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Biomedical subjects

A Baur

Publications and source records attributed to A Baur.

At least 19 recordsLinked to original sources

[Imaging of tumors and tumor-like diseases of the hand].

Tumors and tumor-like lesions of the hand are more frequently benign lesions. Plain film X-rays must be obtained in all patients since they are extensive and panoramic. Ultrasound can accurately assess the internal structure of the mass and its relation with adjacent nerves and vessels. MRI is particularly sensitive to bone marrow and is highly effective in characterizing a wide variety of soft tissue conditions. However, CT remains the method of choice for evaluating bone involvement of soft tissue tumors and small bone tumors such as osteoid oteoma. Where a malignant tumor is considered, thoraco-abdominal and/or bone scintigraphy are essential to evaluate the presence of metastatic lesions.

Bone Neoplasms↗

Glyco-engineering of moss lacking plant-specific sugar residues.

The commercial production of complex pharmaceutical proteins from human origin in plants is currently limited through differences in protein N-glycosylation pattern between plants and humans. On the one hand, plant-specific alpha(1,3)-fucose and beta(1,2)-xylose residues were shown to bear strong immunogenic potential. On the other hand, terminal beta(1,4)-galactose, a sugar common on N-glycans of pharmaceutically relevant proteins, e.g., antibodies, is missing in plant N-glycan structures. For safe and flexible production of pharmaceutical proteins, the humanisation of plant protein N-glycosylation is essential. Here, we present an approach that combines avoidance of plant-specific and introduction of human glycan structures. Transgenic strains of the moss Physcomitrella patens were created in which the alpha(1,3)-fucosyltransferase and beta(1,2)-xylosyltransferase genes were knocked out by targeted insertion of the human beta(1,4)-galactosyltransferase coding sequence in both of the plant genes (knockin). The transgenics lacked alpha(1,3)-fucose and beta(1,2)-xylose residues, whereas beta(1,4)-galactose residues appeared on protein N-glycans. Despite these significant biochemical changes, the plants did not differ from wild type with regard to overall morphology under standard cultivation conditions. Furthermore, the glyco-engineered plants secreted a transiently expressed recombinant human protein, the vascular endothelial growth factor, in the same concentration as unmodified moss, indicating that the performed changes in glycosylation did not impair the secretory pathway of the moss. The combined knockout/knockin approach presented here, leads to a new generation of engineered moss and towards the safe and flexible production of correctly processed pharmaceutical proteins with humanised N-glycosylation profiles.

Base Sequence↗

[Estimation of diffuse bone marrow infiltration of the spine in multiple myeloma: correlation of MRT with histological results].

PURPOSE: To determine the detection of diffuse bone marrow infiltration with MRI in comparison with histopathological findings. MATERIALS AND METHODS: MRI was performed on 45 patients with histologically proven multiple myeloma and on 30 healthy individuals. Three experienced radiologists read separately Tl-weighted SE sequences, STIR sequences and the combination of Tl-weighted SE and STIR sequences of the spine. Additionally, Tl-weighted SE sequences were obtained after gadolinium administration and the percentage increase in signal intensity was calculated. Bone marrow histology was used as gold standard for assessing the grade of infiltration. A dichotomous decision (infiltration yes/no) was made when assessing the MRI examinations. RESULTS: For the visual detection of diffuse infiltration, the best sensitivity was found with Tl-weighted SE sequences, achieving 71 % on average. The specificity was 89 %. The STIR sequences showed a sensitivity of 61 % and a specificity of 98 %, and the combination of Tl-weighted/STIR-sequences achieved a sensitivity of 65 % and a specificity of 94 %. In comparison with the histological findings, the sensitivity of the Tl-weighted sequences was 35 % for low-grade, 89 % for moderate and 100 % for high-grade infiltration. The application of contrast material with calculation of the percentage signal increase improved the detection by 7 %. CONCLUSION: The sensitivity of the visual detection of diffuse multiple myeloma with unenhanced MRI is limited for low-grade or moderate infiltration, whereas the sensitivity for high grade infiltration is reliable. The specificity is high and the diagnostic confidence improves after application of contrast material with calculation of the percentage increase in signal intensity.

Adult↗

Stewart-Treves syndrome as a rare complication of a hereditary lymphedema.

Lymphangiosarcoma (LAS) may occur as a rare complication of primary lymphedema. A case of LAS in hereditary lymphedema of the lower extremity in a 36-year old female is reported. Despite of chemotherapy, local hyperthermia and later amputation of the extremity the patient died of progressive disease due to pulmonary metastasis. In respect to this case, the different therapeutic concepts, as reported in the literature, and their results are presented and discussed.

Adult↗

Contribution of interleukin-12 to the pathogenesis of non-thyroidal illness.

Changes in both central and peripheral thyroid hormone (TH) metabolism occur during illness. These changes, known collectively as non-thyroidal illness, are apparently mediated by the proinflammatory cytokines IL-6, TNFalpha and IFNgamma. IL-12 is involved in regulation of IFNgamma and TNFalpha. The aim of this study was to evaluate the role of IL-12 in TH metabolism during illness. We studied TH metabolism both centrally (in the pituitary) and peripherally (in the liver) in IL-12 knock-out (IL-12 (-/-)) and wild type (WT) mice during illness induced by administration of bacterial endotoxin (LPS). LPS induced a similar decrease in serum T (3), T (4) and liver 5'-DI mRNA expression in IL-12 (-/-) and WT mice with the exception of a smaller reduction of serum T (4) in IL-12 (-/-) mice. In the pituitary, the LPS-induced decline in 5'-DI activity in WT mice was not observed in IL-12 (-/-) mice (p < 0.001), whereas the decrease in DII activity tended to be smaller in IL-12 (-/-) mice (p = 0.066). The lower decrease in pituitary activity of both DI and DII in IL-12 (-/-) mice is possibly related to the lower LPS-induced T (4) decrease. In conclusion, IL-12 is involved in the central regulation of the HPT axis during illness but not in the peripheral regulation.

Animals↗

Moving-table MR angiography of the peripheral runoff vessels: comparison of body coil and dedicated phased array coil systems.

OBJECTIVE: The aim of our study was to compare the signal-to-noise ratio and the diagnostic accuracy of moving-table MR angiography of the peripheral arteries with body coil and dedicated phased array coil systems. SUBJECTS AND METHODS: Forty patients were examined with digital subtraction angiography and moving-table MR angiography with a 1.5-T MR imaging system either with a body coil (n = 20) or with a dedicated phased array coil (n = 20). The timing of contrast material was performed with real-time MR fluoroscopy. RESULTS: For the iliac artery, upper leg, and lower leg, the mean values for signal-to-noise ratios were 56, 51, and 17, respectively, for the body coil, and 54, 74, and 64, respectively, for the dedicated phased array coil. For the body coil, sensitivity and specificity in identifying stenosis greater than 50% and occlusions were 100% and 96%, respectively, for the iliac arteries, and 100% and 96%, respectively, for the upper leg. For the dedicated phased array coil, sensitivity and specificity for stenosis greater than 50% and occlusions were 100% and 96%, respectively, for the iliac arteries, and 100% and 98%, respectively, for the upper leg. Sensitivity and specificity were inferior for the body coil (88% and 85%) compared with the dedicated phased array coil (100% and 96%) in the lower leg. A significant difference of the mean values of contrast-to-noise ratio was found before and after subtraction for the dedicated phased array coil and body-coil techniques (Student's t test, p < 0.01). CONCLUSION: In comparison with the body coil, the dedicated peripheral phased array surface coil system improves signal-to-noise ratio for the upper and lower leg and diagnostic accuracy in the lower leg.

Adult↗

[Differentiation of benign osteoporotic and neoplastic vertebral compression fractures with a diffusion-weighted, steady-state free precession sequence].

PURPOSE: To evaluate the diagnostic accuracy of a diffusion-weighted, steady-state free precession (SSFP) sequence for the differentiation of acute benign osteoporotic and neoplastic vertebral compression fractures. METHODS: 85 patients with 102 vertebral compression fractures were examined with MR imaging using a spine array surface coil (Siemens, Vision, 1.5 Tesla). The following sequences were performed in sagittal orientation: T1-weighted spin echo (SE), short-tau inversion recovery (STIR) and a diffusion-weighted SSFP sequence (TR = 25 msec, diffusion pulse length delta = 3 msec). The SSFP images were evaluated qualitatively on a 5-grade scale from strongly hypointense to strongly hyperintense. Quantitative analysis was performed with region of interest measurements (ROI) and calculation of a bone marrow ratio. RESULTS: 60 fractures were due to osteoporosis and 42 fractures were caused by malignancy. "Hyperintensity" in a vertebral fracture on a SSFP sequence provided a sensitivity of 100 % and a specificity of 93 %. The positive predictive value was 91 %, the negative predictive value was 100 %. Quantitative analysis of the bone marrow ratio showed a statistically significant difference between the osteoporosis and the tumor group (p < 0.001). The mean value for the osteoporotic fractures was - 0.32 (SD 0.33) and + 2.07 (SD 1.37) for the tumor group. CONCLUSION: The SSFP sequence provides a high accuracy in the differentiation of benign osteoporotic and neoplastic vertebral compression fractures.

Adult↗

Expression of 5'-deiodinase enzymes in normal pituitaries and in various human pituitary adenomas.

OBJECTIVE: Local 5'-deiodination of l-thyroxine (T(4)) to active thyroid hormone 3,3',5-tri-iodothyronine (T(3)) catalyzed by the two 5'-deiodinase enzymes (D1 and D2) regulates various T(3)-dependent functions in the anterior pituitary and has been well studied in rodents. Only limited information about deiodinase expression and its cellular distribution in human anterior pituitaries is available. DESIGN: We examined 5'-deiodinase enzyme activities in pituitary adenomas (18 non-functioning, seven TSH-producing, one GH- and TSH-producing, five GH-producing, eight prolactin (PRL)-producing, two adenomas each from patients with Cushing's disease and Nelson's syndrome) and three normal anterior pituitaries. METHODS: Activities were measured as release of (125)I(-) from tyrosyl-ring labeled reverse T(3) with or without propylthiouracil, a potent inhibitor of D1 which does not influence D2 activities. RESULTS: Most of the adenomas and normal tissues expressed both isoenzymes, with D2 activity higher than D1. In a few tissues D1 activity was higher than D2 and some tissues did not express D1 activity at all. Highest activities of both enzymes were found in TSH- and PRL-producing adenomas but absolute activities and the D1/D2 ratio were variable in the same kind of tumor in different patients. CONCLUSION: The finding that all examined tissues expressed 5'-deiodinase activity, most of them expressing both isoenzymes, implies that both enzymes are still active in tumors and that local deiodination is important for the function and feedback regulation of human anterior pituitary.

Adenoma↗

Contrast-enhanced MR angiography in patients after kidney transplantation.

The aim of this study was to investigate the value of a contrast-enhanced 3D MR angiography in detecting postoperative vascular complications after kidney transplantation in comparison with digital subtraction angiography (DSA). Forty-one patients who underwent a kidney transplantation were examined with MR angiography and DSA. Contrast-enhanced MR angiography was performed as a dynamic measurement with one precontrast and three postcontrast measurements. Maximum intensity projection reconstructions were performed for all postcontrast data sets after DSA. The results were evaluated by two independent observers who were unaware of the DSA results. Twenty-three hemodynamically significant arterial stenoses were identified with DSA in the iliac arteries ( n=7), the renal allograft arteries ( n=12), and in their first branches ( n=4). For a patient-based analysis the sensitivity and specificity, respectively, for observer 1 were 100 and 97%, and for observer 2, 100 and 93%. Respective data were 100 and 100% after a consensus evaluation by two observers. Complications involving the renal veins were detected in 2 cases and perfusion defects of the kidney parenchyma were detected in 4 cases. Contrast-enhanced MR angiography is a reliable method in identifying postoperative arterial stenoses after kidney transplantation. In addition, dynamic MR angiography can be helpful in detecting venous complications and perfusion defects in kidney allografts.

Adult↗

Diffusion-weighted imaging of tumor recurrencies and posttherapeutical soft-tissue changes in humans.

The aim of this study was to examine soft tissue tumor recurrences and posttherapeutic soft tissue changes in humans with a diffusion-weighted steady-state free precession (SSFP) sequence. Twenty-four patients with 29 pathologies of the pelvis or the extremities were examined. The lesions were classified as follows: group 1, recurrent viable tumors (n = 10); group 2, postoperative hygromas (n = 7); and group 3, posttherapeutic reactive inflammatory muscle changes (n = 12). The sequence protocol in these patients consisted of short tau inversion recovery images, T2-weighted spin-echo (SE), pre- and postcontrast T1-weighted SE images and the diffusion-weighted SSFP sequence. The signal loss on diffusion-weighting was evaluated visually on a four-grade scale and quantitatively. The signal intensities were measured in regions of interest and a regression analysis was performed. Statistical analyses was performed utilizing the Student's t-test. The signal loss was significantly higher for hygromas and edematous muscle changes than for recurrent tumors (p < 0.001) indicating higher diffusion of water protons. The regression coefficient was -0.11 (mean) for tumors. Hygromas had a significantly higher signal loss than inflammatory edematous muscle changes (p < 0.01). The regression coefficients were -0.29 (mean) for hygromas and -0.22 (mean) for edematous muscle changes. The SSFP sequence seems to be a suitable method for diffusion-weighted imaging of the musculoskeletal system in humans. These preliminary results suggest that the signal loss and the regression coefficients can be used to characterize different types of tissue.

Adult↗

Diffusion-weighted magnetic resonance imaging of spinal bone marrow.

Diffusion-weighted (DW) imaging is an alternative source of image contrast. DW imaging enables to measure the random motion of free water protons on a molecular basis by using different imaging sequences including steady-state free precession imaging, navigated spin-echo DW imaging, and single-shot echo planar imaging. Analysis of intravoxel incoherent motion of water protons is a promising tool that has shown to be of value in the differential diagnosis between benign and malignant spontaneous vertebral fractures. Acute benign osteoporotic fractures show hypo- or isointense signal on DW sequences that reflects persistent free water proton mobility. With increasing diffusion strength a substantial signal loss is found. Metastatic fractures show hyperintensity compared with normal surrounding bone marrow probably due to altered water proton mobility within neoplasm. The ability of the different methods for DW imaging to differentiate other bone marrow alterations needs to be investigated in further studies.

Bone Marrow↗

Diagnostic value of increased diffusion weighting of a steady-state free precession sequence for differentiating acute benign osteoporotic fractures from pathologic vertebral compression fractures.

BACKGROUND AND PURPOSE: Differentiating acute benign from neoplastic vertebral compression fractures can pose a problem in differential diagnosis on routine MR sequences, as signal changes can be quite similar. Our purpose was to assess the value of increasing the diffusion weighting of a diffusion-weighted steady-state free precession (SSFP) sequence for differentiating these two types of vertebral compression fractures. METHODS: Twenty-nine patients with 32 acute vertebral compression fractures caused by osteoporosis (n = 15) or malignancy (n = 17) were examined with a diffusion-weighted SSFP sequence, a T1-weighted spin-echo sequence, and a short-inversion-time inversion recovery sequence. The SSFP sequence was performed with increased diffusion weighting (delta = 0.6, 3.0, 6.0, and 9.0 ms). The signal intensities of the fractured vertebral bodies were rated on a five-point scale from markedly hypointense to markedly hyperintense relative to normal adjacent vertebral bodies. Quantitative analysis was performed by region-of-interest measurements and by calculating the bone marrow contrast ratio. Statistical analysis was performed with the Mann Whitney U test and Student's t test. RESULTS: At delta = 3 ms, the osteoporotic fractures yielded hypointense signal in seven cases, isointense signal in six, and hyperintense signal in two. The fractures showed a progressive signal loss with increased diffusion weighting, so that hypointensity was reached in all but one case. All metastatic fractures had hyperintense signal with delta = 3 and 6.0 ms. With delta = 9.0 ms, four fractures became isointense. CONCLUSION: Increasing diffusion weighting can reduce false-positive hyperintense osteoporotic fractures or make hypointensity more obvious in cases of osteoporotic fractures.

Acute Disease↗

Charge ordering in the TMTTF family of molecular conductors

Using one- and two-dimensional NMR spectroscopy applied to 13C spin-labeled (TMTTF)2AsF6 and (TMTTF)2PF6, we demonstrate the existence of an intermediate charge-ordered phase in the TMTTF family of charge-transfer salts. At ambient temperature, the spectra are characteristic of nuclei in equivalent molecules. Below a continuous charge-ordering transition temperature T(co), there is evidence for two inequivalent molecules with unequal electron densities. The absence of an associated magnetic anomaly indicates only the charge degrees of freedom are involved and the lack of evidence for a structural anomaly suggests that charge-lattice coupling is too weak to drive the transition.

Journal Article↗

[The diagnosis of plasmocytoma with MRT].

BACKGROUND: In multiple myeloma 5 different infiltration patterns can be differentiated: 1. normal appearance of bone marrow, 2. focal involvement, 3. homogeneous diffuse infiltration, 4. combined diffuse and focal infiltration, 5. "salt- and pepper" pattern with inhomogeneous bone marrow with interposition of fat islands. METHODS: For the fast and total acquisition of all patterns a combination of a T1-weighted spin echo sequence and a fat suppression technique is superior. The focal involvement is clearly demonstrated as areas of high signal intensity on e.g. STIR images. Diffuse involvement can be quantified objectively by calculation of the percentage of signal intensity increase after contrast material injection. MRI is superior to X-ray in focal and diffuse involvement. With ultrafast sequences a "screening" of the whole red bone marrow as for myeloma infiltration is possible. PROGNOSIS: In prognosis studies diffuse infiltration is inferior to focal involvement. Patients without bone marrow infiltration have a significantly longer survival than patients with bone marrow infiltration in MRI at the time of diagnosis. However, even patients in stage one of disease (Durie and Salmon) and negative X-ray films can show bone marrow infiltration in MRI. Those patients often show an early disease progression. Good response to therapy in focal involvement are: reduction of signal intensity on T2-weighted spin echo images, lack or rim-like enhancement after contrast material injection or even a normalisation of bone marrow signal. In case of diffuse involvement a partly patchy reconversion to fatty marrow can be seen.

Bone Marrow↗

Diffusion-weighted imaging of the musculoskeletal system in humans.

This article reviews the principles of diffusion-weighted imaging (DWI) and recent results in DWI of the musculoskeletal system. The potential of DWI in the diagnosis of pathology of the musculoskeletal system is discussed. DWI is a relatively new MR imaging technique that has already been established in neuroradiology, especially in the early detection of brain ischemia. The random motion of water protons on a molecular basis can be measured with DWI. To date DWI of the abdomen and of the musculoskeletal system has only been employed in scientific studies, but first results indicate that it may also be beneficial in these fields. Different diffusion characteristics have been found in normal tissues such as muscle, fat and bone marrow. Also, pathologic entities such as neoplasms, post-therapeutic soft tissue changes and inflammatory processes can be differentiated. Normal muscle shows significantly higher diffusion values than subcutaneous fat and bone marrow, due to a higher mobility of water protons within muscle. Soft tissue tumors exhibit a significantly lower diffusion value compared with post-therapeutic soft tissue changes and inflammatory processes. Necrotic tumor tissue can be distinguished from viable tumor due to significantly higher diffusion of water protons within necrotic tissue.

Animals↗

Tripled semitendinosus anterior cruciate ligament reconstruction with Endobutton fixation: a 2-3-year follow-up study of 35 patients.

We evaluated the clinical outcome of tripled semitendinosus tendon ACL reconstruction with femoral Endobutton (Acufex, Smith&Nephew, Andover, MA) and tibial Suture Washer (Acufex, Smith&Nephew, Andover, MA) (n 29) or post screw fixation (n 6) in 35 patients on an average of 28 (20-37) months after surgery. On the basis of IKDC criteria, 22 patients showed a normal or nearly normal knee function and 25 patients had a KT 1000 maximal manual side-to-side difference of < or =5 mm at follow-up. Subjectively, 28 patients graded their knee function as normal or nearly normal. The average Lysholm score was 88 points, average OAK score 90 points and average modified HSS score 93 points. 19 patients reached their preinjury level of activity at follow-up. The postoperative Lachman test was < or =1+ in 24 patients and 24 patients also showed an absent pivot shift. Significant bone tunnel enlargement occurred in 26 patients on the femoral side and in 23 patients on the tibial side. We found no correlation between bone tunnel enlargement and clinical outcome. The clinical outcome of tripled semitendinosus tendon ACL reconstruction with Endobutton fixation on the femoral side was not entirely satisfactory. The procedure was associated with a high incidence of bone tunnel enlargement in this series.

Activities of Daily Living↗

Reactive bone marrow changes in infectious spondylitis: quantitative assessment with MR imaging.

PURPOSE: To evaluate diffuse, reactive bone marrow changes in unaffected vertebrae on magnetic resonance (MR) images in patients with proved infectious spondylitis. MATERIALS AND METHODS: Percentage signal intensity increase of the unaffected bone marrow on contrast material-enhanced MR images (percentage enhancement) was calculated retrospectively in 22 cases of infectious spondylitis and 86 cases without bone marrow disease. Multiple regression analysis and Student t test statistics were performed. RESULTS: Multiple regression analysis showed a significant influence of age and the presence of spondylitis on the values of percentage enhancement (P: <.001). For those aged 35 years or younger, the mean percentage enhancement was 43.2% +/- 4.0 for patients with infectious spondylitis (n = 3) and was 26.4% +/- 8.6 for the control group (n = 23). For those older than 35 years, the mean percentage enhancement was 28.2% +/- 12.2 for patients with infectious spondylitis (n = 19) and 17.5% +/- 7.9 (P: <.001) for the control group (n = 63). Six (27%) of 22 patients with infectious spondylitis showed abnormal percentage enhancement values in unaffected bone marrow when the upper limit of the normal value was 2 SDs above the mean of the control group. CONCLUSION: On MR images, reactive bone marrow changes can be found in unaffected vertebrae in patients with infectious spondylitis. The signal intensity changes and increased percentage enhancement associated with this disease are similar to those of myeloproliferative and diffuse neoplastic disorders and bone marrow stimulation in hemolytic anemia.

Adult↗

Effects of proinflammatory cytokines on anterior pituitary 5'-deiodinase type I and type II.

Cytokines are locally produced in the anterior pituitary and act through para-/autocrine mechanisms to modulate cell growth and hormone production. 5'-Deiodinases type I (D1) and type II (D2) are also expressed in the anterior pituitary and play an integrative role in the regulation of hormone production and pituitary feedback. D1 activity is known to be regulated by proinflammatory cytokines in liver and thyroid. Therefore, we examined the effects of IL-1 beta, IL-6 and TNF alpha on 5'-deiodinase activities in reaggregates of rat anterior pituitaries and rat somatomammotroph GH3 cells cultured alone, or in a bicameral culture system together with the murine folliculo-stellate (FS) cell line TtT/Gf. In reaggregate cultures of rat anterior pituitaries IL-1 beta stimulated D1 and D2 dose-dependently and D2 activity was increased by TNF alpha. When GH3 cells were cocultured with TtT/Gf cells, D2 activities were 2.3-fold lower than in GH3 cells cultured alone. TNF alpha (50 ng/ml) and IL-6 (100 U/ml) stimulated D2 in GH3 cells when the cells were cultured alone and treated with these cytokines for 24 h. When TtT/Gf cells in the coculture model were treated with IL-1 beta, TNF alpha and IL-6, no effect on D1 or D2 activities in GH3 cells was observed. In male, adult rats a single LPS injection (i.p.) stimulated D2 and D1 activities in the anterior pituitary, and decreased liver D1 activities and serum TSH levels. In vitro, LPS stimulation of the coculture model of GH3 and FS cells also increased D1 activity. Electrophoretic mobility shift assays (EMSAs) revealed that IL-1 beta and TNF alpha activate the transcription factor NF kappa B in reaggregates of rat anterior pituitaries and in TtT/Gf cells cultured alone or cocultured with GH3 cells. Taken together, these findings imply that in anterior pituitary cells 5'-deiodinase activities are stimulated by locally produced cytokines in a para-/autocrine manner but cell types other than FS cells seem to mediate some of the effects.

Animals↗