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Biomedical subjects

A Franke

Publications and source records attributed to A Franke.

At least 127 records · Page 7Linked to original sources
PubMed1996

Left ventricular volume calculations using a multiplanar transoesophageal echoprobe; in vitro validation and comparison with biplane angiography.

BACKGROUND: Biplane angiographic and transthoracic echocardiographic volume calculations have shown to be sufficiently reliable in symmetric hearts; however, they are unreliable in the presence of aneurysmatic distortions. Multiplane transoesophageal echocardiography offers unobstructed cross-sectional views of the heart from one stable transducer position with the potential of imaging irregular cavity forms more accurately. It was the purpose of this in vitro study to compare the precision of multiplanar transoesophageal echocardiography to that of biplane angiography in determining left ventricular volumes, especially in aneurysmatic models. METHODS: Seven silicon rubber models of the left ventricle from post-mortem specimens (four with aneurysms) were filled with 30 different volumes (range 153-256 ml, 197 +/- 30 ml). Echocardiographic cross-sections (20 degree rotational steps) were obtained from different transducer positions, utilizing a multiplanar probe with a central rotational axis. Volumes were calculated using the disc-summation method. For comparison the same volumes were determined by standard biplane angiography. The minimum number of echo cross-section necessary to optimize precision was analysed by calculating volumes for each increasing equidistant rotational step. RESULTS: Linear correlation between measured volume using a multiplanar transoesophageal echoprobe and true volume was high (r = 0.97) and significantly better than for biplane angiography (r = 0.88; P < 0.001). Measurement bias and imprecision were also significantly lower with multiplanar echocardiography than with biplane angiography (3.9 +/- 7.1% vs 11.1 +/- 15.4%, and 2.0 +/- 3.7% vs 5.9 +/- 8.3%; P < 0.001). Precision of biplane angiographic volume measurements was significantly influenced by the presence of aneurysmatic distortions. Multiplanar echo volumes, however, were not influenced by left ventricular geometry and transducer positions. Nine echo cross-sections provided optimal precision. CONCLUSIONS: Three-dimensional echocardiographic volume calculations using a multiplanar transoesophageal echoprobe and the disc-summation method provide precise measurements unaffected by left ventricular geometry and transducer position in an in vitro setting. Standard biplane angiography is significantly less precise.

Angiography↗
PubMed1996

Large differences in substitutional pattern and evolutionary rate of 12S ribosomal RNA genes.

We demonstrate using Drosophila, periodical cicadas, and hominid primates, that the molecular clock based on animal mitochondrial small-subunit (12S) rRNA genes ticks at significantly different relative rates depending on which taxa and which region of the gene are examined. Drosophila, which are commonly used as model taxa, are evolving in a highly peculiar manner with the majority of sites in the 3' half of the 12S gene apparently invariant. The analogous 3' half of the mitochondrial large-subunit rRNA gene (16S) appears to be similarly constrained. It is surprising that these regions that are already highly constrained in all animals should be even more constrained in Drosophila, especially when the Drosophila mitochondrial genome as a whole does not display a similar rate slowdown. This extreme 12S rate slowdown is not apparent in periodical cicadas or hominid primates and appears to be related to strong structural and functional constraints rather than a depressed mutation rate. Finally, the slow average rate of evolution in the third domain of Drosophila does not imply that the few variable sites lack multiple hits.

Animals↗
PubMed1996

Detection of abnormal aortic elastic properties in asymptomatic patients with Marfan syndrome by combined transoesophageal echocardiography and acoustic quantification.

OBJECTIVE: To evaluate the potential value of transoesophageal echocardiography combined with automated border detection and acoustic quantification for the assessment of elastic properties of the thoracic aorta in patients with Marfan syndrome. SUBJECTS: 16 patients with Marfan syndrome and 12 age matched normal controls. METHODS: Transoesophageal echocardiography was performed in all subjects. Minimum and maximum diameters of the descending thoracic aorta were obtained from M mode images and acoustic quantification was used for the on-line evaluation of cross sectional aortic area and peak positive area changes over time. Compliance, distensibility, and stiffness index were calculated using M mode data and non-invasively measured blood pressure and were compared with the indices derived from acoustic quantification. RESULTS: Aortic dimensions normalised for body surface area were not statistically different between patients and normal controls, but there were significant differences for all elasticity indices except compliance. Marfan patients had a lower distensibility [4.2 (SD 1.8) v 5.8 (2.1) cm2/dyn, P < 0.05] and a higher stiffness index [9.7 (3.0) v 7.1 (1.8), P < 0.05]. The dynamic indices derived from the acoustic quantification were significantly smaller in Marfan patients [peak positive area change: 5.1 (1.0) v 7.7 (1.7) cm2/s; P < 0.001; and normalised peak positive area change: 2.5 (1.2) v 4.0 (0.8) cm2/s respectively, P < 0.001] and were suitable to discriminate between normal and abnormal elastic properties. CONCLUSIONS: In Marfan syndrome elastic properties of the descending aorta are significantly different from normal controls, even in the absence of vessel dilatation. In addition to established static indices, indices derived from acoustic quantification reflect dynamic changes of the cross sectional area for the evaluation of regional vessel mechanics. The on-line assessment of peak positive area change allows differentiation from normal individuals and may be more accurate than standard M mode measurements.

Adult↗
PubMed1996

Evidence that MSL-mediated dosage compensation in Drosophila begins at blastoderm.

In Drosophila equalization of the amounts of gene products produced by X-linked genes in the two sexes is achieved by hypertranscription of the single male X chromosome. This process, dosage compensation, is controlled by a set of male-specific lethal (msl) genes, that appear to act at the level of chromatin structure. The properties of the MSL proteins have been extensively studied in the polytene salivary gland chromosomes where they bind to the same set of sites along the male X chromosome in a co-dependent manner. Here we report experiments that show that the MSL proteins first associate with the male X chromosome as early as blastoderm stage, slightly earlier than the histone H4 isoform acetylated at lysine 16 is detected on the X chromosome. MSL binding to the male X chromosome is observed in all somatic tissues of embryos and larvae. Binding of the MSLs to the X chromosome is also interdependent in male embryos and prevented in female embryos by the expression of Sex-lethal (Sxl). A delayed onset of binding of the MSLs in male progeny of homozygous mutant msl-1 or mle mothers coupled with the previous finding that such males have an earlier lethal phase supports the idea that msl-mediated dosage compensation begins early in embryogenesis. Other results show that the maleless (MLE) protein on embryo and larval chromosomes differs in its reactivity with antibodies; the functional significance of this finding remains to be explored.

Animals↗
PubMed1996

Detection of residual leukemic cells in acute lymphocytic leukemia of B-cells (B-ALL) by a nonradioactive PCR-based technique.

Patients suffering from B-ALL were analyzed for residual leukemic cells by means of the PCR technique. Using primers specific for conserved domains of each VH-family and a primer universal to the JH-regions, immunoglobulin gene fragments have been amplified from bone marrow aspirate-derived DNA in six cases of B-ALL. Cloning and sequencing of the amplified fragments revealed the usage of the VH251-family in two cases. VH-families 1 and 3 were used in one case each. One patient showed abnormal rearrangement with the participation of two JH regions. In the remaining case a VH6 germline fragment was involved in an apparently abnormal rearrangement. Based on the sequence information, clone-specific DIG-labeled probes were designed and used in subsequent nonradioactive hybridization protocols to estimate the prevalence of residual leukemic cells in the course of therapy. Five of the six cases of B-ALL could be included in the rest cell analysis. In all patients investigated, residual leukemic cells were detected, independent of whether a normal or apparently abnormal rearrangement has occurred. These findings imply that the prevalence of residual leukemic cells in B-ALL indicates a high risk of relapse.

Adult↗
PubMed1996

[Quadricuspid aortic valve: diagnosis by multiple transesophageal echocardiography].

The case of a quadricuspid aortic valve diagnosed in adult age is reported. A 67-year-old patient, who had no previous diseases or cardiovascular complaints, presented in the clinic for an embolic occlusion of the left retinal artery. Isolated moderate aortic regurgitation was diagnosed clinically and echocardiographically. For its further evaluation and for seeking embolic sources, multiplane transesophageal echocardiography was performed, which discovered a quadricuspid aortic valve as the cause of aortic regurgitation and major atherosclerotic lesions in the ascending aorta and the aortic arch as possible cause of the embolic event. The fourth, accessory cusp, smaller than the other three, was localized between the non-coronary and left coronary cusp. In the short axis view the quadricuspid aortic valve showed in diastole a "X"-configuration, with a persistent central orifice between the commissures, which was the cause of the regurgitation jet in color Doppler examination, and in the systole a trapezoid opening pattern. In the long-axis view the valve showed a tricuspid closing pattern. The quadricuspid aortic valve can be exactly diagnosed by multiplane transesophageal echocardiography.

Aged↗
PubMed1995

Mapping functional domains of the polycomb protein of Drosophila melanogaster.

In Drosophila the Polycomb group (Pc-G) proteins are responsible for the stable and heritable silencing of genes. The Pc-G apparently uses heterochromatin-like mechanisms to transcriptionally inactivate developmental regulators such as the homeotic genes. The Polycomb (Pc) protein is part of a large multimeric complex composed of other members of the Pc-G. We have identified functionally relevant domains of the Pc protein by sequencing different Pc alleles. Additionally, using a Pc-beta gal fusion protein with deleted internal histidine repeats, we found that this mutant protein cannot bind to four particular target loci, but otherwise does not change the remaining overall binding pattern. We show that, in contrast to the dotted subnuclear localization of the wild-type protein, the nuclear distribution of mutant proteins becomes homogeneous. Surprisingly, in Pc mutants the polyhomeotic protein, another member of the Pc-G, is also redistributed in the nucleus. Our results indicate that the appropriate subnuclear localization of the two proteins is critical for the silencing function of the Pc-G complex.

Alleles↗
PubMed1995

gamma-Glutamyl transpeptidase-cellular expression in populations of normal human mononuclear cells and patients suffering from leukemias.

The expression of the ectoenzyme gamma-glutamyl transpeptidase (EC2.3.2.2., gamma GT) was investigated by flow cytometry on populations of peripheral blood mononuclear cells (PBMC) from healthy subjects and patients suffering from several types of leukemia before and under chemotherapy. In unstimulated PBMC, 28% of these cells were found to be gamma GT positive. The highest expression was measured on monocytes (CD14/gamma GT+ cells: 60%). Within the subsets of T lymphocytes (CD3/gamma GT+ cells: 18%) we saw no clear differences between CD4+ and CD8+ cells. B lymphocytes, NK cells, and activated cells showed low expressions (up to 10%). Treatment of PBMC with mitogens, alpha-IFN, IL-2, and GM-CSF did not affect the enzyme expression on normal mononuclear cells (MNC). However, a rapid increase of gamma GT+ cells was found in the presence of glutathione (GSH) and n-acetyl cysteine (nAC), particularly on monocytes, B cells, and NK cells. Comparing 40 healthy subjects and untreated patients suffering from leukemias, a significantly higher expression of gamma GT+ cells in the total MNC populations (B-CLL: 57%, CML: 62% gamma GT+ cells) was observed in B-chronic lymphocytic leukemia (B-CLL) and chronic myelogenous leukemia (CML), whereas other leukemias did not show clear differences. Most interestingly, the gamma GT expression was diminished in all populations of CML cells after 5 h of incubation in the presence of 10 units/ml IFN-alpha. These data suggest a possible protective role of gamma GT in MNC and a regulatory function of this enzyme in the development of CML.

Adult↗
PubMed1995

Molecular characterization of the male-specific lethal-3 gene and investigations of the regulation of dosage compensation in Drosophila.

In Drosophila, dosage compensation occurs by transcribing the single male X chromosome at twice the rate of each of the two female X chromosomes. This hypertranscription requires four autosomal male-specific lethal (msl) genes and is negatively regulated by the Sxl gene in females. Two of the msls, the mle and msl-1 genes, encode proteins that are associated with hundreds of specific sites along the length of the male X chromosome. MLE and MSL-1 X chromosome binding are negatively regulated by Sxl in females and require the functions of the other msls in males. To investigate further the regulation of dosage compensation and the role of the msls in this process, we have cloned and molecularly characterized another msl, the msl-3 gene. We have found that MSL-3 is also associated with the male X chromosome. We have further investigated whether Sxl negatively regulates MSL-3 X-chromosome binding in females and whether MSL-3 X-chromosome binding requires the other msls. Our results suggest that the MLE, MSL-1 and MSL-3 proteins may associate with one another in a male-specific heteromeric complex on the X chromosome to achieve its hypertranscription.

Amino Acid Sequence↗
PubMed1995

[Three-dimensional reconstruction of heart valves].

The reconstruction of three-dimensional data sets from two-dimensional echocardiographic images offers several fundamental advantages: 1. more complete data than present in the few standard 2D-view; 2. off-line generation of any desired plane, cut, or perspective after the data set has been acquired; 3. access to quantitative parameters like surface areas (e.g., of valve leaflets or portions of leaflets), volumes, and others, without geometric assumptions. The mitral valve has been the focus of several studies using various techniques of reconstruction of transthoracic or transesophageal images. These studies have shown the mitral annulus to be a non-planar, "saddle-shaped" structure, with an average distance of highest to lowest points of 14 mm in normals. This recognition of mitral annular non-planarity has led to a more stringent echocardiographic definition of mitral valve prolapse. Further studies have shown systolic shrinkage of mitral annular area by about 30% and systolic apico-basal translation of the annulus by approximately 1 cm in normals. In patients with dilated cardiomyopathy, the annulus is flattened, and both cyclic change in annular area and apico-basal translation are significantly reduced. 3D-studies of the left ventricular outflow tract in hypertrophic obstructive cardiomyopathy allow measurement of outflow tract and leaflet surface areas and dynamic spatial visualization of systolic anterior motion of the anterior mitral leaflet. Automated techniques to reconstruct the full grey value data set from a high number of parallel or rotational transesophageal planes allow impressive visualization of normal and diseased mitral and aortic valves or valve prostheses, with special emphasis on generating "surgical" views and perspectives, which cannot be obtained by conventional tomographic imaging.(ABSTRACT TRUNCATED AT 250 WORDS)

Aortic Valve↗
PubMed1995

[3-dimensional reconstruction of multiplanar transesophageal echocardiography images: a methodologic report with case examples].

First experience with the dynamic three-dimensional reconstruction of transesophageal echocardiographic images in more than 100 patients with various cardiac diseases are reported. Ninety different two-dimensional image planes were acquired for each reconstruction using a conventional multiplanar transducer, connected to a stepper motor and controlled by a computer-based image acquisition system with special software. Acquisition time for one data set was 2.3 +/- 0.9 min, and calculation time to achieve three-dimensional images was 20-45 min. Several cardiac structures were reconstructed and analyzed qualitatively and quantitatively (measurements of distances and areas, volume calculation by Simpson's rule). Image sequences showing three-dimensional depth by gray scale modification were generated. After image acquisition one can select any desired cut plane to achieve perspectives that cannot be obtained by two-dimensional technique. Advantages of three-dimensional echocardiography are the display and potential quantification of pathomorphology of the left ventricle and mitral valve, atrial septal defects, intracardiac masses (i.e., myxomas, vegetations), and direct spatial imaging of complex congenital heart diseases. In principle, three-dimensional data sets have advantages for the quantitative evaluation of irregular formed cardiac structures, since the three-dimensional data set is more complete than cross-sections used in conventional two-dimensional echocardiography. Currently, however, these advantages are limited by the necessity of human interaction to segment the structures of interest.

Adolescent↗
PubMed1995

[Improved evaluation of prosthetic heart valve regurgitation with multiplanar transesophageal echocardiography].

UNLABELLED: To study the value of the newly introduced multiplane transesophageal transducer technology for the assessment of prosthetic valve regurgitation, 63 consecutive patients with 35 mitral and 33 aortic prostheses (23 bioprostheses and 45 mechanical prostheses) were examined. Transvalvular, paravalvular, and, in mechanical valves, normal or pathological transvalvular regurgitation were identified using first 0 degrees (transverse) and 90 degrees (longitudinal) planes combined with flexion of the echoscope tip and then additionally using multiple intermediary planes by transducer rotation. In a subgroup of 20 patients interobserver variability was evaluated. Both methods showed regurgitation in 56/58 valves; one additional case of regurgitation was seen by multiplane imaging only. However, there were 19 cases of regurgitation not clearly classifiable by biplane technique compared to only three using multiplane technique. Grading of severity was concordant by both modalities in 66 and discordant in only two cases. Observers disagreed on severity in 2/20 cases based on biplane imaging, but in none based on multiplane imaging; classification of regurgitation differed in 6/20 biplane and 1/20 multiplane images respectively. CONCLUSION: Multiplane transesophageal imaging improves classification of prosthetic regurgitation, but has little effect on severity grading.

Adult↗
PubMed1995

[The management of adolescents and adults with congenital heart defects: 3 years experiences with interdisciplinary consultation].

UNLABELLED: Since September 1991, 204 patients (pts), 109 male and 95 female, mean age 27.3 +/- 10.6 years, were followed in a newly established interdisciplinary outpatient clinic combining both adult and pediatric cardiologists. 61 pts predominantly presented with left-to-right shunt congenital heart disease (CHD), 32 with valvar CHD, 20 with aortic coarctation, 23 with complex acyanotic, and 49 with cyanotic CHD. The population included 19 pts with Marfan syndrome. 106 pts had had previous cardiac surgery, 32 of them with up to three reoperations. Deficits and needs in medical and social care were analyzed in 100 pts using a standardized questionnaire at the time of first examination: One-third of pts were not or only incompletely informed about their CHD, previous surgical procedures and need for antibiotic prophylaxis of endocarditis. Only a minority of pts had had vocational advice (34%) or counseling concerning contraception (40%) or pregnancy (30%). Cardiac catheterization was performed in 37 pts (18%) after being first seen in our outpatient clinic, followed by a primary surgical intervention in 19 and reoperation in eight cases. Overall, 30 pts (15%) underwent surgery (28) or interventional procedures (one closure of the arterial duct, one AV node ablation after Mustard-operation) as a consequence of admission to our unit. Successful late Fontan operations were performed in four adults aged 21 to 35 years. There was 1/30 postoperative death (M. Ebstein, thrombosis of the mechanical prosthesis). The population includes five pts with severe pulmonary vascular disease (one waiting for lung transplantation) and two pts with pulmonary artery arborisation malformations not amenable to surgery. CONCLUSION: In a population of 204 adolescents and adults with CHD, we clearly found deficits in medical and social care and, in addition, an unexpected high percentage of necessary invasive investigations (18%) and surgical or interventional procedures (15%). Interdisciplinary management of these patients is mandatory combining the special facilities of adult and pediatric cardiologists.

Activities of Daily Living↗
PubMed1995

[Patients in (post)modern society--does psychosomatic medicine still have concrete foundations?].

The paper describes the scientific development psychosomatic medicine has undergone in the last decades, as well as the politically induced changes in the German Health Care system. In three future scenarios the dangers of a) biological and b) voluntaristic schools of thought are presented along with the c) consequences of ecological destruction and economic power. The increasing trend for psychosomatic medicine to use salutogenetic models is discussed as a feasible approach for the prevention of fear-provoking perspectives.

Forecasting↗
PubMed1995

Three-dimensional reconstruction of cardiac structures from transesophageal echocardiography.

Although tomographic imaging has been very successful in cardiology,the quantitation of volumes, surfaces, and masses,as well as understanding of complex morphologies would improve by three-dimensional imaging. This review focuses on approaches to 3-D reconstruction from transesophageal echocardiography. In the past, several attempts using either stepwise parallel translation or stepwise rotation of the transducer have been made. In vitro and, to a limited extent, in vivo studies have confirmed high accuracy in calculating left ventricular volumes in such manner. Complex cardiac structures and their motion, such as the mitral annulus, mitral leaflets, atrial septal defects, and others have been reconstructed from patient studies. Although potentially a powerful tool for cardiac imaging with promising quantitation capabilities, progress is needed in particular in the field of border detection to make 3-D imaging practical enough for clinical use.

Computer Graphics↗
PubMed1995

Extra-abdominal aggressive fibromatosis after treatment of a Morbus Hodgkin. A case report.

The proliferations of the connective tissue, which are summed up under the term fibromatoses, assume a special position with regard to their biologic behavior. While superficial fibromatoses are more likely to grow slowly, musculoaponeurotic fibromatoses (Desmoid tumor)--like malignant tumors--show a locally bound aggressive, rapid growth behavior. A metastazation, however, can never be proved. The research on etiology of fibromatoses has yielded only little knowledge. Besides genetic and hormonal factors, physical reasons are under discussion, too. The present study aims to add another description of a case report to the small number of case presentations on radiotherapy-associated fibromatosis. In 1977, a now 67-old-patient was irradiated because of a Morbus Hodgkin lymphoma in the left side of his neck. Prior to the radiation, the patient had undergone several surgeries. 17 years after the radiation, the patient developed an aggressive fibromatosis (prelaryngeal, right) in the formerly irradiated region. As the localization of the fibromatosis does not allow us to establish a connection to his numerous operations preceding the fibromatosis, a radiation-associated Desmoid tumor must be assumed. Immunohistologically, no estrogen receptors were detectable.

Actins↗