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Brunner A, Unterberger SH, Auer H, Hautz T, Schneeberger S, Stalder R, Badzoka J, Kappacher C, Huck CW, Zelger B, Pallua JD. Suitability of Fourier transform infrared microscopy for the diagnosis of cystic echinococcosis in human tissue sections. J Biophotonics 2024:e202300513. [PMID: 38531615 DOI: 10.1002/jbio.202300513] [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] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/14/2024] [Accepted: 03/17/2024] [Indexed: 03/28/2024]
Abstract
Cystic echinococcosis (CE) is a global health concern caused by cestodes, posing diagnostic challenges due to nonspecific symptoms and inconclusive radiographic results. Diagnosis relies on histopathological evaluation of affected tissue, demanding comprehensive tools. In this retrospective case study, Fourier transform infrared microscopy was explored for detecting and identifying CE through biochemical changes in human tissue sections. Tissue samples from 11 confirmed CE patients were analyzed. Archived FFPE blocks were cut and stained, and then CE-positive unstained sections were examined using Fourier transform infrared microscopy post-deparaffinization. Results revealed the method's ability to distinguish echinococcus elements from human tissue, irrespective of organ type. This research showcases the potential of mid-infrared microscopy as a valuable diagnostic tool for CE, offering promise in enhancing diagnostic precision in the face of the disease's complexities.
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Affiliation(s)
- A Brunner
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria
| | - S H Unterberger
- Department of Material-Technology, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - H Auer
- Department of Medical Parasitology, Clinical Institute of Hygiene and Medical Microbiology, Medical University of Vienna, Vienna, Austria
| | - T Hautz
- OrganLifeTM, Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - S Schneeberger
- OrganLifeTM, Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - R Stalder
- Institute of Mineralogy and Petrography, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - J Badzoka
- Institute of Analytical Chemistry and Radiochemistry, University of Innsbruck, Innsbruck, Austria
| | - C Kappacher
- Institute of Analytical Chemistry and Radiochemistry, University of Innsbruck, Innsbruck, Austria
| | - C W Huck
- Institute of Analytical Chemistry and Radiochemistry, University of Innsbruck, Innsbruck, Austria
| | - B Zelger
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria
| | - J D Pallua
- Department of Hospital for Orthopedics and Traumatology, Medical University of Innsbruck, Innsbruck, Austria
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Schoberleitner I, Faserl K, Tripp CH, Pechriggl EJ, Sigl S, Brunner A, Zelger B, Hermann-Kleiter N, Baier L, Steinkellner T, Sarg B, Egle D, Brunner C, Wolfram D. Silicone implant surface microtopography modulates inflammation and tissue repair in capsular fibrosis. Front Immunol 2024; 15:1342895. [PMID: 38566997 PMCID: PMC10985323 DOI: 10.3389/fimmu.2024.1342895] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
Excessive fibrous capsule formation around silicone mammary implants (SMI) involves immune reactions to silicone. Capsular fibrosis, a common SMI complication linked to host responses, worsens with specific implant topographies. Our study with 10 patients investigated intra- and inter-individually, reduced surface roughness effects on disease progression, wound responses, chronic inflammation, and capsular composition. The results illuminate the significant impact of surface roughness on acute inflammatory responses, fibrinogen accumulation, and the subsequent fibrotic cascade. The reduction of surface roughness to an average roughness of 4 μm emerges as a promising approach for mitigating detrimental immune reactions, promoting healthy wound healing, and curbing excessive fibrosis. The identified proteins adhering to rougher surfaces shed light on potential mediators of pro-inflammatory and pro-fibrotic processes, further emphasizing the need for meticulous consideration of surface design. The composition of the implant capsule and the discovery of intracapsular HSP60 expression highlight the intricate web of stress responses and immune activation that can impact long-term tissue outcomes.
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Affiliation(s)
- Ines Schoberleitner
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Klaus Faserl
- Protein Core Facility, Institute of Medical Chemistry, Biocenter, Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph H. Tripp
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - Elisabeth Judith Pechriggl
- Department of Anatomy, Histology and Embryology, Institute of Clinical and Functional Anatomy, Medical University of Innsbruck, Innsbruck, Austria
| | - Stephan Sigl
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Andrea Brunner
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria
- INNPATH GmbH, Tirol Kliniken, Innsbruck, Austria
| | - Bettina Zelger
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria
| | - Natascha Hermann-Kleiter
- Institute of Cell Genetics, Department for Genetics and Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | - Leoni Baier
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Theresia Steinkellner
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Bettina Sarg
- Protein Core Facility, Institute of Medical Chemistry, Biocenter, Medical University of Innsbruck, Innsbruck, Austria
| | - Daniel Egle
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christine Brunner
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Dolores Wolfram
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, Innsbruck, Austria
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Schmidt VM, Zelger P, Wöss C, Fodor M, Hautz T, Schneeberger S, Huck CW, Arora R, Brunner A, Zelger B, Schirmer M, Pallua JD. Handheld hyperspectral imaging as a tool for the post-mortem interval estimation of human skeletal remains. Heliyon 2024; 10:e25844. [PMID: 38375262 PMCID: PMC10875450 DOI: 10.1016/j.heliyon.2024.e25844] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 01/30/2024] [Accepted: 02/02/2024] [Indexed: 02/21/2024] Open
Abstract
In forensic medicine, estimating human skeletal remains' post-mortem interval (PMI) can be challenging. Following death, bones undergo a series of chemical and physical transformations due to their interactions with the surrounding environment. Post-mortem changes have been assessed using various methods, but estimating the PMI of skeletal remains could still be improved. We propose a new methodology with handheld hyperspectral imaging (HSI) system based on the first results from 104 human skeletal remains with PMIs ranging between 1 day and 2000 years. To differentiate between forensic and archaeological bone material, the Convolutional Neural Network analyzed 65.000 distinct diagnostic spectra: the classification accuracy was 0.58, 0.62, 0.73, 0.81, and 0.98 for PMIs of 0 week-2 weeks, 2 weeks-6 months, 6 months-1 year, 1 year-10 years, and >100 years, respectively. In conclusion, HSI can be used in forensic medicine to distinguish bone materials >100 years old from those <10 years old with an accuracy of 98%. The model has adequate predictive performance, and handheld HSI could serve as a novel approach to objectively and accurately determine the PMI of human skeletal remains.
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Affiliation(s)
- Verena-Maria Schmidt
- Institute of Forensic Medicine, Medical University of Innsbruck, Muellerstraße 44, 6020 Innsbruck, Austria
| | - Philipp Zelger
- University Clinic for Hearing, Voice and Speech Disorders, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
| | - Claudia Wöss
- Institute of Forensic Medicine, Medical University of Innsbruck, Muellerstraße 44, 6020 Innsbruck, Austria
| | - Margot Fodor
- OrganLifeTM, Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Theresa Hautz
- OrganLifeTM, Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Stefan Schneeberger
- OrganLifeTM, Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Christian Wolfgang Huck
- Institute of Analytical Chemistry and Radiochemistry, University of Innsbruck, 6020 Innsbruck, Austria
| | - Rohit Arora
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Andrea Brunner
- Institute of Pathology, Neuropathology, and Molecular Pathology, Medical University of Innsbruck, Muellerstrasse 44, 6020 Innsbruck, Austria
| | - Bettina Zelger
- Institute of Pathology, Neuropathology, and Molecular Pathology, Medical University of Innsbruck, Muellerstrasse 44, 6020 Innsbruck, Austria
| | - Michael Schirmer
- Department of Internal Medicine, Clinic II, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
| | - Johannes Dominikus Pallua
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
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Brunner A, Thalhammer-Thurner GC, Willenbacher W, Haun M, Zelger BG, Willenbacher E. In-depth molecular analysis of lymphomas with lymphoplasmacytic differentiation may provide more precise diagnosis and rational treatment allocation. Ann Hematol 2024; 103:553-563. [PMID: 37951851 PMCID: PMC10798918 DOI: 10.1007/s00277-023-05531-9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 10/30/2023] [Indexed: 11/14/2023]
Abstract
We performed a molecular analysis of formalin-fixed paraffin embedded and decalcified bone marrow trephine biopsies of 41 patients with a B-cell disorder with lymphoplasmacytic differentiation to enable a more precise diagnosis and to describe potentially prognostic and therapeutic relevant mutations. Analysis was performed with a commercially available next-generation sequencing (NGS) lymphoma panel (Lymphoma Solution, SophiaGenetics). Results were correlated with clinical and pathological parameters. Our group covered a spectrum of B-cell disorders with plasmacytic differentiation ranging from Waldenstroem's macroglobulinemia (WM), to small-B-cell lymphomas with plasmacytic differentiation (SBCL-PC) to IgM myeloma (MM). The most helpful diagnostic criteria included morphology and immuno-phenotype as a prerequisite for the interpretation of molecular analysis. MYD88 mutation was present in nearly all WM, but also in 50% of SBCL-PCs, while MM were consistently negative. Driver mutations, such as TP53, were already detectable early in the course of the respective diseases indicating a higher risk of progression, transformation, and reduced progression-free survival. In addition, we report on a novel BIRC3 frameshift mutation in one case of a progressive WM. Our data indicate that patients with LPL/WM might benefit from thorough pathological work-up and detailed molecular analysis in terms of precise diagnosis and targeted treatment allocation.
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Affiliation(s)
- Andrea Brunner
- Department of Pathology, Neuropathology and Molecular Pathology, Innsbruck Medical University, Innsbruck, Austria.
| | | | - Wolfgang Willenbacher
- Internal Medicine V, Haematology & Oncology, Innsbruck Medical University, Innsbruck, Austria
- Syndena GmbH, Connect to Cure, Innsbruck, Austria
| | - Margot Haun
- Department of Pathology, Neuropathology and Molecular Pathology, Innsbruck Medical University, Innsbruck, Austria
- Institute of Pathophysiology, Innsbruck Medical University, Innsbruck, Austria
| | - Bettina Gudrun Zelger
- Department of Pathology, Neuropathology and Molecular Pathology, Innsbruck Medical University, Innsbruck, Austria
| | - Ella Willenbacher
- Internal Medicine V, Haematology & Oncology, Innsbruck Medical University, Innsbruck, Austria
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Zelger P, Brunner A, Zelger B, Willenbacher E, Unterberger SH, Stalder R, Huck CW, Willenbacher W, Pallua JD. Deep learning analysis of mid-infrared microscopic imaging data for the diagnosis and classification of human lymphomas. J Biophotonics 2023; 16:e202300015. [PMID: 37578837 DOI: 10.1002/jbio.202300015] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 07/19/2023] [Accepted: 08/09/2023] [Indexed: 08/15/2023]
Abstract
The present study presents an alternative analytical workflow that combines mid-infrared (MIR) microscopic imaging and deep learning to diagnose human lymphoma and differentiate between small and large cell lymphoma. We could show that using a deep learning approach to analyze MIR hyperspectral data obtained from benign and malignant lymph node pathology results in high accuracy for correct classification, learning the distinct region of 3900 to 850 cm-1 . The accuracy is above 95% for every pair of malignant lymphoid tissue and still above 90% for the distinction between benign and malignant lymphoid tissue for binary classification. These results demonstrate that a preliminary diagnosis and subtyping of human lymphoma could be streamlined by applying a deep learning approach to analyze MIR spectroscopic data.
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Affiliation(s)
- P Zelger
- University Hospital of Hearing, Voice and Speech Disorders, Medical University of Innsbruck, Innsbruck, Austria
| | - A Brunner
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria
| | - B Zelger
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria
| | - E Willenbacher
- University Hospital of Internal Medicine V, Hematology & Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | - S H Unterberger
- Institute of Material-Technology, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - R Stalder
- Institute of Mineralogy and Petrography, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - C W Huck
- Institute of Analytical Chemistry and Radiochemistry, Innsbruck, Austria
| | - W Willenbacher
- University Hospital of Internal Medicine V, Hematology & Oncology, Medical University of Innsbruck, Innsbruck, Austria
- Oncotyrol, Centre for Personalized Cancer Medicine, Innsbruck, Austria
| | - J D Pallua
- University Hospital for Orthopedics and Traumatology, Medical University of Innsbruck, Innsbruck, Austria
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Schoberleitner I, Augustin A, Egle D, Brunner C, Amort B, Zelger B, Brunner A, Wolfram D. Is It All about Surface Topography? An Intra-Individual Clinical Outcome Analysis of Two Different Implant Surfaces in Breast Reconstruction. J Clin Med 2023; 12:jcm12041315. [PMID: 36835850 PMCID: PMC9967160 DOI: 10.3390/jcm12041315] [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: 11/30/2022] [Revised: 01/23/2023] [Accepted: 02/04/2023] [Indexed: 02/10/2023] Open
Abstract
The most common long-term complication of silicone breast implants (SMI) remains capsular fibrosis. The etiology of this exaggerated implant encapsulation is multifactorial but primarily induced by the host response towards the foreign material silicone. Identified risk factors include specific implant topographies. Of note, breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) has only been observed in response to textured surface implants. We hypothesize that reduction of SMI surface roughness causes less host response and, hence, better cosmetic outcomes with fewer complications for the patient. A total of 7 patients received the routinely used CPX®4 breast expander (~60 µM Ra) and the novel SmoothSilk® (~4 µM Ra), fixed prepectoral with a titanized mesh pocket and randomized to the left or right breast after bilateral prophylactic NSME (nipple-sparing mastectomy). We aimed to compare the postoperative outcome regarding capsule thickness, seroma formation, rippling, implant dislocation as well as comfortability and practicability. Our analysis shows that surface roughness is an influential parameter in controlling fibrotic implant encapsulation. Compared intra-individually for the first time in patients, our data confirm an improved biocompatibility with minor capsule formation around SmoothSilk® implants with an average shell roughness of 4 µM and in addition an amplification of host response by titanized implant pockets.
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Affiliation(s)
- Ines Schoberleitner
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria
| | - Angela Augustin
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria
| | - Daniel Egle
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria
| | - Christine Brunner
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria
| | - Birgit Amort
- Department of Radiology, Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria
| | - Bettina Zelger
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Müllerstraße 44, A-6020 Innsbruck, Austria
| | - Andrea Brunner
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Müllerstraße 44, A-6020 Innsbruck, Austria
| | - Dolores Wolfram
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria
- Correspondence: ; Tel.: +43-512-504-82050
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Brunner A, Willenbacher E, Willenbacher W, Zelger B, Zelger P, Huck CW, Pallua JD. Visible- and near-infrared hyperspectral imaging for the quantitative analysis of PD-L1+ cells in human lymphomas: Comparison with fluorescent multiplex immunohistochemistry. Spectrochim Acta A Mol Biomol Spectrosc 2023; 285:121940. [PMID: 36208576 DOI: 10.1016/j.saa.2022.121940] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/22/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION We analyzed the expression of PD-L1 in human lymphomas using hyperspectral imaging (HSI) compared to visual assessment (VA) and conventional digital image analysis (DIA) to strengthen further the value of HSI as a tool for the evaluation of brightfield-based immunohistochemistry (IHC). In addition, fluorescent multiplex immunohistochemistry (mIHC) was used as a second detection method to analyze the impact of a different detection method. MATERIAL AND METHODS 18 cases (6 follicular lymphomas and 12 diffuse large B-cell lymphomas) were stained for PD-L1 by IHC and for PD-L1, CD3, and CD8 by fluorescent mIHC. The percentage of positively stained cells was evaluated with VA, HSI, and DIA for IHC and VA and DIA for mIHC. Results were compared between the different methods of detection and analysis. RESULTS An overall high concordance was found between VA, HSI, and DIA in IHC (Cohens Kappa = 0.810VA/HSI, 0.710 VA/DIA, and 0.516 HSI/DIA) and for VAmIHCversus DIAmIHC (Cohens Kappa = 0.894). Comparing IHC and mIHC general agreement differed depending on the methods compared but reached at most a moderate agreement (Coheńs Kappa between 0.250 and 0.483). This is reflected by the significantly higher percentage of PD-L1+ cells found with mIHC (pFriedman = 0.014). CONCLUSION Our study shows a good concordance for the different analysis methods. Compared to VA and DIA, HSI proved to be a reliable tool for assessing IHC. Understanding the regulation of PD-L1 expression will further enlighten the role of PD-L1 as a biomarker. Therefore it is necessary to develop an instrument, such as HSI, which can offer a reliable and objective evaluation of PD-L1 expression.
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Affiliation(s)
- A Brunner
- Innsbruck Medical University, Institute of Pathology, Neuropathology and Molecular Pathology, Innsbruck, Austria
| | - E Willenbacher
- Innsbruck Medical University, Internal Medicine. V, Hematology & Oncology, Innsbruck, Austria
| | - W Willenbacher
- Innsbruck Medical University, Internal Medicine. V, Hematology & Oncology, Innsbruck, Austria; Syndena GmbH, Connect to Cure, Karl-Kapferer-Straße 5, 6020 Innsbruck, Austria
| | - B Zelger
- Innsbruck Medical University, Institute of Pathology, Neuropathology and Molecular Pathology, Innsbruck, Austria
| | - P Zelger
- Innsbruck Medical University, University Clinic for Hearing, Voice and Speech Disorders, Anichstrasse 35, Innsbruck, Austria
| | - C W Huck
- University of Innsbruck, Institute of Analytical Chemistry and Radiochemistry, Innsbruck, Austria
| | - J D Pallua
- Innsbruck Medical University, Department of Traumatology and Orthopaedics, Innsbruck, Austria.
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Schmidt VM, Zelger P, Woess C, Pallua AK, Arora R, Degenhart G, Brunner A, Zelger B, Schirmer M, Rabl W, Pallua JD. Application of Micro-Computed Tomography for the Estimation of the Post-Mortem Interval of Human Skeletal Remains. Biology (Basel) 2022; 11:biology11081105. [PMID: 35892961 PMCID: PMC9331256 DOI: 10.3390/biology11081105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/22/2022] [Accepted: 07/22/2022] [Indexed: 12/02/2022]
Abstract
It is challenging to estimate the post-mortem interval (PMI) of skeletal remains within a forensic context. As a result of their interactions with the environment, bones undergo several chemical and physical changes after death. So far, multiple methods have been used to follow up on post-mortem changes. There is, however, no definitive way to estimate the PMI of skeletal remains. This research aimed to propose a methodology capable of estimating the PMI using micro-computed tomography measurements of 104 human skeletal remains with PMIs between one day and 2000 years. The present study indicates that micro-computed tomography could be considered an objective and precise method of PMI evaluation in forensic medicine. The measured parameters show a significant difference regarding the PMI for Cort Porosity p < 0.001, BV/TV p > 0.001, Mean1 p > 0.001 and Mean2 p > 0.005. Using a machine learning approach, the neural network showed an accuracy of 99% for distinguishing between samples with a PMI of less than 100 years and archaeological samples.
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Affiliation(s)
- Verena-Maria Schmidt
- Institute of Legal Medicine, Medical University of Innsbruck, Muellerstraße 44, 6020 Innsbruck, Austria; (V.-M.S.); (C.W.); (W.R.)
| | - Philipp Zelger
- University Clinic for Hearing, Voice and Speech Disorders, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria;
| | - Claudia Woess
- Institute of Legal Medicine, Medical University of Innsbruck, Muellerstraße 44, 6020 Innsbruck, Austria; (V.-M.S.); (C.W.); (W.R.)
| | - Anton K. Pallua
- Former Institute for Computed Tomography-Neuro CT, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria;
| | - Rohit Arora
- University Hospital for Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria;
| | - Gerald Degenhart
- Department of Radiology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria;
| | - Andrea Brunner
- Institute of Pathology, Neuropathology, Molecular Pathology, Medical University of Innsbruck, Muellerstrasse 44, 6020 Innsbruck, Austria; (A.B.); (B.Z.)
| | - Bettina Zelger
- Institute of Pathology, Neuropathology, Molecular Pathology, Medical University of Innsbruck, Muellerstrasse 44, 6020 Innsbruck, Austria; (A.B.); (B.Z.)
| | - Michael Schirmer
- Department of Internal Medicine, Clinic II, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria;
| | - Walter Rabl
- Institute of Legal Medicine, Medical University of Innsbruck, Muellerstraße 44, 6020 Innsbruck, Austria; (V.-M.S.); (C.W.); (W.R.)
| | - Johannes D. Pallua
- University Hospital for Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria;
- Correspondence:
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Brunner A, Schmidt VM, Zelger B, Woess C, Arora R, Zelger P, Huck CW, Pallua J. Visible and Near-Infrared hyperspectral imaging (HSI) can reliably quantify CD3 and CD45 positive inflammatory cells in myocarditis: Pilot study on formalin-fixed paraffin-embedded specimens from myocard obtained during autopsy. Spectrochim Acta A Mol Biomol Spectrosc 2022; 274:121092. [PMID: 35257987 DOI: 10.1016/j.saa.2022.121092] [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] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 02/17/2022] [Accepted: 02/25/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION To implement Hyperspectral Imaging (HSI) as a tool for quantifying inflammatory cells in tissue specimens by the example of myocarditis in a collective of forensic patients. MATERIAL AND METHODS 44 consecutive patients with suspected myocardial inflammation at autopsy, diagnosed between 2013 and 2018 at the Institute of ForensicMedicine, Medical University of Innsbruck, were selected for this study. Using the IMEC SNAPSCAN camera, visible and near infrared hyperspectral images were collected from slides stained with CD3 and CD45 to assess quantity and spatial distribution of positive cells. Results were compared with visual assessment (VA) and conventional digital image analysis (DIA). RESULTS Finally, specimens of 40 patients were evaluated, of whom 36 patients (90%) suffered from myocarditis, two patients (5%) had suspected healing/healed myocarditis, and two did no have myocarditis (5%). The amount of CD3 and CD45 positive cells did not differ significantly between VA, HSI, and DIA (pVA/HSI/DIA = 0.46 for CD3 and 0.81 for CD45). Coheńs Kappa showed a very high correlation between VA versus HSI, VA versus DIA, and HSI versus DIA for CD3 (Coheńs Kappa = 0.91, 1.00, and 0.91, respectively). For CD45 an almost as high correlation was seen for VA versus HSI and HSI versus DIA (Coheńs Kappa = 0.75 and 0.70) and VA versus DIA (Coheńs Kappa = 0.89). CONCLUSION HSI is a reliable and objective method to count inflammatory cells in tissue slides of suspected myocarditis. Implementation of HSI in digital pathology might further expand the possibility of a sophisticated method.
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Affiliation(s)
- A Brunner
- Innsbruck Medical University, Institute of Pathology, Neuropathology, and Molecular Pathology, Muellerstrasse 44, 6020 Innsbruck, Austria
| | - V M Schmidt
- Institute of Forensic Medicine, Medical University of Innsbruck, Muellerstraße 44, 6020 Innsbruck, Austria
| | - B Zelger
- Innsbruck Medical University, Institute of Pathology, Neuropathology, and Molecular Pathology, Muellerstrasse 44, 6020 Innsbruck, Austria
| | - C Woess
- Institute of Forensic Medicine, Medical University of Innsbruck, Muellerstraße 44, 6020 Innsbruck, Austria.
| | - R Arora
- University Hospital for Orthopedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - P Zelger
- University Clinic for Hearing, Voice and Speech Disorders, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria
| | - C W Huck
- Institute of Analytical Chemistry and Radiochemistry, University of Innsbruck, Innrain 80-82, Innsbruck, Austria
| | - J Pallua
- Innsbruck Medical University, Institute of Pathology, Neuropathology, and Molecular Pathology, Muellerstrasse 44, 6020 Innsbruck, Austria; Institute of Forensic Medicine, Medical University of Innsbruck, Muellerstraße 44, 6020 Innsbruck, Austria; University Hospital for Orthopedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
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10
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Brunner A, Kruis W, Schömig-Markiefka B, Morgenstern J, Engels M, Büttner R, Forner DM. Prevalence of abnormal Pap smear results in inflammatory bowel disease: a prospective study. J Cancer Res Clin Oncol 2022; 148:3071-3079. [PMID: 34981194 DOI: 10.1007/s00432-021-03909-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 12/27/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE Development of malignancy is a pending threat for patients with inflammatory bowel disease (IBD). Aim of this study was to analyze cervical dysplasia and infection with human papilloma virus (HPV) in patients with IBD. METHODS This was a prospective, single center cohort study in Germany. Consecutive IBD patients admitted to the Department of Gastroenterology were sent to Gynecology, where a questionnaire was answered and gynecological examinations including a smear for cytology and HPV were taken. Participants of a general screening program constituted controls. Descriptive statistics, 95% confidence intervals and odds ratios were calculated. RESULTS A total of 101 patients were recruited of which 99 patients participated. Analysis showed a significant (p = 0.05) difference between the prevalence of abnormal smears in patients with (22%) and without (6%) immunosuppressive therapy, while the latter had cervical abnormalities comparable with healthy controls (5%). All immunosuppressants showed similarly high risks for abnormal smear results. Only 11/99 (11%) patients had positive high-risk HPV tests, which is comparable with general population. CONCLUSION The prevalence of abnormal cervical smears is higher in IBD patients compared to healthy individuals, but the difference is confined to patients with IBD and immunosuppressive therapy. Annual screening is advisable.
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Affiliation(s)
- Andrea Brunner
- Evangelisches Krankenhaus Kalk, Buchforststr. 2, 51103, Köln, Germany
| | - Wolfgang Kruis
- Evangelisches Krankenhaus Kalk, Buchforststr. 2, 51103, Köln, Germany.
| | | | - Julia Morgenstern
- Abteilung für Gastroenterologie, Pulmologie und Allgemeine Innere Medizin, Evangelisches Krankenhaus Kalk, Buchforststr. 2, 51103, Köln, Germany
| | - Marianne Engels
- Institut für Pathologie des Universitätsklinikums Köln, Kerpener Str. 62, 50937, Köln, Germany
| | - Reinhard Büttner
- Institut für Pathologie des Universitätsklinikums Köln, Kerpener Str. 62, 50937, Köln, Germany
| | - Dirk Michael Forner
- Klinik für Gynäkologie und Geburtshilfe, Evangelisches Krankenhaus Kalk, Buchforststr. 2, 51103, Köln, Germany
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11
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Willenbacher E, Brunner A, Zelger B, Unterberger SH, Stalder R, Huck CW, Willenbacher W, Pallua JD. Application of mid-infrared microscopic imaging for the diagnosis and classification of human lymphomas. J Biophotonics 2021; 14:e202100079. [PMID: 34159739 DOI: 10.1002/jbio.202100079] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/15/2021] [Accepted: 06/15/2021] [Indexed: 06/13/2023]
Abstract
Mid-infrared (MIR) microscopic imaging of indolent and aggressive lymphomas was performed including formalin-fixed and paraffin-embedded samples of six follicular lymphomas and 12 diffuse large B-cell-lymphomas as well as reactive lymph nodes to investigate benefits and challenges for lymphoma diagnosis. MIR images were compared to defined pathological characteristics such as indolent versus aggressive versus reactive, germinal centre versus activated cell-of-origin (COO) subtypes, or a low versus a high proliferative index and level of PD-L1 expression. We demonstrated that MIR microscopic imaging can differentiate between reactive lymph nodes, indolent and aggressive lymphoma samples. Also, it has potential to be used in the subtyping of lymphomas, as shown with the differentiation between COO subtypes, the level of proliferation and PD-L1 expression. MIR microscopic imaging is a promising tool for diagnosis and subtyping of lymphoma and further evaluation is needed to fully explore the advantages and disadvantages of this method for pathological diagnosis.
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Affiliation(s)
- Ella Willenbacher
- Internal Medicine V: Hematology & Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | - Andrea Brunner
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria
| | - Bettina Zelger
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Roland Stalder
- Institute of Mineralogy and Petrography, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - Christian W Huck
- Institute of Analytical Chemistry and Radiochemistry, Innsbruck, Austria
| | - Wolfgang Willenbacher
- Internal Medicine V: Hematology & Oncology, Medical University of Innsbruck, Innsbruck, Austria
- Oncotyrol, Center for personalized Cancer Medicine, Innsbruck, Austria
| | - Johannes D Pallua
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria
- University Hospital for Orthopedics and Traumatology, Medical University of Innsbruck, Innsbruck, Austria
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Tulchiner G, Brunner A, Schmidinger M, Staudacher N, Orme J, Horninger W, Thurnher M, Culig Z, Pichler R. CMTM6 expression as a potential biomarker for immunotherapy in metastatic renal cell carcinoma. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00926-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Tulchiner G, Pichler R, Ulmer H, Staudacher N, Lindner AK, Brunner A, Zelger B, Steinkohl F, Aigner F, Horninger W, Thurnher M. Sex-specific hormone changes during immunotherapy and its influence on survival in metastatic renal cell carcinoma. Cancer Immunol Immunother 2021; 70:2805-2817. [PMID: 33646368 PMCID: PMC8423679 DOI: 10.1007/s00262-021-02882-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 02/01/2021] [Indexed: 12/12/2022]
Abstract
Renal cell carcinoma (RCC) is a highly vascularized and immunogenic tumor, being an ideal candidate for checkpoint blockade-based immunotherapy. Accordingly, checkpoint inhibitors have demonstrated clinical efficacy in patients with metastatic RCC (mRCC). Sex-specific differences in cancer immunotherapy may be explained by the interaction of sex hormone signaling, genetic and environmental factors, affecting the innate and adaptive immune response in men and women in different ways. The aim of this prospective study was to monitor for the first time changes in sex hormones including luteinizing hormone (LH), follicle-stimulating hormone (FSH), LH/FSH ratio and 17-ß-estradiol (E2) in 22 mRCC patients (12 male and 10 female) receiving nivolumab therapy. In contrast to female patients, male patients showed a significant increase in E2 (p = 0.006) and LH/FSH ratio (p = 0.013) from the beginning of nivolumab therapy to week 12 of follow-up. Moreover, survival analysis revealed a significant negative association between LH/FSH ratio and progression-free survival (PFS) (p = 0.022) as well as between therapy response (p = 0.009) in males compared to females at interim evaluation (week 6/8). Our findings may therefore be the first reference to sex hormone changes during immunotherapy.
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Affiliation(s)
- Gennadi Tulchiner
- Department of Urology & Immunotherapy Unit, Medical University Innsbruck, Anichstrasse 35 and Innrain 66a, 6020, Innsbruck, Austria
| | - Renate Pichler
- Department of Urology & Immunotherapy Unit, Medical University Innsbruck, Anichstrasse 35 and Innrain 66a, 6020, Innsbruck, Austria.
| | - Hanno Ulmer
- Department of Medical Statistics, Informatics and Health Economics, Medical University Innsbruck, Schoepfstraße 41, 6020, Innsbruck, Austria
| | - Nina Staudacher
- Department of Urology & Immunotherapy Unit, Medical University Innsbruck, Anichstrasse 35 and Innrain 66a, 6020, Innsbruck, Austria
| | - Andrea Katharina Lindner
- Department of Urology & Immunotherapy Unit, Medical University Innsbruck, Anichstrasse 35 and Innrain 66a, 6020, Innsbruck, Austria
| | - Andrea Brunner
- Department of Pathology, Medical University Innsbruck, Muellerstraße 44, 6020, Innsbruck, Austria
| | - Bettina Zelger
- Department of Pathology, Medical University Innsbruck, Muellerstraße 44, 6020, Innsbruck, Austria
| | - Fabian Steinkohl
- Department of Radiology, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Friedrich Aigner
- Department of Radiology, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Wolfgang Horninger
- Department of Urology & Immunotherapy Unit, Medical University Innsbruck, Anichstrasse 35 and Innrain 66a, 6020, Innsbruck, Austria
| | - Martin Thurnher
- Department of Urology & Immunotherapy Unit, Medical University Innsbruck, Anichstrasse 35 and Innrain 66a, 6020, Innsbruck, Austria.
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14
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Tulchiner G, Brunner A, Schmidinger M, Staudacher N, Orme JJ, Thurnher M, Horninger W, Culig Z, Pichler R. CMTM6 expression as a potential biomarker for immunotherapy in metastatic renal cell carcinoma. BJU Int 2021; 128:29-32. [PMID: 33455021 PMCID: PMC8359430 DOI: 10.1111/bju.15341] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Gennadi Tulchiner
- Department of Urology, Medical University Innsbruck, Innsbruck, Austria
| | - Andrea Brunner
- Department of Pathology, Neuropathology and Molecular Pathology, Medical University Innsbruck, Innsbruck, Austria
| | - Manuela Schmidinger
- Clinical Division of Oncology, Department of Medicine I and Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria
| | - Nina Staudacher
- Department of Urology, Medical University Innsbruck, Innsbruck, Austria
| | - Jacob J Orme
- Division of Medical Oncology, Mayo Clinic, Rochester, MN, USA
| | - Martin Thurnher
- Department of Urology, Medical University Innsbruck, Innsbruck, Austria
| | | | - Zoran Culig
- Department of Urology, Medical University Innsbruck, Innsbruck, Austria
| | - Renate Pichler
- Department of Urology, Medical University Innsbruck, Innsbruck, Austria
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15
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Laimer J, Bruckmoser E, Helten T, Kofler B, Zelger B, Brunner A, Zelger B, Huck CW, Tappert M, Rogge D, Schirmer M, Pallua JD. Hyperspectral imaging as a diagnostic tool to differentiate between amalgam tattoos and other dark pigmented intraoral lesions. J Biophotonics 2021; 14:e202000424. [PMID: 33210464 DOI: 10.1002/jbio.202000424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/13/2020] [Accepted: 11/15/2020] [Indexed: 06/11/2023]
Abstract
The goal of this project is to identify any in-depth benefits and drawbacks in the diagnosis of amalgam tattoos and other pigmented intraoral lesions using hyperspectral imagery collected from amalgam tattoos, benign, and malignant melanocytic neoplasms. Software solutions capable of classifying pigmented lesions of the skin already exist, but conventional red, green and blue images may be reaching an upper limit in their performance. Emerging technologies, such as hyperspectral imaging (HSI) utilize more than a hundred, continuous data channels, while also collecting data in the infrared. A total of 18 paraffin-embedded human tissue specimens of dark pigmented intraoral lesions (including the lip) were analyzed using visible and near-infrared (VIS-NIR) hyperspectral imagery obtained from HE-stained histopathological slides. Transmittance data were collected between 450 and 900 nm using a snapshot camera mounted to a microscope with a halogen light source. VIS-NIR spectra collected from different specimens, such as melanocytic cells and other tissues (eg, epithelium), produced distinct and diagnostic spectra that were used to identify these materials in several regions of interest, making it possible to distinguish between intraoral amalgam tattoos (intramucosal metallic foreign bodies) and melanocytic lesions of the intraoral mucosa and the lip (each with P < .01 using the independent t test). HSI is presented as a diagnostic tool for the rapidly growing field of digital pathology. In this preliminary study, amalgam tattoos were reliably differentiated from melanocytic lesions of the oral cavity and the lip.
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Affiliation(s)
- Johannes Laimer
- University Hospital for Craniomaxillofacial and Oral Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Tom Helten
- University Hospital for Craniomaxillofacial and Oral Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Barbara Kofler
- University Hospital of Otorhinolaryngology, Medical University of Innsbruck, Innsbruck, Austria
| | - Bettina Zelger
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria
| | - Andrea Brunner
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria
| | - Bernhard Zelger
- University Hospital for Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christian W Huck
- Institute of Analytical Chemistry and Radiochemistry, Leopold Franzens University of Innsbruck, Innsbruck, Austria
| | - Michelle Tappert
- Hyperspectral Intelligence Inc., Gibsons, British Columbia, Canada
| | - Derek Rogge
- Hyperspectral Intelligence Inc., Gibsons, British Columbia, Canada
| | - Michael Schirmer
- Department of Internal Medicine, Clinic II, Medical University of Innsbruck, Innsbruck, Austria
| | - Johannes D Pallua
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria
- University Hospital for Orthopedics and Traumatology, Medical University of Innsbruck, Innsbruck, Austria
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Abstract
INTRODUCTION The case report describes an atrial dissociation in a 9-year-old male boxer diagnosed by ECG and echocardiography. Torticollis, severe neck pain and auscultatory arrhythmia were found during the clinical examination. In addition, a mass was found in the left tympanic bulla and histologically a carcinoma of the middle ear was diagnosed.
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17
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Willenbacher E, Brunner A, Willenbacher W, Zelger B, Wolf D, Rogge D, Tappert M, Pallua JD. Visible and near-infrared hyperspectral imaging techniques allow the reliable quantification of prognostic markers in lymphomas: A pilot study using the Ki67 proliferation index as an example. Exp Hematol 2020; 91:55-64. [PMID: 32966868 DOI: 10.1016/j.exphem.2020.09.191] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 08/25/2020] [Accepted: 09/16/2020] [Indexed: 01/15/2023]
Abstract
In this study, we examined the suitability of visible and infrared (Vis-NIR) hyperspectral imaging (HSI) for the quantification of prognostic markers in non-Hodgkin lymphoma on the example of the Ki67 proliferation index. Ki67 quantification was done on six follicular lymphomas (FLs) and 12 diffuse large B-cell lymphomas (DLBCLs) by applying classic immunohistochemistry. The Ki67 index was comparatively assessed visually, using HSI-based quantification and a digital imaging analysis (DIA) platform. There was no significant difference between visual assessment (VA), DIA, and HSI in FLs. For DLBCLs, VA resulted in significantly higher Ki67 values than HSI (p = 0.023) and DIA (p = 0.006). No such difference was seen comparing analysis by HSI and DIA (p = 0.724). Cohen's κ revealed a "substantial correlation" of Ki67 values for HSI and DIA in FLs and DLBCLs (κ = 0.667 and 0.657). Here we provide the first evidence that, comparably to traditional DIA, HSI can be used reliably to quantify protein expression, as exemplified by the Ki67 proliferation index. By covering the near-infrared spectrum, HSI might offer additional information on the biochemical composition of pathological specimens, although our study could not show that HSI is clearly superior to conventional DIA. However, the analysis of multiplex immunohistochemistry might benefit from such an approach, especially if overlapping immunohistochemical reactions were possible. Further studies are needed to explore the impact of this method on the analysis and quantification of multiple marker expression in pathological specimens.
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Affiliation(s)
- Ella Willenbacher
- Internal Medicine V: Hematology & Oncology, Innsbruck Medical University, Innsbruck, Austria
| | - Andrea Brunner
- Institute of Pathology, Neuropathology and Molecular Pathology, Innsbruck Medical University, Innsbruck, Austria
| | - Wolfgang Willenbacher
- Internal Medicine V: Hematology & Oncology, Innsbruck Medical University, Innsbruck, Austria; Oncotyrol, Center for Personalized Cancer Medicine, Innsbruck, Austria
| | - Bettina Zelger
- Institute of Pathology, Neuropathology and Molecular Pathology, Innsbruck Medical University, Innsbruck, Austria
| | - Dominik Wolf
- Internal Medicine V: Hematology & Oncology, Innsbruck Medical University, Innsbruck, Austria; Medical Clinic 3, University Clinic Bonn, Bonn, Germany
| | - Derek Rogge
- Hyperspectral Intelligence Inc., Gibsons, BC, Canada
| | | | - Johannes D Pallua
- Institute of Pathology, Neuropathology and Molecular Pathology, Innsbruck Medical University, Innsbruck, Austria; University Hospital for Orthopedics and Traumatology, Medical University of Innsbruck, Innsbruck, Austria.
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18
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Abstract
Information, archives, and intelligent artificial systems are part of everyday life in modern medicine. They already support medical staff by mapping their workflows with shared availability of cases' referral information, as needed for example, by the pathologist, and this support will be increased in the future even more. In radiology, established standards define information models, data transmission mechanisms, and workflows. Other disciplines, such as pathology, cardiology, and radiation therapy, now define further demands in addition to these established standards. Pathology may have the highest technical demands on the systems, with very complex workflows, and the digitization of slides generating enormous amounts of data up to Gigabytes per biopsy. This requires enormous amounts of data to be generated per biopsy, up to the gigabyte range. Digital pathology allows a change from classical histopathological diagnosis with microscopes and glass slides to virtual microscopy on the computer, with multiple tools using artificial intelligence and machine learning to support pathologists in their future work.
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Affiliation(s)
- J D Pallua
- Department of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Müllerstraße 44, A-6020, Innsbruck, Austria.
| | - A Brunner
- Department of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Müllerstraße 44, A-6020, Innsbruck, Austria
| | - B Zelger
- Department of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Müllerstraße 44, A-6020, Innsbruck, Austria
| | - M Schirmer
- Department of Internal Medicine, Clinic II, Medical University of Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria
| | - J Haybaeck
- Department of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Müllerstraße 44, A-6020, Innsbruck, Austria; Department of Pathology, Medical Faculty, Otto-von-Guericke University Magdeburg, Leipzigerstrasse 44, D-Magdeburg, Germany; Diagnostic & Research Center for Molecular BioMedicine, Institute of Pathology, Medical University of Graz, Neue Stiftingtalstrasse 6, A-8010, Graz, Austria
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Kuscher S, Kronberger IE, Loizides A, Plaikner M, Ninkovic M, Brunner A, Auer H, Gassner EM, Öfner D, Schneeberger S. Exploring the limits of hepatic surgery for alveolar echinococcosis—10-years’ experience in an endemic area of Austria. Eur Surg 2019. [DOI: 10.1007/s10353-019-0596-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Degasper C, Brunner A, Sampson N, Tsibulak I, Wieser V, Welponer H, Marth C, Fiegl H, Zeimet AG. NADPH oxidase (NOX4) im normalen Endometrium und im Endometriumkarzinom. Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1681987] [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: 10/27/2022] Open
Affiliation(s)
- C Degasper
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
| | - A Brunner
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
| | - N Sampson
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
| | - I Tsibulak
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
| | - V Wieser
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
| | - H Welponer
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
| | - C Marth
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
| | - H Fiegl
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
| | - AG Zeimet
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
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Willenbacher E, Willenbacher W, Wolf DG, Zelger B, Peschel I, Manzl C, Haun M, Brunner A. Digital PCR in bone marrow trephine biopsies is highly sensitive for MYD88 L265P detection in lymphomas with plasmacytic/plasmacytoid differentiation. Br J Haematol 2019; 186:189-191. [PMID: 30763982 DOI: 10.1111/bjh.15792] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Ella Willenbacher
- Internal Medicine V. Haematology and Oncology, Innsbruck Medical University, Innsbruck, Austria
| | - Wolfgang Willenbacher
- Internal Medicine V. Haematology and Oncology, Innsbruck Medical University, Innsbruck, Austria.,Oncotyrol, Centre for Personalized Cancer Medicine, Innsbruck, Austria
| | - Dominik G Wolf
- Internal Medicine V. Haematology and Oncology, Innsbruck Medical University, Innsbruck, Austria.,Medical Clinic 3, Oncology, Haematology, Rheumatology and Immunoncology, University Clinic Bonn (UKB), Bonn, Germany
| | - Bettina Zelger
- Institute of Pathology, Neuropathology and Molecular Pathology, Innsbruck Medical University, Innsbruck, Austria
| | - Ines Peschel
- Institute for Medical and Chemical Laboratory Diagnostics, Medical University Innsbruck, Innsbruck, Austria
| | - Claudia Manzl
- Division of General Pathology, Department of Pathology, Innsbruck Medical University, Innsbruck, Austria
| | - Margot Haun
- Institute of Pathology, Neuropathology and Molecular Pathology, Innsbruck Medical University, Innsbruck, Austria
| | - Andrea Brunner
- Institute of Pathology, Neuropathology and Molecular Pathology, Innsbruck Medical University, Innsbruck, Austria
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Degasper C, Brunner A, Sampson N, Tsibulak I, Wieser V, Welponer H, Marth C, Fiegl H, Zeimet AG. NADPH oxidase 4 expression in the normal endometrium and in endometrial cancer. Tumour Biol 2019; 41:1010428319830002. [PMID: 30813866 DOI: 10.1177/1010428319830002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023] Open
Abstract
The aim of this study was to explore the role of NOX4 in the biology of the normal endometrium and endometrial cancer. NOX4 plays a key role in other adenocarcinomas and has been implicated in the pathogenesis of diabetes and obesity, which are important risk factors for endometrial cancer. NOX4 expression was assessed in 239 endometrial cancer and 25 normal endometrium samples by quantitative real-time polymerase chain reaction, in situ hybridization, and immunohistochemistry. DNA methylation of the NOX4 promoter was determined by means of MethyLight PCR. Data were correlated with clinicopathological parameters and analyzed in the context of diabetes and body mass index. In the normal endometrium, NOX4 microRNA expression was significantly higher in the secretory transformed compared with proliferative endometrium ( p = 0.008). In endometrial cancer specimens, NOX4 expression did not differ between diabetic and non-diabetic patients, but was the highest in patients with a body mass index ≤ 26 ( p = 0.037). The lowest NOX4 expression was found in carcinosarcomas ( p = 0.007). High NOX4 expression predicted poorer clinical outcome with regard to overall survival, especially in non-diabetic patients and those with a body mass index > 20. Independent prognostic significance of NOX4 transcripts was retained in type I endometrial cancer and was the most meaningful in patients with a body mass index > 20. No prognostic impact was shown for NOX4 promoter methylation in endometrial cancer. For the first time, we demonstrate that NOX4 plays a considerable role in the cycle-dependent changes in the normal endometrium and in the biology of endometrial cancer.
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Affiliation(s)
- Christine Degasper
- 1 Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Andrea Brunner
- 2 Department of Pathology, Medical University of Innsbruck, Innsbruck, Austria
| | - Natalie Sampson
- 3 Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - Irina Tsibulak
- 1 Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Verena Wieser
- 1 Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Hannah Welponer
- 1 Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christian Marth
- 1 Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Heidi Fiegl
- 1 Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Alain Gustave Zeimet
- 1 Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
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Biedermann R, Riccabona J, Giesinger JM, Brunner A, Liebensteiner M, Wansch J, Dammerer D, Nogler M. Results of universal ultrasound screening for developmental dysplasia of the hip: a prospective follow-up of 28 092 consecutive infants. Bone Joint J 2018; 100-B:1399-1404. [PMID: 30295526 DOI: 10.1302/0301-620x.100b10.bjj-2017-1539.r2] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [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: 11/05/2022]
Abstract
AIMS The purpose of this study was to analyze the incidence of the different ultrasound phenotypes of developmental dysplasia of the hip (DDH), and to determine their subsequent course. PATIENTS AND METHODS A consecutive series of 28 092 neonates was screened and classified according to the Graf method as part of a nationwide surveillance programme, and then followed prospectively. Abnormal hips were followed until they became normal (Graf type I). Type IIb hips and higher grades were treated by abduction in a Tübinger orthosis until normal. Dislocated hips underwent closed or open reduction. RESULTS Overall, 90.2% of hips were normal at birth. Type IIa hips (8.9%) became normal at a median of six weeks (interquartile range (IQR) 6 to 9). Type IIc and IId hips (0.67%) became normal after ten weeks (IQR 7 to 13). There were 19 type lll and eight type lV hips at baseline. There were 24 closed reductions and one open reduction. No late presentations of DDH were detected within the first five years of life. CONCLUSION The incidence of DDH was eight per 1000 live births. The treatment rate was 1% (n = 273). The rate of first operations on the newborn hip was 0.86, and rate of open surgery was 0.04. The cumulative rate of open surgery was 0.07. The authors take the view that early identification and treatment in abduction of all dysplastic hips in early childhood reduces the rate of open reduction and secondary DDH-related surgery later in life. Cite this article: Bone Joint J 2018;100-B:1399-1404.
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Affiliation(s)
- R Biedermann
- Department of Orthopaedics, Medical University of Innsbruck, Innsbruck, Austria
| | - J Riccabona
- Department of Orthopaedics, Medical University of Innsbruck, Innsbruck, Austria
| | - J M Giesinger
- Innsbruck Institute of Patient-Centered Outcome Research (IIPCOR), Innsbruck, Austria
| | - A Brunner
- Department of Orthopaedics, Medical University of Innsbruck, Innsbruck, Austria
| | - M Liebensteiner
- Department of Orthopaedics, Medical University of Innsbruck, Innsbruck, Austria
| | - J Wansch
- Department of Orthopaedics, Medical University of Innsbruck, Innsbruck, Austria
| | - D Dammerer
- Department of Orthopaedics, Medical University of Innsbruck, Innsbruck, Austria
| | - M Nogler
- Department of Orthopaedics, Medical University of Innsbruck, Innsbruck, Austria
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24
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Pichler R, Fritz J, Lackner F, Sprung S, Brunner A, Horninger W, Loidl W, Pircher A, Heidegger I. Prognostic Value of Testing PD-L1 Expression After Radical Cystectomy in High-risk Patients. Clin Genitourin Cancer 2018; 16:e1015-e1024. [DOI: 10.1016/j.clgc.2018.05.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 05/29/2018] [Accepted: 05/29/2018] [Indexed: 01/08/2023]
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25
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Pallua JD, Brunner A, Zelger B, Stalder R, Unterberger SH, Schirmer M, Tappert MC. Clinical infrared microscopic imaging: An overview. Pathol Res Pract 2018; 214:1532-1538. [PMID: 30220435 DOI: 10.1016/j.prp.2018.08.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 08/22/2018] [Accepted: 08/26/2018] [Indexed: 11/16/2022]
Abstract
New developments in Mid-infrared microscopic imaging instrumentation and data analysis have turned this method into a conventional technique. This imaging method offers a global analysis of samples, with a resolution close to the cellular level enabling the acquisition of local molecular expression profiles. It is possible to get chemo-morphological information about the tissue status, which represents an essential benefit for future analytical interpretation of pathological changes of tissue. In this review, we give an overview of Mid-infrared microscopic imaging and its applications in clinical research.
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Affiliation(s)
- J D Pallua
- Department of Pathology, Medical University of Innsbruck, Müllerstraße 44, 6020, Innsbruck, Austria; Institute of Legal Medicine, Medical University of Innsbruck, Müllerstraße 44, 6020, Innsbruck, Austria.
| | - A Brunner
- Department of Pathology, Medical University of Innsbruck, Müllerstraße 44, 6020, Innsbruck, Austria
| | - B Zelger
- Department of Pathology, Medical University of Innsbruck, Müllerstraße 44, 6020, Innsbruck, Austria
| | - R Stalder
- Institute of Mineralogy and Petrography, Leopold-Franzens University Innsbruck, Innrain 52, 6020, Innsbruck, Austria
| | - S H Unterberger
- Material-Technology, Leopold-Franzens University Innsbruck, Technikerstraße 13, 6020, Innsbruck, Austria
| | - M Schirmer
- Department of Internal Medicine, Clinic II, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - M C Tappert
- Hyperspectral Intelligence Inc., Box 851, V0N 1V0, Gibsons, Canada
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26
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Seeber A, Klinglmair G, Fritz J, Steinkohl F, Zimmer KC, Aigner F, Horninger W, Gastl G, Zelger B, Brunner A, Pichler R. High IDO-1 expression in tumor endothelial cells is associated with response to immunotherapy in metastatic renal cell carcinoma. Cancer Sci 2018; 109:1583-1591. [PMID: 29498788 PMCID: PMC5980224 DOI: 10.1111/cas.13560] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [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: 01/23/2018] [Revised: 02/22/2018] [Accepted: 02/25/2018] [Indexed: 12/22/2022] Open
Abstract
Nivolumab belongs to the standard therapy in the second‐line setting of metastatic renal cell carcinoma (mRCC). Although deep and long‐lasting responses are seen in some patients, the majority of patients will further progress. PD‐L1 is still under critical evaluation as a predictive biomarker. Thus, more accurate biomarkers are clearly warranted. Here, we investigated for the first time the predictive role of IDO‐1, a negative immune‐regulatory molecule, on clear cell RCC tissues of 15 patients undergoing nivolumab therapy. IDO‐1 and other immune inhibitory molecules (PD‐L1, PD‐L2, FOXP3) as well as immune cell subsets (CD3, CD4 and CD8) were measured on formalin‐fixed, paraffin‐embedded sections of RCC specimens by immunohistochemistry. IDO‐1 was predominantly expressed in tumor endothelial cells, and was totally absent from tumor cells itself. IDO‐1 overexpression (>10%) could be detected more frequently in responders (100%, n = 6/6) compared to non‐responders (33.3%, n = 3/9; P = .028), resulting in a better progression‐free survival during immunotherapy (IDO‐1 ≤ 10% vs >10%, median: 3.5 vs not estimated (NE) months, P = .01 by log‐rank test). In addition, IDO‐1 was positively correlated with CD8+ T cell expression (rs = .691, P = .006). PD‐L1 expression on tumor cells was negative in 13 (86.7%) of 15 patients, irrespective of therapeutic response (responders vs non‐responders: 83.3% vs 88.9%). No differences were noticed in the PD‐L1 expression on tumor‐infiltrating immune cells (PD‐L1 < 1% in 66.7% of both responders and non‐responders). In contrast to PD‐L1, these results suggest that IDO‐1 may be a more promising predictive biomarker for response to immune‐based cancer therapy in mRCC.
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Affiliation(s)
- Andreas Seeber
- Department of Internal Medicine V, Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | - Gerald Klinglmair
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - Josef Fritz
- Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Innsbruck, Austria
| | - Fabian Steinkohl
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Kai-Christian Zimmer
- Department of Internal Medicine V, Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | - Friedrich Aigner
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Wolfgang Horninger
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - Günther Gastl
- Department of Internal Medicine V, Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | - Bettina Zelger
- Department of Pathology, Division of General Pathology, Medical University of Innsbruck, Innsbruck, Austria
| | - Andrea Brunner
- Department of Pathology, Division of General Pathology, Medical University of Innsbruck, Innsbruck, Austria
| | - Renate Pichler
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
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Thangavadivel S, Zelle-Rieser C, Olivier A, Postert B, Untergasser G, Kern J, Brunner A, Gunsilius E, Biedermann R, Hajek R, Pour L, Willenbacher W, Greil R, Jöhrer K. CCR10/CCL27 crosstalk contributes to failure of proteasome-inhibitors in multiple myeloma. Oncotarget 2018; 7:78605-78618. [PMID: 27732933 PMCID: PMC5346663 DOI: 10.18632/oncotarget.12522] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 07/04/2016] [Accepted: 10/03/2016] [Indexed: 11/25/2022] Open
Abstract
The bone marrow microenvironment plays a decisive role in multiple myeloma progression and drug resistance. Chemokines are soluble mediators of cell migration, proliferation and survival and essentially modulate tumor progression and drug resistance. Here we investigated bone marrow-derived chemokines of naive and therapy-refractory myeloma patients and discovered that high levels of the chemokine CCL27, known so far for its role in skin inflammatory processes, correlated with worse overall survival of the patients. In addition, chemokine levels were significantly higher in samples from patients who became refractory to bortezomib at first line treatment compared to resistance at later treatment lines. In vitro as well as in an in vivo model we could show that CCL27 triggers bortezomib-resistance of myeloma cells. This effect was strictly dependent on the expression of the respective receptor, CCR10, on stroma cells and involved the modulation of IL-10 expression, activation of myeloma survival pathways, and modulation of proteasomal activity. Drug resistance could be totally reversed by blocking CCR10 by siRNA as well as blocking IL-10 and its receptor. From our data we suggest that blocking the CCR10/CCL27/IL-10 myeloma-stroma crosstalk is a novel therapeutic target that could be especially relevant in early refractory myeloma patients.
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Affiliation(s)
| | | | | | - Benno Postert
- Tyrolean Cancer Research Institute, Innsbruck, Austria
| | - Gerold Untergasser
- Tyrolean Cancer Research Institute, Innsbruck, Austria.,Laboratory of Tumor Angiogenesis and Tumorbiology, Department of Internal Medicine V, Medical University of Innsbruck, Innsbruck, Austria
| | - Johann Kern
- Laboratory of Tumor Angiogenesis and Tumorbiology, Department of Internal Medicine V, Medical University of Innsbruck, Innsbruck, Austria
| | - Andrea Brunner
- Department of Pathology, Medical University Innsbruck, Innsbruck, Austria
| | - Eberhard Gunsilius
- Laboratory of Tumor Angiogenesis and Tumorbiology, Department of Internal Medicine V, Medical University of Innsbruck, Innsbruck, Austria
| | - Rainer Biedermann
- Department of Orthopedic Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - Roman Hajek
- Babak Myeloma Group, Department of Pathological Physiology, Faculty of Medicine, Masaryk University, Department of Clinical Hematology, University Hospital Brno, Brno, Czech Republic.,Department of Hematooncology, Faculty of Medicine, University of Ostrava and University Hospital Ostrava, Ostrava, Czech Republic
| | - Ludek Pour
- Babak Myeloma Group, Department of Pathological Physiology, Faculty of Medicine, Masaryk University, Department of Clinical Hematology, University Hospital Brno, Brno, Czech Republic.,Department of Hematooncology, Faculty of Medicine, University of Ostrava and University Hospital Ostrava, Ostrava, Czech Republic
| | - Wolfgang Willenbacher
- Department of Internal Medicine V, University Hospital Innsbruck, Innsbruck, Austria
| | - Richard Greil
- Tyrolean Cancer Research Institute, Innsbruck, Austria.,Salzburg Cancer Research Institute-Laboratory of Immunological and Molecular Cancer Research, Salzburg, Austria.,Third Medical Department at The Paracelsus Medical University Salzburg, Austria.,Cancer Cluster Salzburg (CCS), Salzburg, Austria
| | - Karin Jöhrer
- Tyrolean Cancer Research Institute, Innsbruck, Austria
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28
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Huber GF, Hüllner M, Schmid C, Brunner A, Sah B, Vetter D, Kaufmann PA, von Schulthess GK. Benefit of 18F-fluorocholine PET imaging in parathyroid surgery. Eur Radiol 2018; 28:2700-2707. [PMID: 29372312 DOI: 10.1007/s00330-017-5190-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 11/08/2017] [Accepted: 11/09/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To assess the additional diagnostic value of 18F-fluorocholine PET imaging in preoperative localization of pathologic parathyroid glands in clinically manifest hyperparathyroidism in case of negative or conflicting ultrasound and scintigraphy results. METHODS A retrospective, single-institution study of 26 patients diagnosed with hyperparathyroidism. In cases where ultrasound and scintigraphy failed to detect the location of an adenoma in order to allow a focused surgical approach, an additional 18F-fluorocholine PET scan was performed and its results were compared with the intraoperative findings. RESULTS A total of 26 patients underwent 18F-fluorocholine PET/CT (n = 11) or PET/MRI (n = 15). Adenomas were detected in 25 patients (96.2%). All patients underwent surgery, and the location predicted by PET hybrid imaging was confirmed intraoperatively by frozen section and adequate parathyroid hormone drop after removal. None of the patients needed revision surgery during follow-up. CONCLUSIONS These results demonstrate that 18F-fluorocholine PET imaging is a highly accurate method to detect parathyroid adenomas even in case of previous localization failure by other imaging examinations. KEY POINTS • With 18 F-fluorocholine PET imaging, parathyroid adenomas could be detected in 96.2%. • 18 F-fluorocholine imaging is a highly accurate method to detect parathyroid adenomas. • We encourage its use, where ultrasound fails to detect an adenoma.
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Affiliation(s)
- G F Huber
- Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland.
| | - M Hüllner
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - C Schmid
- Department of Endocrinology, Diabetology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - A Brunner
- Department of Endocrinology, Diabetology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - B Sah
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - D Vetter
- Department of General Surgery, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - P A Kaufmann
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - G K von Schulthess
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
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29
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Pichler R, Fritz J, Zavadil C, Schäfer G, Culig Z, Brunner A. Tumor-infiltrating immune cell subpopulations influence the oncologic outcome after intravesical Bacillus Calmette-Guérin therapy in bladder cancer. Oncotarget 2018; 7:39916-39930. [PMID: 27221038 PMCID: PMC5129981 DOI: 10.18632/oncotarget.9537] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [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: 03/22/2016] [Accepted: 05/05/2016] [Indexed: 12/22/2022] Open
Abstract
Although Bacillus Calmette-Guérin (BCG) is the most successful immunotherapy for high-risk non-muscle-invasive bladder cancer, approximately 30% of patients are unresponsive to treatment. New biomarkers are important to identify patients who will benefit most from BCG during a worldwide BCG shortage. Local immune cell subsets were measured on formalin-fixed, paraffin-embedded tissue sections of bladder cancer by immunohistochemistry, using monoclonal antibodies to tumor-associated macrophages (TAMs; CD68, CD163), B-lymphocytes (CD20) and T-lymphocyte subsets (CD3, CD4, CD8, GATA3, T-bet, FOXP3 and CD25). Cell densities in the lamina propria without invasion, at the invasive front if present, in the papillary tumor stroma, and in the neoplastic urothelium were calculated. Twenty-nine (72.5%) of 40 patients were classified as BCG responders after a mean follow-up of 35.3 months. A statistically significant association was observed for BCG failure with low density of CD4+ and GATA3+ T-cells, and increased expression of FOXP3+ and CD25+ regulatory T-cells (Tregs) as well as CD68+ and CD163+ TAMs. Survival analysis demonstrated prolonged recurrence-free survival (RFS) in patients with an increased count of CD4+ and GATA3+ T-cells. TAMs, Tregs and T-bet+ T-cells were inversely correlated with RFS. Thus, the tumor microenvironment seems to influence the therapeutic response to BCG, permitting an individualized treatment.
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Affiliation(s)
- Renate Pichler
- Department of Urology, Division of Experimental Urology, Medical University of Innsbruck, A-6020 Innsbruck, Austria
| | - Josef Fritz
- Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, A-6020 Innsbruck, Austria
| | - Claudia Zavadil
- Department of Pathology, Division of General Pathology, Medical University of Innsbruck, A-6020 Innsbruck, Austria
| | - Georg Schäfer
- Department of Pathology, Division of General Pathology, Medical University of Innsbruck, A-6020 Innsbruck, Austria
| | - Zoran Culig
- Department of Urology, Division of Experimental Urology, Medical University of Innsbruck, A-6020 Innsbruck, Austria
| | - Andrea Brunner
- Department of Pathology, Division of General Pathology, Medical University of Innsbruck, A-6020 Innsbruck, Austria
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30
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Pichler R, Tulchiner G, Oberaigner W, Schaefer G, Horninger W, Brunner A, Heidegger I. Effect of Urinary Cytology for Detecting Recurrence in Remnant Urothelium After Radical Cystectomy: Insights From a 10-year Cytology Database. Clin Genitourin Cancer 2017; 15:e783-e791. [DOI: 10.1016/j.clgc.2017.03.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 02/20/2017] [Accepted: 03/06/2017] [Indexed: 01/24/2023]
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31
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Lanz S, Brunner A, Graubner C, Marti E, Gerber V. Insect Bite Hypersensitivity in Horses is Associated with Airway Hyperreactivity. J Vet Intern Med 2017; 31:1877-1883. [PMID: 28921663 PMCID: PMC5697210 DOI: 10.1111/jvim.14817] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 05/31/2017] [Accepted: 08/01/2017] [Indexed: 11/29/2022] Open
Abstract
Background Genetic and epidemiologic evidence suggests that in horses, as in other species, different manifestations of hypersensitivity may occur together. Hypothesis Horses affected with insect bite hypersensitivity (IBH) show airway hyperreactivity (AH) to inhaled histamine, even in the absence of overt clinical signs of equine asthma (EA). Animals Twenty‐two healthy controls (group C), 24 horses suffering from IBH alone (group IBH), and 23 horses suffering from IBH and EA (group IBH/EA). Methods The clinical histories were assessed using 2 standardized questionnaires, the Horse Owner Assessed Respiratory Signs Index (HOARSI), and IBH scoring. Horses were classified as EA‐affected if their HOARSI was >1 and as IBH‐affected if IBH score was >0. Confounding disorders were excluded by clinical examination. The arterial partial pressure of oxygen (PaO2) was measured and flowmetric plethysmography used to assess airway reactivity to increasing doses of inhaled histamine. Results The median histamine provocation concentration (PC) when ∆flow values increased by 35% (PC35) was significantly higher in group C (5.94 [1.11–26.33] mg/mL) compared to group IBH (2.95 [0.23–10.13] mg/mL) and group IBH/EA (2.03 [0.43–10.94] mg/mL; P < 0.01). The PC50 and PC75 showed very similar differences between groups. Furthermore, PaO2 was significantly lower in group IBH (84 ± 8 mmHg) and group IBH/EA (78 ± 11 mmHg) compared to group C (89 ± 6 mmHg; P < 0.01). Conclusions and Clinical Importance IBH is associated with AH and decreased PaO2, even in the absence of overt respiratory clinical signs.
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Affiliation(s)
- S Lanz
- Swiss Institute of Equine Medicine, University of Bern and Agroscope, Berne, Switzerland
| | - A Brunner
- Swiss Institute of Equine Medicine, University of Bern and Agroscope, Berne, Switzerland
| | - C Graubner
- Swiss Institute of Equine Medicine, University of Bern and Agroscope, Berne, Switzerland
| | - E Marti
- Department of Clinical Research, University of Bern, Berne, Switzerland
| | - V Gerber
- Swiss Institute of Equine Medicine, University of Bern and Agroscope, Berne, Switzerland
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32
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Froese G, Brunner A. Optimierung der E-E-Zeit durch Standard Operating Procedures (SOPs). Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1602322] [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: 10/19/2022] Open
Affiliation(s)
- G Froese
- Landesklinikum Mödling, Abteilung Gynäkologie und Geburtshilfe
| | - A Brunner
- Landesklinikum Mödling, Abteilung Gynäkologie und Geburtshilfe
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33
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Lafleur J, Staudigl C, Stonek F, Brunner A, Baminger F, Brunnmayr-Petkin G, Unterrichter V, Tempfer C, Hefler L. Chlamydieninfektionen und Konisation. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1599175] [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: 10/19/2022] Open
Affiliation(s)
- J Lafleur
- Gynäkologisches Tumorzentrum, Ordensklinikum Linz
| | - C Staudigl
- Gynäkologisches Tumorzentrum, Ordensklinikum Linz
| | - F Stonek
- Abteilung für Gynäkologie und Geburtshilfe, LK Weinviertel Mistelbach-Gänserndorf
| | - A Brunner
- Abteilung für Gynäkologie und Geburtshilfe, LK Mödling
| | - F Baminger
- Abteilung für Gynäkologie und Geburtshilfe, KH BHS Ried/Innkreis
| | | | | | - C Tempfer
- Abteilung für Gynäkologie und Geburtshilfe, LK Weinviertel Mistelbach-Gänserndorf
| | - L Hefler
- Gynäkologisches Tumorzentrum, Ordensklinikum Linz
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34
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Pichler R, Gruenbacher G, Culig Z, Brunner A, Fuchs D, Fritz J, Gander H, Rahm A, Thurnher M. Intratumoral Th2 predisposition combines with an increased Th1 functional phenotype in clinical response to intravesical BCG in bladder cancer. Cancer Immunol Immunother 2016; 66:427-440. [PMID: 28005163 PMCID: PMC5359386 DOI: 10.1007/s00262-016-1945-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [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: 07/12/2016] [Accepted: 12/11/2016] [Indexed: 12/11/2022]
Abstract
Th1-type immunity is considered to be required for efficient response to BCG in bladder cancer, although Th2 predisposition of BCG responders has recently been reported. The aim was to evaluate the relationship of Th1 and Th2 components in 23 patients undergoing BCG treatment. Peripheral blood, serum and urine samples were prospectively collected at baseline, during and after BCG. Th1 (neopterin, tryptophan, kynurenine, kynurenine-to-tryptophan ratio (KTR), IL-12, IFN-γ, soluble TNF-R75 and IL-2Rα) and Th2 (IL-4, IL-10) biomarkers as well as CD4 expression in T helper (Th), effector and regulatory T cells were determined. Local immune cell subsets were measured on formalin-fixed, paraffin-embedded cancer tissue by immunohistochemistry to examine expression of transcription factors that control Th1 (T-bet) and Th2-type (GATA3) immunity. We confirmed a Th2 predisposition with a mean GATA3/T-bet ratio of 5.51. BCG responders showed significantly higher levels of urinary (p = 0.003) and serum neopterin (p = 0.012), kynurenine (p = 0.015), KTR (p = 0.005), IFN-γ (p = 0.005) and IL-12 (p = 0.003) during therapy, whereas levels of IL-10 decreased significantly (p < 0.001) compared to non-responders. GATA3/T-bet ratio correlated positively with serum neopterin (p = 0.008), IFN-γ (p = 0.013) and KTR (p = 0.018) after the first BCG instillation. We observed a significant increase in CD4 expression in the Th cell population (p < 0.05), with only a modest tendency toward higher frequency in responders compared to non-responders (p = 0.303). The combined assessment of GATA3/T-bet ratio, neopterin and KTR may be a useful biomarker in predicting BCG response. Th2-promoting factors such as GATA3 may trigger Th1-type immune responses and thus contribute to the BCG success.
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Affiliation(s)
- Renate Pichler
- Department of Urology, Research Group of Urologic Oncology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
| | - Georg Gruenbacher
- Department of Urology, Research Group of Urologic Oncology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.,Immunotherapy Research Unit, Medical University of Innsbruck, Innsbruck, Austria
| | - Zoran Culig
- Department of Urology, Research Group of Urologic Oncology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.,Division of Experimental Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - Andrea Brunner
- Division of General Pathology, Department of Pathology, Medical University of Innsbruck, Innsbruck, Austria
| | - Dietmar Fuchs
- Division of Biological Chemistry, Biocenter, Medical University of Innsbruck, Innsbruck, Austria
| | - Josef Fritz
- Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Innsbruck, Austria
| | - Hubert Gander
- Department of Urology, Research Group of Urologic Oncology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.,Immunotherapy Research Unit, Medical University of Innsbruck, Innsbruck, Austria
| | - Andrea Rahm
- Department of Urology, Research Group of Urologic Oncology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.,Immunotherapy Research Unit, Medical University of Innsbruck, Innsbruck, Austria
| | - Martin Thurnher
- Department of Urology, Research Group of Urologic Oncology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.,Immunotherapy Research Unit, Medical University of Innsbruck, Innsbruck, Austria
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Zelle-Rieser C, Thangavadivel S, Biedermann R, Brunner A, Stoitzner P, Willenbacher E, Greil R, Jöhrer K. T cells in multiple myeloma display features of exhaustion and senescence at the tumor site. J Hematol Oncol 2016; 9:116. [PMID: 27809856 PMCID: PMC5093947 DOI: 10.1186/s13045-016-0345-3] [Citation(s) in RCA: 191] [Impact Index Per Article: 23.9] [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: 08/19/2016] [Accepted: 10/18/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Multiple myeloma is an incurable plasma cell malignancy that is mostly restricted to the bone marrow. Cancer-induced dysfunction of cytotoxic T cells at the tumor site may be responsible for immune evasion and therapeutical failure of immunotherapies. Therefore, enhanced knowledge about the actual status of T cells in myeloma bone marrow is urgently needed. Here, we assessed the expression of inhibitory molecules PD-1, CTLA-4, 2B4, CD160, senescence marker CD57, and CD28 on T cells of naive and treated myeloma patients in the bone marrow and peripheral blood and collected data on T cell subset distribution in both compartments. In addition, T cell function concerning proliferation and expression of T-bet, IL-2, IFNγ, and CD107a was investigated after in vitro stimulation by CD3/CD28. Finally, data was compared to healthy, age-matched donor T cells from both compartments. METHODS Multicolor flow cytometry was utilized for the analyses of surface molecules, intracellular staining of cytokines was also performed by flow cytometry, and proliferation was assessed by 3H-thymidine incorporation. Statistical analyses were performed utilizing unpaired T test and Mann-Whitney U test. RESULTS We observed enhanced T cell exhaustion and senescence especially at the tumor site. CD8+ T cells expressed several molecules associated with T cell exhaustion (PD-1, CTLA-4, 2B4, CD160) and T cell senescence (CD57, lack of CD28). This phenotype was associated with lower proliferative capacity and impaired function. Despite a high expression of the transcription factor T-bet, CD8+ T cells from the tumor site failed to produce IFNγ after CD3/CD28 in vitro restimulation and displayed a reduced ability to degranulate in response to T cell stimuli. Notably, the percentage of senescent CD57+CD28- CD8+ T cells was significantly lower in treated myeloma patients when compared to untreated patients. CONCLUSIONS T cells from the bone marrow of myeloma patients were more severely impaired than peripheral T cells. While our data suggest that terminally differentiated cells are preferentially deleted by therapy, immune-checkpoint molecules were still present on T cells supporting the potential of checkpoint inhibitors to reactivate T cells in myeloma patients in combination therapies. However, additional avenues to restore anti-myeloma T cell responses are urgently needed.
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Affiliation(s)
| | | | - Rainer Biedermann
- Department of Orthopedic Surgery, Medical University of Innsbruck, Anichstraße 35, Innsbruck, Austria
| | - Andrea Brunner
- Department of Pathology, Medical University of Innsbruck, Müllerstraße 44, Innsbruck, Austria
| | - Patrizia Stoitzner
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Anichstraße 35, Innsbruck, Austria
| | - Ella Willenbacher
- Department of Internal Medicine V, Medical University of Innsbruck, Anichstraße 35, Innsbruck, Austria
| | - Richard Greil
- Tyrolean Cancer Research Institute, Innrain 66, 6020, Innsbruck, Austria.,Salzburg Cancer Research Institute (SCRI), Müllner Hauptstraße 48, 5020, Salzburg, Austria.,Third Medical Department at The Paracelsus Medical University Salzburg, Müllner Hauptstraße 48, Salzburg, Austria
| | - Karin Jöhrer
- Tyrolean Cancer Research Institute, Innrain 66, 6020, Innsbruck, Austria.
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Webb BJ, Brunner A, Ford CD, Gazdik MA, Petersen FB, Hoda D. Fecal microbiota transplantation for recurrent Clostridium difficile infection in hematopoietic stem cell transplant recipients. Transpl Infect Dis 2016; 18:628-33. [PMID: 27214585 DOI: 10.1111/tid.12550] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 03/16/2016] [Accepted: 03/27/2016] [Indexed: 12/12/2022]
Abstract
Recurrent Clostridium difficile infection (CDI) is a consequence of intestinal dysbiosis and is particularly common following hematopoietic stem cell transplantation (HSCT). Fecal microbiota transplantation (FMT) is an effective method of treating CDI by correcting intestinal dysbiosis by passive transfer of healthy donor microflora. FMT has not been widely used in immunocompromised patients, including HSCT recipients, owing to concern for donor-derived infection. Here, we describe initial results of an FMT program for CDI at a US HSCT center. Seven HSCT recipients underwent FMT between February 2015 and February 2016. Mean time post HSCT was 635 days (25-75 interquartile range [IQR] 38-791). Five of the patients (71.4%) were on immunosuppressive therapy at FMT; 4 had required long-term suppressive oral vancomycin therapy because of immediate recurrence after antibiotic cessation. Stool donors underwent comprehensive health and behavioral screening and laboratory testing of serum and stool for 32 potential pathogens. FMT was administered via the naso-jejunal route in 6 of the 7 patients. Mean follow-up was 265 days (IQR 51-288). Minor post-FMT adverse effects included self-limited bloating and urgency. One patient was suspected of having post-FMT small intestinal bacterial overgrowth. No serious adverse events were noted and all-cause mortality was 0%. Six of 7 (85.7%) patients had no recurrence; 1 patient recurred at day 156 post FMT after taking an oral antibiotic and required repeat FMT, after which no recurrence has occurred. Diarrhea was improved in all patients and 1 patient with gastrointestinal graft-versus-host disease was able to taper off systemic immunosuppression after FMT. With careful donor selection and laboratory screening, FMT appears to be a safe and effective therapy for CDI in HSCT patients and may confer additional benefits. Larger studies are necessary to confirm safety and efficacy and explore other possible effects.
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Affiliation(s)
- B J Webb
- Division of Epidemiology and Infectious Diseases, Intermountain Healthcare, Salt Lake City, Utah, USA
| | - A Brunner
- Intermountain Acute Leukemia/Blood and Marrow Transplant Program, LDS Hospital, Salt Lake City, Utah, USA
| | - C D Ford
- Intermountain Acute Leukemia/Blood and Marrow Transplant Program, LDS Hospital, Salt Lake City, Utah, USA
| | - M A Gazdik
- Division of Epidemiology and Infectious Diseases, Intermountain Healthcare, Salt Lake City, Utah, USA
| | - F B Petersen
- Intermountain Acute Leukemia/Blood and Marrow Transplant Program, LDS Hospital, Salt Lake City, Utah, USA
| | - D Hoda
- Intermountain Acute Leukemia/Blood and Marrow Transplant Program, LDS Hospital, Salt Lake City, Utah, USA
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Almanzar G, Mayerl C, Seitz JC, Höfner K, Brunner A, Wild V, Jahn D, Geier A, Fassnacht M, Prelog M. Expression of 11beta-hydroxysteroid-dehydrogenase type 2 in human thymus. Steroids 2016; 110:35-40. [PMID: 27025972 DOI: 10.1016/j.steroids.2016.03.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 09/08/2015] [Revised: 03/18/2016] [Accepted: 03/22/2016] [Indexed: 01/10/2023]
Abstract
11beta-hydroxysteroid-dehydrogenase type 2 (11β-HSD2) is a high affinity dehydrogenase which rapidly inactivates physiologically-active glucocorticoids to protect key tissues. 11β-HSD2 expression has been described in peripheral cells of the innate and the adaptive immune system as well as in murine thymus. In absence of knowledge of 11β-HSD2 expression in human thymus, the study aimed to localize 11β-HSD2 in human thymic tissue. Thymic tissue was taken of six healthy, non-immunologically impaired male infants below 12months of age with congenital heart defects who had to undergo correction surgery. 11β-HSD2 protein expression was analyzed by immunohistochemistry and Western blot. Kidney tissue, peripheral blood mononuclear cells (PBMCs) and human umbilical vein endothelial cells (HUVEC) were taken as positive controls. Significant expression of 11β-HSD2 protein was found at single cell level in thymus parenchyma, at perivascular sites of capillaries and small vessels penetrating the thymus lobuli and within Hassall's bodies. The present study demonstrates that 11β-HSD2 is expressed in human thymus with predominant perivascular expression and also within Hassall's bodies. To our knowledge, this is the first report confirming 11β-HSD2 expression at the protein level in human thymic tissue underlining a potential role of this enzyme in regulating glucocorticoid function at the thymic level.
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Affiliation(s)
- Giovanni Almanzar
- Department of Pediatrics, University Hospital Wuerzburg, Josef-Schneider-Str. 2, 97080 Wuerzburg, Germany
| | - Christina Mayerl
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria
| | - Jan-Christoph Seitz
- Department of Pediatrics, University Hospital Wuerzburg, Josef-Schneider-Str. 2, 97080 Wuerzburg, Germany
| | - Kerstin Höfner
- Department of Pediatrics, University Hospital Wuerzburg, Josef-Schneider-Str. 2, 97080 Wuerzburg, Germany
| | - Andrea Brunner
- Department of Pathology, Medical University Innsbruck, Muellerstr. 41, 6020 Innsbruck, Austria
| | - Vanessa Wild
- Institute of Pathology, University of Wuerzburg, and Comprehensive Cancer Center Mainfranken, Josef-Schneider-Str. 2, 97080 Wuerzburg, Germany
| | - Daniel Jahn
- Department of Internal Medicine II, University Hospital Wuerzburg, Josef-Schneider-Str. 2, 97080 Wuerzburg, Germany
| | - Andreas Geier
- Department of Internal Medicine II, University Hospital Wuerzburg, Josef-Schneider-Str. 2, 97080 Wuerzburg, Germany
| | - Martin Fassnacht
- Department of Internal Medicine I, University Hospital Wuerzburg, Josef-Schneider-Str. 2, 97080 Wuerzburg, Germany
| | - Martina Prelog
- Department of Pediatrics, University Hospital Wuerzburg, Josef-Schneider-Str. 2, 97080 Wuerzburg, Germany.
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Willenbacher W, Thangavadivel S, Greil R, Willenbacher E, Weger R, Manzl C, Jöhrer K, Brunner A. Low Beclin-1 expression predicts improved overall survival in patients treated with immunomodulatory drugs for multiple myeloma and identifies autophagy inhibition as a promising potentially druggable new therapeutic target: an analysis from The Austrian Myeloma Registry (AMR). Leuk Lymphoma 2016; 57:2330-41. [DOI: 10.3109/10428194.2016.1144880] [Citation(s) in RCA: 4] [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: 01/04/2023]
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39
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Raulot L, Mione G, Hoffmann C, Bracard S, Braun M, Brunner A, Vezain A, Langard S, Lesage F, Durupt L, Richard S. Intravenous thrombolytic therapy for ischemic stroke via telemedicine compared with bedside treatment in an experienced stroke unit. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.eurtel.2015.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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40
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Willenbacher W, Willenbacher E, Zelle-Rieser C, Biedermann R, Weger R, Jöhrer K, Brunner A. Bone marrow microenvironmental CD4 + and CD8 + lymphocyte infiltration patterns define overall- and progression free survival in standard risk multiple myeloma--an analysis from the Austrian Myeloma Registry. Leuk Lymphoma 2015; 57:1478-81. [PMID: 26413883 DOI: 10.3109/10428194.2015.1099646] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Wolfgang Willenbacher
- a Internal Medicine V - Hematology and Oncology , Medical University of Innsbruck , Innsbruck , Austria ;,b Area 4 Health Technology Assessment and Bioinformatics, ONCOTYROL - Center for Personalized Cancer Medicine , Innsbruck , Austria
| | - Ella Willenbacher
- a Internal Medicine V - Hematology and Oncology , Medical University of Innsbruck , Innsbruck , Austria
| | | | - Rainer Biedermann
- d Department of Orthopedic Surgery , Medical University of Innsbruck , Innsbruck , Austria
| | - Roman Weger
- b Area 4 Health Technology Assessment and Bioinformatics, ONCOTYROL - Center for Personalized Cancer Medicine , Innsbruck , Austria
| | - Karin Jöhrer
- c Tyrolean Cancer Research Institute , Innsbruck , Austria
| | - Andrea Brunner
- e Department of Pathology, Division of General Pathology , Medical University of Innsbruck , Innsbruck , Austria
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41
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Willenbacher E, Willenbacher W, Zeller-Riese C, Biedermann R, Weger R, Joehrer K, Brunner A. Bone marrow micro-environmental CD4+ and CD8+ lymphocyte infiltration patterns significantly define overall- and progression free survival in standard risk multiple myeloma: An analysis from the Austrian Myeloma Registry (AMR). J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e19530] [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
Affiliation(s)
| | | | | | - Rainer Biedermann
- Medical University of Innsbruck, Department of Orthopedic Surgery, Innsbruck, Austria
| | - Roman Weger
- ONCOTYROL - Center for Personalized Cancer Medicine, Area 4 Health Technology Assessment and Bioinformatics, Innsbruck, Austria
| | - Karin Joehrer
- Tyrolean Cancer Research Institute (TCRI), Innsbruck, Austria
| | - Andrea Brunner
- Medical University of Innsbruck, Department of Pathology, Division of General Pathology, Innsbruck, Austria
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42
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Prelog M, Schiefecker D, Fille M, Brunner A, Bernd Zimmerhackl L. Acute Nosocomial Urinary Tract Infection in Children. Infect Control Hosp Epidemiol 2015; 28:1019-23. [PMID: 17620256 DOI: 10.1086/519209] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2006] [Accepted: 02/08/2007] [Indexed: 11/03/2022]
Abstract
The spectrum and antimicrobial susceptibilities of pathogens causing acute nosocomial urinary tract infection in hospitalized pediatric patients were revealed to be heterogeneous. Therefore, to avoid the failure of empirical antimicrobial therapy in these patients, underlying disease and previous antimicrobial treatment have to be considered.
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Affiliation(s)
- Martina Prelog
- Department of Pediatrics, Innsbruck Medical University, Innsbruck, Austria.
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43
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Kapoun A, O'Reilly E, Cohn A, Bendell J, Smith L, Strickler J, Gluck W, Liu Y, Wallace B, Tam R, Cancilla B, Brunner A, Hill D, Zhou L, Dupont J, Zhang C, Wang M. 465 Biomarker analysis in Phase 1b study of anti-cancer stem cell antibody Tarextumab (TAR) in combination with nab-paclitaxel and gemcitabine (Nab-P+Gem) demonstrates pharmacodynamic (PD) modulation of the Notch pathway in patients (pts) with untreated metastatic pancreatic cancer (mPC). Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70591-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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44
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Brunner A, Stäuber F, Göhler S, Czepa D, Wendel M, Seuser A, Hilberg T. Impact of joint status on contraction steadiness of m. quadriceps femoris in people with severe haemophilia. Haemophilia 2014; 20:884-90. [DOI: 10.1111/hae.12493] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2014] [Indexed: 12/19/2022]
Affiliation(s)
- A. Brunner
- Department of Sports Medicine; University of Wuppertal; Wuppertal Germany
| | - F. Stäuber
- Department of Sports Medicine; University of Wuppertal; Wuppertal Germany
| | - S. Göhler
- Department of Sports Medicine; University of Wuppertal; Wuppertal Germany
| | - D. Czepa
- Department of Sports Medicine; University of Wuppertal; Wuppertal Germany
| | - M. Wendel
- Institute of Motion Analysis and Quality Control of the Locomotive System; Bonn Germany
| | - A. Seuser
- Institute of Motion Analysis and Quality Control of the Locomotive System; Bonn Germany
| | - T. Hilberg
- Department of Sports Medicine; University of Wuppertal; Wuppertal Germany
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45
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Spilka R, Ernst C, Bergler H, Rainer J, Flechsig S, Vogetseder A, Lederer E, Benesch M, Brunner A, Geley S, Eger A, Bachmann F, Doppler W, Obrist P, Haybaeck J. eIF3a is over-expressed in urinary bladder cancer and influences its phenotype independent of translation initiation. Cell Oncol (Dordr) 2014; 37:253-67. [PMID: 25070653 DOI: 10.1007/s13402-014-0181-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2014] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The eukaryotic translation initiation factor (eIF) 3a, the largest subunit of the eIF3 complex, is a key functional entity in ribosome establishment and translation initiation. In the past, aberrant eIF3a expression has been linked to the pathology of various cancer types but, so far, its expression has not been investigated in transitional cell carcinomas. Here, we investigated the impact of eIF3 expression on urinary bladder cancer (UBC) cell characteristics and UBC patient survival. METHODS AND RESULTS eIF3a expression was reduced through inducible knockdown in the UBC-derived cell lines RT112, T24, 5637 and HT1197. As a consequence of eIF3a down-regulation, UBC cell proliferation, clonogenic potential and motility were found to be decreased and, concordantly, UBC tumour cell growth rates were found to be impaired in xenotransplanted mice. Polysomal profiling revealed that reduced eIF3a levels increased the abundance of 80S ribosomes, rather than impairing translation initiation. Microarray-based gene expression and ontology analyses revealed broad effects of eIF3a knockdown on the transcriptome. Analysis of eIF3a expression in primary formalin-fixed paraffin embedded UBC samples of 198 patients revealed that eIF3a up-regulation corresponds to tumour grade and that high eIF3a expression corresponds to longer overall survival rates of patients with low grade tumours. CONCLUSIONS From our results we conclude that eIF3a expression may have a profound effect on the UBC phenotype and, in addition, may serve as a prognostic marker for low grade UBCs.
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Affiliation(s)
- Rita Spilka
- Laboratory of Pathology Dr. Obrist & Dr. Brunhuber OG, Klostergasse 1, 6511, Zams, Tyrol, Austria,
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Pichler R, Heidegger I, Brunner A, Steiner H. Long-term follow-up of a primary teratoma with somatic-type malignancy within the thyroid gland mimicking thyroid carcinoma. Clin Genitourin Cancer 2014; 12:e221-4. [PMID: 25088747 DOI: 10.1016/j.clgc.2014.03.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 03/28/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Renate Pichler
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - Isabel Heidegger
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - Andrea Brunner
- Division of General Pathology, Department of Pathology, Medical University of Innsbruck, Innsbruck, Austria
| | - Hannes Steiner
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria.
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Bouvier M, Brunner A, Aime F. Arrosage nocturne des rues et effets induits sur le rafraîchissement ambiant en cas de canicule. ACTA ACUST UNITED AC 2014. [DOI: 10.1051/tsm/201312043] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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48
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Pircher A, Verdorfer I, Brunner A, Hopfinger G, Steurer M. Paraneoplastic phenomena and diagnostic challenges in angioimmunoblastic T-cell lymphoma (AITL): report of two cases and review of the literature. In Vivo 2014; 28:327-332. [PMID: 24815834] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Angioimmunoblastic T-cell lymphoma (AITL) is an aggressive subtype of peripheral T-cell lymphoma with unique clinical, pathological and genetic features. Clinical diagnosis is often hampered as typical lymphoma-associated symptoms may not be found at the time of first presentation and only occur later during disease progression. However, as AITL leads to a de-regulated immune system, various paraneoplastic syndromes or autoimmune reactions may represent the first clinical signs, resulting in delayed diagnosis and treatment. CASE REPORT We herein describe two AITL cases characterized by a fatal clinical course and the occurrence of unusual paraneoplastic phenomena, including fluid retention and disseminated intravascular coagulation, respectively. Despite multiple diagnostic procedures, both patients died of rapid disease progression and definitive diagnoses could only be established post-mortem. CONCLUSION These cases underscore the complex diagnostic challenges of AITL and illustrate the requirement for careful clinical evaluation and prompt integration of different diagnostic parameters, including immunohistochemistry, flow cytometry, conventional cytogenetics and molecular genetics, to enable adequate and prompt therapeutic interventions.
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Affiliation(s)
- Andreas Pircher
- Department of Internal Medicine V, Medical University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria.
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Stäuber F, Brunner A, Czepa D, Krüger S, Wendel M, Seuser A, Hilberg T, Göhler S. Altersabhängige Ansteuerung der Muskulatur im Stand bei Patienten mit Hämophilie. Hamostaseologie 2014; 34 Suppl 1:S36-42. [DOI: 10.5482/hamo-14-02-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 09/17/2014] [Indexed: 11/05/2022] Open
Abstract
SummaryThe haemophilic arthropathy affects the function of the knee joint muscles. The aim of this study was to investigate the myoelectrical signal of knee joint muscles in different age stages during upright standing. Surface EMG (SEMG) amplitudes of quadriceps, hamstrings and gastrocnemii were measured in 191 patients with severe haemophilia A (n=164) and B (n=27) while standing on an even surface. After an age-based classification of patients into the subgroups HA: 17–29 (n = 37), HB: 30–39 (n = 50), HC: 40–49 (n = 61), HD: 50–70 in years (n = 43) the clinical WFH score for the ankle and knee joint was determined. To normalize the SEMG values amplitude ratios (percentage of cumulated activity) were calculated with respect to the specific limb. With increasing age, the patient showed descriptively a deterioration of the joint situation. The extensors of the knee joint reached significantly higher absolute and percentage levels in the muscle activity with increasing age (p < 0.05). The absolute amplitude values of the Mm. gastrocnemii showed no differences in the age groups while the relative levels were decreased.The present study shows that patients with increasing age and degree of haemophilic arthro pathy deve lop a modified control strategy during upright standing, in the form of a shift from the plantar flexors to the extensors of the knee joint.
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Dittmar M, Bigalke M, Brunner A, Hannewald W, Honig D, Honig M, Kiener W, Kopf H, Schmidt T, Seeliger J, Birkholz T. Ein regional angepasstes Vorgehen zur Vorsichtung und Sichtungskennzeichnung beim Massenanfall von Verletzten. Notarzt 2013. [DOI: 10.1055/s-0033-1349617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- M. Dittmar
- Klinik für Anästhesiologie, Universitätsklinikum Regensburg (Direktor: Prof. Dr. B. Graf, MS)
| | - M. Bigalke
- Ärztlicher Leiter Rettungsdienst, Rettungsdienstbereich Amberg
| | - A. Brunner
- Arbeiter-Samariter-Bund, Regionalverband Jura
| | - W. Hannewald
- Bayerisches Rotes Kreuz, Kreisverband Schwandorf
| | - D. Honig
- Bayerisches Rotes Kreuz, Kreisverband Amberg-Sulzbach
| | - M. Honig
- Bayerisches Rotes Kreuz, Kreisverband Amberg-Sulzbach
| | - W. Kiener
- Johanniter-Unfall-Hilfe, Regionalverband Ostbayern
| | - H. Kopf
- Bayerisches Rotes Kreuz, Kreisverband Schwandorf
| | - T. Schmidt
- Bayerisches Rotes Kreuz, Kreisverband Schwandorf
| | - J. Seeliger
- Bayerisches Rotes Kreuz, Kreisverband Schwandorf
| | - T. Birkholz
- Ärztlicher Leiter Rettungsdienst, Rettungsdienstbereich Amberg
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