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Kunzelmann M, Wittmann A, Nold V, Presser B, Schreiber J, Gehrig T, Sadlers S, Scholz R, Solzin J, Berger A, Eppler K. Functional design of experiment for potency assay optimization and in-silico simulation. J Pharm Biomed Anal 2023; 234:115584. [PMID: 37481901 DOI: 10.1016/j.jpba.2023.115584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/20/2023] [Accepted: 07/14/2023] [Indexed: 07/25/2023]
Abstract
For biotherapeutic analytics, robust and reliable potency assays are required. Design of experiment (DoE) approaches are used to investigate the impact of multiple assay parameters. Currently, specific assay features (e.g., half effective concentration) are modelled independently from each other. A joint interpretation of several assay features is thus difficult. In our functional DoE approach, we use the functional relationship of the assay features to describe the sigmoidal dose-response curve. With the composed functional form, the direct impact of assay parameters on the dose-response curve shape was modelled. Moreover, a multivariate desirability was defined and used for assay optimization. We believe that functional modelling contributes to understanding the joint influence of assay parameters and helps to design robust biotherapeutic analytics.
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Affiliation(s)
- Marco Kunzelmann
- Analytical Development Biologicals, Boehringer Ingelheim Pharma GmbH & Co KG, Birkendorfer Straße 65, 88397 Biberach an der Riß, Germany.
| | - Anja Wittmann
- Analytical Development Biologicals, Boehringer Ingelheim Pharma GmbH & Co KG, Birkendorfer Straße 65, 88397 Biberach an der Riß, Germany
| | - Verena Nold
- Analytical Development Biologicals, Boehringer Ingelheim Pharma GmbH & Co KG, Birkendorfer Straße 65, 88397 Biberach an der Riß, Germany
| | - Beate Presser
- Analytical Development Biologicals, Boehringer Ingelheim Pharma GmbH & Co KG, Birkendorfer Straße 65, 88397 Biberach an der Riß, Germany
| | - Jasmin Schreiber
- Analytical Development Biologicals, Boehringer Ingelheim Pharma GmbH & Co KG, Birkendorfer Straße 65, 88397 Biberach an der Riß, Germany
| | - Tanja Gehrig
- Analytical Development Biologicals, Boehringer Ingelheim Pharma GmbH & Co KG, Birkendorfer Straße 65, 88397 Biberach an der Riß, Germany
| | - Sabine Sadlers
- Analytical Development Biologicals, Boehringer Ingelheim Pharma GmbH & Co KG, Birkendorfer Straße 65, 88397 Biberach an der Riß, Germany
| | - Reinhard Scholz
- Analytical Development Biologicals, Boehringer Ingelheim Pharma GmbH & Co KG, Birkendorfer Straße 65, 88397 Biberach an der Riß, Germany
| | - Johannes Solzin
- Virus Therapeutics Center, Boehringer Ingelheim Pharma GmbH & Co KG, Birkendorfer Straße 65, 88397 Biberach an der Riß, Germany
| | - Alexander Berger
- Analytical Development Biologicals, Boehringer Ingelheim Pharma GmbH & Co KG, Birkendorfer Straße 65, 88397 Biberach an der Riß, Germany
| | - Karoline Eppler
- Analytical Development Biologicals, Boehringer Ingelheim Pharma GmbH & Co KG, Birkendorfer Straße 65, 88397 Biberach an der Riß, Germany.
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2
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Al Halabi KT, Sievers P, Stichel D, Sommerkamp AC, Sill M, Jäger N, Wittmann A, Kramm C, Snuderl M, Pfister SM, von Deimling A, Sahm F, Jones DTW. OS11.5.A PATZ1 fusions define a novel molecularly distinct CNS tumor entity with a broad histological spectrum. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
DNA methylation profiling has emerged as a useful tool for robust classification of rare CNS tumors with a broad morphological spectrum. Routine diagnostic molecular profiling performed in Heidelberg and at international collaborating centers revealed a small but recurring number of CNS tumors with fusions of the PATZ1 gene coupled to either MN1 or EWSR1, displaying a distinct genome-wide methylation profile; indicating that these tumors could form a seperate biological entity.
MATERIAL AND METHODS
We obtained genome-wide DNA-methylation array profiling of 68 primary CNS tumors. RNA-sequencing was perfomed on (n=23/68, 34%) of the tumor samples, including (n=6) from fresh frozen tissue used for gene expression profiling. For n=3 cases, whole exome sequencing (WES) data was generated, and gene panel sequencing data was available for n=13 cases, We systematically reevaluated the histopahthological features of 14 tumors, while immunohistochemical (IHC) staining with Ki-67, GFAP, MAP2, NeuN, Olig-2, Synaptophysin, S-100 and Vimentin was performed for (n=12) tumors. We finally collected clinical data to preliminarily characterize this novel tumor entity.
RESULTS
A selected analysis of the tumors in this novel cohort (n=68), compared with a reference cohort consisting of 15 other low- and high-grade glial and glioneuronal tumor classes, confirmed a clearly distinct grouping. No similarity was seen with the MN1:BEND2 and MN1:CXXC5-fused CNS-tumors. Analysis of Copy number profiles derived from the DNA-methylation data showed a mostly quite genome, with (n=64/65, 98%) of tumors showing copy number variations on Chromosome 22. RNA-sequencing detected PATZ1 fusions in all tumors sequenced (n=12; MN1:PATZ1, n=11; EWSR1:PATZ1). IGF2, PAX2 and GATA2, all genes involved in brain stem cell biology, were upregulated compared to a combined reference cohort of other glioma subtypes. DNA-sequencing showed no relevant alterations at the level of point mutations or small insertions/deletions. The tumors in our cohort showed polyphenotypic histologies along the glial spectrum, with a subset of tumors being diagnosed as Gliobastoma, WHO Grade 4 and bi- and multiphasic differentaion patterns being evident. IHC performed on tissue available did not favor a particular lineage, with most tumors showing immunopositivity to GFAP. Reverse translation of the gene expression data showed a potential role for NG2 as immunostaining marker. The median age was 11.0 years (0–80), (MN1:PATZ1 manifested at a younger age (median = 4 years) vs EWSR1:PATZ1 (median = 14 years)). Median PFS was 12 months.
CONCLUSION
We describe here a novel, molecularly distinct CNS tumor class with strikingly variable histopathologic morphology. We postulate that the PATZ1 fusions are a key driver of tumor initiation. Preliminary indications suggest an intermediate prognosis.
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Affiliation(s)
- K T Al Halabi
- Hopp Children’s Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Pediatric Glioma Research Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - P Sievers
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - D Stichel
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A C Sommerkamp
- Hopp Children’s Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Pediatric Glioma Research Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - M Sill
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - N Jäger
- Hopp Children’s Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A Wittmann
- Hopp Children’s Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Pediatric Glioma Research Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - C Kramm
- Division of Pediatric Hematology and Oncology, University Medical Center Göttingen, Göttingen, Germany
| | - M Snuderl
- Division of Neuropathology, NYU Langone Health, New York, NY, United States
| | - S M Pfister
- Hopp Children’s Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology and Immunology, Heidelberg University Hospital, Heidelberg, Germany
| | - A von Deimling
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - F Sahm
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - D T W Jones
- Hopp Children’s Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Pediatric Glioma Research Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
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3
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Deng MY, Sill M, Sturm D, Stichel D, Witt H, Ecker J, Wittmann A, Schittenhelm J, Ebinger M, Schuhmann MU, Figarella-Branger D, Aronica E, Staszewski O, Preusser M, Haberler C, Lauten M, Schüller U, Hartmann C, Snuderl M, Dunham C, Jabado N, Wesseling P, Deckert M, Keyvani K, Gottardo N, Giangaspero F, von Hoff K, Ellison DW, Pietsch T, Herold-Mende C, Milde T, Witt O, Kool M, Korshunov A, Wick W, von Deimling A, Pfister SM, Jones DTW, Sahm F. Diffuse glioneuronal tumour with oligodendroglioma-like features and nuclear clusters (DGONC) - a molecularly defined glioneuronal CNS tumour class displaying recurrent monosomy 14. Neuropathol Appl Neurobiol 2020; 46:422-430. [PMID: 31867747 DOI: 10.1111/nan.12590] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 12/17/2022]
Abstract
AIMS DNA methylation-based central nervous system (CNS) tumour classification has identified numerous molecularly distinct tumour types, and clinically relevant subgroups among known CNS tumour entities that were previously thought to represent homogeneous diseases. Our study aimed at characterizing a novel, molecularly defined variant of glioneuronal CNS tumour. PATIENTS AND METHODS DNA methylation profiling was performed using the Infinium MethylationEPIC or 450 k BeadChip arrays (Illumina) and analysed using the 'conumee' package in R computing environment. Additional gene panel sequencing was also performed. Tumour samples were collected at the German Cancer Research Centre (DKFZ) and provided by multinational collaborators. Histological sections were also collected and independently reviewed. RESULTS Genome-wide DNA methylation data from >25 000 CNS tumours were screened for clusters separated from established DNA methylation classes, revealing a novel group comprising 31 tumours, mainly found in paediatric patients. This DNA methylation-defined variant of low-grade CNS tumours with glioneuronal differentiation displays recurrent monosomy 14, nuclear clusters within a morphology that is otherwise reminiscent of oligodendroglioma and other established entities with clear cell histology, and a lack of genetic alterations commonly observed in other (paediatric) glioneuronal entities. CONCLUSIONS DNA methylation-based tumour classification is an objective method of assessing tumour origins, which may aid in diagnosis, especially for atypical cases. With increasing sample size, methylation analysis allows for the identification of rare, putative new tumour entities, which are currently not recognized by the WHO classification. Our study revealed the existence of a DNA methylation-defined class of low-grade glioneuronal tumours with recurrent monosomy 14, oligodendroglioma-like features and nuclear clusters.
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Affiliation(s)
- M Y Deng
- Hopp Children's Cancer Center Heidelberg (KiTZ), University Hospital Heidelberg, Heidelberg, Germany.,Junior Research Group Pediatric Glioma Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - M Sill
- Hopp Children's Cancer Center Heidelberg (KiTZ), University Hospital Heidelberg, Heidelberg, Germany.,Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany
| | - D Sturm
- Hopp Children's Cancer Center Heidelberg (KiTZ), University Hospital Heidelberg, Heidelberg, Germany.,Junior Research Group Pediatric Glioma Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Pediatric Oncology, Hematology and Immunology, Hopp Children's Cancer Center (KiTZ), University Hospital Heidelberg, Heidelberg, Germany
| | - D Stichel
- Department of Neuropathology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - H Witt
- Hopp Children's Cancer Center Heidelberg (KiTZ), University Hospital Heidelberg, Heidelberg, Germany.,Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany.,Department of Pediatric Oncology, Hematology and Immunology, Hopp Children's Cancer Center (KiTZ), University Hospital Heidelberg, Heidelberg, Germany
| | - J Ecker
- Hopp Children's Cancer Center Heidelberg (KiTZ), University Hospital Heidelberg, Heidelberg, Germany.,Department of Pediatric Oncology, Hematology and Immunology, Hopp Children's Cancer Center (KiTZ), University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Pediatric Oncology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
| | - A Wittmann
- Hopp Children's Cancer Center Heidelberg (KiTZ), University Hospital Heidelberg, Heidelberg, Germany.,Junior Research Group Pediatric Glioma Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - J Schittenhelm
- Department of Neuropathology, Institute of Pathology and Neuropathology and Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital of Tübingen, Tübingen, Germany
| | - M Ebinger
- Department of Pediatric Hematology/Oncology, Children's University Hospital, Tübingen, Germany
| | - M U Schuhmann
- Department of Neurosurgery, Division of Pediatric Neurosurgery, University Hospital Tübingen, Tübingen, Germany
| | - D Figarella-Branger
- Inst Neurophysiopathol, CHU Timone, Service d'Anatomie Pathologique et de Neuropathologie, Aix Marseille Univ, APHM, CNRS, INP, Marseille, France
| | - E Aronica
- Department of (Neuro)Pathology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - O Staszewski
- Institute of Neuropathology, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - M Preusser
- Clinical Division of Oncology, Department of Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria
| | - C Haberler
- Institute of Neurology, Comprehensive Cancer Centre Vienna, Medical University of Vienna, Vienna, Austria
| | - M Lauten
- Department of Paediatrics, Paediatric Haematology and Oncology, University of Lübeck, Lübeck, Germany
| | - U Schüller
- Department of Paediatric Haematology and Oncology and Institute of Neuropathology, University Medical Centre Hamburg-Eppendorf, Research Institute at the Children's Cancer Centre Hamburg, Hamburg, Germany
| | - C Hartmann
- Department of Neuropathology, Institute of Pathology, Hannover Medical School (MHH), Hannover, Germany
| | - M Snuderl
- Department of Pathology, Division of Neuropathology, NYUSoM, New York, NY, USA
| | - C Dunham
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - N Jabado
- Department of Human Genetics, McGill University, Montreal, QC, Canada.,Department of Pediatrics, McGill University, McGill University Heath Centre Research Institute, Montreal, QC, Canada
| | - P Wesseling
- Department of Pathology, Amsterdam Universities Medical Centers/VUmc, Brain Tumor Center Amsterdam University Medical Center, Amsterdam, The.,Princess Máxima Center for Pediatric Oncology, Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M Deckert
- Institute of Neuropathology, University Hospital of Cologne, Cologne, Germany
| | - K Keyvani
- Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany
| | - N Gottardo
- Telethon Kids Institute, Perth, WA, Australia.,Centre for Child Health Research, University of Western Australia, Perth, WA, Australia.,Department of Oncology, Princess Margaret Hospital, Perth, WA, Australia
| | - F Giangaspero
- Department of Radiological, Oncological and Anatomo-Pathological Science, Sapienza University of Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli (Is), Italy
| | - K von Hoff
- Department of Paediatric Haematology and Oncology, Charité-Universitätsmedizin, Berlin, Germany
| | - D W Ellison
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - T Pietsch
- Institute of Neuropathology, Brain Tumor Reference Center of the Society for Neuropathology and Neuroanatomy, University of Bonn Medical Center, Bonn, Germany
| | - C Herold-Mende
- Division of Experimental Neurosurgery, Department of Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany
| | - T Milde
- Hopp Children's Cancer Center Heidelberg (KiTZ), University Hospital Heidelberg, Heidelberg, Germany.,Department of Pediatric Oncology, Hematology and Immunology, Hopp Children's Cancer Center (KiTZ), University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Pediatric Oncology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
| | - O Witt
- Hopp Children's Cancer Center Heidelberg (KiTZ), University Hospital Heidelberg, Heidelberg, Germany.,Department of Pediatric Oncology, Hematology and Immunology, Hopp Children's Cancer Center (KiTZ), University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Pediatric Oncology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
| | - M Kool
- Hopp Children's Cancer Center Heidelberg (KiTZ), University Hospital Heidelberg, Heidelberg, Germany.,Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany
| | - A Korshunov
- Department of Neuropathology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - W Wick
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Neurooncology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
| | - A von Deimling
- Department of Neuropathology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - S M Pfister
- Hopp Children's Cancer Center Heidelberg (KiTZ), University Hospital Heidelberg, Heidelberg, Germany.,Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany.,Department of Pediatric Oncology, Hematology and Immunology, Hopp Children's Cancer Center (KiTZ), University Hospital Heidelberg, Heidelberg, Germany
| | - D T W Jones
- Hopp Children's Cancer Center Heidelberg (KiTZ), University Hospital Heidelberg, Heidelberg, Germany.,Junior Research Group Pediatric Glioma Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - F Sahm
- Hopp Children's Cancer Center Heidelberg (KiTZ), University Hospital Heidelberg, Heidelberg, Germany.,Department of Neuropathology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
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4
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Lueken U, Kuhn M, Yang Y, Straube B, Kircher T, Wittchen HU, Pfleiderer B, Arolt V, Wittmann A, Ströhle A, Weber H, Reif A, Domschke K, Deckert J, Lonsdorf TB. Modulation of defensive reactivity by GLRB allelic variation: converging evidence from an intermediate phenotype approach. Transl Psychiatry 2017; 7:e1227. [PMID: 28872638 PMCID: PMC5639239 DOI: 10.1038/tp.2017.186] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 06/07/2017] [Accepted: 07/04/2017] [Indexed: 01/20/2023] Open
Abstract
Representing a phylogenetically old and very basic mechanism of inhibitory neurotransmission, glycine receptors have been implicated in the modulation of behavioral components underlying defensive responding toward threat. As one of the first findings being confirmed by genome-wide association studies for the phenotype of panic disorder and agoraphobia, allelic variation in a gene coding for the glycine receptor beta subunit (GLRB) has recently been associated with increased neural fear network activation and enhanced acoustic startle reflexes. On the basis of two independent healthy control samples, we here aimed to further explore the functional significance of the GLRB genotype (rs7688285) by employing an intermediate phenotype approach. We focused on the phenotype of defensive system reactivity across the levels of brain function, structure, and physiology. Converging evidence across both samples was found for increased neurofunctional activation in the (anterior) insular cortex in GLRB risk allele carriers and altered fear conditioning as a function of genotype. The robustness of GLRB effects is demonstrated by consistent findings across different experimental fear conditioning paradigms and recording sites. Altogether, findings provide translational evidence for glycine neurotransmission as a modulator of the brain's evolutionary old dynamic defensive system and provide further support for a strong, biologically plausible candidate intermediate phenotype of defensive reactivity. As such, glycine-dependent neurotransmission may open up new avenues for mechanistic research on the etiopathogenesis of fear and anxiety disorders.
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Affiliation(s)
- U Lueken
- Center of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - M Kuhn
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Y Yang
- Department of Psychiatry and Psychotherapy, Phillips-University Marburg, Marburg, Germany
| | - B Straube
- Department of Psychiatry and Psychotherapy, Phillips-University Marburg, Marburg, Germany
| | - T Kircher
- Department of Psychiatry and Psychotherapy, Phillips-University Marburg, Marburg, Germany
| | - H-U Wittchen
- Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - B Pfleiderer
- Department of Clinical Radiology, University Hospital Münster, Münster, Germany
| | - V Arolt
- Department of Psychiatry, University Hospital Münster, Münster, Germany
| | - A Wittmann
- Department of Psychiatry and Psychotherapy, Charité - University Medicine Berlin, Berlin, Germany
| | - A Ströhle
- Department of Psychiatry and Psychotherapy, Charité - University Medicine Berlin, Berlin, Germany
| | - H Weber
- Center of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - A Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - K Domschke
- Center of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - J Deckert
- Center of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - T B Lonsdorf
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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5
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Donovan C, Heyer A, Pfeifer E, Polen T, Wittmann A, Krämer R, Frunzke J, Bramkamp M. A prophage-encoded actin-like protein required for efficient viral DNA replication in bacteria. Nucleic Acids Res 2015; 43:5002-16. [PMID: 25916847 PMCID: PMC4446434 DOI: 10.1093/nar/gkv374] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 04/09/2015] [Indexed: 12/31/2022] Open
Abstract
In host cells, viral replication is localized at specific subcellular sites. Viruses that infect eukaryotic and prokaryotic cells often use host-derived cytoskeletal structures, such as the actin skeleton, for intracellular positioning. Here, we describe that a prophage, CGP3, integrated into the genome of Corynebacterium glutamicum encodes an actin-like protein, AlpC. Biochemical characterization confirms that AlpC is a bona fide actin-like protein and cell biological analysis shows that AlpC forms filamentous structures upon prophage induction. The co-transcribed adaptor protein, AlpA, binds to a consensus sequence in the upstream promoter region of the alpAC operon and also interacts with AlpC, thus connecting circular phage DNA to the actin-like filaments. Transcriptome analysis revealed that alpA and alpC are among the early induced genes upon excision of the CGP3 prophage. Furthermore, qPCR analysis of mutant strains revealed that both AlpA and AlpC are required for efficient phage replication. Altogether, these data emphasize that AlpAC are crucial for the spatio-temporal organization of efficient viral replication. This is remarkably similar to actin-assisted membrane localization of eukaryotic viruses that use the actin cytoskeleton to concentrate virus particles at the egress sites and provides a link of evolutionary conserved interactions between intracellular virus transport and actin.
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Affiliation(s)
- Catriona Donovan
- Department of Biology I, Ludwig-Maximilians-University Munich, Großhaderner Str. 2-4, 82152 Planegg-Martinsried, Germany Institute for Biochemistry, University of Cologne, Zülpicherstr. 47, 50674 Cologne, Germany
| | - Antonia Heyer
- Institut für Bio- und Geowissenschaften, IBG-1: Biotechnologie, Forschungszentrum Jülich, D-52425 Jülich, Germany
| | - Eugen Pfeifer
- Institut für Bio- und Geowissenschaften, IBG-1: Biotechnologie, Forschungszentrum Jülich, D-52425 Jülich, Germany
| | - Tino Polen
- Institut für Bio- und Geowissenschaften, IBG-1: Biotechnologie, Forschungszentrum Jülich, D-52425 Jülich, Germany
| | - Anja Wittmann
- Institute for Biochemistry, University of Cologne, Zülpicherstr. 47, 50674 Cologne, Germany
| | - Reinhard Krämer
- Institute for Biochemistry, University of Cologne, Zülpicherstr. 47, 50674 Cologne, Germany
| | - Julia Frunzke
- Institut für Bio- und Geowissenschaften, IBG-1: Biotechnologie, Forschungszentrum Jülich, D-52425 Jülich, Germany
| | - Marc Bramkamp
- Department of Biology I, Ludwig-Maximilians-University Munich, Großhaderner Str. 2-4, 82152 Planegg-Martinsried, Germany Institute for Biochemistry, University of Cologne, Zülpicherstr. 47, 50674 Cologne, Germany
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6
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Straube B, Reif A, Richter J, Lueken U, Weber H, Arolt V, Jansen A, Zwanzger P, Domschke K, Pauli P, Konrad C, Gerlach AL, Lang T, Fydrich T, Alpers GW, Ströhle A, Wittmann A, Pfleiderer B, Wittchen HU, Hamm A, Deckert J, Kircher T. The functional -1019C/G HTR1A polymorphism and mechanisms of fear. Transl Psychiatry 2014; 4:e490. [PMID: 25514753 PMCID: PMC4270311 DOI: 10.1038/tp.2014.130] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 10/23/2014] [Accepted: 10/26/2014] [Indexed: 01/01/2023] Open
Abstract
Serotonin receptor 1A gene (HTR1A) knockout mice show pronounced defensive behaviour and increased fear conditioning to ambiguous conditioned stimuli. Such behaviour is a hallmark of pathological human anxiety, as observed in panic disorder with agoraphobia (PD/AG). Thus, variations in HTR1A might contribute to neurophysiological differences within subgroups of PD/AG patients. Here, we tested this hypothesis by combining genetic with behavioural techniques and neuroimaging. In a clinical multicentre trial, patients with PD/AG received 12 sessions of manualized cognitive-behavioural therapy (CBT) and were genotyped for HTR1A rs6295. In four subsamples of this multicentre trial, exposure behaviour (n=185), defensive reactivity measured using a behavioural avoidance test (BAT; before CBT: n=245; after CBT: n=171) and functional magnetic resonance imaging (fMRI) data during fear conditioning were acquired before and after CBT (n=39). HTR1A risk genotype (GG) carriers more often escaped during the BAT before treatment. Exploratory fMRI results suggest increased activation of the amygdala in response to threat as well as safety cues before and after treatment in GG carriers. Furthermore, GG carriers demonstrated reduced effects of CBT on differential conditioning in regions including the bilateral insulae and the anterior cingulate cortex. Finally, risk genotype carriers demonstrated reduced self-initiated exposure behaviour to aversive situations. This study demonstrates the effect of HTR1A variation on defensive behaviour, amygdala activity, CBT-induced neural plasticity and normalization of defence behaviour in PD/AG. Our results, therefore, translate evidence from animal studies to humans and suggest a central role for HTR1A in differentiating subgroups of patients with anxiety disorders.
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Affiliation(s)
- B Straube
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany,Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Strasse 8, 35039 Marburg, Germany. E-mail:
| | - A Reif
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - J Richter
- Department of Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany
| | - U Lueken
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - H Weber
- Department of Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany
| | - V Arolt
- Department of Psychiatry, University of Münster, Münster, Germany
| | - A Jansen
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - P Zwanzger
- Department of Psychiatry, University of Münster, Münster, Germany
| | - K Domschke
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - P Pauli
- Department of Psychology, University of Würzburg, Würzburg, Germany
| | - C Konrad
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany,Department of Psychiatry, University of Münster, Münster, Germany
| | - A L Gerlach
- Department of Psychology, University of Cologne, Cologne, Germany
| | - T Lang
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany,University of Bremen and Christoph-Dornier Foundation for Clinical Psychology, Bremen, Germany
| | - T Fydrich
- Department of Psychology, Humboldt University, Berlin, Germany
| | - G W Alpers
- Department of Psychology, Clinical and Biological Psychology, School of Social Sciences, Mannheim, Germany
| | - A Ströhle
- Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - A Wittmann
- Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - B Pfleiderer
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - H-U Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - A Hamm
- Department of Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany
| | - J Deckert
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - T Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
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Wittmann A, Schlagenhauf F, Guhn A, Lueken U, Gaehlsdorf C, Stoy M, Bermpohl F, Fydrich T, Pfleiderer B, Bruhn H, Gerlach AL, Kircher T, Straube B, Wittchen HU, Arolt V, Heinz A, Ströhle A. Anticipating agoraphobic situations: the neural correlates of panic disorder with agoraphobia. Psychol Med 2014; 44:2385-2396. [PMID: 24398049 DOI: 10.1017/s0033291713003085] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Panic disorder with agoraphobia is characterized by panic attacks and anxiety in situations where escape might be difficult. However, neuroimaging studies specifically focusing on agoraphobia are rare. Here we used functional magnetic resonance imaging (fMRI) with disorder-specific stimuli to investigate the neural substrates of agoraphobia. METHOD We compared the neural activations of 72 patients suffering from panic disorder with agoraphobia with 72 matched healthy control subjects in a 3-T fMRI study. To isolate agoraphobia-specific alterations we tested the effects of the anticipation and perception of an agoraphobia-specific stimulus set. During fMRI, 48 agoraphobia-specific and 48 neutral pictures were randomly presented with and without anticipatory stimulus indicating the content of the subsequent pictures (Westphal paradigm). RESULTS During the anticipation of agoraphobia-specific pictures, stronger activations were found in the bilateral ventral striatum and left insula in patients compared with controls. There were no group differences during the perception phase of agoraphobia-specific pictures. CONCLUSIONS This study revealed stronger region-specific activations in patients suffering from panic disorder with agoraphobia in anticipation of agoraphobia-specific stimuli. Patients seem to process these stimuli more intensively based on individual salience. Hyperactivation of the ventral striatum and insula when anticipating agoraphobia-specific situations might be a central neurofunctional correlate of agoraphobia. Knowledge about the neural correlates of anticipatory and perceptual processes regarding agoraphobic situations will help to optimize and evaluate treatments, such as exposure therapy, in patients with panic disorder and agoraphobia.
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Affiliation(s)
- A Wittmann
- Department of Psychiatry and Psychotherapy,Charité University Medicine Berlin,Germany
| | - F Schlagenhauf
- Department of Psychiatry and Psychotherapy,Charité University Medicine Berlin,Germany
| | - A Guhn
- Department of Psychiatry, Psychosomatics and Psychotherapy,University of Wuerzburg,Wuerzburg,Germany
| | - U Lueken
- Institute of Clinical Psychology and Psychotherapy,Technische Universität Dresden,Dresden,Germany
| | - C Gaehlsdorf
- Department of Psychiatry and Psychotherapy,Charité University Medicine Berlin,Germany
| | - M Stoy
- Department of Psychiatry and Psychotherapy,Charité University Medicine Berlin,Germany
| | - F Bermpohl
- Department of Psychiatry and Psychotherapy,Charité University Medicine Berlin,Germany
| | - T Fydrich
- Institute of Psychology,Psychotherapy and Somatopsychology - Humboldt Universität zu Berlin,Germany
| | - B Pfleiderer
- Department of Clinical Radiology,University of Münster,Münster,Germany
| | - H Bruhn
- Department of Radiology,University of Jena,Jena,Germany
| | - A L Gerlach
- Department of Psychology,University of Cologne,Cologne,Germany
| | - T Kircher
- Department of Psychiatry and Psychotherapy,Philipps-University Marburg,Marburg,Germany
| | - B Straube
- Department of Psychiatry and Psychotherapy,Philipps-University Marburg,Marburg,Germany
| | - H-U Wittchen
- Institute of Clinical Psychology and Psychotherapy,Technische Universität Dresden,Dresden,Germany
| | - V Arolt
- Department of Psychiatry,University of Münster,Münster,Germany
| | - A Heinz
- Department of Psychiatry and Psychotherapy,Charité University Medicine Berlin,Germany
| | - A Ströhle
- Department of Psychiatry and Psychotherapy,Charité University Medicine Berlin,Germany
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Marincic M, Wittmann A, Manhart J, Gruber C, Sartor D, Geiss I. Intensivpflichtige Hyponatriämie nach Fehldosierung von Desmopressin. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1374747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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9
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Becker M, Maximov S, Becker M, Meyer U, Wittmann A, Krämer R. Analysis of putative protomer crosstalk in the trimeric transporter BetP: The heterotrimer approach. Biochim Biophys Acta 2014; 1837:888-98. [PMID: 24637177 DOI: 10.1016/j.bbabio.2014.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 02/11/2014] [Accepted: 03/05/2014] [Indexed: 12/19/2022]
Abstract
The homotrimeric, secondary active betaine carrier BetP from Corynebacterium glutamicum is a model system for stress-regulated transport in bacteria. Its activity responds to hyperosmotic stress and it harbors two different functions, transport catalysis (betaine uptake) and stimulus sensing, resp. activity regulation. Structural information from 2D and 3D crystals as well as functional analysis of monomerized BetP suggested the presence of conformational crosstalk between the individual protomers. To study whether the oligomeric state is functionally significant on a mechanistic level we generated heterooligomeric complexes of BetP in which single protomers within the trimer can be addressed. By testing dominant negative effects in a trimer of one active protomer combined with two protomers in which transport and regulation were abolished, we provide experimental evidence for the absence of functionally significant conformational crosstalk between the protomers on the level of both transport and regulation. This is supported by experiments using mutant forms of putative interacting signal donor and acceptor domains of individual BetP protomers. This result has important consequences for oligomeric transport proteins in general and BetP in particular.
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Affiliation(s)
- Markus Becker
- Institute of Biochemistry, University of Cologne, 50674 Cologne, Germany
| | - Stanislav Maximov
- Institute of Biochemistry, University of Cologne, 50674 Cologne, Germany
| | - Michael Becker
- Institute of Biochemistry, University of Cologne, 50674 Cologne, Germany
| | - Ute Meyer
- Institute of Biochemistry, University of Cologne, 50674 Cologne, Germany
| | - Anja Wittmann
- Institute of Biochemistry, University of Cologne, 50674 Cologne, Germany
| | - Reinhard Krämer
- Institute of Biochemistry, University of Cologne, 50674 Cologne, Germany.
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10
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Lueken U, Straube B, Reinhardt I, Maslowski NI, Wittchen HU, Ströhle A, Wittmann A, Pfleiderer B, Konrad C, Ewert A, Uhlmann C, Arolt V, Jansen A, Kircher T. Altered top-down and bottom-up processing of fear conditioning in panic disorder with agoraphobia. Psychol Med 2014; 44:381-394. [PMID: 23611156 DOI: 10.1017/s0033291713000792] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Although several neurophysiological models have been proposed for panic disorder with agoraphobia (PD/AG), there is limited evidence from functional magnetic resonance imaging (fMRI) studies on key neural networks in PD/AG. Fear conditioning has been proposed to represent a central pathway for the development and maintenance of this disorder; however, its neural substrates remain elusive. The present study aimed to investigate the neural correlates of fear conditioning in PD/AG patients. METHOD The blood oxygen level-dependent (BOLD) response was measured using fMRI during a fear conditioning task. Indicators of differential conditioning, simple conditioning and safety signal processing were investigated in 60 PD/AG patients and 60 matched healthy controls. RESULTS Differential conditioning was associated with enhanced activation of the bilateral dorsal inferior frontal gyrus (IFG) whereas simple conditioning and safety signal processing were related to increased midbrain activation in PD/AG patients versus controls. Anxiety sensitivity was associated positively with the magnitude of midbrain activation. CONCLUSIONS The results suggest changes in top-down and bottom-up processes during fear conditioning in PD/AG that can be interpreted within a neural framework of defensive reactions mediating threat through distal (forebrain) versus proximal (midbrain) brain structures. Evidence is accumulating that this network plays a key role in the aetiopathogenesis of panic disorder.
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Affiliation(s)
- U Lueken
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany
| | - B Straube
- Department of Psychiatry and Psychotherapy, Philipps University Marburg, Germany
| | - I Reinhardt
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Germany
| | - N I Maslowski
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany
| | - H-U Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany
| | - A Ströhle
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Germany
| | - A Wittmann
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Germany
| | - B Pfleiderer
- Department of Clinical Radiology, University of Münster, Germany
| | - C Konrad
- Department of Psychiatry and Psychotherapy, Philipps University Marburg, Germany
| | - A Ewert
- Department of Clinical Radiology, University of Münster, Germany
| | - C Uhlmann
- Department of Psychiatry and Psychotherapy, University of Münster, Germany
| | - V Arolt
- Department of Psychiatry and Psychotherapy, University of Münster, Germany
| | - A Jansen
- Department of Psychiatry and Psychotherapy, Philipps University Marburg, Germany
| | - T Kircher
- Department of Psychiatry and Psychotherapy, Philipps University Marburg, Germany
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11
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Sotnikov SV, Wittmann A, Yen YC, Wotjak C, Landgraf R, Czibere L. Central glucocorticoid system dysfunction in a mouse model of extreme anxiety: clinical implications. Pharmacopsychiatry 2013. [DOI: 10.1055/s-0033-1353301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
This paper will examine the experience of Needle Stick Injuries (NSI) in Germany. There is evidence that these experiences have relevance for the whole of Europe. The protective measures described in this paper are important for the safety of all health care workers. This paper will describe incidents of NSI with reference to sero-conversion after the incident. The protection of health care workers is of prime importance and this paper will discuss the most successful methods of protection. The paper will examine briefly the cost of these protective measures.
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Affiliation(s)
- A Wittmann
- Bergische Universität Wuppertal, Germany.
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13
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Witzke HJ, Fuchs S, Schmitz E, Wittmann A, Kralj N, Vetter HO. Surgical glove perforation – Raising the bar for safety during cardiac surgery. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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14
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Wittmann A. WISE (Workshop on Injection Safety in Endocrinology) recommendations. Editorial. Diabetes Metab 2012; 38 Suppl 1:S1. [PMID: 22305438 DOI: 10.1016/s1262-3636(12)70974-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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15
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Witt H, Mack SC, Ryzhova M, Bender S, Sill M, Isserlin R, Benner A, Hielscher T, Milde T, Remke M, Jones DTW, Northcott PA, Garzia L, Bertrand KC, Wittmann A, Deimling AV, Kulozik AE, Witt O, Bader GD, Rutka JT, Lichter P, Korshunov A, Taylor MD, Pfister SM. Identification of Two Molecular and Clinical Distinct Entities of Posterior Fossa Ependymoma. Klin Padiatr 2011. [DOI: 10.1055/s-0031-1292598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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16
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Wittmann A, Schlagenhauf F, John T, Guhn A, Rehbein H, Siegmund A, Stoy M, Held D, Schulz I, Fehm L, Fydrich T, Heinz A, Bruhn H, Ströhle A. A new paradigm (Westphal-Paradigm) to study the neural correlates of panic disorder with agoraphobia. Eur Arch Psychiatry Clin Neurosci 2011; 261:185-94. [PMID: 21113608 DOI: 10.1007/s00406-010-0167-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2010] [Accepted: 10/28/2010] [Indexed: 11/24/2022]
Abstract
Agoraphobia (with and without panic disorder) is a highly prevalent and disabling anxiety disorder. Its neural complexity can be characterized by specific cues in fMRI studies. Therefore, we developed a fMRI paradigm with agoraphobia-specific stimuli. Pictures of potential agoraphobic situations were generated. Twenty-six patients, suffering from panic disorder and agoraphobia, and 22 healthy controls rated the pictures with respect to arousal, valence, and agoraphobia-related anxiety. The 96 pictures, which discriminated best between groups were chosen, split into two parallel sets and supplemented with matched neutral pictures from the International Affective Picture System. Reliability, criterion, and construct validity of the picture set were determined in a second sample (44 patients, 28 controls). The resulting event-related "Westphal-Paradigm" with cued and uncued pictures was tested in a fMRI pilot study with 16 patients. Internal consistency of the sets was very high; parallelism was given. Positive correlations of picture ratings with Mobility Inventory and Hamilton anxiety scores support construct validity. FMRI data revealed activations in areas associated with the fear circuit including amygdala, insula, and hippocampal areas. Psychometric properties of the Westphal-Paradigm meet necessary quality requirements for further scientific use. The paradigm reliably produces behavioral and fMRI patterns in response to agoraphobia-specific stimuli. To our knowledge, it is the first fMRI paradigm with these properties. This paradigm can be used to further characterize the functional neuroanatomy of panic disorder and agoraphobia and might be useful to contribute data to the differentiation of panic disorder and agoraphobia as related, but conceptually different clinical disorders.
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Affiliation(s)
- A Wittmann
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
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Kralj N, Wittmann A, Koever J, Gasthaus K, Hofman F. Study on blood contact in simulated surgical needle stick injuries with single or double latex gloving. Inj Prev 2010. [DOI: 10.1136/ip.2010.029215.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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18
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Mayr SI, Wittmann A, Burkhardt H, Popov Y, Romushkevich R, Bayuk I, Heidinger P, Wilhelm H. Integrated interpretation of physical properties of rocks of the borehole Yaxcopoil-1 (Chicxulub impact structure). ACTA ACUST UNITED AC 2008. [DOI: 10.1029/2007jb005420] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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19
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Pfister SM, Mendrzyk F, Korshunov A, Wittmann A, Toedt G, Benner A, Werft W, Kulozik A, Scheurlen W, Radlwimmer B, Lichter P. Molecular risk stratification in pediatric medulloblastoma. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.9506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9506 Background: Medulloblastoma is the most common malignant brain tumor and a significant cause of cancer mortality in children. Despite considerable therapeutic advances, prognosis remains poor, with a five-year-survival rate of about 60% emphasizing the urgent need for markers to allow for a more accurate tailoring of treatment intensity. Methods: We performed genome-wide analysis of DNA-copy number in 112 medulloblastomas using array-CGH. All patients had received craniospinal irradiation after surgery. Standard adjuvant chemotherapy with lomustine, cisplatin and vincristine or a regimen with equal potency had been administered to 73 patients. To identify novel prognostic markers, DNA copy number information was correlated with survival data using log rank and chi-square tests. For selected candidate genes identified by array-CGH, mRNA and protein expression were analyzed by real-time quantitative PCR, and immunohistochemically on tissue microarrays consisting of medulloblastomas from 189 patients. Results: Copy-number gains of chromosomes 6 and 17q, high-level amplifications of MYC and MYCN, and loss of 9p21.3 (CDKN2A locus) were identified as significant adverse prognostic markers; monosomy 6 was associated with good prognosis. Monosomy 6 and gain of 17q were mutually exclusive, whereas trisomy 6 almost always occurred in conjunction with 17q gain. Tumors with trisomy 6 and 17q gains exhibit strong up-regulation of MAP3K7 (chr. 6) and NLK (17q) mRNA, two key-enzymes of the non-canonical calcium-dependent Wnt-signaling pathway. Furthermore, this subgroup exclusively shows high mRNA-expression of several cancer-retina antigens (e.g. GNGT1, GNGT2, PDE6, RCV1, RDS and NRL). Tumors with monosomy 6, in contrast, display highly activated canonical Wnt signaling as indicated by nuclear protein expression of beta-catenin. Conclusions: We propose a model for the molecular risk stratification of medulloblastoma comprising five risk groups with significantly different survival using copy-number status of MYC, MYCN, and chromosomes 6 and 17q. Furthermore, we give evidence for a role of noncanonical calcium-dependent Wnt-signalling in medulloblastoma metastasis in a subset of tumors. Cancer-retina antigens could be used to facilitate the diagnosis and follow-up of this molecular subgroup. No significant financial relationships to disclose.
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Affiliation(s)
- S. M. Pfister
- German Cancer Research Center, Heidelberg, Germany; Burdenko Neurosurgical Institute, Moscow, Russian Federation; University of Heidelberg, Heidelberg, Germany; Cnopf'sche Kinderklinik, Nuernberg, Germany
| | - F. Mendrzyk
- German Cancer Research Center, Heidelberg, Germany; Burdenko Neurosurgical Institute, Moscow, Russian Federation; University of Heidelberg, Heidelberg, Germany; Cnopf'sche Kinderklinik, Nuernberg, Germany
| | - A. Korshunov
- German Cancer Research Center, Heidelberg, Germany; Burdenko Neurosurgical Institute, Moscow, Russian Federation; University of Heidelberg, Heidelberg, Germany; Cnopf'sche Kinderklinik, Nuernberg, Germany
| | - A. Wittmann
- German Cancer Research Center, Heidelberg, Germany; Burdenko Neurosurgical Institute, Moscow, Russian Federation; University of Heidelberg, Heidelberg, Germany; Cnopf'sche Kinderklinik, Nuernberg, Germany
| | - G. Toedt
- German Cancer Research Center, Heidelberg, Germany; Burdenko Neurosurgical Institute, Moscow, Russian Federation; University of Heidelberg, Heidelberg, Germany; Cnopf'sche Kinderklinik, Nuernberg, Germany
| | - A. Benner
- German Cancer Research Center, Heidelberg, Germany; Burdenko Neurosurgical Institute, Moscow, Russian Federation; University of Heidelberg, Heidelberg, Germany; Cnopf'sche Kinderklinik, Nuernberg, Germany
| | - W. Werft
- German Cancer Research Center, Heidelberg, Germany; Burdenko Neurosurgical Institute, Moscow, Russian Federation; University of Heidelberg, Heidelberg, Germany; Cnopf'sche Kinderklinik, Nuernberg, Germany
| | - A. Kulozik
- German Cancer Research Center, Heidelberg, Germany; Burdenko Neurosurgical Institute, Moscow, Russian Federation; University of Heidelberg, Heidelberg, Germany; Cnopf'sche Kinderklinik, Nuernberg, Germany
| | - W. Scheurlen
- German Cancer Research Center, Heidelberg, Germany; Burdenko Neurosurgical Institute, Moscow, Russian Federation; University of Heidelberg, Heidelberg, Germany; Cnopf'sche Kinderklinik, Nuernberg, Germany
| | - B. Radlwimmer
- German Cancer Research Center, Heidelberg, Germany; Burdenko Neurosurgical Institute, Moscow, Russian Federation; University of Heidelberg, Heidelberg, Germany; Cnopf'sche Kinderklinik, Nuernberg, Germany
| | - P. Lichter
- German Cancer Research Center, Heidelberg, Germany; Burdenko Neurosurgical Institute, Moscow, Russian Federation; University of Heidelberg, Heidelberg, Germany; Cnopf'sche Kinderklinik, Nuernberg, Germany
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20
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Wittmann A, Schroeer M, Bock C, Poertner H. Thermal tolerance in the lugworm Arenicola marina: Burrow irrigation and respiration. Comp Biochem Physiol A Mol Integr Physiol 2007. [DOI: 10.1016/j.cbpa.2007.01.525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Bendt AK, Beckers G, Silberbach M, Wittmann A, Burkovski A. Utilization of creatinine as an alternative nitrogen source in Corynebacterium glutamicum. Arch Microbiol 2004; 181:443-50. [PMID: 15148566 DOI: 10.1007/s00203-004-0679-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2004] [Revised: 04/13/2004] [Accepted: 04/20/2004] [Indexed: 11/30/2022]
Abstract
In order to utilize different nitrogen sources and to survive situations of nitrogen limitation, microorganisms have developed several mechanisms to adapt their metabolism to changes in the nitrogen supply. In this communication, the use of creatinine as an alternative nitrogen source in Corynebacterium glutamicum, the identification of a membrane protein involved in creatinine uptake, the transcriptional regulation of the corresponding gene, and expression regulation of the gene encoding the creatinine deaminase are reported. As shown by mutant analyses, RNA hybridization experiments and real-time PCR, the expression of two genes, crnT and codA, is increased in response to nitrogen limitation, and regulation depends on the global nitrogen regulator AmtR. In addition, synthesis of creatinine deaminase during nitrogen starvation was shown by two-dimensional gel electrophoresis and MALDI-TOF-MS followed by peptide mass fingerprint analysis.
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MESH Headings
- Adaptation, Physiological
- Aminohydrolases/analysis
- Aminohydrolases/genetics
- Aminohydrolases/metabolism
- Bacterial Proteins/analysis
- Bacterial Proteins/isolation & purification
- Bacterial Proteins/physiology
- Biological Transport
- Corynebacterium/genetics
- Corynebacterium/metabolism
- Creatinine/metabolism
- Cytoplasm/chemistry
- Electrophoresis, Gel, Two-Dimensional
- Gene Expression Regulation, Bacterial
- Genes, Bacterial
- Membrane Proteins/isolation & purification
- Membrane Proteins/metabolism
- Nitrogen Compounds/metabolism
- RNA, Bacterial/analysis
- RNA, Bacterial/isolation & purification
- RNA, Messenger/analysis
- RNA, Messenger/isolation & purification
- Repressor Proteins/physiology
- Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
- Transcription, Genetic
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Affiliation(s)
- Anne K Bendt
- Institut für Biochemie der Universität zu Köln, Zülpicher-Str. 47, 50674, Köln, Germany
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22
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Badics E, Wittmann A, Rupp M, Stabauer B, Zifko UA. Systematic muscle building exercises in the rehabilitation of stroke patients. NeuroRehabilitation 2002; 17:211-4. [PMID: 12237501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
The effects of targeted strength training in patients with muscle weakness of central origin following cerebrovascular accidents has hardly been investigated to date. This prospective non-randomized study of 56 patients was designed to shed light on the effects of strength building exercises on muscle tone and on the gain in muscle strength achieved with them. All patients underwent a full residential neurologic rehabilitation program for 4 weeks, which included an exercise program for restoring the extensor strength of the legs and the supporting strength of the arms by leg and arm presses. Throughout the rehabilitation program muscle spasticity was evaluated clinically and maximal muscle strength on completion of the exercise program was compared to baseline. The extensor strength of the legs increased by 31.0 (+/- 26.7)% by 40.2 (+/- 15)%. significant for both variables. The extent of strength gain was positively correlated with the intensity and the number of exercising units. Muscle tone, which was abnormally high at baseline, did not further increase in any one case. The results of this study showed that targeted strength training significantly increased muscle power in patients with muscle weakness of central origin without any negative effects on spasticity.
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Affiliation(s)
- E Badics
- Klinik Pirawarth, Kurhausstrasse 100, A-2222 Bad Pirawarth, Austria
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Affiliation(s)
- E. Badics
- Klinik Pirawarth, Kurhausstrasse 100, A-2222 Bad Pirawarth, Austria. Tel.: ; Fax: ; E-mail:
| | - A. Wittmann
- Klinik Pirawarth, Kurhausstrasse 100, A-2222 Bad Pirawarth, Austria. Tel.: ; Fax: ; E-mail:
| | - M. Rupp
- Klinik Pirawarth, Kurhausstrasse 100, A-2222 Bad Pirawarth, Austria. Tel.: ; Fax: ; E-mail:
| | - B. Stabauer
- Klinik Pirawarth, Kurhausstrasse 100, A-2222 Bad Pirawarth, Austria. Tel.: ; Fax: ; E-mail:
| | - U.A. Zifko
- Klinik Pirawarth, Kurhausstrasse 100, A-2222 Bad Pirawarth, Austria. Tel.: ; Fax: ; E-mail:
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24
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Affiliation(s)
- A Wittmann
- Department of Neurology, University of Virginia, Charlottesville 22908, USA.
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25
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Abstract
This paper describes the construction of an adult male voxel model named "Golem" intended to be used for Monte Carlo simulations to calculate dosimetric quantities for radiation protection considerations. The model was segmented from whole-body medical image data of a living person who was 38 years old and had external dimensions close to those of the ICRP Reference Man. The segmentation process using dedicated image processing hard- and software is described and the resulting model is characterised with respect to weight and height of the total body, organ and tissue masses and red bone marrow distribution. A comparison with the respective data for ICRP Reference Man and three further voxel models is presented. Golem was found to agree reasonably well with Reference Man, so that he can be used for the assessment of "representative" body doses.
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Affiliation(s)
- M Zankl
- GSF-National Research Center for Environment and Health, Institute of Radiation Protection, Neuherberg, Germany.
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26
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Saito K, Wittmann A, Koga S, Ida Y, Kamei T, Funabiki J, Zankl M. Construction of a computed tomographic phantom for a Japanese male adult and dose calculation system. Radiat Environ Biophys 2001; 40:69-75. [PMID: 11357713 DOI: 10.1007/s004110000082] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Computational human phantoms have been widely used to estimate organ doses and other dosimetric quantities related to the human body where direct measurements are difficult to perform. In recent years, voxel phantoms (voxel = volume element) based on computed tomographic (CT) data of real persons have been constructed which provide a realistic description of the human anatomy. A CT phantom of a Japanese male adult with an average body size was developed as the first Asian voxel phantom. The segmented phantom consists of more than 100 regions enabling the calculation of doses for various parts of the body. The bone marrow distribution was precisely modelled according to the CT values. The EGS4 Monte Carlo transport code was combined with the phantom to calculate organ doses for external exposure due to photons and electrons up to 1 TeV. The calculated organ doses were compared with respective data using MIRD-type mathematical phantoms. In some cases, significant discrepancies in doses were observed, demonstrating the necessity of sophisticated models for accurate dose calculations.
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Affiliation(s)
- K Saito
- Japan Atomic Energy Research Institute, Department of Health Physics, Tokai-mura, Ibaraki-ken, 319-1195 Japan.
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27
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Wittmann A. Body composition in an employee health improvement program. Coll Antropol 1998; 22:447-50. [PMID: 9887600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
We checked the change in health status of employees of an Austrian company over a period of one year. In June 1995 medical and anthropometric tests were carried out. From the results of the tests, we made individual recommendations for training and nutrition. Lectures, demonstration sessions and regular sessions in gymnastics were held during the year. In June 1996 a re-test was carried out. In 1995, 95 men and 27 women, in 1996, 62 men and 27 women participated in the investigation. A comparative statistical analysis was carried out for the group of men. Body fat tissue decreased and fat free mass increased highly significantly (p = 0.000), systolic blood pressure decreased about 10 mmHg on average (p = 0.000), exhalation volume as well as the relative physical work capacity increased very high significantly (p = 0.000 for both parameters). There were no significant changes of diastolic blood pressure, glucose, cholesterol and triglyceride levels.
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Affiliation(s)
- A Wittmann
- Institute of Medicine and Sport Science, Vienna, Austria
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Hofmockel G, Bassukas ID, Wittmann A, Dämmrich J. Is the expression of multidrug resistance gene product a prognostic indicator for the clinical outcome of patients with renal cancer? Br J Urol 1997; 80:11-7. [PMID: 9240173 DOI: 10.1046/j.1464-410x.1997.00228.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To determine the significance of the expression of the multidrug resistance gene product (MDR-1) for the aggressiveness of renal cell carcinoma (RCC). PATIENTS AND METHODS The study comprised 31 patients with clinically locally confined RCC treated with radical nephrectomy (mean age 64.1 years, range 41-78; mean follow-up 5.4 years, range 4.3-7.3). Their survival time and disease-free period were evaluated retrospectively. The expression of the MDR-1 gene product was determined immunohistochemically using the JSB-1 antibody in formalin-fixed paraffin-embedded tumour samples from these patients. The significance of this variable and tumour stage and malignancy grade was assessed for predicting the survival and disease-free period using Kaplan-Meier plots (log-rank test or Tarone's test) and the Cox multiple hazard regression analysis. RESULTS In a univariate analysis, tumour stage (P < 0.002), malignancy grade (P < 0.007) and MDR-1 (P < 0.03) were significant prognostic variables for both survival and disease-free period. Lower MDR-1 expression was correlated with poorer prognosis. On multivariate analysis, MDR-1 and tumour stage were significant factors for predicting the disease-free period, whereas tumour stage and malignancy grade were the most relevant factors for survival time. Calculating prognostic indices based on the results of the Cox analysis, MDR-1 could replace malignancy grade, resulting in a better prediction of survival and disease-free period (P < 0.001 vs 0.0031, P < 0.001 vs 0.021, respectively). CONCLUSION MDR-1, an established predictor for chemo-resistance, may also be a potent prognostic factor for outcome in patients with locally confined RCC. Moreover, MDR-1 expression seems to correlate with the differentiation of the RCC and thus its value as an objective measure of the degree of differentiation should be further explored.
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Affiliation(s)
- G Hofmockel
- Department of Urology, University of Würzburg Medical School, Germany
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29
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Goepel M, Wittmann A, Rübben H, Michel MC. Comparison of adrenoceptor subtype expression in porcine and human bladder and prostate. Urol Res 1997; 25:199-206. [PMID: 9228673 DOI: 10.1007/bf00941983] [Citation(s) in RCA: 79] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We have quantified and characterized alpha 1-, alpha 2- and beta-adrenoceptor subtypes in porcine bladder detrusor and bladder neck, human bladder detrusor, and porcine and human prostate. alpha 1-, alpha 2- and beta-adrenoceptor were identified in radioligand binding studies using [3H]prazosin, [3H]RX 821002 and [125I]iodocyanopindolol, respectively, as the radioligands. In porcine male and female detrusor and bladder neck and male prostate, adrenoceptors were detected in the order of abundance beta > alpha 2 >> alpha 1 (not detectable), with no major difference between the sexes or between detrusor and bladder neck. In human detrusor and prostate the order of abundance was beta > alpha 2 >> alpha 1 (not detectable) and beta >> alpha 1 > alpha 2, respectively. The alpha 2-adrenoceptors in all tissues were homogeneously of the alpha 2A-subtype as evidenced by competition binding studies with yohimbine, prazosin, ARC 239 and oxymetazoline. The beta-adrenoceptors represented a mixed population with a dominance of the beta 2-subtype in all tissues as demonstrated by competition binding with ICI 118,551 and CGP 20,712A. We conclude that pigs may be a suitable model for studies of detrusor function with respect to adrenoceptor expression. They may be less suitable for studies of bladder neck or prostate function.
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Affiliation(s)
- M Goepel
- Department of Urology, University of Essen Medical School, Germany
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Hofmockel G, Wittmann A, Dammrich J, Bassukas ID. Expression of p53 and bcl-2 in primary locally confined renal cell carcinomas: no evidence for prognostic significance. Anticancer Res 1996; 16:3807-11. [PMID: 9042262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
p53 tumor suppressor gene mutations are present in a wide variety of human cancers, and the bcl-2 gene product is considered to prevent apoptosis. However, the significance of these gene products for the aggressiveness of the tumor and correspondingly for the prognosis of patients with renal cell carcinoma (RCC) is unclear. The expression of p53 and bcl-2 gene products was studied immunohistochemically using formalin-fixed paraffinembedded tumor samples of 31 locally confined RCC of patients treated with radical nephrectomy. The significance of these 2 parameters, in addition to tumor stage and malignancy grade, was tested with regard to survival and time of no recurrence using Kaplan-Meier-plots by the log rank test or Tarone's test and the Cox multiple hazard regression analysis (mean follow-up 5.4 years). Only 5 of the 31 RCCs stained positively for p53 and only 2 showed positive bcl-2 staining of tumor cells. Tumor stage (P < 0.002) and malignancy grade (P < 0.007) were statistically significant prognostic parameters for both survival and disease-free period by univariate analysis. In contrast, the detection of either p53 (P > 0.67) or bcl-2 gene product (P > 0.28) had no prognostic impact. Also in the multivariate statistical analysis, neither of the 2 parameters i.e. p53 and bcl-2 expression significantly improved the prognostic impact of the conventional prognosticators stage and grade, if applied in addition. The expression of p53 and bcl-2 seems unimportant as a prognostic factor in locally confined RCCs.
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Affiliation(s)
- G Hofmockel
- Department of Urology, University of Würburg, Germany
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Abstract
Acquired immunodeficiency syndrome (AIDS) caused by the human immunodeficiency virus (HIV) may turn out to be the largest lethal epidemic of infection ever. The estimated global number of HIV-infected adults in 1993 was 13 million, with projections of up to 40 million by the year 2000. Human immunodeficiency virus infections and AIDS are relevant to surgeons with respect to the surgical management of AIDS patients in general, the treatment of the increasingly long list of surgical complications specific to AIDS patients in particular, and the risks of patient-to-surgeon and surgeon-to-patient HIV transmission. Because of migration of individuals and populations throughout the world, even surgeons practicing in relatively unaffected regions should be familiar with the potential surgical implications of AIDS. Ethical considerations arise, as well. Are surgeons obliged to operate on HIV-positive or AIDS patients? Some surgeons adhere strictly to the Hippocratic Oath, whereas others reserve the right to be selective on whom they operate, except in emergencies. Other common ethical considerations in the AIDS patient are similar to those arising in the terminal cancer case: whether to operate or not; whether to provide advanced support such as total parenteral nutrition or hemodialysis. Answers are not simple and require close collaboration between the surgeon, the AIDS specialist, and involved members of other specialties. Emergency operations become necessary to treat AIDS independent disease such as acute cholecystitis and appendicitis or AIDS-related life-threatening conditions such as gastrointestinal bleeding, obstruction, perforation, or ischemia complicating Kaposi's sarcoma, lymphoma, and cytomegalovirus or disseminated nontuberculous mycobacterial infections. Delays and errors in diagnosis are frequent. Poor nutritional state with weight loss, low serum albumin, and leukocyte count prevails in most patients requiring emergency operations and account for a high mortality. By applying solid judgment and selecting management appropriately, the surgeon has the ability to prolong life and to improve the quality of life for these unfortunate patients, and to do so with extremely minimal risk to himself and his team.
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Affiliation(s)
- M M Wittmann
- Department of Surgery, University of Colorado Health Center, Denver, USA
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Abstract
To estimate the risk resulting from exposures to ionizing radiation, the organ and tissue doses should be assessed. A convenient method is the calculation of these doses using representations of the human body, called models or phantoms, together with computer codes simulating the transport of radiation in the body. Most commonly used are mathematical phantoms whose external and internal volumes are defined by simple geometric bodies. More recently, phantoms constructed from computed tomographic data of real persons were introduced as an improvement. These phantoms present advantages concerning the location and shape of the organs, in particular the hard bone and bone marrow, whose distribution can be assessed with high resolution. So far, three of these phantoms were constructed at the GSF, a fourth is under process. The construction technique is described, and some calculational results of organ doses due to external photon irradiation are presented.
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Affiliation(s)
- M Zankl
- GSF, Forschungszentrum fur Umwelt und Gesundheit GmbH, Neuherberg, Germany
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Abstract
In the head and neck area CT imaging (particularly the HR-technique) is a well-established diagnostic procedure. Besides other locations it has been successfully used in the preoperative evaluation of the temporal bone. Nevertheless, the sophisticated anatomy of this special area is hard to interpret in certain cases. In the present study we report on our preliminary results in producing a multiplanar reconstruction of the area mentioned above. Temporal bones were used that had been excised during autopsy. The specimen were examined under a CT imager of the 3rd generation with a high-resolution mode. Sections of 1 mm thickness were obtained. For the evaluation a surface model was used; the segmentation was carried out mainly automatically. The surface was calculated using a triangulation algorithm. The obtained data enabled us to receive three-dimensional aspects of the temporal bone; these reconstructions could be examined from any desired perspective. Our results indicate that the multiplanar reconstruction might be of great importance for the diagnostic evaluation of temporal bone diseases in the future. In the meantime several technical problems have to be solved to guarantee a sufficient quality of the reconstructed specimen.
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Affiliation(s)
- G Grevers
- HNO-Klinik und Poliklinik der Universität München
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Abstract
The effect of the laser on compact, glandular tissue at the dosage employed for the local palliative treatment of tumors, can largely be mimicked with the aid of high-frequency current (HF-current), applied with the aid of an electro-hydro-thermo-probe: The experiments described in the present study were performed on the livers of 70 male Wistar rats. The laser was applied for 2 seconds at an output of 80 J at a distance to the tissue of 0.5 cm. In the first stage, in the acute experiment, the effect of the HF-current was matched to that of the laser by varying the modulated and unmodulated current components. It was found that the depths of penetration into the tissue at the given laser settings could be achieved with modulated HF-current (so-called coagulation current) at an output of more than 72 watts (equipment setting K 10) coagulation being performed for 10 seconds. The admixture of modulated HF-current (so-called cutting current) reduces the depth of penetration into the tissue. In the first 5 days, the depth of penetration increases after both laser irradiation and HF-coagulation, by a factor of 2 to 3. With respect to the depths of penetration (DP), the scatter ranges, and the histological changes, no difference is to be seen between laser and HF lesions: Laser DP = 5.7 mm (confidence range: 4.4-7.0 mm); HF DP (equipment setting K 10) = 4.8 mm (confidence range: 3.6-5.4 mm).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- W Matek
- Medical Department, University Erlangen-Nuremberg
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Wittmann A. [Simultaneous intra- and extrauterine pregnancy]. Geburtshilfe Frauenheilkd 1988; 48:601-2. [PMID: 3063588 DOI: 10.1055/s-2008-1026547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
A case is reported of simultaneous intrauterine and extrauterine pregnancy, accompanied by a right tubal pregnancy and rupture in the 8th week of gestation and a spontaneous parturition in the 42nd week. Frequency and aetiological factors, as well as diagnostic possibilities and differential diagnostic considerations are discussed.
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Wittmann A. [Decision for a denture]. Quintessenz J 1971; 1:43-4. [PMID: 4949023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Wittmann A. [The neglected good patient]. Quintessenz J 1971; 1:33-4. [PMID: 5292595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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43
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Wittmann A. [A tablet is not always good]. Quintessenz J 1971; 1:39-40. [PMID: 5292507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Wittmann A. [Dentistry and social sciences]. Quintessenz J 1971; 1:41-2. [PMID: 5292706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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45
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Affiliation(s)
- A Wittmann
- Solar Physics Division, Universitäts-Sternwarte, Göttingen
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46
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Wittmann A. [The dental assistant as an important link]. Quintessenz J 1971; 1:33-4. [PMID: 5292694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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