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Biomedical subjects

Markus Weber

Publications and source records attributed to Markus Weber.

42 records · Page 3Linked to original sources

Contrast-enhanced three-dimensional magnetic resonance angiography for visualization of ectopic varices.

We report the case of a 62-year-old male with portal hypertension and recurrent bleeding refractory to surgical intervention from varices in a sigmoid stoma. Although stomal varices were detected neither by physical examination, stomal endoscopy, nor duplex sonography, contrast-enhanced three-dimensional magnetic resonance angiography of the portal vein and its collateral branches demonstrated their presence. Surgical revisions of the stoma failed to prevent bleeding, but implantation of a transjugular intrahepatic shunt successfully prevented recurrent hemorrhage. This case indicates that contrast-enhanced, three-dimensional magnetic resonance angiography is useful to detect this rare complication of portal hypertension and helps to tailor adequate treatment in patients with recurrent bleeding from stomal varices.

Contrast Media↗

Inhibition of angiogenesis in vitro by alphav integrin-directed antisense oligonucleotides.

The integrin alpha v beta 3 plays a central role in angiogenesis. In this study, we used antisense oligodeoxyribonucleotides (ONs) directed against the alpha v subunit of alpha v beta 3 to inhibit integrin expression. Ten ON sequences, which were selected by systematic alignment of computer-predicted secondary structures of alpha v mRNA, were transfected into human umbilical vein endothelial cells (HUVECs). Following stimulation by PMA, five antisense ONs significantly inhibited alpha v mRNA and protein expression in activated HUVEC at a concentration of 0.05 mciroM with complete prevention of PMA-induced alpha v up-regulation by the most potent antisense ON. Inhibition of alpha v expression was associated with significant inhibition of migration of HUVEC by 28% and had no effect on proliferation and apoptosis. Moreover, transfection of antisense ON inhibited the formation of tube-like structures of HUVEC in Matrigel by 44%. In a cell culture model of angiogenesis consisting of a co-culture of endothelial cells with fibroblasts, transfection of antisense ONs resulted in an inhibition of tube formation of 61%. In conclusion, alpha v antisense ONs are potent inhibitors of angiogenesis in vitro. They might, therefore, be a therapeutic alternative to antagonists, which directly bind to alpha v integrins, and might be useful for the treatment of malignant tumors and hematological malignancies.

Apoptosis↗

Corticomotoneuronal connections in primary lateral sclerosis (PLS).

BACKGROUND: The relationship between primary lateral sclerosis (PLS) and amyotrophic lateral sclerosis (ALS) is uncertain. The slow progression and dominant upper motor neuron features of PLS are associated with a high threshold to cortical magnetic stimulation and sometimes slow central motor conduction. In ALS the cortical threshold may be reduced early in the disease and central conduction is usually normal. Corticomotoneuronal function appears to be impaired differently in PLS and ALS. SUBJECTS AND METHODS: We assessed corticomotoneuronal function by analyzing the primary peak in the peristimulus time histograms (PSTHs) in 12 PLS and 12 ALS patients. Surface recorded motor evoked potentials (MEPs) and central motor conduction time (CMCT) were determined. PSTHs were constructed from 4-5 different, voluntarily recruited motor units in each patient and the onset latency, number of excess bins, duration and synchrony of the primary peak were measured. RESULTS: The mean cortical threshold of single motor units in PLS was 73.6%, significantly higher than in ALS (60.3%; p < 2.2 x 10(-5)). Profoundly delayed primary peaks occurred in both PLS and ALS. Onset latency and desynchronization of the primary peak were similar in PLS and ALS, but the duration of the primary peak was significantly longer in PLS (p < 0.04). CONCLUSIONS: Desynchronized primary peaks indicate dysfunction or demise of corticomotoneurones. Higher threshold and longer duration of the primary peak in PLS probably reflect different excitability and greater loss of corticomotoneuronal connections than in ALS.

Adult↗

Dehydroepiandrosterone in relation to other adrenal hormones during an acute inflammatory stressful disease state compared with chronic inflammatory disease: role of interleukin-6 and tumour necrosis factor.

OBJECTIVE: Serum levels of dehydroepiandrosterone (DHEA) and DHEA sulphate (DHEAS) are low in chronic inflammatory diseases, although the reasons are unexplained. Furthermore, the behaviour of serum levels of these hormones during an acute inflammatory stressful disease state is not well known. SUBJECTS AND METHODS: In this study in patients with an acute inflammatory stressful disease state (13 patients undergoing cardiothoracic surgery) and patients with chronic inflammation (61 patients with inflammatory bowel diseases (IBD)) vs. 120 controls, we aimed to investigate adrenal hormone shifts looking at serum levels of DHEA in relation to other adrenal hormones. Furthermore, we tested the predictive role of serum tumour necrosis factor (TNF) and interleukin-6 (IL-6) for a change of serum levels of DHEA in relation to other adrenal hormones. RESULTS: The molar ratio of serum levels of DHEA/androstenedione (ASD) was increased in patients with an acute inflammatory stressful disease state and was decreased in patients with chronic inflammation. The molar ratio of serum levels of DHEAS/DHEA was reduced during an acute inflammatory stressful disease state and was increased in patients with chronic inflammation. A multiple linear regression analysis revealed that elevated serum levels of TNF were associated with a high ratio of serum levels of DHEA/ASD in all groups (for IL-6 in patients with an acute inflammatory stressful disease state only), and, similarly, elevated serum levels of TNF were associated with a high ratio of serum levels of DHEAS/DHEA only in IBD (for IL-6 only in healthy subjects). CONCLUSIONS: This study indicates that changes of serum levels of DHEA in relation to serum levels of other adrenal hormones are completely different in patients with an acute inflammatory stressful disease state compared with patients with chronic inflammation. The decrease of serum levels of DHEAS and DHEA is typical for chronic inflammation and TNF and IL-6 play a predictive role for these changes.

Acute Disease↗

Risk management in the design of medical device software systems.

The safety of any medical device system is dependent on the application of a disciplined, well-defined, risk management process throughout the product life cycle. Hardware, software, human, and environmental interactions must be assessed in terms of intended use, risk, and cost/benefit criteria. This article addresses these issues in the context of medical devices that incorporate software. The article explains the principles of risk management, using terminology and examples from the domain of software engineering. It may serve as a guide to those new to the concepts of risk management and as an aide-memoire for medical device system/software engineers who are more familiar with the topic.

Consumer Product Safety↗