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Hensler S, Behm P, Wehrli M, Marks M, Ferguson S, Herren D, Schindele S. Lateral stability in healthy proximal interphalangeal joints versus surface replacement and silicone arthroplasty: Results of a three-dimensional motion analysis study. Hand Surgery and Rehabilitation 2020; 39:296-301. [DOI: 10.1016/j.hansur.2020.02.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 02/11/2020] [Accepted: 02/20/2020] [Indexed: 11/16/2022]
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Behm P, Nührenberg T, Bönner F, Neumann FJ. [Update ESC-Guideline: Myocardial Revascularization]. Dtsch Med Wochenschr 2019; 144:1417-1422. [PMID: 31594016 DOI: 10.1055/a-0867-5426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This article gives an overview of the novelties of the current ESC-guideline on "myocardial revascularization (2018)". Twenty completely new recommendations were given (seven class I, five class IIa, six class IIb and two class III). Moreover, four recommendations were upgraded and six downgraded. The comprehensive changes relate to preprocedural (diagnosis, choice of revacularisation-strategy), intraprocedural (revascularisation) and postprocedural aspects.
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Affiliation(s)
- Patrick Behm
- Klinik für Kardiologie, Pneumologie und Angiologie, Heinrich-Heine-Universität, Düsseldorf
| | - Thomas Nührenberg
- Klinik für Kardiologie und Angiologie II, Universitäts-Herzzentrum Freiburg · Bad Krozingen, Bad Krozingen
| | - Florian Bönner
- Klinik für Kardiologie, Pneumologie und Angiologie, Heinrich-Heine-Universität, Düsseldorf
| | - Franz-Josef Neumann
- Klinik für Kardiologie und Angiologie II, Universitäts-Herzzentrum Freiburg · Bad Krozingen, Bad Krozingen
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Weiss H, Behm P, Gastl M, Kelm M, Boenner F. P5257Prediction of 12-month cardiovascular event-free survival with regadenoson perfusion cardiovascular magnetic resonance. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
To identify and stratify coronary artery disease (CAD) non-invasively, cardiovascular magnetic resonance (CMR) derived perfusion imaging holds a class Ia recommendation.
As Gold standard, hyperemia is induced by an intravenous application of adenosine in a body weight adapted dosage over a constant time. However, adenosin has two disadvantages: 1.) efficacy of adenosine to induce maximal hyperemia via peripheral line is imperfect and 2.) additional adenosine specific effects exclude patients having comorbidities (e.g. AV-blocks and obstructive lung disease). Fortunately, regadenoson as aselective A2A-receptor agonist has the main advantages of being easier to handle (bolus application) and to be not restricted to patients without specific comorbidities. However, there is a lack of comprehensive data on the prognostic value of regadenoson perfusion CMR to predict clinical endpoints. To assess the predictive value of regadenoson perfusion CMR, our hypothesis was, that a “negative” ischemia test result by regadenoson-CMR predicted freedom from MACE at 12 month.
Methods
676 patients, with known or suspected CAD with intermediate risk were retrospectively analyzed from May 2015 till December 2016. Cardiovascular risk factors (CVRF) like age, sex, arterial hypertension, dis-/hyperlipidemia, cigarette smoking status and diabetes were documented. All included patients received perfusion CMR (Philips 1.5 Tesla) with regadenoson (0.4 mg) and a positive ischemia test was defined as perfusion defects in ≥1,5 cardiac segments (using the 17-segment model). Major cardiovascular events (MACE) were defined as cardiovascular death, rehospitalisation due to myocardial infarction and rehospitalisation due to revascularization. The follow-up time was 12 month.
Results
80,3% (n=543) of all analyzed patients showed negative ischemia testing in CMR and were thus followed up for 12 month. From these patients, 284 (52,3%) had a pre-existing coronary artery disease. The mean age regarding only the patients with negative ischemia was 66 years (65% male and 35% female) with 1,35±1,03 CVRF. The primary endpoint (MACE) occurred in 6 patients (1,1%): 3 (0,6%) died due to cardiovascular events, 1 (0,2%) suffered from a myocardial infarction and 2 (0,4%) received coronary revascularization. Consequently, an event-free survival was correctly predicted in 98,9% of all patients. No undesirable adverse reactions have appeared.
Conclusion
Regadenoson-CMR predicts a very low MACE-rate and an event-free survival in 98,9% in over 500 patients. In our study, Regadenoson was well tolerated and no side effects were reported.
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Affiliation(s)
- H Weiss
- University Hospital Dusseldorf, Dusseldorf, Germany
| | - P Behm
- University Hospital Dusseldorf, Dusseldorf, Germany
| | - M Gastl
- University Hospital Dusseldorf, Dusseldorf, Germany
| | - M Kelm
- University Hospital Dusseldorf, Dusseldorf, Germany
| | - F Boenner
- University Hospital Dusseldorf, Dusseldorf, Germany
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Schipke JD, Eichhorn L, Behm P, Cleveland S, Kelm M, Boenner F. Glossopharyngeal insufflation and kissing papillary muscles. Scand J Med Sci Sports 2018; 29:299-304. [PMID: 30376212 DOI: 10.1111/sms.13329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jochen D Schipke
- c/o Forschungsgruppe Experimentelle Chirurgie, Universitäts-Klinikum Düsseldorf, Düsseldorf, Germany
| | - Lars Eichhorn
- Clinic and Policlinic for Anaesthesiology and Operative Intensive Care Medicine, University of Bonn, Bonn, Germany
| | - Patrick Behm
- Clinic for Cardiology, Pneumology & Angiology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Sinclair Cleveland
- Institute of Neuro- and Sensory Physiology, Heinrich Heine Universität Düsseldorf, Düsseldorf, Germany
| | - Malte Kelm
- Clinic for Cardiology, Pneumology & Angiology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Florian Boenner
- Clinic for Cardiology, Pneumology & Angiology, University Hospital Düsseldorf, Düsseldorf, Germany
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Gastl M, Behm P, Haberkorn S, Holzbach L, Veulemans V, Jacoby C, Schnackenburg B, Zeus T, Kelm M, Bönner F. Role of T2 mapping in left ventricular reverse remodeling after TAVR. Int J Cardiol 2018; 266:262-268. [DOI: 10.1016/j.ijcard.2018.02.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 02/01/2018] [Accepted: 02/08/2018] [Indexed: 10/14/2022]
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Spieker M, Katsianos E, Gastl M, Behm P, Horn P, Jacoby C, Schnackenburg B, Reinecke P, Kelm M, Westenfeld R, Bönner F. T2 mapping cardiovascular magnetic resonance identifies the presence of myocardial inflammation in patients with dilated cardiomyopathy as compared to endomyocardial biopsy. Eur Heart J Cardiovasc Imaging 2017; 19:574-582. [DOI: 10.1093/ehjci/jex230] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 09/07/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Spieker
- Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Moorenstraße 5, Duesseldorf 40221, Germany
| | - E Katsianos
- Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Moorenstraße 5, Duesseldorf 40221, Germany
| | - M Gastl
- Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Moorenstraße 5, Duesseldorf 40221, Germany
| | - P Behm
- Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Moorenstraße 5, Duesseldorf 40221, Germany
| | - P Horn
- Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Moorenstraße 5, Duesseldorf 40221, Germany
| | - C Jacoby
- Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Moorenstraße 5, Duesseldorf 40221, Germany
| | - B Schnackenburg
- Philips Healthcare, Röntgenstraße 24, Hamburg 22335, Germany
| | - P Reinecke
- Insitute of Pathology, Heinrich-Heine University, Moorenstraße 5, Duesseldorf 40221, Germany
| | - M Kelm
- Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Moorenstraße 5, Duesseldorf 40221, Germany
- CARID (Cardiovascular Research Institute Düsseldorf), Moorenstraße 5, Duesseldorf 40221, Germany
| | - R Westenfeld
- Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Moorenstraße 5, Duesseldorf 40221, Germany
| | - F Bönner
- Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Moorenstraße 5, Duesseldorf 40221, Germany
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Bönner F, Haberkorn S, Behm P, Schnackenburg B, Krüger S, Weiss S, Meyer C, Kelm M, Neizel-Wittke M. Magnetic resonance guided renal denervation using active tracking: first in vivo experience in Swine. Int J Cardiovasc Imaging 2017; 34:431-439. [DOI: 10.1007/s10554-017-1244-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 09/08/2017] [Indexed: 10/18/2022]
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Gastl M, Lachmann V, Janzarik N, Veulemans V, Haberkorn S, Holzbach L, Behm P, Jacoby C, Schnackenburg B, Zeus T, Kelm M, Boenner F. P3333CMR feature tracking and T2 mapping provide additional information to distinguish athlete's heart from pathologic left ventricular hypertrophy. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3333] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Behm P, Gastl M, Jahn A, Rohde A, Krueger S, Weiss S, Schnackenburg B, Sager M, Duering K, Clogenson H, Horn P, Westenfeld R, Kelm M, Neizel-Wittke M, Boenner F. P1076MR-guided endomyocardial biopsy in a preclinical in vivo model. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1076] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Spieker M, Haberkorn S, Gastl M, Behm P, Katsianos S, Horn P, Jacoby C, Schnackenburg B, Reinecke P, Kelm M, Westenfeld R, Bönner F. Abnormal T2 mapping cardiovascular magnetic resonance correlates with adverse clinical outcome in patients with suspected acute myocarditis. J Cardiovasc Magn Reson 2017; 19:38. [PMID: 28351402 PMCID: PMC5370450 DOI: 10.1186/s12968-017-0350-x] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 03/01/2017] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND While most patients recover from suspected acute myocarditis (sAMC) some develop progressive disease with 5-year mortality up to 20%. Recently, parametric Cardiovascular Magnetic Resonance (CMR) approaches, quantifying native T1 and T2 relaxation time, have demonstrated the ability to increase diagnostic accuracy. However, prognostic implications of T2 values in this cohort are unknown. The purpose of the study was to investigate the prognostic relevance of elevated CMR T2 values in patients with sAMC. METHODS AND RESULTS We carried out a prospective study in 46 patients with sAMC defined by current ESC recommendations. A combined endpoint was defined by the occurrence of at least one major adverse cardiac event (MACE) and hospitalisation for heart failure. Event rate was 24% (n = 11) for 1-year-MACE and hospitalisation. A follow-up after 11 ± 7 months was performed in 98% of the patients. Global T2 values were significantly increased at acute stage of disease compared to controls and decreased over time. During acute disease, elevated global T2 time (odds ratio 6.3, p < 0.02) as well as myocardial fraction with T2 time >80 ms (odds ratio 4.9, p < 0.04) predicted occurrence of the combined endpoint. Patients with clinical recovery revealed significantly decreased T2 relaxation times at follow-up examinations; however, T2 values were still elevated compared to healthy controls. CONCLUSION Assessment of myocardial T2 relaxation times at initial presentation facilitates CMR-based risk stratification in patients with acute myocarditis. T2 Mapping may emerge as a new tool to monitor inflammatory myocardial injuries during the course of disease.
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Affiliation(s)
- Maximilian Spieker
- Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Sebastian Haberkorn
- Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Mareike Gastl
- Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Patrick Behm
- Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Stratis Katsianos
- Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Patrick Horn
- Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Christoph Jacoby
- Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | | | - Petra Reinecke
- Institute of Pathology, Heinrich Heine University, Duesseldorf, Germany
| | - Malte Kelm
- Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
- CARID, Cardiovascular Research Institute Düsseldorf, Duesseldorf, Germany
| | - Ralf Westenfeld
- Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Florian Bönner
- Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
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Gastl M, Behm P, Jacoby C, Kelm M, Bönner F. Multiparametric cardiac magnetic resonance imaging (CMR) for the diagnosis of Loeffler's endocarditis: a case report. BMC Cardiovasc Disord 2017; 17:74. [PMID: 28284183 PMCID: PMC5346256 DOI: 10.1186/s12872-017-0492-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 02/03/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Endocarditis parietalis fibroplastica Löfflein (EPF) is a rare form of primary restrictive cardiomyopathy with poor prognosis. It is generally caused by hypereosinophilic syndrome with eosinophilic penetration of the heart. This leads to congestive heart failure in three different stages. As a frequent manifestation of neoplastic diseases, cardiac involvement means poor prognosis. CASE PRESENTATION The present report deals with a case of EPF caused by non-specified T-cell lymphoma (T-NOS). Besides an elevated Troponin-T enzyme, the electrocardiogram and the transthoracic echocardiography did not show any characteristic results. Due to risk/benefit assessment and low thrombocyte amounts, endomyocardial biopsy and catheterization were discarded. Using cardiovascular magnetic resonance (CMR) with steady-state free precession sequences, T2-mappping, strain analysis and late gadolinium enhancement, we were able to clearly highlight cardiac involvement at different stages. These findings characterized T-NOS as a palliative situation. CONCLUSION Multiparametric CMR can not only identify EPF but also characterize the patchy disease state. This provides an individual prognosis assessment. Aside from prognosis estimation, it can also be used for therapy monitoring.
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Affiliation(s)
- Mareike Gastl
- Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Patrick Behm
- Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Christoph Jacoby
- Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Malte Kelm
- Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Florian Bönner
- Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
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Hemm-Ode S, Wettmann P, Kistler B, Behm P, Schkommodau E, Coste J, Lemaire J, Shah A. Intraoperative optical flow based tremor evaluation - a feasibility study. BIOMED ENG-BIOMED TE 2013; 58 Suppl 1:/j/bmte.2013.58.issue-s1-A/bmt-2013-4008/bmt-2013-4008.xml. [DOI: 10.1515/bmt-2013-4008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Müller-Marbach AM, Keitel V, Göbel T, Jensen BE, Göbels S, Baur C, Schneitler S, Schneitler V, Behm P, Becker M, Brinkmeyer C, Foede M, Hüttig F, Beyer M, Breuer M, Filke S, Giesecke C, Haars U, Haes J, Heinzel-Pleines U, Kann S, Kocheril SJ, Mallach S, Sagert C, Qvartskhava N, Winzer R, Donner MG. [The clinical spectrum of urea cycle defects in adult patients]. Z Gastroenterol 2011; 49:1535-1542. [PMID: 22139877 DOI: 10.1055/s-0031-1281791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Urea cycle defects belong to the most common metabolic disorders with a cumulative incidence of 1:8000. A common trait of urea cycle defects is a disturbed detoxification of ammonia leading to hyperammonemia in the event of a high nitrogen load. Most patients develop symptoms in the neonatal period or in infancy, e. g. vomiting, seizures and disturbed consciousness. Depending on the affected enzyme and its residual activity, patients differ in the age at first presentation, the character and severity of symptoms and in the susceptibility to metabolic derangement. The presence of hyperammonemia and an altered plasma amino acid profile give the essential diagnostic clues. Since modern therapeutic measures have prolonged the life expectancy of these patients and provided the possibility of a first presentation in adulthood, patients with urea cycle defects have become an increasing challenge in internal medicine. The reported case series illustrates the heterogeneous clinical course of these disorders from childhood to adulthood.
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Abstract
BACKGROUND Emulsified perfluorocarbons (PFCs) are preferentially phagocytized by monocytes/macrophages and are readily detected by (19)F MRI. This study tests the hypothesis that (19)F MRI can be used to quantitate pulmonary inflammation by tracking of infiltrating PFC-loaded monocytes. METHODS AND RESULTS Pneumonia was induced in mice by intratracheal instillation of lipopolysaccharides (LPS) followed by intravenous injection of PFCs. Whereas regular (1)H MRI provided no evidence of lung injury 24 hours after LPS, the concurrent (19)F images clearly show PFC accumulation in both pulmonary lobes. Imaging at 48 hours after LPS revealed signals in (1)H images at the same location as the 24-hour (19)F signals. Thus, progressive pneumonia was first predicted by (19)F MRI early after PFC administration. Without LPS, at no time were (19)F signals observed within the lung. Histology and fluorescence-activated cell sorting (FACS) combined with (19)F MRI confirmed the presence of infiltrating PFC-loaded monocytes/macrophages after LPS challenge. Additional experiments with graded doses of LPS demonstrated that (19)F signal intensity strongly correlated with both LPS dose and pathological markers of lung inflammation. In separate studies, dexamethasone and CGS21680 (adenosine 2A receptor agonist) were used to demonstrate the ability of (19)F MRI to monitor anti-inflammatory therapies. CONCLUSIONS PFCs serve as a contrast agent for the prognostic and quantitative assessment of pulmonary inflammation by in vivo (19)F MRI, which is characterized by a high degree of specificity due to the lack of any (19)F background. Because PFCs are biochemically inert, this approach may also be suitable for human applications.
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Affiliation(s)
- Bernd Ebner
- Institut für Herz- und Kreislaufphysiologie, Heinrich-Heine-Universität, Düsseldorf, Germany
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Schulz D, Rothenhöfer C, Behm P. [Development and current possibilities of cerebrospinal fluid diagnosis in the routine laboratory. 2. Studies on protein composition]. Fortschr Med 1979; 97:353-8. [PMID: 369971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In the 1st part of this paper (Schulz et al. 1979) a survey was given of the cytological and the chemical procedures at present available for cerebrospinal fluid diagnostics. The 2nd part describes different laboratory methods to separate the protein mixture of cerebrospinal fluid into protein fractions or single proteins. These surveys intend both an improvement of the quality and a unification of laboratory methods regarding diagnostic examinations of cerebrospinal fluid.
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