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Biomedical subjects

M Maeder

Publications and source records attributed to M Maeder.

At least 19 recordsLinked to original sources

[A case of coronary vasospasm treated with stent placement].

We report about a 49 year old woman with repeated chest pain at rest. During hyperventilation significant ST-segment elevation in leads V1-V5 appeared. Bicycle stress test did not provoke any ECG changes. Coronary angiography showed a significant stenosis of the left anterior descending coronary artery. Successful balloon angioplasty followed by stent implantation was performed. After an uneventful course of twelve months, hyperventilation could provoke neither chest pain nor ECG changes again without any antispastic medical treatment. Impact of fixed atherosclerotic lesions for the occurrence of coronary vasospasm, usefulness of hyperventilation as a non-invasive provocation test and therapy are discussed.

Angina Pectoris, Variant↗

Aortic homograft endocarditis caused by Rhodotorula mucilaginosa.

Serious infections caused by Rhodotorula spp. are rare and usually occur in immunocompromised people, especially in patients with tumors and long-time use of indwelling central venous catheters. We report a case of Rhodotorula mucilaginosa homograft endocarditis in an otherwise healthy man, which was successfully treated by surgery in combination with amphotericin B and subsequently intraconazole.

Antifungal Agents↗

[Spontaneous coronary artery dissection as a rare cause of an acute coronary syndrome].

Spontaneous coronary artery dissection is a rare cause of an acute coronary syndrome. This report describes a previously healthy woman without cardiovascular risk factors who presented with an acute anterior non-ST elevation myocardial infarction. Coronary angiography revealed an isolated longitudinal dissection in the middle part of the left anterior descending coronary artery (LAD) with normal flow of the contrast media. The patient was treated conservatively with heparin, aspirin, clopidogrel, and beta-receptor blocker. Stress exercise test was normal at discharge. After an event-free follow-up of three and a half months coronary angiography showed a completely normal LAD. Literature about epidemiology, pathogenesis, diagnosis and treatment of spontaneous coronary artery dissection is reviewed.

Adrenergic beta-Antagonists↗

Resolving factor analysis.

Bilinear data matrices may be resolved into abstract factors by factor analysis. The underlying chemical processes that generated the data may be deduced from the abstract factors by hard (model fitting) or soft (model-free) analyses. We propose a novel approach that combines the advantages of both hard and soft methods, in that only a few parameters have to be fitted, but the assumptions made about the system are very general and common to a range of possible models: The true chemical factors span the same space as the abstract factors and may be mapped onto the abstract factors by a transformation matrix T, since they are a linear combination of the abstract factors. The difference between the true factors and any other linear combination of the abstract factors is that the true factors conform to known chemical constraints (for instance, nonnegativity of absorbance spectra or monomodality of chromatographic peaks). Thus, by excluding linear combinations of the abstract factors that are not physically possible (assuming a unique solution), we can find the true chemical factors. This is achieved by passing the elements of a transformation matrix to a nonlinear optimization routine, to find the best estimate of T that fits the criteria. The optimization routine usually converges to the correct minimum with random starting parameters, but more difficult problems require starting parameters based on some other method, for instance EFA. We call the new method resolving factor analysis (RFA). The use of RFA is demonstrated with computer-generated kinetic and chromatographic data and with real chromatographic (HPLC) data. RFA produces correct solutions with data sets that are refractory to other methods, for instance, data with an embedded nonconstant baseline.

Journal Article↗

Technical considerations in the repair of combined aortic arch and diaphragm rupture after blunt trauma.

Rupture of the aortic arch and laceration of the diaphragm after blunt trauma are two serious lesions that are difficult to manage. (1,2) We repaired both lesions in a patient with an anterior approach (i.e., a median sternotomy and a superior median laparotomy). The repair, carried out during extracorporeal circulation, turned out to be relatively easy to perform. The potential dangers associated with the use of cardiopulmonary bypass after blunt trauma must be acknowledged. In selected cases, however, when no strong contraindications to the administration of anticoagulation exist, the anterior approach and the use of cardiopulmonary bypass offer an excellent exposure for the repair of both lesions.

Adult↗

Benign partial epilepsy of childhood: a longitudinal neuropsychological and EEG study of cognitive function.

The study combined prospective neuropsychological and EEG results of 22 children presenting with typical benign partial epilepsy with rolandic spikes (n=19) and occipital spikes (n=3). The aims were to assess the types of cognitive problems which may be encountered in this population, to evaluate the course of cognitive and learning capacities during the active phase of epilepsy, and to see if there was a correlation with paroxysmal activity on the EEG. Average age at entry in the study was 8.4 years and each child was seen two to four times over a period of 1 to 3 years. EEGs showed persistent spike foci in most cases that worsened in three cases, but there were no continuous spike-waves during sleep. No child had persistent stagnation, marked fluctuations, or a regression in cognitive abilities. Of 22 children, 21 had average IQ (>80). Eight children had school difficulties requiring special adjustment. No single cognitive profile was identified. Four children had delayed language development and eight children had transient weak scores in one isolated domain (verbal, visuospatial, memory) which improved or normalized during the course of the study with concomitant EEG improvement or normalization. In two of the three children with aggravation of the paroxysmal EEG activity, clinical changes were documented. A proportion of children with typical benign partial epilepsy with rolandic spikes showed mild, varied, and transient cognitive difficulties during the course of their epilepsy, and in most cases this probably had a direct relation with the paroxysmal EEG activity.

Child↗

Are there clinical and laboratory predictors of 5-year mortality in HIV-infected children and adolescents with hemophilia?

To determine factors associated with survival in a cohort of HIV-infected children and adolescents with hemophilia, an analysis of the 5-year mortality data for 207 HIV-infected young men was performed to examine the effect of selected clinical covariates on survival. The subjects were enrolled into the Hemophilia Growth and Development Study cohort from 1989 to 1990. Estimated mean time since infection at baseline was 6.7 years and mean estimated age at infection was 6.5 years. The baseline characteristics examined for their association with the hazard of death over the 5-year follow-up period were the following: absolute CD4+ cell count, hemoglobin status, skin test anergy, results of brain magnetic resonance imaging, non-hemophilia-related muscle atrophy (NHRMA), height for age, and impaired neuropsychological functioning as measured by the Vineland Adaptive Behavior and the Pediatric Behavior Scales. In all, 66 deaths occurred over the 5-year follow-up, 62 of whom met the 1987 (n = 56) or 1993 (n = 6) U.S. Centers for Disease Control and Prevention (CDC) definition of AIDS. Although each of the characteristics listed previously significantly increased the hazard of death by Cox proportional hazard regression models, only NHRMA remained a significant predictor of AIDS-related death when added to models that included each of the other cited baseline covariates.

Adolescent↗

Temperate bacteriophages are common among Actinobacillus actinomycetemcomitans isolates from periodontal pockets.

Actinobacillus actinomycetemcomitans is a suspected etiologic agent in destructive periodontal diseases. The detection of bacteriophages in A. actinomycetemcomitans in the subgingival plaque of patients with rapidly destructive forms of periodontitis led to the hypothesis that bacteriophage infection might increase the virulence of this bacterium (19). A. actinomycetemcomitans was isolated from 68 subjects from the Netherlands and Switzerland with localized juvenile periodontitis, rapidly progressing periodontitis, or adult periodontitis, and was tested for the presence of temperate bacteriophage with the overlay plate technique. More than half of the A. actinomycetemcomitans strains were found to release bacteriophage which formed individual plaques on indicator strains. Electron microscopy of preparations from 7 strains revealed virions with an icosahedral head and a contractile tail typical for double-stranded DNA bacteriophages. The presence of A. actinomycetemcomitans carrying temperate bacteriophage was not correlated with the composition of the subgingival microflora nor with the clinical form of periodontal disease. Destructive periodontal disease of subjects with phage-carrying A. actinomycetemcomitans was not more severe than of subjects with phage-free A. actinomycetemcomitans as determined by several clinical parameters. In contrast, the pocket depth and the attachment loss were significantly lower for adult periodontitis subjects with phage-carrying A. actinomycetemcomitans. It seems unlikely that the frequently occurring temperate bacteriophages increase significantly the virulence of A. actinomycetemcomitans.

Adult↗

Artefacts and morphological changes during chemical fixation.

The normally 'condensed' (darkly stained) chromosomes of dinoflagellates decondense by swelling. This occurs in an increasing number of cells when the concentration of added OsO4 is decreased. With different fixatives other types of disintegration can be observed, which vary with the concentration. With cryofixation and freeze-substitution the chromosomes are most 'condensed'. Escherichia coli infected with bacteriophage T4, with or without active lysozyme production, were studied by optical densitometry for partial lysis and by light and electron microscopy for observing swelling. When active lysozyme is present some of the acrolein (2.5%)-glutaraldehyde (2%)-fixed cells swell at 0 degrees C, but do not in the absence of lysozyme nor when fixed at room temperature. If OsO4 is added at concentrations < or = 0.5%, partial lysis occurs when lysozyme is present. The optical density decreases, the cells lose some matter and swell slightly. The corresponding electron micrographs show gap formation by curdling and/or a decreased concentration of the cytoplasm which reveals certain phage-related particles.

Animals↗

Influence of a new experimental bonding agent on marginal seal of Class V restorations: an in-vitro study.

The performance of a new experimental dentin bonding agent (A.R.T. Bond) was evaluated in vitro. Its influence on the marginal seal of mixed class V restorations made on freshly extracted third molars, using 7 different restoration techniques was studied. When using the new dentin bonding agent, the results of the dye penetration test revealed the least dentinal leakage with the direct inlay technique. Dye penetration scores of bulk and incrementally placed restorations were higher, but not significantly different from the direct inlay. The absence of the dentin bonding agent in incrementally placed restorations resulted in significantly higher leakage values.

Dental Bonding↗

In vitro evaluation of marginal fit and morphology of fired ceramic inlays.

The marginal adaptation of fired ceramic inlays prepared by three dental technicians in two ceramic materials was evaluated in vitro. The thickness of the sealing gap varied between 46.4 and 57.6 microns, and the percentage of marginal ceramic defects ranged between 8.6% and 25.0% of the total inlay circumference. The incidence of marginal defects increased in areas of complex occlusal morphology. Differences observed in inlay adaptation were related to the technician rather than to the material used. The accuracy of ceramic inlays was comparable to that of metallic and porcelain-fused-to-metal crowns with butt-joint margins and fell within the range of clinically acceptable adaptation.

Aluminum Oxide↗

MR-imaging of chronic spinal cord injury. Association with neurologic function.

Twenty-two para- and tetraplegic patients with chronic spinal cord injuries were examined with magnetic resonance imaging (MRI). The clinical course in the entire rehabilitation period was recorded and an attempt was made to associate the functional status of the patients with the morphologic findings on MRI. Small and large spinal cord cysts and syringomyelia, cord atrophy, and spinal stenosis were found. Additionally, in a number of patients regions of increased signal intensity within the cord, interpreted as myelomalacia, and obliteration of the intradural extramedullary space, interpreted as arachnopathy, were noted. The large number (13/22) of cystic lesions in our patients was unexpected. It was in contrast to the rate reported in autopsy studies of paraplegics which note only few cysts. Whereas a direct association of morphologic findings with neurologic symptoms and the clinical course was difficult, it was found that patients with large cysts and spinal cord atrophy generally showed no tendency to improve in spite of the measures taken during the rehabilitation period. It is difficult to decide whether the initial trauma with cord hemorrhage is limiting the chance of neurological improvement or if a sequence of events leading from hemorrhage to gliosis and cystic necrosis is the determining factor.

Adolescent↗

Basic nuclear proteins of the histone-less eukaryote Crypthecodinium cohnii (Pyrrhophyta): two-dimensional electrophoresis and DNA-binding properties.

Unlike typical eukaryotes, the Dinoflagellate Crypthecodinium cohnii does not contain histones but six major basic, low molecular weight nuclear proteins which represent only 10% of the DNA mass and differ from histones in their electrophoretic and DNA-binding properties. These proteins are resolved in two-dimensional electrophoresis (AUT-PAGE x SDS-PAGE). Three proteins with an apparent molecular mass of 16, 16.5 and 17 kDa (p16, p16.5 and p17) are present in addition to the major 14 kDa basic nuclear component (HCc). HCc itself is resolved in three proteins (alpha, beta and gamma). When the proteins are not reduced with 2-mercaptoethanol before 2D-PAGE, the migration of HCc alpha, beta and gamma is modified in a way which suggests the formation of both inter- and intramolecular disulfide bridges and thus, the presence of at least two cysteines. The amino-acid analysis of HCc proteins resolved in 2D gels confirms that they are lysine-rich. HCc alpha, beta and gamma as well as p16, p16.5 and p17 are removed from isolated chromatin with 0.6 M NaCl, indicating that their affinity for DNA in vivo is lower than that of core histones. Furthermore, in vitro, they bind more tightly to single-stranded than to double-stranded DNA.

Animals↗

In vitro resistance to fracture of porcelain inlays bonded to tooth.

To assess the resistance to fracture of ceramic inlays, extracted sound human molars were restored with different ceramic materials and glass-ionomer or composite resin luting cement. Compression forces were applied to the specimens until they fractured, and maximal force developed, extent and location of fractures, and the micromorphology of the fractured surfaces were studied. Inlays made of Vitadur N with aluminum oxide profile and bonded with composite resin demonstrated the highest resistance among the restorative combinations, but their resistance was still lower than that of intact (control) teeth. The extent of fracture increased proportionally to the fracture resistance of the specimens. Scanning electron microscopic observation confirmed the effectiveness of the adhesion between composite resin and etched ceramic and the absence of sufficient micromechanical anchoring between glass-ionomer cement and etched ceramic.

Cementation↗

Length and shape variants of the bacteriophage T4 head: mutations in the scaffolding core genes 68 and 22.

The shape and size of the bacteriophage T4 head are dependent on genes that determine the scaffolding core and the shell of the prohead. Mutants of the shell proteins affect mainly the head length. Two recently identified genes (genes 67 and 68) and one already known gene (gene 22), whose products are scaffold constituents, have been investigated. Different types of mutants were shown to strongly influence the proportion of aberrantly shaped particles. By model building, these shape variants could be represented as polyhedral bodies derived from icosahedra, through outgrowths along different polyhedral axes. The normal, prolate particle is obtained by elongation along a fivefold axis. The mutations of the three core genes (genes 67, 68, and 22) affect the width mainly by lateral outgrowths of the prolate particle, although small and large isometric particles are also found. Many of the aberrant particles are multitailed, suggesting a correlation between tail attachment sites and shape.

DNA Mutational Analysis↗

Prohead core of bacteriophage T4 can act as an intermediate in the T4 head assembly pathway.

Bacteriophage T4 assembly was impaired in Escherichia coli hdB3-1 at an incubation temperature below 30 degrees C. Naked prohead cores (head scaffold) bound to the inner surface of the plasma membrane accumulated, and the major shell protein (gp23) precipitated into visible intracellular aggregates in the cytoplasm. Shifting the temperature to 42 degrees C allowed newly synthesized gp23 to assemble around the accumulated cores. We conclude that synchronous assembly of the scaffold and shell is not obligatory and that naked cores can serve as intermediates in the T4 assembly pathway.

Cell Membrane↗

Amber mutants in gene 67 of phage T4. Effects on formation and shape determination of the head.

Two amber mutations in gene 67 of bacteriophage T4 were constructed by oligonucleotide-directed mutagenesis and the resulting mutated genes were recombined back into the phage genome and their phenotype was studied. The 67amK1 mutation is close to the amino terminus of the gene, and phage carrying this mutation are unable to form plaques on suppressor-negative hosts. A second mutation, 67amK2, which lies in the middle of the gene, three codons N-terminal to a proteolytic cleavage site, produces a small number of viable phage particles. In suppressor-negative hosts, both mutants produce polyheads and proheads. 67amK1 assembles only few proheads that have a disorganized core structure, as judged from thin sections of infected cells. The proheads and the mature phages of both mutants are mainly isometric rather than having the usual prolate shape. Depending on the 67 mutant and the host, between 20% and 73% of the particles that are produced are isometric, and 1 to 10% are two-tailed biprolate particles. 67amK2 phages grown on a supD suppressor strain that inserts serine in place of the wild-type leucine do not contain gp67* derived from gene product 67 (gp67) by proteolytic cleavage. This demonstrates the importance of the correct amino acid at this position in the protein. Other abnormalities in these 67amK2 phages are the presence of uncleaved scaffolding core proteins (IPIII and gp68), indicating a structural alteration in the prohead scaffold, resulting in only partial cleavage. In wild-type phages these proteins are found in the head only in the cleaved form. With double-mutants of 67 with mutations in the major shell protein gp23 no naked scaffolding cores were found, confirming the necessity of gp67 for the assembly or persistence of a "normal" core.

Genes, Viral↗

Shape and fine structure of nucleoids observed on sections of ultrarapidly frozen and cryosubstituted bacteria.

Very rapidly frozen cells of Escherichia coli and Bacillus subtilis were substituted at low temperature into acetone with 1% OsO4 and embedded in Epon. They showed ribosome-free spaces filled with globular and fibrillar material of up to 15 nm. The sizes of structures seen do not exclude DNA superstructures such as supercoils, aggregates, and nucleosomes. With the Feulgen analog osmium-ammines stain, DNA was localized within the ribosome-free space. The bulk of DNA, the nucleoid, is therefore a major part of, or identical to, the main ribosome-free space. The ribosome-free space would correspond directly to the light microscopy phase-contrast image of nucleoids in living bacteria. The shape of the ribosome-free space does not reflect intracellular salt concentrations, nor do the Feulgen-positive areas. The previously observed dependency on the salt concentration of the growth medium seems to be due to permeabilization induced by the chemical fixative at room temperature. The ribosome-free space is more cleft in appearance than the nucleoid obtained by fixation with OsO4 but more confined than its very dispersed form found after aldehyde fixation.

Bacillus subtilis↗