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Biomedical subjects

Marion Schneider

Publications and source records attributed to Marion Schneider.

7 recordsLinked to original sources
PubMed2006

Prospective comparison of push enteroscopy and push-and-pull enteroscopy in patients with suspected small-bowel bleeding.

BACKGROUND AND AIMS: The management of patients with suspected mid-gastrointestinal bleeding has in the past been difficult, as push enteroscopy (PE) only allows limited endoscopic access for diagnosis and treatment. Recently published uncontrolled data on push-and-pull enteroscopy (PPE) using the double-balloon technique suggest that this new method has a high diagnostic yield and therapeutic efficacy. A prospective controlled study was therefore carried out to compare PPE with PE as the common nonsurgical gold standard method. METHODS: The diagnostic yield, complications, and various examination parameters were compared in 52 consecutive patients with suspected mid-gastrointestinal bleeding who were evaluated with both enteroscopy methods. RESULTS: No relevant complications were observed with either method. Sedoanalgesia, examination times, and X-ray exposure were lower with PE. The insertion depth was significantly greater with PPE than with PE (230 cm vs 80 cm, p < 0.0001). The overall diagnostic yield with PPE (38 of 52 patients, 73%) and the results of oral PPE only (33 of 52 patients, 63%) were superior to those with PE (23 of 52 patients, 44%; p < 0.0001). PPE identified additional lesions in deeper parts of the small bowel in PE-positive patients in 78% of cases (18 of 23 patients). CONCLUSIONS: For endoscopic examination of the small bowel in patients with suspected mid-gastrointestinal bleeding, PPE is superior to PE with regard to the length of small bowel visualized, as well as the diagnostic yield. As the method also allows endoscopic treatment to be carried out, PPE should always be considered before open surgery and intraoperative endoscopy in patients with mid-gastrointestinal bleeding.

Adult↗
PubMed2006

Active cytomegalovirus infection in patients with septic shock.

Cytomegalovirus (CMV) is a pathogen of emerging importance for patients with septic shock. In this prospective study, 25 immunocompetent CMV-seropositive patients with septic shock and an intensive care unit stay of > or =7 days were monitored by using quantitative pp65-antigenemia assay, shell vial culture, and virus isolation. Within 2 weeks, active CMV infection with low-level pp65-antigenemia (median 3 positive/5x10(5) leukocytes) developed in 8 (32%) patients. Infection was controlled within a few weeks (median 26 days) without use of antiviral therapy. Duration of intensive care and mechanical ventilation were significantly prolonged in patients with active CMV infection. CMV reactivation was associated with concomitant herpes simplex virus reactivation (p = 0.004). The association between active CMV infection and increased illness could open new therapeutic options for patients with septic shock. Future interventional studies are required.

Adult↗
PubMed2005

Changes in the novel orphan, C5a receptor (C5L2), during experimental sepsis and sepsis in humans.

Sepsis is associated with extensive complement activation, compromising innate immune defenses, especially in neutrophils (PMN). Recently, a second C5a receptor (C5L2) was detected on PMN without evidence of intracellular signaling. The current study was designed to determine changes in C5L2 in blood PMN during sepsis. In vitro exposure of PMN to C5a, but not to fMLP, led to reduced content of C5L2. Following cecal ligation and puncture-induced sepsis in rats, PMN demonstrated a time-dependent decrease in C5L2. In vivo blockade of C5a during experimental sepsis resulted in preservation of C5L2. Similarly, PMN from patients with progressive sepsis showed significantly reduced C5L2 expression (n = 26), which was virtually abolished in patients who developed multiorgan failure (n = 10). In contrast, sepsis survivors exhibited retention of C5L2 (n = 12/13). The data suggest that C5L2 on PMN diminishes during sepsis due to systemic generation of C5a, which is associated with a poor prognosis.

Amino Acid Sequence↗
PubMed2005

Significant angiogenic potential is present in the microenvironment of muscle flaps in humans.

The purpose of this study was to determine the presence of growth factors and the quality of angiogenic potential in the wound microenvironment in different types of flaps in humans. The wound exudates from 23 flaps were processed for analysis of transforming growth factor beta1 (TGF-beta1), epidermal growth factor (EGF), interleukin 1alpha (IL-1alpha), platelet-derived growth factor-AB (PDGF-AB), vascular endothelial growth factor (VEGF), and insulin-like growth factor (IGF-1) by enzyme-linked immunosorbent assay (ELISA) or radio immuno assay (RIA). Angiogenic activity of wound fluid from latissimus flaps was determined by thymidine incorporation in porcine microendothelial cells exposed to various concentrations of wound fluid and control media. Angiogenic and matrix growth factors were altered in a linear fashion during the wound-healing process. Regression analysis provided evidence for decreasing levels of PDGF and EGF for latissimus flaps. Also, statistically significant differences of growth factor levels were found for paired comparison of flap types at different times after operation. Growth of in-vitro endothelial cells was stimulated most by 10 percent wound fluid, compared to any of the individual recombinant angiogenic factors or combinations of these factors. The data suggest that vascularized tissue flaps will promote wound healing by providing sufficient sources of growth factors in the wound environment. The particular type of flap, i.e., muscle or fasciocutaneous flap, does not seem to have an impact on growth-factor expression.

Cytokines↗