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1.
Heliyon ; 4(12): e01049, 2018 Dec.
Article in English | MEDLINE | ID: mdl-30603691

ABSTRACT

OBJECTIVES: This study aimed to investigate the effects of using hydroxyl apatite functionalized calcium carbonate (FCC) particles on occluding dentinal tubules. METHODS: Dentine specimens extracted from eighteen human molars with exposed dentinal tubules were divided into three groups (n = 6/group): a) Cut surface with smear layer; b) EDTA (smear layer removed with 17% EDTA for 1 min); and c) Grit blasted functionalized calcium carbonate (FCC) with and air pressure of 280 kPa. Microscopic dentinal tubule occlusion, tubule diameter and tubule area were evaluated using scanning electron microscopy (SEM) before and after grit blasting. Biomineralization of specimens was carried out in a simulated body fluid (SBF). Elemental analysis of occluding materials was carried out using energy-dispersive X-ray spectroscopy (EDX). X-ray diffraction (XRD) analysis was performed to demonstrate the crystal structure of the biomineralized layer on dentine. RESULTS: FCC particles showed penetration into the dentinal tubules by breakage of their original particle shape and size. EDTA treated surface had higher number and larger size tubules than those with smear layer or grit blasted (p < 0.005). SEM-EDX analysis revealed mineral precipitation of calcium phosphate on the SBF immersed dentin specimens. XRD analysis showed typical crystal structure of hydroxyl apatite for the biomineralized surface layer on dentine. CONCLUSIONS: Grit blasted FCC particles initially occluded effectively the opened dentinal tubules and biomineralization occurred in tubules primarily occluded by the FCC particles. However, in the optimal in vitro conditions in SBF, no difference between biomineralization was found between the grit blasted surface and the control surface. CLINICAL SIGNIFICANCE: Several materials and methods have been established for treatment of dentinal hypersensitivity although a golden standard treatment has not been discovered. Grit blasted functionalized calcium carbonate has a potential to occlude and remineralize exposed dentinal tubules. This could offer a more biological approach on treatment of dentin hypersensitivity.

2.
Nutr Metab Cardiovasc Dis ; 27(11): 999-1007, 2017 Nov.
Article in English | MEDLINE | ID: mdl-29074383

ABSTRACT

BACKGROUND AND AIMS: As a modifiable lifestyle factor, diet is hypothesized to play an important role in the progression of atherosclerosis. The aim of this study was to explore associations of comprehensive dietary patterns derived by cluster analysis with degree and progression of coronary artery calcification (CAC) over five years of follow-up. METHODS AND RESULTS: In the population-based Heinz Nixdorf Recall study, 3718 participants (45-75 years; 47.6% men) without coronary heart disease completed a food frequency questionnaire at baseline. Five distinct dietary patterns were identified using cluster analysis: "Health-conscious", "Traditional German/Less alcohol", "Mediterranean-like", "Western" and "Animal fat/Alcohol" (used as reference). CAC was measured using electron-beam computed tomography at baseline and five years later. CAC after five years was predicted based on sex- and age-specific baseline percentiles. After comparing observed and predicted CAC Scores, CAC progression was classified as slow, expected, or rapid. Compared to "Animal fat/Alcohol" diet, a "Mediterranean-like" diet was associated with a relative risk (RR) for a rapid CAC progression in both sexes (men: 0.61; 95%-confidence interval [95%-CI]: 0.41; 0.90; women: 0.59; 95%-CI: 0.45; 0.78). Furthermore, reduced RRs were observed in women with a "Health-conscious" and a "Traditional German/Less alcohol" diet (0.63; 95%-CI: 0.47; 0.84, respectively 0.69; 95%-CI: 0.52; 0.90). No association was observed for a "Western" diet for both sexes. Similar results were revealed for degree of CAC. CONCLUSION: The study results support the hypothesis that a "Mediterranean-like" diet is associated with a lower CAC-progression and lower degree of CAC in men and women.


Subject(s)
Coronary Artery Disease/epidemiology , Diet , Feeding Behavior , Vascular Calcification/epidemiology , Aged , Alcohol Drinking , Cluster Analysis , Computed Tomography Angiography , Coronary Angiography/methods , Coronary Artery Disease/diagnostic imaging , Coronary Artery Disease/prevention & control , Diet/adverse effects , Diet Surveys , Diet, Healthy , Diet, Mediterranean , Diet, Western , Dietary Fats , Disease Progression , Female , Germany/epidemiology , Humans , Linear Models , Male , Middle Aged , Odds Ratio , Prospective Studies , Protective Factors , Risk Factors , Severity of Illness Index , Time Factors , Vascular Calcification/diagnostic imaging , Vascular Calcification/prevention & control
3.
Herz ; 42(7): 622-628, 2017 Nov.
Article in German | MEDLINE | ID: mdl-28921000

ABSTRACT

The tricuspid valve and the right ventricle are hemodynamically closely related. Pathological changes of the valve or of the ventricle itself and also various diseases beyond that can result in a downward spiral of mutual interference, which is of prognostic importance for the patient. The development of a functional tricuspid regurgitation is of great importance. Especially with the help of 3D-echocardiography, more and more changes and mechanisms have been identified that are crucial in this process. This article provides a review of the relationship between the tricuspid valve and the right ventricle emphasizing the current knowledge of the causes, the pathophysiological concepts, the underlying structural changes and the therapeutic approaches based on this.


Subject(s)
Heart Ventricles/physiopathology , Hemodynamics/physiology , Tricuspid Valve Insufficiency/physiopathology , Tricuspid Valve/physiopathology , Cardiomegaly/diagnostic imaging , Cardiomegaly/physiopathology , Echocardiography, Three-Dimensional , Heart Ventricles/diagnostic imaging , Humans , Hypertension, Pulmonary/diagnostic imaging , Hypertension, Pulmonary/physiopathology , Papillary Muscles/physiopathology , Prognosis , Statistics as Topic , Tricuspid Valve/diagnostic imaging , Tricuspid Valve Insufficiency/diagnostic imaging , Ventricular Dysfunction, Right/diagnostic imaging , Ventricular Dysfunction, Right/physiopathology
4.
Genes Brain Behav ; 12(5): 583-92, 2013 Jul.
Article in English | MEDLINE | ID: mdl-23566274

ABSTRACT

Data comparability between different laboratories strongly depends on the individually applied analysis method. This factor is often a critical source of variation in rodent phenotyping and has never been systematically investigated in Pavlovian fear conditioning paradigms. In rodents, fear is typically quantified in terms of freezing duration via manual observation or automated systems. While manual analysis includes biases such as tiredness or inter-personal scoring variability, computer-assisted systems are unable to distinguish between freezing and immobility. Consequently, the novel software called MOVE follows a semi-automatized approach that prefilters video sequences of interest for the final human judgment. Furthermore, MOVE allows integrating additional data sources (e.g. force-sensitive platform, EEG) to reach the most accurate and precise results. MOVE directly supports multi-angle video recordings with webcams or standard laboratory equipment. The integrated manual key logger and internal video player complement this all-in-one software solution. Calculating the interlaboratory variability of manual freezing evaluation revealed significantly different freezing scores in two out of six laboratories. This difference was minimized when all experiments were analyzed with MOVE. Applied to a genetically modified mouse model, MOVE revealed higher fear responses of CB1 deficient mice compared to their wild-type littermates after foreground context fear conditioning. Multi-angle video analysis compared to the single-camera approach reached up to 15% higher accuracy and two fold higher precision. Multidimensional analysis provided by integration of additional data sources further improved the overall result. We conclude that the widespread usage of MOVE could substantially improve the comparability of results from different laboratories.


Subject(s)
Conditioning, Classical , Fear , Software , Animals , Data Interpretation, Statistical , Mice , Rats , Video Recording
5.
Br J Radiol ; 85(1015): e300-6, 2012 Jul.
Article in English | MEDLINE | ID: mdl-22010027

ABSTRACT

OBJECTIVE: Cardiac CT allows the detection and quantification of coronary artery calcification (CAC). Electron-beam CT (EBCT) has been widely replaced by high-end CT generations in the assessment of CAC. The aim of this study was to compare the CAC scores derived from an EBCT with those from a dual-source CT (DSCT). METHODS: We retrospectively selected 92 patients (61 males; mean age, 60.7 ± 12 years) from our database, who underwent both EBCT and DSCT. CAC was assessed using the Agatston score by two independent readers (replicates: 1, 2; 3=mean of reading 1 and 2). RESULTS: EBCT scores were on average slightly higher than DSCT scores (281 ± 569 vs 241 ± 502; p<0.05). In regression analysis R(2)-values vary from 0.956 (1) to 0.966 (3). We calculated a correction factor as EBCT=(DSCT+1)(1.026)-1. When stratifying into CAC categories (0, 1-99, 100-399, 400-999 and ≥1000), 79 (86%) were correctly classified. From those with positive CAC scores, 7 out of 61 cases (11%, κ=0.81) were classified in different categories. Using the corrected DSCT CAC score, linear regression analysis for the comparison to the EBCT results were r=0.971 (p<0.001), with a mean difference of 6.4 ± 147.8. Five subjects (5.4%) were still classified in different categories (κ=0.84). CONCLUSION: CAC obtained from DSCT is highly correlated with the EBCT measures. Using the calculated correction factor, agreement only marginally improved the clinical interpretation of results. Overall, for clinical purposes, face value use of DSCT-derived values appears as useful as EBCT for CAC scoring.


Subject(s)
Calcinosis/diagnostic imaging , Coronary Angiography/methods , Coronary Artery Disease/diagnostic imaging , Tomography, X-Ray Computed/classification , Tomography, X-Ray Computed/methods , Aged , Calcium/analysis , Calcium/metabolism , Cohort Studies , Coronary Artery Disease/physiopathology , Databases, Factual , Female , Humans , Linear Models , Male , Middle Aged , Multivariate Analysis , Reproducibility of Results , Retrospective Studies , Sensitivity and Specificity
6.
Pathologe ; 32(6): 521-3, 2011 Nov.
Article in German | MEDLINE | ID: mdl-21732079

ABSTRACT

Heterotopic gastric mucosa is a rare finding in the rectum. Apart from two other hypotheses, a misdifferentiation of entodermal stem cells is the most widely accepted aetiopathogenetic assumption today. Due to acid secretion, the lesions predominantly manifest with hematochezia. Therapeutic options include medicinal therapy and particularly (endoscopic) removal. From the pathologist's point of view a careful evaluation is required also in terms of basically possible dysplastic or malignant changes.


Subject(s)
Choristoma/pathology , Gastric Mucosa , Rectal Diseases/pathology , Biopsy , Choristoma/surgery , Colonoscopy , Diagnosis, Differential , Humans , Intestinal Mucosa/pathology , Intestinal Mucosa/surgery , Male , Middle Aged , Rectal Diseases/surgery
7.
Rofo ; 182(4): 334-40, 2010 Apr.
Article in English | MEDLINE | ID: mdl-19941248

ABSTRACT

PURPOSE: Patients with coronary artery disease (CAD) show a high prevalence for concomitant atherosclerotic peripheral arterial disease (PAD). On the other hand, PAD seems to be an additional risk factor for cardiac events. We evaluated the correlation between arterial pathologies as found in whole-body MR angiography and coronary artery calcification (CAC) detected by electron beam computed tomography (EBCT) and multislice CT (MSCT). MATERIALS AND METHODS: Two hundred and twenty-eight patients (161 men; 67 women) with suspicion for CAD/known CAD underwent whole-body contrast-enhanced MR angiography (wb-ce-MRA) and EBCT/MSCT. An atherosclerosis index was calculated for each patient Index = (40)Sigma(n=1) w(i) with w(i) being the grading of the stenosis of the i (ten) of 40 arteria segments (grade: 0 - no plaque; 1 - plaque - < or = 50 % stenosis; 2 - > 50 % stenosis - < or = 90 % stenosis; 3 - > 90 % stenosis - < 100 % stenosis; 4 - occlusion). Correlations between CAC and atherosclerosis index were performed. RESULTS: Wb-ce MRA and CAC correlate only moderately in this population. An atherosclerosis index 8 renders a positive predictive value for a CAC 100 of 63.3 %. CONCLUSION: An atherosclerosis index as defined in this study does not fully correlate with the extent of CAD as revealed by catheter angiography or EBCT/MSCT, but it might theoretically mirror the increased risk by PAD. It thus might be a promising complementary parameter for the prediction of cardiac events. Future studies need to show its possible additional predictive impact.


Subject(s)
Calcinosis/diagnosis , Coronary Angiography , Coronary Artery Disease/diagnosis , Image Processing, Computer-Assisted , Imaging, Three-Dimensional , Magnetic Resonance Angiography , Tomography, Spiral Computed , Whole Body Imaging , Adult , Aged , Cardiac Catheterization , Female , Humans , Male , Middle Aged , Myocardial Infarction/diagnosis , Prognosis , Risk Assessment , Sensitivity and Specificity , Statistics as Topic
8.
Neuroscience ; 165(2): 371-85, 2010 Jan 20.
Article in English | MEDLINE | ID: mdl-19840834

ABSTRACT

We studied auditory thalamocortical interactions in vitro, using an auditory thalamocortical brain slice preparation. Cortical activity evoked by electrical stimulation of the medial geniculate nucleus (MGN) was investigated through field potential recordings and voltage sensitive dyes. Experiments were performed in slices obtained from adult mice (9-14 weeks). Stimulus evoked activity was detected in the granular and supragranular layers after a short latency (5-6 ms). In 9-14 weeks old mice infragranular activity was detected in 10 of 24 preparations and was found to be increased in younger mice (p 31-64). In 14 of 24 slices a prominent horizontal spread was observed, which extended into cortical areas lateral to A1. In these experiments, the shortest onset latencies and largest signal amplitudes were located in the supragranular layers of A1. In areas lateral to A1, shortest onset latencies were located in the granular layer, while largest signal amplitudes were found in the supragranular layers. Evoked cortical activity was sensitive to removal of extracellular Ca(2+) or application of 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX, 10 microM). Short repetitive stimulation, resembling thalamic burst activity (three pulses at 100 Hz), resulted in an increase of signal amplitude and excited area by approximately 25%, without changing the overall spatiotemporal activity profile. Blockade of N-methyl-D-aspartate receptors by 2-amino-5-phosphonopentanoate (AP5, 50 microM) reduced amplitudes and excited area by approximately 15-30%, irrespective of stimulation frequency. Application of bicuculline (10 microM) greatly increased cortical responses to thalamic stimulation. Under these conditions, evoked activity displayed a pronounced horizontal spread in combination with a 2-3-fold increase in amplitude. In conclusion, afferent thalamic inputs primarily activate supragranular and granular layers in the auditory cortex of adult mice. This activation is predominantly mediated by non-NMDA receptors, while GABA(A) receptor-mediated inhibition limits the horizontal and vertical spread of activity.


Subject(s)
Auditory Cortex/physiology , Geniculate Bodies/physiology , Neurons, Afferent/physiology , 2-Amino-5-phosphonovalerate/pharmacology , 6-Cyano-7-nitroquinoxaline-2,3-dione/pharmacology , Aging , Animals , Auditory Cortex/drug effects , Bicuculline/pharmacology , Calcium/metabolism , Electric Stimulation , Evoked Potentials/drug effects , Excitatory Amino Acid Antagonists/pharmacology , GABA Antagonists/pharmacology , Geniculate Bodies/drug effects , In Vitro Techniques , Membrane Potentials/drug effects , Mice , Mice, Inbred C57BL , Neurons, Afferent/drug effects , Receptors, N-Methyl-D-Aspartate/antagonists & inhibitors , Receptors, N-Methyl-D-Aspartate/metabolism , Thalamus/drug effects , Thalamus/physiology , Time Factors , Voltage-Sensitive Dye Imaging
9.
Nervenarzt ; 80(4): 422-9, 2009 Apr.
Article in German | MEDLINE | ID: mdl-19011824

ABSTRACT

Multiple sclerosis (MS) has traditionally been regarded as an inflammatory demyelinating disorder of the CNS in which clinical symptoms result from axon conduction block caused by myelin degradation. However, typical accumulation of permanent neurological deficits during the clinical course of MS cannot be explained solely by de- and remyelinating processes. It is considered to be rather due to neuronal degeneration, for which several reasons could be identified depending on the state of the disease. First, neurons and their axons can be damaged by infiltrating lymphocytes and macrophages either directly by cell-to-cell contact or by the release of harmful mediators such as nitric oxide or glutamate. Second, indirect injury to neurons and axons may occur through the loss of trophic support by neighbouring oligodendrocytes due to destruction of both the myelin sheath and the oligodendrocyte itself. Third, redistribution of certain voltage- and ligand-gated ion channels and transporters along naked demyelinated axons restores axonal conduction but also leads to excessive spatially restricted electrical activity of the axonal membrane, intracellular calcium accumulation, impairment of mitochondrial function, and subsequent neuronal degeneration. The neuroprotective potential of pharmacological modulation of these channels and transporters using already approved drugs has been demonstrated in several animal studies, is the subject of current clinical trials and will be the topic of this review.


Subject(s)
Inflammation/physiopathology , Ion Channel Gating , Ion Channels/metabolism , Models, Neurological , Multiple Sclerosis/physiopathology , Neurodegenerative Diseases/physiopathology , Humans
10.
Z Gastroenterol ; 46(4): 339-43, 2008 Apr.
Article in German | MEDLINE | ID: mdl-18393151

ABSTRACT

INTRODUCTION: Besides conventional colonoscopy, CT and MR colonography offer alternate virtual imaging modalities of the colon. The sensitivity of CT colonography, which is associated with radiation exposure, has been published in prior, large studies. Regarding MR colonography, in particular dark lumen MR colonography with the rectal administration of a water enema as a contrast agent, only limited published data exist. The goal of this study was to compare MR colonography with conventional colonoscopy in the detection of colorectal polyps. In addition the feasibility and image quality in unselected hospitalised patients were assessed. PATIENTS/METHODS: Included were 103 hospitalised patients who had to undergo colonoscopy for various indications. Immediately prior to conventional colonoscopy, MR colonography with rectal water enema and additional intravenous administration of contrast material was performed. Detection rates for polyps and adenomas were documented with both imaging modalities. Image quality and completion rates (practicability) and other (incidental) findings were also recorded. RESULTS: In 15 of 103 patients the MR examination could not be done or was only partially completed. The detection rate of MR colonography for polyps (adenomas) was 2% (4%) for polyps (adenomas) up to 5 mm in diameter, 38% (56%) for polyps (adenomas) 6-10 mm in diameter and 89% (89%) for polyps (adenomas) up to 11 mm in diameter. One flat carcinoma seen with conventional coloscopy was missed on MR colonography. CONCLUSIONS: MR colonography offers the possibility of imaging the colon without exposure to radiation. Polyps and adenomas are detected, similar to the detection rate of CT colonography, with adequate sensitivity only if they are larger than 10 mm in diameter. Therefore this imaging technique is not (yet) suitable as a screening test. Additional limitations are the necessary cooperation of the patient which can reduce the practicability and image quality in selected patients. Further studies like the just started German multicentre trial are needed to assess the position of MR colonography.


Subject(s)
Colonic Neoplasms/diagnosis , Colonic Polyps/diagnosis , Colonography, Computed Tomographic , Colonoscopy , Magnetic Resonance Imaging/methods , Aged , Aged, 80 and over , Colonic Neoplasms/diagnostic imaging , Colonic Polyps/diagnostic imaging , Contrast Media , Data Interpretation, Statistical , Enema , Feasibility Studies , Female , Gadolinium DTPA , Humans , Inpatients , Male , Middle Aged , Sensitivity and Specificity , Water
11.
MMW Fortschr Med ; 149(27-28 Suppl): 75-84, 2007 Jun 28.
Article in German | MEDLINE | ID: mdl-17619604

ABSTRACT

UNLABELLED: The quantification of coronary calcification facilitates improved prediction of cardiovascular diseases, in particular in persons with intermediate risk. The importance of serial measurement of coronary calcium in one to two-year intervals for evaluating the course of the disease and therapeutic monitoring after risk modification is unclear. The precise quantification of the progression of arteriosclerosis could contribute to the non-invasive detection of the chronic, often subclinical development of coronary heart disease at an asymptomatic stage of the disease, long before an irreversible clinical event in the pathogenetic cascade, such as sudden cardiac death or myocardial infarction, occurs. An important prerequisite for evaluating changes in the coronary calcium load is detailed knowledge of reproducibility or variability. In addition to a rapid image acquisition time and the use of calibration phantoms, low heart rate and breathing variability, image acquisition in the late systole, overlapping layers (at the expense of radiation dose) and optimized analysis algorithms also contribute to improvement in reproducibility. The limits of variability however are, above all, dependent upon the calcium load itself. Reproducibility is on the average about 10% and thus lies below the highest expected progression, which is about 10-50% per year, depending upon the initial value and pre-existing conditions Only a few studies have identified calcium score progression as an independent predictor for later events. In several studies, calcium score progression was related to the rate of events, but was not independent of other variables. The most important determinant appears to be the calcium score itself. Other relevant determinants are age, gender, diabetes, obesity and renal failure. Whether lipid values significantly influence the progression has not been clarified. CONCLUSION: Further studies on the natural course of coronary heart disease, particularly in the early disease stages, the determinants of progression and the extent to which the calcification progress can be modified are necessary to assess the benefit of serial score measurement for risk stratification. Until then, the repeated radiation exposure cannot be recommended outside of clinical studies.


Subject(s)
Calcinosis/diagnosis , Coronary Artery Disease/diagnosis , Tomography, Spiral Computed , Tomography, X-Ray Computed , Age Factors , Aged , Calcinosis/mortality , Cause of Death , Coronary Artery Disease/mortality , Death, Sudden, Cardiac/epidemiology , Disease Progression , Female , Follow-Up Studies , Humans , Male , Middle Aged , Myocardial Infarction/mortality , Risk , Sex Factors
12.
Eur J Clin Nutr ; 60(4): 478-85, 2006 Apr.
Article in English | MEDLINE | ID: mdl-16306923

ABSTRACT

OBJECTIVE: Mediterranean diet is associated with decreased levels of inflammatory markers and metabolic risk factors in epidemiologic studies and recent trials on patients with metabolic syndrome. Given the recent improvements in medical treatments, it is unclear if such beneficial effects are also present in patients with coronary artery disease (CAD). We therefore investigated the effect of Mediterranean diet on markers of inflammation and metabolic risk factors in patients with treated CAD. DESIGN: Randomized, controlled trial. SUBJECTS: A total of 101 patients (59.4+/-8.6 years, 23% female) with established and treated CAD (80% statins). INTERVENTIONS: Participants were assigned to a Mediterranean diet group (MG; n=48) with a 1-year program of 100 h of education, or to a written advice-only group (AG; n=53). Before and after intervention, we measured serum high-sensitivity C-reactive protein (hs-CRP), fibrinogen, fasting insulin, homocysteine, serum lipids and plasma fatty acids. RESULTS: The Mediterranean diet program increased the intakes of fish, fruits/vegetables and moderately of canola/olive oil and increased plasma concentrations of long-chain n-3 polyunsaturated fatty acids in the MG. Median hs-CRP and mean fibrinogen, homocysteine, fasting insulin, triglycerides and serum cholesterols remained unchanged in both groups. CONCLUSIONS: Adoption of a Mediterranean diet by patients with medically treated CAD has no effect on markers of inflammation and metabolic risk factors. SPONSORSHIP: Alfried Krupp Foundation, Essen, Germany.


Subject(s)
Coronary Artery Disease/blood , Coronary Artery Disease/diet therapy , Diet, Mediterranean , Inflammation/blood , Biomarkers/blood , C-Reactive Protein/analysis , Coronary Artery Disease/drug therapy , Fatty Acids/blood , Female , Fibrinogen/analysis , Homocysteine/blood , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Inflammation/diet therapy , Insulin/blood , Lipids/blood , Male , Middle Aged , Risk Factors
14.
Z Kardiol ; 92(5): 351-61, 2003 May.
Article in German | MEDLINE | ID: mdl-12966826

ABSTRACT

Non-invasive quantitative indices of atherosclerosis are promising new parameters for an improved prognostic stratification of patients with risk factors that aim at individualized risk factor assessment and modification. In a recently published ACC/AHA consensus document, further data on the diagnostic and prognostic value of coronary calcified plaque quantification were strongly encouraged prior to its use in the general population. In this present work we summarize data published since, which contribute significantly to the prognostic value of fast CT-based noninvasive coronary calcified plaque quantification. It is a measure of atherosclerostic disease activity and is hence an index for the likelihood of future cardiovascular events. Current data indicate that noninvasive quantification of coronary atherosclerosis has incremental prognostic value beyond conventional single risk factor assessment. However, it is not clear yet whether it has a significant value beyond quantitative combined risk assessment using complex risk prediction models such as Framingham charts. Results from ongoing prospective trials such as the MESA study in the US and the Heinz Nixdorf Recall study in Germany will clarify some of the pending issues. In addition, it is still unclear, at what stage of the disease process, which of the available imaging tools will provide optimal diagnostic and prognostic value for the individual patient.


Subject(s)
Calcinosis/diagnostic imaging , Coronary Artery Disease/diagnostic imaging , Tomography, X-Ray Computed , Adult , Aged , Algorithms , Calcinosis/complications , Clinical Trials as Topic , Coronary Angiography , Coronary Artery Disease/complications , Coronary Artery Disease/diagnosis , Coronary Artery Disease/mortality , Coronary Artery Disease/pathology , Coronary Artery Disease/surgery , Female , Follow-Up Studies , Humans , Male , Middle Aged , Myocardial Infarction/etiology , Myocardial Revascularization , Prognosis , Prospective Studies , Randomized Controlled Trials as Topic , Regression Analysis , Risk Assessment , Risk Factors , Stroke/etiology , Time Factors
15.
Z Kardiol ; 92(7): 595-600, 2003 Jul.
Article in German | MEDLINE | ID: mdl-12883844

ABSTRACT

A 51-year-old female hospitalized with a non-specific colitis, presented a crescent-like shadow in the right lower lung accompanied by a reduced right lung volume on a routine chest x-ray. There was no family history of congenital heart disease. The initially performed, noninvasive, contrast enhanced cardiac CT (electron-beam tomography [EBT]) proved the suspected diagnosis of a partial, anomalous pulmonary, transdiaphragmatic vein drainage (APVD) in combination with a hypoplastic right lower lobe and dextrocardia. These findings are in accordance with scimitar syndrome. Regarding to the clinical situation with symptoms like slowly progressive dyspnea on exertion and low exercise tolerance for the last 2 years and an invasively documented left-to-right shunt ratio >50% (Qp:Qs = 2.6 : 1) surgical repair was recommended. The anomalous vein was connected to the left atrium creating a "neo-septum". On a postoperative checkup after 9 months the patient is without any medication, symptoms during moderate activity are relieved, exercise tolerance was substantially better and noninvasive imaging visualized the corrected drainage of the anomalous vein to the left atrium.


Subject(s)
Image Processing, Computer-Assisted , Imaging, Three-Dimensional , Scimitar Syndrome/diagnostic imaging , Tomography, X-Ray Computed , Anastomosis, Surgical , Female , Heart Atria/diagnostic imaging , Heart Atria/surgery , Humans , Middle Aged , Postoperative Complications/diagnostic imaging , Pulmonary Veins/abnormalities , Pulmonary Veins/diagnostic imaging , Pulmonary Veins/surgery , Scimitar Syndrome/surgery
16.
Biophys J ; 80(3): 1538-46, 2001 Mar.
Article in English | MEDLINE | ID: mdl-11222314

ABSTRACT

High concentrations of free Zn2+ ions are found in certain glutamatergic synaptic vesicles in the mammalian brain. These terminals can be visualized histochemically with quinoline sulfonamide compounds that form fluorescent complexes with Zn2+. The present study was undertaken to examine the interaction of the water-soluble quinoline sulfonamide probe, Zinquin (2-methyl-8-(toluene-p-sulfonamido)-6-quinolyloxyacetic acid) with the complex heterogeneous cellular environment. Experiments on rat hippocampal and neocortical slices gave indications that Zinquin in its free acid form was able to diffuse across the plasma and synaptic vesicle membranes. Further experiments were undertaken on unilamellar liposomes to study the interaction of Zinquin and its metal complexes in membranes. These experiments confirmed that Zinquin is able to diffuse across lipid bilayers. Steady-state and time-resolved fluorimetric studies showed that Zinquin in aqueous solution mainly forms a 1:2 (metal:ligand) complex with small amounts of a 1:1 complex. Formation of the 1:1 complex was favored by the presence of lipid, suggesting that it partitions into membranes. Evidence is presented that Zinquin can act as a Zn(2+)-ionophore, exchanging Zn2+ for two protons. The presence of a pH gradient across vesicles traps the Zn(2+)-probe complex within the vesicles. Zinquin is useful as a qualitative probe for detecting the presence of vesicular Zn2+; however, its tendency to partition into membranes and to serve as an ionophore should be borne in mind.


Subject(s)
Brain/physiology , Quinolones , Synaptic Vesicles/physiology , Tosyl Compounds , Zinc/analysis , Animals , Brain/cytology , Cell Membrane/physiology , Diffusion , Fluorescent Dyes , Hippocampus/cytology , Hippocampus/physiology , Hydrogen-Ion Concentration , In Vitro Techniques , Kinetics , Liposomes , Microscopy, Fluorescence , Neocortex/cytology , Neocortex/physiology , Phosphatidylcholines , Quinolones/pharmacokinetics , Rats , Rats, Long-Evans , Spectrometry, Fluorescence , Synaptic Vesicles/ultrastructure , Tosyl Compounds/pharmacokinetics , Zinc/metabolism
17.
Neuron ; 26(2): 483-92, 2000 May.
Article in English | MEDLINE | ID: mdl-10839366

ABSTRACT

Ca2+ ions play an important role during rhythmic bursting of thalamocortical neurons within sleep. The function of Ca2+ during the tonic relay mode of these neurons during wakefulness is less clear. Here, we report that tonic activity in thalamocortical cells results in an increase in the intracellular Ca2+ concentration and subsequent release of Ca2+ from intracellular stores mediated via ryanodine receptors (RyRs). Blockade of Ca2+ release shifted the regular firing of single action potentials toward the generation of spike clusters. Regular spike firing and intracellular Ca2+ release thus appear to be functionally coupled in a positive feedback manner, thereby supporting the relay mode of thalamocortical cells during wakefulness. Regulatory influences may be coupled to this system via the cyclic ADP ribose pathway.


Subject(s)
Calcium/metabolism , Calcium/pharmacology , Cerebral Cortex/physiology , Thalamus/physiology , Action Potentials/physiology , Animals , Cerebral Cortex/cytology , In Vitro Techniques , Intracellular Membranes/metabolism , Nerve Tissue Proteins/physiology , Osmolar Concentration , Rats , Rats, Long-Evans , Ryanodine Receptor Calcium Release Channel/physiology , Thalamus/cytology
18.
Eur Heart J ; 20(5): 354-63, 1999 Mar.
Article in English | MEDLINE | ID: mdl-10206382

ABSTRACT

AIMS: The purpose of this part of the INTERVENT project was (1) to redefine and individually predict post-procedural complications associated with coronary interventions, including alternative/adjunctive techniques to PTCA and (2) to employ the prognostic INTERVENT computer model to clarify the structural relationship between (pre)-procedural risk factors and post-procedural outcome. METHODS AND RESULTS: In a multicentre study, 2500 data items of 455 consecutive patients (mean age: 61.1+/-8.3 years: 33-84 years) undergoing coronary interventions at three university centres were analysed. 80.4% of the patients were male, 16.7% had unstable angina, and 5.1%/10.1% acute/subacute myocardial infarction. There were multiple or multivessel stenoses in 16.0%, vessel bending >90 degrees in 14.5%, irregular vessel contours in 65.0%, moderate calcifications in 20.9%, moderate/severe vessel tortuosity in 53.2% and a diameter stenosis of 90%-99% in 44.4% of cases. The in-lab (out-of-lab) complications were: 0.4% (0.9%) death, 1.8% (0.2%) abrupt vessel closure with myocardial infarction and 5.5% (4.0) haemodynamic disorders. CONCLUSION: Computer algorithms derived from artificial intelligence were able to predict the individual risk of these post-procedural complications with an accuracy of >95% and to explain the structural relationship between risk factors and post-procedural complications. The most important prognostic factors were: heart failure (NYHA class), use of adjunctive/alternative techniques (rotablation, atherectomy, laser), acute coronary ischaemia, pre-existent cardiac medication, stenosis length, stenosis morphology (calcification), gender, age, amount of contrast agent and smoker status. Pre-medication with aspirin or other cardiac medication had a beneficial effect. Techniques, such as laser angioplasty or atherectomy were predictors for post-procedural complications. Single predictors alone were not able to describe the individual outcome completely.


Subject(s)
Angioplasty, Balloon, Coronary/adverse effects , Cardiology/methods , Computer Simulation , Myocardial Ischemia/therapy , Adult , Aged , Aged, 80 and over , Algorithms , Artificial Intelligence , Decision Making, Computer-Assisted , Female , Follow-Up Studies , Humans , Male , Middle Aged , Predictive Value of Tests , Prognosis , Treatment Failure
20.
Eur J Neurosci ; 10(2): 586-97, 1998 Feb.
Article in English | MEDLINE | ID: mdl-9749721

ABSTRACT

One major pathway for calcium entry into neurones is through voltage-activated calcium channels. The distribution of calcium channels over the membrane surface is important for their contribution to neuronal function. Electrophysiological recordings from thalamic cells in situ and after acute isolation demonstrated the presence of high-voltage activated calcium currents. The use of specific L-type calcium channel agonists and antagonists of the dihydropyridine type revealed an about 40% contribution of L-type channels to the total high-voltage-activated calcium current. In order to localize L-type calcium channels in thalamic neurones, fluorescent dihydropyridines were used. They were combined with the fluorescent dye RH414, which allowed the use of a ratio technique and thereby the determination of channel density. The distribution of L-type channels was analysed in the three main thalamic cell types: thalamocortical relay cells, local interneurones and reticular thalamic neurones. While channel density was highest in the soma and decreased significantly in the dendritic region, channels appeared to be clustered differentially in the three types of cells. In thalamocortical cells, L-type channels were clustered in high density around the base of dendrites, while they were more evenly distributed on the soma of interneurones. Reticular thalamic neurones exhibited high density of L-type channels in more central somatic regions. The differential localization of L-type calcium channels found in this study implies their predominate involvement in the regulation of somatic and proximal dendritic calcium-dependent processes, which may be of importance for specific thalamic functions, such as those mediating the transition from rhythmic burst activity during sleep to single spike activity during wakefulness or regulating the relay of visual information.


Subject(s)
Calcium Channels/metabolism , Neurons/metabolism , Thalamus/metabolism , 3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethyl-5-nitro-4-(2-(trifluoromethyl)phenyl)-, Methyl ester/pharmacology , Animals , Calcium Channel Agonists/pharmacology , Calcium Channel Blockers/pharmacology , Calcium Channels/drug effects , Cell Separation , Electric Stimulation , Electrophysiology , Fluorescent Dyes , In Vitro Techniques , Membrane Potentials/drug effects , Membrane Potentials/physiology , Patch-Clamp Techniques , Rats , Thalamus/cytology
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