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Biomedical subjects

M Kirsch

Publications and source records attributed to M Kirsch.

At least 199 records · Page 11Linked to original sources

Contrast-enhanced 3D MRA with centric ordering in k space: a preliminary clinical experience in imaging the abdominal aorta and renal and peripheral arterial vasculature.

The objective of this study was to determine the clinical utility of a contrast-enhanced, centric reordered, three-dimensional (3D) MR angiography (MRA) pulse sequence in imaging the abdominal aorta and renal and peripheral lower extremity arteries. Twenty-eight MRA studies were performed on 23 patients and four volunteers at 1.5 T using a 3D contrast-enhanced, centric reordered pulse sequence. In 20 patients, the abdominal aorta and renal arteries were imaged, and in seven patients, the lower extremity arteries were imaged. In 19 patients, a total of 51 renal vessels were evaluated (33 renal arteries using .1 mmol/kg of gadopentetate dimeglumine and 18 renal arteries using .2 mmol/kg of gadoteridol). A total of 70 peripheral arterial segments were assessed using .2 mmol/kg of gadoteridol. Correlation with conventional angiography was made for the following 14 cases: renal artery stenosis (four cases), abdominal aortic stenosis (one case), arteriovenous fistula in a transplant kidney (one case), renal arteriovenous malformation (one case), common iliac artery aneurysms (one case), and peripheral lower extremity (six cases). Of the 70 peripheral arterial segments evaluated, in 35, there was correlation with x-ray angiography. The mean percent of aortic signal enhancement was significantly higher in the .2 mmol/kg dose group (370.8 +/- 190.3) than in the .1 mmol/kg dose group (184.5 +/- 128.9) (P = .02). However, there was no apparent difference between the two doses for visualization of the renal and accessory renal arteries. There was concordance between the contrast-enhanced 3D MRA studies and conventional angiography in all cases of renal artery and peripheral arterial stenoses and occlusions, including visualization of reconstituted peripheral arterial segments. There was no evidence of spin dephasing effects at sites of stenoses on the 3D contrast-enhanced MRA studies. Contrast-enhanced, centric reordered, 3D MRA can rapidly image the abdominal aorta and renal and accessory renal arteries, as well as peripheral lower extremity arteries, with high resolution. Accurate depiction of the vascular lumen at sites of stenosis is made because of the lack of spin dephasing effects, even with hemodynamically significant stenoses. Additional larger clinical trials are required with this promising technique.

Adult↗

Dark-adaptive cone elongation in the blue acara retina is triggered by green-sensitive cones.

In a dichromatic teleost species, we determined the intensity of light of various wavelengths required to prevent cone elongation by exposing fish at the time of their normal "dusk" phase to monochromatic light (479, 623, and 660 nm) at eight to ten different intensities for 75 min. The positions of single and double cones were measured in tangential sections and expressed as cone indices. At all wavelengths, the spectral responses of both cone types were virtually identical. Furthermore, the sensitivity of the blocking effect was highest at shorter wavelengths. When comparing the relative quantal sensitivities of myoid elongation for the two cone types to the spectral sensitivities of the three types of Aequidens pulcher photoreceptor, we found the closest match between the action spectrum and the absorption spectrum of the green-sensitive single cones. This may indicate that this cone type is capable of reacting directly to decreasing levels of illumination. On the other hand, the identical sensitivity of both cone types argues for an indirect control mechanism of dark-adaptive cone elongation, possibly via a neural pathway involving the inner retinal layers, complementary to the neural control of light adaptation. Green-sensitive single cones are well suited to trigger this response, since (1) their sensitivity is inferior to that of double cones; (2) waters inhabited by the blue acara transmit best at long wavelengths; and (3) at dusk, long-wavelength radiation dominates over other parts of the spectrum. Therefore, green-sensitive cone threshold will be reached first at dusk.

Animals↗

Angiogenesis, metastasis, and endogenous inhibition.

Angiogenesis and the development of metastases are intrinsically connected. Experimental data suggest that establishment and growth of metastases are influenced by soluble factors secreted from the originating solid tumor. Among these factors are so-called endogenous inhibitors of angiogenesis which keep metastasis in a non-proliferating quiescent state. For a number of tumors it has been shown that this dormant state is mediated through inhibition of angiogenesis. This dormant state is characterized by normal proliferation, increased apoptosis, and insufficient neo-vascularization. Removal of inhibiting anti-angiogenic factors led to growth of dormant metastases. A number of endogenous inhibitors have been identified and have shown success in experimental therapeutic trials. This might be of special interest for the treatment of cerebral metastases which are the most common type of malignant brain tumors. Similar to the spread of metastases, it is known that single glioma cells can be found in distant parts of the brain. While local recurrence is a common phenomenon in glioma, formation of clinical apparent distant metastasis occurs rarely. Several lines of evidence suggest that growth inhibition of remote glioma cells may be mediated by an endogenous inhibitory mechanism.

Angiostatins↗

Anti-angiogenic treatment strategies for malignant brain tumors.

The use of angiogenesis inhibitors may offer novel strategies in brain tumor therapy. In contrast to traditional cancer treatments that attack tumor cells directly, angiogenesis inhibitors target at the formation of tumor-feeding blood vessels that provide continuous supply of nutrients and oxygen. With respect to brain tumor therapy, inhibitors of angiogenesis display unique features that are unknown to conventional chemotherapeutic agents. The most important features are independence of the blood-brain barrier, cell type specificity, and reduced resistance. Malignant brain tumors, especially malignant gliomas, are among the most vascularized tumors known. Despite multimodal therapeutic approaches, the prognosis remains dismal. Thus, angiogenesis inhibitors may be highly effective drugs against these tumors. In a clinical setting, they could be applied in the treatment of multiple tumors or postsurgically as an adjuvant therapy to prevent recurrence. This article provides an overview of current anti-angiogenic treatment strategies with emphasis on substances already in clinical trials or candidate substances for clinical trials. The cellular and molecular basis of these substances is reviewed.

Angiogenesis Inhibitors↗