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Biomedical subjects

R Steiner

Publications and source records attributed to R Steiner.

At least 19 recordsLinked to original sources
PubMed2007

Evaluation of carotid artery stenosis with multisection CT and MR imaging: influence of imaging modality and postprocessing.

BACKGROUND AND PURPOSE: We prospectively evaluated the influence of different imaging techniques (time-of-flight MR angiography [TOF-MRA], contrast-enhanced MR angiography [CE-MRA], multisection CT angiography [CTA]) and postprocessing methods (maximum intensity projection [MIP], multiplanar reformation [MPR]) on carotid artery stenosis grading. MATERIALS AND METHODS: Fifty patients (34 men, 16 women) with symptomatic stenosis of the internal carotid artery were examined with a 16-section spiral CT and a 1.5T MR unit. Two MRA techniques were applied: 3D-TOF and CE-MRA. MPR was used for postprocessing with all modalities; MIP was used only with MRA. Four readers measured and calculated the percentage diameter stenosis independently according to NASCET criteria. The Wilcoxon test was used to measure interobserver variability, and the Friedman test was used to test the null-hypothesis of equality of the modalities. RESULTS: The hypothesis for global equality was rejected (P < .001). TOF-MRA and CTA assessed with MPR showed the highest concordance (difference, 0.6%; confidence interval [CI], -3.0, 4.3%), and CE-MRA with MIP and CTA showed the lowest concordance in stenosis grading (difference, 7.0%; CI, 3.4, 10.6%). MPR resulted in lower degrees of stenosis than MIP for both MRA sequences, although not statistically significant (CE, -3.0%; CI, -6.6, 0.6%; TOF, -2.2%; CI, -5.8, 1.4%). When only studies with good or excellent image quality were considered, the differences decreased, but the trends remained. CONCLUSION: Stenosis grading is dependent on the examination method and postprocessing technique. CTA and TOF-MRA evaluated with MPR revealed highest concordance.

Aged↗
PubMed2005

Gene expression in skeletal muscle of coronary artery disease patients after concentric and eccentric endurance training.

Low-intensity concentric (CET) and eccentric (EET) endurance-type training induce specific structural adaptations in skeletal muscle. We evaluated to which extent steady-state adaptations in transcript levels are involved in the compensatory alterations of muscle mitochondria and myofibrils with CET versus EET at a matched metabolic exercise intensity of medicated, stable coronary patients (CAD). Biopsies were obtained from vastus lateralis muscle before and after 8 weeks of CET (n=6) or EET (n=6). Transcript levels for factors involved in mitochondrial biogenesis (PGC-1alpha, Tfam), mitochondrial function (COX-1, COX-4), control of contractile phenotype (MyHC I, IIa, IIx) as well as mechanical stress marker (IGF-I) were quantified using an reverse-transcriptase polymerase chain reaction approach. After 8 weeks of EET, a reduction of the COX-4 mRNA level by 41% and a tendency for a drop in Tfam transcript concentration (-33%, P=0.06) was noted. This down-regulation corresponded to a drop in total mitochondrial volume density. MyHC-IIa transcript levels were specifically decreased after EET, and MyHC-I mRNA showed a trend towards a reduction (P=0.08). Total fiber cross-sectional area was not altered. After CET and EET, the IGF-I mRNA level was significantly increased. The PGC-1alpha significantly correlated with Tfam, and both PGC-1alpha and Tfam significantly correlated with COX-1 and COX-4 mRNAs. Post-hoc analysis identified significant interactions between the concurrent medication and muscular transcript levels as well as fiber size. Our findings support the concept that specific transcriptional adaptations mediate the divergent mitochondrial response of muscle cells to endurance training under different load condition and indicate a mismatch of processes related to muscle hypertrophy in medicated CAD patients.

Adaptation, Biological↗
PubMed2005

[Practice guidelines: conservative treatment of fibroids].

The conservative treatment of uterine fibroids is essentially based on symptomatology and patient's choice of treatment. The gynaecologist must develop a clear therapeutic protocol based on clinical examination, available test results and consideration of patient preference. The therapeutic options include close surveillance, hormonal treatments, conservative operative endoscopy and arterial embolization.

Female↗
PubMed2003

Eccentric endurance training in subjects with coronary artery disease: a novel exercise paradigm in cardiac rehabilitation?

This study evaluated the effects of 8 weeks of eccentric endurance training (EET) in male subjects (age range 42-66 years) with coronary artery disease (CAD). EET was compared to concentric endurance training (CET) carried out at the same metabolic exercise intensity, three times per week for half an hour. CET ( n=6) was done on a conventional cycle ergometer and EET ( n=6) on a custom-built motor-driven ergometer. During the first 5 weeks of the training program the metabolic load was progressively increased to 60% of peak oxygen uptake in both groups. At this metabolic load, mechanical work rate achieved was 97 (8) W [mean (SE)] for CET and 338 (34) W for EET, respectively. Leg muscle mass was determined by dual-energy X-ray absorptiometry, quadriceps strength with an isokinetic dynamometer and muscle fibre composition of the vastus lateralis muscle with morphometry. The leg muscle mass increased significantly in both groups by some 3%. Strength parameters of knee extensors improved in EET only. Significant changes of +11 (4.9)%, +15 (3.2)% and +9 (2.5)% were reached for peak isometric torque and peak concentric torques at 60 degrees s(-1) and 120 degrees s(-1), respectively. Fibre size increased significantly by 19% in CET only. In conclusion, the present investigation showed that EET is feasible in middle-aged CAD patients and has functional advantages over CET by increasing muscle strength. Muscle mass increased similarly in both groups whereas muscle structural composition was differently affected by the respective training protocols. Potential limitations of this study are the cautiously chosen conditioning protocol and the restricted number of subjects.

Coronary Artery Disease↗
PubMed2003

[The cannulated osteo-support rod, a new device for the minimally invasive reduction of fractures].

We report a newly developed device for fracture reduction and the positioning of K-wires, especially the guide wires of cannulated screws. It is designed as a cannulated ball spike pusher whose tip and inlay consists of a K-wire fixed in the lumina of the device by a screw. Thus, in displaced fractures, the (guide) wire can be inserted into the bone from the point of reduction, simplifying the intra-operative technique especially in minimally invasive procedures. Additionally, severely displaced fracture fragments can be handled quite comfortably percutaneously by using this device with a "joy stick" technique. The first practical experience in cannulated screw and K-wire osteosyntheses using this device are reported here.

Bone Screws↗
PubMed2003

[Eccentric muscle work--the unknown side of our movements].

Eccentric muscle work is an important part of our everyday activity, i.e. in breaking and preventing falls. Eccentric phases of movements improve the efficiency of cyclic repetitive activities. The molecular function in eccentric work is not understood, however its characteristics are a low metabolic demand and a high power output. Compared to concentric work there are only small differences in the hemodynamics of eccentric work. The muscle capacity for mechanical load is the limiting factor in eccentric work. Unaccustomed eccentric activity leads to damage of the cytoskeleton, which is the reason for delayed onset of muscle soreness. In sports and rehabilitation eccentric training can result in significant strength gain. Its use is today established to improve structures, which are exposed to eccentric loads in everyday activity. The high mechanical power may be promising in the musculoskeletal rehabilitation of patients with cardiopulmonary limitations.

Coronary Disease↗
PubMed2003

Variable-angle total internal reflection fluorescence microscopy (VA-TIRFM): realization and application of a compact illumination device.

A novel compact illumination device in variable-angle total internal reflection fluorescence microscopy (VA-TIRFM) is described. This device replaces the standard condensor of an upright microscope. Light from different laser sources is delivered via a monomode fibre and focused onto identical parts of a sample under variable angles of total internal reflection. Thus, fluorophores in close proximity to a cell-substrate interface are excited by an evanescent wave with variable penetration depth, and localized with high (nanometre) axial resolution. In addition to quantitative measurements in solution, fluorescence markers of the cytoplasm and the plasma membrane, i.e. calcein and laurdan, were examined using cultivated endothelial cells. Distances between the glass substrate and the plasma membrane were determined using the mathematical algorithm of a four-layer model, as well as a Gaussian-shaped intensity profile of the illumination spot on the samples. Distances between 0 and 30 nm in focal contacts and between 100 and 300 nm in other parts of the cell were thus determined. In addition to measurements of cell-substrate topology, the illumination device appears appropriate for numerous applications in which high axial resolution is required, e.g. experiments on endocytosis or exocytosis, as well as measurements of ion concentrations proximal to the plasma membrane. The compact illumination device is also suitable for combining TIRFM with further innovative techniques, e.g. time-resolved fluorescence spectroscopy, fluorescence lifetime imaging (FLIM) or fluorescence resonance energy transfer (FRET).

2-Naphthylamine↗
PubMed2003

Accuracy and repeatability of beef carcass longissimus muscle area measurements.

This study was conducted to determine the accuracy and repeatability of beef carcass longissimus muscle area (LMA) measurements obtained by three different methods. Longissimus muscle area for beef carcass sides (n = 100) randomly selected in a commercial packing plant was determined: 1) independently by three USDA grading supervisor "experts" using the grid method to obtain triplicate measurements of the same longissimus muscle (LM); 2) by three different Colorado State University personnel tracing the LMA on acetate paper and subsequently measuring the area via a polar planimeter three different times (total of 3 x 3 = 9 observations/LM); and 3) by use of two identical video image analysis (VIA) instruments making triplicate measurements for each LM using three different procedures. Video image analysis Procedure 1 required that LMA be measured by placing the camera head unit over the LM and collecting three sequential images without moving the camera head unit while carcasses were in a stationary position; Procedure 2 required measurement of LMA by placing the camera head unit over the LM and collecting three images, but removing and repositioning the camera head unit between collection of each image while carcasses were in a stationary position; and Procedure 3 required that LMA be measured by placing the camera head unit over the LM and obtaining an image while carcasses were in continuous motion (chain speed of 360 carcasses/ h) during three different circulations past the grading stand. Overall, VIA-derived LMA measurements were highly accurate for all three procedures compared with expert-gridded (R2 = 0.92, 0.90, and 0.84 for Procedures 1, 2, and 3, respectively) and acetate/planimeter-traced (R2 = 0.94, 0.93, and 0.86 for Procedures 1, 2, and 3, respectively) LMA measurements. Instrument LMA repeatability also was comparable to expert-gridded and acetate/planimeter-traced LMA repeatability, as the means of the absolute differences between individual measurements and the average of those same measurements per LM were 1.29, 1.35, 0.52, 0.84, and 1.87 cm2 for expert-gridded, acetate/planimeter-traced, and VIA Procedures 1, 2, and 3, respectively. Therefore, VIA instrumentation can be used to assess beef carcass LMA in both a stationary and operational scenario with high levels of accuracy and repeatability.

Animals↗
PubMed2003

Real-time augmentation of USDA yield grade application to beef carcasses using video image analysis.

In two phases, this study assessed the ability of two video image analysis (VIA) instruments, VIASCAN and Computer Vision System (CVS), to augment assignment of yield grades (YG) to beef carcasses to 0.1 of a YG at commercial packing plant speeds and to test cutout prediction accuracy of a YG augmentation system that used a prototype augmentation touchpanel grading display (designed to operate commercially in real-time). In Phase I, beef carcasses (n = 505) were circulated twice at commercial chain speeds (340 carcasses per hour) by 12 on-line USDA graders. During the first pass, on-line graders assigned a whole-number YG and a quality grade (QG) to carcasses as they would normally. During the second pass, on-line graders assigned only adjusted preliminary yield grades (APYG) and QG to carcasses, whereas the two VIA instruments measured the longissimus muscle area (LMA) of each carcass. Kidney, pelvic, and heart fat (KPH) was removed and weighed to allow computation of actual KPH percentage. Those traits were compared to the expert YG and expert YG factors. On-line USDA graders' APYG were closely related (r = 0.83) to expert APYG. Instrument-measured LMA were closely related (r = 0.88 and 0.94; mean absolute error = 0.3 and 0.2 YG units, for VIASCAN and CVS, respectively) to expert LMA. When YG were augmented using instrument-measured LMA and computed either including or neglecting actual KPH percentage, YG were closely related (r = 0.93 and 0.92, mean absolute error = 0.32 and 0.40 YG units, respectively, using VIASCAN-measured LMA; r = 0.95 and 0.94, mean absolute error = 0.24 and 0.34 YG units, respectively, using CVS-measured LMA) to expert YG. In Phase II, augmented YG were assigned (0.1 of a YG) to beef carcasses (n = 290) at commercial chain speeds using VIASCAN and CVS to determine LMA, whereas APYG and QG were determined by online graders via a touch-panel display. On-line grader YG (whole-number), expert grader YG (to the nearest 0.1 of a YG), and VIASCAN- and CVS-augmented YG (to the nearest 0.1 of a YG) accounted for 55, 71, 60, and 63% of the variation in fabricated yields of closely trimmed subprimals, respectively, suggesting that VIA systems can operate at current plant speeds and effectively augment official USDA application of YG to beef carcasses.

Animals↗
PubMed2002

[Intracanalicular trabeculostomy with the Er:YAG laser].

PURPOSE: To develop a new ab externo technique for glaucoma trabecular surgery using the infrared Er:YAG laser radiation (2.9 micrometer) guided into Schlemm's canal by an optical fiber. MATERIAL AND METHODS: In order to create a drainage canal to the anterior chamber, a quartz fiber (core diameter: 100 micrometer) coupled to an Er:YAG laser was shielded by a metal canula (diameter: 280 micrometer) bent in conformance to the curvature of Schlemm's canal. A 45 degrees -mirror enabled the laser radiation to exit the canula perpendicular to the fiber axis. The complete surgery device was tested on agar medium and enucleated human eyes. RESULTS: Using the unshielded quartz fiber, eight pulses of 8 mJ (frequency: 7 Hz, pulse duration: 150 microseconds) were sufficient to perforate the trabecular meshwork of the human eye. Histology showed a rippled canal with 50 micrometer average diameter and a surrounding necrosis zone of 15-35 micrometer. The complete device could be easily inserted into Schlemm's canal similar to the classic trabeculostomy probe and a conical-shaped canal with a length of 2-3 mm could be created in agar medium within a few seconds. CONCLUSIONS: Initial experience in an experimental set-up show the ab externo creation of a draining canal between Schlemm's canal and the anterior chamber with only minimal irritation of the surrounding tissue. Further refinements of the laser parameters and the biomechanical set-up resulted in a new hand-held device with improved function. The Er:YAG laser intracanalicular trabeculostomy could become a new ab externo technique for minimal invasive therapy of open angle glaucoma.

Equipment Design↗
PubMed2001

Feto-maternal interface of human placenta inhibits angiogenesis in the chick chorioallantoic membrane (CAM) assay.

The rapidly growing chorionic villi of the human placenta characteristically show constant blood vessel growth and differentiation. In contrast, the underlying decidua reveals tissue remodeling without apparent angiogenesis. Using the chick chorioallantoic membrane (CAM) assay, we found marked inhibition of angiogenesis by the feto-maternal interface tissue derived from nine human placentas obtained minutes after delivery. Inhibition was prevented by the addition of monensin, which blocks the release of synthesized cell products, and was markedly reduced by drying or freezing the tissue before the assay. Histology, combined with statistical analysis of the constituent cell types, correlated inhibition of angiogenesis with the number of fetally-derived extravillous trophoblasts in the feto-maternal interface tissue. Electron microscopy revealed endothelial cell damage in preexisting small (but not large) CAM vessels. We conclude that decidual tissue inhibited angiogenesis by releasing a water soluble factor which was under apparent constant production by vaible trophoblast on the CAM. The extravillous trophoblast population resembles tumor cells in its migratory and invasive properties but, in contrast to tumor induced angiogenesis, it is angiostatic, perhaps to counteract angiogenic proteins leaking from the intervillous space which could be detrimental to the maternal organism if active.

Allantois↗
PubMed2001

Increased blood levels of human S100 in melanoma chick embryo xenografts' circulation.

The chorioallantoic membrane (CAM) of the fertilized egg allows grafting of human melanomas for short-term investigations and offers the opportunity to investigate the behavior of metastasizing cells and the release of S100beta into peripheral blood. Tissue from one primary melanoma as well as cutaneous and subcutaneous metastases of 10 melanoma patients with elevated levels of S100 in the peripheral blood before surgery were transplanted onto the CAM of chick embryos at day 5/6 of development. Grafts were nourished by the host blood supply 2 days after transplantation. Histologically, 3 days after grafting, metastasizing melanoma cells could be found near the vessels of the host membrane, penetrating the endothelial layer and entering the blood system. Growth conditions remained stable for 6 days after transplantation. Blood samples were taken from a larger CAM vessel before collecting the xenografts 5 days after grafting. Measurement of human S100 in peripheral blood was performed in a blinded manner. No negative control showed elevated levels of human S100 protein. Samples deriving from melanoma xenografts contained highly elevated levels of S100 protein in 80% of cases. The data strongly support the concept of graft-host interaction concerning adherence of tumors and extravasation of human melanoma cells.

Animals↗
PubMed2001

Model of interstitial pressure as a result of cyclical changes in the capillary wall fluid transport.

Reported interstitial pressures range from -8 to +6 mm Hg in different tissues and from <-20 mm Hg in burned tissue or more than +30 mm Hg in tumors. We have tried to link interstitial pressure to the here proposed cyclical changes in the fluid transport across the capillary wall. In the presented model interstitial pressure is considered as an average of pressures in numerous pericapillary spaces. A single pericapillary pressure is a dynamic difference between the net outward (hydraulic pressure+interstitial colloid osmotic pressure) and inward (plasma colloid oncotic pressure) forces. Hence, dominating net outward forces would result in a positive pericapillary interstitial pressure, while stronger inward forces would produce negative pressures in the pericapillary space. All interruptions of blood flow leave some blood in capillaries with a normal oncotic pressure and no hydrostatic pressure that might act as a strong absorber of interstitial fluid until the blood flow is reestablished. Model assumptions for the systemic circulation capillaries include (a) precapillary sphincters can almost entirely stop the capillary flow, (b) only a minority of sphincters are normally open in the tissue, and (c) hydrostatic pressures in unperfused capillaries are similar to the pressures at their venous ends. The key proposal is that capillaries with closed precapillary sphincters along their entire length have low hydrostatic pressure of 10 to 15 mm Hg. This pressure cannot force filtration, so these capillaries reabsorb interstitial fluid from the pericapillary space along their entire length. In the open capillaries, hydrostatic pressure filtrates fluid to the pericapillary space along most of their length. Fluid enters, moves some 20 or 30 micrometers away and back to be reabsorbed at the same point. Closed periods are periods of intense fluid reabsorption, while the short open periods refill the space with fresh fluid. It can be calculated that subcutaneous tissue interstitial pressure values might develop if the closed periods are 1.14 to 2.66 times longer than the open periods. Positive interstitial pressures observed in some organs might develop if open periods are longer than the closed periods. High interstitial colloid pressure in lungs makes both perfused and unperfused capillaries absorptive, resulting in more negative values of lung interstitial pressure. The same model is used to explain interstitial pressure values in tumors, burned tissue and intestinal villi.

Blood Pressure↗
PubMed2000

Inhibition of tumor angiogenesis by a single-chain antibody directed against vascular endothelial growth factor.

Monoclonal antibody (Ab) directed against the vascular endothelial growth factor, one of the major inducers of angiogenesis, can inhibit tumor growth in mice. Treatment of cancer patients with monoclonal Ab requires large-scale production of the clean Ab and frequent application of the Ab. This might be improved by using single-chain Ab fragments (scFvs), which can be produced in large quantities in bacteria and are attractive for gene therapeutic approaches. Here we describe anti-vascular endothelial growth factor scFvs derived from a human phage-display library able to block the vascularization of the chorioallantoic membrane of chick embryos and reduce the growth of s.c. tumors in nude mice. This work opens the way to develop gene therapy-based strategies using a scFv to treat angiogenesis-dependent diseases.

3T3 Cells↗
PubMed2000

Fluorescence detection of small gastrointestinal tumours: principles, technique, first clinical experience.

Photodynamic therapy (PDT) is a form of cancer treatment based on the selective accumulation of a photosensitizer in neoplastic tissue. The fluorescent properties of a photosensitizer permit diagnostic localization of primary tumours and/or metastasis. Occult lesions are hard to detect and can easily be missed during routine laparoscopy. Fluorescence observation offers additional optical information and the ability to detect these occult tumours. Clinically, we used 5-aminolevulinic acid for peritoneal staining and tumour demarcation via tumour-specific fluorescence induced by protoporphyrin IX. For laparoscopic observations, a "D-Light" system was used; the conventional white light source was equipped with an optical blocking filter that transmits at the excitation wavelength (380-450 nm) and blocks all other parts of the spectrum. With the aid of a suitable observation filter, the relevant fluorescence was detectable. With the help of this fluorescence we increased the capacity to detect occult tumours, that were missed with white-light observation (9/26). In the gastrointestinal tract, we used a krypton laser at 405 nm for PP IX fluorescence induction. Although there were high sensitivity rates for neoplasms (81% peritoneal carcinomas, 60% gastric cancer), no exact histopathological statement could be achieved at because of false-positive fluorescence, mainly caused by inflammation (6/32). Current clinical goals and the future perspectives of photodynamic diagnostic are discussed.

Aminolevulinic Acid↗
PubMed2000

Using cognitive strategies to enhance bladder control and comfort.

Compromised urinary bladder syndrome (CUBS), a combination of frequency and incontinence, causes multiple discomforts for community-dwelling adults. A holistic intervention--audiotaped cognitive strategies--was designed to augment the effects of an educational program designed to treat CUBS. CUBS was operationalized with a voiding diary, and comfort related to bladder health was operationalized in a questionnaire. In this quasi-experimental design the outcomes were measured at four time points. Repeated measures multivariate analyses of variance and nonparametric analyses were conducted to assess differences between the two groups. Results indicated that the treatment group had more comfort and improved CUBS compared with the control group.

Adult↗
PubMed2000

Empirical evidence for the nature of holistic comfort.

The nursing outcome of holistic comfort encompasses physical, psychospiritual, social, and environmental aspects of human nature. The primary purpose of this study was to test four propositions about the nature of comfort: (a) Comfort has equal proportions of state and trait characteristics; (b) comfort is sensitive to changes over time; (c) when subjects are exposed to an effective intervention, they demonstrate differences in comfort that increase in a linear way compared to a control group; and (d) the whole (total comfort) is greater than the sum of its parts (relief plus ease plus transcendence). A secondary purpose of this study was to present preliminary concurrent validity between two types of comfort instruments, a traditional questionnaire with a Likert-type format and visual analog scales. Findings were positive for all theoretical propositions and moderate concurrent validity between the Radiation Therapy Comfort Questionnaire and the visual analog scale for total comfort was demonstrated.

Adult↗