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Biomedical subjects

M Vogel

Publications and source records attributed to M Vogel.

At least 19 recordsLinked to original sources

Ion and polymer dynamics in polymer electrolytes PPO-LiClO4. II. 2H and 7Li NMR stimulated-echo experiments.

We use 2H NMR stimulated-echo spectroscopy to measure two-time correlation functions characterizing the polymer segmental motion in polymer electrolytes PPO-LiClO4 near the glass transition temperature Tg. To investigate effects of the salt on the polymer dynamics, we compare results for different ether oxygen to lithium ratios, namely, 6:1, 15:1, 30:1, and infinity. For all compositions, we find nonexponential correlation functions, which can be described by a Kohlrausch function. The mean correlation times show quantitatively that an increase of the salt concentration results in a strong slowing down of the segmental motion. Consistently, for the high 6:1 salt concentration, a high apparent activation energy Ea=4.1 eV characterizes the temperature dependence of the mean correlation times at Tg<T<or approximately 1.1Tg, while smaller values Ea approximately 2.5 eV are observed for moderate salt contents. The correlation functions are most nonexponential for 15:1 PPO-LiClO4 whereas the stretching is reduced for higher and lower salt concentrations. This finding implies that the local environments of the polymer segments are most diverse for intermediate salt contents, and, hence, the spatial distribution of the salt is most heterogeneous. To study the mechanisms of the segmental reorientation, we exploit that the angular resolution of 2H NMR stimulated-echo experiments depends on the length of the evolution time tp. A similar dependence of the correlation functions on the value of tp in the presence and in the absence of ions indicates that addition of salt hardly affects the reorientational mechanism. For all compositions, mean jump angles of about 15 degrees characterize the segmental reorientation. In addition, comparison of results from 2H and 7Li NMR stimulated-echo experiments suggests a coupling of ion and polymer dynamics in 15:1 PPO-LiClO4.

Journal Article↗

Ion and polymer dynamics in polymer electrolytes PPO-LiClO4. I. Insights from NMR line-shape analysis.

We investigate ion and polymer dynamics in polymer electrolytes PPO-LiClO4 performing 2H and 7Li NMR line-shape analysis. Comparison of temperature dependent 7Li and 2H NMR spectra gives evidence for a coupling of ion and polymer dynamics. 2H NMR spectra for various salt concentrations reveal a strong slowdown of the polymer segmental motion when the salt content is increased. The 2H NMR line shape further indicates that the segmental motion is governed by dynamical heterogeneities. While the width of the distribution of correlation times G(log tau) is moderate for low and high salt content, an extremely broad distribution exists for an intermediate salt concentration of 15:1 PPO-LiClO4. For the latter composition, a weighted superposition of two spectral components, reflecting the fast and the slow polymer segments of the distribution, describes the 2H NMR line shape over a broad temperature range. Analysis of the temperature dependent relative intensity of both spectral components indicates the existence of a continuous rather than a discontinuous distribution G(log tau). Such continuous distribution is consistent with gradual fluctuations of the local salt concentration and, hence, of the local environments of the polymer segments, whereas it is at variance with the existence of large salt-depleted and salt-rich domains featuring fast and slow polymer dynamics, respectively. Finally, for all studied PPO-LiClO4 mixtures, the 2H NMR line shape strongly depends on the echo delay in the applied echo-pulse sequence, indicating that the structural relaxation of the polymer segments involves successive rotational jumps about small angles gamma < 20 degrees .

Journal Article↗

Structured treatment interruptions following immediate initiation of HAART in eight patients with acute HIV-1 seroconversion.

BACKGROUND: The immunological and clinical benefits of structured treatment interruptions (STIs) during primary HIV-1 infection remain largely unclear. PATIENTS AND METHODS: Eight patients identified during primary HIV-1 infection were immediately treated with HAART and underwent subsequent STIs after reaching complete viral suppression of HIV-RNA in peripheral plasma. HAART was re-initiated if either HIV-1 RNA >5000 copies/ml, CD4-cells <200 cells/microl or symptomatic HIV-1 disease was observed. RESULTS: After treatment discontinuation, four of eight patients were able to persistently control HIV-1 viremia below 5000 copies/ml until the last time point of follow-up (median 3 years). CD4-cell counts were within the interquartile range of untreated individuals compared to historical reference data from the MACS cohort. In the remaining study subjects persistent virological control was not reached despite repeated STIs. Moreover, compared to the MACS cohort repetitive virological failures during STIs appeared to induce an accelerated decline of CD4-cells. CONCLUSION: Spontaneous HIV-1 control after treated primary HIV-1 infection was possible in four out of eight individuals, however, if STIs after treated primary infection ameliorate the overall HIV-1 disease progression remains unknown. In the absence of viral control, repetitive viral exposure during STIs might be associated with accelerated decline of CD4-cell counts.

Acute Disease↗

A new ligand field approach to linear transition metal dihalides.

We have performed theoretical multiconfigurational calculations of the molecular energy levels based on two axial ligand field models and determined the model parameters to reproduce ab initio energies of TiCl(2), TiF(2), VCl(2), and VF(2). We develop two extensions to ligand field theory (LFT) for linear transition metal dihalides, which are incorrectly described by standard LFT. The standard LFT is augmented (1) by including the ligand induced hybridization of the d(sigma) orbital with the 4s orbital or (2) by using a different radial part for the d(sigma) orbital. Both models reproduce the energies of the first electronic states in very good agreement with numerical multireference configuration interaction results. Furthermore the model parameters are very close to experimental known Racah parameters describing the term energies of Ti(2+) and V(2+).

Journal Article↗

Tissue Doppler echocardiography before and after the surgical reconstruction of an insufficient mitral valve in a patient with Fontan circulation.

We report a patient with tricuspid atresia after total cavopulmonary connection who developed significant mitral valve regurgitation. Doppler myocardial echocardiography tracings showed "pseudonormalization" of diastolic velocities. After successful surgical reconstruction of the mitral valve, the diastolic myocardial velocities changed to the typical Fontan physiology with predominant late diastolic ventricular filling.

Blood Flow Velocity↗

Remote ischaemic preconditioning protects against cardiopulmonary bypass-induced tissue injury: a preclinical study.

OBJECTIVES: To test the hypothesis that remote ischaemic preconditioning (rIPC) reduces injury after cardiopulmonary bypass (CPB). DESIGN: Randomised study with an experimental model of CPB (3 h CPB with 2 h of cardioplegic arrest). Twelve 15 kg pigs were randomly assigned to control or rIPC before CPB and followed up for 6 h. INTERVENTION: rIPC was induced by four 5 min cycles of lower limb ischaemia before CPB. MAIN OUTCOME MEASURES: Troponin I, glial protein S-100B, lactate concentrations, load-independent indices (conductance catheter) of systolic and diastolic function, and pulmonary resistance and compliance were measured before and for 6 h after CPB. RESULTS: Troponin I increased after CPB in both groups but during reperfusion the rIPC group had lower concentrations than controls (mean area under the curve -57.3 (SEM 7.3) v 89.0 (11.6) ng.h/ml, p = 0.02). Lactate increased after CPB in both groups but during reperfusion the control group had significantly more prolonged hyperlactataemia (p = 0.04). S-100B did not differ between groups. Indices of ventricular function did not differ. There was a tendency to improved lung compliance (p = 0.07), and pulmonary resistance changed less in the rIPC than in the control group during reperfusion (p = 0.02). Subsequently, peak inspiratory pressure was lower (p = 0.001). CONCLUSION: rIPC significantly attenuated clinically relevant markers of myocardial and pulmonary injury after CPB. Transient limb ischaemia as an rIPC stimulus has potentially important clinical applications.

Animals↗

Highly active antiretroviral therapy (HAART) improves survival in HIV-associated Hodgkin's disease: results of a multicenter study.

BACKGROUND: The purpose of the study was to evaluate the outcome of Hodgkin's disease (HD) in patients infected with the human immunodeficiency virus (HIV) with respect to the use of highly active antiretroviral therapy (HAART). MATERIALS AND METHODS: This cohort study included patients with HIV-HD diagnosed from June 1984 to February 2004. Patients treated in the pre-HAART era (1984-1996) were compared with those belonging to the HAART era (1997-2004). RESULTS: Of 66 patients with HIV-HD, 47 (71%) presented with stage III/IV disease and 38 patients (58%) with an AIDS-defining illness. Fifty-nine of 66 patients (89.4%) underwent curative intended chemotherapy. Patients receiving HAART (n = 34) had a significantly better 2-year overall survival (OS) than those not receiving HAART (74% versus 30%, P <0.001). The 2-year OS of HAART-responders was 88% compared with 19% in patients without HAART-response (P = 0.0002). By multivariate analysis patients without HAART had a 5.6-fold higher risk for 3-year mortality [HR 5.6, 95% confidence interval (CI) 2.20-14.26]. Three-year mortality was significantly higher in patients without complete remission (HR 4.40, CI 1.77-10.99), with stage III/IV HD (HR 4.64, CI 1.31-16.49) and with CD4 cells <200/microl (HR 2.69, CI 0.99-7.33). CONCLUSIONS: Use of HAART significantly improved the overall survival in patients with HIV-HD.

Acquired Immunodeficiency Syndrome↗

Acute neuronopathic Gaucher disease complicated by fatal gastrointestinal bleeding.

Gaucher disease, a rare lysosomal storage disease caused by deficiency of glucocerebrosidase, may present with gastrointestinal bleeding. We report about an 11-month-old boy suffering from acute neuronopathic Gaucher disease who died after massive gastrointestinal bleeding. A gastric ulcer was found as the sole bleeding source. The gastric mucosa showed marked infiltration with Gaucher cells, in particular around the ulcer. Alterations of the gastrointestinal mucosa offer a new explanation for gastrointestinal bleedings in this disease.

Fatal Outcome↗

Lymphoid pneumonitis as an immune reconstitution inflammatory syndrome in a patient with CD4 cell recovery after HAART initiation.

In the era of highly active antiretroviral therapy (HAART), immune reconstitution inflammatory syndrome (IRIS) has come to present a significant clinical challenge. Following the recovery of memory T cells, latent infections may lead to clinical and laboratory deterioration despite immunological and virological reconvalescence. However, many other forms of complications after induction of HAART, which are not entirely understood, must be included in the entity of IRIS. Here we report a case of a patient complaining of respiratory distress and fever 10 days after initiating HAART. Radiologically and clinically, his findings mimicked Pneumocystis jiroveci pneumonia. However, no infectious agent could be detected, and bronchoalveolary lavage showed a high cell count (90% lymphocytes and 4% eosinophils) consistent with interstitial pneumonitis. He improved dramatically after treatment with oral steroids.

Antiretroviral Therapy, Highly Active↗

Disseminated mucormycosis in haematological patients: CT and MRI findings with pathological correlation.

Disseminated mucormycosis is a rare, mostly fatal infectious complication in immunocompromised haematological patients. The purpose of our study was to describe the multiorgan manifestations of disseminated mucormycosis documented at CT and MRI in four patients and correlate these with the pathological findings and patient outcome. Irrespective of the site of infection, infarction or haemorrhage are the constant features of invasive mycosis. Identification of one or both of these two major imaging findings in immunocompromised patients should be regarded as an indicator of possible infection by angiotropic fungi, including the genre Mucorales.

Adult↗

Multireference calculations of the electronic structure of VF2 and VCl2.

We investigated the electronic structure of two members of the transition-metal dihalide family, VF(2) and VCl(2). Using the configuration-interaction method in large basis sets we calculated the lowest 17 states of these molecules in the vicinity of their ground-state geometry. We compute the ground-state bond lengths, vibrational frequencies, and dissociation energies. In contrast to predictions of ligand-field theory, we find (4)Sigma(g) (-) ground states for both molecules.

Journal Article↗

Electric field unbinding of solid-supported lipid multilayers.

We studied by X-ray reflectivity the behaviour of fully hydrated solid-supported lipid multilayers under the influence of a transverse electric field, under conditions routinely used in the electroformation process. The kinetics of sample loss (unbinding) was measured as a function of the amplitude and frequency of the applied field by monitoring the integrated intensity of the Bragg peaks. We also performed a time-resolved analysis of the intensity of the first Bragg peak and characterized the final state of the sample.

Binding Sites↗

[Therapy of hepatitis B and hepatitis C coinfection in HIV patients].

Hepatitis coinfection represents a major risk for end stage liver disease in HIV-positive patients. For this reason, categorically every patient should be evaluated in respect to a specific treatment for hepatitis. The immunological benefit of HAART for hepatitis/HIV coinfected patients is not only a reduction of the risk for HIV disease, but also the reduction of the risk for liver associated diseases and outweighs the drawbacks of a potential hepatotoxicity of HAART. Thus, HAART should not be withheld from a patient because of hepatitis coinfection. When cirrhosis is present, semiannual prophylactic checkups are recommended to monitor the occurrence of hepatocellular carcinoma.

AIDS-Related Opportunistic Infections↗

[The vaccination coverage among children aged 24 - 30 months in pediatric offices November 1999 - May 2001. The influence of socio-demographic characteristics].

BACKGROUND: The goal of this study was to investigate the influence of socio-demographic factors on vaccination coverage of 24-30 month old children in paediatric practices. METHODS: Vaccination coverage (VC) was documented for 15,682 children in 196 paediatric practices mainly in the region of Nordrhein. Data on socio-demographic factors were collected for 8,457 children and their influence on the vaccination status (VS) was investigated by means of logistic regression analysis. RESULTS: Complete age-appropriate VC for all vaccines recommended by the Standing Committee for Vaccination (STIKO) was 49.9 %. Complete VC for Diphtheria/Tetanus (DT) was 74.6 % and for first dose measles/mumps/rubella (MMR), 82.1 %. The following factors were associated with complete VS for DT and MMR: completion of last recommended well-child visit, parents living together, low number of siblings, short time to reach practice, parents stating they felt adequately informed about vaccinations. Complete vaccination for DT was inversely associated with being health insured through social security and for MMR with the mother having graduated from high school. CONCLUSIONS: A high proportion of 24-30 month old children did not have an age appropriate VS. Targeted parental education and timely vaccination strategies that take into account socio-demographic risk factors for low vaccination uptake are required.

Child, Preschool↗

Treatment of acute hepatitis C infection in HIV-infected patients: a retrospective analysis of eleven cases.

Studies on hepatitis C virus (HCV) monoinfected patients suggest high sustained treatment response rates of up to 98% when interferon monotherapy is administered during the acute phase of HCV-infection. To clarify whether early treatment of acute hepatitis C is similarly efficient in human immunodeficiency virus (HIV) positive patients, we conducted a retrospective survey of HIV-positive patients with acute HCV infection. Eleven HIV-positive patients who had been treated with interferon or interferon/ribavirin were identified at eight HIV-specialty outpatient clinics. The patients had been treated over a median 25 weeks with standard interferon (two patients), pegylated interferon (four patients) and pegylated interferon in combination with ribavirin (five patients). A post-treatment response (negative serum HCV-RNA at the end of treatment) was seen in 10 of 11 patients and HCV-RNA remained undetectable 24 weeks after the end of treatment in all the 10 responders. Alanine aminotransferase (ALT) normalized in eight patients while two virological responders and one nonresponder showed persistent mild ALT elevations. In conclusion, early treatment of acute hepatitis C seems to achieve high sustained virological treatment response rates also in patients with HIV-infection.

AIDS-Related Opportunistic Infections↗

Successful UVA1 phototherapy in a patient with scleredema adultorum.

Scleredema adultorum is a rare connective tissue disorder of unknown cause. Both bath-PUVA and cream-PUVA therapy were reported to be effective. We describe a patient with scleredema adultorum who showed a striking clinical improvement with a medium-dose UVA1 phototherapy (single dose, 50 J/cm(2); 35 treatments).

Humans↗