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Biomedical subjects

M Thelen

Publications and source records attributed to M Thelen.

At least 199 records · Page 11Linked to original sources

Constitutive activation of protein kinase B and phosphorylation of p47phox by a membrane-targeted phosphoinositide 3-kinase.

BACKGROUND: Phosphoinositide 3-kinase (PI 3-kinase) activity is required for mitogenic signaling and for secretory responses. Cell activation is presumed to cause the translocation of PI 3-kinase from the cytosol to the plasma membrane where the kinase interacts with its substrate phosphatidylinositol (4,5)-bisphosphate. Thus, a membrane-targeted and therefore constitutively active kinase could help elucidate the role of PI 3-kinase in intracellular signaling. RESULTS: The membrane-targeting sequence of Ha-Ras, containing the consensus sequence for palmitoylation and farnesylation, was fused to the carboxyl terminus of p110 alpha, the catalytic subunit of PI 3-kinase. The lipid anchor directed PI 3-kinase to the membrane and led to constitutively elevated phosphatidylinositol (3,4,5)-trisphosphate levels in transfected cells. Expression of membrane-targeted PI 3-kinase resulted in the continuous activation of downstream effectors, such as protein kinase B (PKB, also known as Akt/RAC), which was recently shown to regulate glycogen synthase kinase-3. The constitutive activation of PKB was abolished by the specific PI 3-kinase inhibitor wortmannin, and PKB activation was marginal in transfectants expressing non-membrane-targeted PI 3-kinase. Multiple phosphorylation of the cytosolic factor p47phox is required for the rapid assembly of the phagocyte NADPH oxidase upon stimulation with agonists of G-protein-coupled receptors. We show here that the expression of membrane-targeted PI 3-kinase in the monoblastic cell line GM-1 results in a wortmannin-sensitive continuous phosphorylation of p47phox. CONCLUSIONS: Targeting of PI 3-kinase to the site of its preferred substrate leads to constitutive stimulus-independent enhanced catalysis and is sufficient to regulate different signal transduction pathways.

3T3 Cells↗

Nuclear magnetic resonance imaging with hyperpolarised helium-3.

BACKGROUND: Magnetic resonance imaging (MRI) relies on magnetisation of hydrogen nuclei (protons) of water molecules in tissue as source of the signal. This technique has been valuable for studying tissues that contain significant amounts of water, but biological settings with low proton content, notably the lungs, are difficult to image. We report use of spin-polarised helium-3 for lung MRI. METHODS: A volunteer inhaled hyperpolarised 3He to fill the lungs, which were imaged with a conventional MRI detector assembly. The nuclear spin polarisation of helium, and other noble gases, can be greatly enhanced by laser optical pumping and is about 10(5) times larger than the polarisation of water protons. This enormous gain in polarisation easily overcomes the loss in signal due to the lower density of the gas. FINDINGS: The in-vivo experiment was done in a whole-body MRI scanner. The 3He image showed clear demarcation of the lung against diaphragm, heart, chest wall, and blood vessels (which gave no signal). The signal intensity within the air spaces was greatest in lung regions that are preferentially ventilated in the supine position; less well ventilated areas, such as the apices, showed a weaker signal. INTERPRETATION: MRI with hyperpolarised 3He gas could be an alternative to established nuclear medicine methods. The ability to image air spaces offers the possibility of investigating physiological and pathophysiological processes in pulmonary ventilation and differences in its regional distribution.

Adult↗

Monocyte chemotactic protein 4 (MCP-4), a novel structural and functional analogue of MCP-3 and eotaxin.

A novel human CC chemokine complementary DNA was identified in a library constructed from human fetal RNA, cloned into a baculovirus vector, and expressed in Sf9 insect cells. The mature recombinant protein that was released had the NH2-terminal sequence pyro-QPDALNVPSTC...and consisted of 75 amino acids. Minor amounts of two variants of 77 and 82 residues (NH2 termini: LAQPDA...and FNPQGLAQPDA...) were released as well. The novel chemokine was designated monocyte chemotactic protein 4 (MCP-4) and the variants were designated (LA)MCP-4 and (FNPQGLA)MCP-4. MCP-4 shares the pyroglutamic acidproline NH2-terminal motif and 56-61% sequence identity with the three known monocyte chemotactic proteins and is 60% identical to eotaxin. It has marked functional similarities to MCP-3 and eotaxin. Like MCP-3, MCP-4 is a chemoattractant of high efficacy for monocytes and T lymphocytes. On these cells, it binds to receptors that recognize MCP-1, MCP-3, and RANTES. On eosinophils, MCP-4 has similar efficacy and potency as MCP-3, RANTES, and cotaxin. It shares receptors with eotaxin and shows full cross-desensitization with this cosinophil-selective chemokine. Of the two variants, only (LA)MCP-4 could be purified in sufficient quantities for testing and was found to be at least 30-fold less potent than MCP-4 itself. This suggests that the 75-residue form with the characteristic NH2 terminus of an MCP is the biologically relevant species.

Acetylglucosaminidase↗

Pulmonary hypertension in patients with chronic pulmonary thromboembolism: chest radiograph and CT evaluation before and after surgery.

The purpose of this study was to assess the value of morphometric data on conventional radiography and CT predicting the presence and degree of pulmonary hypertension and to assess the reversibility after surgery. On preoperative X-ray films and CT scans of 50 patients with pulmonary hypertension secondary to chronic thromboembolism, we measured the cardiothoracic ratio, basal diameter, length of cardiac contact to sternum, pulmonary trunk, right and left descending pulmonary artery, and the septum angle. These data were correlated with pulmonary arterial pressure. In 14 X-ray patients and 18 CT patients, with follow-up after surgical thromboendarterectomy the reversibility of these changes was assessed. A dilated pulmonary trunk was the most common abnormality (96% each on X-ray and CT). Pulmonary arteries were dilated on X-ray in 40% (right) and 14% (left), and on CT in 92% (right) and 96% (left). The best correlation with mean arterial pressure was found measuring the pulmonary trunk on CT (r = 0.43, p < 0.01). After surgery, reversibility was most significant for the pulmonary trunk on CT (p < 0.0001). In patients with chronic pulmonary embolism, pulmonary hypertension can best be predicted by assessing the diameter of the pulmonary trunk both on X-ray and CT. No close correlation is present between the extent of any parameter and the level of pulmonary pressure.

Adult↗

Hadamard NMR imaging with slice selection.

Stochastic NMR imaging is one of the less common NMR imaging techniques. Nevertheless, stochastic rf excitation is characterized by some remarkable features: the rf excitation power is at least two orders of magnitude lower in comparison to conventionally pulsed NMR imaging schemes. Thus, the technique is of interest for imaging of large objects. The systematic noise inherent in images obtained with random noise excitation has been eliminated by using pseudorandom noise together with Hadamard transformation for data evaluation. Data acquisition times are comparable to those of ultrafast imaging techniques. For slice selection, z magnetization is destroyed outside the slice region with specially designed low power pulses. Thus, gradient switching times are only limited by T1 and not T2*. Images are reconstructed by the backprojection algorithm. We have set up a stochastic imaging procedure on a conventional Bruker MSL 300 spectrometer, and have drawn a comparison between images obtained by the pseudorandom noise excitation and by conventional Fourier imaging.

Fourier Analysis↗

[Intravascular therapy of aortic aneurysms: initial clinical results].

PURPOSE: A clinical study aiming at examining the implantation technique and the clinical results of a new vascular prosthesis in endovascular therapy of aneurysms of the aorta. MATERIAL AND METHODS: In 21 patients (20 men of 55 to 87 years of age, average age 70 years) with aneurysms of the infrarenal abdominal aorta (AAA n = 19) and the thoracic aorta (n = 2), a self-expanding nitinol stent with outer Dacron sheath (tubular prosthesis n = 4; bifurcation prosthesis n = 17) was implanted by means of an F-18 introductory set after surgical opening of the inguinal artery. RESULTS: By means of the 4 tubular prostheses and 13 of the 17 bifurcation prostheses the aneurysm was bypassed completely. In 4 cases residual perfusion through leaks (n = 3) or collateral blood supply (n = 1) was seen. In 6 patients 7 complications occurred which did not require to be operated on. No patient died in consequence of the surgical intervention or during the hospital stay. Follow-ups up to 8 months after surgery did not reveal any late complications to date. CONCLUSIONS: Endovascular implantation of vascular prostheses is a promising new method for interdisciplinary treatment of aneurysms of the aorta.

Aged↗

[Triphasic spiral CT in the diagnosis of liver diseases: comparison with CT arteriography and CT arterio-portography].

PURPOSE: Assessment of the diagnostic efficacy of triphasic spiral-CT scanning (TPS-CT) for liver disease evaluation. CT arteriography (CTA) and CT arterio-portography (CTAP) were used as reference, methods which together have the highest sensitivity for detecting tumours and the perfusion conditions of the liver. MATERIAL AND METHODS: 50 TPS-CT and CTA/CTPA were performed in 49 patients. After an initial examination without enhancement the first scan was initiated 15-25s after the peripheral bolus injection of contrast medium, the second after an interscan delay of 20-25s. By this means the liver was imaged in different phases of perfusion. In the course of the CTA/CTPA-exam the imaging was carried out after selective, intraarterial application of contrast agent. RESULTS: The differentiation of the perfusion phases succeeded in 90% of the patients. When compared with standard CT, which images only the portal venous phase, the new technique, which additionally shows the arterial perfusion, accomplished an increase in sensitivity for hypervascular lesions (51% vs. 60%). Yet in comparison with CTA/CTPA fewer lesions could be detected (87 vs. 138). Furthermore, by documenting the contrast agent kinetics, characterisation of the lesion was also facilitated. CONCLUSION: DPS-CT is a valuable additional tool for imaging the liver, even if the information yield is less when compared to CTA/CTPA.

Adult↗

[Radiologically assisted percutaneous gastro-/enterostomy--a retrospective analysis of 90 procedures].

PURPOSE: To analyse retrospectively the indications, technique and results of radiologically induced gastrostomies or enterostomies. PATIENTS AND METHOD: Radiologically assisted gastrostomies or enterostomies were induced in 90 patients, mostly with high grade obstructions due to head and neck tumours or oesophageal tumours. 19/90 patients had had previous resection of the oesophagus or gastric operations. RESULTS: A catheter was successfully introduced in all patients. In 11/90 patients this was followed by a two-stage procedure. In 16/90 patients puncture was performed under CT control because of some anatomical peculiarity. Serious complication occurred in 9/90 patients but in only one was surgery necessary. There were no deaths resulting from the procedure but mortality after 30 days was 6.7%. CONCLUSION: Radiologically assisted gastrostomies or enterostomies are a reliable and effective form of treatment even amongst difficult patients. The results and complications are comparable to those from endoscopic procedures.

Adult↗

[What is it called? A formulation and glossary for the finding and understanding of results in HRCT of the lung].

In HRCT reports multiple different, often synonymous, German and English terms are used. The variety of terms impede understanding and acceptance of HRCT. Purpose of this paper is to present a scheme, which is based on the anatomic landmarks (secondary lobule), and the density of pathologic changes, as well as a glossary from the German HRCT-literature, including suitable terms, definitions, synonyms and English terms. Low attenuation changes include emphysemas, air-filled cavities (bullae, cysts, cavitations, honeycombing) and bronchial dilatation, changes with increased density consist of diffuse (ground glass opacity, consolidation) and focal processes (reticular and nodular densities). Reticular densities are categorised in thickened interlobular septae and translobular lines with differentiation of a reticular pattern and curvilinear lines. Nodular processes are categorised according to size, density, morphology, localisation and distribution. Parenchymal distortion and destruction indicate the severity of these processes. Certain patterns are indicative for possible differential diagnoses, and a recommendation for further procedures is given.

Dictionaries, Medical as Topic↗

[Phantom study of optimization of spiral-CT and 3D reconstruction of the tracheobronchial system].

PURPOSE: To optimise three-dimensional spiral CT of the tracheobronchial tree using adequate acquisition and reconstruction parameters for spiral CT of the chest. MATERIAL AND METHODS: Qualitative and quantitative assessment of different 3 D reconstructions of two test objects of the tracheobronchial tree depending on section thickness, reconstruction interval, pitch, and reconstruction algorithm used in spiral CT (Siemens, Somatom plus S) of the chest. The frequency of volume and stairstep artifacts was evaluated. The 3 D reconstructions were generated using a seeded VOI-technique (Allegro, ISG). RESULTS: Reduction of artifacts was achieved by decreasing section thickness. Increasing overlap of source images, lowering the pitch factor, and application of the reconstruction algorithm "slim". Section thickness was the single most important factor which was mainly responsible for the occurrence of volume artifacts. Stairstep artifacts were primarily influenced by the reconstruction interval. CONCLUSION: Spiral CT with a section thickness > 4 mm is not adequate for 3 D reconstructions of the tracheobronchial tree. Overlapping source images with a pitch of 1 and the reconstruction algorithm "slim" can be recommended to reduce artifacts.

Algorithms↗

Normal and abnormal pulmonary ventilation: visualization at hyperpolarized He-3 MR imaging.

To assess the feasibility of helium-3 magnetic resonance (MR) imaging with a three-dimensional fast low-angle shot (FLASH) sequence, He-3 gas (volume, 300 mL; pressure, 3 x 10(5) Pa; polarized up to 45% by means of optimal pumping) was inhaled by five healthy volunteers and five patients with pulmonary diseases. All breath-hold examinations (22-42 seconds) were completed successfully. Normal ventilation was depicted with homogeneous high signal intensity, lesions were depicted as causing defects, and obstructive lung disease was depicted with severely inhomogeneous signal intensity.

Administration, Inhalation↗

Prospective comparison of CT angiography of the legs with intraarterial digital subtraction angiography.

OBJECTIVE: The aim of this study was to determine the accuracy of CT angiography (CTA) with a single spiral acquisition for the diagnosis of arterial stenoses and occlusion in patients with peripheral vascular occlusive disease. SUBJECTS AND METHODS: In a prospective study, intraarterial digital subtraction angiography and i.v. CTA from the groin to the lower calves were performed on 50 patients with vascular occlusive disease. Maximum-intensity-projection images in multiple views were produced. The accuracy of CTA with and without analysis of the axial scans was determined with digital subtraction angiography as the standard. RESULTS: The sensitivities of CTA were 100% for the diagnosis of femoral artery occlusion, 100% for the detection of popliteal artery (including tibial-peroneal arterial trunk) occlusion, and 94% for the detection of tibial artery occlusion. The specificities were 100%, 99%, and 98%, respectively. When maximum-intensity-projection images were interpreted without axial scans, sensitivities were 98%, 85%, and 92% and specificities were 100%, 99%, and 97%, respectively. For the accurate grading of high-grade (75-99%) stenoses of the superficial femoral artery and the popliteal artery (including tibial-peroneal arterial trunk), the sensitivities of CTA were 88% and 73% and the specificities were 94% and 100%, respectively. When maximum-intensity-projection images alone were used, the sensitivities for the correct grading of high-grade stenoses were 58% and 36% and the specificities were 99% and 100%, respectively. CONCLUSION: CTA from the groin to the lower calves is feasible, and the short examination time is a significantly advantage over the time required for other noninvasive techniques. CTA is particularly accurate in the depiction of femoral artery occlusions. Maximum-intensity-projection images are useful, but analysis of axial scans is more accurate for the grading of arterial stenoses. The results of CTA are encouraging enough to warrant further studies. A CTA protocol covering the pelvic and pedal vessels remains to be established and evaluated.

Aged↗

Three-dimensional helical CT of the tracheobronchial tree: evaluation of imaging protocols and assessment of suspected stenoses with bronchoscopic correlation.

OBJECTIVE: To assess the accuracy of three-dimensional (3D) helical CT of normal airways, we evaluated different imaging protocols in test objects and patients. The clinical value of 3D helical CT was composed with bronchoscopy in patients with suspected stenoses, especially before and after endobronchial procedures. SUBJECTS AND METHODS: Solid test objects--one of central airways and one of peripheral airways--were scanned and assessed for volume defects and stairstep artifacts. Fifty helical studies were performed in 36 patients. We evaluated these images for visualization of segmental bronchi; frequency of artifacts; and presence, localization, and degree of stenoses. Bronchoscopic correlation was available for 40 CT examinations. Follow-up 3D helical CT after endobronchial procedures was performed in nine patients. RESULTS: In test objects, thin sections reduced volume artifacts. Overlapping sections mainly diminished stairstep artifacts. In vivo, overlapping sections were superior to contiguous sections for good visualization of the origin (96% versus 89%, p < .01) and of the course (75% versus 54%, p < .001) of segmental bronchi. Three-dimensional helical CT allowed us to assess accurately 36 of 36 central stenoses that were seen on bronchoscopy; however, on 3D helical CT, we missed two of three segmental stenoses. At bronchoscopy, 18 stenoses could not be passed, whereas 3D helical CT provided details for possible endobronchial procedures: length of stenosis, patency (12/18), and spatial orientation of distal bronchi. Follow-up 3D helical CT documented the efficacy of endobronchial treatment. CONCLUSION: Three-dimensional helical CT based on thin overlapping sections accurately visualized the normal airways down to the origin of the segmental bronchi and central stenoses. When it complements bronchoscopy, 3D helical CT allows visualization beyond stenoses, supports planning of endobronchial procedures, and may even substitute for bronchoscopy after endobronchial procedures.

Adult↗

[Follow up control of stage IV neuroblastoma: 123I-MIBG scintigraphy, bone scintigraphy and catecholamine metabolites].

AIM: The diagnostic value of 123I-mIBG-scintigraphy, bone scintigraphy and catecholamine metabolites in the follow up of neuroblastoma stage IV will be evaluated. METHODS: Nineteen children suffering from neuroblastoma were analysed retrospectively by 123I-mIBG-scintigraphy, bone scintigraphy and measurement of homovanillic acid, vanillic acid, neuronspecific enclose, lactate dehydrogenase, and ferritine. Follow up was 7-132 (median 36) months. RESULTS AND CONCLUSION: The significance of the methods was dependent on the time of diagnostic use. In principal, 123I-mIBG-scintigraphy has the highest diagnostic impact. For initial staging and diagnosis of recurrence a combination of all three methods can be used. On the contrary, follow up during chemotherapy is best documented by 123I-mIBG-scintigraphy, whereas bone scintigraphy is of limited and measurement of catecholamine metabolites of less diagnostic value.

3-Iodobenzylguanidine↗

[Infarct of the lower renal artery segment: diagnosis with CT-angiography and 3-dimensional spatial representation].

The case of a CT-angiographically diagnosed partial renal infarction is presented. The infarction was diagnosed during a postoperative CT-control of the arteries after implantation of an aorto-biliac dacron graft. Reformatting of the axial spiral scans data was elaborated with surface rendering, maximum intensity projection, and volume rendering for comparison. Each of the reformatting modalities was able to re-present the renal infarction, elaboration time is short and a clear presentation of the spatial relationship can be obtained.

Angiography↗

PI 3-kinase-dependent and independent chemotaxis of human neutrophil leukocytes.

The migration of neutrophil leukocytes to inflammatory sites is important for the elimination of microorganisms but can under pathological conditions lead to severe tissue damage. The initial chemotactic response is elicited by classical chemoattractants, such as fMet-Leu-Phe or the chemokine interleukin-8 which ligate to G-protein coupled receptors. Neutrophils show also a delayed chemotactic response to growth factors, such as platelet derived growth factor (PDGF) or tumor growth factor (TGF beta). We describe here that classical chemoattractants and growth factors stimulate neutrophil chemotaxis through different signal transduction pathways. Wortmannin, a selective phosphatidylinositol 3-kinase inhibitor, completely blocks growth factor stimulated chemotaxis while having no effect on neutrophil migration stimulated with classical chemoattractants. The results suggest that cell migration can be selectively controlled through the inhibition of distinct signal transduction events.

Androstadienes↗

Motility disorders of the esophagus: diagnosis with barium-rice administration.

PURPOSE: To evaluate the role of barium-rice administration for a standardized diagnosis of dysphagia and esophageal motility disorders. MATERIALS AND METHODS: Sixty healthy volunteers and 218 patients with various esophageal disorders (achalasia, scleroderma and other connective tissue diseases, neurologic diseases, esophagitis and others) were examined both by a conventional barium study and by a barium-rice study. The barium-rice meal consisted of barium sulfate and boiled rice, mixed half and half. The time required for esophageal clearance of one sip was measured. RESULTS: Normal esophageal transit time in healthy controls was between 5 and 15 s for both methods. In patients, the conventional barium study revealed a prolonged transit time in only 16.5% (36 of the 218 cases). The barium-rice study was abnormal in 51.8% (113 of 218 cases), independent of the underlying disease. The barium-rice study was pathological in 77 of those 182 patients (42.3%) who had normal barium transit time. In 24 patients the radiologic results was confirmed by endoscopy and manometric measurements. CONCLUSIONS: Esophageal motility abnormalities are detected by a barium-rice study with a high sensitivity. With this simple and low-cost method, quantitative and reproducible results can be obtained. Barium-rice administration is a suitable tool for screening and follow-up of patients with dysphagia and esophageal motility disorders.

Adolescent↗