Iatrogenic femoropopliteal graft entrapment.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to J Schäfer.
Explore the source record for details and available documents.
A 15-month experiment combining a geochemical survey of Cd, Cu, Zn and Hg with a bioaccumulation study for three filter-feeding bivalve species (oysters, Crassostrea gigas; cockles, Cerastoderma edule; and clams, Ruditapes philippinarum) was conducted in a breeding basin of the Nord Medoc salt marshes connected to the Gironde estuary, which is affected by historic polymetallic pollution. Regular manual surface measurements of temperature, salinity, pH and dissolved O(2) concentration and hourly multiprobe in situ measurements throughout several periods for 6-8 weeks were performed. The geochemical behavior of metals in water, suspended particulate matter and sediment and their ecotoxicological impact on the three bivalve species were evaluated by in situ exposure of juvenile oysters (water column) and adult cockles and clams (sediment surface). The physico-chemical parameters reflected seasonal variations and basin management. A distinct daily periodicity (except salinity) indicated intense photosynthesis and respiration. In summer, low dissolved O(2) saturations ( approximately 40-50%) occurred in the early morning at 30 cm above the sediment, whereas in depressions, the water column near the sediment surface was suboxic. Cadmium, Zn and Cu concentrations in suspended particulate matter exceeded typical estuarine values and were much higher than the homogeneously distributed concentrations in different depth ranges of the basin sediment. Particles collected in sediment traps showed intermediate metal concentrations close to sediment values. These results suggest trace metal recycling due to reductive dissolution under suboxic conditions at the sediment surface resulting in trace metal release to the water column and adsorption onto suspended particles. Dissolved Cd, Zn and Hg concentrations (e.g. 13-136 ng l(-1); 0.3-25.1 microg l(-1) and 0.5-2.0 ng l(-1), respectively) in the basin corresponded to the concentration range typically observed in the Gironde estuary, except for some maximum values attributed to metal recycling. In contrast, dissolved Cu concentrations (1.08-6.08 microg l(-1)) were mostly higher than typical estuarine values, probably due to recycled Cu complexation by dissolved organic matter. Growth, bioaccumulation rates and kinetics in the whole soft body of the bivalves were analyzed every 40 days. Although Cd bioaccumulation of oysters was lower in the basin than in the estuary during the same period (27,000 ng g(-1), dry weight and 40,000 ng g(-1), respectively) these values are largely above the new human consumption safety level (5000 ng g(-1), dw; European Community, 2002). For cockles and clams, Cd bioaccumulation was lower, reaching 1400 ng g(-1) and 950 ng g(-1), respectively. Similar results were obtained for Zn and Cu suggesting physiological differences between the species and/or differences in the exposure of the organisms due to physico-chemical conditions and metal distribution between dissolved and particulate phases. In contrast, Hg bioaccumulation was highest for cockles reaching bioconcentration factors of approximately 200,000, which even exceeded that of Cd in oysters (50,000) for the same exposition period. Nevertheless, Hg concentrations remained relatively low in the three bivalve species.
High-resolution photoemission data of the (110) iron surface reveal the existence of well-defined metallic surface resonances in good correspondence to band calculations. Close to the Fermi level, their dispersion and momentum broadening display anomalies characteristic of quasiparticle renormalization due to coupling to bosonic excitations. Its energy scale exceeds that of phonons by far, and is in striking coincidence with that of the spin wave spectrum in iron. The self-energy behavior thus gives spectroscopic evidence of a quasiparticle mass enhancement due to electron-magnon coupling.
PURPOSE: In-vitro and in-vivo examinations to investigate the influence of one (1D)- and two-dimensional (2D) parallel acquisition techniques (PAT) on contrast-to-noise ratio (CNR) and image quality for bright-lumen 3D MR colonography. MATERIALS AND METHODS: In-vitro measurements were performed on a 1.5 T whole-body MR scanner (MAGNETOM AVANTO(R), Siemens AG, Erlangen) with a standard spoiled 3D gradient-echo (3D GRE) sequence and a volume interpolated 3D GRE (VIBE) sequence using a home-built colon phantom. The relative CNR was determined and image quality evaluated for different acceleration factors (PAT factors). A bright-lumen 3D MR colonography with PAT factors 2, 3, 4 and 6 was performed on a 39-year-old volunteer. The 3D data sets were compared with regard to image quality. RESULTS: The mean relative CNR values for the in-vitro measurements were 1, 0.81, 0.73, 0.52 and 0.4 (3D GRE) and 1, 0.8, 0.65, 0.45 and 0.3 (VIBE) for the PAT factors 1, 2, 3, 4 and 6, respectively. Residual aliasing artifacts not affecting image quality in a distinct manner were visible for 2D PAT, especially for the VIBE sequence. Increasing the PAT factor up to 6 and decreasing the acquisition time down to 10 seconds for the bright-lumen 3D MR colonography could achieve adequate image quality with significantly reduced image artifacts caused by peristalsis and pulsations. DISCUSSION: Even for high PAT factors up to 6, 2D PAT only leads to a moderate CNR loss. For a 3D MR colonography, distinct shorter acquisition times can be achieved with identical resolution.
PURPOSE: To develop and to test an easily produced biological colon model with simulated polypoid lesions. Application of this phantom for the selection of an optimized scan protocol of 16-row CT colonography (CTC) for clinical use. METHODS AND MATERIAL: Six polypoid lesions (1 - 6 mm) were simulated with sutures on the inner face of a porcine colon segment (20 cm). After distending the colon segment with air, the phantom was placed in a water quench and CT scans were performed on a MDCT-scanner (Somatom Sensation 16, Siemens, Forchheim). At constant values for collimation (16x0.75 mm) and voltage (120 kV), 54 different combinations of mAs values (50, 75 and 100 mAs), pitch factors (1, 1.25 and 1.5) and slice thicknesses (0.75, 1.0, 1.5, 2.0, 3.0 and 5.0 mm) were tested systematically. The phantom was scanned in the longitudinal and transverse axis to simulate the different orientation of the colon in the abdomen. Axial slice images and virtual endoscopic views of all data sets were presented separately to 2 radiologists who independently determined number and size of detectable polyps. Dose exposure was measured with an Alderson phantom. RESULTS: The colon model offered a realistic imitation of a polyp-covered, human colon. The experimental set-up allowed a systematic evaluation of polyp detection related to lesion size, orientation of the colon and CTC parameters, with other influencing factors mostly excluded. Polyps were significantly better detected in the longitudinal than in the transverse orientation of the colon. For the detection of lesions of at least 3 mm, a low dose (50 mAs) 16-row CTC should be combined with a pitch of 1.5 and a maximum slice thickness of 3 mm. For the depiction of polyps smaller than 3 mm, slice thickness and pitch should amount to 1 mm and 1.0, respectively. Effective dose of this low dose protocol is 4.08 mSv. CONCLUSION: The porcine colon phantom represents a realistic and easily produced alternative to other colonography models. It allows a preselection of a CTC-protocol for subsequent clinical testings. If the high in vitro performance of the low-dose 16-row CTC-protocol is confirmed on a human collective, the use of 16-row technique would represent a big step for CTC toward a screening method.
We present measurements of the Fermi surface and underlying band structure of a single layer of indium on Si(111) with square root 7 x square root 3 periodicity. Electrons from both indium valence electrons and silicon dangling bonds contribute to a nearly free, two-dimensional metal on a pseudo-4-fold lattice, which is almost completely decoupled at the Fermi level from the underlying hexagonal silicon lattice. The mean free path inferred from our data is quite long, suggesting the system might be a suitable model for studying the ground state of two-dimensional metals.
Low-temperature electronic properties of the charge-density-wave system NbSe3 are reported from angle-resolved photoemission at 15 K. The effect of two instabilities q(1) and q(2) on the k-resolved spectral function is observed for the first time. With a pseudogap background, the gap spectra exhibit maxima at Delta*(1) approximately 110 meV and Delta*(2) approximately 45 meV. Imperfectly nested sections of the Fermi surface lack a Fermi-Dirac edge, and show the signature of a dispersion that is modified by self-energy effects. The energy scale is of the order of the effective gap 2 Delta*(2). The effect disappears above T2, suggesting a correlation with the charge-density-wave state.
PURPOSE: Presentation of the value of postsurgical computed tomography (CT) to diagnose loosening of uncemented femoral stems. MATERIALS AND METHODS: Incremental CT and spiral CT were performed on six femora with implanted uncemented stems after the entire femora were embedded in polymethylmethacrylate. The femora were subsequently sectioned (thickness 1 mm, separation 8 mm) and the medial and lateral contact areas of the prosthetic stem compared with the CT data. RESULTS: The CT showed a contact of femoral stem and cortical bone between 0.4 mm (3.4 %) and 4.8 mm (47.1 %) and the section specimens between 0.9 mm (8.7 %) and 3.4 mm (36.7 %). No correlation was found between the results (r = 0.61), since the individual differences were up to 24 % in almost all sections. CONCLUSIONS: Neither single-slice nor two-slice CT is capable of demonstrating the direct bone-endoprosthesis contact. Multidetector row CT (MDCT) is conceivably more accurate to measure the cortical contact of the femoral stem.
Combined IGF-I and TGF-beta1 application by a poly-(D,L-lactide) (PDLLA) coated interbody cage has proven to promote spine fusion. The purpose of this study was to determine whether there is a dose-dependent effect of combined IGF-I and TGF-beta1 application on intervertebral bone matrix formation in a sheep cervical spine fusion model. Thirty-two sheep underwent C3/4 discectomy and fusion. Stabilisation was performed using a titanium cage coated with a PDLLA carrier including no growth factors in group 1 ( n=8), 75 micro g IGF-I plus 15 micro g TGF-beta1 in group 2 ( n=8), 150 micro g IGF-I plus 30 micro g TGF-beta1 in group 3 ( n=8) and 300 micro g IGF-I plus 60 micro g TGF-beta1 in group 4 ( n=8). Blood samples, body weight and temperature were analysed. Radiographic scans were performed pre- and postoperatively and after 1, 2, 4, 8, and 12 weeks. At the same time points, disc space height and intervertebral angle were measured. After 12 weeks, the animals were killed and fusion sites were evaluated using quantitative computed tomographic (CT) scans to assess bone mineral density, bone mineral content and bony callus volume. Biomechanical testing was performed and range of motion, and neutral and elastic zones were determined. Histomorphological and histomorphometrical analysis were carried out and polychrome sequential labelling was used to determine the time frame of new bone formation. In comparison to the group without growth factors (group 1), the medium- and high-dose growth factor groups (groups 3 and 4) demonstrated a significantly higher bony callus volume on CT scans, a higher biomechanical stability, an advanced interbody bone matrix formation in histomorphometrical analysis, and an earlier bone matrix formation on fluorochrome sequence labelling. Additionally, the medium- and high-dose growth factor groups (groups 3 and 4) demonstrated a significantly higher bony callus volume, a higher biomechanical stability in rotation, and an advanced interbody bone matrix formation in comparison to the low-dose growth factor group (group 2). No significant difference could be determined between the medium- and the high-dose growth factor groups (groups 3 and 4, respectively). The local application of IGF-I and TGF-beta1 by a PDLLA-coated cage significantly improved results of interbody bone matrix formation in a dose-dependent manner. The best dose-response relationship was achieved with the medium growth factor dose (150 micro g IGF-I and 30 micro g TGF-beta1). With an increasing dose of these growth factors, no further stimulation of bone matrix formation was observed. Although these results are encouraging, safety issues of combined IGF-I and TGF-beta1 application for spinal fusion still have to be addressed.
INTRODUCTION: There has been a rapid increase in the use of interbody fusion cages as an adjunct to spondylodesis, although experimental data are lacking. A sheep cervical spine interbody fusion model was used to determine the effect of different cage design parameters (endplate-implant contact area, maximum contiguous pore) on interbody fusion. MATERIAL AND METHOD: IN VITRO EVALUATION: 24 sheep cadaver specimens (C2-C5) were tested in flexion, extension, axial rotation, and lateral bending with a nondestructive flexibility method using a nonconstrained testing apparatus. Four different groups were examined: (1) control group (intact) ( n=24), (2) autologous tricortical iliac crest bone graft ( n=8), (3) Harms cage ( n=8), and (4) SynCage-C ( n=8). IN VIVO EVALUATION: 24 sheep underwent C3/4 discectomy and fusion: group 1: autologous tricortical iliac crest bone graft ( n=8), group 2: Harms cage filled with autologous cancellous iliac crest bone grafts ( n=8), and group 3: SynCage-C filled with autologous cancellous iliac crest bone grafts ( n=8). Radiographic scans were performed pre- and postoperatively and after 1, 2, 4, 8, and 12 weeks, respectively. At the same time points, disc space height (DSH), height index (HI), intervertebral angle (IVA), and endplate angle (EA) were measured. After 12 weeks the animals were killed and fusion sites were evaluated using biomechanical testing in flexion, extension, axial rotation, and lateral bending. Additionally, histomorphological and histomorphometrical analyses were performed. RESULTS: Over a 12-week period the cage groups showed significantly higher values for DSH, HI, IVA, and EA compared to the bone graft. In vivo stiffness was significantly higher for the tricortical iliac crest bone graft and Harms cage than in vitro stiffness. However, there was no difference between in vitro and in vivo stiffness of the SynCage-C. Histomorphometrical evaluation showed a more progressed bone matrix formation in the Harms cage group than in both other groups. CONCLUSION: The parameter endplate-implant contact area was not able to determine subsidence of cages. In contrast, the maximum contiguous pore of a cage significantly correlates with interbody bone matrix formation inside the cage. Additionally, there was no correlation between in vitro and in vivo stiffness of interbody fusion cages. Therefore, biomechanical in vitro studies are not able to determine in vivo outcome of fusion cages. Animal experimental evaluations of interbody fusion cages are essential prior to clinical use.
Although peptide hormone receptors commonly exert their actions at the plasma membrane the cellular mechanisms that route the receptor proteins to the cell surface during biosynthesis are not well characterized. Here we report on the identification of a plasma membrane targeting sequence of rat somatostatin receptor subtype 3. While type 3 somatostatin receptors are present almost exclusively at the cell surface, type 1 receptors localize in addition largely in intracellular vesicular compartments. Chimeric receptors were constructed between rat somatostatin receptors 3 and 1. They were tagged by recombinant DNA techniques with a herpes simplex virus glycoprotein D epitope at the carboxyl-termini to facilitate their detection using fluorescence microscopic methods. Following transfection of the constructs in human embryonic kidney and rat insulinoma cells the chimeric receptors were analyzed by indirect immunofluorescence using anti-epitope monoclonal antibody and confocal laser scanning microscopy. The results demonstrate that the amino-terminal domain of somatostatin receptor 3 suffices to guide chimeric receptors to the cell surface. In marked contrast, chimeric receptors that lack this sequence but contain instead the amino-terminus of somatostatin type 1 receptor localize in an intracellular vesicular compartment.
The electronic band structure of the Peierls compound NbSe3 has been explored for its symmetries with microspot synchrotron photoemission. The Fermi level crossings and deviations from one-dimensional behavior are identified. Density-functional calculations of the Fermi surfaces confirm the nesting conditions relevant for the two phase transitions. The instability along the chains with superstructure periodicity q = 0.44 A(-1) induces a backfolding of the electronic bands, and the Fermi level crossings appear suppressed. This broken symmetry is observed in the fluctuation regime at more than twice the critical temperature, where the correlation length is strongly reduced.
STUDY DESIGN: An in vitro biomechanical study of cervical spine interbody fusion cages using a sheep model was conducted. OBJECTIVES: To evaluate the biomechanical effects of cervical spine interbody fusion cages, and to compare three different cage design groups. SUMMARY AND BACKGROUND DATA: Recently, there has been a rapid increase in the use of cervical spine interbody fusion cages as an adjunct to spondylodesis. These cages can be classified into three design groups: screw, box, or cylinder designs. Although several comparative biomechanical studies of lumbar interbody fusion cages are available, biomechanical data for cervical spine constructs are lacking. Additionally, only limited data are available concerning comparative evaluation of different cage designs. METHODS: In this study, 80 sheep cervical spines (C2-C5) were tested in flexion, extension, axial rotation, and lateral bending with a nondestructive stiffness method using a nonconstrained testing apparatus. Three-dimensional displacement was measured using an optical measurement system (Qualysis). Complete discectomy (C3-C4) was performed. Cervical spine interbody fusion cages were implanted according to manufacturers' information. Eight spines in each of the the following groups were tested: intact, autologous iliac bone graft, two titanium screws (Novus CTTi; Sofamor Danek, Koln, Germany), two titanium screws (BAK-C 8 mm; Sulzer Orthopedics, Baar, Switzerland), one titanium screw (BAK-C 12 mm; Sulzer Orthopedics), carbon box (Novus CSRC; Sofamor Danek), titanium box (Syncage; Synthes, Bochum, Germany), titanium mesh cylinder (Harms; DePuy Acromed, Sulzbach, Germany), titanium cylinder (MSD; Ulrich, Ulm, Germany), and titanium cylinder (Kaden; BiometMerck, Berlin, Germany). The mean apparent stiffness values were calculated from the corresponding load-displacement curves. Additionally, cage volume and volume-related stiffness was determined. RESULTS: After cervical spine interbody fusion cage implantation, flexion stiffness increased, as compared with that of the intact motion segment. On the contrary, rotation stiffness decreased after implantation of a cervical spine interbody fusion cage, except for the Novus CSRC, Syncage, and Kaden-Cage. If two screws were inserted (Novus CTTi and BAK-C 8 mm), there was no significant difference in flexion stiffness between screw and cylinder design groups. If one screw was inserted (BAK-C 12 mm), flexion stiffness was higher for cylinder designs (P < 0.05). Extension and bending stiffness were always higher with cylinder designs (P < 0.05). Volume-related stiffness for flexion extension and bending was highest for the Harms cage (P < 0.05). There was no difference for rotation volume-related stiffness between Harms and Syncage. CONCLUSIONS: The biomechanical results indicate that design variations in screw and cylinder design groups are of little importance. In this study, however, cages with a cylinder design were able to control extension and bending more effectively than cages with a screw design.
Explore the source record for details and available documents.
A 54-year-old female patient presented with exercise-induced proximal muscle pain and weakness of the lower limbs. One year after the onset of these symptoms she developed bilateral ptosis and dysphagia. Molecular genetic analysis of the poly(A) binding protein 2 gene (PABP2) confirmed the presumptive diagnosis of oculopharyngeal muscular dystrophy (OPMD). Exercise-induced proximal muscle pain and weakness are rarely initial symptoms of OPMD. We discuss therapeutic options and present an overview of the relevant literature.
PURPOSE: The aim of the study was to evaluate the feasibility and results of CT-guided percutaneous bone biopsy (PBB) of unknown bone lesions in a representative number of patients. METHODS: In 92 patients (100 biopsies) with different bone lesions CT-guided PBB was performed. RESULTS: The rate of technical success, defined as a successful retrieval of a sufficient tissue sample which then was sent for histological evaluation, was 89% (89/100 biopsies). The diagnostic accuracy was defined as a clinically useful histological result and was obtained in 80% (80/100 biopsies). Minor complications (minimal bleedings) occurred in 3% of all biopsies, no special therapy was necessary. Osteolytic lesions (92%) were classified more accurately by PBB than osteoplastic (80%) or mixed lesions (67%). Considering the anticipated dignity of the lesions prior to PBB, the suspected malignant bone lesions had a better diagnostic accuracy of 82% than the suspected benign bone lesions with an accuracy of 50%. CONCLUSION: Due to its universal availability combined with a low risk and a high diagnostic value the PBB of unknown bone lesions can be regarded as a valuable diagnostic tool. However, leave-me-alone lesions should be excluded.
A new model for the ionization processes in UV matrix-assisted laser desorption/ionization (MALDI) which accounts for the major phenomena observed is presented and discussed. The model retains elements of earlier approaches, such as photoionization and photochemical reactions, but it redefines these in the light of new working questions, most importantly why only singly charged ions are detected. Based on experimental evidence, the formation of singly and multiply charged clusters by a deficiency/excess of ions and also by photoionization and subsequent photochemical processes is pointed out to be the major ionization processes, which typically occur in parallel. The generation of electrons and their partial loss into the surrounding vacuum and solid, on the one hand, results in a positively charged ion-neutral plume facilitating a high overall ionization yield. On the other hand, these electrons, and also the large excess of protonated matrix ions in the negative ion mode, induce effective ion reneutralization in the plume. These neutralization processes are most effective for the highly charged cluster ions initially formed. Their fragmentation behaviour is evidenced in fast metastable fragmentation characteristics and agrees well with an electron capture dissociation mechanism and the enthalpy transfer upon neutralization forms the rationale for the prominent fragmentation and intense chemical noise accompanying successful MALDI. Within the course of the paper, cross-correlations with other desorption/ionization techniques and with earlier discussions on their mechanisms are drawn.
PURPOSE: The aim of this study was to demonstrate on a complex anatomical structure the possibilities and the advantages of a superimposition of a color-coded surface and volume rendering (hybrid rendering) method with the possibility of the performance of a virtual endoscopy. MATERIAL AND METHOD: In 6 patients with cochlear implants a high-resolution spiral computed tomography of the petrous bone was performed. The cochlear implants, the middle and inner ear structures were visualized using a color-coded surface rendering method, either shaded or as a grid. The petrous bone was visualized using a transparent volume rendering method. RESULTS: The hybrid 3D visualization uses the advantages of both the color-coded 3D surface and volume rendering method. In comparison to the axial source images, the hybrid 3D visualization thus facilitates a clearer representation and better assessment of the complex topographical relationship without loss of diagnostic information. The virtual endoscopy facilitates an intraluminal visualization and inspection of all color-coded 3D surface- and volume rendered structures. CONCLUSIONS: The hybrid rendering and virtual endoscopy make the morphological assessment of cochlear implants easier by the simultaneous visualization of the surrounding structures and thereby support the diagnostic imaging methods. This image processing method can be used pre-operatively for the individual planning, simulation, training and further development of surgical procedures and interventions and post-operatively for the control of the position and further developments of implants.