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Biomedical subjects

T Albrecht

Publications and source records attributed to T Albrecht.

At least 37 records · Page 2Linked to original sources

Ultrasound examination of paediatric testicles after laparoscopic laser dissection of internal testicular vessels in cryptorchism.

PURPOSE: To evaluate the growth of testicles, their sonographic structure and the recovery of testicular perfusion through collateral vessels after preliminary laparoscopic laser dissection (PLLD) of the internal spermatic artery in cryptorchism. MATERIALS AND METHODS: The postoperative position, the volume increase, the structural and vascular abnormalities and the incidence of epididymal abnormalities were evaluated with ultrasound in 32 children (mean age: 6.5 +/- 1.34 years) after PLLD. The intratesticular blood flow and the flow-in anastomoses from the deferential and cremasteric arteries were assessed using colour and power Doppler US (7.5 MHz transducer). RESULTS: All testicles were permanently positioned in the scrotum and showed growth after surgical treatment. None of the testes showed sonographic signs of atrophy. There were no clear differences in intratesticular perfusion compared to the non-operated testis. A collateral blood flow in the deferential artery was found in 44 cases by colour and/or power Doppler US. A perfusion to the lower testicular pole was detected in 29 cases by power Doppler. Intraoperatively, 12 epididymal inversions were eliminated so that an elongated epididymis was sonographically visualised in three testes. CONCLUSION: Ultrasound can be used for the postoperative control of the testicular structure and the volume increase as well as detection of the flow-in anastomoses. The collateral blood supply after PLLD was sufficient for subsequent growth of testicles in all cases.

Child↗

[Ultrasound diagnosis of liver metastases with liver-specific contrast media].

In recent years sonographic contrast agents which can be used for liver imaging have become available. Some of these agents (e.g. Levovist, Schering AG, Berlin) display a liver-specific late phase. Visualisation of this late phase requires contrast-specific imaging techniques such as phase or pulse inversion. When scanned in phase inversion during the late phase, normal liver parenchyma shows strong enhancement. This enhancement spares metastases which stand out as echo-poor or almost echo-free enhancement defects. This improves the conpicuity of metastases markedly. The technique increases the number of detectable metastases in up 45% of patients in comparison to unenhanced sonography. In a multi-centre study on 128 patients the sensitivity in the detection of individual metastases was increased from 71% to 88% and specificity improved from 59% to 88%. Contrast-enhanced sonography thus represents a promising alternative to other cross-sectional imaging modalities in the diagnosis of hepatic metastases.

Contrast Media↗

Ultrasound of focal liver lesions.

This paper gives a comprehensive overview of ultrasound of focal liver lesions. Technical aspects such as examination technique and the use of Doppler modes as well as recent developments such as tissue harmonic imaging and microbubble contrast agents are discussed. The clinical significance and sonographic features of various liver lesions such as haemangioma, focal nodular hyperplasia, adenoma, regenerative nodule, metastasis, hepatocellular carcinoma and various types of focal infections are described. With the exception of cysts and typical haemangiomas, definitive characterisation of a liver lesion is often not possible on conventional ultrasound. This situation has changed with the recent advent of ultrasound contrast agents, which permit definitive diagnosis of most lesions. Contrast-enhanced sonography using recently developed contrast-specific imaging modes dramatically extends the role of liver ultrasound by improving its specificity in the detection and characterisation of focal lesions to rival CT and MRI.

Adenoma↗

Plastidic (Pho1-type) phosphorylase isoforms in potato (Solanum tuberosum L.) plants: expression analysis and immunochemical characterization.

Higher plants contain two types of phosphorylase (EC 2.4.1.1). One type is plastidic (Phol) and the other resides in the cytosol (Pho2). For Solanum tuberosum L., two highly homologous Pho1-type sequences (designated as Pho1a and Pho1b, respectively) have been described that occur both in a homodimeric, (Pho1a)2, and a heterodimeric, Pho1a-Pho1b, state [U. Sonnewald et al. (1995) Plant Mol Biol 27:567 576; T. Albrecht et al. (1998) Eur J Biochem 251:981-991]. We present a spatial and temporal analysis of the expression patterns of the Pho1-type phosphorylases in S. tuberosum. Expression was analyzed at transcript, protein and activity levels. The specificity of both the probes and the antibodies used was carefully determined to ensure selectivity of detection. For both the Pho1a and Pho1b probes the degree of cross-hybridization was estimated. Peptide scanning identified the epitopes of the anti-Pho 1a and anti-Pho 1b antibodies. Expression of the two Pho1-type genes was analyzed in various organs of the potato plant. In all organs studied the Pho1a transcript levels exceeded those of Pho1b. Furthermore, leaves of a given developmental stage were sampled during the light period and were analyzed for transcript and protein levels and for various carbohydrate pools as well. The data show that in leaves the Pho1a gene expression closely corresponds to starch accumulation, suggesting that the enzyme fulfils a metabolic function within the process of starch biosynthesis. In tubers, Pho1a is constitutively expressed in the parenchyma cells whereas expression of the Pho1b, gene is restricted to cells in close vicinity of the vascular tissue.

Amino Acid Sequence↗

Degradation of p21cip1 in cells productively infected with human cytomegalovirus.

Human cytomegalovirus (HCMV) stimulates arrested cells to enter the cell cycle by activating cyclin-dependent kinases (Cdks), notably Cdk2. Several mechanisms are involved in the activation of Cdk2. HCMV causes a substantial increase in the abundance of cyclin E and stimulates translocation of Cdk2 from the cytoplasm to the nucleus. Further, the abundance of the Cdk inhibitors (CKIs) p21cip1/waf1 (p21cip1) and p27kip1 is substantially reduced. The activity of cyclin E/Cdk2 increases as levels of CKIs, particularly p21cip1, fall. We have previously shown that these phenomena contribute to priming the cell for efficient replication of HCMV. In this study, the mechanisms responsible for the decrease in p21cip1 levels after HCMV infection were investigated by measuring p21cip1 RNA and protein levels in permissive human lung (LU) fibroblasts after HCMV infection. Northern blot analysis revealed that p21cip1 RNA levels increased briefly at 3 h after HCMV infection and then decreased to their nadir at 24 h; thereafter, RNA levels increased to about 60% of the preinfection level. Western blot analysis demonstrated that the relative abundance of p21cip1 protein roughly paralleled the observed changes in initial RNA levels; however, the final levels of protein were much lower than preinfection levels. After a transient increase at 3 h postinfection, p21cip1 abundance declined sharply over the next 24 h and remained at a very low level through 96 h postinfection. The disparity between p21cip1 RNA and protein levels suggested that the degradation of p21cip1 might be affected in HCMV-infected cells. Treatment of HCMV-infected cells with MG132, an inhibitor of proteasome-mediated proteolysis, provided substantial protection of p21cip1 in mock-infected cells, but MG132 was much less effective in protecting p21cip1 in HCMV-infected cells. The addition of E64d or Z-Leu-Leu-H, each an inhibitor of calpain activity, to HCMV-infected cells substantially increased the abundance of p21cip1 in a concentration-dependent manner. To verify that p21cip1 was a substrate for calpain, purified recombinant p21cip1 was incubated with either m-calpain or mu-calpain, which resulted in rapid proteolysis of p21cip1. E64d inhibited the proteolysis of p21cip1 catalyzed by either m-calpain or mu-calpain. Direct measurement of calpain activity in HCMV-infected LU cells indicated that HCMV infection induced a substantial and sustained increase in calpain activity, although there was no change in the abundance of either m- or mu-calpain or the endogenous calpain inhibitor calpastatin. The observed increase of calpain activity was consistent with the increases in intracellular free Ca2+ and phospholipid degradation in HCMV-infected LU cells reported previously from our laboratory. Considered together, these results suggest that the increase in calpain activity observed following HCMV infection contributes significantly to the reduction of p21cip1 levels and the resultant cell cycle progression.

Amino Acid Motifs↗

Do different types of liver lesions differ in their uptake of the microbubble contrast agent SH U 508A in the late liver phase? Early experience.

PURPOSE: To compare the uptake of SH U 508A in different types of liver lesions by using stimulated acoustic emission. MATERIALS AND METHODS: Thirty-seven patients with characterized lesions (metastasis, n = 17; hepatocellular carcinoma, n = 4; hemangioma, n = 9; focal nodular hyperplasia, n = 7) received 2.5 g SH U 508A. After 5 minutes, stimulated acoustic emission was elicited by using a previously described method. Liver and/or lesional differences were assessed with videodensitometry (objective conspicuity score), and two observers assessed each lesion by using a six-point scale (subjective conspicuity score). RESULTS: Metastases and hepatocellular carcinoma had low stimulated acoustic emission; median objective conspicuity scores were 70% and 68% (all scores were > or =43%), respectively, and subjective conspicuity scores were 2 or higher for both observers. Hemangiomas had reduced stimulated acoustic emission, with more variability; the median objective conspicuity score was 41% (range, 9%-72%), and the median subjective conspicuity scores were 2 (range, 1-4) and 3.5 (range, 1-5) for observers 1 and 2, respectively. Focal nodular hyperplasia had stimulated acoustic emission comparable to that of the liver in all cases; the median objective conspicuity score was -4.7% (all scores were <6%), and the subjective conspicuity score was 1 or lower for both observers. This finding completely separated focal nodular hyperplasia and malignancies. Significant differences were seen between focal nodular hyperplasia and all other lesion types (P < .05). CONCLUSION: Strong late-phase lesional uptake of SH U 508A is characteristic of focal nodular hyperplasia, is seen in some hemangiomas, and was not observed in malignancies.

Adult↗

Phase-inversion sonography during the liver-specific late phase of contrast enhancement: improved detection of liver metastases.

OBJECTIVE: The purpose of our study was to assess whether phase-inversion sonography during the late, liver-specific phase of contrast enhancement using Levovist improves the detection of hepatic metastases relative to unenhanced conventional B-mode sonography. SUBJECTS AND METHODS: Sixty-two patients were studied with unenhanced B-mode sonography and phase-inversion sonography 2.5 min after the injection of Levovist. All patients underwent one reference examination (CT, MR imaging, or intraoperative sonography). The conspicuity, number, size, and distribution of metastases before and after contrast administration as judged by a sonographer (who was unaware of other imaging findings) were compared with each other and with reference imaging. RESULTS: The conspicuity of metastases was improved by contrast-enhanced phase inversion in 94% of patients. Thirty-nine patients showed metastases on reference imaging; 36 of these were positive on baseline sonography and 38 on phase-inversion sonography. Phase-inversion sonography showed more reference imaging-confirmed metastases than baseline sonography in 28 patients (45%). The average number of confirmed metastases per patient was 3.06 for baseline sonography and 5.42 for contrast-enhanced phase-inversion sonography (p < 0.01). The average sensitivity for detecting individual metastases improved from 63% to 91%. Metastases of less than 1 cm were shown in 14 patients on baseline sonography, in 24 patients on phase-inversion sonography, and in 26 on reference imaging. Both sonographic techniques showed false-positive lesions in six patients. CONCLUSION: Contrast-enhanced phase-inversion sonography in the liver-specific phase of contrast enhancement using Levovist provides a marked improvement in the detection of hepatic metastases relative to unenhanced conventional sonography, without loss of specificity. Phase-inversion sonography was particularly advantageous in detecting small metastases and may be a competitive alternative to CT and MR imaging.

Adult↗

[Stimulated acoustic emissions with the ultrasound contrast medium levovist: a clinically useful contrast effect with liver-specific properties].

PURPOSE: The purpose of this study was systematically to investigate stimulated acoustic emission (SAE) with the microbubble contrast agent Levovist (Schering AG, Berlin) in vivo with regards to reproducibility, distribution in various organs over time, dependence on technical factors, and influence on the delineation of focal liver lesions. PATIENTS AND METHODS: 2 intravenous injections of 1 g of Levovist were given to 2 dogs and 1-6 injections of 2.5 g Levovist to 5 healthy volunteers and 37 patients. The liver, spleen, large abdominal vessels, and kidney were intermittently scanned for up to 30 min. Studies were evaluated for the presence of SAE signals by 2 observers. In 20 patients with focal liver lesions (15 with metastases, 4 haemangiomata, 1 hepatocellular carcinoma, and 1 cyst) the influence on lesion visualization was also assessed. RESULTS: SAE effects, lasting up to 30 minutes, were seen in all subjects in the liver and spleen. Vascular and renal SAE signals were noted shortly after injection, lasting up to 6 minutes. SAE was absent or markedly reduced in focal liver lesions, which were seen as colour voids. This increased the conspicuity of focal lesions, and in 5 patients additional metastases were detected that could not be delineated on B-mode alone. CONCLUSION: A liver- and spleen-specific late phase of Levovist can be consistently demonstrated using SAE and the effect increases the conspicuity of focal liver lesions.

Adult↗

[Superparamagnetic iron oxide enhanced MR angiography of the portal vein system].

PURPOSE: Superparamagnetic iron oxide (SPIO) is used for the detection of focal liver lesions. The current study examines whether the blood-pool effect of an approved substance is adequate for contrast-enhanced MR angiography of the portal venous system. METHODS AND MATERIALS: Fifteen patients [9 women, 6 men, mean age 57 (34-73)] were examined with a breathhold 3D-FISP sequence (TR/TE/FA; 5 ms/2 ms/25 degrees) at 1.5 Tesla (Vision; Siemens, Erlangen) during the last third of a half-hour Infusion of a standard dose (15 mumol Fe/kg) of AMI-25 (Endorem, Guerbet Co., France). The image quality of source images and 3D reconstructions was evaluated by two examiners using a 3-point scale. RESULTS: Large vessels (portal vein, left and right branch of the portal vein, superior mesenteric vein, splenic vein) are visualized well or adequately in 80-93% of the cases, while this was achieved in only 53-60% of the small veins (vessels of the first order emptying into the superior mesenteric vein and the spleen). Venous arcades of the mesenterium are not visible by this technique. CONCLUSION: SPIO-supported MRA of the portal venous system yields usable results in the majority of patients. A possible indication is preinterventional angiography together with an SPIO examination for the detection of focal liver lesions.

Adult↗

[Comparison of bolus and infusion of the ultrasound contrast media levovist for color doppler ultrasound of renal arteries].

PURPOSE: To investigate if the duration of Doppler enhancement of the ultrasound contrast agent Levovist can be prolonged by continuous infusion compared to bolus injections in patients. METHODS: 12 patients with suspected renal artery stenosis were included. Each patient received 1 or 2 bolus injections of 4 g each and a "fast" infusion of 3 ml/min (average dose: 7 g) of Levovist. In 8 patients an additional "slow" infusion of 1 ml/min (average dose 4.2 g) was given. The duration of "strong" Doppler signal enhancement and the visualization of vessels were compared. RESULTS: The duration of strong enhancement was substantially prolonged by the slow infusion (bolus 6:21 min, fast infusion: 8:57 min, slow infusion: 15:12 min, p < 0.001). The dose effectiveness (duration of strong enhancement per 1 g Levovist) was markedly improved from 0:57 min (bolus) to 3:36 min (slow infusion). Visualisation of the renal arteries was more complete with the slow infusion. CONCLUSION: Levovist infusions at 1 ml/min are superior to bolus injections in the assessment of renal arteries. They prolong the enhancement, make more efficient use of a given dose of contrast material and thus allow additional clinically relevant information to be obtained at reduced cost.

Adult↗

B-mode enhancement at phase-inversion US with air-based microbubble contrast agent: initial experience in humans.

Pulse- or phase-inversion ultrasonography (US) sums the signals returned from two 180 degrees ultrasound pulses. Linear scattering from tissue results in a signal void while nonlinear signals from microbubbles stand out. The technique was applied with a US contrast agent in 39 human subjects. B-mode enhancement of vessels and organ parenchyma was seen in all cases. Enhancement occurred from flowing and stationary microbubbles. The flow-independent enhancement of normal and abnormal tissue represents a major advance in contrast material-enhanced US with many potential applications especially in tumor imaging.

Adult↗

Gadolinium-DTPA as X-ray contrast medium in clinical studies.

The aim of this study was to investigate the contrast effects of gadolinium (Gd) in patients undergoing digital subtraction angiography (DSA), intravenous urography (IVU) and CT. 15 patients attending for coeliac axis DSA (n = 5), abdominal CT (n = 5) and IVU (n = 5) were injected with 0.3 mmol kg-1 Gd-DTPA, the maximum approved dose. For DSA and IVU, images were categorized as being of diagnostic or non-diagnostic quality. For CT, enhancement was measured in Hounsfield Units (HU). On CT, enhancement with Gd was reproducible in all cases; average peak aortic enhancement was 75 HU but duration was short. On IVU, four of five studies yielded positive pyelograms but all nephrograms were relatively poor. On DSA, all five patients had diagnostic arteriograms and four of five indirect portograms were of diagnostic quality. In all 15 cases, enhancement was weaker than that achieved with routine dosage of iodinated agents. In conclusion, Gd chelates may be clinically useful in X-ray studies under certain circumstances on patients with contraindications to iodinated agents. Higher doses than currently approved would be potentially useful.

Adult↗

Frequency and molecular analysis of hprt mutations induced by estradiol in Chinese hamster V79 cells.

The natural hormone estradiol (E2) induces tumors in rodents and various types of DNA damage in vitro and in vivo, but has not been mutagenic in bacterial or mammalian assays. Recent reports of chromosomal and genetic lesions induced by E2 has led us to re-examine the mutation frequency and molecular alterations of the hypoxanthine-guanine phosphoribosyltransferase (hprt) gene in Chinese hamster V79 cells. E2 at both physiological and pharmacological concentrations (10-11, 10-10, and 10-7, 10-6 M) significantly increased the mutation frequency of the hprt gene by 2. 57-, 3.45-, 2.63-, and 8.78-fold, respectively, compared to the controls, while 10-13, 10-12, 10-9, or 10-8 M E2 induced little change (< or =0.93-fold). PCR and a molecular analysis of the hprt coding sequence identified genetic lesions in the cDNA and/or genomic DNA in 15 of the 21 picked E2-induced mutants (71%). Simple base substitutions, such as Tright curved arrow G or Tright curved arrow A transversions, were the most common mutations (8/21 or 38%) and frequently occurred at 122 bp or 407 bp of the hprt coding sequence. Deletion mutations were detected in 6 of the 21 clones (29%). An Aright curved arrow G and a Cright curved arrow T transition and a four-base insertion (TATT) were identified each in one mutant clone. A RT-PCR analysis demonstrated an abundant expression of the estrogen receptor-alpha (ERalpha). However, ICI 182,780, an antagonist of ERalpha, acted in an additive manner with E2 and increased the hprt mutation frequency. In conclusion, E2 induces a low frequency of mutations (deletions and point mutations) in V79 cells, which is consistent with the weak carcinogenic activity of this hormone. The mutagenic effects of E2 in V79 cells are not mediated by the ERalpha.

Animals↗

Non-invasive diagnosis of hepatic cirrhosis by transit-time analysis of an ultrasound contrast agent.

BACKGROUND: Hepatic cirrhosis is accompanied by several haemodynamic changes including arterialisation of the liver, intrahepatic shunts, pulmonary arteriovenous shunts, and a hyperdynamic circulatory state. We postulated that the hepatic first pass of a bolus of an ultrasound contrast agent injected into a peripheral vein is accelerated in patients with cirrhosis. We investigated this first pass in patients with diffuse liver disease and in normal controls to assess whether it provides useful differential diagnostic information. METHODS: We enrolled 15 patients with biopsy-proven cirrhosis, 12 patients with biopsy-proven non-cirrhotic diffuse liver disease, and 11 normal controls. We carried out continuous spectral doppler ultrasonography of a hepatic vein from 20 s before to 3 min after a peripheral intravenous bolus injection of 2.5 g Levovist. The intensity of the doppler signal was measured and used to plot time-intensity curves. FINDINGS: Patients with cirrhosis showed a much earlier onset of enhancement (arrival time; mean 18.3 s) and peak enhancement (mean 55.5 s) than controls (49.8 s and 97.5 s) or patients with non-cirrhotic diffuse liver disease (35.8 s and 79.7 s). All patients with cirrhosis had an arrival time of the bolus of less than 24 s, whereas the arrival time was 24 s or more in 22 of the 23 other participants. Peak enhancement was higher in patients with cirrhosis (mean 48.7 units) than in the other two groups (12.5 and 12.3 units, respectively). We found highly significant differences between the patients with cirrhosis and each of the other two groups for all variables (p<0.005), whereas we found no significant differences between non-cirrhotic patients and controls. INTERPRETATION: Our preliminary study suggests that analysis of liver transit time of a bolus of ultrasound contrast agent provides useful information about haemodynamic changes in patients with cirrhosis. Measurement of the arrival time of the bolus allows discrimination of patients with cirrhosis from controls and from patients with non-cirrhotic diffuse liver disease, and has potential as a non-invasive test for cirrhosis.

Adult↗