Biomedical subjects
Publications and source records attributed to M Zimmer.
The importance of the dissemination of scientific and clinical advances brought about by the early international dental congresses cannot be underestimated. The congresses in 1889, 1893, 1900 and 1909 set the pattern for discussion and association for the rest of the twentieth and, now, the beginning of the twenty-first century.
OBJECTIVES: The aim of the study was estimation of the influence of computer supervision of delivery on the way of medical management during partus. MATERIALS AND METHODS: Authors analyzed 10,983 labours which took place in years 1990-1999 in University Clinic of Reproduction and Obstetrics of Medical Academy in Wrocław. Cases of labours without computer monitoring was the first analyzed group, and the cases of computer monitoring deliveries was the second group. In both groups, the count of cesarean sections performed because of first symptoms of fetal asphyxia, and Apgar score gained by newborns, were taken into consideration. RESULTS AND CONCLUSIONS: The frequency of cesarean sections and neonatal Apgar score gained by newborns were compared in two characterized group in order to evaluation the influence of computer monitoring deliveries on the neonatal status. No impact of computer supervision on the way of delivery procedures, quality of work and neonatals state was observed.
The aim of this study was the general valuation of the course and the delivery means of the twin pregnancies. The research material composed of 83 from among 5540 pregnant women hospitalized in the Department of Reproduction and Obstetrics Medical University of Wrocław in the years 1995-1999. The mean body mass values and the condition of the newborns have been analyzed on the ground of Apgar's scale, according to the date of delivery. In the period between 23 and 42 week of pregnancy a very high correlation between fetus' body mass and a high correlation between Apgar's scale and the pregnancy's duration has been ascertained. These values have also been estimated in particular periods: 23-27, 28-32, 33-37 and 38-42 weeks of gestation. Statistical analysis didn't indicate any difference between the mean values of Apgar's scale of the newborns from the periods of 33-37 and 38-42 weeks of gestation. There was no evidence of differences either in Apgar's scale values or in the twins' I and II body masses, as well in the whole examined group as in particular periods.
OBJECTIVES: Evaluation of risks involved with the use of oxytocin and prostaglandin in pregnancies after caesarean delivery or uterine surgery. MATERIALS AND METHODS: This study involved 267 pregnant women who underwent caesarean delivery or gynaecological surgery within the uterus (myomectomy or Strassmann corrective surgery). Oxytocin and prostaglandin was used to induce uterine contraction in these women. We analysed their delivery methods and the frequency of complications like uterine rupture and rupture of past caesarean scar. RESULTS: Uterine rupture occurred in one women had history of caesarean delivery (0.5%), and rupture past history of caesarean scar occurred in eight women (3.5%) who previously underwent caesarean delivery. Complications were not found in women with past history of myomectomy or Strassmann Corrective surgery. We did not observe an increase in complications among women who received prostaglandin compared to those who received oxytocin. CONCLUSIONS: 1. Cardiotocographic monitor during labour reduces the risk of uterine rupture and rupture of past caesarean scar in pregnant women with past history of caesarean delivery or other uterine surgeries. 2. The use of prostaglandin in comparison to oxytocin does not increase complications in women with past history of uterine surgery. 3. The choice of delivery method in pregnant women with past history of uterine should be individualised.
OBJECTIVES: The aim of the study was analysis of neonatal status from pregnancies complicated oligohydramnios and from pregnancies complicated premature rupture of the membranes (PROM). MATERIALS AND METHODS: Authors analyzed 15 newborns from pregnancies with oligohydramnios diagnosed and 15- from pregnancies complicated PROM. Mothers of these newborns smoked cigarettes or were exposed to tobacco smoke. The features taken into consideration was prematurity, hypotrophy, malformations, birth weight, Apgar scale gained by newborns in first minutes after delivery. RESULTS AND CONCLUSIONS: The higher perinatal mortality, more frequent occurrence of hypotrophy and malformations were shown in newborns from pregnancies complicated oligohydramnios. The most frequent developmental anomaly was defect of nervosal system. Status of newborns from PROM pregnancies was getting better in according to lengthening duration of gestation. It wasn't stated in case of pregnancies with oligohydramnios complications.
We were investigated in the connection of the frequency of cesarean sections at pregnant women with uterus myomatous and physiological pregnancies. 189 pregnant patients with myomas have been analyzed retrospectively 72 women with physiological pregnancies belong to the controlled group. Our results didn't confirm the higher risk of cesarean sections in analyzed group.
During uterus contractions detaching of amino-chorionic layer from uterus wall occurs and released fibronectin penetrates into amniotic fluid. The aim of this study was to estimate in a quantity mode the presence of fibronectin in amniotic fluid and to find the dependence between the fibronectin level in amniotic fluid and the period of time from collecting the sample to the labor. We wanted also to find the dependence between fibronectin level in amniotic fluid and duration of pregnancy, preterm rupture of amniotic membranes, patients' age, parity and number of deliveries. We analysed 86 pregnant women where we estimated the fibronectin level in specimens of amniotic fluid. During carrying out the experiment we noted that fibronectin is present in amniotic fluid and can be identified in a quantity mode. We have proved dependence between fibronectin level in amniotic fluid and the period of time from collecting the sample, up to the delivery. Fibronectin level in amniotic fluid in pregnancies uncomplicated with premature delivery was on the average 350 mg/ml. Increase of fibronectin in amniotic fluid above 700 mg/ml points at detaching of amino-chorionic layer and the occurrence of unavoidable preterm labor at the time no longer than 24 hours. Fibronectin level in amniotic fluid doesn't depend of pregnancy duration, preterm rupture of amniotic membranes.
OBJECTIVE: The aim of this study was to asses usefulness of cerebro-placental ratio in the estimation of the intrauterine fetal well being in pregnancies complicated by intrauterine growth retardation and prediction of perinatal outcome. MATERIAL AND METHODS: We investigated 22 pregnant women between 28th and 40th week of pregnancy with IUGR detected by ultrasound examination. 19 pregnant women between 28th and 41st week of pregnancy was control group. We measured parameters blood flow in umbilical arteries and in middle cerebral arteries in both groups. We calculated cerebro placental ratios(CPR, CPP). We divided pregnant women with IUGR int 2 groups depending on correct (CPR, CPP > 1.08) or incorrect (CPR, CPP < 1.08). In both groups we analyzed perinatal outcome. RESULTS: In group pregnancies complicated with IUGR cerebro-placental ratios (CPR and CPP) were statistically significant lower than in control group. (for CPR p < 0.015 and for CPP p < 0.033). Sensitivity of cerebro placental ratio in screening small gestational age fetuses was 59% and specificity 89%. Sensitivity of cerebro placental ratio in predicting adverse perinatal outcome was 85% and specificity was 82%. CONCLUSIONS: Statistically significant decrease of cerebro-placental ratios is observed in pregnancies complicated wit IUGR. Cerebro placental ratio is very useful tool for prediction of adverse perinatal outcome.
OBJECTIVES: Assessment of the effectiveness of using low molecular weight heparin in the prophylaxis of venous thrombo-embolic diseases in pregnant women, parturients and puerperants. MATERIAL AND METHODS: 14,106 female patients were retrospectively analysed in the period between 1990-1999. The patients were divided into 4 groups: I--142 pregnant patients with crural varices, II--10 pregnant patients who had suffered from deep venous thrombosis, III--5 patients with implanted artificial cardiac valves, IV--13,949 patients without any risk factors. In the patients in groups I-III low molecular weight heparin was used prophylactically. RESULTS: In the studied groups no cases of pulmonary embolism were observed. Superficial venous thrombosis occurred in 10 women (3 in group I and 7 in group IV). Deep venous thrombosis occurred in 5 patients (2 in group I and 3 in group IV). In patients who received low molecular weight heparin over a long period of time, no excessive bleeding during delivery was observed. Other complications in the form of osteoporosis and thrombocytopenia were also not observed. CONCLUSIONS: 1. Administering of low molecular weight heparin during pregnancy, labour and puerperium has no influence on the increase of maternal et fetal complications. 2. Administering of low molecular weight heparin in pregnant women, in labour and in puerperium with increase risk of thrombo-embolic disease allows to avoid pulmonary arteries embolism. 3. Pregnant women and women in puerperium with increased risk of venous thrombo-embolic disease should be under control of experienced obstetrician in cooperation with vascular surgeon and hematologist.
OBJECTIVES AND STUDY DESIGN: The analysis of the influence of the closure or nonclosure of the visceral peritoneum during cesarean sections on the course of puerperium and late consequences. MATERIALS AND METHODS: There were 577 patients at whom cesarean section was performed. They were divided into two groups: in the first group (270 patients) during the cesarean sections visceral peritoneum was closed whereas, in the second group (307 patients) visceral peritoneum was not closed. Postoperative course and conditions of the organs in situ at the time of the following operations was considered. RESULTS: There were no differences in regard to postoperative course between two groups. In the group where visceral peritoneum was closed adhesions and upward dislocation of the bladder was observed whereas in the group where visceral peritoneum was not closed these abnormalities were not observed. CONCLUSIONS: 1. Nonclosure of the visceral peritoneum during cesarean sections is safe procedure. 2. Nonclosure of the visceral peritoneum during cesarean sections reduced frequency of the postoperative adhesions. 3. Nonclosure of the visceral peritoneum prevent upward dislocation of the urinary bladder.
The aim of the work was estimation of effectiveness of Synarel preparation in the treatment of pelvic pain syndrom caused by endometriosis, and assessment of remission of endometriosal focuses, situated in the small pelvis. Examination were performed on 10 cases which were divided into two groups. First of them the group of 6 patients with the intensive premenstrual pain complaints. The second group involved 4 patients with the little subjective pain ailments, which were treated for sterility. The patients were qualified for the 6-months Synarel treatment in according to the grade of intensification of endometriosis. The studies proved that Synare therapy was well-tolerate and effective in the treatment of intermediate and low-advanced cases of endometriosis with pelvic pain complaints.
Neutrophil elastase, proteinase-3, and azurocidin are primary components of neutrophil azurophilic granules and are encoded by closely linked genes (gene symbols ELA2, PRTN3, and AZU1, respectively) in a region of approximately 50 kb. These genes are coordinately expressed in a granulocyte-specific fashion, but the mechanisms defining this pattern of expression are unknown. To understand the role of chromatin organization in governing the expression of ELA2, PRTN3, and AZU1, we mapped this region of chromosome 19 and identified the adipsin (complement factor D) gene in proximity to the 3' end of ELA2. We then examined the changes in chromatin structure at the locus which accompany myeloid cell differentiation and identified 17 DNase I hypersensitive sites (DHS 1 to 17) in U-937 cells, an early myelomonocytic cell line expressing high levels of neutrophil elastase. Chemically induced differentiation and concomitant downregulation of AZU1, PRTN3, and ELA2 transcription in U-937 cells is not accompanied by changes in the DHS-pattern. Mature neutrophils, however, do not carry any of these hypersensitive sites, indicating a large degree of chromatin remodeling at this locus accompanying terminal granulocytic differentiation. Sixteen of the 17 DHS identified in U-937 cells are also present in the HL-60 myelomonocytic cell line. Hematopoietic cell lines representing the early erythroid and lymphocyte lineages, and a nonhematopoietic cell line display a subset of the hypersensitive sites. The altered chromatin structure specific to cells that actively transcribe the AZU1-PRTN3-ELA2 genes suggests that chromatin reorganization is an important mechanism regulating the myeloid-specific transcription of this gene cluster.
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Under physiological conditions firefly luciferase catalyzes the highly efficient emission of yellow-green light from the substrates luciferin, Mg-ATP, and oxygen. In nature, bioluminescence emission by beetle luciferases is observed in colors ranging from green (approximately 530 nm) to red (approximately 635 nm), yet all known luciferases use the same luciferin substrate. In an earlier report [Branchini, B. R., Magyar, R. M., Murtiashaw, M. H., Anderson, S. M., and Zimmer, M. (1998) Biochemistry 37, 15311-15319], we described the effects of mutations at His245 on luciferase activity. In the context of molecular modeling results, we proposed that His245 is located at the luciferase active site. We noted too that the H245 mutants displayed red-shifted bioluminescent emission spectra. We report here the construction and purification of additional His245 mutants, as well as mutants at residues Lys529 and Thr343, all of which are stringently conserved in the beetle luciferase sequences. Analysis of specific activity and steady-state kinetic constants suggested that these residues are involved in luciferase catalysis and the productive binding of substrates. Bioluminescence emission spectroscopy studies indicated that point mutations at His245 and Thr343 produced luciferases that emitted light over the color range from green to red. The results of mutational and biochemical studies with luciferase reported here have enabled us to propose speculative mechanisms for color determination in firefly bioluminescence. An essential role for Thr343, the participation of His245 and Arg218, and the involvement of bound AMP are indicated.
Vasodilator-stimulated phosphoprotein (VASP), a substrate of cAMP- and cGMP-dependent protein kinases, is associated with focal adhesions, cell-cell contacts, microfilaments, and highly dynamic membrane regions. VASP, which is expressed in most cell types and in particularly high levels in human platelets, binds to profilin, zyxin, vinculin, F-actin, and the Listeria monocytogenes surface protein ActA. VASP is a member of the enabled (Ena)/VASP protein family and is thought to be involved in actin filament formation and integrin alphaIIbbeta3 inhibition in human platelets. To gain further insight into the in vivo function of this protein, VASP-deficient mice were generated by homologous recombination. VASP-/- mice demonstrated hyperplasia of megakaryocytes in bone marrow and spleen but exhibited no other macroscopic or microscopic abnormalities. Activation of platelets with thrombin induced a more than 2-fold higher surface expression of P-selectin and fibrinogen binding in VASP-deficient platelets in comparison to wild type. These data support the concept that VASP is a negative modulator of platelet and integrin alphaIIbbeta3 activation. Although the limited phenotypic differences between wild-type and VASP-/- mice suggested functional compensation of VASP by members of the Ena/VASP family, alterations in the expression levels of mammalian enabled (Mena) and Ena-VASP-like (Evl) protein were not detected. VASP-deficient mice may provide an interesting model system for diseases in which enhanced platelet activation plays a major role.
The transcription factor NF-ATc is synthesized in three prominent isoforms. These differ in the length of their C terminal peptides and mode of synthesis. Due to a switch from the use of a 3' polyA site to a more proximal polyA site, NF-ATc expression switches from the synthesis of the two longer isoforms in naive T cells to that of short isoform A in T effector cells. The relative low binding affinity of cleavage stimulation factor CstF-64 to the proximal polyA site seems to contribute to its neglect in naive T cells. These alternative polyadenylation events ensure the rapid accumulation of high concentrations of NF-ATc necessary to exceed critical threshold levels of NF-ATc for gene induction in effector T cells.
This paper will describe one of the major trends in health care delivery: family oriented primary care. Implications and future directions for practice, education and research in the United States and Germany will be described and contrasted. The paper is a result of an ongoing dialogue between the first author, a Fulbright Professor at the University of Witten/Herdecke, and the second and third authors. The authors believe that, contextualizing emerging trends in health care delivery in this way, helps to clarify both what is unique to each country and what is actually or potentially shared in common.
In order to model the active site of urease which contains two nickel ions with differing coordination geometries new parameters were derived for the AMBER* force field. These parameters were obtained by structure based optimization and use a single set of parameters with points on a sphere approach to model nickel(II) high-spin in all its coordination geometries. The force field was successfully used to model the active site of urease and to predict that a bridging water between the two nickel ions in urease was missing from the solid state structure of urease. A thorough conformational search was undertaken to find the conformations available to urea within urease. All the low energy conformations found were used to determine a consensus urea binding model.