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T Falke

Publications and source records attributed to T Falke.

4 recordsLinked to original sources

[Intra-arterial and intramuscular transplantation of adult, autologous bone marrow stem cells. Novel treatment for therapy-refractory peripheral arterial occlusive disease].

HISTORY AND CLINICAL FINDINGS: A 62-year-old man had limb ischemia in stage IIb (Fontaine's classification). After surgical and interventional measures the right superficial femoral artery had remained occluded for more than one year. The patient's walking distance was only 100 meters. It was therefore decided to do a combined intraarterial and intramuscular transplantation of stem cells into the right limb. INVESTIGATIONS: Before and 10 weeks after the transplantation noninvasive tests, namely walking distance, ankle-brachial index at rest and during exercise, occlusion plethysmography and capillary venous oxygen saturation were measured. The patient was also asked to fill in a questionnaire of his symptoms. THERAPY AND RESULTS: After harvesting the patient's bone marrow the mononuclear cell fraction was separated (109.8 x 10(6)). Afterwards 10 ml of the cell suspension were injected into the right superficial femoral artery and 5 ml each of the suspension was injected into 5 different locations of the quadriceps femoris and the gastrocnemius muscles. After 10 weeks" follow-up a seven-fold improvement of walking distance and an increase of tissue oxygen saturation of more then 50% were recorded. The ankle-brachial index at rest remained unchanged, but on exercise it increased by 24%. CONCLUSION: The combined intraarterial and intramuscular transplantation of human autologous bone marrow stem cells may be a novel and clinically feasible treatment for patients with severe chronic limb ischemia. The success of this approach may be the result of increased neo-angiogenesis, especially of the small muscle-supplying vessels.

Arterial Occlusive Diseases↗

Quantitative MRI of uterine leiomyomas during triptorelin treatment: reproducibility of volume assessment and predictability of treatment response.

Magnetic resonance (MR) imaging is increasingly applied for the quantitative evaluation of uterine leiomyomas. MR is thought to be more accurate in comparison to ultrasound (US) techniques. MR signal intensity (SI) may prove to be predictive of myoma response to GnRH agonist treatment. This study aimed to evaluate the precision of uterine volume assessment by a parallel planimetric MR method and the accuracy of the ellipsoid formula based calculations from MR and US images. It was also attempted to analyze the precision of MR leiomyoma volume measurements and examine the relation between pretreatment myoma SI patterns and the response to agonist therapy. Twenty-seven women with a myomatous uterus were scanned three times during GnRH agonist treatment for 6 months. T1- and T2-weighted, as well as T1 contrast-enhanced sequences of the uterus were obtained in the transverse and sagittal plane. Abdominal US of the uterus was performed with a conventional sector scanner. By the use of a software system for analysis of three-dimensional images obtained by MR, uterine volume was measured by a parallel planimetric method (MR-ROI) as well as the use of the ellipsoid formula (MR-ELL). Myoma volume was assessed by the MR-ROI method. SI of the myomas was estimated from selected tissue samples as well as from the integral myoma region of interest. By abdominal US, volume was assessed by the ellipsoid equation (US-ELL). Within- and between-observer and method reliability (Rw/Rb) was calculated from mean squares obtained by analysis of variance. For uterine volume assessment, reliability between observers and between methods when the MR-ROI and MR-ELL methods were analyzed was excellent. For the US-ELL measurements, the between-observer reliability was limited. Moreover, the reliability of the US-ELL was low when the MR-ROI method was used as the standard. Myoma volume assessment with the MR-ROI method showed high between-observer and between-method agreement. The myoma/fat SI ratio and the mean SI coefficient of variation failed to show a correlation with the degree of response to triptorelin treatment of individual myomas. In MR uterine volume assessment the MR-ELL method is very accurate compared with the more complicated MR-ROI method. The agreement between MR and US is limited. Therefore, the ellipsoid method on MR images is to be regarded as the method of choice for quantitative assessment of uterine volume response to hormonal treatment. Myoma SI patterns were shown to be of no value in the response prediction of myomas to treatment with GnRH agonists.

Antineoplastic Agents, Hormonal↗