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Troester A, Kohn J, Wang Q, Weaver L, Hassan I, Gaertner W, Marmor S, Goffredo P. Management and staging of anal adenocarcinoma in the United States: a population-based analysis. J Gastrointest Surg 2024; 28:519-527. [PMID: 38583905 DOI: 10.1016/j.gassur.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/29/2023] [Accepted: 01/13/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Anal adenocarcinoma is rare with no standardized treatment regimen or staging system. Therefore, different combinations of chemotherapy, radiation, and surgery are used in management. Within the staging system, tumor stage can be based on the depth of invasion, as for rectal adenocarcinoma, or size, as in anal squamous cell carcinoma. This study aimed to analyze patterns of care and clinically available staging systems for anal adenocarcinoma using a national database. METHODS Adults diagnosed with anal adenocarcinoma were identified in the Surveillance, Epidemiology, and End Results database (2004-2019). In addition, 6 different treatment regimens were identified. Stages were categorized according to the American Joint Committee on Cancer classifications of rectal adenocarcinoma and anal squamous cell carcinoma. RESULTS Of 1040 patients, 48% were female, the median age was 67 years, and 18% had distant metastases. Chemoradiotherapy + abdominoperineal resection was the most common treatment regimen (22%). Moreover, 5-year overall survival (OS) and disease-specific survival (DSS) were the highest for local excision only (67% and 85%) and the lowest in the alternative group (34% and 48%). After adjustment, the treatment groups that did not include surgery were associated with worse 5-year OS. In multivariable analysis, the T stage based on depth of invasion showed incrementally lower OS for T2 and T3 anal adenocarcinomas. CONCLUSION Omission of surgical resection in combination with chemoradiotherapy was associated with worse OS and DSS, suggesting the relevance of surgery in anal adenocarcinoma management. Prognostically, rectal staging based on depth of invasion better discriminated between T stages, indicating that providers should consider using this system in practice.
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Affiliation(s)
- Alexander Troester
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, United States
| | - Julia Kohn
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, United States
| | - Qi Wang
- Clinical and Translational Science Institute, University of Minnesota, Minneapolis, Minnesota, United States
| | - Lauren Weaver
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, United States
| | - Imran Hassan
- Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
| | - Wolfgang Gaertner
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, United States; Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota, United States
| | - Schelomo Marmor
- Center for Clinical Quality and Outcomes Discovery and Evaluation, University of Minnesota, Minneapolis, Minnesota, United States
| | - Paolo Goffredo
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, United States; Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota, United States.
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Goffredo P, Boatman S, Troester A, Marmor S, Hassan I, Gaertner W, Madoff R. Radiotherapy Does Not Increase Long Term Cardiovascular Mortality in Colorectal Cancer Patients. Am Surg 2023; 89:4961-4962. [PMID: 36413459 DOI: 10.1177/00031348221142588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Affiliation(s)
- Paolo Goffredo
- Division of Colon & Rectal Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Sonja Boatman
- Division of Colon & Rectal Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Alexander Troester
- Division of Colon & Rectal Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Schelomo Marmor
- Division of Colon & Rectal Surgery, University of Minnesota, Minneapolis, MN, USA
- Center for Clinical Quality and Outcomes Discovery and Evaluation (C-QODE), University of Minnesota, Minneapolis, MN, USA
| | - Imran Hassan
- Department of Surgery, University of Iowa, Iowa City, IA, USA
| | - Wolfgang Gaertner
- Division of Colon & Rectal Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Robert Madoff
- Division of Colon & Rectal Surgery, University of Minnesota, Minneapolis, MN, USA
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Sun SY, Gaertner W, Reynolds MA. Outcomes of Watch and Wait Following Total Neoadjuvant Therapy for Rectal Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e340. [PMID: 37785191 DOI: 10.1016/j.ijrobp.2023.06.2401] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To evaluate the outcomes of patients with locally advanced rectal cancer who achieved a clinical complete response (cCR) after total neoadjuvant therapy and enrolled in a prospective watch and wait (WW) database. MATERIALS/METHODS Consecutive patients with locally advanced rectal cancer who achieved cCR following total neoadjuvant therapy (long-course chemoradiotherapy plus systemic chemotherapy) and were enrolled in our institutional WW surveillance protocol from 2014 through 2022 with the intention of organ preservation. Patients with lack of follow up according to our institutional protocol were excluded. Primary outcomes included local tumor regrowth and distant metastatic disease recurrence. RESULTS Thirty-three consecutive patients (48% male; median age 61 [33-77] years) with the diagnosis of locally advanced rectal adenocarcinoma were managed by a multidisciplinary team. All patients had Eastern Cooperative Oncology Group Performance Status score of 0 or 1 at time of rectal cancer diagnosis. Location of tumor included upper rectum (18%), middle rectum (40%), and lower rectum (42%). On initial staging magnetic resonance imaging, 4 (12%) patients had evidence of extramural venous invasion, 6 (18%) had a threatened mesorectal margin, and 4 (12%) had anal sphincter or levator ani tumor involvement. A majority (61%) received chemotherapy followed by long-course chemoradiotherapy. Only one patient had an unplanned break during radiotherapy. Local tumor regrowth was diagnosed in 4 (12%) patients and all underwent successful salvage surgery without additional local failures at a median follow-up of 19 [12-48] months. Two of these four patients remain disease-free at a median follow-up time of 12.5 months. Mean time to local tumor regrowth as first site of cancer recurrence was 33.5 [18-46] months. Distant metastatic disease as the first site of recurrence occurred two patients (6%). Mean time to distant metastatic disease as first site of recurrence was 27 months. Only one mortality occurred in the entire group at a median follow-up of 49 [8-102] months. CONCLUSION Organ preservation after total neoadjuvant therapy for locally advanced rectal cancer yields excellent outcomes with low local and distant relapse rates. Structured surveillance protocols and multidisciplinary care are essential for success.
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Affiliation(s)
- S Y Sun
- University of Minnesota, Minneapolis, MN
| | - W Gaertner
- University of Minnesota, Minneapolis, MN
| | - M A Reynolds
- Department of Radiation Oncology, University of Minnesota Medical School, Minneapolis, MN
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Cleary RK, Silviera M, Reidy TJ, McCormick J, Johnson CS, Sylla P, Cannon J, Lujan H, Kassir A, Landmann R, Gaertner W, Lee E, Bastawrous A, Bardakcioglu O, Pandey S, Attaluri V, Bernstein M, Obias V, Franklin ME, Pigazzi A. Intracorporeal and extracorporeal anastomosis for robotic-assisted and laparoscopic right colectomy: short-term outcomes of a multi-center prospective trial. Surg Endosc 2022; 36:4349-4358. [PMID: 34724580 PMCID: PMC9085698 DOI: 10.1007/s00464-021-08780-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 10/13/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND Studies to date show contrasting conclusions when comparing intracorporeal and extracorporeal anastomoses for minimally invasive right colectomy. Large multi-center prospective studies comparing perioperative outcomes between these two techniques are needed. The purpose of this study was to compare intracorporeal and extracorporeal anastomoses outcomes for robotic assisted and laparoscopic right colectomy. METHODS Multi-center, prospective, observational study of patients with malignant or benign disease scheduled for laparoscopic or robotic-assisted right colectomy. Outcomes included conversion rate, gastrointestinal recovery, and complication rates. RESULTS There were 280 patients: 156 in the robotic assisted and laparoscopic intracorporeal anastomosis (IA) group and 124 in the robotic assisted and laparoscopic extracorporeal anastomosis (EA) group. The EA group was older (mean age 67 vs. 65 years, p = 0.05) and had fewer white (81% vs. 90%, p = 0.05) and Hispanic (2% vs. 12%, p = 0.003) patients. The EA group had more patients with comorbidities (82% vs. 72%, p = 0.04) while there was no significant difference in individual comorbidities between groups. IA was associated with fewer conversions to open and hand-assisted laparoscopic approaches (p = 0.007), shorter extraction site incision length (4.9 vs. 6.2 cm; p ≤ 0.0001), and longer operative time (156.9 vs. 118.2 min). Postoperatively, patients with IA had shorter time to first flatus, (1.5 vs. 1.8 days; p ≤ 0.0001), time to first bowel movement (1.6 vs. 2.0 days; p = 0.0005), time to resume soft/regular diet (29.0 vs. 37.5 h; p = 0.0014), and shorter length of hospital stay (median, 3 vs. 4 days; p ≤ 0.0001). Postoperative complication rates were comparable between groups. CONCLUSION In this prospective, multi-center study of minimally invasive right colectomy across 20 institutions, IA was associated with significant improvements in conversion rates, return of bowel function, and shorter hospital stay, as well as significantly longer operative times compared to EA. These data validate current efforts to increase training and adoption of the IA technique for minimally invasive right colectomy.
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Affiliation(s)
- Robert K. Cleary
- Department of Surgery, Saint Joseph’s Mercy Hospital, 5325 Elliott Drive, Ste 104, Ann Arbor, MI 48106 USA
| | - Matthew Silviera
- Department of Surgery, Washington University School of Medicine, St. Louis, MO USA
| | - Tobi J. Reidy
- Department of Surgery, Franciscan Health, Indianapolis, IN USA
| | - James McCormick
- Colon and Rectal Surgery, Allegheny Health Network, Pittsburgh, PA USA
| | - Craig S. Johnson
- Department of Surgery, Oklahoma Surgical Hospital, Tulsa, OK USA
| | - Patricia Sylla
- Division of Colorectal Surgery, Department of Surgery, Mount Sinai Hospital, New York, NY USA
| | - Jamie Cannon
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL USA
| | - Henry Lujan
- Colon and Rectal Surgery, Jackson Health System, Miami, FL USA
| | - Andrew Kassir
- Colon and Rectal Clinical, Honor Health, Scottsdale, AZ USA
| | - Ron Landmann
- Department of Colon Rectal Surgery, Baptist MD Andersen Cancer Center, Jacksonville, FL USA
| | - Wolfgang Gaertner
- Division of Colon and Rectal Surgery, University of Minnesota, Minneapolis, MN USA
| | - Edward Lee
- Department of Surgery, Albany Medical College, Albany, NY USA
| | - Amir Bastawrous
- Colon and Rectal Clinic, Swedish Medical Center, Seattle, WA USA
| | - Ovunc Bardakcioglu
- Department of Colorectal, Las Vegas School of Medicine, University of Nevada, Las Vegas, Las Vegas, NV USA
| | - Sushil Pandey
- West Valley Colon and Rectal Surgery Center, Sun City, AZ USA
| | - Vikram Attaluri
- Colon and Rectal Surgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA USA
| | - Mitchell Bernstein
- Division of Colon and Rectal Surgery, NYU Langone Medical Center, New York, NY USA
| | - Vincent Obias
- Division of Colon and Rectal Surgery, The George Washington University Hospital, Washington, DC USA
| | | | - Alessio Pigazzi
- Division of Colon and Rectal Surgery, Weill Medical College Cornell University, New York, NY USA
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Holubar SD, Lightner AL, Poylin V, Vogel JD, Gaertner W, Davis B, Davis KG, Mahadevan U, Shah SA, Kane SV, Steele SR, Paquette IM, Feingold DL. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Surgical Management of Ulcerative Colitis. Dis Colon Rectum 2021; 64:783-804. [PMID: 33853087 DOI: 10.1097/dcr.0000000000002037] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Stefan D Holubar
- Department of Colorectal Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Amy L Lightner
- Department of Colorectal Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Vitaliy Poylin
- McGaw Medical Center of Northwestern University, Chicago, Illinois
| | - Jon D Vogel
- Colorectal Surgery Section, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Wolfgang Gaertner
- Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Bradley Davis
- Colon and Rectal Surgery, Carolinas Medical Center, Charlotte, North Carolina
| | | | - Uma Mahadevan
- Department of Medicine, University of California, San Francisco, California
| | - Samir A Shah
- Department of Medicine, Brown University, Providence, Rhode Island
| | - Sunanda V Kane
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Scott R Steele
- Department of Colorectal Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Ian M Paquette
- Division of Colon and Rectal Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Daniel L Feingold
- Section of Colorectal Surgery, Rutgers University, New Brunswick, New Jersey
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Wheelwright M, Yousaf H, Plummer R, Cartwright D, Gaertner W, Amin K. Perianal Histoplasmosis Presenting as a Mass Suspicious for Malignancy: A Case Report with Review of Gastrointestinal Manifestations of Histoplasmosis. Am J Case Rep 2019; 20:1740-1744. [PMID: 31761896 PMCID: PMC6892389 DOI: 10.12659/ajcr.918220] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Patient: Male, 66 Final Diagnosis: Perianal histoplasmosis Symptoms: Perianal pain Medication: — Clinical Procedure: Surgical biopsy of the lesion Specialty: Pathology
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Affiliation(s)
- Matthew Wheelwright
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Hira Yousaf
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Regina Plummer
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - David Cartwright
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Wolfgang Gaertner
- Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Khalid Amin
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
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Simianu VV, Curran T, Gaertner W, Kwaan MR, Madoff R, Jensen CC. Cost-Effectiveness Evaluation of Surgical Approaches to Proctectomy. J Am Coll Surg 2019. [DOI: 10.1016/j.jamcollsurg.2019.08.864] [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: 11/25/2022]
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8
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Kolla BC, Chengappa M, Gaertner W, Blaes AH. Impact of adjuvant chemotherapy in appendiceal adenocarcinoma. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e16193] [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: 11/20/2022] Open
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Fleming F, Gaertner W, Ternent CA, Finlayson E, Herzig D, Paquette IM, Feingold DL, Steele SR. The American Society of Colon and Rectal Surgeons Clinical Practice Guideline for the Prevention of Venous Thromboembolic Disease in Colorectal Surgery. Dis Colon Rectum 2018; 61:14-20. [PMID: 29219916 DOI: 10.1097/dcr.0000000000000982] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Fergal Fleming
- Prepared by the Clinical Practice Guidelines Committee of The American Society of Colon and Rectal Surgeons
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Gaertner W. [Legalisation of commercialized live organ donation in Germany: pro]. Dtsch Med Wochenschr 2008; 133:2644. [PMID: 19053000 DOI: 10.1055/s-0028-1105862] [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: 10/21/2022]
Affiliation(s)
- W Gaertner
- Theoretische Volkswirtschaftslehre, Fachbereich Wirtschaftswissenschaften, Universität Osnabrück, 49069 Osnabrück.
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Gaertner W, Oesterhelt D, Vogel J, Maurer R, Schneider S. Photocycles of bacteriorhodopsins containing 13-alkylsubstituted retinals. Biochemistry 2002. [DOI: 10.1021/bi00409a055] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Schulenberg PJ, Gaertner W, Braslavsky SE. Time-resolved volume changes during the bacteriorhodopsin photocycle: A photothermal beam deflection study. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100023a046] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Trissl HW, Gaertner W. Rapid charge separation and bathochromic absorption shift of flash-excited bacteriorhodopsins containing 13-cis or all-trans forms of substituted retinals. Biochemistry 2002. [DOI: 10.1021/bi00377a015] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rohr M, Gaertner W, Schweitzer G, Holzwarth AR, Braslavsky SE. Quantum yields of the photochromic equilibrium between bacteriorhodopsin and its bathointermediate K: femto- and nanosecond optoacoustic spectroscopy. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100193a074] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gaertner W, Oesterhelt D, Towner P, Hopf H, Ernst L. 13-(Trifluoromethyl)retinal forms an active and far-red-shifted chromophore in bacteriorhodopsin. J Am Chem Soc 2002. [DOI: 10.1021/ja00415a037] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gaertner W, Oesterhelt D, Seifert-Schiller E, Towner P, Hopf H, Boehm I. Acetylenic retinals form functional bacteriorhodopsins but do not form bovine rhodopsins. J Am Chem Soc 2002. [DOI: 10.1021/ja00331a040] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Noguchi T, Kolaczkowski S, Gaertner W, Atkinson GH. Resonance Raman spectra of 13-demethylretinal bacteriorhodopsin and of a picosecond bathochromic photocycle intermediate. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100375a030] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sennesael J, Verbeelen D, Degré S, Unger P, Stolear JC, Ostrowski J, von Hattingberg HM, Gaertner W. Pharmacokinetics of linsidomine (SIN 1) after single and multiple intravenous short infusions in patients with renal insufficiency. Int J Clin Pharmacol Ther Toxicol 1993; 31:533-41. [PMID: 8294165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Pharmacokinetic measurements were performed in two groups of patients with coronary heart disease (CHD) after single and multiple dosing of 2 mg linsidomine (SIN 1). The drug was administered by intravenous short time infusion in 12 CHD-patients with renal insufficiency (RI group, Clcr: 11 +/- 6 ml/min) and in 12 CHD-patients with normal kidney function (control group, Clcr: 88 +/- 22 ml/min). The measurement of plasma concentration time courses of total SIN 1C (SIN 1 + SIN 1C) was found to be suitable for an estimation of the SIN 1C related half-life of the terminal phase (t50% = 1.5 +/- 0.5 h), as SIN 1 was eliminated from plasma rapidly (t50% = 12 to 20 min). Furthermore, the mean total SIN 1C plasma profiles were equal after single and multiple administration of the drug giving evidence that SIN 1C is not accumulating during repetitive dosing of SIN 1 in patients with renal disease. The mean maximum renal fraction of total SIN 1C excretion of RI-subjects (fe = 0.8 +/- 0.8% of dose) was significantly different from the corresponding mean value of the control group (fe(N) = 5.8 +/- 5.1% of dose). No differences were found for fe and fe(N) between day 1 and day 4. As SIN 1 is degraded in plasma very rapidly and as SIN 1C is cleared mainly extrarenally, any restrictions concerning repetitive SIN 1 dosage regimen should not be considered for CHD-patients with renal failure.
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Affiliation(s)
- J Sennesael
- Academisch Ziekenhuis V.U.B., Nefrologie, Brussels, Belgium
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Towner P, Gaertner W, Walckhoff B, Oesterhelt D, Hopf H. Regeneration of rhodopsin and bacteriorhodopsin. The role of retinal analogues as inhibitors. Eur J Biochem 1981; 117:353-9. [PMID: 6456145 DOI: 10.1111/j.1432-1033.1981.tb06345.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The rate of regeneration of rhodopsin, from 11-cis-retinal and opsin, and bacteriorhodopsin from all-trans-retinal and bacterio-opsin, in the presence or absence of compounds whose structures partially resemble retinal were measured. Some of these compounds severely slowed down the regeneration process, but did not influence the extent of regeneration. In the case of compounds with a carbonyl functional group they were not joined to the active site of the apo-protein via a Schiff's base linkage since after treatment with NaBH4 an active apo-protein remained. The most effective inhibitors of rhodopsin regeneration were molecules whose structure could be superimposed on 9-cis or 11-cis retinal up to carbon atom 11. These C13 and C15 molecules were not distinguished between aldehyde, ketone or alcohol functional groups. The regeneration of bacteriorhodopsin was not inhibited by retinal analogues with short side chains. The most effective inhibitors were the all-trans C17-aldehyde (beta-ionylideneacetaldehyde) or C18-ketone (beta-ionylidenepent-3-ene-2-one) which, compared to retinal, lack two or three carbon atoms from the end of the poylene chain. The inhibition was very dependent upon the presence of the all-trans isomer and required aldehyde or ketone as functional group nitriles and alcohols were less effective. However, similarly to retinol, the all-trans C17 and C18 alcohols underwent a bathochromic shift and showed fine-structured spectra when mixed with bacterio-opsin.
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