioperative concept for this intervention underwent various modifications in January 2001. This study describes the effect of these modifications on the blood loss in a retrospective analysis comparing approximately 100 operations by a single experienced surgeon before the change (group 1) with 100 operations thereafter (group 2). MATERIALS AND METHODS: The new perioperative concept comprised the following points: reducing the intravenously applied volume, employing a peridural catheter (PDC), and maintaining a 25-30 degrees Trendelenburg's position. The difference in pre- and postsurgical hemoglobin (Hb) was analyzed before (group 1) and after the intervention (group 2). If transfusions were performed, this value was corrected according to the following formula: 1 ml of erythrocyte concentrate increases the patient's Hb by 0.003 g/dl. RESULTS: Assessment was possible in 201 of 234 cases, 110 from the first and 91 from the second group. The mean transfusion-corrected Hb difference was 5.3 g/dl in group 1 (20% transfusion rate) and 3.52 g/dl in group 2 (1.09% transfusion rate); p>0.0001. The median intravenous volume applied was 5.960 ml in group 1 and 3.490 ml in group 2 (p>0.0001). The complication rate did not differ between groups. CONCLUSION: The new perioperative concept minimizes the intraoperative blood loss during radical open retropubic prostatectomy. Transfusions are only necessary in rare cases. The complication rate remains unaltered.

Blood Loss, Surgical↗

[Non-contact donor cornea trephination with a flying spot excimer laser system].

BACKGROUND: One of the most common complications after mechanical penetrating keratoplasty is the occurrence of irregular astigmatism. We developed a method to prepare donor grafts for transplantation applying excimer laser techniques. The quality of the cut edges and exposure time were evaluated. MATERIALS AND METHODS: The beam of an experimental excimer laser (OPTex, Lambda Physik) was homogenized and guided by an optical system including lenses and scanner mirrors. A special software was used to conduct the laser beam in a circular mode over the surface of the cornea. Corneas from porcine eyes were stabilized in an artificial anterior chamber. Twenty in vitro explants were trephinated applying our method and subsequently investigated by electron microscopy and histology. RESULTS: All experiments provided regular and smooth cut edges. The average exposure time until perforation was 10.5 min (SD 2.7 min), the diameter of the grafts was 8.0 mm. CONCLUSION: The experiments showed the possibility of non-contact trephination and generation of smooth cut edges with a rotating focussed excimer laser beam in a porcine cornea model. A major advantage of the system is the possibility of customized "tailored" grafts.

Angioplasty, Balloon, Laser-Assisted↗

[Lavasept as an alternative to PVP-iodine as a preoperative antiseptic in ophthalmic surgery. Randomized, controlled, prospective double-blind trial].

BACKGROUND: To reduce the risk of endophthalmitis PVP-iodine is typically used preoperatively. Since iodine is contraindicated in patients with a specific allergic history or severe thyroid disorder we studied the effect of Lavasept, which contains Polyhexanid as an antiseptic alternative. PATIENTS AND METHODS: In a randomized controlled double-blind trial 3 drops of 0.2% Lavasept, 1.25% PVP-iodine or Ringer's solution were applied preoperatively to 67 patients, which have had a minimum of 5 colony forming units (cfu's) in the conjunctival swap. The effectiveness and tolerability were measured. RESULTS: After application of Lavasept or PVP-iodine, the number of cfu was statistically significantly reduced. Lavasept reduced the number of bacterial colonies significantly better than PVP-iodine (p=0.05). All test solutions were equally well tolerated. CONCLUSION: The use af Lavasept is safe, well tolerated and reduces the microbiological contamination of the conjunctival fornix effectively. lt provides a more effective reduction of the cfu's than PVP-iodine 1.25% and this effect tends to be prolonged. Lavasept is a good alternative option in ophthalmology for preoperative antisepsis.

Anti-Infective Agents, Local↗

Plasma levels of NT-pro-BNP in patients with atrial fibrillation before and after electrical cardioversion.

OBJECTIVE: Plasma levels of brain natriuretic peptide (BNP) have been examined in studies on patients with persistent atrial fibrillation, both before and after electrical cardioversion. Studied patients often showed a comorbidity with congestive heart failure, which complicates interpretation of measured BNP values as a natriuretic peptide. The aim of this study was to examine plasma levels of N-terminal fragment pro-brain natriuretic peptide (NT-pro-BNP), which is the more stable but inactive cleavage product of pro-BNP in patients with atrial fibrillation, but normal left ventricular ejection fraction, before and after electrical cardioversion. PATIENTS AND METHODS: NT-pro-BNP plasma levels of 34 consecutive patients were measured before, shortly after and 11 days after electrical cardioversion. All patients showed a normal ejection fraction after echocardiographic or laevocardiographic criteria. RESULTS: At baseline, all patients showed elevated NT-pro-BNP compared to a healthy control group (1086 vs. 66.9 pg/ml, p<0.001). After a mean follow-up time of 11 days in patients with persistent restored sinusrhythm, NT-pro-BNP decreased from 1071 pg/ml at baseline to 300 pg/ml (p<0.001). In contrast, patients with recurrence of atrial fibrillation showed increased levels from 1570.5 pg/ml at baseline to 1991 pg/ml (p=0.13; n.s.). Recurrence of atrial fibrillation was independent from height of NT-pro-BNP levels at baseline (p=0.23). CONCLUSIONS: Atrial fibrillation in patients with a normal left ventricular ejection fraction is associated with elevated NT-pro-BNP plasma levels, which decrease when a persistent sinus-rhythm can be restored by electrical cardioversion. On the other hand, NT-pro-BNP seems to increase (n.s.) when recurrence of atrial fibrillation occurs. Finally, NT-pro-BNP is no valid predictor for long-term success of sinus-rhythm restoration by electrical cardioversion.

Adult↗

Perioperative management in pediatric heart transplantation.

Peri- and early postoperative mortality significantly influences the probability of survival following heart transplantation in children. Main causes of death early after transplantation are rejection, non specific graft failure and RV failure due to pulmonary hypertension. Optimal therapy of pulmonary hypertension and aggressive use of assist devices as a bridge to recovery will substantially improve survival in the early period after transplantation. Furthermore, the use of marginal donor organs will be more acceptable because transient myocardial insufficiency may recover during extracorporeal life support.

Child↗

Changes in the subcellular distribution of glutathione during virus infection in Cucurbita pepo (L.).

Changes in the subcellular distribution and quantification of glutathione were studied with electron microscopic immunogold cytochemistry in Zucchini yellow mosaic virus (ZYMV)-infected Styrian pumpkin plants (Cucurbita pepo L. ssp. pepo var. styriaca Greb.) two weeks after inoculation. The amount of gold particles bound to glutathione was statistically evaluated for different cell structures, including mitochondria, plastids, nuclei, peroxisomes, and cytosol. In general, ZYMV-infected plants showed higher gold labelling density in intact mesophyll cells of the 5th (older leaves) and the youngest fully developed leaves (younger leaves), and decreased levels of glutathione within root tip cells when compared to the control. In general, within older and younger leaves the highest amount of gold particles was found in mitochondria and the lowest amount in plastids. In ZYMV-infected older leaves, an increase in glutathione was found in peroxisomes (1.7-fold), the cytosol (1.6-fold), mitochondria (1.4-fold), and nuclei (1.2-fold), whereas glutathione levels in plastids did not differ significantly when compared to control cells. In ZYMV-infected younger leaves elevated glutathione contents were found in the cytosol (3-fold), nuclei (2.1-fold), peroxisomes (1.8-fold), and plastids (1.5-fold), whereas mitochondria showed an insignificant decrease in glutathione levels in comparison to the control. In root tip cells of ZYMV-infected plants the amount of gold particles bound to glutathione was decreased in all investigated cell structures by between 0.7- to 0.8-fold. Additionally, total glutathione contents were determined in older and younger leaves using high-performance liquid chromatography (HPLC), which revealed no significant differences between control and ZYMV-infected leaves. The relevance of the results of both methods were compared and are discussed.

Cell Nucleus↗

[Activation of granulocytes and antiproteases in open heart surgery].

OBJECTIVE: Cardiovascular surgical procedures with extracorporeal circulation (ECC) lead to neutrophil activation followed by the release of proteases such as neutrophil elastase (NE) and oxidants. The mis-balance between proteases and their physiological inhibitors may contribute to morbidity in the postoperative period. In this study, the effects of cardiac surgery on neutrophil mediators were evaluated. Release of neutrophil elastase and plasma levels of the natural NE antagonists alpha (1)-proteinase inhibitor (API) and secretory leukocyte proteinase inhibitor (SLPI) were measured. The oxidative burst and the phagocytic activity were also evaluated. Tissue destruction was quantified by measuring the serum concentration of fibronectin. METHODS: Blood samples were obtained from 30 patients undergoing elective coronary artery bypass grafting (n = 30). NE and SLPI concentrations were measured by ELISA, API and fibronectin plasma levels were determined by nephelometry. Neutrophil phagocytic activity and oxidative burst were evaluated by flow cytometry. RESULTS: Neutrophil elastase plasma concentrations rose during ECC (245 +/- 107 microg/ml versus 44 +/- 14 microg/ml after induction, p < 0.001), whereas SLPI and API were decreased after onset of ECC. 24 h after ECC SLPI (54 +/- 17 ng/ml versus 41 +/- 10 ng/ml, p < 0.05) and API (3 +/- 0.5 g/l versus 1.6 +/- 0.3 g/l, p < 0.05) increased significantly compared to baseline values. A minor increase in phagocytic activity was observed after the onset of ECC. There were no significant changes in the oxidative burst. CONCLUSION: Cardiac surgery with ECC leads to neutrophil activation and elastase release. The imbalance between NE and the NE inhibitors API and SLPI may increase the risk for tissue damage due to granulocyte activation after cardiac surgery.

Aged↗

Imaging orientational order and lipid density in multilamellar vesicles with multiplex CARS microscopy.

Multiplex coherent anti-Stokes Raman scattering (CARS) microscopy is used to measure the width of the orientational order distribution of lipid acyl chains within a three-dimensionally confined microscopic probing volume. A theoretical model is developed to describe and simulate the polarization-dependent measurements. We observe that the orientational order in phosphatidylcholine multilammellar vesicles increases significantly upon addition of small amounts (<or=15 mol%) of cholesterol and is significantly reduced for unsaturated lipids. Based on these measurements and using the quantitative nature of multiplex CARS microscopy the exact local concentration of lipid molecules within the vesicles can be measured in terms of the number of lipid bilayers present in the microscopic probing volume.

Lipids↗

Interstitial glucose in skeletal muscle of diabetic patients during an oral glucose tolerance test.

AIM: The presence of a transcapillary arterial-interstitial gradient for glucose (AIG(glu)) in skeletal muscle may be interpreted as a consequence of intact cellular glucose uptake. We hypothesized that the AIG(glu) decreases in Type 2 diabetes mellitus as a consequence of insulin resistance, whereas it remains intact in Type 1 diabetes. METHODS: Glucose concentrations were measured in serum and interstitial space fluid of skeletal muscle during an oral glucose tolerance test (OGTT) in patients with Type 1 and Type 2 diabetes and in young and middle-aged healthy volunteers, using microdialysis. RESULTS: The area under the curve for glucose in serum (AUC(SE)) was higher than in interstitial space fluid of skeletal muscle (AUC(MU)) in healthy young (AUC(SE) = 1147 +/- 332 vs. AUC(MU) = 633 +/- 257 mM/min/ml; P = 0.006), healthy middle-aged volunteers (AUC(SE) = 1406 +/- 186 vs. AUC(MU) = 1048 +/- 229 mM/min/ml; P = 0.001) and in Type 1 diabetic patients (AUC(SE) = 2273 +/- 486 vs. AUC(MU) = 1655 +/- 178 mM/min/ml; P = 0.003). In contrast, in Type 2 diabetic patients AUC(SE) (2908 +/- 1023 mM/min/ml) was not significantly different from AUC(MU) (2610 +/- 722 mM/min/ml; P = NS). CONCLUSION: The present data indicate that AIG(glu) is compromised in Type 2 diabetes in contrast to Type 1 diabetes where it appears to be normal. Because no changes in muscle blood flow were detected, insulin resistance appears to be the main cause for the observed decreased AIG(glu) in skeletal muscle in Type 2 diabetic patients.

Adolescent↗

Alternative splicing of IL-24 in melanocytes by deletion of exons 3 and 5.

Two novel interleukin-24 (IL-24) splice variants were identified in normal human melanocytes by sequencing cloned polymerase chain reaction (PCR) products that are not expressed in metastatic melanoma. These gene products have been generated by differential skipping of exons 3 (IL-24 delE3) and 5 (IL-24 delE5). IL-24 delE3 has limited sequence identity to the IL-24-interacting protein mda-7s, and IL-24 delE5 is homologous to IL-24.

Alternative Splicing↗

Effect of exercise on transdermal nicotine release in healthy habitual smokers.

OBJECTIVE: Transdermal nicotine patches have become a frequently prescribed tool in smoking cessation programs during the past years. However, there is circumstantial evidence that transdermal nicotine release substantially varies with physical activity producing toxic plasma concentrations that may account for severe adverse events. METHODS: We, therefore, compared nicotine release from two different transdermal nicotine systems (TDNS) at rest and during strenuous physical activity in a two-period crossover study in healthy smokers (n = 10). The subjects were randomly assigned to receive either 21 mg/day of formulation A or B on study Day 1 and 2. Patches were applied eight hours before starting standardized physical activity, and nicotine concentrations were measured in plasma and topically in the tissue layers underneath the application site by microdialysis. RESULTS: There was no difference between groups in the mean values for area under the time-concentration curve at rest from 0 - 8 hours AUC(0-8) (p < 0.799) and during exercise from 8 - 11 hours AUC(8-11) (p < 0.878). C(max) values between groups with C(max) values of 16.4 +/- 9.5 ng/ml and 16.0 +/- 10.7 ng/ml at rest (p < 0.919, NS) and 10.05 +/- 6.8 ng/ml and 10.2 +/- 6.9 ng/ml (p < 0.959, NS) during exercise did not differ significantly. Nicotine tissue concentrations increased two-fold during exercise versus baseline (p < 0.878). Skin blood flow increased significantly during exercise compared with baseline (p < 0.001). No adverse events were observed. CONCLUSION: The present study provides evidence that transdermal nicotine release from TDNS increases during exercise. However, this increase has no significant effect on overall plasma pharmacokinetics. Our pharmacokinetic data further indicate that the two TDNS formulations are equivalent during conditions of rest and exercise.

Administration, Cutaneous↗

Effect of morphological properties of transferred embryonic stages on tubal migration Implications for in vivo culture in the bovine oviduct.

In cattle, there is no practical method, which allows tubal transfer of pre-implantation embryos for routine in vivo culture as it has been established in sheep. The aim of our study was to perform tubal transfer by transvaginal endoscopy in synchronized heifers, in order to expose embryos at various embryonic stages to the physiological mechanisms of migration in the non-ligated oviducts. Various embryonic stages were transferred by transvaginal endoscopy into the oviducts of temporary recipients and were recovered on Day 7. The transfer of embryos in hyaluronate containing medium ("Hyaluronan"), zygotes stripped of cumulus ("Denuded Zygotes"), embryos embedded in cumulus ("Zygotes with Cumulus"), matured oocytes with capacitated spermatozoa ("GIFT") or embryos embedded in Na alginate ("Alginate") led to increasing recovery rates (13, 30, 56, 63 and 71%, respectively). However, the developmental rate on Day 7 was adversely affected (16, 11, 8, 16 and 8%), whereas the blastocyst rate on Day 8 showed more balanced results (17, 14, 18, 21 and 11%). Our data demonstrate that the structural properties of transferred embryos affect tubal migration and are crucial for subsequent in vivo culture. Embryos enclosed in cumulus cells or alginate synchronize more successfully with the oviductal transport systems than denuded stages or embryos in hyaluronate containing medium.

Alginates↗