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Riedl S, Röhl FW, Bonfig W, Brämswig J, Richter-Unruh A, Fricke-Otto S, Bettendorf M, Riepe F, Kriegshäuser G, Schönau E, Even G, Hauffa B, Dörr HG, Holl RW, Mohnike K. Genotype/phenotype correlations in 538 congenital adrenal hyperplasia patients from Germany and Austria: discordances in milder genotypes and in screened versus prescreening patients. Endocr Connect 2019; 8:86-94. [PMID: 30620712 PMCID: PMC6365666 DOI: 10.1530/ec-18-0281] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 01/08/2019] [Indexed: 12/27/2022]
Abstract
Congenital adrenal hyperplasia (CAH) due to CYP21A2 gene mutations is associated with a variety of clinical phenotypes (salt wasting, SW; simple virilizing, SV; nonclassical, NC) depending on residual 21-hydroxylase activity. Phenotypes and genotypes correlate well in 80-90% of cases. We set out to test the predictive value of CAH phenotype assignment based on genotype classification in a large multicenter cohort. A retrospective evaluation of genetic data from 538 CAH patients (195 screened) collected from 28 tertiary centers as part of a German quality control program was performed. Genotypes were classified according to residual 21-hydroxylase activity (null, A, B, C) and assigned clinical phenotypes correlated with predicted phenotypes, including analysis of Prader stages. Ultimately, concordance of genotypes with clinical phenotypes was compared in patients diagnosed before or after the introduction of nationwide CAH-newborn screening. Severe genotypes (null and A) correlated well with the expected phenotype (SW in 97 and 91%, respectively), whereas less severe genotypes (B and C) correlated poorly (SV in 45% and NC in 57%, respectively). This was underlined by a high degree of virilization in girls with C genotypes (Prader stage >1 in 28%). SW was diagnosed in 90% of screening-positive babies with classical CAH compared with 74% of prescreening patients. In our CAH series, assigned phenotypes were more severe than expected in milder genotypes and in screened vs prescreening patients. Diagnostic discrimination between phenotypes based on genotypes may prove overcome due to the overlap in their clinical presentations.
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Affiliation(s)
- Stefan Riedl
- Division of Pediatric Pulmology, Allergology and Endocrinology, Department of Pediatrics, Medical University of Vienna, Vienna, Austria
- Department of Pediatrics, St. Anna Kinderspital, Medical University of Vienna, Vienna, Austria
- Correspondence should be addressed to S Riedl:
| | | | - Walter Bonfig
- Department of Pediatrics, Klinikum Wels-Grieskirchen, Wels, Austria
| | - Jürgen Brämswig
- Department of Pediatrics, Pediatric Endocrinology, Westfälische Wilhelmsuniversität Münster, Münster, Germany
| | - Annette Richter-Unruh
- Department of Pediatrics, Pediatric Endocrinology, Westfälische Wilhelmsuniversität Münster, Münster, Germany
| | - Susanne Fricke-Otto
- Department of Pediatrics, Pediatric Endocrinology, Helios Klinikum Krefeld, Krefeld, Germany
| | - Markus Bettendorf
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
| | - Felix Riepe
- Pediatric Endocrinology, Kronshagen, Kiel, Germany
| | - Gernot Kriegshäuser
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Steyr, Steyr, Austria
| | - Eckhard Schönau
- Department of Pediatrics, Pediatric Endocrinology, Universität zu Köln, Cologne, Germany
| | - Gertrud Even
- Department of Pediatrics, Pediatric Endocrinology, Universität zu Köln, Cologne, Germany
| | - Berthold Hauffa
- Department of Pediatric Endocrinology, University of Duisburg-Essen, Essen, Germany
| | - Helmuth-Günther Dörr
- Department of Pediatrics, Pediatric Endocrinology, Friedrich Alexander Universität Erlangen, Erlangen, Germany
| | - Reinhard W Holl
- Institute of Epidemiology and Medical Biometry (ZIBMT), University of Ulm, Ulm, Germany
| | - Klaus Mohnike
- Department of Pediatrics, Pediatric Endocrinology, Otto von Guericke Universität Magdeburg, Magdeburg, Germany
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von Arnim U, Röhl FW, Miehlke S, Jechorek D, Reinhold D, Wex T, Malfertheiner P. Letter: multivariate clinical model for eosinophilic oesophagitis - is this generalisable to a general population? Authors' reply. Aliment Pharmacol Ther 2017; 45:861. [PMID: 28211624 DOI: 10.1111/apt.13967] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Affiliation(s)
- U von Arnim
- Department of Gastroenterology, Hepatology and Infectious Diseases, Otto- von- Guericke University, Magdeburg, Germany
| | - F W Röhl
- Institute of Biometrics and Medical Informatics, Otto- von- Guericke University, Magdeburg, Germany
| | - S Miehlke
- Centre for Digestive Diseases, Hamburg-Eppendorf, Germany
| | - D Jechorek
- Institue of Pathology, Otto- von- Guericke University, Magdeburg, Germany
| | - D Reinhold
- Institute of Molecular and Clinical Immunology, Otto- von- Guericke University, Magdeburg, Germany
| | - T Wex
- Department of Gastroenterology, Hepatology and Infectious Diseases, Otto- von- Guericke University, Magdeburg, Germany
| | - P Malfertheiner
- Department of Gastroenterology, Hepatology and Infectious Diseases, Otto- von- Guericke University, Magdeburg, Germany
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Wybranski C, Adamchic I, Röhl FW, Ricke J, Fischbach F, Fischbach K. Freehand direct arthrography of the shoulder using near real-time guidance in an open 1.0-T MRI scanner. Skeletal Radiol 2017; 46:51-58. [PMID: 27771753 DOI: 10.1007/s00256-016-2507-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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] [Received: 06/11/2016] [Revised: 09/17/2016] [Accepted: 09/29/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess the technical success and duration of magnetic resonance imaging (MRI)-guided freehand direct shoulder arthrography (FDSA) with near real-time imaging implemented in a routine shoulder MRI examination on an open 1.0-T MRI scanner, and to assess the learning curve of residents new to this technique. METHODS An experienced MRI interventionalist (the expert) performed 125 MRI-guided FDSA procedures, and 75 patients were treated by one of three residents without previous experience in MRI-guided FDSA. Technical success rate and duration of MRI-guided FDSA of the expert and the residents were compared. The residents' learning curves were assessed. The occurrence of extra-articular deposition and leakage of contrast media from the puncture site and the subsequent impairment of image interpretation were retrospectively analyzed. RESULTS Overall technical success was 97.5 %. The expert needed overall fewer puncture needle readjustments and was faster at puncture needle positioning (p < 0.01). The learning curve of the residents, however, was steep. They leveled with the performance of the expert after ≈ 15 interventions. With a minimal amount of training all steps of MRI-guided FDSA can be performed in ≤10 min. CONCLUSION Magnetic resonance-guided FDSA in an open 1.0-T MRI scanner can be performed with high technical success in a reasonably short amount of time. Only a short learning curve is necessary to achieve expert level.
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Affiliation(s)
- Christian Wybranski
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.
| | - Ilya Adamchic
- Department of Radiology and Nuclear Medicine, Otto-von-Guericke University Medical School, Magdeburg, Germany
| | - Friedrich-Wilhelm Röhl
- Institute of Biometry and Medical Informatics, Otto-von-Guericke University Medical School, Magdeburg, Germany
| | - Jens Ricke
- Department of Radiology and Nuclear Medicine, Otto-von-Guericke University Medical School, Magdeburg, Germany
| | - Frank Fischbach
- Department of Radiology and Nuclear Medicine, Otto-von-Guericke University Medical School, Magdeburg, Germany
| | - Katharina Fischbach
- Department of Radiology and Nuclear Medicine, Otto-von-Guericke University Medical School, Magdeburg, Germany
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Schmiedeberg K, Krause H, Röhl FW, Hartig R, Jorch G, Brunner-Weinzierl MC. T Cells of Infants Are Mature, but Hyporeactive Due to Limited Ca2+ Influx. PLoS One 2016; 11:e0166633. [PMID: 27893767 PMCID: PMC5125607 DOI: 10.1371/journal.pone.0166633] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 11/01/2016] [Indexed: 12/12/2022] Open
Abstract
CD4 T cells in human infants and adults differ in the initiation and strength of their responses. The molecular basis for these differences is not yet understood. To address this the principle key molecular events of TCR- and CD28-induced signaling in naive CD4 T cells, such as Ca2+ influx, NFAT expression, phosphorylation and translocation into the nucleus, ERK activation and IL-2 response, were analyzed over at least the first 3 years of life. We report dramatically reduced IL-2 and TNFα responses in naive CD31+ T cells during infancy. Looking at the obligatory Ca2+ influx required to induce T cell activation and proliferation, we demonstrate characteristic patterns of impairment for each stage of infancy that are partly due to the differential usage of Ca2+ stores. Consistent with those findings, translocation of NFATc2 is limited, but still dependent on Ca2+ influx as demonstrated by sensitivity to cyclosporin A (CsA) treatment. Thus weak Ca2+ influx functions as a catalyst for the implementation of restricted IL-2 response in T cells during infancy. Our studies also define limited mobilization of Ca2+ ions as a characteristic property of T cells during infancy. This work adds to our understanding of infants’ poor T cell responsiveness against pathogens.
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Affiliation(s)
- Kristin Schmiedeberg
- Department of Experimental Pediatrics, University Hospital, Otto-von-Guericke University, Magdeburg, Germany
| | - Hardy Krause
- Clinic of Pediatric Surgery University Hospital, Otto-von-Guericke University, Magdeburg, Germany
| | - Friedrich-Wilhelm Röhl
- Institute of Biometry and Medical Informatics University Hospital, Otto-von-Guericke University, Magdeburg, Germany
| | - Roland Hartig
- Institute for Molecular and Clinical Immunology, University Hospital, Otto-von-Guericke University, Magdeburg, Germany
| | - Gerhard Jorch
- Department of Experimental Pediatrics, University Hospital, Otto-von-Guericke University, Magdeburg, Germany
| | - Monika C. Brunner-Weinzierl
- Department of Experimental Pediatrics, University Hospital, Otto-von-Guericke University, Magdeburg, Germany
- * E-mail:
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Foth D, Röhl FW, Friedrich C, Tylkoski H, Rabe T, Römer T, Kitay A, Ahrendt HJ. Symptoms of uterine myomas: data of an epidemiological study in Germany. Arch Gynecol Obstet 2016; 295:415-426. [DOI: 10.1007/s00404-016-4239-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 11/08/2016] [Indexed: 11/28/2022]
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Venerito M, Varbanova M, Röhl FW, Reinhold D, Frauenschläger K, Jechorek D, Weigt J, Link A, Malfertheiner P. Oxyntic gastric atrophy inHelicobacter pylorigastritis is distinct from autoimmune gastritis. J Clin Pathol 2016; 69:677-85. [DOI: 10.1136/jclinpath-2015-203405] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 11/30/2015] [Indexed: 12/11/2022]
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Schütte K, Tippelt B, Schulz C, Röhl FW, Feneberg A, Seidensticker R, Arend J, Malfertheiner P. Malnutrition is a prognostic factor in patients with hepatocellular carcinoma (HCC). Clin Nutr 2015; 34:1122-7. [DOI: 10.1016/j.clnu.2014.11.007] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Revised: 10/15/2014] [Accepted: 11/10/2014] [Indexed: 12/15/2022]
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Varbanova M, Wex T, Jechorek D, Röhl FW, Langner C, Selgrad M, Malfertheiner P. Impact of the angulus biopsy for the detection of gastric preneoplastic conditions and gastric cancer risk assessment. J Clin Pathol 2015; 69:19-25. [DOI: 10.1136/jclinpath-2015-202858] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 06/21/2015] [Indexed: 12/31/2022]
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Wybranski C, Eberhardt B, Fischbach K, Fischbach F, Walke M, Hass P, Röhl FW, Kosiek O, Kaiser M, Pech M, Lüdemann L, Ricke J. Accuracy of applicator tip reconstruction in MRI-guided interstitial 192Ir-high-dose-rate brachytherapy of liver tumors. Radiother Oncol 2015; 115:72-7. [PMID: 25779722 DOI: 10.1016/j.radonc.2015.01.018] [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] [Received: 07/15/2014] [Revised: 01/23/2015] [Accepted: 01/26/2015] [Indexed: 11/26/2022]
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Schippan J, Eggemann H, Altmann U, Röhl FW, Costa SD. Endokrine Therapie des metastasierten Mammakarzinoms des Mannes – eine retrospektive Analyse von 80 Patienten im Vergleich mit 541 Frauen. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388356] [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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Eggemann H, Heuer H, Schwarzenau-Szydlowski C, Amse T, Röhl FW, Costa SD. Laparoskopisch assistierte vaginale Hysterektomie versus vaginale Hysterektomie – eine prospektive, randomisierte, Doppel-blind-Studie bei Patientinnen mit der Indikation zur vaginalen Hysterektomie. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388319] [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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Wybranski C, Kosiek O, Röhl FW, Pech M, Ricke J, Fischbach K, Fischbach F. MR-geführte direkte Schulter-Arthrografie an einem offenen 1.0 Tesla Hochfeld Magnetresonanztomographen (MRT). ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Wybranski C, Strach K, Krenzien F, Bunke J, Kosiek O, Röhl FW, Ricke J, Fischbach F. Real-time MR-gesteuerte perkutane Abszessdrainage an einem offenen 1.0 Tesla Magnetresonanztomografen (MRT). ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346520] [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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Luchtmann M, Jachau K, Adolf D, Röhl FW, Baecke S, Lützkendorf R, Müller C, Bernarding J. Ethanol modulates the neurovascular coupling. Neurotoxicology 2012; 34:95-104. [PMID: 23159106 DOI: 10.1016/j.neuro.2012.10.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Revised: 10/28/2012] [Accepted: 10/29/2012] [Indexed: 12/14/2022]
Abstract
Despite some evidence of the underlying molecular mechanisms the neuronal basis of ethanol-induced effects on the neurovascular coupling that forms the BOLD (blood oxygenation level dependent) signal is poorly understood. In a recent fMRI (functional magnetic resonance imaging) study monitoring ethanol-induced changes of the BOLD signal a reduction of the amplitude and a prolongation of the BOLD signal were observed. However, the BOLD signal is assumed to consist of a complex superposition of different underlying signals. To gain insight how ethanol influences stimulus efficacy, oxygen extraction, transit time and vessel-related parameters the fMRI time series from the sensori-motor and the visual cortex were analyzed using the balloon model. The results show a region-dependent decrease of the stimulus efficacy to trigger a post-stimulus neurovascular response as well as a prolongation of the transit time through the venous compartment. Oxygen extraction, feedback mechanisms and other vessel-related parameters were not affected. The results may be interpreted as follows: the overall mechanisms of the neurovascular coupling are still acting well at the moderate ethanol level of about 0.8‰ (in particular the vessel-related parts), but the potency to evoke a neurovascular response is already compromised most obviously in the supplementary motor area responsible for complex synchronizing and planning processes.
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Affiliation(s)
- Michael Luchtmann
- Department of Neurosurgery, Otto-von-Guericke-University Magdeburg, Institute for Biometry and Medical Informatics, Otto-von-Guericke-University Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany.
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Lehmann HI, Wolke C, Malenke W, Röhl FW, Hammwöhner M, Bukowska A, Lendeckel U, Goette A. Enzymatic activity of DPIV and renin-angiotensin system (RAS) proteases in patients with left ventricular dysfunction and primary prevention implantable cardioverter/defibrillator (ICD). Int J Cardiol 2012; 168:255-60. [PMID: 23063136 DOI: 10.1016/j.ijcard.2012.09.083] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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] [Received: 12/23/2011] [Revised: 03/19/2012] [Accepted: 09/15/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Patients (pts) with severely decreased left ventricular ejection fraction (LV-EF ≤ 35%) are at high risk for sudden cardiac death (SCD). We sought to investigate, if pts with primary prevention ICD hold alterations in enzyme-activities of the dipeptidyl-aminopeptidase IV (DPIV) and the renin-angiotensin system (RAS) before VT/VF occurrence. METHODS 57 Pts (53 male, mean age 64.9 [42-84] years, mean LV-EF 26 ± 5%) with ischemic (n=49) or non-ischemic cardiomyopathy (n=8) who had received an ICD/CRT-D for primary prevention, were included. Pts were assessed for appropriate ICD intervention for VT/VF during a mean follow-up of 365 ± 90 days. Serum levels of dipeptidyl-aminopeptidase IV (DPIV), aminopeptidase N (APN), aminopeptidase B (APB), insulin-regulated aminopeptidase (IRAP), and angiotensin-converting enzyme 2 (ACE2) were determined. RESULTS Pts with appropriate ICD intervention (n=16) had higher serum activities of IRAP (mean difference=12.681 pkat/mL; p=0.007), and DPIV (mean difference=117.557 pkat/mL; p=0.032) than pts without appropriate ICD intervention. Furthermore, ACE2 activity was significantly higher (median: 223.7 RFU/smL vs. 169.10 RFU/smL; p=0.037). A Cox regression analysis indicated DPIV activity >50th centile to have a hazard ratio (HR) of 5.955 (CI 95%: 1.670-21.241; p=0.006) for prediction of appropriate ICD intervention. In a multivariate Cox regression model, DPIV and IRAP >50th centile remained predictive for appropriate ICD intervention. CONCLUSION Our prospective study shows that pts with primary prevention ICD, who receive appropriate ICD intervention during follow-up, can be identified by elevated activities of DPIV and several RAS proteases. Hence, theses biomarkers seem to be of prognostic relevance in a primary prevention collective. Our data has to be proven in larger cohorts.
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Affiliation(s)
- H Immo Lehmann
- Working Group of Molecular Electrophysiology, Faculty of Medicine, Otto-von-Guericke-University, Magdeburg, Germany
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Eggemann H, Ignatov A, Stabenow R, Minkwitz GV, Röhl FW, Hildebrandt G, Hass P, Costa SD. Postmastectomy radiotherapy in male breast cancer –20 Years follow-up data. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1286451] [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] Open
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Firsching R, Müller C, Pauli SU, Voellger B, Röhl FW, Behrens-Baumann W. Noninvasive assessment of intracranial pressure with venous ophthalmodynamometry. Clinical article. J Neurosurg 2011; 115:371-4. [PMID: 21529131 DOI: 10.3171/2011.3.jns101275] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECT Venous ophthalmodynamometry is a technique used to register the pressure within the central retinal vein. Because the outflow of the central retinal vein is exposed to the intracranial pressure (ICP), the pressure of the central retinal vein may be correlated with the ICP. In the absence of adequate statistical evidence, the authors compared the pressure of the central retinal vein with results of simultaneous invasive monitoring of ICP in neurosurgical patients. METHODS The pressure within the central retinal vein was recorded in 102 patients, in whom invasive continuous monitoring of ICP had become necessary for various reasons, mostly because of suspected hydrocephalus and intracranial hemorrhage. RESULTS A highly significant correlation of the pressure in the central retinal vein and the intracranial cavity was confirmed statistically. An increased pressure of the central retinal vein indicated an elevated ICP, with a probability of 84.2%, whereas a normal pressure of the central retinal vein indicated a normal ICP in 92.8% of patients. Conclusions Venous ophthalmodynamometry is a valuable technique for the noninvasive assessment of ICP.
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Affiliation(s)
- Raimund Firsching
- Otto-von-Guericke-Universität Magdeburg, Universitätsklinikum Magdeburg A. ö. R., Klinik für Neurochirurgie, Magdeburg, Germany.
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Wybranski C, Zeile M, Löwenthal D, Fischbach F, Pech M, Röhl FW, Gademann G, Ricke J, Dudeck O. Value of diffusion weighted MR imaging as an early surrogate parameter for evaluation of tumor response to high-dose-rate brachytherapy of colorectal liver metastases. Radiat Oncol 2011; 6:43. [PMID: 21524305 PMCID: PMC3111366 DOI: 10.1186/1748-717x-6-43] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 04/27/2011] [Indexed: 12/13/2022] Open
Abstract
Background To assess the value of diffusion weighted imaging (DWI) as an early surrogate parameter for treatment response of colorectal liver metastases to image-guided single-fraction 192Ir-high-dose-rate brachytherapy (HDR-BT). Methods Thirty patients with a total of 43 metastases underwent CT- or MRI-guided HDR-BT. In 13 of these patients a total of 15 additional lesions were identified, which were not treated at the initial session and served for comparison. Magnetic resonance imaging (MRI) including breathhold echoplanar DWI sequences was performed prior to therapy (baseline MRI), 2 days after HDR-BT (early MRI) as well as after 3 months (follow-up MRI). Tumor volume (TV) and intratumoral apparent diffusion coefficient (ADC) were measured independently by two radiologists. Statistical analysis was performed using univariate comparison, ANOVA and paired t test as well as Pearson's correlation. Results At early MRI no changes of TV and ADC were found for non-treated colorectal liver metastases. In contrast, mean TV of liver lesions treated with HDR-BT increased by 8.8% (p = 0.054) while mean tumor ADC decreased significantly by 11.4% (p < 0.001). At follow-up MRI mean TV of non-treated metastases increased by 50.8% (p = 0.027) without significant change of mean ADC values. In contrast, mean TV of treated lesions decreased by 47.0% (p = 0.026) while the mean ADC increased inversely by 28.6% compared to baseline values (p < 0.001; Pearson's correlation coefficient of r = -0.257; p < 0.001). Conclusions DWI is a promising imaging biomarker for early prediction of tumor response in patients with colorectal liver metastases treated with HDR-BT, yet the optimal interval between therapy and early follow-up needs to be elucidated.
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Affiliation(s)
- Christian Wybranski
- Department of Radiology and Nuclear Medicine, Otto-von-Guericke University Magdeburg, Germany
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Eggemann H, Krocker J, Elling D, Lampe D, Lantzsch T, Weise M, Röhl FW, Costa SD. Die B-Plastik – Eine retrospektive Studie zur Wertigkeit und Patientenzufriedenheit einer brusterhaltenden Therapie bei zentralem Sitz des Mammakarzinoms. Geburtshilfe Frauenheilkd 2010. [DOI: 10.1055/s-0030-1269944] [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: 10/18/2022] Open
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20
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Bukowska A, Röcken C, Erxleben M, Röhl FW, Hammwöhner M, Huth C, Ebert MP, Lendeckel U, Goette A. Atrial expression of endothelial nitric oxide synthase in patients with and without atrial fibrillation. Cardiovasc Pathol 2010; 19:e51-60. [DOI: 10.1016/j.carpath.2008.12.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2008] [Revised: 12/12/2008] [Accepted: 12/24/2008] [Indexed: 10/21/2022] Open
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Fill Malfertheiner S, Malfertheiner MV, Mönkemüller K, Röhl FW, Malfertheiner P, Costa SD. Gastroesophageal reflux disease and management in advanced pregnancy: a prospective survey. Digestion 2009; 79:115-20. [PMID: 19321944 DOI: 10.1159/000209381] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2008] [Accepted: 12/12/2008] [Indexed: 02/04/2023]
Abstract
BACKGROUND Heartburn is known to be common during pregnancy, however validated data on gastroesophageal reflux disease (GERD) are missing. The aim of this survey was to study the prevalence of GERD, the frequency and severity of typical GERD symptoms, and their impact on quality of life and therapeutic management in advanced pregnancy. METHODS One hundred and thirty-five consecutive pregnant women in the third trimester were included in a prospective study using validated questionnaires: RDQ, QOLRAD and a self-administered questionnaire detailing sociodemographic factors. RESULTS The prevalence for GERD in this unselected population was 56.3%. Among symptoms regurgitation was the most frequent with 47.3%, whereas heartburn was graded as the most severe symptom. The impact of GERD on the QOL of the pregnant women was significant (p < 0.001). 22.9% of the GERD population required medication because of severe symptoms, often reported to be insufficient for symptoms relief. CONCLUSION GERD is common in late pregnancy with an important negative impact on the QOL. GERD in advanced pregnancy deserves more attention and better therapeutic management.
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Affiliation(s)
- Sara Fill Malfertheiner
- Department of Obstetrics and Gynecology, Otto-von-Guericke University, Magdeburg, Gerhart-Hauptmann-Strasse 35, DE-39108 Magdeburg, Germany.
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Goette A, Bukowska A, Dobrev D, Pfeiffenberger J, Morawietz H, Strugala D, Wiswedel I, Röhl FW, Wolke C, Bergmann S, Bramlage P, Ravens U, Lendeckel U. Acute atrial tachyarrhythmia induces angiotensin II type 1 receptor-mediated oxidative stress and microvascular flow abnormalities in the ventricles. Eur Heart J 2009; 30:1411-20. [PMID: 19269986 PMCID: PMC2688683 DOI: 10.1093/eurheartj/ehp046] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Aims Patients with paroxysmal atrial fibrillation (AF) often present with typical angina pectoris and mildly elevated levels of cardiac troponin (non ST-segment elevation myocardial infarction) during an arrhythmic event. However, in a large proportion of these patients, significant coronary artery disease is excluded by coronary angiography. Here we explored the potential underlying mechanism of these events. Methods and results A total of 14 pigs were studied using a closed chest, rapid atrial pacing (RAP) model. In five pigs RAP was performed for 7 h (600 b.p.m.; n = 5), in five animals RAP was performed in the presence of angiotensin-II type-1-receptor (AT1-receptor) inhibitor irbesartan (RAP+Irb), and four pigs were instrumented without intervention (Sham). One-factor analysis of variance was performed to assess differences between and within the three groups. Simultaneous measurements of fractional flow reserve (FFR) and coronary flow reserve (CFR) before, during, and after RAP demonstrated unchanged FFR (P = 0.327), but decreased CFR during RAP (RAP: 67.7 ± 7.2%, sham: 97.2 ± 2.8%, RAP+Irb: 93.2 ± 3.3; P = 0.0013) indicating abnormal left ventricular (LV) microcirculation. Alterations in microcirculatory blood flow were accompanied by elevated ventricular expression of NADPH oxidase subunit Nox2 (P = 0.039), lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1, P = 0.004), and F2-isoprostane levels (P = 0.008) suggesting RAP-related oxidative stress. Plasma concentrations of cardiac troponin-I (cTn-I) increased in RAP (RAP: 613.3 ± 125.8 pmol/L vs. sham: 82.5 ± 12.5 pmol/L; P = 0.013), whereas protein levels of eNOS and LV function remained unchanged. RAP+Irb prevented the increase of Nox2, LOX-1, and F2-isoprostanes, and abolished the impairment of microvascular blood flow. Conclusion Rapid atrial pacing induces AT1-receptor-mediated oxidative stress in LV myocardium that is accompanied by impaired microvascular blood flow and cTn-I release. These findings provide a plausible mechanism for the frequently observed cTn-I elevation accompanied with typical angina pectoris symptoms in patients with paroxysmal AF and normal (non-stenotic) coronary arteries.
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Affiliation(s)
- Andreas Goette
- Division of Cardiology, University Hospital Magdeburg, Otto-von-Guericke University, Leipzigerstr. 44, 39120 Magdeburg, Germany.
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Kuchenbecker J, Röhl FW. Ist ein web-basierter Farbsehtests für Screeninguntersuchungen geeignet? Klin Monbl Augenheilkd 2008. [DOI: 10.1055/s-0028-1110063] [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]
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Rose C, Röhl FW, Hanke J, Schwegler H, Yilmazer-Hanke DM. Maternal and genetic effects on the acoustic startle reflex and its sensitization in C3H/HeN, DBA/2JHd and NMRI mice following blastocyst transfer. Behav Genet 2008; 38:596-611. [PMID: 18719991 DOI: 10.1007/s10519-008-9222-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2008] [Accepted: 08/04/2008] [Indexed: 11/26/2022]
Abstract
In the present study, reciprocal embryo transfers were conducted to examine genetic and maternal effects on the baseline and fear-sensitized acoustic startle response (ASR) in the two inbred strains C3H/HeN and DBA/2JHd and the outbred strain NMRI. The largest differences in the ASR were found in untreated strains (effect size 0.6). The transfer procedure per se had a significant effect on the behavior of NMRI mice resulting in a reduction in the baseline, and an increase in the fear-sensitized ASR. In contrast, there were no significant effects of the transfer procedure in the two inbred strains. Autosomal genetic effects had a stronger impact on the amplitude of the ASR (effect sizes 0.5) than sex (effect sizes 0.06) as revealed by reciprocal embryo transfer. Nevertheless, the genetic effects on the fear-sensitized ASR were somewhat more variable and strain-dependent (effect sizes 0.1-0.2). Global maternal effects were detected after embryo transfer into NMRI mothers resulting in a larger reduction of the ASR in the offspring of DBA and NMRI donors than C3H donors (effect sizes 0.1-0.2). An additional fostering procedure was introduced to dissect uterine and postnatal maternal effects in NMRI offspring. Uterine factors changed the baseline ASR of the offspring in direction of the recipient mother strain. Surprisingly, postnatal maternal effects on the ASR were contrary to the behavior of the rearing mother. In conclusion, both genetic and prenatal/postnatal maternal factors persistently influenced the ASR of the offspring, whereas the fear-sensitized ASR was mainly influenced by genetic factors. Our study shows that uterine and postnatal maternal influences deserve more attention when determining the phenotype of genetically engineered mice at least in the first generation following embryo transfer.
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Affiliation(s)
- Claudia Rose
- Institut für Anatomie, Medizinische Fakultät, Otto-von-Guericke Universität, Magdeburg, Germany
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Bukowska A, Schild L, Keilhoff G, Hirte D, Neumann M, Gardemann A, Neumann KH, Röhl FW, Huth C, Goette A, Lendeckel U. Mitochondrial dysfunction and redox signaling in atrial tachyarrhythmia. Exp Biol Med (Maywood) 2008; 233:558-74. [PMID: 18375832 DOI: 10.3181/0706-rm-155] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [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: 11/16/2022] Open
Abstract
Accumulating evidence links calcium-overload and oxidative stress to atrial remodeling during atrial fibrillation (AF). Furthermore, atrial remodeling appears to increase atrial thrombogeneity, characterized by increased expression of adhesion molecules. The aim of this study was to assess mitochondrial dysfunction and oxidative stress-activated signal transduction (nuclear factor-kappaB [NF-kappa B], lectin-like oxidized low-density lipoprotein receptor [LOX-1], intercellular adhesion molecule-1 [ICAM-1], and hemeoxgenase-1 [HO-1]) in atrial tissue during AF. Ex vivo atrial tissue from patients with and without AF and, additionally, rapid pacing of human atrial tissue slices were used to study mitochondrial structure by electron microscopy and mitochondrial respiration. Furthermore, quantitative reverse transcription polymerase chain reaction (RT-PCR), immunoblot analyses, gel-shift assays, and enzyme-linked immunosorbent assay (ELISA) were applied to measure nuclear amounts of NF-kappa B target gene expression. Using ex vivo atrial tissue samples from patients with AF we demonstrated oxidative stress and impaired mitochondrial structure and respiration, which was accompanied by nuclear accumulation of NF-kappa B and elevated expression levels of the adhesion molecule ICAM-1 and the oxidative stress-induced markers HO-1 and LOX-1. All these changes were reproduced by rapid pacing for 24 hours of human atrial tissue slices. Furthermore, the blockade of calcium inward current with verapamil effectively prevented both the mitochondrial changes and the activation of NF-kappa B signaling and target gene expression. The latter appeared also diminished by the antioxidants apocynin and resveratrol (an inhibitor of NF-kappa B), or the angiotensin II receptor type 1 antagonist, olmesartan. This study demonstrates that calcium inward current via L-type calcium channels contributes to oxidative stress and increased expression of oxidative stress markers and adhesion molecules during cardiac tachyarrhythmia.
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Affiliation(s)
- Alicja Bukowska
- University Hospital Magdeburg, Institute of Experimental Internal Medicine, Leipzigerstrasse 44, 39120 Magdeburg, Germany
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Goette A, Bukowska A, Lendeckel U, Erxleben M, Hammwöhner M, Strugala D, Pfeiffenberger J, Röhl FW, Huth C, Ebert MPA, Klein HU, Röcken C. Angiotensin II receptor blockade reduces tachycardia-induced atrial adhesion molecule expression. Circulation 2008; 117:732-42. [PMID: 18227384 DOI: 10.1161/circulationaha.107.730101] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.8] [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: 11/16/2022]
Abstract
BACKGROUND Increased levels of inflammatory markers are predictors of thromboembolic events during atrial fibrillation (AF). Increased endocardial expression of adhesion molecules (ie, vascular cell adhesion molecule [VCAM] and intercellular adhesion molecule [ICAM]) could be an important link between initiation of inflammatory and prothrombogenic mechanisms responsible for thrombus development at the atrial endocardium (endocardial remodeling). METHODS AND RESULTS Tissue microarrays were used to screen right atrial tissue specimens obtained from 320 consecutive patients for differences in atrial expression of the prothrombogenic proteins VCAM-1, ICAM-1, thrombomodulin, plasminogen activator inhibitor-1, and von Willebrand factor. An in vitro organotypic human atrial tissue model and a pig model of rapid atrial pacing were used to determine the therapeutic impact of angiotensin II receptor blockade. Immunohistochemical analyses showed that all prothrombogenic proteins are expressed by endocardial cells. Using multivariable analysis, only the intensity of VCAM-1 expression was increased in patients with AF (P=0.03). Increased atrial VCAM-1 expression was confirmed by Western blotting in patients with persistent and paroxysmal AF (persistent AF 207+/-42% versus sinus rhythm 100+/-16%, P=0.028; paroxysmal AF 193+/-42%, P=0.024 versus sinus rhythm). In vitro pacing of ex vivo human atrial tissue slices confirmed that rapid activation causes VCAM-1 upregulation (mRNA and protein levels). Pacing-induced VCAM-1 expression was abolished by olmesartan. To confirm this finding in vivo, VCAM-1 expression was determined in 14 pigs after rapid atrial pacing (600 bpm). Atrial tachycardia caused an upregulation of VCAM-1 expression, which was prevented by irbesartan, consistent with the observed increase in plasma levels of angiotensin II. Alterations in the in vivo VCAM-1 expression were more pronounced in the left atrium (>5-fold compared with sham) than in the right atrium (3.5-fold compared with sham). CONCLUSIONS AF and rapid atrial pacing both increase endocardial VCAM-1 expression, which can be attenuated by angiotensin II receptor blockade. This provides evidence that angiotensin II plays a pathophysiological role in prothrombotic endocardial remodeling.
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Affiliation(s)
- Andreas Goette
- Division of Cardiology, Otto von Guericke University Hospital Magdeburg, Magdeburg, Germany.
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Klatte T, Ittenson A, Röhl FW, Ecke M, Allhoff EP, Böhm M. Pretreatment with interferon-alpha2a modulates perioperative immunodysfunction in patients with renal cell carcinoma. ACTA ACUST UNITED AC 2008; 31:28-34. [PMID: 18268396 DOI: 10.1159/000112214] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Complex perioperative immunodysfunction occurs in patients with renal cell carcinoma undergoing surgery. Here, we report on the effect of preoperative treatment with interferon-alpha2a (IFN-alpha2a). MATERIALS AND METHODS 30 patients with a renal tumour received preoperative IFN-alpha2a for 6 days beginning 1 week before nephrectomy, 30 did not. Parameters of cellular and humoral immunity were measured in venous blood at various intervals using flow cytometry and ELISA. Endpoints included effects on immune parameters, toxicity, and survival. RESULTS Toxicity was grade 1 in 52%, 2 in 30%, and 3 in 4%. During IFN-alpha2a administration, leukocytes, monocytes, granulocytes, B-cell marker CD19, activation markers, CD4+CD25+ regulatory T-cells, and vascular endothelial growth factor (VEGF) dropped significantly, but no difference was observed in T-cell and natural killer (NK)-cell markers, and IL-10. Postoperatively, T-cell and activation markers decreased in both groups, but CD4, CD28, IL-6, IL-10, and HLA-DR alterations were significantly less accentuated in patients who had been treated with IFN-alpha2a. After a median follow-up of 23 months, survival did not differ between the groups (p = 0.54). CONCLUSIONS Perioperative immunodysfunction can be modulated by preoperative administration of IFN- alpha2a. IFN-alpha2a decreased the level of VEGF and CD4+CD25+ regulatory T-cells implicating a potential combination with tyrosine kinase inhibitors and vaccines.
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Affiliation(s)
- Tobias Klatte
- Department of Urology, Otto-von-Guericke University, Magdeburg, Germany
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Röcken C, Röhl FW, Diebler E, Lendeckel U, Pross M, Carl-McGrath S, Ebert MPA. The angiotensin II/angiotensin II receptor system correlates with nodal spread in intestinal type gastric cancer. Cancer Epidemiol Biomarkers Prev 2007; 16:1206-12. [PMID: 17548686 DOI: 10.1158/1055-9965.epi-05-0934] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We aimed to substantiate the putative significance of angiotensin II receptor type 1 (AT1R) and type 2 (AT2R) for gastric cancer biology by investigating the correlation of their expression with various clinicopathologic variables and patient survival. Local expression of AT1R, AT2R, and angiotensin-converting enzyme (ACE) was investigated by immunohistochemistry in tumor and corresponding nontumor specimens obtained from 100 patients with gastric cancer, and compared with the ACE insertion/deletion gene polymorphism. AT1R and AT2R were found in the tumor epithelial cells of 26 (26%) and 95 (95%) patients, respectively. AT1R was significantly more prevalent (P < 0.001) in intestinal type gastric cancer than in diffuse type gastric cancer. In intestinal type gastric cancer, its expression correlated with the N category (P = 0.009) and the International Union Against Cancer tumor stage (P = 0.024). AT1R+ intestinal type gastric cancers had a larger number of lymph node metastases (P = 0.026), a higher International Union Against Cancer tumor stage (P = 0.032), and a shorter survival time (P = 0.009) than AT1R- tumors. Multivariate analysis with lymph nodes as a dependent variable showed that AT1R status and ACE-I/D gene polymorphism are independent risk factors. Irrespective of the genotype, AT1R+ gastric cancers had a relative risk of lymph node metastases of 4.40 (95% confidence interval, 1.30-14.86). When the ACE genotype was included, the relative risk of having lymph node metastases increased considerably in AT1R+ tumors being heterozygous or homozygous for the ACE D allele (odds ratio, 19.00; 95% confidence interval, 1.45-248.24). Our study shows that AT1R and AT2R are expressed locally in gastric cancer and that the combination of AT1R expression and ACE I/D gene polymorphism correlates with nodal spread in intestinal type gastric cancer.
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Affiliation(s)
- Christoph Röcken
- Department of Pathology, Charité University Hospital, Charitéplatz 1, D-10117 Berlin, Germany.
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Kuchenbecker J, Röhl FW, Wesselburg A, Bernarding J, Behrens-Baumann W. Untersuchungen zur Validität eines webbasierten Farbsehtests für Screeninguntersuchungen des Farbensehens. Ophthalmologe 2007; 104:47-53. [PMID: 17160379 DOI: 10.1007/s00347-006-1443-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [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: 10/23/2022]
Abstract
BACKGROUND With standardized examination conditions, a web-based color vision test using pseudoisochromatic color plates can deliver test results comparable to those yielded by conventional color vision tests. The aim of the study is to analyze to what extent a web-based color vision test can be used as a screening test on the internet after visual monitor calibration. METHODS A German-language web-based color vision test with 25 pseudoisochromatic color plates based on the color plates of Velhagen and Broschmann and of Ishihara was developed, which can be seen at http://www.farbsehtest.de. Volunteers were recruited by means of specific information distributed on the internet, in various print media, and on the radio. RESULTS Over a period of 12 months, 2,126 of the initial volunteers [541 women and 1,588 men; mean age 34.27 (+/-14.1) years] with a valid test result for 25 color plates performed the web-based color vision test, 1,700 (506 women and 1,194 men) of whom passed it. Of the 426 volunteers who did not pass the test, 32 were women and 394, men. Counter-testing was performed on 101 volunteers (34 women and 67 men) with a mean age of 36.74 (+/-11.6) years. CONCLUSIONS The results recorded in the patients who underwent counter-testing suggest that, if handled correctly, the web-based color vision test can be used as a color vision screening test on the internet.
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Affiliation(s)
- J Kuchenbecker
- Augenklinik des Helios-Klinikums Berlin-Buch, Karower Str. 11, 13125, Berlin, Germany.
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Rose C, Schwegler H, Hanke J, Röhl FW, Yilmazer-Hanke DM. Differential effects of embryo transfer and maternal factors on anxiety-related behavior and numbers of neuropeptide Y (NPY) and parvalbumin (PARV) containing neurons in the amygdala of inbred C3H/HeN and DBA/2J mice. Behav Brain Res 2006; 173:163-8. [PMID: 16860404 DOI: 10.1016/j.bbr.2006.06.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2006] [Revised: 06/12/2006] [Accepted: 06/14/2006] [Indexed: 10/24/2022]
Abstract
The effects of reciprocal embryo transfers were studied on anxiety-related behavior of inbred C3H/HeN and DBA/2J mice on the elevated plus maze (EPM), and related to amygdaloid neuropeptide Y (NPY)- and parvalbumin (PARV)-immunoreactive neurons. Embryo transfer significantly reduced closed arm entries in in-stain-transferred C3H mice, and maternal factors influenced open arm entries only in interaction with genetic background and sex. In DBA/2J-mice, embryo transfer resulted in a reduced number of NPY-immunoreactive (NPY-ir) neurons, while PARV-immunoreactive (PARV-ir) cells were not affected. In C3H/HeN mice, however, in-strain embryo transfer only resulted in a reduction of the number of PARV-immunoreactive neurons. Maternal factors mainly induced changes in the number of NPY-ir neurons in the basolateral complex of the amygdala either directly or in interaction with genetic factors. In summary, in-strain embryo transfer had a minor effect on the behavior of C3H/HeN mice, and a differential influence on the numbers of amygdaloid NPY-ir and PARV-ir neurons of inbred C3H/HeN and DBA/2J mice. Maternal factors had a stronger impact on the numbers of NPY-ir neurons than PARV-ir neurons. The present results indicate that alterations in behavior and amygdala morphology induced by embryo transfer or maternal factors depend on the genetic background of the mouse strains used.
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Affiliation(s)
- Claudia Rose
- Institut für Anatomie, Section Neuroanatomy, Otto-von-Guericke Universität, Haus 43, Leipziger Street 44, D-39120 Magdeburg, Germany.
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Rose C, Röhl FW, Schwegler H, Hanke J, Yilmazer-Hanke DM. Maternal and Genetic Effects on Anxiety-Related Behavior of C3H/HeN, DBA/2J and NMRI Mice in a Motility-Box Following Blastocyst Transfer. Behav Genet 2006; 36:745-62. [PMID: 16465481 DOI: 10.1007/s10519-005-9037-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2005] [Accepted: 11/15/2005] [Indexed: 10/25/2022]
Abstract
Reciprocal embryo transfers were conducted to examine genetic and maternal effects on the behavior of inbred C3H/HeN and DBA/2J mice, and outbred NMRI mice using a motility-box. The behavioral variables measured were (i) horizontal locomotor activity assessed as the path and time spent during traveling; (ii) vertical activity assessed as the time spent with and numbers of rearings/leanings; (iii) and the time spent in the more anxiogenic central field. The transfer procedure per se resulted in a minor increase in vertical activity of inbred C3H/HeN mice, but had no effect in inbred DBA/2J mice. In contrast, outbred NMRI mice displayed a lower central field activity following embryo transfer indicating a higher anxiety level. Moreover, genetic differences between the mouse strains studied remained stable following embryo transfer for locomotor and vertical activity, but not central field activity depending on the recipient mother strain. Maternal effects were found for (i) vertical activity in the two inbred mouse strains, (ii) all behavioral variables studied in outbred NMRI mice, and (iii) an interaction with gender for the time spent in the anxiogenic central field. An additional fostering procedure revealed that the vertical activity of NMRI mice was modified towards the behavior of the recipient C3H/HeN strain by uterine factors, whereas the postnatal maternal effect of C3H/HeN mothers was the opposite. In summary, the effects of the embryo transfer procedure per se, stability of genetic characteristics following embryo transfer and maternal effects were related to the mouse strains used as donators and recipients, and the behavioral variables studied.
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Affiliation(s)
- Claudia Rose
- Institut für Anatomie, Otto-von-Guericke Universität Magde- burg, Magdeburg, Germany
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Buch M, Reschke K, Röhl FW, Mohnike K, Lehnert H. Risikofaktoren für die Entwicklung einer Insulinresistenz bei Erwachsenen mit SGA. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-943828] [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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Vorwerk P, Mohnike K, Wex H, Röhl FW, Zimmermann M, Blum WF, Mittler U. Insulin-like growth factor binding protein-2 at diagnosis of childhood acute lymphoblastic leukemia and the prediction of relapse risk. J Clin Endocrinol Metab 2005; 90:3022-7. [PMID: 15687344 DOI: 10.1210/jc.2004-0461] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Despite remarkable advances in the clinical outcome of most children with acute lymphoblastic leukemia, a substantial number of patients ultimately relapse or suffer from side effects of treatment. In the present study, we investigated components of the IGF system for their predictive value to identify patients with an increased risk of relapse. Serum levels of IGF-I, IGF-II, IGF binding protein (IGFBP)-1, IGFBP-2, and IGFBP-3 were measured in 162 children with acute lymphoblastic leukemia treated by the Berlin Frankfurt Munster Study Group. At diagnosis we found elevated IGFBP-2, low IGFBP-3, low IGF-I, and low normal IGF-II, but normal IGFBP-1 levels. Highly elevated IGFBP-2 and low IGFBP-3 at the time of diagnosis correlated with a higher risk of an event such as lack of remission or a relapse. Serum IGFBP-2 was identified as an independent factor that adds additional information for the prediction of events (relapse or treatment failure) to the conventional prognostic factors such as white blood cell count and platelet count at diagnosis.
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Affiliation(s)
- Peter Vorwerk
- Department of Pediatric Hematology/Oncology, University Otto von Guericke Magdeburg, E.-Larisch-Weg 17-19, D-39112 Magdeburg, Germany.
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Weisshaar E, Dunker N, Röhl FW, Gollnick H. Antipruritic effects of two different 5-HT3 receptor antagonists and an antihistamine in haemodialysis patients. Exp Dermatol 2005; 13:298-304. [PMID: 15140020 DOI: 10.1111/j.0906-6705.2004.00184.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.6] [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
Pruritus is the most distressing symptom in haemodialysis (HD) patients. Its aetiology has not yet been delineated, and thus there are no good therapeutical options. Case reports and series attribute antipruritic potency to the serotonin receptor antagonists of the 5-HT3 type in renal pruritus. It was the aim of this study to investigate the antipruritic effect of two different 5-HT3 receptor antagonists and an antihistamine in 11 patients undergoing HD. Pruritus was induced by iontophoresis with serotonin and histamine and recorded before and after HD. These data were compared to those obtained after oral pretreatment with the 5-HT3 receptor antagonists tropisetron 5 mg and ondansetron 8 mg and the antihistamine cetirizine 10 mg. Ten healthy volunteers served as a control group. Vasocutaneous parameters (wheal and flare), skin temperature and alloknesis were also determined. Itching in HD patients and controls was not significantly diminished by oral pretreatment with the serotonin receptor antagonists. In controls, but not in HD patients, cetirizine significantly reduced itching, skin temperature and vasocutaneous parameters. Our data additionally demonstrate that there are no significant differences in vasocutaneous parameters, itching and alloknesis in HD patients before and after dialysis. We conclude that 5-HT3 receptor blockers such as tropisetron and ondansetron and the antihistamine cetirizine do not sufficiently reduce serotonin- and histamine-induced itching in haemodialyis patients.
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Affiliation(s)
- Elke Weisshaar
- Department of Dermatology and Venereology, Otto-von-Guericke-University, Magdeburg, Germany.
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Abstract
BACKGROUND Screening tests of visual functions using the Internet are theoretically possible. To use these tests as a screening test, they must deliver comparable results with conventional test procedures. A web-based color vision test was developed based on pseudoisochromatic color plates. METHOD The web-based color vision test was developed according to the pseudoisochromatic color plates by Velhagen and Broschmann using the programming-languages HTML, Java, and Perl. Sixty-five voluntary subjects, including nine color-deficient subjects, were examined by luminescence color plates (via web-based color vision test) and pigment color plates (via book). The statistical analysis was performed by determining the correspondence and the 95%-confidence interval. RESULTS The correspondence of the test results for all subjects was 0.98 and the 95%-confidence interval was within 0.91 and 0.99. The correspondence of the test results in the group of color-deficient subjects was 1.0 and because of the limited number the 95%-confidence interval was within 0.71 and 1.0. CONCLUSIONS The web-based color vision test with luminescence color plates for color-efficient and color-deficient subjects delivers test results comparable to pigment color plates under standardized examination conditions. Further studies are needed to examine if the web-based color vision test can also be used as an Internet screening test.
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Böhm M, Ittenson A, Klatte T, Schierbaum KF, Röhl FW, Ansorge S, Allhoff EP. Pretreatment with interleukin-2 modulates perioperative immunodysfunction in patients with renal cell carcinoma. Folia Biol (Praha) 2004; 49:63-8. [PMID: 12779014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Complex perioperative immunodysfunction occurs in patients with renal cell carcinoma undergoing nephrectomy. Here, the effect of pretreatment with IL-2 is addressed. Of 63 patients who underwent tumour nephrectomy, 26 patients received four doses of 10 Mio IE/m2 IL-2 b.d. s.c. (i.e. a total of 40 Mio IE/m2) a week before operation, 37 did not. Parameters of cellular and humoral immunity (differential blood count, T-cell markers CD2, CD3, CD4, and CD8, B-cell markers CD19 and CD20, monocyte markers CD13 and CD14, NK-cell marker CD16, activation markers CD25, CD26, CD69 and HLA-DR, and cytokines IL-1-receptor antagonist (IL-1RA), IL-2, soluble IL-2-receptor (sIL-2R), IL-6, IL-10, and TGFbeta) were measured in peripheral venous blood. Blood was drawn before IL-2, one day before and immediately after the operation, and on the 1st, 3rd, 5th, and 10th postoperative day. All patients showed postoperatively elevated leukocyte and granulocyte counts, and elevated serum levels of cytokines IL-6 and IL-10. T-cell and activation markers were decreased. However, all these alterations were less accentuated in patients who had been pretreated with IL-2. Monocyte counts and IL-2 and TGFbeta levels were decreased, but IL-1RA and sIL-2R levels were elevated in pretreated patients. IL-2-related toxicity was WHO grade I-II in all patients, grade III in one patient. The anaesthetic regimen had no measurable effect. IL-6 concentrations were higher in renal venous than in venous pool blood, indicating IL-6 production in the tumour in vivo. Tumour-specific survival was better in pretreated patients with tumours extending beyond the kidney. Pretreatment with IL-2 modulates perioperative immunodysfunction in patients undergoing tumour nephrectomy. This affects in particular T-cell-mediated immunity and levels of cytokines IL-10 and IL-6. The IL-2 application scheme used here was followed by distinct counter regulation including monocytes, IL-2, sIL-2R, IL-1RA and TGFbeta. Taken together, pretreatment with IL-2 may complement surgery in the treatment of patients with renal cell carcinoma, and may help close the therapeutic gap between neo-adjuvant and adjuvant immunotherapy.
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Affiliation(s)
- M Böhm
- Department of Urology, Otto-von-Guericke-University, Magdeburg, Germany.
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Petz D, Klauck S, Röhl FW, Malfertheiner P, Roessner A, Röcken C. Feasibility of histological grading and staging of chronic viral hepatitis using specimens obtained by thin-needle biopsy. Virchows Arch 2003; 442:238-44. [PMID: 12647213 DOI: 10.1007/s00428-002-0749-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2002] [Accepted: 11/20/2002] [Indexed: 12/15/2022]
Abstract
We performed a retrospective study to investigate the feasibility of grading and staging of chronic viral hepatitis on specimens obtained by means of thin-needle biopsy (TNB; 20G) using the modified Ishak-system (J Hepatol 1995; 22:696-699). Specimens obtained using large-needle biopsy (LNB; 17G) served as a control. A total of 100 biopsy specimens from 88 patients were included in the study. Of the patients, 30 suffered from chronic hepatitis B, 54 from chronic hepatitis C, and 4 from both; 59 specimens were obtained by TNB and 41 by LNB. All four categories of the Ishak-system, i.e., interface hepatitis, confluent necrosis, lobular inflammation and portal inflammation, could be applied to TNB specimens and provided similar total scores to those observed in LNB specimens. Specimens obtained by TNB facilitated the diagnosis of liver cirrhosis. However, they bore the risk of underestimating the presence of cirrhosis in favor of advanced bridging fibrosis, whereas no differences were found in the overall recognition of liver fibrosis. Intra- and interobserver variabilities were not affected by the needle size. For the interobserver agreement, the kappa values for the category of inflammation ranged from 0.003 to 0.419 (TNB) and 0.096 to 0.470 (LNB) and for staging we noted kappa values of 0.351 (TNB) and 0.456 (LNB). Reproducibility increased when a tolerance of +/-1 was accepted for grading (total score) and staging; in this case, observer variability was less than 20%. This study showed that grading and staging of chronic viral hepatitis is feasible in TNB specimens and that intra- and interobserver variability poses a greater problem than needle size.
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Affiliation(s)
- Daniela Petz
- Department of Pathology, Otto-von-Guericke-University, Leipziger Strasse 44, 39120, Magdeburg, Germany
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Schwitalla S, Heres F, Röhl FW, Pfau G, Kessling C. [Intraoperative oxygen consumption and organ function in liver transplantation]. Anaesthesiol Reanim 2002; 26:88-94. [PMID: 11552435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Liver transplantation has become established as a reasonable and promising treatment option in terminal stages of liver diseases. Since there is no permanent artificial liver support available, primary "non-function" (PNF) of the graft is one of the most threatening complications. Therefore, an early and, if possible, intraoperative assessment of liver function is essential. Pathological changes in total oxygen consumption (VO2) are considered as an early indicator for the occurrence of PNF. Previously, PNF was analyzed using extensive calculations according to the Fick method, but since inauguration of the PhysioFlex anaesthesia device (Dräger, Lübeck, Germany), which is based on a closed anaesthesia circuit, continuous monitoring of oxygen consumption has become possible. The aim of the study was to investigate whether continuous VO2 monitoring using PhysioFlex allows immediate detection of pathological changes in graft function in the very early neohepatic phase of liver tranplantation. Therefore, 51 liver transplants were investigated at the University Hospital of Magdeburg with regard to a correlation between intraoperative VO2 values and ischaemic time periods of the donor organ and the postoperative liver function. A regular course of oxygen consumption was found in uncomplicated transplants and prompt liver function within normal ranges. PNF was not observed in any transplants. Changes in oxygen consumption were caused by early retransplants or by the delayed start of graft-based metabolism intraoperatively and transient diminished liver function found postoperatively, e.g., in pre-existing hepatorenal syndrome. In addition, VO2 indicated precisely the anhepatic and neohepatic phases during the course of liver transplantation. There was no correlation between the course of glucose content of the blood and the metabolic index of glucose and oxygen consumption or between both parameters and initial graft function. Furthermore, the duration of ischaemic time periods was not closely associated with oxygen consumption during the reperfusion phase. However, there was a correlation between intraoperative VO2 and postoperative bilirubin values, while a correlation between VO2 and GLDH as a further relevant parameter of postoperative graft function could not be confirmed, most likely because of the great variance in these values. In conclusion, the results suggest that changes in total oxygen consumption may, in part, be caused by changes in liver metabolism, depending on the various phases of liver transplantation. In addition, oxygen analysis allows monitoring of the critical phases of liver transplantation such as the anhepatic and early neohepatic periods with regard to immediate detection of early changes in graft metabolism. For routine use of this parameter, steady measurement of the mean value displayed on the PhysioFlex for selectable time periods would be helpful in addition to the continuous VO2 analysis, since there is a greater variance in the single VO2 values, which are documented by the anaesthesiologist, than in the online-detected and automatically calculated values of specific periods of transplantation.
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Affiliation(s)
- S Schwitalla
- Universitätsklinik für Anaesthesiologie und Intensivtherapie, Medizinischen Fakultät, Otto-von-Guericke-Universität Magdeburg.
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Böhm M, Ittenson A, Philipp C, Röhl FW, Ansorge S, Allhoff EP. Complex perioperative immuno-dysfunction in patients with renal cell carcinoma. J Urol 2001; 166:831-6. [PMID: 11490228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
PURPOSE Patients with renal cell carcinoma have an impaired function of the immune system, which is the basis for different approaches of immunotherapy. We address perioperative changes of several parameters of the immune system in these patients. MATERIALS AND METHODS Parameters of cellular and humoral immunity, including differential blood count, T cell markers CD2, 3, 4 and 8, B cell markers CD19 and 20, monocyte markers CD13 and 14, natural killer cell marker CD16, activation markers CD25, CD26 and HLA-DR, and cytokines interleukin-1 (IL-1) receptor antagonist, IL-2, soluble IL-2 receptor, IL-6, IL-10 and transforming growth factor-beta, were measured in the venous blood of patients who underwent renal surgery extracorporeal shock wave lithotripsy (ESWL, Dornier Medical Systems, Inc., Marietta, Georgia). Patients were grouped and age matched, and 37 underwent tumor nephrectomy, 20 open renal surgery for nonmalignant reasons and 24 ESWL. A group consisting of 39 controls received no treatment. RESULTS Little change was detected in controls and those patients who received ESWL. Patients who underwent open renal surgery had increased leukocyte and granulocyte counts until postoperative day 3 but had low T cell counts. The postoperative decrease in CD25 expressing cells corresponded to an increase in the soluble IL-2-receptor. Cytokines IL-6 and 10, which also have immunosuppressive properties, were markedly increased postoperatively. These changes were more noted (p <0.01) in those patients who underwent tumor nephrectomy than open renal surgery for nonmalignant reasons and remained detectable when paired patients with similar surgical trauma were compared. In tumor nephrectomy cases renal venous IL-6 was higher than peripheral venous levels. CONCLUSIONS Patients with renal cell carcinoma suffer from selective immuno-dysfunction, indicating a rationale for perioperative immunomodulation.
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Affiliation(s)
- M Böhm
- Department of Urology, Institute of Experimental Internal Medicine, Otto-von-Guericke-University, Magdeburg, Germany
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Meyer FP, Tröger U, Röhl FW. Reliability of symptom reports by healthy volunteers treated with placebo over several time periods. Arzneimittelforschung 2000; 50:768-71. [PMID: 10994163 DOI: 10.1055/s-0031-1300286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
In four test periods (medication-free control, three placebo periods with the suggestion randomised placebo or sedative or stimulant) 78 healthy medical students had to check off on a side-effect questionnaire those symptoms that they had experienced over the previous 72 h (adverse nondrug reactions). In the control period only 14 volunteers (18%) were without symptoms. In the course of 4 weeks this number doubled, and the number of symptoms complained decreased correspondingly, e.g. tiredness, headaches, muscle and joint pains etc. This development is relevant inasmuch as in phase-I studies the well-being of the volunteers is often monitored over protracted periods of time and perhaps decreasing interest or a decreasing motivation must be reckoned with. One or two rounds of tests present special situations, in any case, which cannot be reproduced. As the frequency of the symptoms complained of is modified by the personality structure, balanced groups must be formed for controlled studies. In Phase I trials it may sometimes be useful to characterize the volunteers psychologically.
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Affiliation(s)
- F P Meyer
- Institute of Clinical Pharmacology, Magdeburg, Germany
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Manger T, Fahlke J, Pross M, Fuhlroth J, Röhl FW, Lippert H. [Laparoscopic cholecystectomy. A recommendable indication in acute cholecystitis?]. Zentralbl Chir 2000; 124:1121-9. [PMID: 10670100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
While laparoscopic cholecystectomy has become the procedure of choice for the elective treatment of symptomatic cholecystolithiasis the question whether patients with acute cholecystitis should be operated laparoscopically or conventionally is still debated. Nevertheless, more and more surgeons tend to use the laparoscopic approach even in patients with acute cholecystitis. Of 1006 laparoscopic cholecystectomies performed at our hospital 42 were done for acute cholecystitis. Conversion to an open procedure was necessary in only one patient because of severe inflammatory changes. The overall mortality was zero. The average age was 45.9 years for all patients and 50.4 years for those with acute cholecystitis. The average operating time in patients with acute cholecystitis was 81 minutes compared to 62 minutes in patients who underwent elective laparoscopic cholecystectomy. The complication rate and the average hospitalization time did not differ significantly between the two groups. Our own data as well as the data retrieved from the literature seem to indicate that laparoscopic cholecystectomy is superior to the open procedure in the treatment of acute cholecystitis. Prerequisite is that the operation is performed less than 72 hours after the onset of the symptoms by an experienced operating team and the readiness to convert to open procedure if necessary. Under those circumstances laparoscopic cholecystectomy seems to be the treatment of choice for acute cholecystitis.
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Affiliation(s)
- T Manger
- Klinik und Poliklinik für Chirurgie, Medizinische Fakultät Otto-von-Guericke-Universität, Magdeburg
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Weisshaar E, Ziethen B, Röhl FW, Gollnick H. The antipruritic effect of a 5-HT3 receptor antagonist (tropisetron) is dependent on mast cell depletion--an experimental study. Exp Dermatol 1999; 8:254-60. [PMID: 10439222 DOI: 10.1111/j.1600-0625.1999.tb00379.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The background of this study is that 5-HT3 receptor antagonists are reported to have an antipruritic effect in uremic and cholestatic pruritus. Recently, we could not confirm such an effect in healthy subjects under experimental conditions. Therefore, it was the aim of the present study to further evaluate a possible antipruritic effect of a 5-HT3 receptor antagonist (tropisetron) on serotonin- and histamine-induced itch before and after skin mast cell depletion in 10 healthy subjects. The results were compared to serotonin and histamine iontophoresis in non-pretreated and pretreated skin with an orally applied antihistamine (cetirizine). Skin mast cell depletion was performed by iontophoretical application of compound 48/80. Wheals and flares were planimetrically evaluated. Itching and burning sensations were rated on an analog scale over a 24-min period. The test protocol also comprised alloknesis, defined as induction of perifocal itch sensations by a mechanical stimulus. When serotonin was iontophoretically applied after mast cells had been depleted before, oral tropisetron resulted not only in significantly lower whealing, itching and alloknesis but also reduced flares. In contrast, after oral pretreatment with tropisetron histamine-induced reactions before and after mast cell depletion did not significantly change. Our study demonstrates that in this model, tropisetron as a 5-HT3 receptor antagonist does not effect histamine-induced itch but has a measurable effect in serotonin-induced reactions when mast cells were depleted before. From these data evidence now exists why tropisetron is to some extent effective in certain types of pruritus such as uremic pruritus, known for increased histamine liberation and increased serotonin levels as well as degranulated and diffusely spread mast cells in the skin.
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Affiliation(s)
- E Weisshaar
- Department of Dermatology and Venereology, Otto-von-Guericke-University Magdeburg, Germany.
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43
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Lindner H, Röhl FW, Behrens-Baumann W. [Contrast enhancement in the public environment--improvement in orienting capacity of visually handicapped patients]. Klin Monbl Augenheilkd 1999; 214:231-45. [PMID: 10407805 DOI: 10.1055/s-2008-1034781] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 10/21/2022]
Abstract
BACKGROUND Partially sighted often experience problems in orientation in public areas. Individual visual aids can only be used with limitations. Improving light intensity and colour contrasts of timetables, information signs, direction symbols, etc. can provide remedies. Experimentally substantiated directives do not yet exist. PATIENTS AND METHODS Experiments were conducted in 231 partially sighted subjects (binocular vision < 0.3) diagnosed as experiencing dullness when watching the media, having maculopathies, glaucomas, or dystrophic alterations of the retina or choroid, and in 43 normal subjects to determine the subjective assessment of colour and light-intensity contrasts. The presented contrast patterns were Hartmann-characters as infield (3.3 degrees) with a rectangular surround (19.5 degrees x 14.3 degrees). Three experimental series were carried out in which subjects assigned 14 non-coloured/non-coloured contrasts, 35 non-coloured/colour contrasts and 30 colour/colour contrasts to any of the five assessment classes of extremely poor, poor, optimal, sharp, extremely sharp. The colour contrasts consisted of combinations of yellow, green, red, purple, blue, and non-coloured. RESULTS For non-coloured/non-coloured, the subjects preferred positive contrasts (bright infield, dark surround). Preferred contrast levels were 0.91 to 0.99 for positive contrasts and -0.96 to -0.99 for negative contrasts. For colour/non-coloured contrasts, 90% of the partially sighted preferred yellow as the foreground colour with a contrast level above 0.89. For colour/colour contrasts, optimal assessments of 90% of all partially sighted were yellow/purple and yellow/blue with contrast levels above 0.90. The determined results are applicable for the exact experimental contrast settings only. A field manual was prepared for planning and design of contrasts suited for the partially sighted in public areas. CONCLUSIONS Partially sighted, in subjective contrasts assessment, prefer bright characters of signs on a dark background for both non-coloured and colour contrasts with contrast levels above 0.9. Yellow was the preferred infield colour.
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Affiliation(s)
- H Lindner
- Otto-von-Guericke-Universität Magdeburg, Universitätsaugenklinik, Magdeburg
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Grunewald JP, Röhl FW, Kirches E, Dietzmann K. Correlation of DNA content and nucleomorphometric features with World Health Organization grading of meningiomas. Mod Pathol 1998; 11:216-23. [PMID: 9504694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Many studies dealing with extracranial cancer showed a strong correlation of DNA ploidy to a poor clinical outcome, recurrence, or malignancy. In brain tumors, analysis of DNA content did not always provided significant diagnostic information. In this study, DNA density and karyometric parameters of 50 meningiomas (26 Grade I, 10 Grade II, 14 Grade III) were quantitatively evaluated by digital cell image analyses of Feulgen-stained nuclei. In particular, the densitometric parameter SEXT, which describes nuclear DNA content, as well as the morphometric values LENG (a computer-assisted measurement of nuclear circumference), AREA (a computer-assisted measurement of nuclear area), FCON (a parameter that describes nuclear roundness), and CONC (a describing nuclear contour), evaluated with the software IMAGE C, were correlated to World Health Organization (WHO) grading using univariate and multivariate methods. AREA and LENG values showed significant differences between tumors of Grades I and III. FCON values were unable to distinguish WHO Grade III from Grade I/II but were useful in clearly separating Grade II from Grade I tumors. CONC values detected differences between WHO Grades II and I/III tumors but not between the latter. SEXT values clearly distinguished Grade III from Grade I/II tumors. The 1c, 2c, 2.5c, and 5c exceeding rates showed no predictive values. Only the 6c exceeding rate showed a significant difference between Grades I and III. These results outline the characteristic features of the atypical (Grade II) meningiomas, which make them a recognizable tumor entity distinct from benign and anaplastic meningiomas. The combination of DNA densitometric and morphometric findings seems to be a powerful addition to the histopathologic classification of meningiomas, as suggested by the WHO.
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Affiliation(s)
- J P Grunewald
- Institute of Neuropathology, University of Magdeburg, Germany
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Abstract
OBJECTIVE Healthy volunteers are involved in stage I of clinical investigations. It appears to be necessary to characterize such subjects more closely. Representing an essential aspect are symptoms giving rise to complaints that are typical side effects of drugs but that often also occur as adverse nondrug reactions. Correlations are supposed to exist between personality, motivation, and emotion of subjects and the incidence of their complaints. METHODS One hundred thirty medical students answered the "Questionnaire for Side Effects of Drugs" (Reidenberg and Löwenthal, 1968), and they were studied with regard to their personality (Freiburg Personality Inventory), motivation (Motivation Q-Sort) and emotion (State-Trait-Anxiety Inventory). RESULTS The most frequent complaints noted in young healthy volunteers who did not take any drugs were fatigue (65%), headache (25%), and nasal congestions (30%). Only 11% of the medical students were free of symptoms, 50% stated that they had one or two symptoms, and 3% had more than six symptoms. Statistically significant, even though weak, correlations existed between the number of symptoms and the personality traits of nervousness and neuroticism, motivation, and trait-anxiety. However, cluster analysis was adopted to form two groups: One subgroup (not nervous, emotionally stable, success-motivated, and not very anxious) that stated less adverse nondrug reactions, and another contrasting subgroup that complained about symptoms more frequently. CONCLUSION It appears that the distribution of the incidence of complaints in a nonselected group of healthy volunteers is not of a random character. The relevance of this finding to stage I clinical trials is evident.
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Affiliation(s)
- F P Meyer
- Department of Clinical Pharmacology, Otto-von-Guericke University, Magdeburg, Germany
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Lindner H, Beyer I, Röhl FW, Behrens-Baumann W. [Subjective contrast evaluation by visually handicapped patients]. Ophthalmologe 1996; 93:467-75. [PMID: 8963149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Personal optical and electronic devices are helpful to people with binocular vision of less than 0.3 or a substantially impaired visual field. Striking brightness and color contrast may help patients to orient themselves outdoors. This is particularly true for patients with age-related macular degeneration who have diminished contrast sensitivity as evaluated by the Vistech test and the low-contrast sensitivity test. In this study, the desired level or color combination of contrasts was assessed subjectively by a scaled estimate. The patients were required to assess a sample of 79 black-and-white and color contrasts according to a five-point scale comprising the ratings "much too low", "low", "optimal", "high", "much too high". The visual fields (outfield, infield) were either colorless or contained the colors yellow, green, red, purple or blue. The study involved 59 patients with age-related macular degeneration. Ninety percent of the patients were over 65 years old. There were twice as many women as men. The control group population consisted of 43 emmetropic subjects. In black or white infields on a colorless background (light gray to dark gray), a slight preference for positive (infield lighter than the background) contrast situations was found. The optimal contrasts were in the range of [K[ > 0.91. When colored infields were presented on a colorless background, the light infield colors yellow and green were preferred. The optimal contrast level was found to be [K[ > 0.85. Similarly, when colorless and colored infields were presented, light infield colors (white, yellow, green) on a dark background (purple, blue) were preferred. In selecting contrasts, subjects with impaired vision because of age-related macular degeneration preferred positive contrasts, i.e., mainly white, yellow and green on a colored or colorless background. These results provide information that can be used in designing orientation aids, e.g., road striping and lines, edges of stairs, handrails, timetables, etc. Conflicts of interest with emmetropic subjects is not to be expected. Subjects in the control group, while preferring similar contrasts, were ready to accept a wider range than the partially sighted.
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Affiliation(s)
- H Lindner
- Universitäts-Augenklinik, Otto-von-Guericke-Universität Magdeburg
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47
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Abstract
The aim of the present study was to quantify the personality structure and motivation of medical students, who are often the most readily available source of healthy volunteers, since it has long been known that the pharmacodynamics and pharmacokinetics of drugs can be substantially modified by predominant personality traits (e.g. neuroticism, extraversion). Over the course of 4 years, a total of 337 subjects (165 males, 172 females) out of the 496 medical students asked, participated in the study after appropriate instruction. Students were tested using the Motivation Q-Sort method which, by means of questions ("questionnaire sort"), investigates whether a subject tends to react in a success-motivated (SM) or a failure-motivated (FM) mode. The variable measured is the so-called net hope (NH), where NH > 1.6 corresponds to SM and NH < -0.3 corresponds to FM. We also used the Freiburg Personality Inventory (FPI) as a suitable method of determining personality structure. The predominant traits of interest found were nervousness (FPI 1), extraversion (FPI E), and neuroticism (FPI N). In the first series of tests (primary selection), motivation only was determined in 337 volunteers. The range was fairly broad, with NH values from 4.32 (highly SM) to -3.09 (highly FM). In the second series of tests, about 60 SM and 60 FM subjects were selected. The Motivation Q-Sort method was repeated with students placed under more difficult conditions, and the FPI was also performed.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- F P Meyer
- Department of Clinical Pharmacology, University Hospital, Otto-von-Guericke University, Magdeburg, Germany
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Röhl FW. Hahn, Gerald J. and Meeker, William Q.: Statistical Intervals. A Guide for Practitioners. John Wiley & Sons, Inc., New York 1991, 392 pp., £49,95. Biom J 1994. [DOI: 10.1002/bimj.4710360222] [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: 11/08/2022]
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Mielke U, Röhl FW. [Quantitative aspects of the agar micro-copy procedure for multiple copies of various materials occurring in hospitals]. Z Gesamte Hyg 1983; 29:376-9. [PMID: 6356656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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50
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Röhl FW, Mielke U. [Quantitative aspects of the agar microscopy procedure]. Z Gesamte Hyg 1982; 28:777-80. [PMID: 6761983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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