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Biomedical subjects

T Weiss

Publications and source records attributed to T Weiss.

At least 37 records · Page 2Linked to original sources

Enhancement of TNF receptor p60-mediated cytotoxicity by TNF receptor p80: requirement of the TNF receptor-associated factor-2 binding site.

TNFR p60 (TNFR60) is the main mediator of TNF-induced apoptosis, although in some cells TNFR80 is also involved. TNFR80-dependent induction or enhancement of cytotoxicity has been explained by intracellular signaling, "ligand passing," or induction of endogenous TNF. Using HeLa transfectants expressing wild-type TNFR80 and deletion mutants derived from them, we have investigated the mechanism of TNFR80-mediated cytotoxicity. TNFR80 induces no cytotoxicity on its own, but is functional in these transfectants, as selective stimulation activates nuclear factor-kappaB (NF-kappaB) and induces NF-kappaB-dependent cellular responses (IL-6 and manganese superoxide dismutase). TNFR60-induced cytotoxicity, however, is enhanced about 1000-fold by costimulation of TNFR80, whereas only additive responses are observed with regard to NF-kappaB-dependent responses. Ligand passing is not critically involved, because a similar potentiation of TNFR60-mediated cytotoxicity was observed when agonistic Abs were used for stimulation of both receptors. In addition, in HeLa cells overexpressing a truncated form of TNFR80 lacking the cytoplasmic domain, no TNFR80-dependent potentiation of TNFR60-mediated cytotoxicity was detectable, emphasizing that intracellular signaling of TNFR80 is required for synergistic activity. The involvement of endogenously produced TNF can be ruled out by the use of TNF-neutralizing Abs. The ability of TNFR80 to cooperate with TNFR60 could be mapped to the binding site for the TNF receptor-associated factor-2. These results are in agreement with a differential cooperation of both TNFR; an additive effect is obtained in those responses that are initiated by both receptors via identical pathways, i.e., activation of NF-kappaB, whereas induction of cytotoxicity is most likely mediated by distinct signaling pathways, allowing positive cooperativity.

Binding Sites

Efficacy of a new prostaglandin E1 regimen in outpatients with severe intermittent claudication: results of a multicenter placebo-controlled double-blind trial.

For the first time efficacy and safety of a new prostaglandin E1 (PGE1) regimen in the treatment of intermittent claudication were evaluated in a randomized, double-blind, placebo-controlled multicenter clinical trial. The study involved 213 outpatients with a maximum walking distance of 50 to 200 m measured on the treadmill (3 km/hr, 12% grade). After a 2-week run-in phase they received a 2-hour intravenous infusion of 60 micrograms PGE1 or placebo 5 days a week for 4 weeks. It was followed by a 4-week interval treatment with the same medication administered only twice a week. Patients were monitored for 3 months when they received no study medication. In the PGE1 group the intention-to-treat analysis (n = 208) revealed an increase in walking distance after 4 weeks of 75% (placebo, 43%). At the end of the interval treatment the walking distance had improved to 101% (placebo, 60%). The results remained virtually constant during follow-up (PGE1, 104%, placebo, 63%). Between-group comparisons showed significant differences in favor of PGE1 for all three time points of measurement (p < 0.05, p < 0.01, and p < 0.05). PGE1 was well tolerated; the rate of adverse reactions related to the treatment was 12.8% (placebo, 7.7%). In summary, these results show that the new PGE1 regimen is effective and safe in the treatment of outpatients with intermittent claudication.

Aged

Circulating vascular cell adhesion molecule-1 correlates with the extent of human atherosclerosis in contrast to circulating intercellular adhesion molecule-1, E-selectin, P-selectin, and thrombomodulin.

Secondary prevention of atherosclerosis, especially before the onset of symptoms, appears desirable and could be possible with a serum marker detecting atherosclerosis. Circulating, shedded forms of adhesion molecules may serve as such because their expression is upregulated in atherosclerotic plaques. In 52 patients with peripheral arterial vascular disease (Fontaine class IIa, 7 patients; class IIb, 29 patients; and class III, 16 patients), the extent of atherosclerosis was evaluated on the basis of angiograms of a large portion of the arterial system. The area diseased by atherosclerosis was determined by the percentage of vessel wall irregularities of the following calculated segments: aorta (distal from the kidney arteries), common iliac artery, external iliac artery, common femoral artery, lateral circumflex femoral artery, and popliteal artery. The maximal surface area that could exhibit atherosclerotic changes was 250 cm2. The serum concentration of circulating vascular cell adhesion molecule-1 (VCAM-1) correlated with the extent of atherosclerosis (r = .8, P < .001). In contrast, circulating intercellular adhesion molecule-1, E-selectin, P-selectin, and thrombomodulin (as markers for endothelial cell damage) did not correlate with the extent of atherosclerosis. Furthermore, circulating VCAM-1 could be used to indicate stages of atherosclerosis with a high degree of statistical significance. The potential bias of factors such as age, diabetes mellitus, hypercholesterolemia, arterial hypertension, renal failure, and history of myocardial infarction on the correlation of circulating VCAM-1 with the extent of atherosclerosis could be excluded by multivariate analysis. These findings suggest an important role of VCAM-1 in atherosclerosis and may serve as the basis for further evaluation of circulating VCAM-1 as a potential serum marker for atherosclerosis.

Adult

Reliability of dipole localization for the movement-evoked field component MEF I.

The movement-evoked field I (MEF I) component is the largest and most stable neuromagnetic component accompanying self-paced movements. In order to use MEG for studying dynamic changes in the cortical organization of movements, data about the reliability and variability of these neuromagnetic components for individual subjects must be established during different sessions. For this aim, three male subjects were requested to perform self-paced flexions of their index finger and thumb in repeated sessions while the MEG was recorded by a 31 channel system. The MEF I was identified for each session and a single equivalent dipole was calculated for this component. The dipole localizations of the various sessions were compared. The standard deviation of the localization for all persons and all values amounts to 4.0-5.2 mm for the three spatial dimensions. Our data suggest that the spatial distance between two single focal sources fitted to the MEF I must be greater than 14 mm to be interpreted as distinct. However, the neuromagnetic field structure and the resulting dipole localization of the MEF I component are quite stable and could be used for the evaluation of cortical plasticity.

Adult

Assessment of isometric contractions performed with maximal subjective effort: corresponding results for EEG changes and force measurements.

In order to find a parameter or parameters that can be attributed to movements performed with maximal subjective effort, EEG recordings and force measurements were taken in connection with isometric muscle contractions performed with 80% of the subjective maximal force (IMC80) or with maximal subjective effort (IMC100). Criteria based on EEG recordings and force measurements have been considered as indicators for maximal subjective effort in a given movement. The following criteria were selected: A. If the mean spectral theta amplitude across the parieto-occipital area decreases from IMC80 to IMC100 then the isometric contraction is taken to be performed with maximal effort; B. If the obtained force values can be fitted to a switch function and if the achieved forces are only a predetermined percentage lower than the maximal force value obtained over all trials then this isometric contraction is accepted to be performed with maximal effort. 18 out of 24 cases fulfill the EEG criterion whereas the criterion for force measurements is fulfilled in 16 out of 24 trials. The comparison between the results obtained by means of the EEG criterion and by means of criterion for force measurement shows that the results are in agreement in 22 out of 24 cases (p < .001). The high correspondence of the assessments allows us to suspect that both criteria specify the same phenomenon, namely the performance of a motor task with maximal subjective effort.

Adult

Positive association of the beta fibrinogen H1/H2 gene variation to basal fibrinogen levels and to the increase in fibrinogen concentration during acute phase reaction but not to coronary artery disease and myocardial infarction.

BACKGROUND: Fibrinogen has been demonstrated to be an independent risk factor of cardiovascular disease. The absence of the HaeIII cutting site (H2 allele) of an H1/H2 gene variation in the promoter region of the beta fibrinogen gene was associated with increased levels of fibrinogen. METHODS AND RESULTS: In the present study, the effects of the H1/H2 gene variation not only on plasma fibrinogen concentrations but also on coronary artery disease (CAD) and myocardial infarction (MI) were investigated in 923 individuals who underwent coronary angiography for diagnostic purposes. Relation of the H1/H2 genotype to fibrinogen plasma levels: A strong association was observed between the H1/H2 gene variation and fibrinogen levels. The differences in fibrinogen plasma levels between H2H2 and H1H1 homozygotes were almost threefold more pronounced within subjects with clinical chemical signs of an acute phase reaction (CRP > or = 7.5 mg/l) than within a subgroup of subjects without these signs (CRP < 7.5 mg/l) (median of CRP distribution: 7.5 mg/l). In 207 patients who underwent aortocoronary bypass surgery plasma fibrinogen levels were almost identical directly after surgery. Two days after operation fibrinogen increased to clearly higher levels in H2H2 homozygotes than in H1H2 and H1H1 genotypes, whereas almost the same maximal increases in fibrinogen concentrations were reached 3-4 days after surgery in all individuals. Relation of the H1/H2 genotype to CAD and MI. Whereas in the total population the plasma fibrinogen concentrations were strongly associated with smoking, CAD and MI, an association of the H1/H2 gene variation to CAD and MI was not detected. However, mean age at first MI of H2H2 individuals (62.9 years) was clearly higher than of H1H2 genotypes (56.9 years) and of H1H1 subjects (56.4 years). In addition, in a subgroup of individuals with a higher risk of MI by either high apoB and/or low apoA1 plasma levels the portion of MI patients was clearly smaller within H2H2 homozygotes than within H1H2 or H1H1 genotypes, although-also in these high risk groups-mean age at first MI of H2H2 individuals were higher than of the other two genotypes. CONCLUSIONS: Obviously, the H2 allele of the fibrinogen H1/H2 genotype does not only influence basal fibrinogen concentrations, but particularly also the extent of fibrinogen level increase during acute phase reaction. Whereas the fibrinogen plasma level is positively associated with coronary artery disease and myocardial infarction, the H2 allele-although exhibiting an association with elevated fibrinogen levels-was not positively associated with CAD and MI.

Acute-Phase Reaction

Internal consistency of dipole localizations for the human movement-evoked magnetic field component 1 (MEF 1).

The present magnetoencephalographic study was conducted in order to assess the accuracy of dipole localizations for the movement-evoked field component 1 (MEF 1). Three male subjects were requested to perform self-paced flexions of their index finger and thumb in repeated sessions of 60 trials while the neuromagnetic field was recorded by a 31 channel system. Single moving dipole localizations were performed for the MEF 1. The error within single sessions was calculated by split-half reliability and window-homogeneity in a total of 61 sessions. The mean spatial deviation between both halves amounted to 3.8 mm. The window-homogeneity was found to be 2 mm deviation/10 ms.

Adult

The outcome of patients with acute myocardial infarction ineligible for thrombolytic therapy. Israeli Thrombolytic Survey Group.

PURPOSE: The aim of this study was to determine the proportion of patients with acute myocardial infarction (AMI) excluded from thrombolytic therapy on a national basis and to evaluate the prognosis of these patients by reasons of ineligibility and according to the alternative therapies that they received during hospitalization. PATIENTS AND METHODS: During a national survey, 1,014 consecutive patients with AMI were hospitalized in all the 25 coronary care units operating in Israel. RESULTS: Three hundred and eighty-three patients (38%) were treated with a thrombolytic agent and included in the GUSTO study. Ineligible patients for GUSTO were treated: (1) without any reperfusion therapy (n = 449), (2) by mechanical revascularization (n = 97), or (3) given 1.5 million units of streptokinase (n = 85) outside of the GUSTO protocol. The inhospital and 1-year post-discharge mortality rates were 6% and 2% in patients included in the GUSTO study; 6% and 5% in those mechanically reperfused; 15% and 10% in those treated with thromoblysis despite ineligibility for the GUSTO trial, and 15% and 13% among patients not treated with any reperfusion therapy. CONCLUSIONS: Ineligibility for thrombolysis among patients with AMI remains high. Patients ineligible for thrombolysis according to the GUSTO criteria, but nevertheless treated with a thrombolytic agent were exposed to an increased risk.

Actuarial Analysis

[APC (activated protein C) resistance and oral contraceptives].

Resistance to activated protein C [1,2,3,4,5,6] is the most frequent hereditary cause of thromboses and is widespread through-out the population. Women with APC resistance have an enhanced risk of thrombosis compared to the total population. The risk increase, with the intake of oral contraceptives.

Blood Coagulation Tests

[Obstructive sleep apnea in patients with coronary heart disease].

Patients with obstructive sleep apnea have an increased cardiovascular morbidity and mortality, those with co-existent coronary artery disease being particularly at risk. The object of our study was to evaluate the prevalence of obstructive sleep apnea in patients with coronary artery disease. 153 patients (117 men, 36 women) with verified coronary artery disease were given a highly sensitive standardized questionnaire. The 59 patients with pathological results were then checked with a 6-channel non-laboratory monitoring system. 22.2% of all patients had a respiratory disturbance index (RDI) above 5/h. and 14.4% above 10/h. 13.3% had a pathological RDI and additionally suffered from excessive daytime sleepiness. Patients with coronary artery disease have a high prevalence of obstructive sleep apnea and should consequently be screened for this sleep-related breathing disorder.

Aged

Influence of coronary angioplasty on the progression of coronary atherosclerosis.

This study examines the effect of coronary angioplasty on the progression and appearance of new disease in sites of the coronary tree that were not dilated by the balloon. We examined 355 pairs of coronary angiograms from 252 patients. The study consisted of consecutive patients who were referred for catheterization > 1 month after successful angioplasty. Progression/regression and the appearance of new narrowings at sites not dilated by angioplasty were determined. The life-table method was used to determine outcome, and any event (progression, regression, and new narrowing) was analyzed according to the time of occurrence. The angioplasty artery was compared with the non-angioplasty artery and the effect of restenosis was determined by comparing arteries with and without restenosis. Progression/regression rates were not significantly different in angioplasty and non-angioplasty arteries. More new narrowings were identified in the angioplasty artery (p < 0.01). With regard to narrowings located in the angioplasty artery, progression was more common, regression less common, and the appearance of new narrowings more common in arteries with restenosis than in non-angioplasty arteries or arteries without restenosis. We believe that mechanical trauma to the artery during angioplasty could accelerate disease progression and the appearance of new narrowings in angioplasty arteries, whereas normalization of flow rate and pattern, especially in arteries without restenosis, attenuates the rate of progression and the appearance of new narrowings in these arteries. The final outcome depends on the balance between these factors.

Angioplasty, Balloon, Coronary

Gene polymorphism but not catalytic activity of angiotensin I-converting enzyme is associated with coronary artery disease and myocardial infarction in low-risk patients.

BACKGROUND: An insertion/deletion (I/D) polymorphism of the angiotensin I-converting enzyme (ACE) gene has been postulated to be associated with an increased risk of coronary artery disease (CAD) and myocardial infarction (MI). METHODS AND RESULTS: In the present study, the effects of I/D gene polymorphism and of ACE activity on CAD and MI were investigated in 920 individuals who underwent coronary angiography for diagnostic purposes. In the total population and in all CAD and MI groups, a strong association was observed between the gene polymorphism and ACE activities; DD genotypes had approximately twofold higher ACE activities than II genotypes. Although classic risk and protective factors of CAD and MI were identified, associations of ACE genotype and of ACE activity to CAD and MI were not detected in the total population. Among subjects defined to be at lower risk of MI by low body mass index and low cigarette consumption, however, an association of the DD genotype with MI was found. Exclusion of individuals with triglyceride levels > 140 mg/dL and cholesterol levels > 180 mg/dL revealed an association of the DD genotype with CAD. An association of the ACE activity with CAD or MI could not be demonstrated in any of the low-risk populations. CONCLUSIONS: Increased ACE activity obviously is not a risk factor of CAD or MI. The importance of the deletion polymorphism for the development of CAD and MI may be restricted to individuals without classic risk factors.

Case-Control Studies

Theta power decreases in preparation for voluntary isometric contractions performed with maximal subjective effort.

In order to find EEG parameters that can be attributed to movements performed with maximal subjective effort, EEG recordings and force measurements were realized in connection with isometric contractions (IMC). IMC were performed with submaximal and maximal subjective effort. Mean spectral power density within the theta band was found as an indicator for maximal subjective effort. The theta power across the parieto-occipital area decreases from rest through movements performed with submaximal force to movements performed with maximal effort. It is argued that this theta decrease possibly reflects a down-regulation of the posterior attention system in order to minimize the influences of external stimuli during the preparation for voluntary IMC performed with maximal subjective effort.

Adult

Form and magnitude of beta-sympathetic and parasympathetic influences on pulse transit time.

In this study, we examined autonomic influences on pulse transit time measured from the R-wave of the electrocardiogram (R-PTT). Six subjects received three doses each of isoproterenol and atropine. Isoproterenol produced a significant linear decrease in R-PTT, a significant linear increase in heart rate (HR), and a significant linear decrease in diastolic blood pressure (DBP). Atropine produced a significant linear decrease in R-PTT and significant linear increases in HR and DBP. The R-PTT shortening effect of isoproterenol may reflect positive inotropic effects of beta-sympathetic myocardial stimulation. The R-PTT shortening effect of atropine may reflect reduction of parasympathetic inhibition of ventricular myocardial activity. However, possible vascular contributions to these effects remain to be determined. Nonetheless, the results encourage further examination of R-PTT in research concerning autonomic regulation of cardiovascular activity.

Adult

Activation processes during mental practice in stroke patients.

In healthy subjects, mental practice is known to improve motor performance. It is also known to be accompanied by a higher central nervous activity. Since such effects seem to be desirable for rehabilitation, we investigated the possibility of detecting changes in central nervous activity by means of EEG in stroke patients, and whether these changes were similar to those observed in healthy subjects. 12 left-sided hemiplegic patients who underwent a specific post-stroke rehabilitation treatment were requested to perform a simple arm movement sequence. In the following mental practice period the patients were requested to image the same sequence without any real movement. EEG background activity was recorded during rest and imagination periods. After the calculation of z-transformed power values within the theta, alpha, and beta-1 band, differences between rest and imagination periods were evaluated for their significance. Stroke patients show significant decreases of theta, alpha, as well as beta-1 power during mental practice in comparison to the rest period. These changes are similar to those obtained in healthy subjects. Theta power decreases in central and parietal leads. Central alpha power diminishes only during imagination of the contralateral arm. This phenomenon as well as the decrease of beta-1 power in central derivation were also obtained during real motor performance and might indicate an activation of the sensorimotor cortex. In accordance with the hypothesis of internal feedback mechanisms, this activation is a necessary prerequisite for motor learning during mental practice.

Aged

Reactive hyperemia of skin microcirculation in septic neonates.

Reactive hyperemia after 1 min of arterial occlusion was studied in back, thigh and heel skin of 40 preterm and full-term neonates using laser Doppler flowmetry. Twelve infants had clinical signs of septicemia, but normal laboratory tests at the time of fluxmetry. However, CRP, leukocyte count and the ratio of immature to total neutrophils increased during the following days and septicemia was confirmed by positive blood cultures (septic group). Seven neonates with clinical signs of septicemia had developed neither positive blood cultures nor laboratory signs (non-septic group). Fifteen were healthy neonates. In the septic neonates, time to reach maximal hyperemia, maximum post-occlusive hyperemia and recovery time of skin perfusion were increased significantly in back and thigh skin and the heal skin temperature was decreased when compared to healthy neonates. Healthy and non-septic neonates showed no significant difference in any of the parameters. We conclude that altered reactive hyperemia in the skin may be an earlier sign of neonatal septicemia than laboratory tests.

Humans

Mental practice of motor skills used in poststroke rehabilitation has own effects on central nervous activation.

In the last years it has been shown that the use of the EMG triggered electrical myostimulation (ETEM) brings good results in poststroke rehabilitation. It has been hypothesized that the relearning effects obtained by means of ETEM are due to the reinstatement of proprioceptive feedback. However, the technique is most powerful if imagination of motor acts (the so called mental practice) is used as an initial part of ETEM. Since mental practice in healthy people leads to central nervous activation processes as well as to an improvement of motor skills, we investigated the effects of mental practice alone on central nervous activity by means of EEG in stroke patients. Twelve left-sided hemiplegic patients who underwent a specific poststroke rehabilitation treatment were requested to perform a simple arm movement sequence. In the following mental practice period the patients were requested to imagine the same sequence without any real movement. EEG background activity was recorded during baseline and imagination periods. After the calculation of z-transformed power values within the alpha and beta-1 band, differences between rest and imagination periods were evaluated for significance. Stroke patients showed significant decreases of alpha as well as beta-1 power during mental practice in comparison to the rest period. These changes are similar to those obtained in healthy subjects. Central alpha power diminished only during imagination of the contralateral arm. This phenomenon as well as the decrease of beta-1 power in central derivation were also obtained during real motor performance and might indicate an activation of the sensorimotor cortex. In accordance with the hypothesis of internal feedback mechanisms, this activation is a necessary prerequisite for motor learning during mental practice. We conclude that mental practice of motor skills might have own effects in poststroke rehabilitation.

Aged

Very early thrombolysis in acute myocardial infarction--a light at the end of the tunnel.

Myocardial damage in acute myocardial infarction is a time-dependent process. Thrombolytic therapy effectively opens the coronary artery, restores coronary blood flow and prevents ongoing necrosis. We examined the effect of very early thrombolytic therapy (including prehospital administration) in a consecutive group of 510 patients with myocardial infarction on the following factors: mortality, complications and the preservation of left ventricular function. The treatment was given to 89 at home (time delay to treatment 1.2 +/- 0.6 h) and 421 in hospital (2.0 +/- 1.0 h). Twelve patients died in hospital and major hemorrhage occurred in 10. The arterial patency rate in 416 patients who underwent coronary angiography 6 days later was 82%. Infarct size measured by left ventriculography was determined by the area at risk, the delay time until the initiation of thrombolytic therapy, the total duration of ischemic pain and the degree of restoration of arterial blood flow. We conclude that early thrombolytic therapy, particularly prehospital management, is feasible and safe and reduces infarct size and mortality. A further decrease in the delay to initiation of treatment and more effective thrombolytic therapy will further decrease mortality and myocardial damage.

Aged