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Biomedical subjects

Jürgen Schäfer

Publications and source records attributed to Jürgen Schäfer.

10 recordsLinked to original sources

Prospective randomized comparison of radiation exposure from full spine radiographs obtained in three different techniques.

PROBLEM: The purpose of the investigation was a comparison of two different digital X-ray techniques with conventional standing full spine films. Evaluation of dose area product, image quality and inter-observer error of Cobb-angle measurement in patients with scoliosis and kyphoscoliosis were studied. METHODS: A consecutive series of 150 patients were prospectively randomized into three groups. Patients in group 1 (n=53) received a conventional standing postero-anterior full spine radiograph. All films were evaluated on the light box. Patients in group 2 (n=48) received a X-ray using the digital storage phosphor plate system (CR). For group 3 (n=49) digital pulsed fluoroscopy was used. In groups 2 and 3 images were exported to a picture archiving and communicating system (PACS) workstation and viewed on a monitor (Siemens SMM 21140P, Germany). Dose area product measurements were performed in all three groups (Diamentor-M, PTW, Freiburg). Three experienced investigators independently reviewed all pictures. Pedicles and endplates were counted. Cobb-angles of the main curves were measured. RESULTS: The mean dose area product was 97.0 cGy cm(2) (37.0-380.0 cGy cm(2)) for conventional films, 31.5 cGy cm(2) (6.0-66.0 cGy cm(2)) for CR imaging and 5.0 cGy cm(2) (1.0-29.0 cGy cm(2)) for digital fluoroscopy. The differences of Cobb-angle measurements were not significantly different for the three methods. Differences in the count of pedicles and endplates between the investigators were significantly lower for the conventional film as an indicator for the best detail presentation. CONCLUSION: A significant reduction in dose area product is possible with modern digital X-ray methods. The inter-observer error of Cobb-angle measurement is not significantly altered. The detail information is decreased in comparison to conventional films.

Adolescent↗

Quantitative lung perfusion mapping at 0.2 T using FAIR True-FISP MRI.

Perfusion measurements in lung tissue using arterial spin labeling (ASL) techniques are hampered by strong microscopic field gradients induced by susceptibility differences between the alveolar air and the lung parenchyma. A true fast imaging with steady precession (True-FISP) sequence was adapted for applications in flow-sensitive alternating inversion recovery (FAIR) lung perfusion imaging at 0.2 Tesla and 1.5 Tesla. Conditions of microscopic static field distribution were assessed in four healthy volunteers at both field strengths using multiecho gradient-echo sequences. The full width at half maximum (FWHM) values of the frequency distribution for 180-277 Hz at 1.5 Tesla were more than threefold higher compared to 39-109 Hz at 0.2 Tesla. The influence of microscopic field inhomogeneities on the True-FISP signal yield was simulated numerically. Conditions allowed for the development of a FAIR True-FISP sequence for lung perfusion measurement at 0.2 Tesla, whereas at 1.5 Tesla microscopic field inhomogeneities appeared too distinct. Perfusion measurements of lung tissue were performed on eight healthy volunteers and two patients at 0.2 Tesla using the optimized FAIR True-FISP sequence. The average perfusion rates in peripheral lung regions in transverse, sagittal, and coronal slices of the left/right lung were 418/400, 398/416, and 370/368 ml/100 g/min, respectively. This work suggests that FAIR True-FISP sequences can be considered appropriate for noninvasive lung perfusion examinations at low field strength.

Adolescent↗

Prospective comparison of the impact on treatment decisions of whole-body magnetic resonance imaging and computed tomography in patients with metastatic malignant melanoma.

Patient management and treatment strategies for metastatic melanoma depend largely on the stage of metastatic disease. The aim of this study was to compare contrast-enhanced whole-body magnetic resonance imaging (wbMRI) and whole-body computed tomography (wbCT) to detect distant metastases for staging. A total of 43 patients (41 with completed wbCT and wbMRI examination) with known American Joint Committee on Cancer (AJCC) stage III-IV malignant melanoma were examined and 775 metastases were identified by both methods. Whole-body CT was able to detect 522 metastases, whereas wbMRI found 730 metastases. Whole-body CT identified 188 pulmonary metastases, compared with 143 metastases detected by wbMRI. In kidneys, adrenal glands and lymph nodes, respectively, wbCT and wbMRI detected the same number of lesions. Whole-body MRI detected more metastases than wbCT in liver (detection rate 122/199), spleen (26/54), subcutaneous tissue (39/61), muscle (4/11), bone marrow (23/132) and brain (15/25). Therapy was modified as a consequence of wbMRI findings in 10/41 (24%) patients. In conclusion, wbMRI detected clearly more malignant melanoma metastases in most organ systems with the exception of lung metastases. More accurate and complete staging by wbMRI has an impact on treatment strategy in about one-quarter of the patients.

Adolescent↗

A complicated case of bilateral cystic nephroma in a 16-month-old boy.

We describe a case of a progressive bilateral cystic nephroma (BCN) in a child undergoing a multistaged surgical procedure. After partial resection of the left sided tumor, a progress occurred on that side and the left kidney had to be removed 10 weeks later. After 35 months a tumor progression was observed on the right side together with an ureteral obstruction leading to a decreased renal function. In a third operation a complete tumor resection on the right side was achieved through longitudinal partial nephrectomy, reconstruction of the renal pelvis, and reanastomosis of the reconstructed pelvis and ureter. The patient showed no evidence of the disease at 28 months of follow-up. The presented case provides an evidence that in BCN a tumor progress may occur after multistaged surgical approaches. A single-staged complete tumor resection with renal salvage techniques seems indicated.

Disease Progression↗

Protein sequence tags: a novel solution for comparative proteomics.

Comparative proteome profiling using stable isotope peptide labelling and mass spectrometry has emerged as a promising strategy. Here, we show the broad potential of our proprietary protein sequence tag (PST) technology. A special feature of PST is its ability to detect a wide variety of proteins including the pharmaceutically relevant membrane and nuclear proteins. This procedure addresses a similar number of proteins, compared to the multidimensional protein identification technology approach, but offers additionally a quantitative analysis with its recently developed quantitative PST version.

Amino Acid Sequence↗

Fast whole-body assessment of metastatic disease using a novel magnetic resonance imaging system: initial experiences.

OBJECTIVE: The objective of this study was to investigate the clinical use of a novel whole-body magnetic resonance imaging (MRI) system for comprehensive assessment of tumor spread in clinical routine. MATERIAL AND METHODS: Sixty-five patients with different tumors with known metastatic disease and 6 healthy volunteers were included. High-resolution MRI from head to toe was performed using multiple phased-array surface coil elements, 24 independent receiver channels, and an integrated parallel acquisition technique (iPAT). A total room time of less than 60 minutes was required. Whole-body MRI and conventional spiral computed tomography (CT) were independently evaluated and compared in terms of feasibility, location/number of detected metastases, and therapeutic relevance. RESULTS: Whole-body MRI was successfully performed in 68 of 71 subjects. Compared with CT, more metastases were detected by MRI in 11 of 63 patients (17%), particularly in brain, liver, spleen, lymph nodes, bone marrow, muscle, and subcutaneous fat tissue. According to these findings, therapy had to be modified in 6 of 63 patients (10%). CONCLUSIONS: High-resolution whole-body MRI is feasible in clinical routine within 1 single examination and offers great potential for fast assessment of individual tumor spread and total tumor burden.

Adolescent↗

Comparative proteomic analysis of proliferating and functionally differentiated mammary epithelial cells.

Proliferation and differentiation of mammary epithelial cells are governed by hormonal stimuli, cell-cell, and cell-matrix interactions. Terminal differentiation of mammary epithelial cells depends upon the action of the lactogenic hormones, insulin, glucocorticoids, and prolactin that enable them to synthesize and secrete milk proteins. These differentiated cells are polarized and carry out vectorial transport of milk constituents across the apical plasma membrane. To gain additional insights into the mechanisms governing differentiation of mammary epithelial cells, we identified proteins whose expression distinguishes proliferating from differentiated mammary epithelial cells. For this purpose we made use of the HC11 mammary epithelial line, which is capable of differentiation in response to lactogenic hormones. Using two-dimensional gel electrophoresis and mass spectrometry, we found about 60 proteins whose expression levels changed in between these two differentiation states. Bioinformatic analysis revealed differential expression of cytoskeletal components, molecular chaperones and regulators of protein folding and stability, calcium-binding proteins, and components of RNA-processing pathways. The actin cytoskeleton is asymmetrically distributed in differentiated epithelial cells, and the identification of proteins involved in mRNA binding and localization suggests that asymmetry might in part be achieved by controlling cellular localization of mRNAs. The proteins identified provide insights into the differentiation of mammary epithelial cells and the regulation of this process.

Animals↗

Tandem mass tags: a novel quantification strategy for comparative analysis of complex protein mixtures by MS/MS.

A novel MS/MS-based analysis strategy using isotopomer labels, referred to as "tandem mass tags" (TMTs), for the accurate quantification of peptides and proteins is described. The new tags are designed to ensure that identical peptides labeled with different TMTs exactly comigrate in all separations. The tags require novel methods of quantification analysis using tandem mass spectrometry. The new tags and analysis methods allow peptides from different samples to be identified by their relative abundance with greater ease and accuracy than other methods. The new TMTs permit simultaneous determination of both the identity and relative abundances of peptide pairs using a collision induced dissociation (CID)-based analysis method. Relative abundance measurements made in the MS/MS mode using the new tags are accurate and sensitive. Compared to MS-mode measurements, a very high signal-to-noise ratio is achieved with MS/MS based detection. The new tags should be applicable to a wide variety of peptide isolation methods.

Isotopes↗

Characterization of low abundant membrane proteins using the protein sequence tag technology.

About 25% of open reading frames in fully sequenced genomes are estimated to encode transmembrane proteins that represent valuable targets for drugs. However, the global analysis of membrane proteins has been proven to be problematic, e.g., because of their very amphiphilic nature. In this paper, we show that the recently published Protein Sequence Tag (PST) technology combined with an efficient sample preparation is a powerful method to perform protein analysis of highly enriched membrane fractions. The PST approach is a gel-free proteomics tool for the analysis of proteins, which relies on a "sampling" strategy by isolating N-terminal protein sequence tags from cyanogen bromide cleaved proteins. The identification of these N-terminal PST peptides is based on LC-MS/MS. The effectiveness of the technology is demonstrated for a membrane fraction, which was isolated from crude mitochondria of yeast after alkaline sodium carbonate treatment. The PST approach performed on this fraction analyzed 148 proteins, whereas 84% are identified as membrane proteins. More interestingly, among these membrane proteins 56% are predicted to be of low abundance. These encouraging results are an important step toward the development of a quantitative PST approach (qPST) for the differential display of membrane protein analysis.

Carbonates↗