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Billig S, Hein M, Kirchner C, Schumacher D, Habigt MA, Mechelinck M, Fuchs D, Klinge U, Theißen A, Beckers C, Bleilevens C, Kramann R, Uhlig M. Coronary Microvascular Dysfunction in Acute Cholestasis-Induced Liver Injury. Biomedicines 2024; 12:876. [PMID: 38672230 PMCID: PMC11048529 DOI: 10.3390/biomedicines12040876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/08/2024] [Accepted: 04/14/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Previous studies have shown cardiac abnormalities in acute liver injury, suggesting a potential role in the associated high mortality. METHODS We designed an experimental study exploring the short-term effects of acute cholestasis-induced liver injury on cardiac function and structure in a rodent bile duct ligation (BDL) model to elucidate the potential interplay. Thirty-seven male Sprague-Dawley rats were subjected to BDL surgery (n = 28) or served as sham-operated (n = 9) controls. Transthoracic echocardiography, Doppler evaluation of the left anterior descending coronary artery, and myocardial contrast echocardiography were performed at rest and during adenosine and dobutamine stress 5 days after BDL. Immunohistochemical staining of myocardial tissue samples for hypoxia and inflammation as well as serum analysis were performed. RESULTS BDL animals exhibited acute liver injury with elevated transaminases, bilirubin, and total circulating bile acids (TBA) 5 days after BDL (TBA control: 0.81 ± 2.54 µmol/L vs. BDL: 127.52 ± 57.03 µmol/L; p < 0.001). Concurrently, cardiac function was significantly impaired, characterized by reduced cardiac output (CO) and global longitudinal strain (GLS) in the echocardiography at rest and under pharmacological stress (CO rest control: 120.6 ± 24.3 mL/min vs. BDL 102.5 ± 16.6 mL/min, p = 0.041; GLS rest control: -24.05 ± 3.8% vs. BDL: -18.5 ± 5.1%, p = 0.01). Myocardial perfusion analysis revealed a reduced myocardial blood flow at rest and a decreased coronary flow velocity reserve (CFVR) under dobutamine stress in the BDL animals (CFVR control: 2.1 ± 0.6 vs. BDL: 1.7 ± 0.5 p = 0.047). Immunofluorescence staining indicated myocardial hypoxia and increased neutrophil infiltration. CONCLUSIONS In summary, acute cholestasis-induced liver injury can lead to impaired cardiac function mediated by coronary microvascular dysfunction, suggesting that major adverse cardiac events may contribute to the mortality of acute liver failure. This may be due to endothelial dysfunction and direct bile acid signaling.
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Affiliation(s)
- Sebastian Billig
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany (C.B.)
| | - Marc Hein
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany (C.B.)
| | - Celine Kirchner
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany (C.B.)
| | - David Schumacher
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany (C.B.)
- Department of Nephrology and Clinical Immunology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Moriz Aljoscha Habigt
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany (C.B.)
| | - Mare Mechelinck
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany (C.B.)
| | - Dieter Fuchs
- FUJIFILM VisualSonics, Inc., Joop Geesinkweg 140, 1114 AB Amsterdam, The Netherlands
| | - Uwe Klinge
- Department of General, Visceral and Transplantation Surgery, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Alexander Theißen
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany (C.B.)
| | - Christian Beckers
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany (C.B.)
| | - Christian Bleilevens
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany (C.B.)
| | - Rafael Kramann
- Department of Nephrology and Clinical Immunology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Moritz Uhlig
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany (C.B.)
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Billig S, Hein M, Uhlig M, Schumacher D, Thudium M, Coburn M, Weisheit CK. [Anesthesia for aortic valve stenosis : Anesthesiological management of patients with aortic valve stenosis during noncardiac surgery]. Anaesthesiologie 2024; 73:168-176. [PMID: 38334810 PMCID: PMC10920418 DOI: 10.1007/s00101-024-01380-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/02/2024] [Indexed: 02/10/2024]
Abstract
Aortic valve stenosis is a common condition that requires an anesthesiologist's in-depth knowledge of the pathophysiology, diagnostics and perioperative features of the disease. A newly diagnosed aortic valve stenosis is often initially identified from the anamnesis (dyspnea, syncope, angina pectoris) or a suspicious auscultation finding during the anesthesiologist's preoperative assessment. Interdisciplinary collaboration is essential to ensure the optimal management of these patients in the perioperative setting. An accurate anamnesis and examination during the preoperative assessment are crucial to select the most suitable anesthetic approach. Additionally, a precise understanding of the hemodynamic peculiarities associated with aortic valve stenosis is necessary. After a short summary of the overall pathophysiology of aortic valve stenosis, this review article focuses on the specific anesthetic considerations, risk factors for complications, and the perioperative management for noncardiac surgery in patients with aortic valve stenosis.
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Affiliation(s)
- Sebastian Billig
- Klinik für Anästhesiologie, Universitätsklinikum Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
| | - Marc Hein
- Klinik für Anästhesiologie, Universitätsklinikum Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
| | - Moritz Uhlig
- Klinik für Anästhesiologie, Universitätsklinikum Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
| | - David Schumacher
- Klinik für Anästhesiologie, Universitätsklinikum Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
| | - Marcus Thudium
- Klinik für Anästhesiologie und operative Intensivmedizin, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
| | - Mark Coburn
- Klinik für Anästhesiologie und operative Intensivmedizin, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
| | - Christina K Weisheit
- Klinik für Anästhesiologie und operative Intensivmedizin, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
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Mechelinck M, Hein M, Kupp C, Braunschweig T, Helmedag MJ, Klinkenberg A, Habigt MA, Klinge U, Tolba RH, Uhlig M. Experimental Liver Cirrhosis Inhibits Restenosis after Balloon Angioplasty. Int J Mol Sci 2023; 24:11351. [PMID: 37511114 PMCID: PMC10379020 DOI: 10.3390/ijms241411351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/09/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
The effect of liver cirrhosis on vascular remodeling in vivo remains unknown. Therefore, this study investigates the influence of cholestatic liver cirrhosis on carotid arterial remodeling. A total of 79 male Sprague Dawley rats underwent bile duct ligation (cirrhotic group) or sham surgery (control group) and 28 days later left carotid artery balloon dilatation; 3, 7, 14 and 28 days after balloon dilatation, the rats were euthanized and carotid arteries were harvested. Histological sections were planimetrized, cell counts determined, and systemic inflammatory parameters measured. Up to day 14 after balloon dilatation, both groups showed a comparable increase in neointima area and degree of stenosis. By day 28, however, both values were significantly lower in the cirrhotic group (% stenosis: 20 ± 8 vs. 42 ± 10, p = 0.010; neointimal area [mm2]: 0.064 ± 0.025 vs. 0.138 ± 0.025, p = 0.024). Simultaneously, cell density in the neointima (p = 0.034) and inflammatory parameters were significantly higher in cirrhotic rats. This study demonstrates that cholestatic liver cirrhosis in rats substantially increases neointimal cell consolidation between days 14 and 28. Thereby, consolidation proved important for the degree of stenosis. This may suggest that patients with cholestatic cirrhosis are at lower risk for restenosis after coronary intervention.
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Affiliation(s)
- Mare Mechelinck
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany
| | - Marc Hein
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany
| | - Carolin Kupp
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany
| | - Till Braunschweig
- Department of Pathology, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany
| | - Marius J Helmedag
- Department of General, Visceral and Transplantation Surgery, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany
| | - Axel Klinkenberg
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany
| | - Moriz A Habigt
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany
| | - Uwe Klinge
- Department of General, Visceral and Transplantation Surgery, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany
| | - René H Tolba
- Institute for Laboratory Animal Science and Experimental Surgery, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany
| | - Moritz Uhlig
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany
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Uhlig M, Hein M, Habigt MA, Tolba RH, Braunschweig T, Helmedag MJ, Arici M, Theißen A, Klinkenberg A, Klinge U, Mechelinck M. Cirrhotic Cardiomyopathy Following Bile Duct Ligation in Rats-A Matter of Time? Int J Mol Sci 2023; 24:ijms24098147. [PMID: 37175858 DOI: 10.3390/ijms24098147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/28/2023] [Accepted: 04/30/2023] [Indexed: 05/15/2023] Open
Abstract
Cirrhotic patients often suffer from cirrhotic cardiomyopathy (CCM). Previous animal models of CCM were inconsistent concerning the time and mechanism of injury; thus, the temporal dynamics and cardiac vulnerability were studied in more detail. Rats underwent bile duct ligation (BDL) and a second surgery 28 days later. Cardiac function was assessed by conductance catheter and echocardiography. Histology, gene expression, and serum parameters were analyzed. A chronotropic incompetence (Pd31 < 0.001) and impaired contractility at rest and a reduced contractile reserve (Pd31 = 0.03, Pdob-d31 < 0.001) were seen 31 days after BDL with increased creatine (Pd35, Pd42, and Pd56 < 0.05) and transaminases (Pd31 < 0.001). A total of 56 days after BDL, myocardial fibrosis was seen (Pd56 < 0.001) accompanied by macrophage infiltration (CD68: Pgroup < 0.001) and systemic inflammation (TNFα: Pgroup < 0.001, white blood cell count: Pgroup < 0.001). Myocardial expression of peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC1α) was increased after 31 (Pd31 < 0.001) and decreased after 42 (Pd42 < 0.001) and 56 days (Pd56 < 0.001). Caspase-3 expression was increased 31 and 56 days after BDL (Pd31 = 0.005; Pd56 = 0.005). Structural changes in the myocardium were seen after 8 weeks. After the second surgery (second hit), transient myocardial insufficiency with secondary organ dysfunction was seen, characterized by reduced contractility and contractile reserve.
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Affiliation(s)
- Moritz Uhlig
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany
| | - Marc Hein
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany
| | - Moriz A Habigt
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany
| | - René H Tolba
- Institute for Laboratory Animal Science and Experimental Surgery, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany
| | - Till Braunschweig
- Department of Pathology, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany
| | - Marius J Helmedag
- Department of General, Visceral and Transplantation Surgery, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany
| | | | - Alexander Theißen
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany
| | | | - Uwe Klinge
- Department of General, Visceral and Transplantation Surgery, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany
| | - Mare Mechelinck
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany
- Institute for Laboratory Animal Science and Experimental Surgery, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany
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Krueger JC, Habigt MA, Helmedag MJ, Uhlig M, Moss M, Bleich A, Tolba RH, Rossaint R, Hein M, Mechelinck M. Evaluation of score parameters for severity assessment of surgery and liver cirrhosis in rats. Anim Welf 2023; 32:e29. [PMID: 38487427 PMCID: PMC10936376 DOI: 10.1017/awf.2023.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 09/17/2022] [Accepted: 10/06/2022] [Indexed: 03/12/2023]
Abstract
Severity assessment in animals is an ongoing field of research. In particular, the question of objectifiable and meaningful parameters of score-sheets, as well as their best combination, arise. This retrospective analysis investigates the suitability of a score-sheet for assessing severity and seeks to optimise it for predicting survival in 89 male Sprague Dawley rats (Rattus norvegicus), during an experiment evaluating the influence of liver cirrhosis by bile duct ligation (BDL) on vascular healing. The following five parameters were compared for their predictive power: (i) overall score; (ii) relative weight loss; (iii) general condition score; (iv) spontaneous behaviour score; and (v) the observer's assessment whether pain might be present. Suitable cut-off values of these individual parameters and the combination of multiple parameters were investigated. A total of ten rats (11.2%; 10/89) died or had to be sacrificed at an early stage due to pre-defined humane endpoints. Neither the overall score nor any individual parameter yielded satisfactory results for predicting survival. Using retrospectively calculated cut-off values and combining the overall score with the observer's assessment of whether the animal required analgesia (dipyrone) for pain relief resulted in an improved prediction of survival on the second post-operative day. This study demonstrates that combining score parameters was more suitable than using single ones and that experienced human judgement of animals can be useful in addition to objective parameters in the assessment of severity. By optimising the score-sheet and better understanding the burden of the model on rats, this study contributes to animal welfare.
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Affiliation(s)
- Johanne C Krueger
- Institute for Laboratory Animal Science and Experimental Surgery, RWTH Aachen University, Faculty of Medicine, Aachen 52074, Germany
- Animal Welfare Unit, University of Bonn, Bonn 53113, Germany
| | - Moriz A Habigt
- Department of Anaesthesiology, RWTH Aachen University, Faculty of Medicine, Pauwelsstraße 30, Aachen 52074, Germany
| | - Marius J Helmedag
- Department of General, Visceral and Transplantation Surgery, RWTH Aachen University, Faculty of Medicine, Aachen 52074, Germany
| | - Moritz Uhlig
- Department of Anaesthesiology, RWTH Aachen University, Faculty of Medicine, Pauwelsstraße 30, Aachen 52074, Germany
| | - Michaela Moss
- Institute for Laboratory Animal Science and Experimental Surgery, RWTH Aachen University, Faculty of Medicine, Aachen 52074, Germany
| | - André Bleich
- Institute for Laboratory Animal Science and Central Animal Facility, Hannover Medical School, Hannover 30625, Germany
| | - René H Tolba
- Institute for Laboratory Animal Science and Experimental Surgery, RWTH Aachen University, Faculty of Medicine, Aachen 52074, Germany
| | - Rolf Rossaint
- Department of Anaesthesiology, RWTH Aachen University, Faculty of Medicine, Pauwelsstraße 30, Aachen 52074, Germany
| | - Marc Hein
- Department of Anaesthesiology, RWTH Aachen University, Faculty of Medicine, Pauwelsstraße 30, Aachen 52074, Germany
| | - Mare Mechelinck
- Institute for Laboratory Animal Science and Experimental Surgery, RWTH Aachen University, Faculty of Medicine, Aachen 52074, Germany
- Department of Anaesthesiology, RWTH Aachen University, Faculty of Medicine, Pauwelsstraße 30, Aachen 52074, Germany
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Uhlig M, Karasimos E. Quiz intensiv – stellen Sie die Diagnose! Anasthesiol Intensivmed Notfallmed Schmerzther 2023; 58:195-198. [PMID: 36958315 DOI: 10.1055/a-1888-6512] [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: 03/25/2023]
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Billig S, Hein M, Mechelinck M, Schumacher D, Roehl AB, Fuchs D, Kramann R, Uhlig M. Comparative assessment of coronary physiology using transthoracic pulsed-wave Doppler and myocardial contrast echocardiography in rats. Eur Radiol Exp 2023; 7:6. [PMID: 36757486 PMCID: PMC9911582 DOI: 10.1186/s41747-022-00319-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 12/28/2022] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Coronary physiology assessment in rodents by ultrasound is an excellent noninvasive and easy to perform technique, including pulsed-wave Doppler (PWD) and myocardial contrast echocardiography (MCE). Both techniques and the corresponding calculated parameters were investigated in this study at rest as well as their response to pharmacologically induced stress. METHODS Left ventricular myocardial function was assessed in eight anaesthetised rats using transthoracic echocardiography. Coronary physiology was assessed by both PWD of the left coronary artery and MCE using a bolus method. Measurements were performed at rest and under stimulation with adenosine and dobutamine. Effects of stimulation on the calculated parameters were evaluated and rated by effect size (η2). RESULTS Changes could be demonstrated by selected parameters of PWD and MCE. The clearest effect in PWD was found for diastolic peak velocity (η2 = 0.58). It increased from 528 ± 110 mm/s (mean ± standard deviation) at rest to 839 ± 342 mm/s (p = 0.001) with adenosine and 1093 ± 302 mm/s with dobutamine (p = 0.001). The most distinct effect from MCE was found for the normalised wash-in rate (η2 = 0.58). It increased from 1.95 ± 0.35% at rest to 3.87 ± 0.85% with adenosine (p = 0.001) and 3.72 ± 1.03% with dobutamine (p = 0.001). CONCLUSION Induced changes in coronary physiology by adenosine and dobutamine could successfully be monitored using MCE and PWD in anaesthetised rats. Due to the low invasiveness of the measurements, this protocol could be used for longitudinal animal studies.
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Affiliation(s)
- Sebastian Billig
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Marc Hein
- grid.1957.a0000 0001 0728 696XDepartment of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Mare Mechelinck
- grid.1957.a0000 0001 0728 696XDepartment of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany
| | - David Schumacher
- grid.1957.a0000 0001 0728 696XDepartment of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany ,grid.1957.a0000 0001 0728 696XInstitute of Experimental Medicine and Systems Biology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Anna B. Roehl
- grid.1957.a0000 0001 0728 696XDepartment of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Dieter Fuchs
- grid.509684.60000 0001 2309 6090FUJIFILM VisualSonics, Inc., Joop Geesinkweg 140, 1114 AB Amsterdam, The Netherlands
| | - Rafael Kramann
- grid.1957.a0000 0001 0728 696XInstitute of Experimental Medicine and Systems Biology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany ,grid.1957.a0000 0001 0728 696XDivision of Nephrology and Clinical Immunology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany ,Department of Internal Medicine, Nephrology and Transplantation, Erasmus Medical, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Moritz Uhlig
- grid.1957.a0000 0001 0728 696XDepartment of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany
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Krauter S, Burow K, Scherer T, Uhlig M, Böckmann A. Zahnfleischbluten und eine Vorliebe für Schoko-Vanille-Pudding. Monatsschr Kinderheilkd 2022. [DOI: 10.1007/s00112-022-01569-7] [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: 10/16/2022]
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Uhlig M, Hein M, Habigt MA, Tolba RH, Braunschweig T, Helmedag MJ, Klinge U, Koch A, Trautwein C, Mechelinck M. Acute myocardial injury secondary to severe acute liver failure: A retrospective analysis supported by animal data. PLoS One 2021; 16:e0256790. [PMID: 34460845 PMCID: PMC8405020 DOI: 10.1371/journal.pone.0256790] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 08/17/2021] [Indexed: 11/29/2022] Open
Abstract
To investigate whether acute liver failure (ALF) leads to secondary acute myocardial injury, 100 ALF patients that were retrospectively identified in a single center based on ICD 10 codes and 8 rats from an experimental study that died early after bile duct ligation (BDL) were examined. Creatine kinase (CK), creatine kinase-MB isoenzyme (CKMB) and cardiac troponin-I (cTnI) were analyzed as markers of myocardial injury. For histological analysis, hematoxylin-eosin (HE), elastic Van Gieson (EVG), CD41 and myeloperoxidase were used to stain rat hearts. Major adverse cardiac events (MACEs) were a critical factor for mortality (p = 0.037) in human ALF. Deceased patients exhibited higher levels of CKMB than survivors (p = 0.023). CKMB was a predictor of mortality in ALF (p = 0.013). Animals that died early after BDL exhibited increased cTnI, CKMB, tumor necrosis factor α (TNFα) and interleukin-6 (IL-6) levels compared to controls (cTnI: p = 0.011, CKMB: p = 0.008, TNFα: p = 0.003, IL-6: p = 0.006). These animals showed perivascular lesions and wavy fibers, microthrombi and neutrophilic infiltration in the heart. MACEs are decisive for mortality in human ALF, and elevated CKMB values indicate that this might be due to structural myocardial damage. Accordingly, CKMB was found to have predictive value for mortality in ALF. The results are substantiated by data from a rat BDL model demonstrating diffuse myocardial injury.
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Affiliation(s)
- Moritz Uhlig
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Marc Hein
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Moriz A. Habigt
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - René H. Tolba
- Institute for Laboratory Animal Science and Experimental Surgery, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Till Braunschweig
- Department of Pathology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Marius J. Helmedag
- Department of General, Visceral and Transplantation Surgery, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Uwe Klinge
- Department of General, Visceral and Transplantation Surgery, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Alexander Koch
- Department of Gastroenterology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Christian Trautwein
- Department of Gastroenterology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Mare Mechelinck
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- Institute for Laboratory Animal Science and Experimental Surgery, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
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Aringer I, Artinger K, Kirsch AH, Schabhüttl C, Jandl K, Bärnthaler T, Mooslechner AA, Herzog SA, Uhlig M, Kirsch A, Frank S, Banas M, Pollheimer M, Eller P, Rosenkranz AR, Heinemann A, Eller K. Blockade of prostaglandin E 2 receptor 4 ameliorates nephrotoxic serum nephritis. Am J Physiol Renal Physiol 2018; 315:F1869-F1880. [PMID: 30332316 DOI: 10.1152/ajprenal.00113.2018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Prostaglandin E2 (PGE2) signaling is known to modulate inflammation and vascular resistance. Receptors of PGE2 [E-type prostanoid receptors (EP)] might be an attractive pharmacological target in immune-mediated diseases such as glomerulonephritis. We hypothesized that selective EP4 antagonism improves nephrotoxic serum nephritis (NTS) by its anti-inflammatory properties. Mice were subjected to NTS and treated with the EP4 antagonist ONO AE3-208 (10 mg·kg body wt-1·day-1] or vehicle starting from disease initiation. In one set of experiments, treatment was started 4 days after NTS induction. Tubular epithelial cells were evaluated in vitro under starving conditions. EP4 antagonist treatment significantly improved the NTS phenotype without affecting blood pressure levels. Remarkably, the improved NTS phenotype was also observed when treatment was started 4 days after NTS induction. EP4 antagonism decreased tubular chemokine (C-X-C motif) ligand ( Cxcl) 1 and Cxcl-5 expression and thereby subsequently reduced interstitial neutrophil infiltration into the kidney. In vitro, tubular epithelial cells increasingly expressed Cxcl-5 mRNA and Cxcl-5 protein when treated with PGE2 or an EP4 agonist under starving conditions, which was blunted by EP4 antagonist treatment. Together, EP4 antagonism improves the NTS phenotype, probably by decreasing mainly Cxcl-5 production in tubular cells, thereby reducing renal neutrophil infiltration.
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Affiliation(s)
- Ida Aringer
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.,Division of Pharmacology, Otto Loewi Research Center, BioTechMed Graz, Medical University of Graz , Graz , Austria
| | - Katharina Artinger
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Alexander H Kirsch
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Corinna Schabhüttl
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.,Intensive Care Unit, Department of Internal Medicine, Medical University of Graz , Graz , Austria
| | - Katharina Jandl
- Division of Pharmacology, Otto Loewi Research Center, BioTechMed Graz, Medical University of Graz , Graz , Austria.,Ludwig Boltzmann Institute for Lung Vascular Research , Graz , Austria
| | - Thomas Bärnthaler
- Division of Pharmacology, Otto Loewi Research Center, BioTechMed Graz, Medical University of Graz , Graz , Austria
| | - Agnes A Mooslechner
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Sereina A Herzog
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz , Graz , Austria
| | - Moritz Uhlig
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Andrijana Kirsch
- Gottfried Schatz Research Center, Molecular Biology and Biochemistry, Medical University of Graz , Graz , Austria
| | - Saša Frank
- Gottfried Schatz Research Center, Molecular Biology and Biochemistry, Medical University of Graz , Graz , Austria
| | - Miriam Banas
- Clinical Division of Nephrology, Department of Internal Medicine, University Hospital Regensburg , Regensburg , Germany
| | | | - Philipp Eller
- Ludwig Boltzmann Institute for Lung Vascular Research , Graz , Austria
| | - Alexander R Rosenkranz
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Akos Heinemann
- Division of Pharmacology, Otto Loewi Research Center, BioTechMed Graz, Medical University of Graz , Graz , Austria
| | - Kathrin Eller
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
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11
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Kumral D, Schaare HL, Beyer F, Reinelt J, Uhlig M, Liem F, Lampe L, Babayan A, Reiter A, Erbey M, Roebbig J, Loeffler M, Schroeter ML, Husser D, Witte AV, Villringer A, Gaebler M. The age-dependent relationship between resting heart rate variability and functional brain connectivity. Neuroimage 2018; 185:521-533. [PMID: 30312808 DOI: 10.1016/j.neuroimage.2018.10.027] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 10/05/2018] [Accepted: 10/09/2018] [Indexed: 12/30/2022] Open
Abstract
Resting heart rate variability (HRV), an index of parasympathetic cardioregulation and an individual trait marker related to mental and physical health, decreases with age. Previous studies have associated resting HRV with structural and functional properties of the brain - mainly in cortical midline and limbic structures. We hypothesized that aging affects the relationship between resting HRV and brain structure and function. In 388 healthy subjects of three age groups (140 younger: 26.0 ± 4.2 years, 119 middle-aged: 46.3 ± 6.2 years, 129 older: 66.9 ± 4.7 years), gray matter volume (GMV, voxel-based morphometry) and resting state functional connectivity (eigenvector centrality mapping and exploratory seed-based functional connectivity) were related to resting HRV, measured as the root mean square of successive differences (RMSSD). Confirming previous findings, resting HRV decreased with age. For HRV-related GMV, there were no statistically significant differences between the age groups, nor similarities across all age groups. In whole-brain functional connectivity analyses, we found an age-dependent association between resting HRV and eigenvector centrality in the bilateral ventromedial prefrontal cortex (vmPFC), driven by the younger adults. Across all age groups, HRV was positively correlated with network centrality in the bilateral posterior cingulate cortex. Seed-based functional connectivity analysis using the vmPFC cluster revealed an HRV-related cortico-cerebellar network in younger but not in middle-aged or older adults. Our results indicate that the decrease of HRV with age is accompanied by changes in functional connectivity along the cortical midline. This extends our knowledge of brain-body interactions and their changes over the lifespan.
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Affiliation(s)
- D Kumral
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; MindBrainBody Institute at the Berlin School of Mind and Brain, Humboldt-Universitaet zu Berlin, Berlin, Germany.
| | - H L Schaare
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; International Max Planck Research School NeuroCom, Leipzig, Germany
| | - F Beyer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Subproject A1, Collaborative Research Centre 1052 "Obesity Mechanisms", University of Leipzig, Leipzig, Germany
| | - J Reinelt
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - M Uhlig
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; International Max Planck Research School NeuroCom, Leipzig, Germany
| | - F Liem
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - L Lampe
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - A Babayan
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - A Reiter
- Lifespan Developmental Neuroscience, Technical University of Dresden, Dresden, Germany; Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - M Erbey
- MindBrainBody Institute at the Berlin School of Mind and Brain, Humboldt-Universitaet zu Berlin, Berlin, Germany
| | - J Roebbig
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - M Loeffler
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - M L Schroeter
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Department of Cognitive Neurology, University of Leipzig, Leipzig, Germany
| | - D Husser
- Department of Electrophysiology, Leipzig Heart Centre, University of Leipzig, Leipzig, Germany
| | - A V Witte
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - A Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; MindBrainBody Institute at the Berlin School of Mind and Brain, Humboldt-Universitaet zu Berlin, Berlin, Germany; Subproject A1, Collaborative Research Centre 1052 "Obesity Mechanisms", University of Leipzig, Leipzig, Germany; LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Center for Stroke Research Berlin, Charité - Universitaetsmedizin Berlin, Berlin, Germany
| | - M Gaebler
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; MindBrainBody Institute at the Berlin School of Mind and Brain, Humboldt-Universitaet zu Berlin, Berlin, Germany; LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
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Loibl S, Barinoff J, Seiler S, Decker T, Denkert C, Hardy-Bessard AC, Senkus-Konefka E, Cognetti F, Palmieri C, Gelmon K, Luebbe K, Furlanetto J, Mueller V, Mundhenke C, Schmidt M, von Minckwitz G, Uhlig M, Burchardi N, Thill M. Abstract OT3-05-04: A randomized, open-label, multi-center phase IV study evaluating palbociclib plus endocrine treatment versus a chemotherapy-based treatment strategy in patients with hormone receptor-positive, HER2-negative metastatic breast cancer in a real world setting (PADMA). Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-ot3-05-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
Although endocrine therapy (ET) is recommended as first-line therapy for hormone receptor (HR)-positive, HER2-negative metastatic breast cancer (MBC) up to 50% of patients receive chemotherapy in this setting. Meanwhile new targeted treatment options for combination with ET have been developed and endocrine-based therapy with the CDK4/6 inhibitor Palbociclib (P) improves the progression free survival (PFS) of ET alone by about 50%. So far, there is no data comparing chemotherapy with or without maintenance ET and ET in combination with P as first-line therapy. Patients included in clinical trials are often criticized not to mirror the general breast cancer population and every-day clinical practice due to rigid inclusion and exclusion criteria, limited number of treatment options, strict monitoring intervals and study assessments.
Methods:
PADMA trial is a so called low intervention trial with no rigid inclusion and exclusion criteria, and study assessments.Patients with first-line HR+/HER2- MBC who are candidate for mono-chemotherapy will be eligible to receive either P plus ET per label or mono-chemotherapy per investigator´s choice with or without maintenance ET (1:1 randomization). Primary objective is to compare the time-to-treatment failure (TTF) for patients randomized to receive the mono-chemotherapy treatment strategy versus those randomized to receive P and ET. TTF is defined as time from randomization to discontinuation of treatment due to disease progression, treatment toxicity, patient's preference, or death. Main secondary objectives are progression free survival, overall survival at 36 months, amongst other time to event endpoints as well as toxicity and compliance. All patients receive a specific mobile device (PADMA-Phone) and a validated wearable device (ActiWatch) in order to collect data regarding sleep and activity levels, patient well-being and health care utilization (number and duration of phone calls, and patient visits to investigator site) for assessment of daily monitoring treatment impact (DMTI).
Results:
Overall, 360 patients will be accrued to show an improved TTF for P in combination with ET compared to mono-chemotherapy of investigator´s choice with or without maintenance ET. Recruitment will start in QIII/2017 and is planned for approximately 18 months in 100 sites in Germany, Spain, Poland, Italy, France, UK and Canada.
Conclusions:
The aim of PADMA is to demonstrate that an endocrine-based strategy consisting of ET plus P is superior to a chemotherapy-based strategy as first-line therapy in women with HR+/HER2- MBC in a real world setting. Assessment of patient-reported outcome, health care utilization, and sleep and activity levels will deliver important information on the differences between endocrine-based and chemotherapy-based treatment.
Citation Format: Loibl S, Barinoff J, Seiler S, Decker T, Denkert C, Hardy-Bessard A-C, Senkus-Konefka E, Cognetti F, Palmieri C, Gelmon K, Luebbe K, Furlanetto J, Mueller V, Mundhenke C, Schmidt M, von Minckwitz G, Uhlig M, Burchardi N, Thill M. A randomized, open-label, multi-center phase IV study evaluating palbociclib plus endocrine treatment versus a chemotherapy-based treatment strategy in patients with hormone receptor-positive, HER2-negative metastatic breast cancer in a real world setting (PADMA) [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT3-05-04.
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Affiliation(s)
- S Loibl
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - J Barinoff
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - S Seiler
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - T Decker
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - C Denkert
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - A-C Hardy-Bessard
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - E Senkus-Konefka
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - F Cognetti
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - C Palmieri
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - K Gelmon
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - K Luebbe
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - J Furlanetto
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - V Mueller
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - C Mundhenke
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - M Schmidt
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - G von Minckwitz
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - M Uhlig
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - N Burchardi
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - M Thill
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
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Ezenwaka CE, Kalloo R, Uhlig M, Schwenk R, Eckel J. Serum adiponectin levels and enzyme markers of liver dysfunction in diabetic and non-diabetic Caribbean subjects. Br J Biomed Sci 2016; 63:117-22. [PMID: 17058711 DOI: 10.1080/09674845.2006.11732735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Low adiponectin levels are associated with elevated plasma alanine aminotransferase, a marker of reduced hepatic insulin sensitivity and a risk factor for type 2 diabetes. This study aims to determine the relationship between serum adiponectin level and alanine aminotransferase in diabetic and non-diabetic subjects. Fifty-six type 2 diabetic patients and 33 non-diabetic subjects participate in the study. Baseline plasma concentrations of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and glucose are measured on a chemistry analyser. Insulin and adiponectin are measured using enzyme-linked immunoassay techniques and insulin resistance is determined using the homeostatic model assessment method. Diabetic patients showed significantly lower levels of serum adiponectin than did the non-diabetic subjects, whereas levels of alanine aminotransferase and alkaline phosphatase were similar in both groups. While female non-diabetic subjects showed higher serum adiponectin levels than did female diabetic patients, alanine aminotransferase level did not differ (P>0.05). No significant relationship was seen between adiponectin and alanine aminotransferase in diabetic and non-diabetic subjects (P>0.05). Serum adiponectin levels were higher in non-diabetic subjects but there was no significant correlation between adiponectin and alanine aminotransferase in both groups of subjects. The data suggest that low serum adiponectin level may not be a suitable marker for impaired liver function in diabetic patients.
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Affiliation(s)
- C E Ezenwaka
- Unit of Pathology and Microbiology, Faculty of Medical Sciences, The University of the West Indies, Trinidad.
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Thomas S, Uhlig M, Wiedwald U, Han L, Ziemann P, Albrecht M. Super spin-glass state and exchange bias in Fe/CoO hybrid nanostructures. Nanotechnology 2013; 24:155703. [PMID: 23518827 DOI: 10.1088/0957-4484/24/15/155703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Fe/CoO heterostructures were realized by depositing Fe thin films on CoO nanoparticle arrays. Magnetization measurements revealed that 1 nm Fe exhibits a superparamagnetic behavior at 300 K and a super spin-glass state at temperatures below 80 K. The superparamagnetic as well as super spin-glass state vanishes for higher Fe film thicknesses once Fe starts to form a continuous layer across the CoO nanoparticle arrays. Furthermore, all samples exhibit an exchange bias effect at 6 K after field cooling, with a maximum exchange bias field of about 60 Oe for a Fe thickness of 2 nm. M-H loops of thicker Fe samples show a two-step magnetization reversal where Fe in the area in between CoO nanoparticles reverses at low fields, while, in proximity to the CoO nanoparticles, Fe switches at substantially higher fields. Both reversals are exchange biased.
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Affiliation(s)
- S Thomas
- Institute of Physics, Chemnitz University of Technology, Chemnitz, Germany.
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Lindenberg R, Uhlig M, Scherfeld D, Schlaug G, Seitz RJ. Cerebral Representations of Emblematic Gesture Processing: Perception and Motor Imagery. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)72179-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Uhlig M, Lindenberg R, Scherfeld D, Seitz RJ. Zur zerebralen Repräsentation emblematischer Gesten: Perzeption und Motor Imagery. KLIN NEUROPHYSIOL 2009. [DOI: 10.1055/s-0029-1216125] [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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Uhlig M, Marais E. Hansen, M. (1999): Hydrophiloidea (s. str.) (Coleoptera). In: World Catalogue of Insects 2: 1-416. Published by Apollo Books Aps, Kirkeby Sand 19, DK-5771 Stenstrup, Denmark. ISBN 87-88757-31-5 Hardback. DKK 690.00. ZOOSYST EVOL 2008. [DOI: 10.1002/mmnz.20030790207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Uhlig M. Nilsson, A. N. (2001): Dytiscidae (Coleoptera). In: World Catalogue of Insects 3: 1-395. Published by Apollo Books Aps. Kirkeby Sand 19. DK-5771 Stenstrup Denmark. ISBN 87-88757-62-5 Hardback. DKK 690.00. ZOOSYST EVOL 2008. [DOI: 10.1002/mmnz.20040800125] [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] Open
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Uhlig M. Pearson, D. L. & Vogler, A. P. (2001): Tiger Beetles. The Evolution, Ecology, and Diversity of the Cicindelids. Comstock Publishing Associates. A Division of Cornell University Press. Ithaca and London. 333pp. ISBN 0-8014-3882-9. ZOOSYST EVOL 2008. [DOI: 10.1002/mmnz.20040800126] [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: 11/11/2022] Open
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Uhlig M, Marais E. Hansen, M. (1998): Hydraenidae (Coleoptera). In: World Catalogue of Insects 1: 1-169. Published by Apollo Books Aps, Kirkeby Sand 19, DK-5771 Stenstrup, Denmark. ISBN 87-88757-27-7 Hardback. DKK 290.00. ZOOSYST EVOL 2008. [DOI: 10.1002/mmnz.20030790206] [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] Open
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Uhlig M, Kozlik B, Borutta A. Der Einsatz von Prophylaxehelferinnen in Kindertagesstätten Thüringens und die Mundgesundheit von Vorschulkindern. Gesundheitswesen 2006. [DOI: 10.1055/s-2006-939638] [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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Uhlig M, Passlack W, Eckel J. Identification and characterization of a novel variant in the highly conserved catalytic center of Rab11a. Eur J Med Genet 2006; 49:29-36. [PMID: 16473307 DOI: 10.1016/j.ejmg.2005.04.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2004] [Indexed: 11/17/2022]
Abstract
Small GTPases of the Rab family regulate vesicular traffic and distribution of proteins in different cell types. Rab11a is a member of this GTP hydrolyzing protein class and acts as a mediator of insulin stimulated translocation of the glucose transporter GLUT4 in peripheral tissues including heart and skeletal muscle. Here we report on Rab11a Q70R, a mutation in the catalytic center of Rab11a, observed in the cardiomyoblast cell line H9c2. Analysis of GTPase activity showed that Rab11a Q70L acts as a classical constitutive active mutant. Interestingly, the GTPase activity of Rab11a Q70R was not significantly different from the enzymatic activity of the Rab11a Q70 wild type protein. We therefore conclude that the glutamine residue of Rab11a at position 70 is not strictly essential for GTPase activity of this protein in contrast to Ras and other Rab proteins.
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Affiliation(s)
- M Uhlig
- Institute of Clinical Biochemistry and Pathobiochemistry, German Diabetes Center, Auf'm Hennekamp 65, D-40225 Düsseldorf, Germany
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Schwenk R, Uhlig M, Eckel J. Rab11 reguliert die GLUT4 Endozytose in Kardiomyozyten und wird kurzzeitig durch Insulin aktiviert. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-943841] [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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Uhlig M. Pearson, D. L. & Vogler, A. P. (2001): Tiger Beetles. The Evolution, Ecology, and Diversity of the Cicindelids. Comstock Publishing Associates. A Division of Cornell University Press. Ithaca and London. 333pp. ISBN 0-8014-3882-9. ZOOSYST EVOL 2004. [DOI: 10.1002/mmnz.4850800126] [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: 11/09/2022] Open
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Ezenwaka CE, Kalloo R, Uhlig M, Eckel J. Relationship between adiponectin and metabolic variables in Caribbean offspring of patients with type 2 diabetes mellitus. Horm Metab Res 2004; 36:238-42. [PMID: 15114523 DOI: 10.1055/s-2004-814454] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [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: 10/26/2022]
Abstract
AIM To examine the relationship between adiponectin and metabolic variables in the offspring of patients with type 2 diabetes mellitus. METHODS Fasting blood samples and anthropometric indices were taken from 34 subjects, offspring of patients with type 2 diabetes, and 24 healthy control subjects without any immediate family history of diabetes. Plasma glucose and serum adiponectin, insulin, triglycerides, total cholesterol, HDL and LDL cholesterol levels were measured, and insulin resistance (IR) was calculated based on the homeostasis model assessment (HOMA) method. RESULTS Offspring and control subjects were sex-matched, but the offspring were older and had higher body mass index and waist circumference than the control subjects (p < 0.05). The offspring had significantly higher mean fasting plasma glucose concentrations; however, their mean serum insulin, adiponectin, triglyceride, total cholesterol, HDL and LDL cholesterol and HOMA-derived IR levels did not significantly differ from those of the control subjects (p > 0.05). While the negative correlation between serum adiponectin and HDL cholesterol levels in the offspring remained statistically significant after adjusting for the effect of age, sex and BMI (r = -0.37, p < 0.05), the negative correlation between adiponectin and serum triglyceride, LDL cholesterol or IR levels became non-significant after controlling for the above variables (p > 0.05 in all cases). CONCLUSION The correlation between adiponectin and some known biochemical risk factors for developing diabetes and cardiovascular disease in the offspring of patients with diabetes warrants further study to evaluate its potential in assessing the risk of developing these disorders.
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Affiliation(s)
- C E Ezenwaka
- Unit of Pathology & Microbiology, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad.
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Uhlig M, Marais E. Hansen, M. (1999): Hydrophiloidea (s. str.) (Coleoptera). In: World Catalogue of Insects 2: 1–416. Published by Apollo Books Aps, Kirkeby Sand 19, DK-5771 Stenstrup, Denmark. ISBN 87-88757-31-5 Hardback. DKK 690.00. ZOOSYST EVOL 2003. [DOI: 10.1002/mmnz.4850790207] [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: 11/06/2022] Open
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Briel D, Pohlers D, Uhlig M, Vieweg S, Scholz GH, Thormann M, Hofmann HJ. 3-Amino-5-phenoxythiophenes: syntheses and structure-function studies of a novel class of inhibitors of cellular L-triiodothyronine uptake. J Med Chem 1999; 42:1849-54. [PMID: 10346938 DOI: 10.1021/jm980288r] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A series of substituted 3-amino-5-phenoxythiophenes was synthesized starting from malodinitrile and carbon disulfide. The resulting dicyanoketenedithiolate reacts via Thorpe-Dieckmann cyclization with halogen methanes bearing electron-withdrawing groups to give thiophene-2-thiolates, which can be transformed into 3-amino-5-(methylsulfonyl)thiophene-4-carbonitriles. Replacement of the methylsulfonyl groups by substituted phenolates provides the substituted 3-amino-5-phenoxythiophenes. Some of the derivatives show a considerable inhibitory potency for the L-T3 uptake in inhibition studies on human HepG2 hepatoma cells with maximum values of about 60% at a dose of 10(-5) M for the most potent 2-benzoyl derivatives. The structure of the phenoxythiophenes fits well into a general concept derived for other classes of L-T3 uptake inhibitors, which postulates an angular and perpendicular orientation of the ring systems in these compounds as a prerequisite for an inhibitory potency. Docking studies for the phenoxythiophenes with transthyretin as a receptor model show their preferred attack at the L-T4/L-T3 binding channel.
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Affiliation(s)
- D Briel
- Institute of Pharmacy, Faculty of Biosciences, Pharmacy, and Psychology, University of Leipzig, Brüderstrasse 34, D-04103 Leipzig, Germany
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Scholz GH, Vieweg S, Uhlig M, Thormann M, Klossek P, Goldmann S, Hofmann HJ. Inhibition of thyroid hormone uptake by calcium antagonists of the dihydropyridine class. J Med Chem 1997; 40:1530-8. [PMID: 9154974 DOI: 10.1021/jm9604989] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [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: 02/04/2023]
Abstract
A series of substituted 4-phenyl-1,4-dihydropyridines 2a-m was tested for their inhibitory effects on L-triiodothyronine (L-T3) uptake by human HepG2 hepatoma cells. The most potent compounds were the nitro-substituted derivatives 2,6-dimethyl-4-(4'-nitrophenyl)-1,4-dihydropyridine-3,5-dicarboxylic acid 3-ethyl ester 5-methyl ester (2m) and the well-known calcium antagonists nitrendipine (2k) and nifedipine (2j) with an uptake inhibition between 80.5 and 85.8% at an application dose of 10(-5) M. On the basis of a theoretical conformational analysis (ab initio MO theory, molecular mechanics, molecular dynamics) of the dihydropyridine derivatives, a unifying stereochemical concept was derived postulating an angular arrangement of the two rings where the phenyl ring of the calcium antagonists, which corresponds to the outer phenyl ring of the thyroid hormones, is bisecting the dihydropyridine ring as a prerequisite for inhibitory potency. This model includes also inhibitors of the N-phenylanthranilic acid type. The interaction of the calcium antagonists with transthyretin (TTR) is discussed in relation to thyroid hormones. The influence of hydrophobicity was estimated by the experimental determination of the 1-octanol/water partition coefficients.
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Affiliation(s)
- G H Scholz
- Universität Leipzig, Zentrum für Innere Medizin, Medizinische Klinik und Poliklinik III, Abteilung Endokrinologie/Diabetologie, Germany
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Uhlig M. Hentschel, E. & G. Wagner: Zoologisches Wörterbuch. Tiernamen, allgemeinbiologische, anatomische, physiologische Termini und biographische Daten. — 4. überarbeitete Auflage. Gustav Fischer Verlag Stuttgart, 1990 (UTB für Wissenschaft: Uni-Taschenbücher; 367), 573 S., 12 × 18,5 cm, Preis: kartoniert 36,80 DM, gebunden 49,50 DM. — ISBN 3–437–20453-X. ZOOSYST EVOL 1992. [DOI: 10.1002/mmnz.4830680214] [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: 11/10/2022] Open
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Uhlig M. [Studies of transparent objects with the incident light interference microscope]. Mikroskopie 1967; 21:269-70. [PMID: 4892457] [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: 01/12/2023]
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Uhlig M. [Interferometric length testing of microobjectives (Principle of prof. Nomarski)]. Mikroskopie 1966; 20:247-54. [PMID: 5989976] [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: 01/17/2023]
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