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Biomedical subjects

L Jäger

Publications and source records attributed to L Jäger.

At least 55 records · Page 3Linked to original sources
PubMed1998

Alternating episodes of vestibular nerve excitation and failure.

Recurrent episodes of oscillopsia, rotational vertigo, and postural imbalance were elicited and modulated by changing the horizontal head positions of a patient with an arachnoid cyst in the right cerebellopontine angle that distorted the vestibulocochlear nerve. Oculomotor analysis revealed two different types of attacks depending on the particular head position: 1) episodes of vestibular hypofunction (minutes to several hours) with normal head position and 2) paroxysmal vestibular excitation (seconds) with head rotation to the left. The most likely cause is a transition from conduction block to ectopic discharges, which occurs when various peripheral nerves are compressed. One week after resection of the cyst and decompression of the eighth cranial nerve the patient was symptom free, and the electronystagmogram was normal.

Arachnoid Cysts↗
PubMed1998

[Leukotriene receptor antagonists and bronchial asthma].

Leukotrienes play an important role in the pathogenesis of the allergic bronchial asthma. The cysteinyl-leukotrienes C4, D4 and E4 (formerly known as slow reacting substance of anaphylaxis, SRS-A) are able to induce all components of the asthmatic reaction. The synthesis of adequate receptor antagonists stimulated expectations to develop on this way new and especially effective antiasthmatic drugs. The results of the first generation was disappointing. Newer compounds are able to protect from bronchoconstriction-inducing noxes (especially in analgesic intolerance), to improve chronic asthma (symptoms scores, long-time resp. rescue medication). Especially remarkable are recent data which prove antiinflammatory activities. Studies are underway to define the position of these drugs in generally accepted recommendations on asthma therapy. This group of drugs is the first one with a defined action.

Animals↗
PubMed1998

Fluoroscopic MR of the pharynx in patients with obstructive sleep apnea.

PURPOSE: The purpose of our study was to introduce an ultrafast MR imaging technique of the pharynx as a diagnostic tool for viewing the mechanism of obstruction in patients with obstructive sleep apnea. METHODS: Six healthy volunteers and 16 patients with obstructive sleep apnea were examined on a 1.5-T whole-body imager using a circular polarized head coil. Ultrafast two-dimensional fast low-angle shot sequences were obtained in midsagittal and axial projections during transnasal shallow respiration at rest, during simulation of snoring, and during performance of the Müller maneuver. All patients underwent physical examination, transnasal fiberoptic endoscopy, and polysomnography. RESULTS: Five to six images were obtained per second with an in-plane resolution of 2.67 x 1.8 mm and 2.68 x 2.34 mm, allowing visualization of motion of the tongue, soft palate, uvula, and posterior pharyngeal surface. MR findings correlated well with results of clinical examination. The length of obstruction in the oropharynx, which cannot be ascertained by transnasal endoscopy of the pharynx, was clearly visible MR images. Differences between patients with obstructive sleep apnea and healthy subjects in terms of the degree of obstruction in the velopharynx and oropharynx depicted on MR images during the Müller maneuver were highly significant. CONCLUSION: We believe that ultrafast MR imaging is a reliable noninvasive method for use in the evaluation of obstructive sleep apnea.

Airway Obstruction↗
PubMed1997

[Imaging of the labyrinth and vestibular nerve. Clinical significance for differential diagnosis of vestibular diseases].

High resolution magnetic resonance imaging (HR-MRI) and computed tomography (HR-CT) of the inner ear are becoming more important for the diagnosis of peripheral vestibular lesions. Modern HR-MRI techniques allow visualization of detailed anatomic features of the vestibulo-cochlear regions as well as pathologic findings in the inner ear such as, neoplastic lesions (e.g., small intracanalicular acoustic neuromas), anomalies causing vertigo and hearing loss (e.g. Mondini's-malformation, perilymph fistula, vestibular paroxysmia), and inflammatory diseases (e.g., Cogan's syndrome, labyrinthitis, zoster neuritis). HR-CT is still the first examination that should be performed in patients with middle ear diseases (e.g., tumor, infection), trauma (e.g. temporal bone fractures), or fibro-osseous diseases. Although the imaging of the vestibulo-cochlear system has dramatically improved, there are still several peripheral vestibular disorders that cannot be visualized so far, e.g., benign paroxysmal positioning vertigo, idopathic vestibular neuritis or Menière's disease.

Diagnosis, Differential↗
PubMed1997

Variability of disk position in asymptomatic volunteers and patients with internal derangements of the TMJ.

This study determined the variability of temporomandibular joint (TMJ) disk position in medial, central, and lateral aspects of the joint using magnetic resonance imaging (MRI). Subjects had clinical evidence of reciprocal TMJ clicking (N = 123) or restricted mandibular motion (N = 52). Eighty-nine asymptomatic volunteers provided a control group. Disk position was quantified on MRI by measuring the angle formed by a line through the middle of the condyle and perpendicular to the Frankfort plane and a line through the same midpoint of the condyle and tangential to the posterior-most aspect of the disk. The disk position in asymptomatic TMJs varied considerably with a tendency toward farther anterior placement in more lateral images. In 47 TMJs from a total of 52 TMJ5 (90%), restricted mobility was associated with anterior disk displacement (ADD) without reduction. The disk position demonstrated a mean displacement of 77 degrees without significant differences at the medial and lateral aspects of the condyle. One hundred TMJs from a total of 123 TMJs (81%) with reciprocal clicking demonstrated ADD with reduction. Tomograms revealed larger lateral displacements or rotational displacements in these joints, whereas medial images frequently showed similar ranges of disk positions as compared with asymptomatic TMJs. The results suggest that disk positions of up to +15 degrees on medial tomograms and +30 degrees on lateral tomograms should be regarded as normal variations. Furthermore, multisection analysis of all parasagittal images improved the separation between disk displacement and asymptomatic TMJs.

Adolescent↗
PubMed1996

Application of reversed-phase high-performance liquid chromatography in the purification of major allergens from grass pollen.

Group 1 and 5 allergens of different grasses possess similar physicochemical parameters (molecular weight, pI) and therefore separation with conventional chromatographic methods (gel filtration, ion exchange chromatography) is difficult or impossible to achieve. In this paper we describe the isolation of biologically active group 1 and 5 allergens from extracts of Lolium perenne and Phleum pratense by means of reverse phase chromatography on HPLC. The chromatograms showed very different retention times for group 1 (Rt 19.1-20.5 min) and group 5 (Rt 24.3-26.3 min) containing fractions. In addition, this technique is suitable for the separation of group 5 allergens into 5a and 5b subgroups and for the estimation of the amounts of allergen (groups 1 and 5) in the different extracts.

Allergens↗
PubMed1996

Differential expression of cytokine genes in CD27-positive and -negative CD4 lymphocyte subsets from healthy humans and rheumatoid arthritis patients.

Immunofluorescence analysis of CD27 expression by CD4 lymphocytes from the peripheral blood of healthy humans or rheumatoid arthritis (RA) patients and from the synovial fluid (SF) of RA patients was carried out, along with the estimation of cytokine gene [interleukin (IL) 2, IL-3, IL-4, IL-5, IL-6, IL-6R, IL-10 and interferon-gamma (IFN-gamma)] expression in these lymphocyte subsets by RT-PCR. Although no differences in CD27-positive and -negative peripheral blood CD4 cell subset distribution were revealed, marked differences in IL-3, IL-4, IL-5 and IFN-gamma mRNA expression were detected between these lymphocyte subsets and between control and disease states. These results showed that phenotyping of different cell subsets in disease cannot provide adequate information about lymphocyte functional status. To estimate differences in cytokine gene expression, CD4 lymphocytes from the peripheral blood and SF of RA patients were compared. In both cases, mRNAs for IL-2, IL-4, IL-10 and IFN-gamma were detected, but CD4 cells from SF failed to express detectable levels of IL-5 mRNA despite our findings of a CD27-cell accumulation within the synovial population of CD4 lymphocytes. These are the first data to demonstrate that expression of the IL-5 gene in RA SF CD27- lymphocytes is down-regulated and that IL-5 disregulation in RA cannot be ruled out.

Arthritis, Rheumatoid↗
PubMed1996

[Computerized tomography of malignancies of the oral cavity, the oropharynx and hypopharynx and invasiveness].

Carcinomas of the oral cavity, oropharynx and hypopharynx represents 5% of all malignant neoplasms. The vast majority, over 90%, are squamous cell carcinomas; less common are lymphomas and tumors of the minor salivary glands. In general, the clinical findings already suggest the presence of a tumor. Therefore, the role of imaging is precise tumor localisation and staging of the malignancy. CT is still the gold standard, although MRI is gaining more importance. We present the CT appearance of most frequent malignancies of the oral cavity, oro- and hypopharynx, discussing briefly the pertinent anatomy.

Carcinoma, Squamous Cell↗
PubMed1996

[Value of fat signal suppression MRI pulse sequences for diagnosis of malignant tumors in the area of the head-neck].

PURPOSE: Evaluation of frequency-selective fat saturation (FS) and short-tau inversion recovery (STIR) fat suppression (FU) in MRI of patients with malignant head and neck tumors. METHODS: Forty-five patients with biopsy-proven carcinomas of the extracranial head and neck were examined with MRI at 1.0 T. A T2-weighted TSE sequence with and without STIR-FU and a T1-weighted SE sequence with and without FS were compared in axial slices. RESULTS: STIR-FU was successful in all and FS in 85-88% of the head examinations (nasopharynx, sinuses, oropharynx, and oral cavity) and 33-46% of the neck examinations (hypopharynx and larynx). When visualization and delineation of tumors were ranked on a four-point scale (0-3), respective mean values for images with/without FU or FS were 2.6/1.9 for T2-TSE in all examinations, 2.2/1.7 (nasopharynx and sinuses) and 1.3/1.4-1.6 (oropharynx, oral cavity, hypopharynx, and larynx) for T1-SE without contrast media administration (CM) and 2.3/2.1 (nasopharynx and sinuses) and 2.4-2.5/1.9-2.0 (oropharynx, oral cavity, hypopharynx, and larynx) with CM. CONCLUSIONS: STIR-T2-TSE was a technically reliable pathfinder for localization and extension of both tumors and lymph nodes. FS-T1-SE was technically unreliable in examinations of the hypopharynx and larynx. With CM, FS-T1-SE was most useful for MRI of carcinomas of the oral cavity and oropharynx. In the nasopharynx and sinuses, T1-SE with CM and FS-T1-SE with or without CM were equal for tumor visualization and delineation.

Adipose Tissue↗
PubMed1996

[Initial results with MRI-controlled laser-induced interstitial thermotherapy of head and neck tumors].

Laser-induced interstitial thermo-therapy (LITT) was introduced as a minimally invasive form of therapy for tumors in different anatomic regions. However, in the orofacial region, it has not been used so far for inoperable T4 carcinomas. Since vascular and neural structures are often close to the tumor or are even involved, online monitoring of LITT is necessary. The aim of our study was to establish a method of monitoring LITT with MRI (magnetic resonance imaging) in the orofacial region. Five patients with T4 carcinomas of the orofacial region underwent LITT under anesthesia. A 1.5 T whole-body imager with a circular polarized head coil was used. Before and after the intervention, the region of interest was studied using T1- and T2-weighted sequences in axial and coronal planes, with and without contrast enhancement (intravenous Gd-DTPA). Temperature distribution was monitored with a T1-weighted 2D-FLASH (fast low angle shot) sequence. The positioning of the optical fibers was monitored with MRI. Nd:YAG laser equipment was used for laser application. The necrosis was best seen on contrast-enhanced MRI. Immediately after LITT, the outcome could be determined by MRI. We proposed that MRI-guided LITT be used for neoplasms in the orofacial region at advanced stages.

Aged↗
PubMed1996

[Functional MRI of the pharynx in obstructive sleep apnea using rapid 2D FLASH sequences].

Functional imaging of the pharynx used to be the domain of cineradiography, CT and ultrafast CT. The development of modern MRI techniques led to new access to functional disorders of the pharynx. The aim of this study was to implement a new MRI technique to examine oropharyngeal obstructive mechanisms in patients with obstructive sleep apnea (OSA). Sixteen patients suffering from OSA and 6 healthy volunteers were examined on a 1.5 T whole-body imager ("Vision", Siemens, Erlangen Medical Engineering, Germany) using a circular polarized head coil. Imaging was performed with 2D flash sequences in midsagittal and axial planes. Patients and volunteers were asked to breathe normally through the nose and to simulate snoring and the Mueller maneuver during magnetic resonance imaging (MRI). Prior to MRI, all patients underwent an ear, nose and throat (ENT) examination, functional fiberoptic nasopharyngoscopy and polysomnography. A temporal resolution of 6 images/s and an in-plane resolution of 2.67 x 1.8 mm were achieved. The mobility of the tongue, soft palate and pharyngeal surface could be clearly delineated. The MRI findings correlated well with the clinical examinations. We propose ultrafast MRI as a reliable and non-invasive method of evaluating pharyngeal obstruction and their levels.

Adult↗
PubMed1996

MRI-guided laser interstitial thermal therapy (LITT) of head and neck tumors: progress with a new method.

A less invasive method for treatment of tumors is being tested based on interstitial photothermal ablation via infrared Nd:YAG laser fiber optics. The technique can be applied safely and effectively for therapy of common tumors in humans. In the current study five patients were treated by interstitial laser palliation with the Nd:YAG laser using special fiberoptic applicator tips, which distribute laser energy efficiently throughout the tumor volume. Magnetic resonance imaging (MRI) scanning was employed to locate the tumor, position the fibers correctly, and monitor the development of thermal necrosis in the tumors. Two patients were diagnosed with adenoid cystic carcinoma of the paranasal sinuses, one with a recurrent carcinoma of the tongue and oropharynx, one with a recurrent carcinoma limited to the oropharynx, and one patient with a carcinoma of the epi- and oropharynx. The maximum follow-up without recurrence was 2 years in a patient with an adenoid cystic carcinoma tumor of the paranasal sinuses. There were no immediate or delayed complications. Anatomical structures including eyes, brain, and important vessels were recognized by MRI during laser therapy. MRI-guided interstitial laser photothermal ablation appears to be a safe and effective method for treatment of selected tumors of the head and neck region with particular applications in palliation of inoperable tumor recurrences.

Aged↗
PubMed1996

Visualization of inner ear structures by three-dimensional high-resolution magnetic resonance imaging.

High-resolution computed tomography (CT) has long been the method of choice in the visualization of the petrous bone, the internal auditory canal, and the cerebellopontine angle. The introduction of magnetic resonance imaging (MRI), especially of the three-dimensional Fourier transformation constructive interference in steady state (3DFT-CISS), has proved to be superior in the detection of soft-tissue lesions in the inner ear. The aim of this study was to visualize small anatomic structures of the inner ear and cerebellopontine angle. The examinations were performed with a standard head coil on a 1.5-T Magnetom ("Vision"; Siemens, Erlangen, Germany). The three-dimensional reconstruction of the cochlea, semicircular canals, and vestibulum allowed detailed visualization, as well as the imaging of cranial nerves VII and VIII. Our results indicate that 3DFT-CISS MRI is a valuable diagnostic tool in the evaluation of inner ear anatomy and pathology; in most cases, however, it must be supplemented by HR-CT.

Aged↗
PubMed1995

Functional role of CD26 on human B lymphocytes.

CD26 is a well-known activation marker on T cells and natural killer (NK) cells [1]. It is identical with the ectopeptidase dipeptidyl peptidase IV (DP IV). The expression of CD26 on B cells has been discussed controversially [2,3]. We have studied the expression of this enzyme on B cells from the peripheral blood of healthy donors and of CVID patients, on cells of the Daudi Burkitt line and the EBV-transformed B-cell lines Jojo and Laz509. DP IV was detected by using anti-CD26 monoclonal antibodies and with help of specific enzyme substrates. Further the influence of specific synthetic DP IV inhibitors on mitogenic activation of purified B cells and DNA synthesis of cell lines was studied. We could show that in both groups 0-5% of freshly isolated CD20-positive B cells do express the CD26 antigen. After stimulation with pokeweed mitogen or St. aureus protein, the fraction of CD26-positive cells was enhanced up to 51% and 36%, respectively. Interestingly, induction of CD26 expression on B cells from CVID patients occurs in a manner similar to the B cells from healthy donors. Treatment of peripheral blood B cells and B-cell lines with highly specific competitive DP IV inhibitors leads to a significant inhibition of DNA synthesis in a dose-dependent manner. These data show that CD26 can be considered to be an activation marker not only of T- and NK cells but also of a main population of B cells, suggesting an involvement of CD26 in B-cell activation.

B-Lymphocytes↗