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Gwinner W, Anaokar S, Blogg M, Hermann B, Repetur CDP, Schiffer M. Long-Term Outcomes with Prolonged-Release Tacrolimus in Kidney Transplantation: A Retrospective Real-World Data Analysis. Ann Transplant 2024; 29:e942167. [PMID: 38500255 PMCID: PMC10960500 DOI: 10.12659/aot.942167] [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] [Received: 08/14/2023] [Accepted: 02/09/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Long-term real-world outcomes data for kidney transplant recipients (KTRs) converting from immediate-release tacrolimus (IRT) to prolonged-release tacrolimus (PRT) are limited. MATERIAL AND METHODS A retrospective, non-interventional review of adult KTRs treated with PRT for ≥1 month was conducted in Germany. Data were extracted from time of transplant (2008-2014) to 2018. Primary composite endpoints (graft loss, biopsy-confirmed acute rejection, graft dysfunction) and secondary endpoints (all-cause mortality, kidney function course, and tacrolimus dose/trough levels) were analyzed for sub-cohorts: de novo PRT, early conversion from IRT (within 6 months post-transplant), and late conversion (7 months to 3 years). RESULTS Analysis included 163 patients (101 de novo, 12 early converters, and 50 late converters). The overall Kaplan-Meier estimate of freedom from efficacy failure through 5 years was 0.537, (95% confidence interval (CI) 0.455-0.612) (de novo: 0.512 [0.407-0.608]; early converters: 0.500 [0.208-0.736]; late converters: 0.594 [0.443-0.717]). The overall survival rate was 0.925 (95% CI 0.872-0.957) (de novo: 0.900 [0.823-0.945]; early converters: 0.917 [0.539-0.988]; late converters: 0.977 [0.846-0.997]). During follow-up, there was a gradual reduction in tacrolimus dose and trough levels; kidney function remained stable in all cohorts. Multivariable analysis found re-transplantation, organ donor quality, best estimated glomerular filtration rate 8-12 weeks after transplant, and treatment center (between-center differences in age, sex, donor status/quality) were significantly associated with efficacy failure. CONCLUSIONS There was no difference in long-term survival profiles between KTRs who received PRT de novo vs those who converted from IRT, with 5-year survival remaining high in both groups.
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Affiliation(s)
- Wilfried Gwinner
- Department of Nephrology, Hannover Medical School, Hannover, Germany
| | | | - Martin Blogg
- Astellas Pharma Europe Ltd., Addlestone, United Kingdom
| | | | | | - Mario Schiffer
- Department of Nephrology and Hypertension, Universitätsklinikum Erlangen und Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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2
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Rives-Lange C, Zimmer A, Merazka A, Carette C, Martins-Bexinga A, Hauw-Berlemont C, Guerot E, Jannot A, Diehl J, Czernichow S, Hermann B. Evolution of the nutritional status of COVID-19 critically-ill patients: A prospective observational study from ICU admission to three months after ICU discharge. Clin Nutr 2022; 41:3026-3031. [PMID: 34134915 PMCID: PMC8142813 DOI: 10.1016/j.clnu.2021.05.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/07/2021] [Accepted: 05/12/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND & AIMS Malnutrition following intensive care unit (ICU) stay is frequent and could be especially prominent in critically ill Coronavirus Disease 2019 (COVID-19) patients as they present prolonged inflammatory state and long length stay. We aimed to determine the prevalence of malnutrition in critically ill COVID-19 patients both at the acute and recovery phases of infection. METHODS We conducted a prospective observational study including critically ill COVID-19 patients requiring invasive mechanical ventilation discharged alive from a medical ICU of a university hospital. We collected demographic, anthropometric and ICU stay data (SAPS2, recourse to organ support and daily energy intake). Nutritional status and nutritional support were collected at one month after ICU discharge (M1) by phone interview and at 3 months after ICU discharge (M3) during a specialized and dedicated consultation conducted by a dietitian. Malnutrition diagnosis was based on weight loss and body mass index (BMI) criteria following the Global Leadership Initiative on Malnutrition. Primary outcome was the prevalence of malnutrition at M3 and secondary outcomes were the evolution of nutritional status from ICU admission to M3 and factors associated with malnutrition at M3. RESULTS From march 13th to may 15th, 2020, 38 patients were discharged alive from the ICU, median [IQR] age 66 [59-72] years, BMI 27.8 [25.5-30.7] kg/m2 and SAPS2 47 [35-55]. Thirty-three (86%) patients were followed up to M3. Prevalence of malnutrition increased during the ICU stay, from 18% at ICU admission to 79% at ICU discharge and then decreased to 71% at M1 and 53% at M3. Severe malnutrition prevailed at ICU discharge with a prevalence of 55% decreasing 32% at M3. At M3, the only factors associated with malnutrition in univariate analysis were the length of invasive mechanical ventilation and length of ICU stay (28 [18-44] vs. 13 [11-24] days, P = 0.011 and 32 [22-48] vs. 17 [11-21] days, P = 0.006, respectively), while no ICU preadmission and admission factors, nor energy and protein intakes distinguished the two groups. Only 35% of undernourished patients at M3 had benefited from a nutritional support. CONCLUSION Malnutrition is frequent, protracted and probably underrecognized among critically ill Covid-19 patients requiring invasive mechanical ventilation with more than half patients still being undernourished three months after ICU discharge. A particular attention should be paid to the nutritional status of these patients not only during their ICU stay but also following ICU discharge.
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Affiliation(s)
- C. Rives-Lange
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Nutrition, Hôpital Européen Georges Pompidou, Paris, France,Université de Paris, F-75015, Paris, France,METHODS Team, INSERM, UMR1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Paris, France,Corresponding author. Service de Nutrition, Hôpital Européen Georges Pompidou, 20 rue Leblanc, Paris, France
| | - A. Zimmer
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Nutrition, Hôpital Européen Georges Pompidou, Paris, France
| | - A. Merazka
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Nutrition, Hôpital Européen Georges Pompidou, Paris, France
| | - C. Carette
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Nutrition, Hôpital Européen Georges Pompidou, Paris, France,Université de Paris, F-75015, Paris, France,Assistance Publique-Hôpitaux de Paris (APHP), Centre D’Investigation Clinique, INSERM, U1418, Hôpital Européen Georges Pompidou, Paris, France
| | - A. Martins-Bexinga
- Université de Paris, F-75015, Paris, France,METHODS Team, INSERM, UMR1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Paris, France
| | - C. Hauw-Berlemont
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Réanimation Médicale, Hôpital Européen Georges Pompidou, Paris, France
| | - E. Guerot
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Réanimation Médicale, Hôpital Européen Georges Pompidou, Paris, France
| | - A.S. Jannot
- Université de Paris, F-75015, Paris, France,Assistance Publique-Hôpitaux de Paris (AP-HP), Service D'informatique Médicale, Biostatistiques et Santé Publique, Hôpital Européen Georges Pompidou, Paris, France
| | - J.L. Diehl
- Université de Paris, F-75015, Paris, France,Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Réanimation Médicale, Hôpital Européen Georges Pompidou, Paris, France,Innovative Therapies in Haemostasis, INSERM, F-75006 Paris, France and Biosurgical Research Lab (Carpentier Foundation), Assistance Publique - Hôpitaux de Paris-Centre (APHP-CUP), F-75015, Paris, France
| | - S. Czernichow
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Nutrition, Hôpital Européen Georges Pompidou, Paris, France,Université de Paris, F-75015, Paris, France,METHODS Team, INSERM, UMR1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Paris, France
| | - B. Hermann
- Université de Paris, F-75015, Paris, France,Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Réanimation Médicale, Hôpital Européen Georges Pompidou, Paris, France,Institut Du Cerveau et de La Moelle épinière - ICM, Inserm U1127, CNRS UMR 7225, F-75015, Paris, France
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Hugo C, Weihprecht H, Banas B, Schröppel B, Jank S, Arns W, Schenker P, Rath T, Hergesell O, Feldkamp T, Hermann B, Schiffer M. Renal Function and Patient-Reported Outcomes in Stable Kidney Transplant Patients Following Conversion From Twice-Daily Immediate-Release Tacrolimus to Once-Daily Prolonged-Release Tacrolimus: A 12-Month Observational Study in Routine Clinical Practice in Germany (ADAGIO). Transplant Proc 2021; 53:1484-1493. [PMID: 33610306 DOI: 10.1016/j.transproceed.2021.01.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 01/08/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION This 12-month, noninterventional study on routine clinical practice in Germany evaluated renal function in stable kidney transplant recipients converted from immediate-release tacrolimus (IR-T) to prolonged-release tacrolimus (PR-T). METHODS Renal function was assessed in 183 patients by estimated glomerular filtration rate using the modification of diet in renal disease-4 formula. Self-reported gastrointestinal health-related quality of life, adherence, satisfaction with PR-T, suspected rejection episodes, and safety were also assessed at conversion and at 3, 6, and 12 months. RESULTS Conversion from IR-T to PR-T resulted in stable kidney function over 12 months, with a difference in estimated glomerular filtration rate between the first and final visits of 0.1 mL/min/1.73 m2 (95% confidence interval, -1.6, 1.8). Eight patients experienced an acute rejection episode (4.4%). At each assessment, gastrointestinal health-related quality of life was low and adherence was high. Most patients reported that they were very satisfied (69.8%) or satisfied (28.1%) with PR-T at the final visit. Among patients reporting a preference, 78.4% preferred PR-T, 2.2% preferred IR-T, and 19.4% reported no preference. The safety profile of PR-T was consistent with that previously described. CONCLUSION Conversion of stable kidney transplant recipients from IR-T to PR-T provided stable kidney and graft function over 12 months (Verband Forschender Arzneimittelhersteller--registered study: NIS ADV-02).
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Affiliation(s)
- Christian Hugo
- Division of Nephrology, Medizinische Klinik und Poliklinik III, Technische Universität Dresden, Dresden, Germany
| | - Horst Weihprecht
- Department of Internal Medicine, Division of Nephrology, University Hospital Augsburg, Augsburg, Germany.
| | - Bernhard Banas
- Department of Nephrology, University Hospital Regensburg, Regensburg, Germany
| | | | - Sabine Jank
- Department of Nephrology, Transplantation KfH-Kidney Center, Nuremberg, Germany
| | - Wolfgang Arns
- Cologne Merheim Medical Center, Cologne General Hospital, Cologne, Germany
| | - Peter Schenker
- Department of Surgery, University Hospital Knappschaftskrankenhaus Bochum, Ruhr-University Bochum, Bochum, Germany
| | - Thomas Rath
- Department of Nephrology and Transplantation, Westpfalz-Klinikum, Kaiserslautern, Germany
| | - Olaf Hergesell
- Nephrologisches Zentrum Villingen-Schwenningen, Villingen-Schwenningen, Erlangen, Germany
| | - Thorsten Feldkamp
- Department of Internal Medicine IV, Universitätsklinikum Schleswig Holstein, Kiel, Germany
| | | | - Mario Schiffer
- Department of Nephrology and Hypertension, Universitätsklinikum Erlangen, Germany
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Diehl JL, Peron N, Chocron R, Debuc B, Guerot E, Hauw-Berlemont C, Hermann B, Augy JL, Younan R, Novara A, Langlais J, Khider L, Gendron N, Goudot G, Fagon JF, Mirault T, Smadja DM. Respiratory mechanics and gas exchanges in the early course of COVID-19 ARDS: a hypothesis-generating study. Ann Intensive Care 2020; 10:95. [PMID: 32676824 PMCID: PMC7364286 DOI: 10.1186/s13613-020-00716-1] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/08/2020] [Indexed: 12/11/2022] Open
Abstract
Rationale COVID-19 ARDS could differ from typical forms of the syndrome. Objective Pulmonary microvascular injury and thrombosis are increasingly reported as constitutive features of COVID-19 respiratory failure. Our aim was to study pulmonary mechanics and gas exchanges in COVID-2019 ARDS patients studied early after initiating protective invasive mechanical ventilation, seeking after corresponding pathophysiological and biological characteristics. Methods Between March 22 and March 30, 2020 respiratory mechanics, gas exchanges, circulating endothelial cells (CEC) as markers of endothelial damage, and D-dimers were studied in 22 moderate-to-severe COVID-19 ARDS patients, 1 [1–4] day after intubation (median [IQR]). Measurements and main results Thirteen moderate and 9 severe COVID-19 ARDS patients were studied after initiation of high PEEP protective mechanical ventilation. We observed moderately decreased respiratory system compliance: 39.5 [33.1–44.7] mL/cmH2O and end-expiratory lung volume: 2100 [1721–2434] mL. Gas exchanges were characterized by hypercapnia 55 [44–62] mmHg, high physiological dead-space (VD/VT): 75 [69–85.5] % and ventilatory ratio (VR): 2.9 [2.2–3.4]. VD/VT and VR were significantly correlated: r2 = 0.24, p = 0.014. No pulmonary embolism was suspected at the time of measurements. CECs and D-dimers were elevated as compared to normal values: 24 [12–46] cells per mL and 1483 [999–2217] ng/mL, respectively. Conclusions We observed early in the course of COVID-19 ARDS high VD/VT in association with biological markers of endothelial damage and thrombosis. High VD/VT can be explained by high PEEP settings and added instrumental dead space, with a possible associated role of COVID-19-triggered pulmonary microvascular endothelial damage and microthrombotic process.
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Affiliation(s)
- J-L Diehl
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, 75006, Paris, France. .,Intensive Care Unit and Biosurgical Research Lab (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, 20 Rue Leblanc, 75015, Paris, France.
| | - N Peron
- Intensive Care Unit, AH-HP, Georges Pompidou European Hospital, Université de Paris, 75015, Paris, France
| | - R Chocron
- Université de Paris, PARCC, INSERM, 75015, Paris, France.,Emergency Department, AP-HP, Georges Pompidou European Hospital, 75015, Paris, France
| | - B Debuc
- Plastic Surgery Department, AP-HP, Georges Pompidou European Hospital, Université de Paris, 75015, Paris, France
| | - E Guerot
- Intensive Care Unit, AH-HP, Georges Pompidou European Hospital, Université de Paris, 75015, Paris, France
| | - C Hauw-Berlemont
- Intensive Care Unit, AH-HP, Georges Pompidou European Hospital, Université de Paris, 75015, Paris, France
| | - B Hermann
- Intensive Care Unit, AH-HP, Georges Pompidou European Hospital, Université de Paris, 75015, Paris, France
| | - J L Augy
- Intensive Care Unit, AH-HP, Georges Pompidou European Hospital, Université de Paris, 75015, Paris, France
| | - R Younan
- Intensive Care Unit, AH-HP, Georges Pompidou European Hospital, Université de Paris, 75015, Paris, France
| | - A Novara
- Intensive Care Unit, AH-HP, Georges Pompidou European Hospital, Université de Paris, 75015, Paris, France
| | - J Langlais
- Intensive Care Unit, AH-HP, Georges Pompidou European Hospital, Université de Paris, 75015, Paris, France
| | - L Khider
- Vascular Medicine Department and Biosurgical Research Lab (Carpentier Foundation), AP-HP, Georges Pompidou European Hospital, Université de Paris, 75015, Paris, France
| | - N Gendron
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, 75006, Paris, France.,Hematology Department and Biosurgical Research Lab (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, 75015, Paris, France
| | - G Goudot
- Emergency Department, AP-HP, Georges Pompidou European Hospital, 75015, Paris, France
| | - J-F Fagon
- Intensive Care Unit, AH-HP, Georges Pompidou European Hospital, Université de Paris, 75015, Paris, France
| | - T Mirault
- Université de Paris, PARCC, INSERM, 75015, Paris, France.,Vascular Medicine Department, AP-HP, Georges Pompidou European Hospital, 75015, Paris, France
| | - D M Smadja
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, 75006, Paris, France.,Hematology Department and Biosurgical Research Lab (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, 75015, Paris, France
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5
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Marois C, Quirins M, Hermann B, Mouri S, Bouzbib C, Rudler M, Thabut D, Weiss N. [Metabolic encephalopathies]. Rev Med Interne 2019; 40:88-97. [PMID: 30638703 DOI: 10.1016/j.revmed.2018.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 05/31/2018] [Revised: 11/12/2018] [Accepted: 11/15/2018] [Indexed: 12/16/2022]
Abstract
Metabolic encephalopathies (ME) are a common cause of admission to emergency rooms, to hospitalization wards or to intensive care units. They could account for 10 to 20% of causes of comatose states in ICU and could be associated to a poor outcome especially in older patients. Nevertheless, they are often reversible and are associated with a favorable outcome when diagnosed and rapidly treated. They correspond to an altered brain functioning secondary to the deficiency of a substance that is mandatory for the normal brain functioning or to the accumulation of a substance that can be either endogenous or exogenous. It preferably occurs in co-morbid patients, complicating its diagnosis and its management. Altered brain functioning, going from mild neuropsychological impairment to coma, movement disorders especially myoclonus and the absence of any obvious differential diagnosis are highly suggestive of the diagnosis. Whereas some biological samplings and brain MRI are essential to rule out differential diagnosis, some others, such as electroencephalogram, may be able to propose important clues in favor of the diagnosis. Once simple symptomatic measures are introduced, the treatment consists mainly in the correction of the cause. Specific treatment options are only seldom available for ME; this is the case for hepatic encephalopathy and some drug-induced encephalopathies. We will successively describe in this review the main pathophysiological mechanisms, the main causes, favoring circumstances of ME, the differential diagnosis to rule out and the etiological work-up for the diagnosis. Finally, a diagnostic and therapeutic strategy for the care of patients with ME will be proposed.
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Affiliation(s)
- C Marois
- Unité de réanimation neurologique, département de neurologie, Sorbonne université, groupement hospitalier Pitié-Salpêtrière Charles-Foix, Assistance publique des hôpitaux de Paris (AP-HP), 75013 Paris, France
| | - M Quirins
- Service de neurologie adulte, hôpital Bicêtre, Assistance publique des hôpitaux de Paris (AP-HP), 94250 Le Kremlin-Bicêtre, France
| | - B Hermann
- Unité de réanimation neurologique, département de neurologie, Sorbonne université, groupement hospitalier Pitié-Salpêtrière Charles-Foix, Assistance publique des hôpitaux de Paris (AP-HP), 75013 Paris, France
| | - S Mouri
- Brain Liver Pitié-Salpêtrière (BLIPS) Study Group, unité de soins intensifs d'hépatologie, service d'hépato-gastroentérologie, Inserm, centre de recherche Saint-Antoine, Sorbonne université, groupement hospitalier Pitié-Salpêtrière Charles-Foix, Assistance publique des hôpitaux de Paris (AP-HP), 75013 Paris, France
| | - C Bouzbib
- Brain Liver Pitié-Salpêtrière (BLIPS) Study Group, unité de soins intensifs d'hépatologie, service d'hépato-gastroentérologie, Inserm, centre de recherche Saint-Antoine, Sorbonne université, groupement hospitalier Pitié-Salpêtrière Charles-Foix, Assistance publique des hôpitaux de Paris (AP-HP), 75013 Paris, France
| | - M Rudler
- Brain Liver Pitié-Salpêtrière (BLIPS) Study Group, unité de soins intensifs d'hépatologie, service d'hépato-gastroentérologie, Inserm, centre de recherche Saint-Antoine, Sorbonne université, groupement hospitalier Pitié-Salpêtrière Charles-Foix, Assistance publique des hôpitaux de Paris (AP-HP), 75013 Paris, France
| | - D Thabut
- Brain Liver Pitié-Salpêtrière (BLIPS) Study Group, unité de soins intensifs d'hépatologie, service d'hépato-gastroentérologie, Inserm, centre de recherche Saint-Antoine, Sorbonne université, groupement hospitalier Pitié-Salpêtrière Charles-Foix, Assistance publique des hôpitaux de Paris (AP-HP), 75013 Paris, France
| | - N Weiss
- Brain Liver Pitié-Salpêtrière (BLIPS) Study Group, unité de réanimation neurologique, département de neurologie, Inserm, centre de recherche Saint-Antoine, Sorbonne université, groupement hospitalier Pitié-Salpêtrière Charles-Foix, Assistance publique des hôpitaux de Paris (AP-HP), 47-83, boulevard de l'Hôpital, 75013 Paris, France.
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6
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Law-Ye B, Dodet P, Hermann B, Trunet S, Dormont D, Pyatigorskaya N, Leclercq D. Progressive white-matter demyelination in delayed CO poisoning encephalopathy. J Neuroradiol 2017; 45:59-62. [PMID: 29030015 DOI: 10.1016/j.neurad.2017.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 05/08/2017] [Accepted: 09/05/2017] [Indexed: 11/30/2022]
Affiliation(s)
- B Law-Ye
- Neuroradiology department, hospital Pitié-Salpêtrière, AP-HP, Paris, France; Faculty of medicine Pierre-and-Marie-Curie, Sorbonne universités, Paris, France.
| | - P Dodet
- Faculty of medicine Pierre-and-Marie-Curie, Sorbonne universités, Paris, France; Neurology department, hospital Pitié-Salpêtrière, AP-HP, Paris, France
| | - B Hermann
- Neurology department, hospital Pitié-Salpêtrière, AP-HP, Paris, France
| | - S Trunet
- Neuroradiology department, hospital Pitié-Salpêtrière, AP-HP, Paris, France
| | - D Dormont
- Neuroradiology department, hospital Pitié-Salpêtrière, AP-HP, Paris, France; Faculty of medicine Pierre-and-Marie-Curie, Sorbonne universités, Paris, France
| | - N Pyatigorskaya
- Neuroradiology department, hospital Pitié-Salpêtrière, AP-HP, Paris, France; Faculty of medicine Pierre-and-Marie-Curie, Sorbonne universités, Paris, France
| | - D Leclercq
- Neuroradiology department, hospital Pitié-Salpêtrière, AP-HP, Paris, France
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7
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Pichler G, Pux C, Babeluk R, Hermann B, Stoiser E, De Campo A, Grisold A, Zollner-Schwetz I, Krause R, Schippinger W. MRSA prevalence rates detected in a tertiary care hospital in Austria and successful treatment of MRSA positive patients applying a decontamination regime with octenidine. Eur J Clin Microbiol Infect Dis 2017; 37:21-27. [PMID: 28849282 DOI: 10.1007/s10096-017-3095-4] [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: 06/30/2017] [Accepted: 08/14/2017] [Indexed: 12/31/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) decontamination regimens predominantly use chlorhexidine bathing in combination with mupirocin nasal ointment. However, resistances in Staphylococcus aureus strains are increasingly common and there is a need of alternative, safe and feasible protocols. This interventional cohort study performed at the Albert Schweitzer Hospital in Graz, Austria, aimed to (1) determine MRSA prevalence at different body sites and (2) assess the efficacy of the decontamination using octenidine-based leave-on products added to existing robust infection control measures. All inpatients of this tertiary care hospital being treated in geriatric medical wards (GWs) and apallic care units (ACUs) were screened for MRSA and decontamination rates were determined after one, two or three decontamination cycles, respectively. At baseline, MRSA was detected in 25 of the 126 patients screened (19.8%). We found MRSA in 13/126 (10.3%) swabs from nasal vestibules, in 12/126 (9.5%) skin swabs, in 11/51 (21.6%) swabs from PEG-stomata or suprapubic catheters and in 8/13 (61.5%) tracheostomata swabs. A maximum of three 5-day decontamination cycles reduced the number of MRSA positive patients by 68.0%. Excluding non-compliant and deceased patients, decontamination reduced MRSA carriage by 93.3% (n = 15). No adverse events related to the applied decontamination regimen occurred. Exclusive screening of the nose might underreport MRSA prevalence rates. In this study, decontamination with octenidine-based leave-on products was safe and effective in a critical patient population.
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Affiliation(s)
- G Pichler
- Department of Neurology, Albert Schweitzer Hospital, 8020, Graz, Styria, Austria.
| | - C Pux
- Department of Neurology, Albert Schweitzer Hospital, 8020, Graz, Styria, Austria
| | - R Babeluk
- Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - B Hermann
- Department of Medical Geriatrics, Albert Schweitzer Hospital, Graz, Styria, Austria
| | - E Stoiser
- Department of Medical Geriatrics, Albert Schweitzer Hospital, Graz, Styria, Austria
| | - A De Campo
- Department of Internal Medicine, Albert Schweitzer Hospital, Graz, Styria, Austria
| | - A Grisold
- Department of Microbiology and Environmental Medicine, Institute of Hygiene, Medical University of Graz, Graz, Styria, Austria
| | - I Zollner-Schwetz
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Styria, Austria
| | - R Krause
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Styria, Austria
| | - W Schippinger
- Department of Internal Medicine, Albert Schweitzer Hospital, Graz, Styria, Austria
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Hermann B, Lehners N, Brodhun M, Boden K, Hochhaus A, Kochanek M, Meckel K, Mayer K, Rachow T, Rieger C, Schalk E, Weber T, Schmeier-Jürchott A, Schlattmann P, Teschner D, von Lilienfeld-Toal M. Influenza virus infections in patients with malignancies -- characteristics and outcome of the season 2014/15. A survey conducted by the Infectious Diseases Working Party (AGIHO) of the German Society of Haematology and Medical Oncology (DGHO). Eur J Clin Microbiol Infect Dis 2016; 36:565-573. [PMID: 27838792 PMCID: PMC5309266 DOI: 10.1007/s10096-016-2833-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 10/26/2016] [Indexed: 12/03/2022]
Abstract
Influenza virus infections (IVI) may pose a vital threat to immunocompromised patients such as those suffering from malignancies, but specific data on epidemiology and outcome in these patients are scarce. In this study, we collected data on patients with active cancer or with a history of cancer, presenting with documented IVI in eight centres in Germany. Two hundred and three patients were identified, suffering from haematological malignancies or solid tumours; 109 (54 %) patients had active malignant disease. Influenza A was detected in 155 (77 %) and Influenza B in 46 (23 %) of patients (genera not determined in two patients). Clinical symptoms were consistent with upper respiratory tract infection in 55/203 (27 %), influenza-like illness in 82/203 (40 %), and pneumonia in 67/203 (33 %). Anti-viral treatment with oseltamivir was received by 116/195 (59 %). Superinfections occurred in 37/203 (18 %), and admission on an intensive care unit was required in 26/203 (13 %). Seventeen patients (9 %) died. Independent risk factors for death were delayed diagnosis of IVI and bacterial or fungal superinfection, but not underlying malignancy or ongoing immunosuppression. In conclusion, patients with IVI show high rates of pneumonia and mortality. Early and rapid diagnosis is essential. The high rate of pneumonia and superinfections should be taken into account when managing IVI in these patients.
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Affiliation(s)
- B Hermann
- Leibniz Institut für Naturstoff-Forschung und Infektionsbiologie, Hans-Knöll-Institut, 07745 , Jena, Germany.
| | - N Lehners
- Department of Haematology and Oncology, University Hospital Heidelberg, Heidelberg, Germany
| | - M Brodhun
- Medizinische Klinik II, Abteilung für Haematologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - K Boden
- Institut für Klinische Chemie und Laboratoriumsmedizin, University Hospital Jena, Jena, Germany
| | - A Hochhaus
- Medizinische Klinik II, Abteilung für Haematologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - M Kochanek
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
| | - K Meckel
- Medizinische Klinik II, Abteilung für Haematologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - K Mayer
- Medizinische Klinik III, University Hospital Bonn, Bonn, Germany
| | - T Rachow
- Medizinische Klinik II, Abteilung für Haematologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - C Rieger
- Internistische Lehrpraxis der Ludwig-Maximilians-Universität München, University of Munich, Munich, Germany
| | - E Schalk
- Otto-von-Guericke University Magdeburg, Medical Centre, Department of Haematology and Oncology, Magdeburg, Germany
| | - T Weber
- University Hospital Halle, Halle, Germany
| | - A Schmeier-Jürchott
- University Medical Centre of the Johannes Gutenberg University, Mainz, Germany
| | - P Schlattmann
- Department of Medical Statistics, Informatics and Documentation, University Hospital Jena, Jena, Germany
| | - D Teschner
- University Medical Centre of the Johannes Gutenberg University, Mainz, Germany
| | - M von Lilienfeld-Toal
- Leibniz Institut für Naturstoff-Forschung und Infektionsbiologie, Hans-Knöll-Institut, 07745 , Jena, Germany.,Medizinische Klinik II, Abteilung für Haematologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany.,Forschungscampus InfectoGnostics, Jena, Germany.,Integriertes Forschungs- und Behandlungszentrum Sepsis und Sepsisfolgen (CSCC), Universitätsklinikum Jena, Jena, Germany
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9
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Affiliation(s)
- B Hermann
- Brain Liver Pitié-Salpêtrière Study Group, Groupement Hospitalier Pitié-Salpêtrière-Charles Foix, Paris, France.,Unité de Réanimation Neurologique, Fédération de Neurologie, Pôle des Maladies du Système Nerveux, Groupement Hospitalier Pitié-Salpêtrière-Charles Foix, Paris, France
| | - N Weiss
- Brain Liver Pitié-Salpêtrière Study Group, Groupement Hospitalier Pitié-Salpêtrière-Charles Foix, Paris, France.,Unité de Réanimation Neurologique, Fédération de Neurologie, Pôle des Maladies du Système Nerveux, Groupement Hospitalier Pitié-Salpêtrière-Charles Foix, Paris, France
| | - D Thabut
- Brain Liver Pitié-Salpêtrière Study Group, Groupement Hospitalier Pitié-Salpêtrière-Charles Foix, Paris, France. .,Unité de Soins Intensifs d'Hépato-gastroentérologie, Groupement Hospitalier Pitié-Salpêtrière-Charles Foix, Paris, France.
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10
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Zingler G, Hermann B, Fischer T, Herdegen T. Cardiovascular adverse events by non-steroidal anti-inflammatory drugs: when the benefits outweigh the risks. Expert Rev Clin Pharmacol 2016; 9:1479-1492. [DOI: 10.1080/17512433.2016.1230495] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Gerhard Zingler
- Medical Department, Former employee of MSD Sharp & Dohme GmbH, Munich, Germany
| | - Birgit Hermann
- Practical Orthopedist (Private Practice), Hamburg, Germany
| | - Tim Fischer
- Medical Department, Employee of MSD Sharp & Dohme GmbH, Munich, Germnany
| | - Thomas Herdegen
- Institute of Experimental and Clinical Pharmacology, University Hospital Schleswig-Holstein, Kiel, Germany
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11
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Wang X, Mitchell C, Jackson D, Varghese T, Hermann B, Kliewer M, Dempsey R. WE-E-134-10: Correlation of Cognitive Function with Ultrasound Strain Indices. Med Phys 2013. [DOI: 10.1118/1.4815613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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12
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Welzel G, Boch A, Blank E, Kraus-Tiefenbacher U, Keller A, Hermann B, Sütterlin M, Wenz F. Radiation-related Quality of Life Parameters after Targeted Intraoperative Radiotherapy vs. Whole Breast Radiotherapy in Patients with Breast Cancer: Results from the Randomized Phase III Trial TARGIT-A. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.376] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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13
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Tome W, Gondi V, Hermann B, Mehta M. 8705 ORAL Neurocognitive Function (NCF) Impairment Following Fractionated Stereotactic Radiotherapy (FSRT) for Benign or Low-Grade Adult Brain Tumours. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72256-0] [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: 10/17/2022]
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14
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15
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Lei Y, Garrahan N, Hermann B, Fautsch MP, Johnson DH, Hernandez MR, Boulton M, Morgan JE. Transretinal degeneration in ageing human retina: a multiphoton microscopy analysis. Br J Ophthalmol 2010; 95:727-30. [PMID: 21183516 DOI: 10.1136/bjo.2010.180869] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM Retinal cell remodelling has been reported as a consistent feature of ageing. However, the degree to which this results in transretinal degeneration is unclear. To address this, the authors used multiphoton microscopy to quantify retinal degeneration in post-mortem human eyes of two age groups. METHODS Retinas from six young subjects (18-33 years old) and six older subjects (74-90 years old) were prepared as wholemount preparations. All retinas were stained with 4,6-diamidino-2-phenylindole and imaged by multiphoton confocal microscopy to quantify neuron densities in the retinal ganglion cell layer (RGCL), inner nuclear layer (INL) and outer nuclear layer (ONL). Neurons were counted using automated cell identification algorithms. All retinas were imaged hydrated to minimise tissue artefacts. RESULTS In both groups, 56% of the area within the central 4 mm eccentricity and 27% of the area with eccentricity between 4 mm and 7 mm were imaged. Compared with young subjects, the peak RGCL neuron loss in the aged subjects (25.5%) was at 1 mm eccentricity. INL and ONL neuron densities significantly decreased at 1-2 mm eccentricity (8.7%) and 0.5-4 mm eccentricity (15.6%) respectively (P <0.05). The reduction in neuron density in the INL corresponded, spatially, to the region with the greatest neuron loss in the RGCL and ONL. CONCLUSIONS This is the first study to correlate neurodegeneration in different populations of cells in the ageing retinas. These data confirm that the greatest neuronal loss occurs in the RGCL and ONL in human ageing retinas, whereas the INL is relatively preserved.
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Affiliation(s)
- Y Lei
- Optometry and Vision Sciences, Cardiff University, Cardiff, UK
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Reis T, Schneider F, Hermann B, Bohrer M, Schmitt R, Obertacke U, Wenz F. Kypho-IORT: A Novel Treatment of Spinal Metastases with Intraoperative Radiotherapy during Kyphoplasty. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1356] [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: 10/19/2022]
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17
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18
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Bizheva K, Pflug R, Hermann B, Povazay B, Sattmann H, Qui P, Anger E, Reitsamer H, Popov S, Taylor JR, Unterhuber A, Ahnelt P, Drexler W. Depth-resolved optical probing of retinal physiology with functional ultrahigh resolution optical coherence tomography. J Vis 2010. [DOI: 10.1167/6.13.40] [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: 11/24/2022] Open
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19
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Hermann B, Hofer B, Meier C, Drexler W. Spectroscopic measurements with dispersion encoded full range frequency domain optical coherence tomography in single- and multilayered non-scattering phantoms. Opt Express 2009; 17:24162-74. [PMID: 20052127 DOI: 10.1364/oe.17.024162] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
In this study, depth resolved measurements of absorption profiles in the wavelength range of 800 nm with a bandwidth of 140 nm are demonstrated using high speed spectroscopic frequency domain OCT(SOCT) and a full range reconstruction algorithm (dispersion encoded full range, DEFR). The feasibility of the algorithm for SOCT is tested in simulation and experiment. With proper calibration, SOCT with DEFR is able to extract absolute, depth resolved absorption profiles over the whole wavelength range at once without the need of tuning and performing measurements at single wavelengths sequentially. The superior acquisition speed and better phase stability in frequency domain as compared to time domain results in a better reproducibility and practicability for spectroscopic measurements. In addition, high acquisition speed in excess of 20 kHz allows to measure absorption dynamics with 50 micros time resolution, which might be useful for the investigation of pharmacokinetics or pharmacodynamics. SOCT of approximately 600 microm thick single- and multilayered, weakly scattering phantoms with varying absorption in the range of 5-80 cm(-1), equivalent to blood absorption in capillaries, is presented. SOCT measurements are compared with those using a spectrometer in transmission mode. For Indocyanine Green (ICG), a dynamic absorption measurements are demonstrated.
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Affiliation(s)
- B Hermann
- Biomedical Imaging Group, School of Optometry & Vision Science, Cardiff University, Cardiff CF24 9LU, United Kingdom
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20
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Wenz F, Welzel G, Elena B, Hermann B, Steil V, Suetterlin M, Kraus-Tiefenbacher U. Low Energy X-rays for IORT Tumor Bed Boost during Breast Conserving Surgery (BCS) - A Five Year Single Center Experience. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.478] [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]
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21
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Hermann B. IN53-TH-02 Memory and neurobehavioral complications of epilepsy. J Neurol Sci 2009. [DOI: 10.1016/s0022-510x(09)70187-x] [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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22
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Lei Y, Garrahan N, Hermann B, Fautsch MP, Johnson DH, Hernandez MR, Boulton M, Morgan JE. Topography of neuron loss in the retinal ganglion cell layer in human glaucoma. Br J Ophthalmol 2009; 93:1676-9. [PMID: 19671529 DOI: 10.1136/bjo.2009.159210] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
AIM To determine if retinal ganglion cell (RGC) loss influences the loss of surrounding RGCs to generate clustered patterns of cell death in human glaucoma. It is hypothesised that retinal ganglion cell loss accelerates the loss of surrounding cells to generate, at a local, cellular scale, clustered patterns of retinal of RGC death. The absence of these interactions would result in a diffuse pattern RGC loss. METHOD Six glaucomatous retinas (67-83 years old) and six age-matched control retinas (61-89 years old) were prepared as wholemounts and stained by 4',6-diamidino-2-phenylindole (DAPI) solution (3 microg/ml in PBS). An area corresponding to central 14 degrees of the visual field was imaged. The nearest-neighbour distribution was determined for cells in both normal and glaucomatous RGCL. RESULTS Clustered RGC loss in human glaucoma was observed on a background of diffuse loss. The mean nearest-neighbour distance (NND) of the glaucomatous retinas was significantly higher than with controls (p<0.001). The distribution of NND in glaucomatous retinas was skewed to the higher values with a higher positive kurtosis relative to controls. The quantitative analysis of the pattern of cell loss is supported by the visual inspection of the patterns of cell loss. DISCUSSION The nearest-neighbour analysis is consistent with the presence of two patterns of cell loss in the RGCL in glaucoma. While the diffuse of cell loss can account for an overall reduction in the RGC population, an additional non-random pattern is consistent with the hypothesis that RGC loss has a local influence on the viability of surrounding cells.
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Affiliation(s)
- Y Lei
- School of Optometry and Vision Sciences, Cardiff University, Cardiff CF244LU, UK
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23
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Tosun D, Siddarth P, Toga A, Hermann B, Caplan R. Childhood Absence Seizures are Associated With Morphometric Alterations in Posterior Cortical Regions. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)71578-2] [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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24
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Wenz FK, Welzel G, Blank E, Hermann B, Steil V, Suetterlin M, Kraus-Tiefenbacher U. Intraoperative radiotherapy (IORT) as a boost during breast conserving surgery (BCS) using low kV X-rays: The first 5 years of experience with a novel approach. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.626] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
626 Background: Recently, the concept of IORT during BCS has been introduced using linear accelerators, brachytherapy or dedicated mobile IORT devices generating fast electrons or low energy X-rays. Here, we report the first 5 years of a single center experience after introduction of a novel approach to deliver IORT as a tumor bed boost during BCS for breast cancer. Methods: 155 breast cancers in 154 women (median age 63 yrs, range 30 - 83 yrs, T1/T2 = 110/45, N0/N+ = 104/51) were treated between February 2002 and December 2007 at the University Medical Center Mannheim/University of Heidelberg, in whom IORT as tumor bed boost was applied using 50 kV X rays (20 Gy, INTRABEAM, Carl Zeiss Oberkochen, additional OR time about 45 - 60 min) followed by 46 - 50 Gy external beam whole breast radiotherapy (EBRT). Chemotherapy was given before EBRT. The median interval between BCS+IORT and EBRT was 10 wks. Median follow-up was 34 mon (max 79.6 mon, 1 pt lost to f/u). Overall survival (OS), local relapse free survival (LRFS) and disease free survival (DFS) were calculated at 5 yrs using the Kaplan Meier method. 81 patients were evaluated at 3 yr f/u for normal tissue effects using the LENT SOMA scoring system. Results: Ten patients have died, 2 pts suffered from in breast relapse and 8 pts developed distant metastases yielding a 5yr OS of 87.0%, a 5yr LRFS of 98.4% and a 5 yr DFS of 73.9%. Grade 3 fibroses of the tumor bed were detected in 6% of the patients after 3 yrs. Skin toxicity was mild (teleangiectases and hyperpigmentations in 6% each). Conclusions: IORT as a tumor bed boost using the INTRABEAM system yields low recurrence and toxicity rates when followed by external beam whole breast radiotherapy. [Table: see text]
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Affiliation(s)
- F. K. Wenz
- University Medical Center Mannheim, Mannheim, Germany
| | - G. Welzel
- University Medical Center Mannheim, Mannheim, Germany
| | - E. Blank
- University Medical Center Mannheim, Mannheim, Germany
| | - B. Hermann
- University Medical Center Mannheim, Mannheim, Germany
| | - V. Steil
- University Medical Center Mannheim, Mannheim, Germany
| | - M. Suetterlin
- University Medical Center Mannheim, Mannheim, Germany
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25
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Zeiler F, Považay B, Glittenberg C, Hermann B, Hagen S, Lie S, Drexler W, Binder S. Comparison of UHR-OCT versus Stratus-OCT for definition of early retinal changes after intravitreal Bevacizumab (Avastin®) application in patients with AMD. Spektrum Augenheilkd 2009. [DOI: 10.1007/s00717-009-0313-1] [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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26
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Kraus-Tiefenbacher U, Welzel G, Hermann B, Siebenlist K, Wasser K, Sütterlin M, Wenz F. 0119 Breast seroma after intraoperative radiotherapy with low-kV x-rays. Breast 2009. [DOI: 10.1016/s0960-9776(09)70160-2] [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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27
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Boda-Heggemann J, Mennemeyer P, Wertz H, Ehmann M, Hermann B, Koehler F, Riesenacker N, Lohr F, Wenz F. Accuracy of Stereotactic Ultrasound (BAT) for Daily Repositioning in Upper Abdomen - An Online Comparison by 3D-3D Matching with Cone-beam CT. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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28
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Koehler F, Boda-Heggemann J, Wertz H, Ehmann M, Riesenacker N, Küpper B, Mennemeyer P, Hermann B, Lohr F, Wenz F. Intrafraction Motion of the Prostate during One IMRT Session: A Fiducial-based 3D Measurement with Cone-beam CT. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.1106] [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: 11/26/2022]
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29
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Wenz FK, Welzel G, Keller A, Findeisen P, Neumaier M, Hermann B. Bone remodeling markers in breast and prostate cancer patients undergoing endocrine and bisphosponate therapy. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.9602] [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: 11/20/2022] Open
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30
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Zeiler F, Glittenberg C, Považay B, Hermann B, Drexler W, Binder S. Fördert die chronische papillovitreale Traktion die Progredienz einer Optikusatrophie? Spektrum Augenheilkd 2007. [DOI: 10.1007/s00717-007-0232-y] [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: 10/22/2022]
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31
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Welzel G, Fleckenstein K, Mai S, Hermann B, Kraus-Tiefenbacher U, Schaefer J, Wenz F. Be Careful With Predamaged Brain: Differences in Memory Function Before and After Whole Brain Radiation Therapy in Patients With and Without Brain Metastases. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.190] [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: 10/22/2022]
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32
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Glittenberg C, Považay B, Hermann B, Zeiler F, Falkner C, Drexler W, Binder S. Dreidimensionale Rekonstruktion von Schichtbildaufnahmen der Netzhaut. Spektrum Augenheilkd 2007. [DOI: 10.1007/s00717-006-0172-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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33
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Stur M, Hermann B, Ergun E, Unterhuber A, Wirtitsch M, Sattmann H, Drexler W. Optische Kohärenztomographie der Photorezeptorschicht im gesunden Auge und bei hereditärer Makuladystrophie. Spektrum Augenheilkd 2007. [DOI: 10.1007/s00717-006-0170-0] [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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34
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Welzel G, Hermann B, Kraus-Tiefenbacher U, Wenz F. Kognitive Funktionen und emotionales Befinden von Brustkrebspatientinnen bei Strahlentherapiebeginn. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-972108] [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: 10/21/2022] Open
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35
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Bizheva K, Pflug R, Hermann B, Považay B, Sattmann H, Qiu P, Anger E, Reitsamer H, Popov S, Taylor JR, Unterhuber A, Ahnelt P, Drexler W. Optophysiology: depth-resolved probing of retinal physiology with functional ultrahigh-resolution optical coherence tomography. Proc Natl Acad Sci U S A 2006; 103:5066-71. [PMID: 16551749 PMCID: PMC1405907 DOI: 10.1073/pnas.0506997103] [Citation(s) in RCA: 160] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Noncontact, depth-resolved, optical probing of retinal response to visual stimulation with a <10-microm spatial resolution, achieved by using functional ultrahigh-resolution optical coherence tomography (fUHROCT), is demonstrated in isolated rabbit retinas. The method takes advantage of the fact that physiological changes in dark-adapted retinas caused by light stimulation can result in local variation of the tissue reflectivity. fUHROCT scans were acquired from isolated retinas synchronously with electrical recordings before, during, and after light stimulation. Pronounced stimulus-related changes in the retinal reflectivity profile were observed in the inner/outer segments of the photoreceptor layer and the plexiform layers. Control experiments (e.g., dark adaptation vs. light stimulation), pharmacological inhibition of photoreceptor function, and synaptic transmission to the inner retina confirmed that the origin of the observed optical changes is the altered physiological state of the retina evoked by the light stimulus. We have demonstrated that fUHROCT allows for simultaneous, noninvasive probing of both retinal morphology and function, which could significantly improve the early diagnosis of various ophthalmic pathologies and could lead to better understanding of pathogenesis.
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Affiliation(s)
- K. Bizheva
- *Center for Biomedical Engineering and Physics/Christian Doppler Laboratory and
| | - R. Pflug
- Department of Physiology, Medical University of Vienna, A-1090 Vienna, Austria; and
| | - B. Hermann
- *Center for Biomedical Engineering and Physics/Christian Doppler Laboratory and
| | - B. Považay
- *Center for Biomedical Engineering and Physics/Christian Doppler Laboratory and
| | - H. Sattmann
- *Center for Biomedical Engineering and Physics/Christian Doppler Laboratory and
| | - P. Qiu
- *Center for Biomedical Engineering and Physics/Christian Doppler Laboratory and
| | - E. Anger
- Department of Physiology, Medical University of Vienna, A-1090 Vienna, Austria; and
| | - H. Reitsamer
- Department of Physiology, Medical University of Vienna, A-1090 Vienna, Austria; and
| | - S. Popov
- Femtosecond Optics Group, Physics Department, Imperial College, London SW7 2BW, England
| | - J. R. Taylor
- Femtosecond Optics Group, Physics Department, Imperial College, London SW7 2BW, England
| | - A. Unterhuber
- *Center for Biomedical Engineering and Physics/Christian Doppler Laboratory and
| | - P. Ahnelt
- Department of Physiology, Medical University of Vienna, A-1090 Vienna, Austria; and
| | - W. Drexler
- *Center for Biomedical Engineering and Physics/Christian Doppler Laboratory and
- To whom correspondence should be addressed.
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36
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Linnola RJ, Findl O, Hermann B, Sattmann H, Unterhuber A, Happonen RP, Drexler W. Reply : Intraocular lens-capsular bag imaging with ultrahigh-resolution optical coherence tomography: pseudophakic human autopsy eyes. J Cataract Refract Surg 2006. [DOI: 10.1016/j.jcrs.2005.12.045] [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]
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37
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Dempsey R, Vemuganti R, Hermann B. Mo-W4:5 Increased expression of neurodegenerative disease related genes in the carotid plaques from symptomatic stroke patients. ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)80048-6] [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: 11/15/2022]
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38
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Welzel G, Fleckenstein K, Thoennessen D, Hermann B, Kraus-Tiefenbacher U, Mai S, Wenz F. Cranial Radiation Therapy Induces Acute Cognitive Impairments in Patients with Brain Tumors Only. Int J Radiat Oncol Biol Phys 2005. [DOI: 10.1016/j.ijrobp.2005.07.267] [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: 11/29/2022]
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39
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Abstract
The authors examined a cognitive function mediated by the cerebellum, classical eyeblink conditioning, and its relationship to cerebellar volume in healthy controls (n = 59) and temporal lobe epilepsy subjects (n = 77). Controls demonstrated better conditioning, larger cerebellar volumes, and an association between conditioning and cerebellar volume that was not observed in epilepsy patients. These findings provide support for the hypothesis that cerebellar atrophy in epilepsy affects procedural memory.
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Affiliation(s)
- B Hermann
- Matthews Neuropsychology Lab, Department of Neurology, University of Wisconsin, 600 N. Highland, Madison, WI 53792, USA.
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Unterhuber A, Povazay B, Hermann B, Sattmann H, Chavez-Pirson A, Drexler W. In vivo retinal optical coherence tomography at 1040 nm - enhanced penetration into the choroid. Opt Express 2005; 13:3252-8. [PMID: 19495226 DOI: 10.1364/opex.13.003252] [Citation(s) in RCA: 152] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
For the first time in vivo retinal imaging has been performed with a new compact, low noise Yb-based ASE source operating in the 1 microm range (NP Photonics, lambdac = 1040 nm, Deltalambda = 50 nm, Pout = 30 mW) at the dispersion minimum of water with ~7 microm axial resolution. OCT tomograms acquired at 800 nm are compared to those achieved at 1040 nm showing about 200 microm deeper penetration into the choroid below the retinal pigment epithelium. Retinal OCT at longer wavelengths significantly improves the visualization of the retinal pigment epithelium/choriocapillaris/choroids interface and superficial choroidal layers as well as reduces the scattering through turbid media and therefore might provide a better diagnosis tool for early stages of retinal pathologies such as age related macular degeneration which is accompanied by choroidal neovascularization, i.e., extensive growth of new blood vessels in the choroid and retina.
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41
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Abstract
A total of 37 candidates for temporal lobe resection for epilepsy completed the Lateral Dominance Examination, a self-report instrument that measures hand and foot preference. Questionnaire results were compared with speech dominance, which had been determined by Intracarotid Sodium Amytal Procedure. Footedness was as good as handedness as a predictor of language laterality.
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Affiliation(s)
- G S Watson
- Department of Psychology, University of Memphis, TN, USA
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42
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Milanovic D, Lohr F, Götte K, Dobler B, Hermann B, Hörmann K, Wenz F. [Intensity modulated radiotherapy (IMRT) of head and neck tumors. Increased biological effectiveness in high-risk situations by "integrated boost" therapy]. HNO 2005; 52:729-36. [PMID: 15309254 DOI: 10.1007/s00106-003-0951-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Primary tumors of the paranasal sinuses are rare entities which, because of precarious localization and frequently diffuse propagation into neighbouring cavities and the skull base, pose a significant therapeutic problem. Even after complete surgical resection, local relapses are frequent. Postoperative radiotherapy is therefore usually indicated. Intensity modulated radiotherapy (IMRT) is a new technique that helps creating dose distributions that conform closely to the target volume while maximally sparing the organs at risk. This results in the possibility of applying escalated doses to the target while still keeping the incidence of side effects low. What is especially appealing is the possibility of shaping the dose distribution within the target in such a way that areas with a presumably high tumor cell load receive increased doses, a concept which is best described by the term "integrated boost". We present the case of a patient with a sinunasal carcinoma and describe the implications of the clinical implementation of this technique.
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Affiliation(s)
- D Milanovic
- Sektion Strahlentherapie des Instituts für Klinische Radiologie am Universitätsklinikum Mannheim, Mannheim
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43
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Unterhuber A, Povazay B, Bizheva K, Hermann B, Sattmann H, Stingl A, Le T, Seefeld M, Menzel R, Preusser M, Budka H, Schubert C, Reitsamer H, Ahnelt PK, Morgan JE, Cowey A, Drexler W. Advances in broad bandwidth light sources for ultrahigh resolution optical coherence tomography. Phys Med Biol 2004; 49:1235-46. [PMID: 15128201 DOI: 10.1088/0031-9155/49/7/011] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Novel ultra-broad bandwidth light sources enabling unprecedented sub-2 microm axial resolution over the 400 nm-1700 nm wavelength range have been developed and evaluated with respect to their feasibility for clinical ultrahigh resolution optical coherence tomography (UHR OCT) applications. The state-of-the-art light sources described here include a compact Kerr lens mode locked Ti:sapphire laser (lambdaC = 785 nm, delta lambda = 260 nm, P(out) = 50 mW) and different nonlinear fibre-based light sources with spectral bandwidths (at full width at half maximum) up to 350 nm at lambdaC = 1130 nm and 470 nm at lambdaC = 1375 nm. In vitro UHR OCT imaging is demonstrated at multiple wavelengths in human cancer cells, animal ganglion cells as well as in neuropathologic and ophthalmic biopsies in order to compare and optimize UHR OCT image contrast, resolution and penetration depth.
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Affiliation(s)
- A Unterhuber
- Department of Medical Physics, Medical University of Vienna and Christian Doppler Laboratory, A-1090 Vienna, Austria
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44
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Hermann B, Fernández EJ, Unterhuber A, Sattmann H, Fercher AF, Drexler W, Prieto PM, Artal P. Adaptive-optics ultrahigh-resolution optical coherence tomography. Opt Lett 2004; 29:2142-4. [PMID: 15460883 DOI: 10.1364/ol.29.002142] [Citation(s) in RCA: 127] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Merging of ultrahigh-resolution optical coherence tomography (UHR OCT) and adaptive optics (AO), resulting in high axial (3 microm) and improved transverse resolution (5-10 microm) is demonstrated for the first time to our knowledge in in vivo retinal imaging. A compact (300 mm x 300 mm) closed-loop AO system, based on a real-time Hartmann-Shack wave-front sensor operating at 30 Hz and a 37-actuator membrane deformable mirror, is interfaced to an UHR OCT system, based on a commercial OCT instrument, employing a compact Ti:sapphire laser with 130-nm bandwidth. Closed-loop correction of both ocular and system aberrations results in a residual uncorrected wave-front rms of 0.1 microm for a 3.68-mm pupil diameter. When this level of correction is achieved, OCT images are obtained under a static mirror configuration. By use of AO, an improvement of the transverse resolution of two to three times, compared with UHR OCT systems used so far, is obtained. A significant signal-to-noise ratio improvement of up to 9 dB in corrected compared with uncorrected OCT tomograms is also achieved.
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Affiliation(s)
- B Hermann
- Department of Medical Physics, Christian Doppler Laboratory, Medical University of Vienna, Austria
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45
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Leitgeb R, Drexler W, Unterhuber A, Hermann B, Bajraszewski T, Le T, Stingl A, Fercher A. Ultrahigh resolution Fourier domain optical coherence tomography. Opt Express 2004; 12:2156-65. [PMID: 19475051 DOI: 10.1364/opex.12.002156] [Citation(s) in RCA: 113] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
We present, for the first time, in vivo ultrahigh resolution (~2.5 microm in tissue), high speed (10000 A-scans/second equivalent acquisition rate sustained over 160 A-scans) retinal imaging obtained with Fourier domain (FD) OCT employing a commercially available, compact (500x260mm), broad bandwidth (120 nm at full-width-at-half-maximum centered at 800 nm) Titanium:sapphire laser (Femtosource Integral OCT, Femtolasers Produktions GmbH). Resolution and sampling requirements, dispersion compensation as well as dynamic range for ultrahigh resolution FD OCT are carefully analyzed. In vivo OCT sensitivity performance achieved by ultrahigh resolution FD OCT was similar to that of ultrahigh resolution time domain OCT, although employing only 2-3 times less optical power (~300 microW). Visualization of intra-retinal layers, especially the inner and outer segment of the photoreceptor layer, obtained by FDOCT was comparable to that, accomplished by ultrahigh resolution time domain OCT, despite an at least 40 times higher data acquisition speed of FD OCT.
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46
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Hermann B, Bizheva K, Unterhuber A, Povazay B, Sattmann H, Schmetterer L, Fercher A, Drexler W. Precision of extracting absorption profiles from weakly scattering media with spectroscopic time-domain optical coherence tomography. Opt Express 2004; 12:1677-88. [PMID: 19474994 DOI: 10.1364/opex.12.001677] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The feasibility of spectroscopic optical coherence tomography (SOCT) to quantify spatially localized absorption profiles of chromophores embedded in weakly scattering media with a single measurement over the full spectral bandwidth of the light source was investigated by using a state-of-the-art ultra-broad bandwidth Ti:Al(2)O(3) laser (lambdac = 800 nm, Deltalambda = 260 nm, P(out) = 120 mW ex-fiber). The precision of the method as a function of the chromophore absorption, the sample thickness, and different parameters related to the measurement procedure was evaluated both theoretically and experimentally in single and multilayered phantoms. It is demonstrated that in weakly scattering media SOCT is able to extract mua(lambda) as small as 0.5 mm-1 from 450 mum thick phantoms with a precision of ~2% in the central and ~8% at the edges of the used wavelength region. As expected, in phantoms with the same absorption properties and thickness ~180 mum the precision of SOCT decreases to >10% in the central wavelength region.
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47
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Povazay B, Bizheva K, Hermann B, Unterhuber A, Sattmann H, Fercher A, Drexler W, Schubert C, Ahnelt P, Mei M, Holzwarth R, Wadsworth W, Knight J, Russell PSJ. Enhanced visualization of choroidal vessels using ultrahigh resolution ophthalmic OCT at 1050 nm. Opt Express 2003; 11:1980-6. [PMID: 19466083 DOI: 10.1364/oe.11.001980] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
In this article the ability of ultrahigh resolution ophthalmic optical coherence tomography (OCT) to image small choroidal blood vessels below the highly reflective and absorbing retinal pigment epithelium is demonstrated for the first time. A new light source (lambdac= 1050 nm, Deltalambda = 165 nm, Pout= 10 mW), based on a photonic crystal fiber pumped by a compact, self-starting Ti:Al2O3 laser has therefore been developed. Ex-vivo ultrahigh resolution OCT images of freshly excised pig retinas acquired with this light source demonstrate enhanced penetration into the choroid and better visualization of choroidal vessels as compared to tomograms acquired with a state-of-the art Ti:Al2O3 laser (Femtolasers Compact Pro, lc= 780 nm, Deltalambda= 160 nm, Pout= 400 mW), normally used in clinical studies for in vivo ultrahigh resolution ophthalmic OCT imaging. These results were also compared with retinal tomograms acquired with a novel, spectrally broadened fiber laser (MenloSystems, lambdac= 1350 nm, Deltalambda= 470 nm, Pout = 4 mW) permitting even greater penetration in the choroid. Due to high water absorption at longer wavelengths retinal OCT imaging at ~1300 nm may find applications in animal ophthalmic studies. Detection and follow-up of choroidal neovascularization improves early diagnosis of many retinal pathologies, e.g. age-related macular degeneration or diabetic retinopathy and can aid development of novel therapy approaches.
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48
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Unterhuber A, Povazay B, Hermann B, Sattmann H, Drexler W, Yakovlev V, Tempea G, Schubert C, Anger EM, Ahnelt PK, Stur M, Morgan JE, Cowey A, Jung G, Le T, Stingl A. Compact, low-cost Ti:Al2O3 laser for in vivo ultrahigh-resolution optical coherence tomography. Opt Lett 2003; 28:905-7. [PMID: 12816241 DOI: 10.1364/ol.28.000905] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
A compact, low-cost, prismless Ti:Al2O3 laser with 176-nm bandwidth (FWHM) and 20-mW output power was developed. Ultrahigh-resolution ophthalmic optical coherence tomography (OCT) ex vivo imaging in an animal model with approximately 1.2-microm axial resolution and in vivo imaging in patients with macular pathologies with approximately 3-microm axial resolution were demonstrated. Owing to the pump laser, this light source significantly reduces the cost of broadband OCT systems. Furthermore, the source has great potential for clinical application of spectroscopic and ultrahigh-resolution OCT because of its small footprint (500 mm x 180 mm including the pump laser), user friendliness, stability, and reproducibility.
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Affiliation(s)
- A Unterhuber
- Department of Medical Physics, Christian Doppler Laboratory, University of Vienna, Vienna A-1090, Austria
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49
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Bizheva K, Povazay B, Hermann B, Sattmann H, Drexler W, Mei M, Holzwarth R, Hoelzenbein T, Wacheck V, Pehamberger H. Compact, broad-bandwidth fiber laser for sub-2-microm axial resolution optical coherence tomography in the 1300-nm wavelength region. Opt Lett 2003; 28:707-9. [PMID: 12747714 DOI: 10.1364/ol.28.000707] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
A novel, compact, user friendly fiber laser with a broad emission bandwidth (MenloSystems, lambdac = 1375 nm, deltalambda = 470 nm, Pout = 4 mW) was used to achieve unprecedented sub-2-microm axial resolution optical coherence tomography (OCT) in nontransparent biological tissue in the 1300-nm wavelength region. Fresh human skin and arterial biopsies were imaged ex vivo with approximately 1.4-microm axial and approximately 3-microm lateral resolution and 95-dB sensitivity, demonstrating the great potential for clinical OCT applications of this stable, low-cost, and turn-on-key fiber laser.
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Affiliation(s)
- K Bizheva
- Department of Medical Physics, Christian Doppler Laboratory, University of Vienna, Waehringer Strasse 13, Vienna, Austria
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50
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Abstract
The estrogen receptor alpha has been shown to be activated both in a ligand-dependent and in a ligand independent fashion. We investigated whether antidepressants may directly activate the estrogen receptor alpha or enhance ligand-dependent or ligand-independent activation of the estrogen receptor alpha. Whereas both ligand-dependent and ligand-independent activation of the estrogen receptor alpha could be demonstrated in transient transfection studies, antidepressants neither directly activated the estrogen receptor alpha nor did they enhance ligand-dependent or ligand-independent activation. Thus, there are differences between the glucocorticoid receptor and the estrogen receptor alpha with regard to ligand-independent activation and action of antidepressants.
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Affiliation(s)
- B Hermann
- Max-Planck-Institute of Psychiatry, Munich, Federal Republic of Germany
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