Search PubMed⌕ Search

Biomedical subjects

R Felix

Publications and source records attributed to R Felix.

At least 109 records · Page 6Linked to original sources
PubMed2003

Use of statistical parametric mapping of (18) F-FDG-PET in frontal lobe epilepsy.

AIM: Evaluation of the use of statistical parametrical mapping (SPM) of FDG-PET for seizure lateralization in frontal lobe epilepsy. PATIENTS: 38 patients with suspected frontal lobe epilepsy supported by clinical findings and video-EEG monitoring. METHOD: Statistical parametrical maps were generated by subtraction of individual scans from a control group, formed by 16 patients with negative neurological/psychiatric history and no abnormalities in the MR scan. The scans were also analyzed visually as well as semiquantitatively by manually drawn ROIs. RESULTS: SPM showed a better accordance to the results of surface EEG monitoring compared with visual scan analysis and ROI quantification. In comparison with intracranial EEG recordings, the best performance was achieved by combining the ROI based quantification with SPM analysis. CONCLUSION: These findings suggest that SPM analysis of FDG-PET data could be a useful as complementary tool in the evaluation of seizure focus lateralization in patients with supposed frontal lobe epilepsy.

Adolescent↗
PubMed2002

[Coronary artery bypass grafting in patients with highly impaired ventricular function. Long-term outcome].

BACKGROUND AND OBJECTIVE: Left ventricular function is the most important predictor of survival in patients with coronary artery disease. It is also an important indicator for hospital mortality after operation for end-stage coronary artery disease. In our study we investigated, how preoperative ventricular dysfunction influences long term survival after coronary bypass surgery. PATIENTS AND METHODS: Between 4/1986 and 12/2000, 1751 patients (1440 men/311 women) with left ventricular ejection fraction (LVEF) 10-30% underwent coronary bypass grafting (CABG) at the Deutsches Herzzentrum Berlin. The age of the patients was calculated to an average of 59,2 years. The prime criterion for CABG was ischemia ("hibernating myocardium") diagnosed by myocardial scintigraphy, echocardiography and in some cases with magnetic resonance imaging and positron emission tomography. RESULTS: Operative mortality for the group was 7,1%. The actuarial survival rate was 87,6% after 2 years, 76,0% after 5, and 53,3% after 9. 455 had LVEF 10-20%, in these actuarial survival was 79,8% after 2 years, 63,0% after 5 and 45,7% after 9 years. CONCLUSION: We conclude that CABG can be used successfully to improve life expectancy of patients with end-stage coronary artery disease. CABG leads to acceptable prognosis for these high-risk patients when the myocardium is preoperatively identified as being viable.

Adult↗
PubMed2002

Short (1-10 cm) superficial femoral artery occlusions: results of treatment with excimer laser angioplasty.

PURPOSE: To evaluate the safety and long-term results after laser angioplasty of short occlusions of the superficial femoral artery (SFA). METHODS: In a prospective trial in 312 patients with short occlusions of the SFA excimer laser angioplasty for recanalization was applied. The average occlusion length of the SFA was 7.5 cm (range 1-10 cm). The recanalization attempt was done using either a cross-over technique from the contralateral femoral artery (278 patients), antegrade technique (16 patients) or transpopliteal technique (18 patients). RESULTS: Percutaneous transluminal laser angioplasty (PTLA) produced successful recanalization of the SFA in 286 of 312 patients (91.7%). In 26 patients (8.3%) recanalization was not possible. The reason for the unsuccessful PTLAs was obstructing calcified materialn = 8) which was resistant to laser application. In nine cases obstructing calcifications resulted in positioning of the laser catheter in subintimal tissue or perforation of the SFA. In another four patients there was an aberrant anatomy of the SFA which resulted in a direct vessel injury after advancing the laser catheter. In five patients subintimal recanalization failed. After a follow-up period of 36 months there was a primary, primary assisted and secondary patency rate of 49.2%, 76.5% and 86.3%. CONCLUSION: Excimer laser angioplasty of short occlusions of the SFA is a feasible procedure with a low failure rate. Long-term results are promising but additional interventions are required in most patients to achieve a patency rate of 86.3% after 3 years. Further studies are needed to compare the clinical outcome of PTLA and PTA in short occlusions of the SFA.

Angioplasty, Balloon, Laser-Assisted↗
PubMed2002

Hyperthermia in combined treatment of cancer.

Hyperthermia, the procedure of raising the temperature of tumour-loaded tissue to 40-43 degrees C, is applied as an adjunctive therapy with various established cancer treatments such as radiotherapy and chemotherapy. The potential to control power distributions in vivo has been significantly improved lately by the development of planning systems and other modelling tools. This increased understanding has led to the design of multiantenna applicators (including their transforming networks) and implementation of systems for monitoring of E-fields (eg, electro-optical sensors) and temperature (particularly, on-line magnetic resonance tomography). Several phase III trials comparing radiotherapy alone or with hyperthermia have shown a beneficial effect of hyperthermia (with existing standard equipment) in terms of local control (eg, recurrent breast cancer and malignant melanoma) and survival (eg, head and neck lymph-node metastases, glioblastoma, cervical carcinoma). Therefore, further development of existing technology and elucidation of molecular mechanisms are justified. In recent molecular and biological investigations there have been novel applications such as gene therapy or immunotherapy (vaccination) with temperature acting as an enhancer, to trigger or to switch mechanisms on and off. However, for every particular temperature-dependent interaction exploited for clinical purposes, sophisticated control of temperature, spatially as well as temporally, in deep body regions will further improve the potential.

Animals↗
PubMed2002

[Extracapsular spread of cervical lymph node metastases: Diagnostic value of magnetic resonance imaging].

OBJECTIVE: Assessment of the value of magnetic resonance tomography in the determination of extracapsular neoplastic spread and soft tissue infiltration of cervical lymph nodes. MATERIALS AND METHODS: The results of magnetic resonance tomographies of 110 patients with squamous cell carcinoma in the head-neck region were prospectively compared with the findings of the histologic examination after neck dissection. RESULTS: Magnetic resonance tomography reaches a specificity of 72.2 % in the detection of extracapsular neoplastic spread. The sensitivity of the method is 74.4 %. Mainly small (less than 1 cm; n = 11) extracapsular growth was not detected and was diagnosed false-negative in the MRI examinations. CONCLUSION: The specificity (72.2 %) and sensitivity (74.4 %) of MRI examinations to detect extracapsular spread of lymph nodes is only partially satisfying.

Adult↗
PubMed2002

Magnetic Resonance Female Breast Imaging (MRFBI) - Evaluation of the Changes in Signal Intensity over Time Pre- and Post-administration of 0.2 mmol/kg Gd-DTPA.

PURPOSE: We are looking for a threshold value to discriminate between benign and malign breast lesions in MRI of female breast after administration of 0.2 mmol Gadolinum-DTPA/kg bw. MATERIALS AND METHODS: Double coil breast MRI (1.5 Tesla) were performed in 65 patients with an suspicious lesion for malignancy in an anteriorly examination. 57 patients could be evaluated in our study design. Histopathological 35 patients had an invasive carcinoma, 3 patients had an in-situ-carcinoma and in 27 patients benign changes were found. RESULTS: For different carcinoma diameters we found a different increase of signal intensity (SI): small carcinoma (< 10 mm) had an maximum increase of SI of 102 %, medium sized (10 to 20 mm) 222 % and carcinomas over 20 mm showed an increase of 271 %. We did not find a significant difference between SI in benign and malign lesions. The sensitivity was 94.6 % the specificity 65 %. CONCLUSION: A threshold value to distinguish between malign and benign in MRI could not be defined. With the double normal Gd-DTPA dose we do not have better specificity and sensitivity than for normal dose (0.1 mmol/kg bw) is described.

Adult↗
PubMed2002

[Comparison between endorectal MRI (EMRTI) and endorectal sonography (ES) after surgery or therapy for rectal tumors to exclude recurrent or residual tumor].

PURPOSE: This study was designed to evaluate the accuracy and limitations for staging of contrast-enhanced endorectal MR imaging comparing with transrectal US for restaging of rectal lesions after surgery or after therapeutic radiation. Both methods were correlated with histologic findings. METHOD/MATERIALS: The efficacy of these both methods was evaluated in 30 patients with supposed residual or recurrent rectal neoplasms. Contrast enhanced (bolus injection of 0.1 mmol/kg b.w. Gd-DTPA) endorectal MR imaging was performed using a 1.5 Tesla Magnetom. In addition endosonography (7.5 x or 10-MHz transducer) was used. RESULTS: In 8 patients with rectal adenoma after electro-laser resection, 8 patients with rectal carcinoma stage pT1 after transanal resection, 8 patients with rectal carcinoma stage pT2 and 6 patients with rectal carcinoma stage pT3 after regional hyperthermia with radiochemo-therapy, the following results were obtained during the postsurgical or posttherapeutical follow-up with respect to histopathological evaluation: exact staging in 86.6 % with EMRI and 63.3 % in ES, overstaging in 8 % (EMRI) and 23 % (ES), understaging in 0 % (EMRI) and 7 % (ES). The highest diagnostic accuracy was shown in EMRT in patients with rectal adenoma and rectal carcinoma (pT1) and after electro-laser resection or transanal resection during follow-up. CONCLUSIONS: Contrast enhanced endorectal MR imaging appears to be very promising for accurate posttherapeutical staging of rectal cancer and helpful in the diagnosis of recurrence or the differentiation between scar tissue and residual rectal tumor.

Adenoma↗
PubMed2002

[Use of portable computed tomography in non-transportable patients on the intensive care unit: preclinical experience].

PURPOSE: To evaluate different concepts of the application of a portable CT (PCT) directly in a patient's ICU room versus in a specially designed interventional suite (IS). METHODS: 13 patients with maximum ICU treatment were examined by PCT and assessed with regard to their health status by ICU scores (TISS 28, MODS). Only patients with a therapeutic intervention scoring system 28 (TISS 28) value of 40 or greater were included in the study. A TISS 28 value of 40 or more characterizes a patient requiring maximal ICU treatment. Patients were examined by PCT either in the patient's room or in the IS on the ICU. Scanning time and personnel resource expense were determined. The multiple organ dysfunction score (MODS) was utilized for patient characterization. RESULTS: An average of 1.4 hours was needed to perform a PCT scan in the interventional room. A minimum of 4.5 hours or up to a maximum of 7.2 hours were required to perform a bedside scan in the patient's room. There is a noticeable difference between patients with respect to TISS 28. Patients examined by bedside CT were more acutely ill than the others by reason of MODS (8 - 18 patient-room group vs. 3 - 12 IS group). CONCLUSIONS: PCT performed on an ICU assures optimal treatment of patients during CT examination. Portable CT had more time exposure and required more personnel resources than examination in the IS. All PCT examinations performed directly in the patient's room demonstrated the diagnostic value and had direct therapeutic consequences.

Adolescent↗
PubMed2002

[Laser-induced thermotherapy (LITT) for malignant liver tumours: the role of sonography in catheter placement and observation of the therapeutic procedure].

AIM: Evaluation of sonography in the placement of catheters for laser-induced thermotherapy (LITT) as well as for the observation of the therapeutic procedure in cases of malignant liver tumours. METHODS: Following the placement of 1-4 LITT applicators, 18 patients with malignant liver tumours (recurrence of hepatocellular carcinoma n = 5, metachronous liver metastases n = 13) were examined by ultrasound to determine the position of the applicators as well as the sonographic visualisation of the respective lesion. The laser treatment procedure was also observed sonographically. As standard reference method for the documentation of thermally induced necroses we used magnetic resonance tomography 24-48 hours after the procedure. RESULTS: The tip of the applicator could be localised in all cases, and the position of the applicator relative to the lesion could be directly visualised in 78% of cases. The hyperechogenic thermal effect during LITT had a median size of 4.5 cm, thus proving to be significantly larger than the actual necrosis induced (p < 0.01). The sonographic observation of the procedure identified 8/10 primarily incomplete ablations which were then treated again immediately after correction of the position of the applicators. CONCLUSION: Continuous sonographic observation of the procedure of LITT can yield important additional information.

Adult↗
PubMed2002

[Value of contrast-enhanced ultrasound vs. CT and MRI in palpable enlarged lymph nodes of the head and neck].

PURPOSE: To compare the value of B-mode-, plain and contrast enhanced color Doppler ultrasound, CT and MRI with respect to their diagnostic accuracy in palpable enlarged cervical lymph nodes. MATERIAL AND METHODS: Thirty patients (18 - 90 years old) with palpable enlarged lymph nodes of the head and neck underwent B-mode-ultrasound, plain and contrast enhanced color Doppler, CT and MRI (gold standard: histologic analysis in 22 and clinical follow up for at least six months in eight patients). The criteria of malignancy were maximal and minimal lymph node diameter, M/Q-ratio, various morphologic criteria (necrosis, hilus line, internal structure, contour, contrast enhancement), spectral Doppler indices, and vascular architecture in color Doppler. RESULTS: The highest sensitivity (= 1.00, specificity = 0.07 - 0.15) was obtained measuring the lymph node diameter independent on the used imaging modality (ultrasound, CT, MRI), the highest specificity (= 1.00, sensitivity = 0.71) analyzing the vascularity of the lymph node by plain color Doppler. The highest diagnostic (= 0.93) accuracy was delivered by contrast enhanced color Doppler analysis of the vascularity. Sensitivity (= 0.94) and specificity (= 0.92) of this imaging modality were only slightly inferior to the top values. Fisher's exact test revealed significant values in differentiating malignant from benign lymph nodes for B-mode- and MR-analysis of the M/Q-ratio (p < 0001/p < 0.05), B-mode morphology (p < 0.00005), plain and contrast enhanced color Doppler analysis of the vascularity (p < 0.0001/p < 0.000005), MR-morphology (p < 0.0001), and CT-morphology (p < 0.005). CONCLUSION: CT is inferior to MRI, B-mode-ultrasound and contrast-enhanced color Doppler in the differential diagnosis of selectively analyzed, palpably enlarged cervical lymph nodes using the criteria of our study. The analysis of the MR-morphology revealed a slightly inferior diagnostic accuracy to B-mode morphology and color Doppler analysis of the vascularity.

Adolescent↗
PubMed2002

[Analysis of vascularity in breast tumors--comparison of high frequency ultrasound and contrast-enhanced color harmonic imaging].

PURPOSE: To compare the ability of standard power Doppler and color harmonic imaging for visualising breast tumor vascularity using ultrasound probes of various frequencies, and to evaluate the influence on diagnostic accuracy using ultrasound contrast agent. MATERIALS AND METHODS: Twenty patients (x = 43.6 +/- 11.7 years) with suspected malignancy of the breast underwent power Doppler to evaluate vascularity and to offer a differential diagnosis of the lesion. Two criteria were used for differential diagnosis: The quantitative extent of vascularity ("percentage vessel area", PVA) and the qualitative assessment of vascular architecture. The following power Doppler modes were compared in every patient: Plain and enhanced (Levovist(R)) 9 MHz and 12 MHz standard power mode and enhanced 9 MHz color harmonic imaging-(CHI). RESULTS: The PVA increased from a mean of 2.2 +/- 2.9 % (9 MHz standard plain) via 4.8 +/- 4.1 % (12 MHz standard plain), 9.7 +/- 15.3 % (9 MHz standard enhanced), 17.4 +/- 20.0 % (9 MHz CHI enhanced) up to 19.4 +/- 14.8 % (12 MHz standard enhanced). The perceptibility of the vascular structure was best using the enhanced 12 MHz standard power mode, immediately followed by the enhanced 9 MHz CHI mode. The improved detection of vascular signal did not translate into improved diagnostic accuracy. The highest diagnostic accuracy (95 %) was obtained using the enhanced 9 MHz CHI mode (criterion "PVA") and the enhanced 9 MHz standard power mode (criterion "vascular structure"), whereas the 12 MHz probes delivered insufficient diagnostic accuracy and very low specificity. CONCLUSION: Best quantitative and qualitative visualisation of the tumor vascularity was achieved using the enhanced 12 MHz standard power mode. Nevertheless, the highest diagnostic accuracy was obtained using enhanced 9 MHz standard power Doppler and enhanced 9 MHz color harmonic imaging. The visualisation of tumor vascularity and, partially, the diagnostic accuracy are improved significantly by color harmonic imaging without changing the probe frequently.

Adult↗
PubMed2001

Ion transport in sperm signaling.

Ion channels and transporters, key elements in sperm-egg signaling and environmental sensing, are essential for fertilization. External cues and components from the outer envelopes of the egg influence sperm ion permeability and behavior. Combining in vivo measurements of membrane potential, intracellular ions, and second messengers with new molecular approaches and reconstitution strategies are revealing how sperm ion channels participate in motility, sperm maturation, and the acrosome reaction. Sperm are tiny differentiated terminal cells unable to synthesize proteins and difficult to characterize electrophysiologically. Spermatogenic cells, the progenitors of sperm, have become useful tools for probing sperm ion channels since they are larger and molecular biology techniques can be applied. These complementary strategies are opening new avenues to determine how sperm ion channels function in gamete signaling.

Animals↗
PubMed2001

Identification of mouse trp homologs and lipid rafts from spermatogenic cells and sperm.

Intracellular Ca(2+) has an important regulatory role in the control of sperm motility, capacitation, and the acrosome reaction (AR). However, little is known about the molecular identity of the membrane systems that regulate Ca(2+) in sperm. In this report, we provide evidence for the expression of seven Drosophila transient receptor potential homolog genes (trp1-7) and three of their protein products (Trp1, Trp3 and Trp6) in mouse sperm. Allegedly some trps encode capacitative Ca(2+) channels. Immunoconfocal images showed that while Trp6 was present in the postacrosomal region and could be involved in sperm AR, expression of Trp1 and Trp3 was confined to the flagellum, suggesting that they may serve sperm to regulate important Ca(2+)-dependent events in addition to the AR. Likewise, one of these proteins (Trp1) co-immunolocalized with caveolin-1, a major component of caveolae, a subset of lipid rafts potentially important for signaling events and Ca(2+) flux. Furthermore, by using fluorescein-coupled cholera toxin B subunit, which specifically binds to the raft component ganglioside GM1, we identified caveolin- and Trp-independent lipid rafts residing in the plasma membrane of mature sperm. Notably, the distribution of GM1 changes drastically upon completion of the AR.

Acrosome Reaction↗
PubMed2001

Current status of power Doppler and color Doppler sonography in the differential diagnosis of lymph node lesions.

The use of Power Doppler sonography in nodal diseases provides an improvement of early and noninvasive diagnosis of regional metastatic involvement. By using Power Doppler sonography it is possible to characterize lymph nodes as reactively enlarged, metastases, malignant lymphoma, tuberculosis and to study cervical cysts. The high diagnostic accuracy is based on perfusion-characteristics of these lymph nodes. Reactive lymph nodes show increased central perfusion of the hilum, whereas metastases tend to show increased peripheral perfusion. Affected lymph nodes in patients with by malignant lymphoma are highly perfused in the center but also peripheral. Power Doppler sonography is still not able to discriminate small (<8 mm) nonnecrotic metastasis or micrometastases from reactive lymph nodes. The purpose of this paper is to provide a summary of the current status of power Doppler and Doppler sonography in the differential diagnosis of lymph nodes.

Diagnosis, Differential↗
PubMed2001

Calmodulin antagonists inhibit T-type Ca(2+) currents in mouse spermatogenic cells and the zona pellucida-induced sperm acrosome reaction.

The sperm acrosome reaction (AR) is a regulated exocytotic process required for gamete fusion. It depends on an increase in [Ca(2+)](i) mediated by Ca(2+) channels. Although calmodulin (CaM) has been reported to regulate several events during the AR, it is not known whether it modulates sperm Ca(2+) channels. In the present study we analyzed the effects of CaM antagonists W7 and trifluoroperazine on voltage-dependent T-type Ca(2+) currents in mouse spermatogenic cells and on the zona pellucida-induced AR in sperm. We found that these CaM antagonists decreased T-currents in a concentration-dependent manner with IC(50) values of approximately 10 and approximately 12 microM, respectively. W7 altered the channels' voltage dependence of activation and slowed both activation and inactivation kinetics. It also induced inactivation at voltages at which T-channels are not activated, suggesting a promotion of inactivation from the closed state. Consistent with this, W7 inhibited the ZP-induced [Ca(2+)](i) transients in capacitated sperm. Likewise, W7 and TFP inhibited the AR with an IC(50) of approximately 10 microM. In contrast, inhibitors of CaM-dependent kinase II and protein kinase A, as well as a CaM-activated phosphatase, had no effect either on T-currents in spermatogenic cells or on the sperm AR. Together these results suggest a functional interaction between CaM and the sperm T-type Ca(2+) channel. They are also consistent with the involvement of T-channels in the AR.

Acrosome Reaction↗
PubMed2001

Biochemical and biophysical evidence for gamma 2 subunit association with neuronal voltage-activated Ca2+ channels.

A novel gene (Cacng2; gamma(2)) encoding a protein similar to the voltage-activated Ca(2+) channel gamma(1) subunit was identified as the defective gene in the epileptic and ataxic mouse, stargazer. In this study, we analyzed the association of this novel neuronal gamma(2) subunit with Ca(2+) channels of rabbit brain, and the function of the gamma(2) subunit in recombinant neuronal Ca(2+) channels expressed in Xenopus oocytes. Our results showed that the gamma(2) subunit and a closely related protein (called gamma(3)) co-sedimented and co-immunoprecipitated with neuronal Ca(2+) channel subunits in vivo. Electrophysiological analyses showed that gamma(2) co-expression caused a significant decrease in the current amplitude of both alpha(1B)(alpha(1)2.2)-class (36.8%) and alpha(1A)(alpha(1)2.1)-class (39.7%) Ca(2+) channels (alpha(1)beta(3)alpha(2)delta). Interestingly, the inhibitory effects of the gamma(2) subunit on current amplitude were dependent on the co-expression of the alpha(2)delta subunit. In addition, co-expression of gamma(2) or gamma(1) also significantly decelerates the activation kinetics of alpha(1B)-class Ca(2+) channels. Taken together, these results suggest that the gamma(2) subunit is an important constituent of the neuronal Ca(2+) channel complex and that it down-regulates neuronal Ca(2+) channel activity. Furthermore, the gamma(2) subunit likely contributes to the fine-tuning of neuronal Ca(2+) channels by counterbalancing the effects of the alpha(2)delta subunit.

Animals↗
PubMed2001

Inwardly rectifying K(+) channels in spermatogenic cells: functional expression and implication in sperm capacitation.

To fertilize, mammalian sperm must complete a maturational process called capacitation. It is thought that the membrane potential of sperm hyperpolarizes during capacitation, possibly due to the opening of K(+) channels, but electrophysiological evidence is lacking. In this report, using patch-clamp recordings obtained from isolated mouse spermatogenic cells we document the presence of a novel K(+)-selective inwardly rectifying current. Macroscopic current activated at membrane potentials below the equilibrium potential for K(+) and its magnitude was dependent on the external K(+) concentration. The channels selected K(+) over other monovalent cations. Current was virtually absent when external K(+) was replaced with Na(+) or N-methyl-D-glucamine. Addition of Cs(+) or Ba(2+) (IC(50) of approximately 15 microM) to the external solution effectively blocked K(+) current. Dialyzing the cells with a Mg(2+)-free solution did not affect channel activity. Cytosolic acidification reversibly inhibited the current. We verified that the resting membrane potential of mouse sperm changed from -52 +/- 6 to -66 +/- 9 mV during capacitation in vitro. Notably, application of 0.3-1 mM Ba(2+) during capacitation prevented this hyperpolarization and decreased the subsequent exocytotic response to zona pellucida. A mechanism is proposed whereby opening of inwardly rectifying K(+) channels may produce hyperpolarization under physiological conditions and contribute to the cellular changes that give rise to the capacitated state in mature sperm.

Animals↗