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Biomedical subjects

J Vogel

Publications and source records attributed to J Vogel.

At least 19 recordsLinked to original sources

[MR angiography of occlusive changes in the superior thoracic inlet veins].

We used MR angiography to assess the thoracic inlet veins in 5 normal volunteers and 14 patients with thrombosis of these veins. The results were compared with conventional venography and contrast-enhanced computed tomography (CT). The normal anatomy was readily depicted by MR angiography in all normal volunteers. Pathology was assessed correctly by MR angiography in all patients. Thrombosis of the internal jugular vein was seen on MR angiography in all cases whereas conventional venography failed to demonstrate this region adequately in 3 cases. The best overview of the thoracic inlet veins was achieved in the coronal plane; however, for detailed demonstration of pathology, imaging in additional planes was necessary. We conclude that MR angiography is a promising method for non-invasive assessment of thoracic veins.

Evaluation Studies as Topic

Panniculus morbidus.

Eight patients with large panniculi are described where severe problems with hygiene, immobility, and chronic infection were caused by the lymphedematous, chronically infected pannus. Protracted nonsurgical management of the infected panniculus had failed in all 8 patients. Wedge resection without fat undermining removed diseased tissue. Infection and sepsis were eliminated and ambulation was restored in all patients. Formerly immobile patients were returned to normal activity. Significant self-induced weight loss was not observed in a 2-year follow-up period; weight gain, however, was not experienced. The primary anesthetic method was thoracic epidural reducing the requirements for general endotracheal anesthesia. The chronically infected pannus is a surgical problem deserving earlier recognition and resection.

Abdomen

Induction of carcinoma at ureterosigmoid anastomosis--with and without faecal stream.

The induction of tumours at the site of uretero-intestinal anastomosis was investigated in Hannover: WISTAR rats. The rats were divided into 3 groups. In one group (n = 70) the ureter of the left kidney was implanted into the colon, using microsurgical techniques developed for humans. In 13% of the rats in this group benign tumours developed; in 16% malignant tumours occurred. In a second group (n = 76) the ureter was implanted into a rectal bladder; the faeces were excluded from the anastomosis by a descending colon anus praeter. In this group benign tumours developed in 17% and malignant tumours in 8%, all of them being situated at the site of the anastomosis. In a control group (n = 80) no colonic tumour could be identified.

Anastomosis, Surgical

UV activation of human immunodeficiency virus gene expression in transgenic mice.

Human immunodeficiency virus (HIV) infection is associated with a clinical latency of as long as 10 years before the development of disease. One explanation for this delay is the requirement of cofactors such as other DNA or RNA viruses, cytokines critical for immune modulation, or environmental UV light. At least in tissue culture studies, these agents are capable of inducing HIV gene expression in cell lines which either harbor the entire viral genome or contain a reporter gene under the control of the viral long terminal repeat regulatory region. The role of these cofactors in terminating clinical latency and inducing disease has been difficult to ascertain because of the lack of an appropriate animal model. We now report that UV light can markedly induce HIV gene expression in transgenic mice carrying both the cis-acting (long terminal repeat) and trans-acting (the tat gene) elements which are essential for viral transactivation and replication in infected cells. Our finding may explain the clinical observations that cutaneous lesions in HIV-infected individuals are often seen in the sunlight exposed areas of the skin, including the face and neck.

Animals

Sequence analysis of polymerase chain reaction amplified t(14;18) chromosomal breakpoints in formalin fixed, paraffin wax embedded follicular lymphoma.

AIMS: To determine whether junctional sequences of rearranged chromosomes can be amplified by use of the polymerase chain reaction (PCR) and whether direct sequence analysis of the PCR products is possible, using DNA from formalin fixed, paraffin wax embedded biopsy specimens. METHODS: DNA was extracted from paraffin wax embedded, formalin fixed lymphoma specimens, and junctional sequences of rearranged chromosomes were amplified by the PCR. The products were used as templates for asymmetrical PCR. Subsequently, direct sequence analysis was performed using the chain termination method. RESULTS: Formalin fixed, paraffin wax embedded biopsy specimens and PCR amplification could be used to determine the nucleotide sequences of junctional regions of rearranged chromosomes t(14;18) from patients with follicular lymphoma. CONCLUSION: The identification of junctional sequences of the translocation in follicular lymphoma provides a molecular "fingerprint" of t(14;18) of the lymphoma of an individual patient and can be used for the detection of clone specific DNA in any biopsy tissue obtained from the patient. The strategy used for rapid sequence analysis of PCR amplified DNA sequences will be useful in many areas of molecular pathology.

Base Sequence

[Comparison of six peak flow meters for patients].

Five meters of six models of peak flowmeters have been checked by 40 measurements each in series with a pneumotachograph. There were no substantial differences between the five meters of one type, but the various models showed a different scatter, partly due to differences in the applied flow pattern. We prefer those peak flowmeters with less influence of the flow pattern.

Adult

[Laparoscopic cholecystectomy versus mini-lap-cholecystectomy. Results of a prospective, randomized study].

Laparoscopic cholecystectomy (LCCE) was gaining acceptance rapidly, when several institutions could demonstrate the safety of this minimal invasive treatment modality. Nevertheless prospective randomised studies still are missing to prove the advantages of this new treatment modality in contrast to open cholecystectomy. 77 patients with symptomatic cholelithiasis were treated by LCCE (n = 40) or mini-lap CCE (n = 37) in a prospective, randomised study. As preliminary results, there were no differences in duration of anesthesia and operation time, perioperative complications or postoperative need for analgetics. Patients with LCCE had significant less postoperative pain, less restriction of total vital capacity and a shorter postoperative hospital stay as parameters of a diminished operative trauma.

Cholecystectomy

[Use of multi-frequency oscillation method in the respiratory mechanics perimeter diagnosis].

Oscillatory resistance Rrs and reactance Xrs curves were measured in the frequency range 4-25 Hz at FRC-level and at the course of vital capacity manoeuvres. The 55 subjects investigated were separated into the three groups healthy subjects and patients with restrictive and obstructive lung diseases by means of the parameters airway resistance Raw and lung compliance CL estimated by body-plethysmography and esophageal pressure technique, respectively. In accordance with the Raw- and CL-values in each group the parameters Rrs and Xrs demonstrate at FRC-level a different frequency dependent behaviour. An enhancement of Raw in patients with COLD causes a drop of Rrs(f) and a displacement of the whole Xrs-curve into the negative direction. Conversely, the reduction of CL in patients with fibrosis leads to a significant decrease of Xrs-values at lower frequencies without marked changes in the Rrs-curves. An additional enhancement of Raw and a further reduction of CL can be induced by decrease and increase of lung volume VL in comparison with the FRC-level. These alterations can be detected also in the frequency dependent shape of the Rrs- and Xrs-curves. Because of this inverse influence of VL on Raw and CL the diagnostic differentiation between patients with mild obstructive and restrictive lung diseases can be improved by a simultaneous evaluation of the volume and frequency dependence of oscillatory parameters.

Airway Resistance

[99mTc-anti-granulocyte antibodies (BW 250/183) in the detection of appendicitis].

Scintigraphy with 99mTc-labeled anti-granulocyte antibodies (AGAb) was performed in 50 patients with suspected appendicitis. Sequential and static imaging as well as SPECT of the pelvis and abdomen was performed 2 h p.i. In all patients the diagnosis was confirmed either histologically or by long-term follow-up. 13 patients had histologically proven acute appendicitis. In 11 patients the appendix scan had been positive and in 2 patients the scan had shown no significant tracer uptake in the right lower abdomen. The remaining 37 patients turned out not to have acute appendicitis. 29 out of these patients had negative and 3 had positive scan findings. In 5 patients the scan was equivocal. Out of these patients 2 had pathologic findings on the left side of the abdomen which turned out to be acute diverticulitis in one patient and acute peritonitis in the other. The remaining 3 patients with unclear scintigraphic findings had no acute appendicitis. Scintigraphy with AGAb is fast and easy to perform and thus superior to cell labeling methods for diagnosing acute appendicitis. Sensitivity for the diagnosis of acute appendicitis was 85% with a specificity of 91%. Chronic or scarred non-granulocytic appendicitis--in which there is often no definite indication for surgery--was negative in our study except for two cases.

Acute Disease

The HIV tat gene transforms human keratinocytes.

Skin disorders are frequently seen in patients with the acquired immune deficiency syndrome (AIDS). Since many of these cutaneous manifestations are accompanied by an early onset of epidermal hyperplasia, the keratinocyte is a candidate for infection by the human immunodeficiency virus (HIV). We now report that the HIV tat gene, under the control of the viral long terminal repeat (LTR), can efficiently transform human keratinocytes in culture. Our finding suggests that this activity of the tat gene may be responsible for the epidermal hyperplasia that accompanies psoriasis and precedes the development of squamous cell and basal cell carcinomas in AIDS patients.

Animals

Liver cancer in transgenic mice carrying the human immunodeficiency virus tat gene.

Patients with the acquired immunodeficiency syndrome are at risk to develop a variety of different cancers. Based on epidemiological data, Kaposi's sarcoma and non-Hodgkin's lymphoma have been clearly associated with infection by the human immunodeficiency virus (HIV). Additional cancers such as basal cell and squamous cell carcinomas, melanoma, and hepatocellular carcinoma have also been reported to be associated with a diagnosis of acquired immunodeficiency syndrome. A direct causal role of HIV has yet to be established for any of these cancers. We now report that transgenic mice carrying the HIV tat gene develop a high incidence of hepatocellular carcinoma after a long latency and that these changes in the liver are likely to be initiated by extrahepatic growth signals from the tat expressing cells in these mice. We predict that as acquired immunodeficiency syndrome patients begin to respond to therapy and show prolonged survival, such "secondary" malignancies induced by HIV will become increasingly prevalent.

Animals

[Congenital and acquired anomalies of the inferior vena cava. Differential diagnosis using digital subtraction angiography and computed tomography].

Segmental aplasias of the inferior vena cava, thrombosis of the vena cava, tumour infiltration (e.g. renal neoplasms via the renal vein) and external compression (e.g. large hepatic metastases) may produce similar radiomorphologic changes in chest x-ray DSA and CT. These radiomorphological changes are described by case reports. DSA clearly demonstrates the course of the vessels and the collaterals involved. CT may elucidate the paracaval vascular changes. It is only a synopsis of cavography (DSA) and CT with reference to embryogenesis that will lead to a reliable diagnosis and enable a definite decision on therapy and prognosis.

Adolescent

[Port visualization before intraperitoneal chemotherapy: scintigraphy or angiography?].

For assessing the functioning of intraperitoneal port-catheter systems prior to intraperitoneal chemotherapy, scintigraphy/SPECT and subtraction-angiography were compared. The patient under scrutiny had three port-catheter systems. Two of the three ports were functioning well. However, one port did not function. Via scintigraphy with 99m-Tc-nanocolloid this defective port was detected, but the cause was identified only by angiography. By the angiographic technique, a leakage near the port chamber caused by dislocation of the catheter could be verified. SPECT is a more useful method than angiography, since it shows very clearly intraperitoneal distribution by the possibility of reconstructing various slices. In conclusion, both techniques, the scintigraphic and the angiographic one, complement each other well.

Aged

[Problems in recognizing recurrences of craniocervical malignancies in CT].

A retrospective study was carried out involving 39 patients with malignant tumours of the head and neck in order to differentiate by CT changes due to local tumour or lymph node recurrences and various post-operative or post-irradiation changes. In these patients, two or more CT examinations of the neck were available, derived from a fourth generation scanner. The suspected lesions were classified according to their type and the appearances correlated with the treatment and clinical findings. There was frequent overlap between the appearances of benign and malignant changes, so that in individual cases a definite decision often proved impossible.

Adult