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Biomedical subjects

R Pfister

Publications and source records attributed to R Pfister.

At least 37 records · Page 2Linked to original sources
PubMed2002

Exercise intensity of cycle-touring events.

The aim of the study was to analyze the exercise intensity of recreational cyclists participating in a cycling-touring event. In 14 male healthy recreational cyclists heart rate (HR) monitoring was performed during the Otztal Radmarathon 1999 (distance: 230 km; altitude difference: 5500 m) in order to evaluate the HR response and to estimate the cardiopulmonary strains for the less-trained athlete confronted with such a marathon. Four different exercise intensities were defined as percentages of maximal HR (HR(max)) as follows: recovery HR (HR(re)) < 70 % of HR max; moderate aerobic HR (HR(ma)) = 70 - 80 %; intense aerobic HR (HR(ia)) = 80 - 90 %; and anaerobic HR (HR(an)) > 90 %. All athletes finished the competition successfully. The mean racing time was 10 h 14 min, the average speed 22.5 km/h. The mean HR(max) was 188 bpm, the average value of the measured HRs (HR(average)) was 145 bpm resulting in a mean HR(average)/HR(max) ratio of 0.77. Athletes spent 18.5 % (1 h 54 min) of total race time within HR(re), 28 % (2 h 52 min) within HR(ma), 39.5 % (4 h 02 min) within HR(ia), and 14 % (1 h 26 min) within HR(an). The vast majority of exercise was done under "aerobic conditions" (HR(re) + HR(ma) + HR(ia) = 86 % or 8 h 48 min) - confirming the knowledge that the aerobic energy supply is crucial for the performance of long-term exercise. The large amount of high exercise intensities (HR(ia) + HR(an) = 53.5 % or 5 h 30 min), however, features the intense cardiopulmonary strains evoked by such competitions. The HR response was related to the course profile with HRs significantly declining in all subjects to an extent of 10 % during the course of race. Our findings show that the exercise intensity borne by recreational cyclists during a cycle-touring event is high and very similar to that of professionals. With respect to the high cardiovascular strains a thorough medical screening is advisable for any participant of such an event combining both high volume and high intensity loads.

Adult↗
PubMed2001

Immunomagnetic enrichment of CD138 positive cells from weakly infiltrated myeloma patients samples enables the determination of the tumor clone specific IgH rearrangement.

In multiple myeloma, the polymerase chain reaction (PCR) of the Ig heavy chain with allele-specific oligonucleotide (ASO) primers is a common and well-described method of identifying the tumor clone in peripheral blood (PB), bone marrow (BM) or leukapheresis products (LA). A factor which is crucial to the detection of clonal Ig rearrangements lies in the 'purity' of the tumor tissue used for the consensus PCR. We describe the application of a method to enrich CD138 positive myeloma cells derived from weakly infiltrated PB-, BM- and LA-samples. These are subjected to immunomagnetic enrichment with the MACS system, using an CD138 antibody directly conjugated to magnetic beads to obtain an enriched tumor cell population and the subsequent amplification of tumor specific IgH rearrangements. We investigated 29 samples (ten PB, ten BM, nine LA) with a median myeloma cell content of 0.5%. The approach led to a median enrichment factor of 118. Tumor-specific rearrangements could be amplified reproducibly from samples containing less than 0.1% myeloma cells.

Consensus Sequence↗
PubMed2001

Antihypertensive efficacy of amlodipine in children with chronic kidney diseases.

In adults the calcium antagonist amlodipine given once a day has proved to be an attractive addition to the antihypertensive armamentarium. The present report describes our experience in 43 paediatric outpatients (26 boys and 17 girls, aged between 1.1 and 19, median 9.8 years) with chronic kidney diseases. The patients were given amlodipine for 16 weeks as part of their antihypertensive treatment. Before amlodipine arterial pressure was 150 (142-163)/90 (84-95) mm Hg (median and interquartile range). Six patients withdrew from amlodipine because of oedema, flushing or headache. In the remaining patients amlodipine 7.7 (6.9-9.4) mg/m(2) body surface area once a day significantly decreased arterial pressure by 17 (13-22)/10 (7-13) mm Hg. The efficacy of amlodipine was more pronounced in girls than in boys. No changes in heart rate, body weight and circulating haemoglobin, sodium, potassium and creatinine were noted. In none of the patients circulating potassium, sodium or creatinine changed by more than 0.5 mmol/l, 5 mmol/l respectively 20%. In 11 patients concomitantly treated with cyclosporine the dosage and the trough-level of this agent were stable throughout the trial. In conclusion the present experience in paediatric outpatients with chronic kidney diseases supports the view that amlodipine is an effective and rather well tolerated antihypertensive drug when given once a day.

Adolescent↗
PubMed2001

Local expression of epsilon germline gene transcripts and RNA for the epsilon heavy chain of IgE in the bronchial mucosa in atopic and nonatopic asthma.

BACKGROUND: The demonstration of epsilon germline gene (Cepsilon) transcripts and mature mRNA for the epsilon heavy chain gene (Iepsilon) in the nasal mucosa suggested that IgE synthesis may occur in allergic rhinitis. OBJECTIVE: In view of our previous demonstration of increases in IL-4 mRNA(+) cells in asthmatic subjects, we assessed whether local IgE synthesis may also be a feature of bronchial asthma. METHODS: Fiberoptic bronchoscopic mucosa biopsy specimens were obtained from 9 atopic asthmatic subjects and 10 nonatopic normal (intrinsic) control subjects. To control for atopy, we also studied 9 nonatopic asthmatic subjects and 10 atopic nonasthmatic control subjects. Tissue was processed for immunohistochemistry for B cells (CD20) and in situ hybridization for Iepsilon and Cepsilon RNA(+) cells and IL-4 mRNA(+) cells. RESULTS: B-cell numbers in the bronchial mucosa were similar for asthmatic subjects compared with control subjects, whereas significantly higher numbers of Iepsilon RNA(+) (P =.02 and P =.04, respectively), Cepsilon RNA(+) (P =.01 and P =.03, respectively), and IL-4 mRNA(+) (P =.001 and P =.001, respectively) cells were observed in atopic asthmatic subjects and nonatopic asthmatic subjects, respectively, but not in atopic control subjects compared with nonatopic control subjects. In asthmatic subjects there were significant correlations between Iepsilon RNA(+) cells (r = 0.54, P =.02) and Cepsilon RNA(+) cells (r = 0.48, P =.05) when compared with the number of IL-4 mRNA(+) cells. CONCLUSION: Increases in Iepsilon and Cepsilon RNA(+) cells, but not B-cell numbers, in the bronchial mucosa provide evidence for local IgE synthesis in both atopic and nonatopic asthma. These changes appear to relate to asthma rather than atopy per se and, at least in part, may be under the regulation of IL-4.

Adult↗
PubMed2000

[Hashimoto encephalopathy: steroid-sensitive encephalopathy in Hashimoto thyroiditis].

Hashimoto's encephalopathy is a steroid-responsive, relapsing or progressive encephalopathy associated with Hashimoto's thyroiditis. Characteristic clinical features are confusion, seizures, alteration in conscious level, stroke-like episodes, myoclonus, and tremulousness. High CSF protein levels without pleocytosis and a diffusely abnormal EEG are typical findings. Brain CT and MRI and cerebral angiogram are usually normal. We present two case reports of Hashimoto's encephalopathy in 55- and 77-year-old patients who both responded well to steroid therapy, and review the literature.

Aged↗
PubMed2000

[Hereditary progressive mucinous histiocytosis].

BACKGROUND: Hereditary progressive mucinous histiocytosis is an uncommon condition which to date has only been observed in women. The disease is a non-Langerhans histiocytosis with a stereotypic clinical presentation limited to the skin. The clinical, histological and genetic features of this disease differ considerably from other types of histiocytoses and overload diseases. We report the first case observed in France. CASE REPORT: A 49-year-old woman consulted for asymptomatic papules on the dorsal aspect of the hands known since childhood. The lesions had progressively spread to other regions of the body. The woman's mother and two sisters had the same condition but her two sons and her brother and nephews did not. Standard semi-thin slices and electron microscope histology demonstrated dense cellular infiltration of the reticular dermis with interstitial mucinous overload, voluminous histiocytes with characteristic toluidine blue positive granulations, and a cytoplasm rich in myelin and Zebra bodies respectively. The observed clinical, histological and genetic features were characteristic of progressive hereditary progressive mucinous histiocytosis. DISCUSSION: The pedigree in our case and in those reported in the literature suggest a dominant hereditary condition. The fact that only female cases have been reported to date would suggest X-linked transmission with early death of male fetuses. An autosomal dominant transmission limited to woman as a result of mitochondrial heredity or hormone-related phenomena cannot be ruled out. The progressive extension with age without a tendency for spontaneous regression and the electron microscopy aspect suggest a phospholipid deposit disorder similar to that observed in lysosomial diseases. However, primary macrophage proliferation in response to an unknown stimulus cannot be excluded.

Disease Progression↗
PubMed1998

[What thrombolytic rate can be realized in acute myocardial infarct? Results of the Oltner Heart Emergency Study].

BACKGROUND: Despite the benefits of thrombolytic therapy, there is evidence that not all suitable patients are receiving it. Early and accurate recognition of the ECG changes of myocardial infarction is a prerequisite for effective thrombolytic treatment. METHODS: During the Olten Heart Emergency Study we prospectively evaluated 951 consecutive patients with symptoms suggestive of myocardial infarction who were cared for by the emergency networks connected with Olten Cantonal Hospital. MAIN OUTCOME MEASURES: The final diagnosis was myocardial infarction in 173 patients (18.2%). Diagnostic ST-segment elevation was found in 48.6% and complete left bundle branch block in 13.9% of these patients, representing a total of 62.5% acute myocardial infarction patients eligible for thrombolysis based on the ECG findings. Using a time limit of 6 hours between onset of symptoms and hospital entry for small and medium-size myocardial infarctions and 12 hours for large infarctions, plus an age limit of 70 years for inferior and 75 years for anterior infarctions as exclusion criteria for thrombolysis, we found one or more contraindications for the use of thrombolytic therapy in 50.9% of these patients. The most prevalent contraindication was time delay in the prehospital phase in 38.2%, followed by advanced age in 34.5%. Medical contraindications to thrombolytic treatment were found to be present in only 10.9%. Extension of the prehospital time delay to 24 hours would have increased the candidates for thrombolytic treatment to 39.3%, and raising the upper age limit by 5 years would have increased them to 46.8%. CONCLUSIONS: Our figures for a theoretically adequate thrombolysis rate contrast with many previous studies and the clinical reality in different hospitals both in Switzerland and around the world. In view of the importance and socioeconomic consequences of thrombolytic treatment in myocardial infarction, studies focusing on possible reasons for discrepancies between guidelines for thrombolytic therapy and their implementation in hospital practice would appear to be a necessity in providing measures to improve patient care in this clinical setting.

Adult↗
PubMed1998

Expression of the IL-4 receptor alpha-subunit is increased in bronchial biopsy specimens from atopic and nonatopic asthmatic subjects.

BACKGROUND: Recent studies have provided evidence for increased IL-4 expression in the airways of atopic and nonatopic asthmatic subjects. IL-4 is believed to perform important regulatory roles in asthma; however, the expression of the IL-4 receptor has not been investigated. In this study we examined the mRNA and protein expression of the specific alpha-subunit of the IL-4 receptor (alphaIL-4R) in bronchial biopsy specimens obtained from atopic and nonatopic asthmatic subjects. METHODS: Asthmatic subjects and nonasthmatic control subjects were recruited, and lung function measurements were performed before bronchoscopy. Endobronchial biopsy specimens were examined for the presence of alphaIL-4R mRNA and immunoreactivity by using in situ hybridization and immunocytochemistry, respectively. RESULTS: alphaIL-4R mRNA-positive and immunoreactive cells were detected in the epithelium and subepithelium in biopsy specimens from all subjects. Expression of alphaIL-4R mRNA and protein was significantly increased in the epithelium and subepithelium of biopsy specimens from atopic asthmatic subjects compared with atopic control subjects (P <.05 and P <.001, respectively). Epithelial alphaIL-4R mRNA expression and immunoreactivity did not differ significantly between nonatopic asthmatic subjects and nonatopic control subjects. Although the numbers of alphaIL-4R mRNA-positive cells were augmented in the submucosa of intrinsic asthmatic subjects compared with nonatopic control subjects (P <.05), alphaIL-4R immunoreactivity did not differ significantly between these groups. Increased alphaIL-4R immunoreactive signals were also detected in the endothelial cell layer in both atopic and intrinsic asthmatic subjects compared with atopic and nonatopic control subjects, respectively (P <.05). Combined in situ hybridization immunocytochemistry performed on biopsy sections from asthmatic and control subjects demonstrated alphaIL-4R mRNA expression in CD3-positive T cells and tryptasepositive mast cells, with T cells comprising the larger proportion of alphaIL-4R mRNA-positive cells. Numbers of alphaIL-4R mRNA-positive or immunoreactive cells did not correlate with CD3-positive cell numbers, numbers of IL-4 mRNA-positive cells, or indices of pulmonary function. CONCLUSION: These results demonstrate constitutive alphaIL-4R expression in normal airways and enhanced expression in airway tissue from asthmatic individuals.

Adult↗
PubMed1998

Gene expression screening in Xenopus identifies molecular pathways, predicts gene function and provides a global view of embryonic patterning.

In a large-scale gene expression screen 1765 randomly picked cDNAs were analyzed by whole-mount in situ hybridization in Xenopus embryos. Two hundred and seventy three unique, differentially expressed genes were identified, 204 of which are novel in Xenopus. Partial DNA sequences and expression patterns were documented and assembled into a database, 'AXelDB'. Approximately 30% of cDNAs analyzed represent differentially expressed genes and about 5% show highly regionalized expression. Novel marker genes and potential developmental regulators were found. Differential expression of mitochondrial genes was observed. Marker genes were used to study regionalization of the entire gastrula as well as the tail forming region and the epidermis of the tailbud embryo. Four 'synexpression' groups representing genes with shared, complex expression pattern that predict molecular pathways involved in patterning and differentiation were identified. According to their probable functional significance these groups are designated as Delta1, Bmp4, ER-import and Chromatin group. Within synexpression groups, a likely function of genes without sequence similarity can be predicted. The results indicate that synexpression groups have strong prognostic value. A cluster analysis was made by comparing gene expression patterns to derive a novel parameter, 'tissue relatedness'. In conclusion, this study describes a semi-functional approach to investigate genes expressed during early development and provides global insight into embryonic patterning.

Animals↗
PubMed1998

Molecular concepts of IgE-initiated inflammation in atopic and nonatopic asthma.

Atopic and nonatopic (intrinsic) asthmatics were characterized by a broadly conserved bronchial mucosal proeosinophilic cytokine network in which IL-5 appears to play a key role. Inappropriate IgE-mediated mechanisms may occur in asthma, irrespective of its atopic status, as suggested by elevated serum IgE concentrations and bronchial mucosal expression of FcepsilonRI, IL-4, IL-13, Iepsilon, and Cepsilon. In general, these observations support the concept that these subtypes of asthma, despite showing distinct clinical and biologic features, share many common immunopathologic mechanisms. The most promising future directions of research regarding intrinsic asthma concern the possible identification of novel allergens or antigens, the detailed description of local bronchial mucosal IgE production, and the understanding of a possible macrophage dysfunction. Furthermore, a role for infectious (viral?) or autoimmune processes has yet to be firmly identified in intrinsic asthma. Animal models may also help us to understand the role of IgE and atopy in asthma. Although these are largely IgE-mediated mechanisms, allergen-induced bronchial hyperresponsiveness and eosinophilic inflammation can also occur in the absence of IgE (null mutation of the Cepsilon locus), as shown in a mouse model of hypersensitivity to Aspergillus fumigatus (57). Thus, despite the absence of atopy, IgE-mediated mechanisms may operate in intrinsic asthma (Fig. 1).

Animals↗
PubMed1998

Aggression and goal orientations in handball: influence of institutional sport context.

The purpose of this study was to examine the relationship of goal orientations with aggression in male adolescent handball across three institutional sport context, Physical Education, Interscholastic, and League (clubs). 30 handball games were videotaped (10 per context) and observed on monitor by means of a grid allowing the distinction between Instrumental (nonemotional and task-oriented) and Hostile (an emotional response which is an end in itself (aggression. 240 players also completed the "Questionnaire de Perception du Succès en Sport." A main effect of context emerged from 2 separate one-way multivariate analyses of variance for goal orientations and aggression. Univariate F tests and Newman-Keuls post hoc analyses indicated that Ego-goal orientation and Instrumental aggression were significantly higher in the League context than in the other two. Statistically significant positive correlations. between measures of Ego-goal orientation and aggression were observed. Discriminant function analysis indicated that strongly Ego-goal classified players displayed more Instrumental aggression than lower Ego-goal classified players.

Adolescent↗
PubMed1997

Expression of IL-4 and IL-5 mRNA and protein product by CD4+ and CD8+ T cells, eosinophils, and mast cells in bronchial biopsies obtained from atopic and nonatopic (intrinsic) asthmatics.

We recently demonstrated bronchial mucosal expression of IL-4 and IL-5 at the mRNA and protein level in both atopic and nonatopic (intrinsic) asthma. In this report, using double immunohistochemistry (IHC) and in situ hybridization (ISH), we show that 70% of IL-4 and IL-5 mRNA+ signals co-localized to CD3+ T cells, the majority (>70%) of which were CD4+, although CD8+ cells also expressed IL-4 and IL-5 mRNA. The remaining IL-4 and IL-5 mRNA signals co-localized to mast cells and eosinophils. The cellular distribution of these mRNA species did not differ between atopic and nonatopic asthmatics. In contrast, double IHC showed that IL-4 and IL-5 immunoreactivity was predominantly associated with eosinophils and mast cells, with few IL-5 or IL-4 immunoreactive CD3+ T cells detectable. However, total IL-4- or IL-5-positive cells detected by IHC were <40% of the total mRNA+ cells, raising the possibility that insufficient cytokine protein accumulated within T cells to enable detection by IHC. We conclude that: 1) in atopic and nonatopic asthma CD8+ T cells, in addition to CD4+ T cells, mast cells and eosinophils express mRNA for IL-4 and IL-5; 2) whereas IL-4 and IL-5 mRNA expression was associated mainly with T cells, immunoreactivity for the corresponding protein products was detectable predominantly in eosinophils and mast cells; and 3) this discrepancy may be partly attributable to the relative insensitivity of double IHC technique that does not allow detection of cytokine protein in T cells where, unlike eosinophils and mast cells, there is no facility for storage and concentration in granules.

Adult↗
PubMed1997

[The prehospital phase of patients with suspected acute myocardial infarct: results of the Oltner Cardiac Emergency Study].

Early reperfusion in acute myocardial infarction has been shown to reduce myocardial damage and to improve prognosis. The goals of this study, the Olten Cardiac Emergency Study, were to identify the factors, related to the patients or to the emergency medical services, which influenced pre-hospital delay in patients with symptoms suggestive of acute myocardial infarction. From November 1, 1992, to June 15, 1993, all the events occurring between symptom onset and hospital discharge where analyzed for 341 such patients who were cared for by the emergency networks connected with the Cantonal Hospital, Olten: in addition, follow-up at 3 months was obtained on all patients discharged alive. Of the 341 patients, 14 (4.1%) died out of the hospital. The final diagnoses of the 327 patients admitted to the emergency department were: acute myocardial infarction 18.3%; unstable angina 10.1%; stable angina 3.4%; non-ischemic cardiac diseases 29.4%; other non-cardiac diseases 38.8%. Mean delay between symptom onset and arrival at the hospital was 8 h 55 min (median delay 4 h 10 min); for patients with a final diagnosis of acute myocardial infarction, mean delay was 9 h 43 min (median delay 5 h 10 min). Patient delay was surprisingly long and represented 70.4% of the total pre-hospital delay; 56.6% of the patients did not realize that their symptoms were serious and only 47.1% (and 68.3% of the patients with acute myocardial infarction) came to the hospital by ambulance. These long pre-hospital delays were responsible for the low (13.3%) thrombolysis rate of patients with acute myocardial infarction. We conclude that pre-hospital delay was much too long in our population. Improvements can only be achieved through patient education and better efficiency of emergency networks. Our findings underline the need for public education campaigns on heart attacks.

Aged↗