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Biomedical subjects

Christoph Schick

Publications and source records attributed to Christoph Schick.

10 recordsLinked to original sources

www.tnt-radiology.de: Teach and be taught radiology: implementation of a web-based training program based on user preferences as determined by survery.

RATIONALE AND OBJECTIVES: To create a Web-based training program addressing the needs of a large, heterogeneous audience of users. MATERIALS AND METHODS: We defined our target group as consisting of medical professionals who teach radiology, or who, by their own perception, would benefit from improving their radiologic image interpretation skills. We interviewed 483 members of this group, eliciting their preferences with regard to layout, interactivity, contents, and other categories (11 in total). Considering majority preferences as recommendations and using the help of a special interest group of medical students, we assembled 500 teaching cases over a 1-year period into an interactive training program and made it available on the World Wide Web. RESULTS: Important preferences expressed by majorities of interviewees were: high levels of interactivity, clear layout, intuitive usability, short page load times, permissibility of saving content locally, cost-free access, consideration of user input in the site development. To our knowledge, our web program TNT-Radiology, accessible at , is the first to implement all of these recommendations simultaneously. CONCLUSIONS: We have created a Web-based program usable for teaching and learning radiologic image interpretation that meets the needs of a heterogeneous target audience to an unprecedented extent.

Computer-Assisted Instruction↗

Isothermal reorganization of poly(ethylene terephthalate) revealed by fast calorimetry (1000 K s(-1); 5 ms).

Reorganization of semicrystalline polymers on heating is a fast process. For poly(ethylene terephthalate) (PET) heating rates of several thousand Kelvin per second are needed to prevent reorganization of unstable crystals. Utilizing a thin film vacuum gauge as a fast calorimeter we are able to extend the scanning rate range of commercial DSC's (microK s(-1) to 10 K s(-1)) to rates as high as 10000 K s(-1) on heating and cooling. Because of the fast equilibration time isothermal experiments can be performed after scanning at several thousand Kelvin per second. The dead time after such a quench is in the order of 10 ms and the time resolution is in the order of milliseconds. These ultra fast calorimeters allow us to study the kinetics of extremely fast processes in semicrystalline polymers like reorganization. For PET crystallized at 130 degrees C reorganization needs less than 40 ms between 150 degrees C and 200 degrees C. Isothermal reorganization at 223 degrees C is about two orders of magnitude faster than isothermal crystallization from the isotropic melt at the same temperature. The melt memory for the remaining structures needed for reorganization is removed 25 K above the equilibrium melting temperature of PET.

Journal Article↗

Continuous enhanced expression of Hsc70 but not Hsp70 in rheumatoid arthritis synovial tissue.

OBJECTIVE: To investigate the expression of constitutive and inducible members of the Hsp70 protein family in synovial tissue of patients with rheumatoid arthritis (RA) or osteoarthritis (OA). METHODS: Frozen sections of synovial tissue and isolated synovial adherent cells obtained from 17 RA patients, 5 OA patients, and 1 patient with carpal tunnel syndrome (CTS) were analyzed with specific monoclonal antibodies, by immunohistochemistry, immunocytochemistry, and immunoblotting. RESULTS: Expression of the constitutive chaperone Hsc70 was increased in synovial tissue from 9 of 9 patients with RA, but was faint or undetectable in 3 of 3 samples from patients with OA. In RA samples, cells mainly of the synovial lining stained intensely for Hsc70 as well as for HLA-DR, CD14, and CD68. Also, in vitro-cultured synovial adherent cells from 8 of 9 RA patients overexpressed Hsc70 (specimens from 1 RA patient were used in both the immunochemistry and the in vitro culture studies). On immunoblots of protein extracts, the synovial and HeLa cell molecules appeared identical in size. The inducible chaperone Hsp70 was not detected in samples from any of the same 17 RA patients, except for rare, isolated cells in 3. Samples from 4 of 5 OA patients also were negative for the inducible chaperone Hsp70, and the fifth was very weakly positive. In addition, tissue from 1 patient with CTS was analyzed 10 months before diagnosis of RA. Synovial tissue from this patient showed extreme overexpression of both Hsc70 and Hsp70. CONCLUSION: In RA, synovial lining cells continuously overexpress Hsc70 but not Hsp70. Hsc70 may be up-regulated due to the high activity of these cells in several respects, including antigen processing and presentation.

Adult↗

Catecholamine release in human skin--a microdialysis study.

Dermal microdialysis might be a promising tool to investigate properties of sympathetic neurons in the skin as investigation of peripheral noradrenergic neurons in humans usually relies on highly variable vasoconstrictor reflexes or on indirect measurements like skin temperature recordings. To evaluate this technique, 21 experiments were performed in 15 healthy subjects with four intracutaneous microdialysis fibers (diameter, 200 microm; cutoff, 5 kDa) at hands or feet. After 60 min, saline perfusion tyramine at concentrations of 0.195 to 200 microg/ml was applied for 15 min followed by a 15-min saline perfusion again. Catecholamine concentrations were detected through high-performance liquid chromatography with electrochemical detection. Control experiments were performed in human skin homogenates with and without tyramine incubation. In vivo, norepinephrine (NE) concentration increased from 36.3 +/- 10.2 pg/ml to 84.4 +/- 18.4 pg/ml (P < 0.001) during stimulation with tyramine, dialysate dopamine (DA) concentration increased from 105.2 +/- 36.5 pg/ml to 7162.4 +/- 3972.4 pg/ml (P < 0.001). Both tyramine-induced NE and DA release were dose-dependent (NE: r = 0.438, P < 0.05; DA: r = 0.894, P < 0.001). In skin homogenates, tyramine incubation led to a significant increase of DA concentrations (387.0 +/- 34.8 pg/ml, controls: 13.2 +/- 2.4 pg/ml; P < 0.05), while NE and epinephrine levels remained unchanged. In conclusion, our experiments show that dermal microdialysis is capable of locally measuring catecholamines in human skin. This offers the opportunity to investigate the function of the peripheral sympathetic nervous system. Additional to non-enzymatic oxidation, DA increase probably reflects metabolic degradation of tyramine by non-neuronal pathways and therefore does not reflect local sympathetic innervation.

Adult↗

No alpha-adrenoreceptor-induced C-fiber activation in healthy human skin.

In healthy volunteers, flare responses induced by norepinephrine (NE) iontophoresis have been observed. However, as NE iontophoresis is a combined electrical and chemical stimulus axon, reflexes cannot be directly linked to pharmocological activity of NE. Different concentrations of NE, clonidine (CL), and phenylephrine (PE) (NE: 10(-10)-10(-3) M; CL and PE: 10(-8)-10(-3) M) were applied via intradermal microdialysis fibers into the skin of healthy volunteers. Simultaneously, skin blood flow was visualized by laser-Doppler imaging scans and quantified in a vasoconstriction skin area directly above the membranes to control drug effects and in expected axon reflex vasodilation areas that were 0.75 cm apart. NE, PE, and CL caused dose-dependent vasoconstriction. However, neither in the presumed axon reflex areas (quantitative analysis) nor on laser-Doppler imaging pictures (qualitative analysis) were any vasodilation observed. Even at concentrations causing maximum vasoconstriction (10(-3) M for any drug), no vasodilation was induced. Our results indicate that, in healthy human skin, exogenously supplied alpha-adrenoreceptor agonists alone do not activate nociceptors sufficiently to induce axon reflex flare.

Adrenergic alpha-Agonists↗

Apoptosis as a cellular predictor for histopathologic response to neoadjuvant radiochemotherapy in patients with rectal cancer.

BACKGROUND: Tumor shrinkage by preoperative radiochemotherapy (RCT) can markedly improve surgery in locally advanced (T4) rectal cancer with clear resection margins and may enable sphincter preservation in low-lying tumors. However, tumor response varies considerably, even among tumors treated according to the same protocol. If one is able to identify patients with highly radio-responsive tumors at the time of diagnosis, a selective and individualized policy of preoperative RCT might be pursued. METHODS: The apoptotic index (AI), Ki-67, p53, and bcl-2 were evaluated by immunohistochemistry on pretreatment biopsies from 44 patients treated uniformly according to a prospective neoadjuvant RCT protocol (CAO/AIO/ARO-94). Treatment response was assessed histopathologically in the resected surgical specimen, using a five-point grading system. Expression of each marker was correlated with tumor response and relapse-free survival after curative surgery. RESULTS: Tumors with complete (n = 3) or good (n = 28) response to RCT showed significantly higher pretreatment levels of apoptosis (mean AI: 2.06%) than tumors with moderate (n = 7), minimal (n = 5), or no regression (n = 1) from RCT (AI: 1.44%, p = 0.003). The AI was significantly related to Ki-67 (p = 0.05), but not to p53 and bcl-2 status. Tumor regression and AI best predicted relapse-free survival after combined modality treatment and curative surgery. CONCLUSION: Spontaneous apoptosis in rectal cancer may serve as an important predictor of tumor regression from RCT in rectal cancer and as a significant prognosticator of relapse-free survival. Thus, this molecular marker may finally help to tailor therapy with regard to (neo-) adjuvant treatment of rectal cancer.

Adult↗

High survivin expression is associated with reduced apoptosis in rectal cancer and may predict disease-free survival after preoperative radiochemotherapy and surgical resection.

BACKGROUND: Spontaneous apoptosis has been shown to predict tumor response to preoperative radiochemotherapy in rectal cancer. It remains to be elucidated, however, which genetic profile determines whether a tumor is more or less prone to apoptosis. Recently, a novel member of the inhibitor of apoptosis family, designated survivin, was identified. In the present study, we investigated the impact of survivin on tumor cell apoptosis and the risk to develop distant metastases or local failure after preoperative radiochemotherapy and surgical resection. PATIENTS AND METHODS: The expression of survivin, p53, bcl-2 and the apoptotic index was evaluated by immunohistochemistry on pretreatment biopsies of 54 patients with locally advanced adenocarcinoma of the rectum. Survivin expression was correlated to clinical and histopathological markers, the levels of spontaneous apoptosis, p53 and bcl-2, as well as to disease-free survival, 5-year rates of local failure and distant disease after preoperative radiochemotherapy and surgical resection. RESULTS: Survivin expression inversely correlated with the apoptotic index: High survivin expression was found in 56% of rectal carcinoma biopsies with a median apoptotic index of 1.22%. Conversely, low survivin expression in tumor cells was associated with a high median apoptotic index (2.29%, p = 0.0001). High survivin expression also segregated with bcl-2 overexpression (65% bcl-2+ in tumors with high survivin expression as compared to 35% bcl-2+ in tumors with low survivin expression), but the difference was not statistically significant (p = 0.1). Low survivin expression was significantly related to an increased disease-free survival rate (77% vs 18% at 5 years in tumors with high survivin expression, p = 0.02) and to a reduced risk for distant metastases (18% vs 78% at 5 years in tumors with high survivin expression, p = 0.05) and local failure (6% vs 37% at 5 years in tumors with high survivin expression, p = 0.07). CONCLUSION: An inverse correlation between survivin expression and the level of spontaneous apoptosis in pretreatment biopsies suggests that survivin strongly inhibits tumor cell apoptosis in rectal cancer. Survivin expression may provide a novel predictive indicator for disease-free survival after preoperative radiochemotherapy and surgical resection in rectal cancer.

Adenocarcinoma↗

Cystic lymph node enlargement of the neck: filariasis as a rare differential diagnosis in MRI.

Cervical lymph node enlargement is a common feature of most inflammatory and neoplastic entities of the head and neck. Filariasis can lead to lymphangiectasis resembling lymph node enlargement; however, this is a rare differential diagnosis in European patients. As ethnic minorities are increasing throughout Europe and personal mobility, e.g. during holidays, is increasing, such rare differential diagnoses have to be taken into consideration. We present the case of an Iraqi patient referred to as for a suspected cystic lymph node mass that was verified histologically by open MRI biopsy and proved to be a cystic manifestation of filariasis.

Diagnosis, Differential↗