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Schulze A, Tran D, Daum MTJ, Kisilenko A, Maier-Hein L, Speidel S, Distler M, Weitz J, Müller-Stich BP, Bodenstedt S, Wagner M. Ensuring privacy protection in the era of big laparoscopic video data: development and validation of an inside outside discrimination algorithm (IODA). Surg Endosc 2023:10.1007/s00464-023-10078-x. [PMID: 37145173 PMCID: PMC10338566 DOI: 10.1007/s00464-023-10078-x] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/10/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Laparoscopic videos are increasingly being used for surgical artificial intelligence (AI) and big data analysis. The purpose of this study was to ensure data privacy in video recordings of laparoscopic surgery by censoring extraabdominal parts. An inside-outside-discrimination algorithm (IODA) was developed to ensure privacy protection while maximizing the remaining video data. METHODS IODAs neural network architecture was based on a pretrained AlexNet augmented with a long-short-term-memory. The data set for algorithm training and testing contained a total of 100 laparoscopic surgery videos of 23 different operations with a total video length of 207 h (124 min ± 100 min per video) resulting in 18,507,217 frames (185,965 ± 149,718 frames per video). Each video frame was tagged either as abdominal cavity, trocar, operation site, outside for cleaning, or translucent trocar. For algorithm testing, a stratified fivefold cross-validation was used. RESULTS The distribution of annotated classes were abdominal cavity 81.39%, trocar 1.39%, outside operation site 16.07%, outside for cleaning 1.08%, and translucent trocar 0.07%. Algorithm training on binary or all five classes showed similar excellent results for classifying outside frames with a mean F1-score of 0.96 ± 0.01 and 0.97 ± 0.01, sensitivity of 0.97 ± 0.02 and 0.0.97 ± 0.01, and a false positive rate of 0.99 ± 0.01 and 0.99 ± 0.01, respectively. CONCLUSION IODA is able to discriminate between inside and outside with a high certainty. In particular, only a few outside frames are misclassified as inside and therefore at risk for privacy breach. The anonymized videos can be used for multi-centric development of surgical AI, quality management or educational purposes. In contrast to expensive commercial solutions, IODA is made open source and can be improved by the scientific community.
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Affiliation(s)
- A Schulze
- Department for General, Visceral and Transplant Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
- National Center for Tumor Diseases, Heidelberg, Germany
| | - D Tran
- Department for General, Visceral and Transplant Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
- National Center for Tumor Diseases, Heidelberg, Germany
| | - M T J Daum
- Department for General, Visceral and Transplant Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
- National Center for Tumor Diseases, Heidelberg, Germany
| | - A Kisilenko
- Department for General, Visceral and Transplant Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
- National Center for Tumor Diseases, Heidelberg, Germany
| | - L Maier-Hein
- Division of Intelligent Medical Systems, German Cancer Research Center (Dkfz), Heidelberg, Germany
| | - S Speidel
- Department for Translational Surgical Oncology, National Center for Tumor Diseases, Partner Site Dresden, Dresden, Germany
- Center for the Tactile Internet With Human in the Loop (CeTI), Technische Universität Dresden, Dresden, Germany
| | - M Distler
- Department of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - J Weitz
- Department of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - B P Müller-Stich
- Clarunis, University Center for Gastrointestinal and Liver Disease, Basel, Switzerland
| | - S Bodenstedt
- Department for Translational Surgical Oncology, National Center for Tumor Diseases, Partner Site Dresden, Dresden, Germany
- Center for the Tactile Internet With Human in the Loop (CeTI), Technische Universität Dresden, Dresden, Germany
| | - M Wagner
- Department for General, Visceral and Transplant Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany.
- National Center for Tumor Diseases, Heidelberg, Germany.
- Center for the Tactile Internet With Human in the Loop (CeTI), Technische Universität Dresden, Dresden, Germany.
- Department of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
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2
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Niederwieser D, Lang T, Krahl R, Heinicke T, Maschmeyer G, Al-Ali HK, Schwind S, Jentzsch M, Cross M, Kahl C, Wolf HH, Sayer H, Schulze A, Dreger P, Hegenbart U, Krämer A, Junghanss C, Mügge LO, Hähling D, Hirt C, Späth C, Peter N, Opitz B, Florschütz A, Reifenrath K, Zojer N, Scholl S, Pönisch W, Heyn S, Vucinic V, Hochhaus A, Aul C, Giagounidis A, Balleisen L, Oldenkott B, Staib P, Kiehl M, Schütte W, Naumann R, Eimermacher H, Dörken B, Sauerland C, Lengfelder E, Hiddemann W, Wörmann B, Müller-Tidow C, Serve H, Schliemann C, Hehlmann R, Berdel WE, Pfirrmann M, Krug U, Hoffmann VS. Different treatment strategies versus a common standard arm (CSA) in patients with newly diagnosed AML over the age of 60 years: a randomized German inter-group study. Ann Hematol 2023; 102:547-561. [PMID: 36695874 PMCID: PMC9977880 DOI: 10.1007/s00277-023-05087-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/01/2023] [Indexed: 01/26/2023]
Abstract
A randomized inter-group trial comparing more intensive treatment strategies to a common standard arm 3 + 7 (CSA) was conducted in patients with non-M3 AML. Untreated patients ≥ 60 years were allocated to the CSA (n = 132) or to the study group arms (n = 1154) of the AMLCG (TAD/HAM versus HAM/HAM ± G-CSF followed by TAD and maintenance) and the OSHO (intermediate-dose ara-C/mitoxantrone followed by ara-C/mitoxantrone). Median age of the 1147 eligible patients was 69 (range 60-87) years. CR/CRi status at 90 days was not significantly different between the CSA (54% (95%CI: 45-64)) and the study group arms (53% (95%CI: 47-60) and 59% (95%CI: 58-63)). The five-year event-free survival (EFS) probability (primary endpoint) was 6.2% (95%CI: 2.7-14.0) in the CSA, 7.6% (95%CI: 4.5-12.8) in study group A and 11.1% (95%CI: 9.0-13.7) in B. The 5-year OS was 17.2% (95%CI: 11.0-26.9), 17.0% (95%CI: 2.0-23.9), and 19.5% (95%CI: 16.7-22.8) in CSA, study group A and B, respectively. Neither study group differed significantly from the CSA regarding EFS, OS, or relapse-free survival. In multivariate analyses, allocation to the treatment strategy was not significantly associated with the time-to-event endpoints. The evaluation of more intensive treatment strategies did not show clinically relevant outcome differences when compared to CSA.
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Affiliation(s)
- Dietger Niederwieser
- University Leipzig, 04106, Leipzig, Germany. .,Lithuanian University of Health Sciences, Kaunas, Lithuania. .,Aichi Medical University, Nagakute, Japan.
| | - Thomas Lang
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig Maximilian Universität München, München, Germany
| | | | - Thomas Heinicke
- Dept. Hematology and Oncology, Otto-Von-Guericke-University, Magdeburg, Germany
| | - Georg Maschmeyer
- Dept. Hematology, Oncology and Palliative Care, Klinikum Ernst Von Bergmann, Potsdam, Germany
| | - Haifa Kathrin Al-Ali
- Department of Internal Medicine IV, Oncology/Hematology, Krukenberg Cancer-Center, University Hospital Halle (Saale), Halle, Germany
| | | | | | | | - Christoph Kahl
- Dept. Internal Medicine, Clinic III - Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany.,Dept. Hematology, Oncology and Palliative Care, Klinikum Magdeburg gGmbH, Magdeburg, Germany
| | | | - Herbert Sayer
- Medizinische Klinik (Hämatologie, Stammzelltransplantation, Onkologie), Helios Klinikum Erfurt, Erfurt, Germany
| | | | - Peter Dreger
- Medical Department V, University Hospital, Heidelberg, Germany
| | - Ute Hegenbart
- Medical Department V, University Hospital, Heidelberg, Germany
| | - Alwin Krämer
- Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center (DKFZ) and Dept. of Internal Medicine V, University, Heidelberg, Germany
| | - Christian Junghanss
- Department of Medicine, Clinic III (Hematology, Oncology, Palliative Medicine), Rostock University Medical Center, Rostock, Germany
| | - Lars-Olof Mügge
- Innere Medizin III (Hämatologie, Onkologie Und Palliativmedizin), Hospital Zwickau, Germany
| | - Detlev Hähling
- Dept. Hematology and Oncology, Klinikum Schwerin, Schwerin, Germany
| | - Carsten Hirt
- Innere Medizin C, Universitätsmedizin Greifswald, Sauerbruchstraße, 17475, Greifswald, Germany
| | - Christian Späth
- Innere Medizin C, Universitätsmedizin Greifswald, Sauerbruchstraße, 17475, Greifswald, Germany
| | - Norma Peter
- Medizinische Klinik, Carl-Thieme-Klinikum GmbH, Cottbus, Germany
| | - Bernhard Opitz
- St. Elisabeth Und St, Barbara Hospital Halle (Saale), Halle, Germany
| | | | | | - Niklas Zojer
- 1St Medical Department, Center for Oncology and Hematology & Palliative Care, Klinik Ottakring, Vienna, Austria
| | | | | | | | | | | | - Carlo Aul
- Klinik Für Hämatologie Und Onkologie, St. Johannes Hospital, Duisburg, Germany
| | - Aristoteles Giagounidis
- Klinik Für Hämatologie Und Onkologie, St. Johannes Hospital, Duisburg, Germany.,Dept. Oncology, Hematology and Palliative Care, Marienhospital Düsseldorf, Düsseldorf, Germany
| | | | - Bernd Oldenkott
- Dept. Hematology and Oncology, St. Hedwig Krankenhaus Berlin, Berlin, Germany
| | - Peter Staib
- Dept. Hematology/Oncology, St. Antonius Krankenhaus Eschweiler, Eschweiler, Germany
| | - Michael Kiehl
- Dept. Medicine I, Klinikum Frankfurt/Oder, FrankfurtOder, Germany
| | - Wolfgang Schütte
- Dept. Internal Medicine II, Krankenhaus Martha-Maria, Halle, Germany
| | - Ralph Naumann
- Dept. Hematology, Oncology and Palliative Care, St. Marien-Krankenhaus Siegen, Siegen, Germany
| | - Hartmut Eimermacher
- Dept. Hematology and Oncology, Katholisches Krankenhaus Hagen, Hagen, Germany
| | - Bernd Dörken
- Dept. Hematology and Oncology, Charité Campus Virchow, Berlin, Germany
| | - Cristina Sauerland
- Institute of Biometry and Clinical Research, University Hospital Münster, Münster, Germany
| | - Eva Lengfelder
- IIIrd Medical Dept, University Hospital of Mannheim, Mannheim, Germany
| | | | - Bernhard Wörmann
- Division of Hematology, Oncology and Tumour Immunology, Department of Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Deutsche Gesellschaft für Hämatologie und Medizinische Onkologie, Berlin, Germany
| | - Carsten Müller-Tidow
- Dept. of Medicine A, University Hospital of Münster, Münster, Germany.,Dept. of Medicine V, University Hospital of Heidelberg, Heidelberg, Germany
| | - Hubert Serve
- Dept. of Medicine A, University Hospital of Münster, Münster, Germany.,Department of Medicine, Hematology/Oncology, Goethe University, Frankfurt, Germany
| | | | - Rüdiger Hehlmann
- Mannheim, University of Heidelberg, Mannheim, Germany.,European LeukemiaNet, Weinheim, Germany
| | - Wolfgang E Berdel
- Dept. of Medicine A, University Hospital of Münster, Münster, Germany
| | - Markus Pfirrmann
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig Maximilian Universität München, München, Germany
| | - Utz Krug
- Dept. of Medicine A, University Hospital of Münster, Münster, Germany.,Dept. of Medicine 3, Klinikum Leverkusen, Leverkusen, Germany
| | - Verena S Hoffmann
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig Maximilian Universität München, München, Germany
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3
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Schulte C, Mueller C, Escobar JD, Tong T, Lackner K, Schulze A, Blankenberg S, Salomaa V, Wild P, Zeller T. VEGF beta is a candidate biomarker for cardiovascular risk stratification. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1362] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The blood-based transcriptome changes in relation to body weight but longitudinal data on specific transcripts are rare. Monocytes play a crucial role in the development of atherosclerosis and coronary artery disease. Monitoring monocytic gene expression patterns could aid to identify biomarkers for improved cardiovascular risk stratification. BMI and diabetes mellitus (T2DM) are associated with coronary artery disease (CAD). There are mRNAs associated with the development of atherosclerosis and CAD, which can be detected in circulating cells. The exact pathways and direct targets have not been explored.
Objective
To apply transcriptome screening and validation analysis to identify novel biomarker candidates associated with longitudinal changes of BMI as cardiovascular risk factors and test association with clinical endpoints.
Methods
Transcriptome-wide monocytic gene expression changes were screened in relation to changes in BMI over a time period of 5 years in 1,092 participants of the Gutenberg Health Study with available transcriptomics data at baseline investigation and at 5-years follow-up. Functional enrichment of BMI-related genes (FDR <0.01) was tested based on pathway databases and selected gene sets. Serum VEGFB levels were quantified and validated in serum from n=1,895 individuals from an independent cohort study (FinRisk). In-vitro, THP1 cells were stimulated with recombinant VEGFB.
Results
143 transcripts showed a significant association with change in BMI over 5 years. Decreased VEGFB mRNA levels strongly associated with increased BMI (p=2.8x10–9). Lower levels of VEGFB mRNA were associated with increased mortality (HRperSD=0.757, 95% CI: 0.647–0.885, p=0.0005) following adjustment for age and sex and incident diabetes (p=0.01). Circulating VEGFB levels inversely correlated with VEGFB mRNA (r=−0.2, p=0.0024) and positively correlated with an increase in BMI (beta=0.226, p=8.4x10–6), type 2 diabetes mellitus risk (HRperSD=1.279, 95% CI: 1.148–1.425, p=7.8x10–6) and all-cause mortality (HRperSD=1.184, 95% CI: 1.045–1.342, p=0.008). Further exploration in n=1,895 individuals from FinRisk revealed an association of increased VEGFB levels with increased risk for heart failure (HRperSD=1.373, 95% CI: 1.210–1.560, p=1.0x10–6) and coronary artery disease (HR=1.018, 95% CI: 1.003–1.034, p=0.019), even after adjustment for BMI. In THP-1 culture, stimulation with VEGFB resulted in downregulation of VEGFB mRNA levels.
Conclusion
Decreased monocytic gene expression of VEGFB is related to increased BMI, increased risk of T2DM and all-cause mortality. Vice versa,circulating VEGFB levels associates positively with BMI, diabetes, mortality as well as heart failure and coronary heart disease. We hypothesize that monocytes regulate VEGFB expression by a negative feed-back mechanism based. Circulating VEGFB is a potential novel biomarker candidate for weight-related diabetes risk and cardiovascular risk evaluation.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): DZHK
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Affiliation(s)
- C Schulte
- University Heart & Vascular Center Hamburg , Hamburg , Germany
| | - C Mueller
- University Heart & Vascular Center Hamburg , Hamburg , Germany
| | - J D Escobar
- The University Medical Center Hamburg-Eppendorf, University Center of Cardiovascular Science, University Heart and vascular Center , Hamburg , Germany
| | - T Tong
- The University Medical Center Hamburg-Eppendorf, University Center of Cardiovascular Science, University Heart and vascular Center , Hamburg , Germany
| | - K Lackner
- Johannes Gutenberg University Mainz (JGU), University Medical Center , Mainz , Germany
| | - A Schulze
- Johannes Gutenberg University Mainz (JGU), University Medical Center , Mainz , Germany
| | - S Blankenberg
- University Heart & Vascular Center Hamburg , Hamburg , Germany
| | - V Salomaa
- National Institute for Health and Welfare (THL), Department of Public Health Solutions , Helsinki , Finland
| | - P Wild
- Center for Thrombosis and Hemostasis , Mainz , Germany
| | - T Zeller
- The University Medical Center Hamburg-Eppendorf, University Center of Cardiovascular Science, University Heart and vascular Center , Hamburg , Germany
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4
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Heinicke T, Krahl R, Kahl C, Cross M, Scholl S, Wolf HH, Hähling D, Hegenbart U, Peter N, Schulze A, Florschütz A, Schmidt V, Reifenrath K, Zojer N, Junghanss C, Sayer HG, Maschmeyer G, Späth C, Hochhaus A, Fischer T, Al-Ali HK, Niederwieser D. Correction to: Allogeneic hematopoietic stem cell transplantation improves long‑term outcome for relapsed AML patients across all ages: results from two East German Study Group Hematology and Oncology (OSHO) trials. Ann Hematol 2021; 100:2877-2878. [PMID: 34529106 DOI: 10.1007/s00277-021-04638-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Thomas Heinicke
- Department of Hematology and Oncology, University of Magdeburg, Magdeburg, Germany
| | - Rainer Krahl
- University Hospital Leipzig, 04106, Leipzig, Germany
| | - Christoph Kahl
- Department of Hematology and Oncology, Hospital Magdeburg, Magdeburg, Germany
| | - Michael Cross
- University Hospital Leipzig, 04106, Leipzig, Germany
| | - Sebastian Scholl
- Klinik fur Innere Medizin II, Universitatsklinikum Jena, Jena, Germany
| | - Hans-Heinrich Wolf
- Department of Hematology and Oncology, University Hospital, Halle, Germany
| | - Detlev Hähling
- Department of Hematology and Oncology, Klinikum Schwerin, Schwerin, Germany
| | - Ute Hegenbart
- Departement of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Norma Peter
- Medizinische Klinik, Carl-Thieme-Klinikum GmbH, Cottbus, Germany
| | - Antje Schulze
- Department of Hematology and Oncology, Helios Klinikum Erfurt, Erfurt, Germany
| | | | - Volker Schmidt
- Department of Hematology and Oncology, Helios Klinikum Erfurt, Erfurt, Germany
| | | | - Niklas Zojer
- Department of Medicine I, Wilhelminen Cancer Research Institute, WilhelminenhospitalVienna, Austria
| | - Christian Junghanss
- Hematology, Oncology, Palliative Medicine, University of Rostock, Rostock, Germany
| | - Herbert G Sayer
- Department of Hematology and Oncology, Helios Klinikum Erfurt, Erfurt, Germany
| | - Georg Maschmeyer
- Department of Hematology, Oncology and Palliative Care, Ernst Von Bergmann Hospital, Potsdam, Germany
| | - Christian Späth
- Hematology and Oncology, University of Greifswald, Greifswald, Germany
| | - Andreas Hochhaus
- Klinik fur Innere Medizin II, Universitatsklinikum Jena, Jena, Germany
| | - Thomas Fischer
- Department of Hematology and Oncology, University of Magdeburg, Magdeburg, Germany
| | | | - Dietger Niederwieser
- University Hospital Leipzig, 04106, Leipzig, Germany. .,Lithuanian University of Health Sciences, Kaunas, Lithuania. .,Aichi Medical University, Nagakute, Japan.
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5
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Heinicke T, Krahl R, Kahl C, Cross M, Scholl S, Wolf HH, Hähling D, Hegenbart U, Peter N, Schulze A, Florschütz A, Schmidt V, Reifenrath K, Zojer N, Junghanss C, Sayer HG, Maschmeyer G, Späth C, Hochhaus A, Fischer T, Al-Ali HK, Niederwieser D. Allogeneic hematopoietic stem cell transplantation improves long-term outcome for relapsed AML patients across all ages: results from two East German Study Group Hematology and Oncology (OSHO) trials. Ann Hematol 2021; 100:2387-2398. [PMID: 34232360 PMCID: PMC8357692 DOI: 10.1007/s00277-021-04565-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 06/04/2021] [Indexed: 12/14/2022]
Abstract
Relapse of acute leukemia is a frequent complication with uncertain outcome and poorly defined risk factors. From 1621 patients entered into two prospective clinical trials (AML02; n = 740 and AML04; n = 881), 74.2% reached complete remission (CR) 1 after induction(s) and 59 patients after additional induction ± hematopoietic cell transplantation (HCT). Of the non-refractory patients, 48.4% with a median age of 63 (range 17-85) years relapsed. Relapses occurred within 6 months after CR in 46.5%, between 7 and 18 months in 38.7%, and after 18 months in 14.8% of patients. Relapse treatment resulted in CR2 in 39% of patients depending upon age (54.5% of ≤ 60 and 28.6% of > 60 years), duration of CR1, and treatment of relapse. Overall survival (OS) was 10.9 (7.4-16.2) %, but OS after HCT ± intensive chemotherapy (ICT) was 39.3% (31.8-48.6) at 5 years and not different in younger and older patients. Donor lymphocyte infusion ± chemotherapy and ICT alone resulted only in OS of 15.4% and of 5%, respectively. Independent favorable factors for OS were long CR1 duration, and HCT, while non-monosomal disease was beneficial for OS in elderly patients. Leukemia-free survival [LFS; 24.9 (19.5-31.7) % at 10 years] was affected by similar risk factors. In a competing risk model, the relapse incidence at 5 years was 53.5 ± 3.5% and the non-relapse mortality rate 21.7 ± 2.9%. Lower relapse incidence was observed in patents with HCT, long CR1 duration, and female gender. Risk factors for non-relapse mortality were HCT in younger and type of AML in elderly patients. In conclusion, allogeneic HCT ± IC improved the results in relapsed AML in younger and elderly patients. Increasing CR2 rates and HCT frequency will be the challenge for the next years. Relapse of the disease remains the major problem.
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Affiliation(s)
- Thomas Heinicke
- Department of Hematology and Oncology, University of Magdeburg, Magdeburg, Germany
| | - Rainer Krahl
- University Hospital Leipzig, 04106, Leipzig, Germany
| | - Christoph Kahl
- Department of Hematology and Oncology, Hospital Magdeburg, Magdeburg, Germany
| | - Michael Cross
- University Hospital Leipzig, 04106, Leipzig, Germany
| | - Sebastian Scholl
- Klinik Für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany
| | - Hans-Heinrich Wolf
- Department of Hematology and Oncology, University Hospital, Halle, Germany
| | - Detlev Hähling
- Department of Hematology and Oncology, Klinikum Schwerin, Schwerin, Germany
| | - Ute Hegenbart
- Departement of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Norma Peter
- Medizinische Klinik, Carl-Thieme-Klinikum GmbH, Cottbus, Germany
| | - Antje Schulze
- Department of Hematology and Oncology, Helios Klinikum Erfurt, Erfurt, Germany
| | | | - Volker Schmidt
- Department of Hematology and Oncology, Helios Klinikum Erfurt, Erfurt, Germany
| | | | - Niklas Zojer
- Department of Medicine I, Wilhelminen Cancer Research Institute, Wilhelminenhospital, , Vienna, Austria
| | - Christian Junghanss
- Hematology, Oncology, Palliative Medicine, University of Rostock, Rostock, Germany
| | - Herbert G Sayer
- Department of Hematology and Oncology, Helios Klinikum Erfurt, Erfurt, Germany
| | - Georg Maschmeyer
- Department of Hematology, Oncology and Palliative Care, Ernst Von Bergmann Hospital, Potsdam, Germany
| | - Christian Späth
- Hematology and Oncology, University of Greifswald, Greifswald, Germany
| | - Andreas Hochhaus
- Klinik Für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany
| | - Thomas Fischer
- Department of Hematology and Oncology, University of Magdeburg, Magdeburg, Germany
| | | | - Dietger Niederwieser
- University Hospital Leipzig, 04106, Leipzig, Germany.
- Lithuanian University of Health Sciences, Kaunas, Lithuania.
- Aichi Medical University, Nagakute, Japan.
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6
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Kalogirou C, Linxweiler J, Schmucker P, Snaebjornsson MT, Schmitz W, Wach S, Krebs M, Hartmann E, Puhr M, Müller A, Spahn M, Seitz AK, Frank T, Marouf H, Büchel G, Eckstein M, Kübler H, Eilers M, Saar M, Junker K, Röhrig F, Kneitz B, Rosenfeldt MT, Schulze A. MiR-205-driven downregulation of cholesterol biosynthesis through SQLE-inhibition identifies therapeutic vulnerability in aggressive prostate cancer. Nat Commun 2021; 12:5066. [PMID: 34417456 PMCID: PMC8379214 DOI: 10.1038/s41467-021-25325-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 07/29/2021] [Indexed: 12/19/2022] Open
Abstract
Prostate cancer (PCa) shows strong dependence on the androgen receptor (AR) pathway. Here, we show that squalene epoxidase (SQLE), an enzyme of the cholesterol biosynthesis pathway, is overexpressed in advanced PCa and its expression correlates with poor survival. SQLE expression is controlled by micro-RNA 205 (miR-205), which is significantly downregulated in advanced PCa. Restoration of miR-205 expression or competitive inhibition of SQLE led to inhibition of de novo cholesterol biosynthesis. Furthermore, SQLE was essential for proliferation of AR-positive PCa cell lines, including abiraterone or enzalutamide resistant derivatives, and blocked transactivation of the AR pathway. Inhibition of SQLE with the FDA approved antifungal drug terbinafine also efficiently blocked orthotopic tumour growth in mice. Finally, terbinafine reduced levels of prostate specific antigen (PSA) in three out of four late-stage PCa patients. These results highlight SQLE as a therapeutic target for the treatment of advanced PCa.
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Affiliation(s)
- C Kalogirou
- Department of Biochemistry and Molecular Biology, Theodor-Boveri-Institute, Biocenter, Würzburg, Germany
- Department of Urology and Paediatric Urology, University Hospital Würzburg, Würzburg, Germany
| | - J Linxweiler
- Department of Urology, Saarland University, Homburg/Saar, Germany
| | - P Schmucker
- Department of Urology and Paediatric Urology, University Hospital Würzburg, Würzburg, Germany
| | - M T Snaebjornsson
- German Cancer Research Center, Division of Tumor Metabolism and Microenvironment, Heidelberg, Germany
| | - W Schmitz
- Department of Biochemistry and Molecular Biology, Theodor-Boveri-Institute, Biocenter, Würzburg, Germany
| | - S Wach
- Department of Urology, University Hospital Erlangen, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - M Krebs
- Department of Urology and Paediatric Urology, University Hospital Würzburg, Würzburg, Germany
| | - E Hartmann
- Institute of Pathology, Julius Maximilians University and Comprehensive Cancer Center (CCC) Mainfranken, Würzburg, Germany
| | - M Puhr
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - A Müller
- Clinic for Diagnostic and Interventional Radiology, Saarland University, Homburg/Saar, Germany
| | - M Spahn
- Center for Urology, Hirslanden Private Hospital Group, Zurich, Switzerland
| | - A K Seitz
- Department of Urology and Paediatric Urology, University Hospital Würzburg, Würzburg, Germany
| | - T Frank
- Department of Urology and Paediatric Urology, University Hospital Würzburg, Würzburg, Germany
| | - H Marouf
- Department of Biochemistry and Molecular Biology, Theodor-Boveri-Institute, Biocenter, Würzburg, Germany
| | - G Büchel
- Department of Biochemistry and Molecular Biology, Theodor-Boveri-Institute, Biocenter, Würzburg, Germany
- Mildred Scheel Early Career Center, University Hospital Würzburg, Würzburg, Germany
| | - M Eckstein
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - H Kübler
- Department of Urology and Paediatric Urology, University Hospital Würzburg, Würzburg, Germany
| | - M Eilers
- Department of Biochemistry and Molecular Biology, Theodor-Boveri-Institute, Biocenter, Würzburg, Germany
| | - M Saar
- Department of Urology, Saarland University, Homburg/Saar, Germany
| | - K Junker
- Department of Urology, Saarland University, Homburg/Saar, Germany
| | - F Röhrig
- Department of Biochemistry and Molecular Biology, Theodor-Boveri-Institute, Biocenter, Würzburg, Germany
| | - B Kneitz
- Department of Urology and Paediatric Urology, University Hospital Würzburg, Würzburg, Germany
| | - M T Rosenfeldt
- Institute of Pathology, Julius Maximilians University and Comprehensive Cancer Center (CCC) Mainfranken, Würzburg, Germany
| | - A Schulze
- Department of Biochemistry and Molecular Biology, Theodor-Boveri-Institute, Biocenter, Würzburg, Germany.
- German Cancer Research Center, Division of Tumor Metabolism and Microenvironment, Heidelberg, Germany.
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7
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Schulze A, Schmittenbecher PP. [Apophyseal avulsion in the pelvic region in childhood and adolescence]. Unfallchirurg 2021; 124:519-525. [PMID: 33938973 DOI: 10.1007/s00113-021-01001-x] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND The importance of the apophyseal plates during growth is often underestimated. They act as a muscular insertion and influence the joint mechanics by the load-dependent change in shape. PATHOMECHANISMS An anatomically functional adaptation occurs as protection from overloading. In special kinds of sports with highly dynamic movements, sudden changes of direction and eccentric/concentric muscle activities the resulting stress may exceed the strength of the apophyseal plate. In adolescence this results in a total or partial tearing of the apophysis in the sense of an avulsion injury. In the pelvic region the ischial tuberosity, the anterior superior and inferior iliac spine are mainly affected. DIAGNOSTICS The medical history and clinical diagnostics are supplemented by conventional radiographic imaging. Sectional imaging diagnostics are usually unnecessary. TREATMENT Conservative management by reduced (partial) weight bearing and physiotherapy represents the gold standard in treatment. In cases with a fragment displacement >1.5-2.0 cm and in competitive athletes an open reduction should be considered.
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Affiliation(s)
- A Schulze
- Klinik für Kinderchirurgie, Städtisches Klinikum Karlsruhe, Moltkestr. 90, 76133, Karlsruhe, Deutschland.
| | - P P Schmittenbecher
- Klinik für Kinderchirurgie, Städtisches Klinikum Karlsruhe, Moltkestr. 90, 76133, Karlsruhe, Deutschland
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8
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Kalogirou C, Linxweiler J, Hartmann E, Seitz A, Puhr M, Spahn M, Frank T, Marouf H, Krebs M, Kübler H, Rosenwald A, Saar M, Junker K, Kneitz B, Schmitz W, Rosenfeldt M, Schulze A. Inhibition of cholesterol and steroid synthesis through miR-205 target gene SQLE is an intriguing treatment strategy in various in vitro and in vivo models of prostate cancer. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33838-6] [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: 10/23/2022] Open
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9
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Kaur J, Nagy L, Wan B, Saleh H, Schulze A, Raiman J, Inbar-Feigenberg M. The utility of dried blood spot monitoring of branched-chain amino acids for maple syrup urine disease: A retrospective chart review study. Clin Chim Acta 2020; 500:195-201. [DOI: 10.1016/j.cca.2019.10.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 10/15/2019] [Accepted: 10/17/2019] [Indexed: 01/06/2023]
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10
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Meyer R, Schacht S, Buschmann L, Begemann M, Kraft F, Haag N, Kochs A, Schulze A, Kurth I, Elbracht M. Biallelic CSGALNACT1-mutations cause a mild skeletal dysplasia. Bone 2019; 127:446-451. [PMID: 31325655 DOI: 10.1016/j.bone.2019.07.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/03/2019] [Accepted: 07/14/2019] [Indexed: 11/16/2022]
Abstract
Genetic causes of skeletal disorders are manifold and affect, among others, enzymes of bone and connective tissue synthesis pathways. We present a twelve-year-old boy with a mild skeletal dysplasia, hypermobility of joints and axial malalignment of lower limbs and feet. Exome sequencing revealed a biallelic loss of function mutation in CSGALNACT1, which encodes chondroitin sulfate N-acetylgalactosaminyltransferase 1 and plays a major role in the chondroitin sulfate chain biosynthesis and therefore in the synthesis of glycosaminoglycans. Recently, the first case of a pediatric patient with a mild skeletal dysplasia due to a compound heterozygous large intragenic deletion and a damaging missense variant in CSGALNACT1 was reported. We here identify a second case and the first juvenile patient with a homozygous frameshift variant in CSGALNACT1 which corroborates its role in mild and non-progressive skeletal dysplasia with joint laxity.
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Affiliation(s)
- R Meyer
- Institute of Human Genetics, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - S Schacht
- Department for Radiology, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - L Buschmann
- Institute of Human Genetics, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - M Begemann
- Institute of Human Genetics, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - F Kraft
- Institute of Human Genetics, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - N Haag
- Institute of Human Genetics, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - A Kochs
- Gemeinschaftspraxis Dr. Kochs/Dr. Rode, Aachen, Germany
| | - A Schulze
- Department for Orthopedics, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - I Kurth
- Institute of Human Genetics, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - M Elbracht
- Institute of Human Genetics, Medical Faculty, RWTH Aachen University, Aachen, Germany.
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11
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Schulze A, Neudert M. Vorbereitung zur Facharztprüfung HNO. HNO 2019; 67:628-632. [DOI: 10.1007/s00106-019-0707-6] [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: 10/26/2022]
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12
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Krause K, Sabat R, Witte‐Händel E, Schulze A, Puhl V, Maurer M, Wolk K. Schnitzler 综合征与 CCL2. Br J Dermatol 2019. [DOI: 10.1111/bjd.17670] [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: 11/30/2022]
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13
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Krause K, Sabat R, Witte‐Händel E, Schulze A, Puhl V, Maurer M, Wolk K. CCL2 in Schnitzler syndrome. Br J Dermatol 2019. [DOI: 10.1111/bjd.17654] [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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14
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Krause K, Sabat R, Witte-Händel E, Schulze A, Puhl V, Maurer M, Wolk K. Association of CCL2 with systemic inflammation in Schnitzler syndrome. Br J Dermatol 2018; 180:859-868. [PMID: 30339714 DOI: 10.1111/bjd.17334] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Schnitzler syndrome (SchS) is a rare autoinflammatory disease characterized by urticarial exanthema, bone and joint alterations, fever and monoclonal gammopathy, which manifest mostly in the second half of life. It involves overactivation of the interleukin (IL)-1 system, but the exact pathophysiological pathways remain largely unknown. OBJECTIVES To identify and characterize the pathogenetic players in SchS. METHODS Blood parameters were quantified in patients with SchS compared with healthy controls and patients with psoriasis and hidradenitis suppurativa using enzyme-linked immunosorbent assay (ELISA). CCL2 expression in cultured primary cells was analysed by quantitative reverse-transcriptase polymerase chain reaction and ELISA. RESULTS CCL2, a chemoattractant for monocytic and further mononuclear immune cells, was found to be significantly elevated in patients with SchS. CCL2 levels showed a positive association with global disease activity, especially with bone pain, but not disease duration, gammopathy, neutrophilia or skin disease. In vitro stimulation assays demonstrated a strong CCL2 production capacity of mononuclear immune cells and fibroblasts, but not epithelial or endothelial cells. Among a range of inflammatory mediators, only IL-1β (immune cells, fibroblasts) and tumour necrosis factor (TNF)-α (fibroblasts) were important CCL2 inducers. TNF-α, but not IL-17, strengthened the CCL2-inducing effect of IL-1β in fibroblasts. Accordingly, CCL2 levels positively correlated with both TNF-α and IL-1β serum levels in patients with SchS. Therapeutic IL-1β blockade decreased CCL2 blood levels in these patients as early as 1 week after the initiation of treatment. CONCLUSIONS CCL2 may be an important component of the pathogenetic cascade leading to bone alterations, and a suitable marker of disease activity in patients with SchS.
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Affiliation(s)
- K Krause
- Dermatological Allergology, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Autoinflammation Reference Centre Charité, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - R Sabat
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology and, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Psoriasis Research and Treatment Centre, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - E Witte-Händel
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology and, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Psoriasis Research and Treatment Centre, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - A Schulze
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology and, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Psoriasis Research and Treatment Centre, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - V Puhl
- Dermatological Allergology, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Autoinflammation Reference Centre Charité, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - M Maurer
- Dermatological Allergology, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Autoinflammation Reference Centre Charité, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - K Wolk
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology and, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Psoriasis Research and Treatment Centre, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Berlin-Brandenburg Centre for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
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15
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Coetzee C, Schulze A, Mokwena L, du Toit W, Buica A. Investigation of Thiol Levels in Young Commercial South African Sauvignon blanc and Chenin blanc Wines Using Propiolate Derivatization and GC-MS/MS. S AFR J ENOL VITIC 2018. [DOI: 10.21548/39-2-2683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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16
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Ros S, Flöter J, Kaymak I, Da Costa C, Houddane A, Dubuis S, Griffiths B, Mitter R, Walz S, Blake S, Behrens A, Brindle KM, Zamboni N, Rider MH, Schulze A. 6-Phosphofructo-2-kinase/fructose-2,6-biphosphatase 4 is essential for p53-null cancer cells. Oncogene 2017; 36:3287-3299. [PMID: 28092678 DOI: 10.1038/onc.2016.477] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 11/08/2016] [Accepted: 11/15/2016] [Indexed: 01/02/2023]
Abstract
The bifunctional enzyme 6-phosphofructo-2-kinase/fructose-2,6-biphosphatase-4 (PFKFB4) controls metabolic flux through allosteric regulation of glycolysis. Here we show that p53 regulates the expression of PFKFB4 and that p53-deficient cancer cells are highly dependent on the function of this enzyme. We found that p53 downregulates PFKFB4 expression by binding to its promoter and mediating transcriptional repression via histone deacetylases. Depletion of PFKFB4 from p53-deficient cancer cells increased levels of the allosteric regulator fructose-2,6-bisphosphate, leading to increased glycolytic activity but decreased routing of metabolites through the oxidative arm of the pentose-phosphate pathway. PFKFB4 was also required to support the synthesis and regeneration of nicotinamide adenine dinucleotide phosphate (NADPH) in p53-deficient cancer cells. Moreover, depletion of PFKFB4-attenuated cellular biosynthetic activity and resulted in the accumulation of reactive oxygen species and cell death in the absence of p53. Finally, silencing of PFKFB4-induced apoptosis in p53-deficient cancer cells in vivo and interfered with tumour growth. These results demonstrate that PFKFB4 is essential to support anabolic metabolism in p53-deficient cancer cells and suggest that inhibition of PFKFB4 could be an effective strategy for cancer treatment.
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Affiliation(s)
- S Ros
- Gene Expression Analysis Laboratory, Cancer Research UK London Research Institute, London, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - J Flöter
- Theodor-Boveri-Institute, Biocenter, Am Hubland, Würzburg, Germany
| | - I Kaymak
- Theodor-Boveri-Institute, Biocenter, Am Hubland, Würzburg, Germany
| | - C Da Costa
- Adult Stem Cell Laboratory, The Francis Crick Institute, London, UK
| | - A Houddane
- Protein Phosphorylation Unit, de Duve Institute, Université Catholique de Louvain, Brussels, Belgium
| | - S Dubuis
- Institute of Molecular Systems Biology, ETH Zurich, Zurich, Switzerland
| | - B Griffiths
- Gene Expression Analysis Laboratory, Cancer Research UK London Research Institute, London, UK
| | - R Mitter
- Bioinformatics and Biostatistics, The Francis Crick Institute, London, UK
| | - S Walz
- Comprehensive Cancer Center, Core Unit Bioinformatics, Biocenter, Würzburg, Germany
| | - S Blake
- Adult Stem Cell Laboratory, The Francis Crick Institute, London, UK
| | - A Behrens
- Adult Stem Cell Laboratory, The Francis Crick Institute, London, UK
- Faculty of Life Sciences and Medicine, King's College London, Guy's Campus, London, UK
| | - K M Brindle
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - N Zamboni
- Institute of Molecular Systems Biology, ETH Zurich, Zurich, Switzerland
| | - M H Rider
- Protein Phosphorylation Unit, de Duve Institute, Université Catholique de Louvain, Brussels, Belgium
| | - A Schulze
- Gene Expression Analysis Laboratory, Cancer Research UK London Research Institute, London, UK
- Theodor-Boveri-Institute, Biocenter, Am Hubland, Würzburg, Germany
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17
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Schulze A, Loo R, Ryan P, Wormington M, Favia P, Witters L, Collaert N, Bender H, Vandervorst W, Caymax M. Observation and understanding of anisotropic strain relaxation in selectively grown SiGe fin structures. Nanotechnology 2017; 28:145703. [PMID: 28186001 DOI: 10.1088/1361-6528/aa5fbb] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The performance of heterogeneous 3D transistor structures critically depends on the composition and strain state of the buffer, channel and source/drain regions. In this paper we used an in-line high resolution x-ray diffraction (HRXRD) tool to study in detail the composition and strain in selectively grown SiGe/Ge fin structures with widths down to 20 nm. For this purpose we arranged fins of identical dimensions into larger arrays which were then analyzed using an x-ray beam several tens of micrometers in size. Asymmetric reciprocal space maps measured both parallel and perpendicular to the fins allowed us to extract the lattice parameters in all three spatial directions. Our results demonstrate an anisotropic in-plane strain state of the selectively grown SiGe buffer in case of narrower fins with significantly reduced relaxation in the direction along the fin. This observation was verified using nano-beam electron diffraction, and is explained based on the reduced probability for dislocation half-loops to evolve in trenches narrower than a few times the critical radius. Moreover, we introduce and discuss in detail a methodology for the determination of the composition in case of an anisotropic in-plane strain state which differs from the procedure commonly used for blanket layers. Our findings verify the importance of in-line HRXRD measurements for process development and monitoring as well as the fundamental study of relaxation and defect formation in confined volumes.
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Affiliation(s)
- A Schulze
- imec, Kapeldreef 75, B-3001 Leuven, Belgium
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18
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19
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20
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Dai H, Zhang VW, El-Hattab AW, Ficicioglu C, Shinawi M, Lines M, Schulze A, McNutt M, Gotway G, Tian X, Chen S, Wang J, Craigen WJ, Wong LJ. FBXL4 defects are common in patients with congenital lactic acidemia and encephalomyopathic mitochondrial DNA depletion syndrome. Clin Genet 2017; 91:634-639. [PMID: 27743463 DOI: 10.1111/cge.12894] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 07/29/2016] [Revised: 10/11/2016] [Accepted: 10/11/2016] [Indexed: 11/30/2022]
Abstract
Mutations in FBXL4 have recently been recognized to cause a mitochondrial disorder, with clinical features including early onset lactic acidosis, hypotonia, and developmental delay. FBXL4 sequence analysis was performed in 808 subjects suspected to have a mitochondrial disorder. In addition, 28 samples from patients with early onset of lactic acidosis, but without identifiable mutations in 192 genes known to cause mitochondrial diseases, were examined for FBXL4 mutations. Definitive diagnosis was made in 10 new subjects with a total of 7 novel deleterious variants; 5 null and 2 missense substitutions. All patients exhibited congenital lactic acidemia, most of them with severe encephalopathic presentation, and global developmental delay. Overall, FBXL4 defects account for at least 0.7% (6 out of 808) of subjects suspected to have a mitochondrial disorder, and as high as 14.3% (4 out of 28) in young children with congenital lactic acidosis and clinical features of mitochondrial disease. Including FBLX4 in the mitochondrial diseases panel should be particularly important for patients with congenital lactic acidosis.
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Affiliation(s)
- H Dai
- Baylor Genetics, Houston, TX, USA
| | - V W Zhang
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - A W El-Hattab
- Division of Clinical Genetics and Metabolic Disorders, Pediatric Department, Tawam Hospital, Al-Ain, United Arab Emirates
| | - C Ficicioglu
- Division of Human Genetics and Metabolism, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - M Shinawi
- Division of Genetics and Genomics, Washington University School of Medicine, St. Louis, MO, USA
| | - M Lines
- Department of Genetics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - A Schulze
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - M McNutt
- Children's Medical Center, Dallas, TX, USA
| | - G Gotway
- Children's Medical Center, Dallas, TX, USA
| | - X Tian
- Baylor Genetics, Houston, TX, USA
| | - S Chen
- Baylor Genetics, Houston, TX, USA
| | - J Wang
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - W J Craigen
- Baylor Genetics, Houston, TX, USA.,Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - L-J Wong
- Baylor Genetics, Houston, TX, USA.,Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
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21
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Burgmann M, Aicher J, Teichmann L, Hasbargen U, Schulze A, Flemmer AW. Postnatale Sauerstoffsättigung reifer Neugeborener. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592947] [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: 10/20/2022] Open
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22
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Dobler F, Delius M, Lehner M, Bayer A, Herber-Jonat S, Schulze A, Flemmer AW, Dostert S, Friese K, Mahner S, Hasbargen U. EXIT bei Pierre-Robin-Sequenz – Fallbericht zu perinatalem Management einer Hochrisikogeburt. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592869] [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: 10/20/2022] Open
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Abstract
The prevalence of congenital hip dysplasia in Germany is 2-4 % and that of hip dislocation is 0.5-1 %. If early therapy is not successful or the hip dysplasia or dislocation is diagnosed too late (children of over 1 year of age) surgical treatment is indicated to increase the femoral coverage. The innominate osteotomy, published by Robert B. Salter 1961, is a worldwide established technique to improve the lateral and ventral coverage of the femoral head in primary or secondary hip dysplasia or dislocation. In this paper we discuss Salter's technique and present indications, the perioperative procedure, operative modifications and operative extensions and demonstrate the anatomical requirements, postoperative biomechanical changes and long-term results.
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Affiliation(s)
- A Schulze
- Universitätsklinikum Aachen (AöR), Pauwelsstr. 30, 52074, Aachen, Deutschland.
| | - M Tingart
- Universitätsklinikum Aachen (AöR), Pauwelsstr. 30, 52074, Aachen, Deutschland
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25
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Lüring C, Tingart M, Zahedi A, Schulze A. [Pelvic osteotomies]. Orthopade 2016; 45:643. [PMID: 27338828 DOI: 10.1007/s00132-016-3296-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- C Lüring
- Orthopädische Klinik, Klinikum Dortmund gGgmbH, Beurhausstraße 40, 44137, Dortmund, Deutschland.
| | - M Tingart
- Klinik für Orthopädie, Uniklinikum RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland.
| | - A Zahedi
- Orthopädische Klinik, Klinikum Dortmund gGgmbH, Beurhausstraße 40, 44137, Dortmund, Deutschland
| | - A Schulze
- Klinik für Orthopädie, Uniklinikum RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland
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26
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Niederwieser D, Al-Ali HK, Krahl R, Kahl C, Wolf HH, Kreibich U, Vucinic V, Hegenbart U, Hirt C, Peter N, Opitz B, Florschütz A, Schulze A, Scholl S, Jakob C, Junghanss C, Sayer H, Hochhaus A, Fischer T, Maschmeyer G. Hematopoietic stem cell transplantation (HSCT) compared to consolidation chemotherapy (CT) to increase leukemia free survival (LFS) in acute myelogenous leukemia (AML) patients between 60 and 75 years irrespective of genetic risk: Report from the AML 2004 of the East German Study Group (OSHO). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e18501] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Dietger Niederwieser
- Universitatsklinikum Leipzig AoR, Abt. Hamatologie und internistische Onkologie, Leipzig, Germany
| | | | | | - Christoph Kahl
- Department for Hematology, Klinikum Magdeburg, Magdeburg, Germany
| | | | | | | | - Ute Hegenbart
- Department of Hematology, Oncology, and Rheumatology, Heidelberg University Hospital, Heidelberg, Germany
| | - Carsten Hirt
- Ernst-Moritz-Arndt-Universität Greifswald, Greifswald, Germany
| | | | | | | | | | | | | | - Christian Junghanss
- Department of Hematology and Oncology, University Hospital, Rostock, Germany
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Schulze A, Tran C, Levandovskiy V, Patel V, Cortez MA. Systemic availability of guanidinoacetate affects GABAA receptor function and seizure threshold in GAMT deficient mice. Amino Acids 2016; 48:2041-7. [PMID: 26898547 DOI: 10.1007/s00726-016-2197-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 11/30/2015] [Accepted: 02/08/2016] [Indexed: 11/29/2022]
Abstract
Deficiency of guanidinoacetate methyltransferase (GAMT) causes creatine depletion and guanidinoacetate accumulation in brain with the latter deemed to be responsible for the severe seizure disorder seen in affected patients. We studied electrical brain activity and GABAA mediated mechanisms of B6J.Cg-Gamt(tm1Isb) mice. Electrocorticographic (ECoG) monitoring of pharmacological treatments with ornithine (5 % in drinking water for 5-18 days) and/or Picrotoxin (PTX) (a GABAA receptor antagonist) (1.5 mg/kg, I.P.) in Gamt(MUT) and Gamt(WT) groups [n = 3, mean age (SEM) = 6.9 (0.2) weeks]. Mice were fitted with two frontal and two parietal epidural electrodes under ketamine/xylazine anesthesia. Baseline and test recordings were performed for determination of seizure activity over a 2 h period. The ECoG baseline of Gamt(MUT) exhibited an abnormal monotonous cortical rhythm (7-8 Hz) with little variability during awake and sleep states compared to wild type recordings. Ornithine treatment and also PTX administration led to a relative normalization of the Gamt(MUT) ECoG phenotype. Gamt(WT) on PTX exhibited electro-behavioral seizures, whereas the Gamt(MUT) did not have PTX induced seizures at the same PTX dose. Gamt(MUT) treated with both ornithine and PTX did not show electro-behavioral seizures while ornithine elevated the PTX seizure threshold of Gamt(MUT) mice even further. These data demonstrate: (1) that there is expression of electrical seizure activity in this Gamt-deficient transgenic mouse strain, and (2) that the systemic availability of guanidinoacetate affects GABAA receptor function and seizure thresholds. These findings are directly and clinically relevant for patients with a creatine-deficiency syndrome due to genetic defects in GAMT and provide a rational basis for a combined ornithine/picrotoxin therapeutic intervention.
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Affiliation(s)
- A Schulze
- Program of Genetics and Genome Biology, Peter Gilgan Center for Research and Learning, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada. .,Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
| | - C Tran
- Program of Genetics and Genome Biology, Peter Gilgan Center for Research and Learning, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.,Center for Molecular Diseases, Lausanne University Hospital, Lausanne, Switzerland
| | - V Levandovskiy
- Program of Genetics and Genome Biology, Peter Gilgan Center for Research and Learning, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - V Patel
- Program of Genetics and Genome Biology, Peter Gilgan Center for Research and Learning, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - M A Cortez
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada.,Program of Brain and Behavior Neuroscience and Mental Health, Peter Gilgan Center for Research and Learning, The Hospital for Sick Children, Toronto, ON, Canada
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Abstract
The zeta potential of membrane surfaces and the resulting electrostatic interactions are determining factors of membrane fouling. This publication presents the impact of salt concentration and pH value on these interactions.
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Affiliation(s)
- D. Breite
- Leibniz Institute of Surface Modification
- Leipzig
- Germany
| | - M. Went
- Leibniz Institute of Surface Modification
- Leipzig
- Germany
| | - A. Prager
- Leibniz Institute of Surface Modification
- Leipzig
- Germany
| | - A. Schulze
- Leibniz Institute of Surface Modification
- Leipzig
- Germany
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Breite D, Went M, Thomas I, Prager A, Schulze A. Particle adsorption on a polyether sulfone membrane: how electrostatic interactions dominate membrane fouling. RSC Adv 2016. [DOI: 10.1039/c6ra13787c] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
This study presents a new method focussing on electrostatic interactions during fouling of microfiltration membranes.
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Affiliation(s)
- D. Breite
- Leibniz Institute of Surface Modification
- Leipzig
- Germany
| | - M. Went
- Leibniz Institute of Surface Modification
- Leipzig
- Germany
| | - I. Thomas
- Leibniz Institute of Surface Modification
- Leipzig
- Germany
| | - A. Prager
- Leibniz Institute of Surface Modification
- Leipzig
- Germany
| | - A. Schulze
- Leibniz Institute of Surface Modification
- Leipzig
- Germany
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Lee B, Diaz GA, Rhead W, Lichter-Konecki U, Feigenbaum A, Berry SA, Le Mons C, Bartley J, Longo N, Nagamani SC, Berquist W, Gallagher RC, Harding CO, McCandless SE, Smith W, Schulze A, Marino M, Rowell R, Coakley DF, Mokhtarani M, Scharschmidt BF. Glutamine and hyperammonemic crises in patients with urea cycle disorders. Mol Genet Metab 2016; 117:27-32. [PMID: 26586473 PMCID: PMC4915945 DOI: 10.1016/j.ymgme.2015.11.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 11/10/2015] [Accepted: 11/10/2015] [Indexed: 12/30/2022]
Abstract
UNLABELLED Blood ammonia and glutamine levels are used as biomarkers of control in patients with urea cycle disorders (UCDs). This study was undertaken to evaluate glutamine variability and utility as a predictor of hyperammonemic crises (HACs) in UCD patients. METHODS The relationships between glutamine and ammonia levels and the incidence and timing of HACs were evaluated in over 100 adult and pediatric UCD patients who participated in clinical trials of glycerol phenylbutyrate. RESULTS The median (range) intra-subject 24-hour coefficient of variation for glutamine was 15% (8-29%) as compared with 56% (28%-154%) for ammonia, and the correlation coefficient between glutamine and concurrent ammonia levels varied from 0.17 to 0.29. Patients with baseline (fasting) glutamine values >900 μmol/L had higher baseline ammonia levels (mean [SD]: 39.6 [26.2]μmol/L) than patients with baseline glutamine ≤ 900 μmol/L (26.6 [18.0]μmol/L). Glutamine values >900 μmol/L during the study were associated with an approximately 2-fold higher HAC risk (odds ratio [OR]=1.98; p=0.173). However, glutamine lost predictive significance (OR=1.47; p=0.439) when concomitant ammonia was taken into account, whereas the predictive value of baseline ammonia ≥ 1.0 upper limit of normal (ULN) was highly statistically significant (OR=4.96; p=0.013). There was no significant effect of glutamine >900 μmol/L on time to first HAC crisis (hazard ratio [HR]=1.14; p=0.813), but there was a significant effect of baseline ammonia ≥ 1.0 ULN (HR=4.62; p=0.0011). CONCLUSIONS The findings in this UCD population suggest that glutamine is a weaker predictor of HACs than ammonia and that the utility of the predictive value of glutamine will need to take into account concurrent ammonia levels.
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Affiliation(s)
- B Lee
- Baylor College of Medicine, Houston, TX, USA.
| | - G A Diaz
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - W Rhead
- The Medical College of Wisconsin, Milwaukee, WI, USA
| | | | | | - S A Berry
- Univ. of Minnesota, Minneapolis, MN, USA
| | - C Le Mons
- National Urea Cycle Disorders Foundation, Pasadena, CA, USA
| | - J Bartley
- Miller Children's Hospital, Long Beach, CA, USA
| | - N Longo
- Univ. of UT, Salt Lake City, UT, USA
| | | | | | | | | | - S E McCandless
- Case Western Reserve Univ. Medical Center, Cleveland, OH, USA
| | - W Smith
- Maine Medical Ctr., Portland, ME, USA
| | - A Schulze
- The Hospital for Sick Children, Univ. of Toronto, Canada
| | - M Marino
- Oregon Health Sciences, Portland, OR, USA
| | - R Rowell
- MED Technical Consulting, Inc., Union City, CA, USA
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Schulze A, Cao R, Eyben P, Hantschel T, Vandervorst W. Outwitting the series resistance in scanning spreading resistance microscopy. Ultramicroscopy 2015; 161:59-65. [PMID: 26624516 DOI: 10.1016/j.ultramic.2015.10.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [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: 05/13/2015] [Revised: 10/27/2015] [Accepted: 10/28/2015] [Indexed: 11/18/2022]
Abstract
The performance of nanoelectronics devices critically depends on the distribution of active dopants inside these structures. For this reason, dopant profiling has been defined as one of the major metrology challenges by the international technology roadmap of semiconductors. Scanning spreading resistance microscopy (SSRM) has evolved as one of the most viable approaches over the last decade due to its excellent spatial resolution, sensitivity and quantification accuracy. However, in case of advanced device architectures like fins and nanowires a proper measurement of the spreading resistance is often hampered by the increasing impact of parasitic series resistances (e.g. bulk series resistance) arising from the confined nature of the aforementioned structures. In order to overcome this limitation we report in this paper the development and implementation of a novel SSRM mode (fast Fourier transform-SSRM: FFT-SSRM) which essentially decouples the spreading resistance from parasitic series resistance components. We show that this can be achieved by a force modulation (leading to a modulated spreading resistance signal) in combination with a lock-in deconvolution concept. In this paper we first introduce the principle of operation of the technique. We discuss in detail the underlying physical mechanisms as well as the technical implementation on a state-of-the-art atomic force microscope (AFM). We demonstrate the performance of FFT-SSRM and its ability to remove substantial series resistance components in practice. Eventually, the possibility of decoupling the spreading resistance from the intrinsic probe resistance will be demonstrated and discussed.
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Affiliation(s)
- A Schulze
- IMEC, Kapeldreef 75, 3001 Leuven, Belgium.
| | - R Cao
- IMEC, Kapeldreef 75, 3001 Leuven, Belgium
| | - P Eyben
- IMEC, Kapeldreef 75, 3001 Leuven, Belgium
| | | | - W Vandervorst
- IMEC, Kapeldreef 75, 3001 Leuven, Belgium; KU Leuven, Department of Physics and Astronomy, Celestijnenlaan 200D, 3001 Leuven, Belgium
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Simoen E, Eneman G, Hikavyy AY, Loo R, Gupta S, Merckling C, Alian A, Schulze A, Caymax M, Langer R, Barla K, Claeys C. (Invited) On the Electrical Activity of Extended Defects in High-Mobility Channel Materials. ACTA ACUST UNITED AC 2015. [DOI: 10.1149/06910.0119ecst] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lewis CA, Brault C, Peck B, Bensaad K, Griffiths B, Mitter R, Chakravarty P, East P, Dankworth B, Alibhai D, Harris AL, Schulze A. SREBP maintains lipid biosynthesis and viability of cancer cells under lipid- and oxygen-deprived conditions and defines a gene signature associated with poor survival in glioblastoma multiforme. Oncogene 2015; 34:5128-40. [PMID: 25619842 DOI: 10.1038/onc.2014.439] [Citation(s) in RCA: 159] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Revised: 11/04/2014] [Accepted: 12/05/2014] [Indexed: 12/16/2022]
Abstract
Oxygen and nutrient limitation are common features of the tumor microenvironment and are associated with cancer progression and induction of metastasis. The inefficient vascularization of tumor tissue also limits the penetration of other serum-derived factors, such as lipids and lipoproteins, which can be rate limiting for cell proliferation and survival. Here we have investigated the effect of hypoxia and serum deprivation on sterol regulatory element-binding protein (SREBP) activity and the expression of lipid metabolism genes in human glioblastoma multiforme (GBM) cancer cells. We found that SREBP transcriptional activity was induced by serum depletion both in normoxic and hypoxic cells and that activation of SREBP was required to maintain the expression of fatty acid and cholesterol metabolism genes under hypoxic conditions. Moreover, expression of stearoyl-CoA desaturase, the enzyme required for the generation of mono-unsaturated fatty acids, and fatty acid-binding protein 7, a regulator of glioma stem cell function, was strongly dependent on SREBP function. Inhibition of SREBP function blocked lipid biosynthesis in hypoxic cancer cells and impaired cell survival under hypoxia and in a three-dimensional spheroid model. Finally, gene expression analysis revealed that SREBP defines a gene signature that is associated with poor survival in glioblastoma.
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Affiliation(s)
- C A Lewis
- Gene Expression Analysis Laboratory, Cancer Research UK London Research Institute, London, UK
| | - C Brault
- Theodor-Boveri-Institute, Biocenter, Am Hubland, Würzburg, Germany
| | - B Peck
- Gene Expression Analysis Laboratory, Cancer Research UK London Research Institute, London, UK
| | - K Bensaad
- CRUK Growth Factor Group, The Weatherall Institute of Molecular Medicine, University of Oxford, Headington, Oxford, UK
| | - B Griffiths
- Gene Expression Analysis Laboratory, Cancer Research UK London Research Institute, London, UK
| | - R Mitter
- Bioinformatics and Biostatistics Service, Cancer Research UK London Research Institute, London, UK
| | - P Chakravarty
- Bioinformatics and Biostatistics Service, Cancer Research UK London Research Institute, London, UK
| | - P East
- Bioinformatics and Biostatistics Service, Cancer Research UK London Research Institute, London, UK
| | - B Dankworth
- Theodor-Boveri-Institute, Biocenter, Am Hubland, Würzburg, Germany
| | - D Alibhai
- Light Microscopy Core, Cancer Research UK London Research Institute, London, UK
| | - A L Harris
- CRUK Growth Factor Group, The Weatherall Institute of Molecular Medicine, University of Oxford, Headington, Oxford, UK
| | - A Schulze
- Gene Expression Analysis Laboratory, Cancer Research UK London Research Institute, London, UK
- Theodor-Boveri-Institute, Biocenter, Am Hubland, Würzburg, Germany
- Comprehensive Cancer Center Mainfranken Würzburg, Germany
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Quack V, Rath B, Schenker H, Schulze A, El Mansy Y, Tingart M, Betsch M. [Fusion in adolescent idiopathic scoliosis : Anterior, posterior or combined? One-stage or two-stage?]. Orthopade 2015; 44:879-84. [PMID: 26376986 DOI: 10.1007/s00132-015-3164-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Scoliosis is a complex, three-dimensional spinal deformity with various causes. Adolescent idiopathic scoliosis (AIS) is the most common form. Surgical treatment is indicated for curves greater than 45-50° meaured using the Cobb method. We can distinguish among posterior, anterior or combined surgical procedures. Today, the posterior, transpedicular approach has revolutionized scoliosis surgery. This review gives an overview of current surgical options in scoliosis treatment.
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Affiliation(s)
- V Quack
- Klinik für Orthopädie, RWTH Aachen, Universitätsklinikum Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland.
| | - B Rath
- Klinik für Orthopädie, RWTH Aachen, Universitätsklinikum Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland
| | - H Schenker
- Klinik für Orthopädie, RWTH Aachen, Universitätsklinikum Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland
| | - A Schulze
- Klinik für Orthopädie, RWTH Aachen, Universitätsklinikum Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland
| | - Y El Mansy
- Klinik für Orthopädie, RWTH Aachen, Universitätsklinikum Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland
| | - M Tingart
- Klinik für Orthopädie, RWTH Aachen, Universitätsklinikum Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland
| | - M Betsch
- Klinik für Orthopädie, RWTH Aachen, Universitätsklinikum Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland
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Förster KM, Herber-Jonat S, Huebener C, Hasbargen U, Schmitz C, Schramm R, Lehner M, Stehr M, Schulze A, Flemmer AW. [Establishment of a Neonatal ECMO Programme on the Basis of a Special Training Programme--A 6-year Analysis]. Z Geburtshilfe Neonatol 2015; 219:274-80. [PMID: 26378775 DOI: 10.1055/s-0035-1547298] [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: 10/23/2022]
Abstract
BACKGROUND Internationally the need for neonatal ECMO is decreasing and the Extracorporeal Life Support Organization (ELSO) recommends that centres providing neonatal ECMO should treat at least 6 children per year. METHOD After a one-year training programme and preparation of the clinical application, neonatal ECMO was established and subsequently 41 infants [median age 1 day (1-172 days), median weight 3.25 kg (1.27-5.79 kg)] with severe respiratory failure have been treated within a 6-year period (fall 2008-fall 2014). For rescue therapy we provide inhaled nitric oxide, high-frequency oscillation and other differentiated ventilator strategies. Parallel to the clinical use of ECMO all employees have been trained in a special programme at 3-monthly intervals. RESULTS By establishing an elaborate training programme and concentrating the treatment of critically ill newborns in one centre, the expertise of both running and preventing of neonatal ECMO due to pulmonary failure can be achieved. The diagnoses correlate to those of other centres which perform neonatal ECMO. 13 infants needed ECMO. The resulting overall survival rate was 11/12 (91.7%) infants treated with ECMO with a curative approach. All patients could be weaned from ECMO. CONCLUSION In the context of a specialised university hospital with all treatment options for critically ill newborns and with the establishment of a specialised training programme, neonatal ECMO for pulmonary failure can achieve equally good results in comparison to those of national and international ECMO centres.
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Affiliation(s)
- K M Förster
- Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital am Klinikum der Universität, Neonatologie der Kinderklinik am Perinatalzentrum der LMU München, Campus Großhadern, München
| | - S Herber-Jonat
- Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital am Klinikum der Universität, Neonatologie der Kinderklinik am Perinatalzentrum der LMU München, Campus Großhadern, München
| | - C Huebener
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe am Klinikum der Universität, Perinatalzentrum der LMU München, Campus Großhadern, München
| | - U Hasbargen
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe am Klinikum der Universität, Perinatalzentrum der LMU München, Campus Großhadern, München
| | - C Schmitz
- Herzchirurgische Klinik und Poliklinik am Klinikum der Universität, München
| | - R Schramm
- Herzchirurgische Klinik und Poliklinik am Klinikum der Universität, München
| | - M Lehner
- Kinderchirurgische Klinik und Poliklinik im Dr. von Haunerschen Kinderspital am Klinikum der Universität, München
| | - M Stehr
- Klinik für Kinderchirurgie und Kinderurologie, Cnopf'sche Kinderklinik/Klinik Hallerwiese, Nürnberg
| | - A Schulze
- Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital am Klinikum der Universität, Neonatologie der Kinderklinik am Perinatalzentrum der LMU München, Campus Großhadern, München
| | - A W Flemmer
- Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital am Klinikum der Universität, Neonatologie der Kinderklinik am Perinatalzentrum der LMU München, Campus Großhadern, München
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Studer D, Hasler CC, Schulze A. [Treatment of early onset scoliosis : How far can we go?]. Orthopade 2015; 44:896-904. [PMID: 26345169 DOI: 10.1007/s00132-015-3163-3] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Recently, inconsistent definitions of early onset scoliosis (EOS) and a wide variety of treatment options have been observed. OBJECTIVES To clearly define the term EOS, to depict non-operative and operative treatment options, and to present the limitations of the boundaries of these techniques. METHODS Review of the literature, including conference presentations and expert opinions, in addition to personal experiences. RESULTS Early onset scoliosis (EOS) refers to spine deformity that is present before 10 years of age, regardless of etiology. All existing operative treatment options share a high risk of complications. Therefore, non-operative treatment should act as a time-buying approach to postpone surgery. DISCUSSION Awareness of treatment options and their specific indications, in addition to respecting each patient's individual needs and feasibilities, are crucial for the optimal outcome.
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Affiliation(s)
- D Studer
- Universitätskinderspital beider Basel, Spitalstrasse 33, 4056, Basel, Schweiz.
| | - C C Hasler
- Universitätskinderspital beider Basel, Spitalstrasse 33, 4056, Basel, Schweiz
| | - A Schulze
- Universitätskinderspital beider Basel, Spitalstrasse 33, 4056, Basel, Schweiz
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Eyben P, Bisiaux P, Schulze A, Nazir A, Vandervorst W. Fast Fourier transform scanning spreading resistance microscopy: a novel technique to overcome the limitations of classical conductive AFM techniques. Nanotechnology 2015; 26:355702. [PMID: 26245715 DOI: 10.1088/0957-4484/26/35/355702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A new atomic force microscopy (AFM)-based technique named fast Fourier transform scanning spreading-resistance microscopy (FFT-SSRM) has been developed. FFT-SSRM offers the ability to isolate the local spreading resistance (Sr) from the parasitic series resistance (probe, bulk, and back contact). The parasitic series resistance limits the use of classical SSRM in confined volumes and on very highly doped materials, two increasingly important situations in nanoelectronic components. This is realized via a force modulation at controlled frequency (affecting the SR component) and the extraction of the resistance amplitude at the modulation frequency, performing an FFT-based lock-in deconvolution. A systematic evaluation of the FFT-SSRM performances (i.e., resolution, dynamic range, sensitivity, and repeatability) is presented. The impact of various parameters (i.e., modulation frequency and amplitude or cutoff frequency of the current amplifier) on the performances of FFT-SSRM has been evaluated. We demonstrate the possibility to overcome sensitivity losses due to tip saturation in highly doped material and the utility of the technique in two different structures, presenting isolated and confined volumes.
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Affiliation(s)
- P Eyben
- IMEC, Kapeldreef 75, B-3001, Leuven, Belgium
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Thiel A, Schetelig J, Pönisch W, Schäfer-Eckart K, Aulitzky W, Peter N, Schulze A, Maschmeyer G, Neugebauer S, Herbst R, Hänel A, Morgner A, Kroschinsky F, Bornhäuser M, Lange T, Wilhelm M, Niederwieser D, Ehninger G, Fiedler F, Hänel M. Mito-FLAG with Ara-C as bolus versus continuous infusion in recurrent or refractory AML—long-term results of a prospective randomized intergroup study of the East German Study Group Hematology/Oncology (OSHO) and the Study Alliance Leukemia (SAL). Ann Oncol 2015; 26:1434-40. [DOI: 10.1093/annonc/mdv205] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 04/21/2015] [Indexed: 11/13/2022] Open
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Lamparter J, Schulze A, Riedel J, Wasielica-Poslednik J, König J, Pfeiffer N, Hoffmann EM. Peripapillary Choroidal Thickness and Choroidal Area in Glaucoma, Ocular Hypertension and Healthy Subjects by SD-OCT. Klin Monbl Augenheilkd 2015; 232:390-4. [PMID: 25902084 DOI: 10.1055/s-0035-1545819] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The exact pathogenesis of open angle glaucoma and ocular hypertension remains unclear. Hemodynamic influences are discussed as potential risk factors and the choroid may play an important role in the pathogenesis of open angle glaucoma or ocular hypertension. The current study investigates peripapillary choroidal thickness and choroidal area in patients with open angle glaucoma, subjects with ocular hypertension and healthy subjects using spectral-domain OCT. It furthermore assesses the association between peripapillary choroidal thickness and age, central corneal thickness, refractive error and intraocular pressure. PATIENTS AND METHODS Prospectively recorded data of 213 eyes of 177 open angle glaucoma patients, 73 eyes of 50 subjects with ocular hypertension and 152 eyes of 116 healthy control subjects were analyzed by fitting a linear mixed model including age and disease. RESULTS Peripapillary choroidal thickness was thinnest in glaucoma patients (125 µm), followed by healthy subjects (127 µm) and ocular hypertensive subjects (135 µm). A marginally significant difference was present between ocular hypertension and glaucoma (p=0.059). Thickest choroids were found superiorly and thinnest choroids inferiorly. Choroidal area was highest in the supero-nasal and lowest in the infero-temporal sectors. Choroidal thickness decreased with age, no significant correlation was evident between peripapillary choroidal thickness and refractive error or intraocular pressure. Peripapillary choroidal thickness and central corneal thickness are significantly negative correlated in healthy subjects. CONCLUSIONS There is a trend towards thicker choroids in ocular hypertensive subjects compared to healthy subjects or glaucoma patients. Thickest choroids are found superiorly, thinnest inferiorly. Interestingly, choroidal area is thinnest in the temporal-inferior sector, one of the regions where glaucomatous damage tends to start.
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Affiliation(s)
- J Lamparter
- Department of Ophthalmology, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz (Head of Department: Prof. Dr. med. Norbert Pfeiffer)
| | - A Schulze
- Department of Ophthalmology, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz (Head of Department: Prof. Dr. med. Norbert Pfeiffer)
| | - J Riedel
- Department of Ophthalmology, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz (Head of Department: Prof. Dr. med. Norbert Pfeiffer)
| | - J Wasielica-Poslednik
- Department of Ophthalmology, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz (Head of Department: Prof. Dr. med. Norbert Pfeiffer)
| | - J König
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre of the Johannes Gutenberg University Mainz, Mainz (Head of Department: Prof. Dr. rer. nat. Maria Blettner)
| | - N Pfeiffer
- Department of Ophthalmology, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz (Head of Department: Prof. Dr. med. Norbert Pfeiffer)
| | - E M Hoffmann
- Department of Ophthalmology, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz (Head of Department: Prof. Dr. med. Norbert Pfeiffer)
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Förster KM, Immler S, Ensslen M, Flemmer A, Schulze A, von Poblotzki M, Genzel-Boroviczény O, Heinen F, Hilgendorff A. [Indications and concept of follow-up care of home-monitoring for premature and risk infants]. Klin Padiatr 2015; 227:72-9. [PMID: 25751680 DOI: 10.1055/s-0034-1395663] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The pros and cons of home monitoring especially for premature infants with continuing apneic episodes and/or chronic lung disease are an ongoing discussion. The controversy spans socio-economic requirements, medical indication as well as patient and family needs. Here, the costs of home monitoring and follow-up care on the one hand and longer hospitalization times on the other need to be considered. This article aims to create a basis for this discussion by summarizing current evidence for the indications and considerations for differential diagnoses while also outlining the established follow-up program for these patients at the Dr. v. Hauner Children's Hospital at the Ludwig-Maximilians-University Munich, Germany.
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Affiliation(s)
- K M Förster
- Neonatologie des Dr. von Haunerschen Kinderspitals der Ludwig-Maximilians-Universität München am Perinatalzentrum Campus Großhadern, Klinikum der Universität, München
| | - S Immler
- Neonatologie des Dr. von Haunerschen Kinderspitals der Ludwig-Maximilians-Universität München am Perinatalzentrum Campus Innenstadt, Klinikum der Universität, München
| | - M Ensslen
- Pädiatrische Neurologie, Entwicklungsneurologie und Sozialpädiatrie im Dr. von Haunerschen Kinderspital der Ludwig-Maximilians-Universität München, Campus Innenstadt, Klinikum der Universität, München
| | - A Flemmer
- Neonatologie des Dr. von Haunerschen Kinderspitals der Ludwig-Maximilians-Universität München am Perinatalzentrum Campus Großhadern, Klinikum der Universität, München
| | - A Schulze
- Neonatologie des Dr. von Haunerschen Kinderspitals der Ludwig-Maximilians-Universität München am Perinatalzentrum Campus Großhadern, Klinikum der Universität, München
| | - M von Poblotzki
- Neonatologie des Dr. von Haunerschen Kinderspitals der Ludwig-Maximilians-Universität München am Perinatalzentrum Campus Innenstadt, Klinikum der Universität, München
| | - O Genzel-Boroviczény
- Neonatologie des Dr. von Haunerschen Kinderspitals der Ludwig-Maximilians-Universität München am Perinatalzentrum Campus Innenstadt, Klinikum der Universität, München
| | - F Heinen
- Pädiatrische Neurologie, Entwicklungsneurologie und Sozialpädiatrie im Dr. von Haunerschen Kinderspital der Ludwig-Maximilians-Universität München, Campus Innenstadt, Klinikum der Universität, München
| | - A Hilgendorff
- Neonatologie des Dr. von Haunerschen Kinderspitals der Ludwig-Maximilians-Universität München am Perinatalzentrum Campus Großhadern, Klinikum der Universität, München
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Mola-Schenzle E, Staffler A, Klemme M, Pellegrini F, Molinaro G, Parhofer KG, Messner H, Schulze A, Flemmer AW. Clinically stable very low birthweight infants are at risk for recurrent tissue glucose fluctuations even after fully established enteral nutrition. Arch Dis Child Fetal Neonatal Ed 2015; 100:F126-31. [PMID: 25381093 DOI: 10.1136/archdischild-2014-306168] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE In previous cases, we have observed occasional hypoglycaemic episodes in preterm infants after initial intensive care. In this prospective study, we determined the frequency and severity of abnormal tissue glucose (TG) in clinically stable preterm infants on full enteral nutrition. METHODS Preterm infants born at <1000 g (n=23; G1) and birth weight 1000-1500 g (n=18; G2) were studied at a postmenstrual age of 32±2 weeks (G1) and 33±2 weeks (G2). Infants were fed two or three hourly, according to a standard bolus-nutrition protocol, and continuous subcutaneous glucose measurements were performed for 72 h. Normal glucose values were assumed at ≥2.5 mmol/L (45 mg/dL) and ≤8.3 mmol/L (150 mg/dL). Frequency, severity and duration of glucose values beyond normal values were determined. RESULTS We observed asymptomatic low TG values in 39% of infants in G1 and in 44% in G2. High TG values were detected in 83% in G1 and 61% in G2. Infants in G1 experienced prolonged and more severe low TG episodes, and also more frequent and severe high TG episodes. In G1 and G2, 87% and 67% of the infants, respectively, showed glucose fluctuations characterised by rapid glucose increase followed by a rapid glucose drop after feeds. In more mature infants, glucose fluctuations were less pronounced and less dependent on enteral feeds. CONCLUSIONS Clinically stable well-developing preterm infants beyond their initial period of intensive care show interstitial glucose instabilities exceeding values as low as 2.5 mmol/L and as high as 8.3 mmol/L. This novel observation may play an important role for the susceptibility of these high-risk infants for the development of the metabolic syndrome. TRIAL REGISTRATION NUMBER German trial registration number DRKS00004590.
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Affiliation(s)
- E Mola-Schenzle
- Division of Neonatology, Dr von Hauner Children's Hospital and Perinatal Center, Ludwig Maximilian University Munich-Grosshadern, Munich, Germany
| | - A Staffler
- Division of Neonatology, Regional Hospital Bolzano, Bolzano, Italy
| | - M Klemme
- Division of Neonatology, Dr von Hauner Children's Hospital and Perinatal Center, Ludwig Maximilian University Munich-Grosshadern, Munich, Germany
| | - F Pellegrini
- Division of Neonatology, Regional Hospital Bolzano, Bolzano, Italy
| | - G Molinaro
- Division of Neonatology, Regional Hospital Bolzano, Bolzano, Italy
| | - K G Parhofer
- Department of Internal Medicine, Ludwig-Maximilian-University Munich-Grosshadern, Munich, Germany
| | - H Messner
- Division of Neonatology, Regional Hospital Bolzano, Bolzano, Italy
| | - A Schulze
- Division of Neonatology, Dr von Hauner Children's Hospital and Perinatal Center, Ludwig Maximilian University Munich-Grosshadern, Munich, Germany
| | - A W Flemmer
- Division of Neonatology, Dr von Hauner Children's Hospital and Perinatal Center, Ludwig Maximilian University Munich-Grosshadern, Munich, Germany
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Fischer K, Kühnert M, Gläser R, Schulze A. Photocatalytic degradation and toxicity evaluation of diclofenac by nanotubular titanium dioxide–PES membrane in a static and continuous setup. RSC Adv 2015. [DOI: 10.1039/c4ra16219f] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Diclofenac is a commonly used anti-inflammatory drug, which has been found in surface waters. TiO2 nanotubes with a polymer microfiltration membrane showed high photocatalytic degradation of diclofenac combined with an excellent membrane performance and long term stability.
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Affiliation(s)
- K. Fischer
- Leibniz Institute of Surface Modification
- Leipzig
- Germany
| | - M. Kühnert
- Leibniz Institute of Surface Modification
- Leipzig
- Germany
| | - R. Gläser
- Leipzig University
- Institute of Chemical Technology
- Leipzig
- Germany
| | - A. Schulze
- Leibniz Institute of Surface Modification
- Leipzig
- Germany
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Schulze A, Gärtner M, Scharf HP. [Dorsal sagittal knee joint stability after endoprosthetic knee arthroplasty : Influence of preoperative joint stability and the type of implanted prosthesis]. Orthopade 2014; 44:226-30. [PMID: 25413279 DOI: 10.1007/s00132-014-3047-y] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Anterior knee pain is a known complication after implantation of a prosthesis and a possible reason is a posterior knee joint instability; however, the influence on postoperative stability is just as unknown as the possible influence of the type of prosthesis on postoperative stability. AIM This study investigated two possible preoperative and intraoperative influencing factors by determination of the preoperative joint stability and type of prosthesis.
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Affiliation(s)
- A Schulze
- Orthopädisch-Unfallchirurgisches Zentrum, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68135, Mannheim, Deutschland,
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Schulze A, Fleskes K, Scharf HP. [What do patients in Germany expect from their total knee arthroplasty?]. Z Orthop Unfall 2014; 152:462-8. [PMID: 25313701 DOI: 10.1055/s-0034-1383022] [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] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Only 84 % of patients are satisfied with the operative result after total knee arthroplasty. A relevant reason is non-fulfilled preoperative expectations. Non-fulfilled preoperative expectations cannot be influenced postoperatively. So a knowledge of preoperative expectations and their influential factors is essential. The following study analyses the expectations and influential factors in patients before total knee arthroplasty in Germany. MATERIAL AND METHODS On the day before total knee replacement in 104 patients the following data were collected: school leaving level, comorbidities, articular knee function, psychological mood, health-related quality of life, and preoperative expectations. Statistical evaluation was done by factor analyses of expectations and independent variables, and correlation and regression analyses. RESULTS The following 4 factors of expectations resulted from the factor analyses: (i) relief of pain, (ii) increase of range of motion of the knee, (iii) better mobility, and (iv) better integration in social activities. In general patient expectations on the effects of a total knee replacement are high. Age and better integration in social activities correlate negatively, as also do age and better mobility. Body mass index and better integration in social activities correlate positively. The following formula analyses the expectations of better integration in social life: social expectations = 116-0.991 × age. DISCUSSION For the first time this study determines expectations and influential factors of patients who undergo a total knee replacement in Germany. By knowing the interaction of satisfaction and preoperative expectations, this knowledge is an essential condition to increase satisfaction after total knee replacement in the German population. Collecting the preoperative expectations of patients has to be an indispensable feature of the clinical practice in orthopaedic surgery.
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Affiliation(s)
- A Schulze
- Orthopädisch-Unfallchirurgisches Zentrum, Universitätsmedizin Mannheim
| | - K Fleskes
- Orthopädisch-Unfallchirurgisches Zentrum, Universitätsmedizin Mannheim
| | - H-P Scharf
- Orthopädisch-Unfallchirurgisches Zentrum, Universitätsmedizin Mannheim
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Abstract
Hearing impairment is considered as the most common impairment of a human sense system. According to WHO, 360 Million people worldwide were affected by hearing loss in 2012, out of which 91% were adults and 9% children.Hearing impairment can be triggered by various mechanisms, such as locally destructive processes (chronic otitis media, cholesteatoma or traumatic lesions) or systemic influences like infectious or ototoxic substances (measles, mumps, meningococcal meningitis or medication and industrial agents). Congenital dysplasia, perinatal complications and genetic modifications can lead to hearing loss as well. Moreover, the acute or chronic noise exposure associated with the changing spare time activities in industrial nations represents an increasingly significant source of hearing impairment. In order to achieve the best hearing rehabilita-tion, a specific differential diagnosis in each case is of significant importance.
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Hübener C, Förster KM, Herber-Jonat S, Hasbargen U, Schmitz C, Malec E, Lehner M, Stehr M, Schulze A, Flemmer AW. Neonatale extracorporale Membranoxygenierung (ECMO) bei Lungenversagen – 5 Jahresdaten aus dem Perinatalzentrum des Klinikums Großhadern. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388036] [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: 10/24/2022] Open
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Tran C, Yazdanpanah M, Kyriakopoulou L, Levandovskiy V, Zahid H, Naufer A, Isbrandt D, Schulze A. Stable isotope dilution microquantification of creatine metabolites in plasma, whole blood and dried blood spots for pharmacological studies in mouse models of creatine deficiency. Clin Chim Acta 2014; 436:160-8. [DOI: 10.1016/j.cca.2014.05.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 05/04/2014] [Accepted: 05/06/2014] [Indexed: 10/25/2022]
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Mkopi A, Range N, Lwilla F, Egwaga S, Schulze A, Geubbels E, van Leth F. Validation of indirect tuberculosis treatment adherence measures in a resource-constrained setting. Int J Tuberc Lung Dis 2014; 18:804-9. [DOI: 10.5588/ijtld.13.0675] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Mokhtarani M, Diaz GA, Rhead W, Berry SA, Lichter-Konecki U, Feigenbaum A, Schulze A, Longo N, Bartley J, Berquist W, Gallagher R, Smith W, McCandless SE, Harding C, Rockey DC, Vierling JM, Mantry P, Ghabril M, Brown RS, Dickinson K, Moors T, Norris C, Coakley D, Milikien DA, Nagamani SC, Lemons C, Lee B, Scharschmidt BF. Elevated phenylacetic acid levels do not correlate with adverse events in patients with urea cycle disorders or hepatic encephalopathy and can be predicted based on the plasma PAA to PAGN ratio. Mol Genet Metab 2013; 110:446-53. [PMID: 24144944 PMCID: PMC4108288 DOI: 10.1016/j.ymgme.2013.09.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 09/29/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Phenylacetic acid (PAA) is the active moiety in sodium phenylbutyrate (NaPBA) and glycerol phenylbutyrate (GPB, HPN-100). Both are approved for treatment of urea cycle disorders (UCDs) - rare genetic disorders characterized by hyperammonemia. PAA is conjugated with glutamine in the liver to form phenylacetyleglutamine (PAGN), which is excreted in urine. PAA plasma levels ≥ 500 μg/dL have been reported to be associated with reversible neurological adverse events (AEs) in cancer patients receiving PAA intravenously. Therefore, we have investigated the relationship between PAA levels and neurological AEs in patients treated with these PAA pro-drugs as well as approaches to identifying patients most likely to experience high PAA levels. METHODS The relationship between nervous system AEs, PAA levels and the ratio of plasma PAA to PAGN were examined in 4683 blood samples taken serially from: [1] healthy adults [2], UCD patients of ≥ 2 months of age, and [3] patients with cirrhosis and hepatic encephalopathy (HE). The plasma ratio of PAA to PAGN was analyzed with respect to its utility in identifying patients at risk of high PAA values. RESULTS Only 0.2% (11) of 4683 samples exceeded 500 μg/ml. There was no relationship between neurological AEs and PAA levels in UCD or HE patients, but transient AEs including headache and nausea that correlated with PAA levels were observed in healthy adults. Irrespective of population, a curvilinear relationship was observed between PAA levels and the plasma PAA:PAGN ratio, and a ratio>2.5 (both in μg/mL) in a random blood draw identified patients at risk for PAA levels>500 μg/ml. CONCLUSIONS The presence of a relationship between PAA levels and reversible AEs in healthy adults but not in UCD or HE patients may reflect intrinsic differences among the populations and/or metabolic adaptation with continued dosing. The plasma PAA:PAGN ratio is a functional measure of the rate of PAA metabolism and represents a useful dosing biomarker.
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Affiliation(s)
- M Mokhtarani
- Hyperion Therapeutics, 601 Gateway Blvd., Suite 200, South San Francisco, CA 94080, USA.
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Hövels-Gürich H, Heinrichs AKM, Schulze A, Krings T, Messmer BJ. Hirnstrukturanomalien in der MRT in Bezug zur Psychomotorischen Entwicklung von Jugendlichen und jungen Erwachsenen nach Neonataler Arterieller Switch-Operation (ASO) bei Transposition der großen Arterien (TGA). Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0033-1354459] [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: 10/26/2022]
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