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Beau-Lejdstrom R, Hong LS, Garcia de Albeniz X, Floricel F, Lorenzen J, Bonfitto F, Kalilani L, Loesch C, Luscombe G, Perez-Gutthann S, Mottet I, Foskett N. Incidence of Acute Renal Failure in Patients Using Levetiracetam Versus Other Antiseizure Medications: A Voluntary Post-Authorization Safety Study. Drug Saf 2022; 45:781-790. [PMID: 35761158 DOI: 10.1007/s40264-022-01193-0] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Acute kidney injury is an expected adverse drug reaction listed in the European Union (EU) Summary of Product Characteristics (SmPC) for levetiracetam, one of the most widely used modern antiseizure medications (ASMs). OBJECTIVE We conducted a voluntary post-authorization safety study to characterize the rate of acute renal failure (ARF) in patients exposed to levetiracetam versus other ASMs. METHODS New users of ASMs without prior renal dysfunction were identified and followed for 30 days in the IBM® MarketScan® database (USA, January 2008-December 2017). ARF was defined as a diagnosis on inpatient or emergency department claims. We estimated adjusted incidence rates, incidence rate ratios (IRRs), and incidence rate differences (IRDs) of ARF in patients initiating levetiracetam versus other ASMs. RESULTS Overall, 110,336 patients were eligible for the monotherapy cohort and 96,215 were eligible for the polytherapy cohort. The overall crude rate of ARF following a new ASM was 6.0 and 6.5 per 10,000 patients for the 'monotherapy' and 'polytherapy' cohorts, respectively, in the first 30 days after the index date. In the monotherapy cohort, the IRR for ARF was 1.37 (95% confidence interval [CI] 0.80-2.34) and the corresponding IRD was 2.0 (95% CI - 1.12 to 5.12) additional ARFs per 10,000 patient-months. In the polytherapy cohort, the adjusted IRR for ARF was 0.94 (95% CI 0.51-1.74) and the corresponding IRD was - 0.42 cases per 10,000 patient-months (95% CI - 4.01 to 3.17). CONCLUSIONS The rate of ARFs in ASM new users was very low. In patients without prior ASMs, the estimated difference in risk of ARF associated with initiation of levetiracetam versus initiation of other ASMs was small, with 95% CIs compatible with small protective or harmful effects. In patients receiving polytherapy, the difference was compatible with the null and the 95% CI with small protective or harmful effects.
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von Stillfried S, Freeborn B, Windeck S, Boor P, Böcker J, Schmidt J, Tholen P, Röhrig R, Majeed R, Wienströer J, Bremer J, Weis J, Knüchel R, Breitbach A, Bülow RD, Cacchi C, Wucherpfennig S, Märkl B, Claus R, Dhillon C, Schaller T, Sipos E, Spring O, Braun G, Römmele C, Kling E, Kröncke T, Wittmann M, Hirschbühl K, Heppner FL, Meinhardt J, Radbruch H, Streit S, Horst D, Elezkurtaj S, Quaas A, Göbel H, Friemann J, Hansen T, Titze U, Lorenzen J, Reuter T, Woloszyn J, Baretton G, Hilsenbeck J, Meinhardt M, Pablik J, Sommer L, Holotiuk O, Meinel M, Esposito I, Crudele G, Seidl M, Mahlke N, Hartmann A, Haller F, Eichhorn P, Lange F, Amann KU, Coras R, Ingenwerth M, Rawitzer J, Schmid KW, Theegarten D, Gradhand E, Smith K, Wild P, Birngruber CG, Schilling O, Werner M, Acker T, Gattenlöhner S, Franz J, Metz I, Stadelmann C, Stork L, Thomas C, Zechel S, Ströbel P, Fathke C, Harder A, Wickenhauser C, Glatzel M, Matschke J, Krasemann S, Dietz E, Edler C, Fitzek A, Fröb D, Heinemann A, Heinrich F, Klein A, Kniep I, Lohner L, Möbius D, Ondruschka B, Püschel K, Schädler J, Schröder AS, Sperhake JP, Aepfelbacher M, Fischer N, Lütgehetmann M, Pfefferle S, Jonigk D, Werlein C, Domke LM, Hartmann L, Klein I, Schirmacher P, Schwab C, Röcken C, Langer D, Roth W, Strobl S, Rudelius M, Delbridge C, Kasajima A, Kuhn PH, Slotta-Huspenina J, Weichert W, Weirich G, Stock K, Barth P, Schnepper A, Wardelmann E, Evert K, Evert M, Büttner A, Manhart J, Nigbur S, Bösmüller H, Fend F, Granai M, Klingel K, Warm V, Steinestel K, Umathum VG, Rosenwald A, Vogt N, Kurz F. [Update on collaborative autopsy-based research in German pathology, neuropathology, and forensic medicine]. Pathologie (Heidelb) 2022; 43:101-105. [PMID: 36114379 PMCID: PMC9483541 DOI: 10.1007/s00292-022-01117-w] [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] [Subscribe] [Scholar Register] [Accepted: 08/30/2022] [Indexed: 01/02/2023]
Abstract
BACKGROUND Autopsies are a valuable tool for understanding disease, including COVID-19. MATERIALS AND METHODS The German Registry of COVID-19 Autopsies (DeRegCOVID), established in April 2020, serves as the electronic backbone of the National Autopsy Network (NATON), launched in early 2022 following DEFEAT PANDEMIcs. RESULTS The NATON consortium's interconnected, collaborative autopsy research is enabled by an unprecedented collaboration of 138 individuals at more than 35 German university and non-university autopsy centers through which pathology, neuropathology, and forensic medicine autopsy data including data on biomaterials are collected in DeRegCOVID and tissue-based research and methods development are conducted. More than 145 publications have now emerged from participating autopsy centers, highlighting various basic science and clinical aspects of COVID-19, such as thromboembolic events, organ tropism, SARS-CoV‑2 detection methods, and infectivity of SARS-CoV-2 at autopsy. CONCLUSIONS Participating centers have demonstrated the high value of autopsy and autopsy-derived data and biomaterials to modern medicine. The planned long-term continuation and further development of the registry and network, as well as the open and participatory design, will allow the involvement of all interested partners.
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Affiliation(s)
- Saskia von Stillfried
- Institut für Pathologie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland
| | - Benita Freeborn
- Institut für Pathologie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland
| | - Svenja Windeck
- Institut für Pathologie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland
| | - Peter Boor
- Institut für Pathologie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland ,Medizinische Klinik II (Nephrologie und Immunologie), Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland ,Elektronenmikroskopische Einrichtung, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland
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Kitavi M, Cashell R, Ferguson M, Lorenzen J, Nyine M, McKeown PC, Spillane C. Heritable epigenetic diversity for conservation and utilization of epigenetic germplasm resources of clonal East African Highland banana (EAHB) accessions. Theor Appl Genet 2020; 133:2605-2625. [PMID: 32719910 PMCID: PMC7419381 DOI: 10.1007/s00122-020-03620-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 05/20/2020] [Indexed: 05/22/2023]
Abstract
KEY MESSAGE Genetically identical East African Highland banana (EAHB) clones are epigenetically diverse with heritable epialleles that can contribute to morphological diversity. Heritable epigenetic variation can contribute to agronomic traits in crops and should be considered in germplasm conservation. Despite the genetic uniformity arising from a genetic bottleneck of one ancestral clone, followed by subsequent vegetative propagation, East African Highland bananas (EAHBs) display significant phenotypic diversity potentially arising from somatic mutations, heritable epialleles and/or genotype-by-environment interactions. Here, we use DNA methylation profiling across EAHB accessions representing most of the primary EAHB genepool to demonstrate that the genetically uniform EAHB genepool harbours significant epigenetic diversity. By analysing 724 polymorphic DNA methylation sites by methylation-sensitive AFLP across 90 EAHB cultivars, we could differentiate the EAHB varieties according to their regions (Kenya and Uganda). In contrast, there was minimal association of DNA methylation variation with the five morphological groups that are used to classify EAHBs. We further analysed DNA methylation patterns in parent-offspring cohort, which were maintained in offspring generated by sexual (seed) and asexual (vegetative) propagation, with higher levels of altered DNA methylation observed in vegetatively generated offspring. Our results indicate that the phenotypic diversity of near-isogenic EAHBs is mirrored by considerable DNA methylation variation, which is transmitted between generations by both vegetative reproduction and seed reproduction. Genetically uniform vegetatively propagated crops such as EAHBs harbour considerable heritable epigenetic variation, where heritable epialleles could arise in offspring and contribute to functional traits. This study provides a basis for developing strategies for conservation of epigenetic resources and for integration of epimarkers into crop breeding programmes.
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Affiliation(s)
- M Kitavi
- Genetics and Biotechnology Lab, Plant and AgriBiosciences Research Centre (PABC), Ryan Institute, National University of Ireland Galway, University Road, Galway, H91 REW4, Ireland
- International Institute for Tropical Agriculture (IITA), P.O. Box 30709-00100, Nairobi, Kenya
| | - R Cashell
- Genetics and Biotechnology Lab, Plant and AgriBiosciences Research Centre (PABC), Ryan Institute, National University of Ireland Galway, University Road, Galway, H91 REW4, Ireland
| | - M Ferguson
- International Institute for Tropical Agriculture (IITA), P.O. Box 30709-00100, Nairobi, Kenya
| | - J Lorenzen
- International Institute for Tropical Agriculture (IITA), P.O. Box 30709-00100, Nairobi, Kenya
- Crop R&D, Agricultural Development, Bill & Melinda Gates Foundation, PO Box 23350, Seattle, WA, 98102, USA
| | - M Nyine
- International Institute for Tropical Agriculture (IITA), P.O. Box 30709-00100, Nairobi, Kenya
| | - P C McKeown
- Genetics and Biotechnology Lab, Plant and AgriBiosciences Research Centre (PABC), Ryan Institute, National University of Ireland Galway, University Road, Galway, H91 REW4, Ireland
| | - C Spillane
- Genetics and Biotechnology Lab, Plant and AgriBiosciences Research Centre (PABC), Ryan Institute, National University of Ireland Galway, University Road, Galway, H91 REW4, Ireland.
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Dücker P, Hüning S, Rohde S, Lorenzen J, Nashan D. [Merkel cell carcinoma in chronic lymphocytic leukemia : Successful treatment with PD-L 1 inhibition, avelumab and chlorambucil]. Hautarzt 2020; 71:553-556. [PMID: 32394077 DOI: 10.1007/s00105-020-04599-y] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We report the case of an 85-year-old chronic lymphocytic leukemia patient with a local metastatic MCVPyV-negative Merkel cell carcinoma at initial diagnosis. Therapy comprised surgical excision and radiotherapy but without lymphadenectomy. Six months after the primary diagnosis, liver metastases were detected. They responded to the PD-L1 inhibitor avelumab for more than 15 months. Thus, we postulate a synergistic effect of combined therapy with chlorambucil and avelumab through a mutual improvement of immune function, from which both diseases benefit.
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Affiliation(s)
- P Dücker
- Klinik für Dermatologie, Klinikum Dortmund, Beurhausstr. 40, 44137, Dortmund, Deutschland.
| | - S Hüning
- Klinik für Dermatologie, Klinikum Dortmund, Beurhausstr. 40, 44137, Dortmund, Deutschland
| | - S Rohde
- Institut für Radiologie und Neuroradiologie, Klinikum Dortmund, 44137, Dortmund, Deutschland
| | - J Lorenzen
- Pathologisches Institut, Klinikum Dortmund, 44137, Dortmund, Deutschland
| | - D Nashan
- Klinik für Dermatologie, Klinikum Dortmund, Beurhausstr. 40, 44137, Dortmund, Deutschland
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Madadi S, Schwarzenbach H, Lorenzen J, Soleimani M. MicroRNA expression studies: challenge of selecting reliable reference controls for data normalization. Cell Mol Life Sci 2019; 76:3497-3514. [PMID: 31089747 PMCID: PMC11105490 DOI: 10.1007/s00018-019-03136-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [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: 03/02/2019] [Revised: 04/13/2019] [Accepted: 05/06/2019] [Indexed: 02/06/2023]
Abstract
Accurate determination of microRNA expression levels is a prerequisite in using these small non-coding RNA molecules as novel biomarkers in disease diagnosis and prognosis. Quantitative PCR is the method of choice for measuring the expression levels of microRNAs. However, a major obstacle that affects the reliability of results is the lack of validated reference controls for data normalization. Various non-coding RNAs have previously been used as reference controls, but their use may lead to variations and lack of comparability of microRNA data among the studies. Despite the growing number of studies investigating microRNA profiles to discriminate between healthy and disease stages, robust reference controls for data normalization have so far not been established. In the present article, we provide an overview of different reference controls used in various diseases, and highlight the urgent need for the identification of suitable reference controls to produce reliable data. Our analysis shows, among others, that RNU6 is not an ideal normalizer in studies using patient material from different diseases. Finally, our article tries to disclose the challenges to find a reference control which is uniformly and stably expressed across all body tissues, fluids, and diseases.
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Affiliation(s)
- Soheil Madadi
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Heidi Schwarzenbach
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Johan Lorenzen
- Department of Nephrology, University Hospital Zürich, Zurich, Switzerland
| | - Meysam Soleimani
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran.
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Lorenzen J, Schenzer-Hoffmann E, Braun C, Lorenzen M, Anders S, Adam G, Püschel K. Todesursachenbestimmung mit verblindeter koronaler Ganzkörper-MRT im Vergleich zur rechtsmedizinischen Untersuchung. Rechtsmedizin (Berl) 2019. [DOI: 10.1007/s00194-019-0329-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kaucsár T, Tod P, Godó M, Lorenzen J, Thum T, Szénási G, Hamar P. FP280FUNCTIONAL INVESTIGATION OF MIR-17-5P INHIBITION IN KIDNEY ISCHEMIA-REPERFUSION INJURY IN MICE. Nephrol Dial Transplant 2019. [DOI: 10.1093/ndt/gfz106.fp280] [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: 11/13/2022] Open
Affiliation(s)
| | - Pál Tod
- Semmelweis University, Budapest, Hungary
| | - Mária Godó
- Semmelweis University, Budapest, Hungary
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Müller-Deile J, Dannenberg J, Liu P, Lorenzen J, Nyström J, Thum T, Schiffer M. Identification of cell and disease specific microRNAs in glomerular pathologies. J Cell Mol Med 2019; 23:3927-3939. [PMID: 30950172 PMCID: PMC6533525 DOI: 10.1111/jcmm.14270] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 11/24/2018] [Revised: 01/31/2019] [Accepted: 02/19/2019] [Indexed: 02/06/2023] Open
Abstract
MicroRNAs (miRs) are small non‐coding RNAs that regulate gene expression in physiological processes as well as in diseases. Currently miRs are already used to find novel mechanisms involved in diseases and in the future, they might serve as diagnostic markers. To identify miRs that play a role in glomerular diseases urinary miR‐screenings are a frequently used tool. However, miRs that are detected in the urine might simply be filtered from the blood stream and could have been produced anywhere in the body, so they might be completely unrelated to the diseases. We performed a combined miR‐screening in pooled urine samples from patients with different glomerular diseases as well as in cultured human podocytes, human mesangial cells, human glomerular endothelial cells and human tubular cells. The miR‐screening in renal cells was done in untreated conditions and after stimulation with TGF‐β. A merge of the detected regulated miRs led us to identify disease‐specific, cell type‐specific and cell stress‐induced miRs. Most miRs were down‐regulated following the stimulation with TGF‐β in all cell types. Up‐regulation of miRs after TGF‐β was cell type‐specific for most miRs. Furthermore, urinary miRs from patients with different glomerular diseases could be assigned to the different renal cell types. Most miRs were specifically regulated in one disease. Only miR‐155 was up‐regulated in all disease urines compared to control and therefore seems to be rather unspecific. In conclusion, a combined urinary and cell miR‐screening can improve the interpretation of screening results. These data are useful to identify novel miRs potentially involved in glomerular diseases.
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Affiliation(s)
- Janina Müller-Deile
- Department of Medicine/Nephrology, Friedrich-Alexander University Erlangen, Erlangen, Germany
| | - Jan Dannenberg
- Department of Medicine/Nephrology, Hannover Medical School, Hannover, Germany
| | - Peidi Liu
- Department of Physiology, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Johan Lorenzen
- Department of Medicine/Nephrology, University of Zurich, Zurich, Switzerland
| | - Jenny Nyström
- Department of Physiology, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Thomas Thum
- Institute of Molecular and Translational Therapeutic Strategies, Hannover Medical School, Hannover, Germany.,REBIRTH Excellence Cluster, Hannover Medical School, Hannover, Germany
| | - Mario Schiffer
- Department of Medicine/Nephrology, Friedrich-Alexander University Erlangen, Erlangen, Germany.,Department of Medicine/Nephrology, Hannover Medical School, Hannover, Germany
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Kölling M, Genschel C, Kaucsar T, Hübner A, Rong S, Schmitt R, Sörensen-Zender I, Haddad G, Kistler A, Seeger H, Kielstein JT, Fliser D, Haller H, Wüthrich R, Zörnig M, Thum T, Lorenzen J. Hypoxia-induced long non-coding RNA Malat1 is dispensable for renal ischemia/reperfusion-injury. Sci Rep 2018; 8:3438. [PMID: 29467431 PMCID: PMC5821887 DOI: 10.1038/s41598-018-21720-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 02/09/2018] [Indexed: 12/27/2022] Open
Abstract
Renal ischemia-reperfusion (I/R) injury is a major cause of acute kidney injury (AKI). Non-coding RNAs are crucially involved in its pathophysiology. We identified hypoxia-induced long non-coding RNA Malat1 (Metastasis Associated Lung Adenocarcinoma Transcript 1) to be upregulated in renal I/R injury. We here elucidated the functional role of Malat1 in vitro and its potential contribution to kidney injury in vivo. Malat1 was upregulated in kidney biopsies and plasma of patients with AKI, in murine hypoxic kidney tissue as well as in cultured and ex vivo sorted hypoxic endothelial cells and tubular epithelial cells. Malat1 was transcriptionally activated by hypoxia-inducible factor 1-α. In vitro, Malat1 inhibition reduced proliferation and the number of endothelial cells in the S-phase of the cell cycle. In vivo, Malat1 knockout and wildtype mice showed similar degrees of outer medullary tubular epithelial injury, proliferation, capillary rarefaction, inflammation and fibrosis, survival and kidney function. Small-RNA sequencing and whole genome expression analysis revealed only minor changes between ischemic Malat1 knockout and wildtype mice. Contrary to previous studies, which suggested a prominent role of Malat1 in the induction of disease, we did not confirm an in vivo role of Malat1 concerning renal I/R-injury.
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Affiliation(s)
- Malte Kölling
- Department of Nephrology, University Hospital, Zürich, Switzerland.,Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany
| | - Celina Genschel
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany
| | | | - Anika Hübner
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany
| | - Song Rong
- Department of Nephrology, Hannover Medical School, Hannover, Germany
| | - Roland Schmitt
- Department of Nephrology, Hannover Medical School, Hannover, Germany
| | | | - George Haddad
- Department of Nephrology, University Hospital, Zürich, Switzerland
| | - Andreas Kistler
- Department of Internal Medicine, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland
| | - Harald Seeger
- Department of Nephrology, University Hospital, Zürich, Switzerland
| | - Jan T Kielstein
- Department of Nephrology, Städtisches Klinikum Braunschweig GmbH, Braunschweig, Germany
| | - Danilo Fliser
- Saarland University Medical Centre, Homburg/Saar, Germany
| | - Hermann Haller
- Department of Nephrology, Hannover Medical School, Hannover, Germany
| | - Rudolf Wüthrich
- Department of Nephrology, University Hospital, Zürich, Switzerland
| | - Martin Zörnig
- Georg-Speyer-Haus, Institute for Tumor Biology and Experimental Therapy, Frankfurt, Germany
| | - Thomas Thum
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany.,National Heart and Lung Institute, Imperial College London, London, UK.,Excellence Cluster REBIRTH, Hannover Medical School, Hannover, Germany
| | - Johan Lorenzen
- Department of Nephrology, University Hospital, Zürich, Switzerland.
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Beese M, Mester J, Brumma K, Beyer W, Clausen M, Lorenzen J. Der Röntgenthorax: Routineindikation in der Nachsorge des differenzierten Schilddrüsenkarzinoms? Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1632322] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Zusammenfassung
Ziel: Anhand einer retrospektiven Untersuchung wurde überprüft, inwieweit der routinemäßige Einsatz des Röntgenthorax auch bei Low-risk-Patienten trotz der hohen Sensitivität des Tumormarkers Thyreoglobulin sinnvoll ist. Methode: Es wurden die Krankengeschichten von 609 Patienten mit einem differenzierten Schilddrüsenkarzinom ausgewertet. Bei 50 Patienten wurde eine pulmonale Metastasierung diagnostiziert. Der Thyreoglobulinwert zum Zeitpunkt der Diagnosestellung der pulmonalen Metastasierung wurde mit dem Befund des Röntgenthorax und der vorhandenen weiteren Diagnostik, wie der lod-131-Ganzkörperszintigraphie und CT des Thorax, soweit vorhanden, verglichen. Ergebnisse: Die gefundene Sensitivität des Röntgenthorax im Nachweis von Lungenmetastasen lag mit 52% unterhalb der Sensitivität der 131 -lod-Ganzkörperszintigraphie (64%), der Thorax-CT (82%) und der Sensitivität des Thyreoglobulins unter Suppressionsbedingungen (86%). Bei Patienten mit papillärem Schilddrüsenkarzinom der Tumorstadien I und II entwickelte nur ein Patient im Verlauf eine Lungenmetastasierung. Der Nachweis von Lungenfiliae nur mit Hilfe des Röntgenthorax bei einem Thyreoglobulinwert unter der Nachweisgrenze ist in einer solchen Low-risk-Gruppe sehr selten (berechnete Wahrscheinlichkeit: 1:4000) und mit erheblichen Kosten verbunden. Schlußfolgerung: Der routinemäßige, lebenslange Einsatz des Röntgenthorax ohne Rezidivverdacht (z. B. Thyreoglobulin positiv) ist für Low-risk-Patienten zu überdenken.
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Buchert R, Schulte U, Lorenzen J, Bohuslavizki KH, Mester J, Clausen M, Bleckmann C. Onko-PET: Bildanalyse mittels Monitor versus standardisierter Filmdokumentation. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1632190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Zusammenfassung
Ziel: Die Wertigkeit einer standardisierten Filmdokumentation in der Beurteilung von 2-[18F]Fluor-2-deoxy-D-Glukose (F-18-FDG) Onko-PET-Untersuchungen sollte untersucht werden. Methoden: 100 Onko-PET-Untersuchungen (ohne Schwächungskorrektur) wurden in Hinblick auf Zahl und Lokalisation malignitätsverdächtiger Läsionen ausgewertet: zum einen mittels standardisierter Filmvorlagen und zum anderen unter zusätzlicher Analyse am Monitor. Die Filmdokumentation beinhaltet erstens transversale Schnitte des Gehirns, zweitens koronale Schnitte und Maximum-intensity-projections (MIPs) sowohl des Kopf-/Halsbereiches als auch drittens des Körperstammes und viertens MIPs der Beine. Bei der Monitorauswertung wurden sämtliche Körperabschnitte in koronaler, transversaler und sagittaler Schnittführung analysiert. Ergebnisse: Insgesamt wurden 315 Läsionen bei 100 Patienten detektiert. Bei 96/100 Untersuchungen fand sich eine Übereinstimmung beider Auswertemethoden in Anzahl und Lokalisation der Läsionen. In der Filmauswertung wurden bei drei Patienten insgesamt sieben Herde in den Beinen übersehen. 9/315 Läsionen in 2/100 Patienten erfuhren durch die zusätzliche Monitorauswertung eine Lokalisationsänderung. Hiervon befanden sich acht der neun Läsionen in den Beinen. Erst nach zusätzlicher Dokumentation der Beine in koronaler Schnittführung wurden sämtliche, in den MIPs übersehene Läsionen detektiert und die topographisch falsch zugeordneten Läsionen konnten konkordant zur Monitorauswertung lokalisiert werden. Bei dieser so ergänzten Filmdokumentation führte die zusätzliche Monitorauswertung zu keiner Detektion weiterer Herde und zu einer klinisch nicht relevanten Lokalisationsänderung von lediglich 1/322 Läsionen. Schlußfolgerung: Die beschriebene, standardisierte Filmdokumentation erlaubt eine Befundung unter nur noch gezieltem Einsatz der Analyse am Monitor. Darüber hinaus entspricht der hier vorgestellte Ansatz den Intentionen der nuklearmedizinischen Arbeitsgemeinschaft Standardisierung, daß auswärtige Voruntersuchungen problemlos in eine Verlaufsbeurteilung einbezogen werden können.
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Wit MD, Buchert R, Igel B, Bohuslavizki KH, Lorenzen J. Granulationsgewebe: Pitfall in der Therapiekontrolle mit F-18-FDG-PET nach Chemotherapie. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1632232] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
ZusammenfassungFDG-Speicherung in Entzündungsherden als Ursache für falsch positive Befunde bei der FDG-PET in der primären Tumor- und Metastasendiagnostik ist in der Literatur belegt. Der vorliegende Fall zeigt, daß die vermehrte Speicherung von FDG in aktivierten neutrophilen Granulozyten und Makrophagen auch in der Therapieverlaufskontrolle unter Chemotherapie zu berücksichtigen ist. Bei einem 52jährigem Patienten wurde eine FDG-PET nach Abschluß der Chemotherapie eines Non-Hodgin-Lymphoms des Abdomens mit der Frage nach verbliebener Tumorvitalität durchgeführt. In der FDG-PET fand sich im Randbereich des persistierenden Restbefundes ein erhöhter Glukosestoffwechsel. Histologisch war dieser Befund auf umgebendes Granulationsgewebe mit zentralen nekrotischen Tumoranteilen zurückzuführen.
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Müller-Deile J, Gellrich F, Schenk H, Schroder P, Nyström J, Lorenzen J, Haller H, Schiffer M. Overexpression of TGF-β Inducible microRNA-143 in Zebrafish Leads to Impairment of the Glomerular Filtration Barrier by Targeting Proteoglycans. Cell Physiol Biochem 2016; 40:819-830. [PMID: 27941332 DOI: 10.1159/000453142] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND TGF-β is known as an important stress factor of podocytes in glomerular diseases. Apart from activation of direct pro-apoptotic pathways we wanted to analyze micro-RNA (miRs) driven regulation of components involved in the integrity of the glomerular filtration barrier induced by TGF-β. Since miR-143-3p (miR-143) is described as a TGF-β inducible miR in other cell types, we examined this specific miR and its ability to induce glomerular pathology. METHODS We analyzed miR-143 expression in cultured human podocytes after stimulation with TGF-β. We also microinjected zebrafish eggs with a miR-143 mimic or with morpholinos specific for its targets syndecan and versican and compared phenotype and proteinuria development. RESULTS We detected a time dependent, TGF-β inducible expression of miR-143 in human podocytes. Targets of miR-143 relevant in glomerular biology are syndecans and versican, which are known components of the glycocalyx. We found that syndecan 1 and 4 were predominantly expressed in podocytes while syndecan 3 was largely expressed in glomerular endothelial cells. Versican could be detected in both cell types. After injection of a miR-143 mimic in zebrafish larvae, syndecan 3, 4 and versican were significantly downregulated. Moreover, miR-143 overexpression or versican knockdown by morpholino caused loss of plasma proteins, edema, podocyte effacement and endothelial damage. In contrast, knockdown of syndecan 3 and syndecan 4 had no effects on glomerular filtration barrier. CONCLUSION Expression of versican and syndecan isoforms is indispensable for proper barrier function. Podocyte-derived miR-143 is a mediator for paracrine and autocrine cross talk between podocytes and glomerular endothelial cells and can alter expression of glomerular glycocalyx proteins.
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Affiliation(s)
- Janina Müller-Deile
- Department of Medicine/Nephrology, Hannover Medical School, Hannover ,Germany
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Busch M, Nadal J, Schmid M, Paul K, Titze S, Hübner S, Köttgen A, Schultheiss UT, Baid-Agrawal S, Lorenzen J, Schlieper G, Sommerer C, Krane V, Hilge R, Kielstein JT, Kronenberg F, Wanner C, Eckardt KU, Wolf G. Glycaemic control and antidiabetic therapy in patients with diabetes mellitus and chronic kidney disease - cross-sectional data from the German Chronic Kidney Disease (GCKD) cohort. BMC Nephrol 2016; 17:59. [PMID: 27286816 PMCID: PMC4902996 DOI: 10.1186/s12882-016-0273-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [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: 10/01/2015] [Accepted: 06/02/2016] [Indexed: 01/08/2023] Open
Abstract
Background Diabetes mellitus (DM) is the leading cause of end-stage renal disease. Little is known about practice patterns of anti-diabetic therapy in the presence of chronic kidney disease (CKD) and correlates with glycaemic control. We therefore aimed to analyze current antidiabetic treatment and correlates of metabolic control in a large contemporary prospective cohort of patients with diabetes and CKD. Methods The German Chronic Kidney Disease (GCKD) study enrolled 5217 patients aged 18–74 years with an estimated glomerular filtration rate (eGFR) between 30–60 mL/min/1.73 m2 or proteinuria >0.5 g/d. The use of diet prescription, oral anti-diabetic medication, and insulin was assessed at baseline. HbA1c, measured centrally, was the main outcome measure. Results At baseline, DM was present in 1842 patients (35 %) and the median HbA1C was 7.0 % (25th–75th percentile: 6.8–7.9 %), equalling 53 mmol/mol (51, 63); 24.2 % of patients received dietary treatment only, 25.5 % oral antidiabetic drugs but not insulin, 8.4 % oral antidiabetic drugs with insulin, and 41.8 % insulin alone. Metformin was used by 18.8 %. Factors associated with an HbA1C level >7.0 % (53 mmol/mol) were higher BMI (OR = 1.04 per increase of 1 kg/m2, 95 % CI 1.02–1.06), hemoglobin (OR = 1.11 per increase of 1 g/dL, 95 % CI 1.04–1.18), treatment with insulin alone (OR = 5.63, 95 % CI 4.26–7.45) or in combination with oral antidiabetic agents (OR = 4.23, 95 % CI 2.77–6.46) but not monotherapy with metformin, DPP-4 inhibitors, or glinides. Conclusions Within the GCKD cohort of patients with CKD stage 3 or overt proteinuria, antidiabetic treatment patterns were highly variable with a remarkably high proportion of more than 50 % receiving insulin-based therapies. Metabolic control was overall satisfactory, but insulin use was associated with higher HbA1C levels. Electronic supplementary material The online version of this article (doi:10.1186/s12882-016-0273-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Martin Busch
- Department of Internal Medicine III, University Hospital Jena - Friedrich Schiller University, Erlanger Allee 101, D - 07747, Jena, Germany.
| | - Jennifer Nadal
- Institute of Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany
| | - Matthias Schmid
- Institute of Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany
| | - Katharina Paul
- Department of Internal Medicine III, University Hospital Jena - Friedrich Schiller University, Erlanger Allee 101, D - 07747, Jena, Germany
| | - Stephanie Titze
- Department of Nephrology and Hypertension, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Silvia Hübner
- Department of Nephrology and Hypertension, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Anna Köttgen
- Department of Internal Medicine IV, Medical Center University of Freiburg, Freiburg, Germany
| | - Ulla T Schultheiss
- Department of Internal Medicine IV, Medical Center University of Freiburg, Freiburg, Germany
| | - Seema Baid-Agrawal
- Department of Medicine, Division of Nephrology and Medical Intensive Care, University Hospital Charité, Berlin, Germany
| | - Johan Lorenzen
- Hannover Medical School, Clinic for Nephrology, Hannover, Germany
| | - Georg Schlieper
- Department of Medicine II - Nephrology and Clinical Immunology, University Hospital Aachen, Aachen, Germany
| | - Claudia Sommerer
- Department of Medicine, Division of Nephrology, University Hospital Heidelberg, Heidelberg, Germany
| | - Vera Krane
- Department of Medicine I, Division of Nephrology, University Hospital Würzburg, Würzburg, Germany
| | - Robert Hilge
- Department of Medicine IV, Division of Nephrology, University Hospital of Ludwig-Maximilians University Munich, Munich, Germany
| | - Jan T Kielstein
- Hannover Medical School, Clinic for Nephrology, Hannover, Germany
| | - Florian Kronenberg
- Division of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph Wanner
- Department of Medicine I, Division of Nephrology, University Hospital Würzburg, Würzburg, Germany
| | - Kai-Uwe Eckardt
- Department of Nephrology and Hypertension, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Gunter Wolf
- Department of Internal Medicine III, University Hospital Jena - Friedrich Schiller University, Erlanger Allee 101, D - 07747, Jena, Germany
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Kaucsár T, Lorenzen J, Godó M, Szénási G, Thum T, Hamar P. SP175SOURCE AND FUNCTION OF MIR-17 IN MURINE KIDNEY ISCHEMIA-REPERFUSION INJURY. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw161.08] [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: 11/14/2022] Open
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Müller-Deile J, Dannenberg J, Schröder P, Lorenzen J, Thum T, Nystrom N, Liu P, Haller H, Schiffer M. SP123MICRO-RNA REGULATED NEPHRONECTIN IS IMPORTANT FOR PODOCYTES AND GLOMERULAR BASEMENT MEMBRANE INTERACTIONS. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw160.04] [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: 11/12/2022] Open
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Schauerte C, Hübner A, Rong S, Mengel M, Melk A, Haller H, Thum T, Lorenzen J. SO005TRANSLATION OF ANTI FIBROTIC MICRORNA STRATEGIES INTO A MOUSE MODEL OF CHRONIC ALLOGRAFT DYSFUNCTION. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw117.05] [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: 11/12/2022] Open
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Martino F, Bang C, Kielstein J, Thum T, Lorenzen J. FO023ASYMMETRIC DIMETHYLARGININ INDUCES ENDOTHELIAL DYSFUNCTION VIA MODULATION OF MICRORNA 126. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv139.04] [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: 11/14/2022] Open
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Müller-Deile J, Dannenberg J, Nystrom J, Liu P, Lorenzen J, Thum T, Schröder P, Haller H, Schiffer M. SP044MICRO-RNA REGULATED INTERACTIONS BETWEEN PODOCYTES AND GLOMERULAR BASEMENT MEMBRANE IN PROTEINURIC KIDNEY DISEASES. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv188.07] [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: 11/13/2022] Open
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Jing J, Kielstein JT, Schultheiss UT, Sitter T, Titze SI, Schaeffner ES, McAdams-DeMarco M, Kronenberg F, Eckardt KU, Kottgen A, for the GCKD Study Investigators, Eckardt KU, Titze S, Prokosch HU, Barthlein B, Reis A, Ekici AB, Gefeller O, Hilgers KF, Hubner S, Avendano S, Becker-Grosspitsch D, Hauck N, Seuchter SA, Hausknecht B, Rittmeier M, Weigel A, Beck A, Ganslandt T, Knispel S, Dressel T, Malzer M, Floege J, Eitner F, Schlieper G, Findeisen K, Arweiler E, Ernst S, Unger M, Lipski S, Schaeffner E, Baid-Agrawal S, Petzold K, Schindler R, Kottgen A, Schultheiss U, Meder S, Mitsch E, Reinhard U, Walz G, Haller H, Lorenzen J, Kielstein JT, Otto P, Sommerer C, Follinger C, Zeier M, Wolf G, Busch M, Paul K, Dittrich L, Sitter T, Hilge R, Blank C, Wanner C, Krane V, Schmiedeke D, Toncar S, Cavitt D, Schonowsky K, Borner-Klein A, Kronenberg F, Raschenberger J, Kollerits B, Forer L, Schonherr S, Weissensteiner H, Oefner P, Gronwald W, Zacharias H, Schmid M. Prevalence and correlates of gout in a large cohort of patients with chronic kidney disease: the German Chronic Kidney Disease (GCKD) study. Nephrol Dial Transplant 2014; 30:613-21. [DOI: 10.1093/ndt/gfu352] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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Wang XH, Hu L, Klein JD, Minakuchi H, Wakino S, Hosoya K, Yoshifuji A, Hayashi K, Itoh H, Tanaka T, Higashijima Y, Tanaka S, Yamaguchi J, Nangaku M, Martino F, Kielstein J, Bang C, Thum T, Lorenzen J, Stokman G, El-Hachioui M, Florquin S, Pap D, Himer L, Szebeni B, Sziksz E, Riedl Z, Iwakura Y, Nagy Szakal D, Kis E, Onody A, Veres-Szekely A, Javorszky E, Koszegi S, Fekete A, A. Brandt F, Reusz G, Tulassay T, Vannay A. TISSUE INJURY AND REPAIR. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu118] [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: 11/13/2022] Open
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Chan JSD, Abdo S, Ghosh A, Alquier T, Chenier I, Filep JG, Ingelfinger JR, Zhang SL, Ross EA, Willenberg BJ, Oca-Cossio J, Clapp WL, Terada N, Abrahamson DR, Ellison GW, Matthews CE, Batich CD, Ihoriya C, Satoh M, Sasaki T, Kashihara N, Piwkowska A, Rogacka D, Angielski S, Jankowski M, Pontrelli P, Conserva F, Papale M, Accetturo M, Gigante M, Vocino G, Dipalma AM, Grandaliano G, Di Paolo S, Gesualdo L, Franzen S, Pihl L, Khan N, Gustafsson H, Palm F, Koszegi S, Hodrea J, Lenart L, Hosszu A, Wagner L, Vannay A, Tulassay T, Szabo A, Fekete A, Aoki R, Sekine F, Kikuchi K, Miyazaki S, Yamashita Y, Itoh Y, Kolling M, Park JK, Haller H, Thum T, Lorenzen J, Hirayama A, Yoh K, Ueda A, Itoh H, Owada S, Kokeny G, Szabo L, Fazekas K, Rosivall L, Mozes MM, Kim Y, Koh ES, Lim JH, Kim MY, Chang YS, Park CW, Kim Y, Kim HW, Kim MY, Lim JH, Chang YS, Park CW, Shin BC, Kim HL, Chung JH, Chan JS, Wu TC, Chen JW, Rogacka D, Piwkowska A, Angielski S, Jankowski M, Clotet S, Soler MJ, Rebull M, Pascual J, Riera M, Patinha D, Afonso J, Sousa T, Morato M, Albino-Teixeira A, Kim H, Min HS, Kang MJ, Kim JE, Lee JE, Kang YS, Cha DR, Jo YI, Seo EH, Kim JD, Lee SH, Jorge L, Silva KAS, Luiz RS, Rampaso RR, Lima W, Cunha TS, Schor N, Lee HJ, Park JY, Kim SK, Moon JY, Lee SH, Ihm CG, Lee TW, Jeong KH, Moon JY, Kim S, Park JY, Kim SY, Kim YG, Jeong KH, Lee SH, Ihm CG, Marques C, Mega C, Goncalves A, Rodrigues-Santos P, Teixeira-Lemos E, Teixeira F, Fontes Ribeiro C, Reis F, Fernandes R, Sutariya BK, Badgujar LB, Kshtriya AA, Saraf MN, Chiu CH, Lee WC, Chau YY, Lee LC, Lee CT, Chen JB, Dahan I, Nakhoul F, Thawho N, Ben-Itzhaq O, Levy AP, Conserva F, Pontrelli P, Accetturo M, Cordisco G, Fiorentino L, Federici M, Grandaliano G, Di Paolo S, Gesualdo L, Wystrychowski G, Havel PJ, Graham JL, Zukowska-Szczechowska E, Obuchowicz E, Psurek A, Grzeszczak W, Wystrychowski A, Clotet S, Soler MJ, Rebull M, Gimeno J, Pascual J, Riera M, Almeida BZD, Seraphim DCC, Punaro G, Nascimento M, Mouro M, Lanzoni VP, Lopes GS, Higa EMS, Roca-Ho H, Riera M, Marquez E, Pascual J, Soler MJ. DIABETES EXPERIMENTAL. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu149] [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: 11/13/2022] Open
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Heisterkamp M, Titze S, Lorenzen J, Eckardt KU, Koettgen A, Kielstein JT, Bouquegneau A, Vidal-Petiot E, Vrtovsnik F, Cavalier E, Krzesinski JM, Flamant M, Delanaye P, Anguiano L, Riera M, Pascual J, Barrios C, Betriu A, Valdivielso JM, Fernandez E, Soler MJ, Denys MA, Viaene A, Goessaert AS, Delanghe J, Everaert K, Kim YS, Choi MJ, Deok JY, Kim SG, Bevc S, Hojs N, Hojs R, Ekart R, Gorenjak M, Puklavec L, Bevc S, Hojs N, Hojs R, Ekart R, Gorenjak M, Puklavec L, Piskunowicz M, Hofmann L, Zurcher E, Bassi I, Zweiacker C, Stuber M, Narkiewicz K, Vogt B, Burnier M, Pruijm M, Rusu E, Zilisteanu D, Atasie T, Circiumaru A, Carstea F, Ecobici M, Rosca M, Tanase C, Mihai S, Voiculescu M, Kim YS, Jeon YD, Choi MJ, Kim SG, Polenakovic M, Pop-Jordanova N, Hung SC, Tarng DC, Tuta L, Stanigut A, Mesiano P, Rollino C, Ferro M, Beltrame G, Massara C, Quattrocchio G, Borca M, Bazzan M, Roccatello D, Maksudova A, Urasaeva LI, Khalfina TN, Zilisteanu D, Rusu E, Atasie T, Ecobici M, Circiumaru A, Carstea F, Rosca M, Tanase C, Mihai S, Voiculescu M, Tekce H, Kin Tekce B, Aktas G, Alcelik A, Sengul E, Lindic J, Purg D, Skamen J, Krsnik M, Skoberne A, Pajek J, Kveder R, Bren A, Kovac D, Kin Tekce B, Tekce H, Aktas G, Delgado G, Drechsler C, Wanner C, Blouin K, Pilz S, Tomaschitz A, Kleber ME, Willmes C, Krane V, Marz W, Ritz E, Van Gilst WH, Van Der Harst P, De Boer RA, Scholze A, Petersen L, Hocher B, Rasmussen LM, Tepel M, De Paula EA, Vanelli CP, Caminhas MS, Soares BC, Bassoli FA, Da Costa DMN, Lanna CMM, Galil AGS, Colugnati FAB, Costa MB, Bastos MG, De Paula RB, Santoro D, Zappulla Z, Alibrandi A, Tomasello Andulajevic M, Licari M, Baldari S, Buemi M, Cernaro V, Campenni A, Pallet N, Chauvet S, Levi C, Meas-Yedid V, Beaune P, Thevet E, Karras A, Santos S, Malheiro J, Campos A, Pedroso S, Santos J, Cabrita A, Mayor MM, Ayala R, Ramos C, Franco S, Guillen R, Kim JS, Yang JW, Han BG, Choi SO, Tudor MN, Navajas Martinez MF, Vaduva C, Maria DT, Mota E, Clari R, Mongilardi E, Vigotti FN, Consiglio V, Scognamiglio S, Nazha M, Roggero S, Piga A, Piccoli G, Mukhopadhyay P, Patar K, Chaterjee N, Ganguly K. CKD LAB METHODS, PROGRESSION & RISK FACTORS 1. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu145] [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: 11/14/2022] Open
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Focke CM, Gläser D, Finsterbusch K, Bürger H, Korsching E, Berghäuser KH, Hinrichs B, Krause U, Lorenzen J, Packeisen J, van Diest PJ, Decker T. Abstract P3-05-09: Interlaboratory variability of Ki67 labeling index in breast cancer tissue microarrays. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p3-05-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Objective: Assessment of tumor proliferation using the Ki67 labeling index (Ki67-LI) is increasingly recommended for prognostication and adjuvant chemotherapy decisions in breast cancer. Our aim was to investigate interlaboratory variance of Ki67-LI results using TMA and centralised assessment to exclude preanalytic influences and postanalytic variance, respectively.
Methods: Nine pathology laboratories (8 German and 1 Dutch) performed Ki67 staining of a TMA slide according to their routine in house protocol (including internal and external quality assurance). 40 samples per lab were centrally analyzed. The Ki67-LI was calculated after counting first all tumor cells and subsequently all Ki67 positive tumor cells of each sample regardless of staining intensity. For each tissue sample we evaluated the range of Ki67-LIs between different labs. Further 20 labs of the German Breast Screening Pathology Initiative will participate in 2013.
Results: The range of Ki67-LIs between the labs was: 1-5% in 4 (10%), 6-10% in 6 (15%), 11-15% in 7 (17,5%), 16-20% in 2 (5%), 21-25% in 7 (17%), 26-30% in 4 (10%), 31-35% in 1 (1%), 36-40% in 4 (10%), 41-45% in 2 (5%), 46-50 in 0 (0%) and >50% in 3 samples (7%), respectively. Thus, in 35% of results of the 9 labs (26 of the 40 TMA specimens) the Ki67-LI differed by more than 25%. The analysis of variance (ANOVA) came out with F = 4.24 which is much larger than the critical F value of 1.97 for these study results (p = 7.74902E-05). This means that the observed interlaboratory variance of 4.24 is systematic and not due to sampling error. The respective standard deviation is 33.4%.
Conclusion: In a setting strictly standardised in terms of preanalytic influences by using TMA and postanalytic variance by centralised quantification, Ki67-LI seems to be heavily influenced by laboratory-specific analytic variables. Taking this into consideration, there may be a risk of prognostic or predictive misclassification in some breast cancer patients in daily practice.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-05-09.
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Affiliation(s)
- CM Focke
- Dietrich Bonhoeffer Medical Center, Neubrandenburg, Neubrandenburg, Germany; Institute of Pathology, Paderborn, Paderborn, Germany; Institute of Bioinformatics, University of Münster, Münster, Germany; Institute of Pathology, Thüringen-Hospital Georgius Agricola, Saalfeld, Saalfeld, Germany; Medical Care Center for Pathology and Cytology, Köln, Köln, Germany; Städtisches Klinikum Dessau, Dessau, Germany; Institute of Pathology, Klinikzentrum Mitte, Dortmund, Germany; Joint Practice for Pathology, Osnabrück, Osnabrück, Germany; University Medical Center Utrecht, Utrecht, Netherlands
| | - D Gläser
- Dietrich Bonhoeffer Medical Center, Neubrandenburg, Neubrandenburg, Germany; Institute of Pathology, Paderborn, Paderborn, Germany; Institute of Bioinformatics, University of Münster, Münster, Germany; Institute of Pathology, Thüringen-Hospital Georgius Agricola, Saalfeld, Saalfeld, Germany; Medical Care Center for Pathology and Cytology, Köln, Köln, Germany; Städtisches Klinikum Dessau, Dessau, Germany; Institute of Pathology, Klinikzentrum Mitte, Dortmund, Germany; Joint Practice for Pathology, Osnabrück, Osnabrück, Germany; University Medical Center Utrecht, Utrecht, Netherlands
| | - K Finsterbusch
- Dietrich Bonhoeffer Medical Center, Neubrandenburg, Neubrandenburg, Germany; Institute of Pathology, Paderborn, Paderborn, Germany; Institute of Bioinformatics, University of Münster, Münster, Germany; Institute of Pathology, Thüringen-Hospital Georgius Agricola, Saalfeld, Saalfeld, Germany; Medical Care Center for Pathology and Cytology, Köln, Köln, Germany; Städtisches Klinikum Dessau, Dessau, Germany; Institute of Pathology, Klinikzentrum Mitte, Dortmund, Germany; Joint Practice for Pathology, Osnabrück, Osnabrück, Germany; University Medical Center Utrecht, Utrecht, Netherlands
| | - H Bürger
- Dietrich Bonhoeffer Medical Center, Neubrandenburg, Neubrandenburg, Germany; Institute of Pathology, Paderborn, Paderborn, Germany; Institute of Bioinformatics, University of Münster, Münster, Germany; Institute of Pathology, Thüringen-Hospital Georgius Agricola, Saalfeld, Saalfeld, Germany; Medical Care Center for Pathology and Cytology, Köln, Köln, Germany; Städtisches Klinikum Dessau, Dessau, Germany; Institute of Pathology, Klinikzentrum Mitte, Dortmund, Germany; Joint Practice for Pathology, Osnabrück, Osnabrück, Germany; University Medical Center Utrecht, Utrecht, Netherlands
| | - E Korsching
- Dietrich Bonhoeffer Medical Center, Neubrandenburg, Neubrandenburg, Germany; Institute of Pathology, Paderborn, Paderborn, Germany; Institute of Bioinformatics, University of Münster, Münster, Germany; Institute of Pathology, Thüringen-Hospital Georgius Agricola, Saalfeld, Saalfeld, Germany; Medical Care Center for Pathology and Cytology, Köln, Köln, Germany; Städtisches Klinikum Dessau, Dessau, Germany; Institute of Pathology, Klinikzentrum Mitte, Dortmund, Germany; Joint Practice for Pathology, Osnabrück, Osnabrück, Germany; University Medical Center Utrecht, Utrecht, Netherlands
| | - K-H Berghäuser
- Dietrich Bonhoeffer Medical Center, Neubrandenburg, Neubrandenburg, Germany; Institute of Pathology, Paderborn, Paderborn, Germany; Institute of Bioinformatics, University of Münster, Münster, Germany; Institute of Pathology, Thüringen-Hospital Georgius Agricola, Saalfeld, Saalfeld, Germany; Medical Care Center for Pathology and Cytology, Köln, Köln, Germany; Städtisches Klinikum Dessau, Dessau, Germany; Institute of Pathology, Klinikzentrum Mitte, Dortmund, Germany; Joint Practice for Pathology, Osnabrück, Osnabrück, Germany; University Medical Center Utrecht, Utrecht, Netherlands
| | - B Hinrichs
- Dietrich Bonhoeffer Medical Center, Neubrandenburg, Neubrandenburg, Germany; Institute of Pathology, Paderborn, Paderborn, Germany; Institute of Bioinformatics, University of Münster, Münster, Germany; Institute of Pathology, Thüringen-Hospital Georgius Agricola, Saalfeld, Saalfeld, Germany; Medical Care Center for Pathology and Cytology, Köln, Köln, Germany; Städtisches Klinikum Dessau, Dessau, Germany; Institute of Pathology, Klinikzentrum Mitte, Dortmund, Germany; Joint Practice for Pathology, Osnabrück, Osnabrück, Germany; University Medical Center Utrecht, Utrecht, Netherlands
| | - U Krause
- Dietrich Bonhoeffer Medical Center, Neubrandenburg, Neubrandenburg, Germany; Institute of Pathology, Paderborn, Paderborn, Germany; Institute of Bioinformatics, University of Münster, Münster, Germany; Institute of Pathology, Thüringen-Hospital Georgius Agricola, Saalfeld, Saalfeld, Germany; Medical Care Center for Pathology and Cytology, Köln, Köln, Germany; Städtisches Klinikum Dessau, Dessau, Germany; Institute of Pathology, Klinikzentrum Mitte, Dortmund, Germany; Joint Practice for Pathology, Osnabrück, Osnabrück, Germany; University Medical Center Utrecht, Utrecht, Netherlands
| | - J Lorenzen
- Dietrich Bonhoeffer Medical Center, Neubrandenburg, Neubrandenburg, Germany; Institute of Pathology, Paderborn, Paderborn, Germany; Institute of Bioinformatics, University of Münster, Münster, Germany; Institute of Pathology, Thüringen-Hospital Georgius Agricola, Saalfeld, Saalfeld, Germany; Medical Care Center for Pathology and Cytology, Köln, Köln, Germany; Städtisches Klinikum Dessau, Dessau, Germany; Institute of Pathology, Klinikzentrum Mitte, Dortmund, Germany; Joint Practice for Pathology, Osnabrück, Osnabrück, Germany; University Medical Center Utrecht, Utrecht, Netherlands
| | - J Packeisen
- Dietrich Bonhoeffer Medical Center, Neubrandenburg, Neubrandenburg, Germany; Institute of Pathology, Paderborn, Paderborn, Germany; Institute of Bioinformatics, University of Münster, Münster, Germany; Institute of Pathology, Thüringen-Hospital Georgius Agricola, Saalfeld, Saalfeld, Germany; Medical Care Center for Pathology and Cytology, Köln, Köln, Germany; Städtisches Klinikum Dessau, Dessau, Germany; Institute of Pathology, Klinikzentrum Mitte, Dortmund, Germany; Joint Practice for Pathology, Osnabrück, Osnabrück, Germany; University Medical Center Utrecht, Utrecht, Netherlands
| | - PJ van Diest
- Dietrich Bonhoeffer Medical Center, Neubrandenburg, Neubrandenburg, Germany; Institute of Pathology, Paderborn, Paderborn, Germany; Institute of Bioinformatics, University of Münster, Münster, Germany; Institute of Pathology, Thüringen-Hospital Georgius Agricola, Saalfeld, Saalfeld, Germany; Medical Care Center for Pathology and Cytology, Köln, Köln, Germany; Städtisches Klinikum Dessau, Dessau, Germany; Institute of Pathology, Klinikzentrum Mitte, Dortmund, Germany; Joint Practice for Pathology, Osnabrück, Osnabrück, Germany; University Medical Center Utrecht, Utrecht, Netherlands
| | - T Decker
- Dietrich Bonhoeffer Medical Center, Neubrandenburg, Neubrandenburg, Germany; Institute of Pathology, Paderborn, Paderborn, Germany; Institute of Bioinformatics, University of Münster, Münster, Germany; Institute of Pathology, Thüringen-Hospital Georgius Agricola, Saalfeld, Saalfeld, Germany; Medical Care Center for Pathology and Cytology, Köln, Köln, Germany; Städtisches Klinikum Dessau, Dessau, Germany; Institute of Pathology, Klinikzentrum Mitte, Dortmund, Germany; Joint Practice for Pathology, Osnabrück, Osnabrück, Germany; University Medical Center Utrecht, Utrecht, Netherlands
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Nassenstein K, Deluigi CC, Afube T, Schaaf B, Lorenzen J, Bruder O. Nonbacterial endocarditis presenting as a right ventricular tumor in assumed Behçet's disease. Herz 2013; 40 Suppl 3:225-7. [PMID: 24297403 DOI: 10.1007/s00059-013-4017-6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Revised: 10/18/2013] [Accepted: 10/29/2013] [Indexed: 10/26/2022]
Affiliation(s)
- K Nassenstein
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany,
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Suttorp AC, Heike M, Fähndrich M, Reis H, Lorenzen J. [Heterotopic sebaceous glands in the esophagus: case report with review of the literature]. Der Pathologe 2013; 34:162-4. [PMID: 23111754 DOI: 10.1007/s00292-012-1714-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Heterotopia of sebaceous glands is a very rare endoscopically indistinct benign finding in the esophagus. To date only 30 cases have been reported in the literature. The lesions exhibit a considerable variation in number and size. No malignant transformation has yet been reported. From the pathologists' point of view an inflammatory or neoplastic process has to be excluded as the cause of the non-distinctive endoscopic findings.
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Affiliation(s)
- A-C Suttorp
- Institut für Pathologie, Klinikum Dortmund gGmbH, Standort Mitte, Dortmund.
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Lorenzen J, Thum T. MicroRNAs in Immunität und Organtransplantation. Transfusionsmedizin 2012. [DOI: 10.1055/s-0032-1324869] [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]
Affiliation(s)
- J. Lorenzen
- Institute of Molecular and Translational Therapeutic Strategies [IMTTS], Hannover Medical School, Hannover, Germany
| | - T. Thum
- Institute of Molecular and Translational Therapeutic Strategies [IMTTS], Hannover Medical School, Hannover, Germany
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Lorenzen J, Finck-Wedel AK, Lisboa B, Adam G. Second Opinion Assessment in Diagnostic Mammography at a Breast Cancer Centre. Geburtshilfe Frauenheilkd 2012; 72:734-739. [PMID: 25258466 DOI: 10.1055/s-0032-1315107] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Revised: 04/22/2012] [Accepted: 05/19/2012] [Indexed: 10/28/2022] Open
Abstract
Purpose: The aim of this retrospective study was to evaluate the importance of second opinion assessment for diagnostic mammography and sonography in a breast cancer centre. Material and Method: We analysed a total of 374 diagnostic mammographies and sonographies. All patients had previously undergone mammography and sonography examination in different external clinics, and the findings had been classified according to the BI-RADS system. All patients underwent additional sonography investigation in the outpatient department of our university clinic with additional mammography where necessary. The final diagnosis (histological clarification in 316 cases, follow-up in 58 cases) was compared with the BI-RADS classification made by the external clinics and by the university clinic, and the correlation between their findings and the final diagnosis was analysed. Results: The final diagnosis yielded 146 benign lesions and 228 cancers. In 74 % of cases (277/374), the BI-RADS classification of the first assessment corresponded to that of the second assessment. 26/55 lesions (47 %) were upgraded at the second assessment from BI-RADS 3 to BI-RADS 4, and 71/186 findings (38 %) were downgraded at the second assessment from BI-RADS 4 to BI-RADS 3. The correlation between the initial diagnosis made in the external facilities and the final diagnosis was low (kappa: 0.263), but the correlation between the second opinion assessment and the final diagnosis was significantly (p < 0.001) higher (kappa: 0.765). The second assessment increased the sensitivity from 91 % (208/228) to 99 % (225/228) and the specificity from 32 % (46/146) to 74 % (108/146). 20 additional malignant lesions were only detected at the second assessment; however the second assessment also resulted in 3 additional false-negative findings. Surgical biopsy was prevented in 49 women after the second assessment. Conclusion: An independent second diagnostic evaluation can significantly improve the correlation between BI-RADS classification and the final diagnosis, resulting in a benefit for the patient.
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Affiliation(s)
- J Lorenzen
- Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsklinik Hamburg-Eppendorf, Hamburg, Germany
| | - A K Finck-Wedel
- Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsklinik Hamburg-Eppendorf, Hamburg, Germany
| | - B Lisboa
- Klinik und Poliklinik für Gynäkologie, Universitätsklinik Hamburg-Eppendorf, Hamburg, Germany
| | - G Adam
- Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsklinik Hamburg-Eppendorf, Hamburg, Germany ; Universitätsklinik Hamburg-Eppendorf, Hamburg, Germany
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Martino F, Lorenzen J, Schmidt J, Schmidt M, Broll M, Görzig Y, Kielstein JT, Thum T. Circulating microRNAs are not eliminated by hemodialysis. PLoS One 2012; 7:e38269. [PMID: 22715378 PMCID: PMC3371001 DOI: 10.1371/journal.pone.0038269] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 05/07/2012] [Indexed: 01/02/2023] Open
Abstract
Background Circulating microRNAs are stably detectable in serum/plasma and other body fluids. In patients with acute kidney injury on dialysis therapy changes of miRNA patterns had been detected. It remains unclear if and how the dialysis procedure itself affects circulating microRNA level. Methods We quantified miR-21 and miR-210 by quantitative RT-PCR in plasma of patients with acute kidney injury requiring dialysis and measured pre- and post-dialyser miRNA levels as well as their amount in the collected spent dialysate. Single treatments using the following filters were studied: F60 S (1.3 m2, Molecular Weight Cut Off (MWCO): 30 kDa, n = 8), AV 1000 S (1.8 m2, MWCO: 30 kDa, n = 6) and EMiC 2 (1.8 m2, MWCO: 40 kDa, n = 6). Results Circulating levels of miR-21 or -210 do not differ between pre- and post-dialyzer blood samples independently of the used filter surface and pore size: miR-21: F60S: p = 0.35, AV 1000 S p = 1.0, EMiC2 p = 1.0; miR-210: F60S: p = 0.91, AV 1000 S p = 0.09, EMiC2 p = 0.31. Correspondingly, only traces of both miRNAs could be found in the collected spent dialysate and ultrafiltrate. Conclusions In patients with acute kidney injury circulating microRNAs are not removed by dialysis. As only traces of miR-21 and -210 are detected in dialysate and ultrafiltrate, microRNAs in the circulation are likely to be transported by larger structures such as proteins and/or microvesicles. As miRNAs are not affected by dialysis they might be more robust biomarkers of acute kidney injury.
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Affiliation(s)
- Filippo Martino
- Institute for Molecular and Translational Treatment Strategies (IMTTS), Hannover Medical School, Hannover, Germany
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Abstract
Diabetes mellitus due to its high prevalence and associated complications is a major socioeconomic health problem. Diabetes is characterized by multiple macro- and microvascular complications (e.g. diabetic nephropathy, cardiomyopathy, neuropathy, retinopathy). Research efforts aim to elucidate pathophysiological mechanisms contributing to the disease process. MicroRNAs are endogenous small single stranded molecules regulating targets through mRNA cleavage or translational inhibition. MicroRNAs regulate many biological cellular functions and are often deregulated during diseases. The aim of the present article is to summarize the current knowledge of the impact of microRNAs on the development of diabetes and its associated complications including endothelial and vascular smooth muscle cell dysfunction, diabetic cardiomyopathy, diabetic nephropathy, regulation of pancreatic beta cell function as well as skeletal muscle and hepatic involvement.
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Affiliation(s)
- Johan Lorenzen
- Hannover Medical School, Institute of Molecular and Translational Therapeutic Strategies, Carl-Neuberg Str 1, Hannover 30625, Germany
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Lorenzen J, Frederiksen R, Hoppe C, Hvid R, Astrup A. The effect of milk proteins on appetite regulation and diet-induced thermogenesis. Eur J Clin Nutr 2012; 66:622-7. [PMID: 22274550 DOI: 10.1038/ejcn.2011.221] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES There is increasing evidence to support that a high-protein diet may promote weight loss and prevent weight (re)gain better than a low-protein diet, and that the effect is due to higher diet-induced thermogenesis (DIT) and increased satiety. However, data on the effect of different types of protein are limited. In the present study we compare the effect of whey, casein and milk on DIT and satiety. SUBJECTS/METHODS Seventeen slightly overweight (29 ± 4 kg/m(2)) male subjects completed the study. The study had a randomized, crossover design, where the effect on 4 h postprandial energy expenditure (EE), substrate oxidation and subjective appetite sensation of three isocaloric test meals containing either a whey drink, a casein drink or skim milk was examined. Energy intake (EI) at a subsequent ad libitum lunch was also measured. RESULTS There was no significant effect on subjective appetite sensation, but EI at lunch was lower after the milk test meal than after the casein (9%; P=0.0260) and the whey (9%; P=0.0258) test meals. Postprandial lipid oxidation was significantly higher after the casein test meal compared with the whey test meal (P=0.0147) when adjusted for baseline values. There was no significant difference in effect on EE, protein oxidation or carbohydrate oxidation. CONCLUSIONS Milk reduced subsequent EI more than isocaloric drinks containing only whey or casein. A small but significant increase in lipid oxidation was seen after casein compared with whey.
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Affiliation(s)
- J Lorenzen
- Department of Human Nutrition, Centre for Advanced Food Studies, Faculty of Life Sciences, University of Copenhagen, Frederiksberg, Denmark.
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Kraemer R, Lorenzen J, Kabbani M, Herold C, Busche M, Vogt PM, Knobloch K. Acute effects of remote ischemic preconditioning on cutaneous microcirculation--a controlled prospective cohort study. BMC Surg 2011; 11:32. [PMID: 22111972 PMCID: PMC3231986 DOI: 10.1186/1471-2482-11-32] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Accepted: 11/23/2011] [Indexed: 11/10/2022] Open
Abstract
Background Therapeutic strategies aiming to reduce ischemia/reperfusion injury by conditioning tissue tolerance against ischemia appear attractive not only from a scientific perspective, but also in clinics. Although previous studies indicate that remote ischemic intermittent preconditioning (RIPC) is a systemic phenomenon, only a few studies have focused on the elucidation of its mechanisms of action especially in the clinical setting. Therefore, the aim of this study is to evaluate the acute microcirculatory effects of remote ischemic preconditioning on a distinct cutaneous location at the lower extremity which is typically used as a harvesting site for free flap reconstructive surgery in a human in-vivo setting. Methods Microcirculatory data of 27 healthy subjects (25 males, age 24 ± 4 years, BMI 23.3) were evaluated continuously at the anterolateral aspect of the left thigh during RIPC using combined Laser-Doppler and photospectrometry (Oxygen-to-see, Lea Medizintechnik, Germany). After baseline microcirculatory measurement, remote ischemia was induced using a tourniquet on the contralateral upper arm for three cycles of 5 min. Results After RIPC, tissue oxygen saturation and capillary blood flow increased up to 29% and 35% during the third reperfusion phase versus baseline measurement, respectively (both p = 0.001). Postcapillary venous filling pressure decreased statistically significant by 16% during second reperfusion phase (p = 0.028). Conclusion Remote intermittent ischemic preconditioning affects cutaneous tissue oxygen saturation, arterial capillary blood flow and postcapillary venous filling pressure at a remote cutaneous location of the lower extremity. To what extent remote preconditioning might ameliorate reperfusion injury in soft tissue trauma or free flap transplantation further clinical trials have to evaluate. Trial registration ClinicalTrials.gov: NCT01235286
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Affiliation(s)
- Robert Kraemer
- Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.
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Fiedler J, Jazbutyte V, Kirchmaier BC, Gupta SK, Lorenzen J, Hartmann D, Galuppo P, Kneitz S, Pena JTG, Sohn-Lee C, Loyer X, Soutschek J, Brand T, Tuschl T, Heineke J, Martin U, Schulte-Merker S, Ertl G, Engelhardt S, Bauersachs J, Thum T. MicroRNA-24 regulates vascularity after myocardial infarction. Circulation 2011; 124:720-30. [PMID: 21788589 DOI: 10.1161/circulationaha.111.039008] [Citation(s) in RCA: 313] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Myocardial infarction leads to cardiac remodeling and development of heart failure. Insufficient myocardial capillary density after myocardial infarction has been identified as a critical event in this process, although the underlying mechanisms of cardiac angiogenesis are mechanistically not well understood. METHODS AND RESULTS Here, we show that the small noncoding RNA microRNA-24 (miR-24) is enriched in cardiac endothelial cells and considerably upregulated after cardiac ischemia. MiR-24 induces endothelial cell apoptosis, abolishes endothelial capillary network formation on Matrigel, and inhibits cell sprouting from endothelial spheroids. These effects are mediated through targeting of the endothelium-enriched transcription factor GATA2 and the p21-activated kinase PAK4, which were identified by bioinformatic predictions and validated by luciferase gene reporter assays. Respective downstream signaling cascades involving phosphorylated BAD (Bcl-XL/Bcl-2-associated death promoter) and Sirtuin1 were identified by transcriptome, protein arrays, and chromatin immunoprecipitation analyses. Overexpression of miR-24 or silencing of its targets significantly impaired angiogenesis in zebrafish embryos. Blocking of endothelial miR-24 limited myocardial infarct size of mice via prevention of endothelial apoptosis and enhancement of vascularity, which led to preserved cardiac function and survival. CONCLUSIONS Our findings indicate that miR-24 acts as a critical regulator of endothelial cell apoptosis and angiogenesis and is suitable for therapeutic intervention in the setting of ischemic heart disease.
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Affiliation(s)
- Jan Fiedler
- Hannover Medical School, Institute for Molecular and Translational Therapeutic Strategies, Hannover, Germany.
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Locsey L, Seres I, Sztanek F, Harangi M, Padra J, Asztalos L, Paragh G, Hutchison CA, Bevins A, Langham R, Mancini E, Wirta O, Cockwell P, Hutchison CA, Keir R, Vigano M, Stella A, Evans N, Chappell M, Cockwell P, Fabbrini P, Onuigbo M, Onuigbo N, Onuigbo M, Kim S, Chang JH, Jung JY, Lee HH, Chung W, Zanoli L, Rastelli S, Marcantoni C, Tamburino C, Castellino P, Cho A, Choi H, Lee JE, Jang HR, Huh W, Kim YG, Kim DJ, Oh HY, Zanoli L, Rastelli S, Marcantoni C, Tamburino C, Castellino P, Garcia-Fernandez N, Martin-Moreno PL, Varo N, Nunez-Cordoba JM, Schlieper G, Kruger T, Kelm M, Floege J, Westenfeld R, Choi H, Cho AJ, Jang HR, Lee JE, Huh W, Kim YG, Oh HY, Kim DJ, Doganay S, Oguz AK, Ergun I, Bardachenko N, Kuryata O, Bardachenko L, Garcia-Fernandez N, Martin-Moreno PL, Varo N, Nunez-Cordoba JM, Choi H, Cho AJ, Jang HR, Lee JE, Huh W, Kim YG, Oh HY, Kim DJ, Ravani P, Malberti F, Pirelli S, Scolari F, Barrett B, Presta P, Lucisano G, Rubino A, Serraino F, Amoruso T, Renzulli A, Fuiano G, Kielstein JT, Tolk S, Heiden A, Kuhn C, Hoeper MM, Lorenzen J, Broll M, Kaever V, Burhenne H, Hafer C, Haller H, Burkhardt O, Kielstein J, Zahalkova J, Petejova N, Strojil J, Urbanek K, Bertoli S, Musetti C, Cabiati A, Assanelli E, Lauri G, Marana I, De Metrio M, Rubino M, Campodonico J, Grazi M, Moltrasio M, Marenzi G, Unarokov Z, Mukhoedova T, Fidalgo P, Coelho S, Rodrigues B, Fernandes AP, Papoila AL, Liano F, Soto K, Vanmassenhove J, Vanholder R, Glorieux G, Van Biesen W, Challiner R, Ritchie J, Hutchison A, Challiner R, Ritchie J, Hutchison A, Challiner R, Ritchie J, Hutchison A, Zaharie SI, Maria DT, Zaharie M, Vaduva C, Grauntanu C, Cana-Ruiu D, Mota E, Hayer M, Baharani J, Thomas M, Eldehni T, Selby N, McIntyre C, Fluck R, Kolhe N, Fagugli RM, Patera F, Shah PR, Kaswan KK, Kute VB, Vanikar AV, Gumber MR, Patel HV, Munjappa BC, Enginner DP, Sainaresh VV, Trivedi HL, Teixeira C, Nogueira E, Lopes JA, Almeida E, Pais de Lacerda A, Gomes da Costa A, Franca C, Mariano F, Morselli M, Bergamo D, Hollo' Z, Scella S, Maio M, Tetta C, Dellavalle A, Stella M, Triolo G, Cantaluppi V, Quercia AD, Bertinetto P, Giacalone S, Tamagnone M, Basso E, Karvela E, Gai M, Leonardi G, Anania P, Guarena C, Fenocchio CM, Pacitti A, Segoloni GP, Kim YO, Kim HG, Kim BS, Song HCS, Min JK, Kim SY, Park WD, Dalboni M, Narciso R, Quinto M, Grabulosa C, Cruz E, Monte J, Durao M, Cendoroglo M, Santos O, Batista M, Cho A, Choi H, Lee JE, Jang HR, Huh W, Kim YG, Kim DJ, Oh HY, Mancini E, Bellasi A, Giannone S, Mordenti A, Zanoni A, Santoro A, Presta P, Lucisano G, Rubino A, Serraino F, Renzulli A, Fuiano G, Lee JH, Ha SH, Kim JH, Lee GJ, Jung YC, Malindretos P, Koutroumbas G, Patrinou A, Zagkotsis G, Makri P, Togousidis I, Syrganis C, Li Cavoli G, Tortorici C, Bono L, Ferrantelli A, Giammarresi C, Zagarrigo C, Rotolo U, Kim H, Jun K, Choi W, Kim H, Jun K, Choi W, Krzesinski JM, Parotte MC, Vandevelde C, Keenan J, Dieterle F, Sultana S, Pinches M, Ciorciaro C, Schindler R, Schmitz V, Gautier JC, Benain X, Matchem J, Murray P, Adler S, Haase M, Haase-Fielitz A, Devarajan P, Bellomo R, Cruz DN, Wagener G, Krawczeski CD, Koyner JL, Murray PT, Zappitelli M, Goldstein S, Makris K, Ronco C, Martensson J, Martling CR, Venge P, Siew E, Ware LB, Ikizler A, Mertens PR, Lacquaniti A, Buemi A, Donato V, Lucisano S, Buemi M, Vanmassenhove J, Vanholder R, Glorieux G, Van Biesen W, Panagoutsos S, Kriki P, Mourvati E, Tziakas D, Chalikias G, Stakos D, Apostolakis S, Tsigalou C, Gioka T, Konstantinides S, Vargemezis V, Torregrosa I, Montoliu C, Urios A, Aguado C, Puchades MJ, Solis MA, Juan I, Sanjuan R, Blasco M, Pineda J, Carratala A, Ramos C, Miguel A, Niculae A, Checherita IA, Sandulovici R, David C, Ciocalteu A, Espinoza M, Hidalgo J, Lorca E, Santibanez A, Arancibia F, Gonzalez F, Park MY, Kim EJ, Choi SJ, Kim JK, Hwang SD, Lee KH, Seok SJ, Yang JO, Lee EY, Hong SY, Gil HW, Astapenko E, Shutov A, Savinova G, Rechnik V, Melo MJ, Lopes JA, Raimundo M, Viegas A, Camara I, Antunes F, Kim MJ, Kwon SH, Lee SW, Song JH, Lee JW. Acute kidney injury - Human studies. Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.29] [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: 11/13/2022] Open
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Habicht A, Bröker V, Blume C, Lorenzen J, Schiffer M, Richter N, Klempnauer J, Haller H, Lehner F, Schwarz A. Increase of infectious complications in ABO-incompatible kidney transplant recipients--a single centre experience. Nephrol Dial Transplant 2011; 26:4124-31. [PMID: 21622990 DOI: 10.1093/ndt/gfr215] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Due to the shortage of deceased donors ABO-incompatible (ABOi) living kidney transplantation has become a popular alternative to deceased kidney transplantation. In recent years, recipient desensitization with a combination of anti-CD20 treatment (rituximab), antigen-specific immunoadsorptions (IA) and intravenous immunoglobulin (IVIG), led to promising short-term and intermediate-term results. However, little is known about the impact of this intensified desensitization protocol on the risk of surgical and infectious complications. METHODS We retrospectively analysed 21 consecutive recipients who underwent ABOi renal transplantation. Pre-transplant desensitization included administration of rituximab (375 mg/m(2)), mycophenolate mofetil (MMF), tacrolimus and prednisolone 4 weeks prior of scheduled transplantation as well as IA and IVIG. Forty-seven patients who underwent ABO-compatible (ABOc) renal transplantation served as the control group. Medical records and electronic databases were reviewed for patient and graft survival, renal function, rate of rejections, viral and bacterial infections as well as for surgical complications (SCs) post-transplantation. RESULTS All patients showed an immediate graft function. During a mean follow-up of 15.7 ± 8.3 months (interquartile range 11.9) patient survival was 95 and 98% in the ABOi and ABOc group, respectively. Allograft survival and function, as assessed by serum creatinine levels and calculated glomerular filtration rate at 1 year, did not differ between ABOi and ABOc recipients. Furthermore, the rate of biopsy-proven acute rejections was comparable between the two groups. However, there was a trend towards more SCs within the ABOi group (29 versus 11%, non-significant). In addition, the rate of viral infections including cytomegalovirus, Herpes simplex virus, Varicella zoster virus and polyoma virus was significantly increased among the ABOi recipients (50 versus 21%; P = 0.038) despite comparable tacrolimus trough levels and MMF and steroid doses. CONCLUSIONS Our results, in line with the extended experience of other groups, demonstrate favourable short-term allograft survival and function after ABOi renal transplantation after desensitization with antigen-specific IA, IVIG and rituximab. However, the intensified desensitization was associated with an increased risk of infectious complications. This observation prompted us to briefly escalate the desensitization protocol in ABOi kidney recipients in our centre.
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Affiliation(s)
- Antje Habicht
- Department of Nephrology, Medical School Hannover, Hannover, Germany.
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Sagredo B, Lorenzen J, Casper H, Lafta A. Linkage analysis of a rare alkaloid present in a tetraploid potato with Solanum chacoense background. Theor Appl Genet 2011; 122:471-478. [PMID: 20924746 DOI: 10.1007/s00122-010-1461-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Accepted: 09/21/2010] [Indexed: 05/30/2023]
Abstract
The potato genotype ND4382-19 has Solanum chacoense Bitt. in its genetic background. Foliar alkaloid analysis of it and its progeny ND5873 (ND4382-19 × Chipeta) by gas chromatography-mass spectrometry (GC-MS) showed that, in addition to the expected alkaloids (solanidine, leptinidine, and acetyl-leptinidine), there was an aglycone of another rare alkaloid. Its molecular mass and some of the m/z fragment ions were similar to leptinidine, but the major fragment ion was the m/z 150 peak of solanidine. This fragmentation pattern suggested that this alkaloid is a solanidine-based compound with mass equal to leptinidine. Leptinidine differs from solanidine by an extra -OH group, but the GC-MS fragmentation pattern of the rare compound indicated hydroxylation at a different position than the C-23 of leptinidine. The exact chemical structure is still unknown, and further analysis, such as NMR will be necessary to determine the structure. Segregation analysis of ND5873 (ND4382-19 × Chipeta) showed that presence of this rare compound segregated in a 1:1 ratio, indicating that a single gene controlled its synthesis and/or accumulation in foliar tissue. Analysis with AFLP and microsatellite markers indicated that the locus-controlling presence of this alkaloid resided on potato chromosome I, with the nearest flanking AFLP markers 0.6 and 9.4 cM apart. This rare alkaloid was present in the foliage and not detected in potato tubers. Its presence in leaves did not affect resistance/susceptibility to Colorado potato beetle.
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Affiliation(s)
- B Sagredo
- Instituto de Investigaciones Agropecuarias, CRI-Rayentué, Centro de Estudios Avanzados en Fruticultura, Av. Salamanca s/n. Sector Choapinos, Casilla 13, Rengo, Chile.
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Krämer R, Lorenzen J, Vogt PM, Knobloch K. [Systematic review about eccentric training in chronic achilles tendinopathy]. Sportverletz Sportschaden 2010; 24:204-11. [PMID: 21157656 DOI: 10.1055/s-0029-1245820] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Throughout the recent decade, eccentric training has become a widely accepted therapy option in the conservative treatment of chronic Achilles tendinopathy. Nevertheless, current recommendations are missing regarding dosage and duration of eccentric training as well as standardized training protocols. OBJECTIVES Is eccentric training as a conservative treatment in chronic Achilles tendinopathy of beneficial effect versus other conservative treatments? According to the current scientific data, is it possible to recommend dosages and duration of training time of eccentric training? STUDY DESIGN Systematic review of the current scientific literature on eccentric training as a conservative treatment in chronic Achilles tendinopathy according to the PRISMA-guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). DATA SOURCE National library of Medicine (NLM) between the years 1950 and 2010. STUDY ELIGIBILITY CRITERIA Prospective randomised controlled trials (RCT). PARTICIPANTS 8 RCTs included 416 subjects with a median number of 42 subjects and a range of 17 to 116 subjects per trial. Median follow-up duration was 12 weeks with a range from 12 to 54 weeks. RESULTS 124 papers met the eligibility criteria in the NLM, whereas only eight randomised controlled trials were included in this review after screening titles, abstracts and full texts. All included trials demonstrated an improvement in pain after performing equivalent training protocols of eccentric training in chronic Achilles tendinopathy. LIMITATIONS A pooled statistical evaluation of the included trials could not be performed due to different study designs as well as limited documentation of subjects' compliance. CONCLUSION In spite of different compliance, effects of eccentric training in conservative treatment of chronic mid-portion-Achilles tendinopathy are promising. Because of the heterogeneous outcome variables (ordinal scale, VAS, FAOS, AOFAS, VISA-A) and the methodological limitations of the trials, no definite recommendation can be published concerning dosage and duration of eccentric training in chronic Achilles tendinopathy.
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Affiliation(s)
- R Krämer
- Plastische, Hand- und Wiederherstellungschirurgie, Medizinische Hochschule Hannover.
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Lorenzen J, Krämer R, Vogt P, Knobloch K. Systematische Literaturanalyse über exzentrisches Training bei chronischer Patellatendinopathie: Gibt es einen Standard? Sportverletz Sportschaden 2010; 24:198-203. [DOI: 10.1055/s-0029-1245818] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sandmann M, Fähndrich M, Lorenzen J, Heike M. [Gangliocytic paraganglioma--a rare cause of an upper gastrointestinal bleeding]. Z Gastroenterol 2010; 48:1297-300. [PMID: 21043008 DOI: 10.1055/s-0029-1245521] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Gangliocytic paraganglioma is a rare tumour, occurring nearly exclusively in the descending part of the duodenum. It is regarded as a mostly benign tumour but of unknown malignant potential, which rarely metastasises to local lymph nodes or distantly. CASE REPORT Here we report on a 62-year-old female patient with a marked microcytic anaemia with a haemoglobin concentration of 3.4 mg/dL. Oesophagogastroduodenoscopy showed an ulcerous periampullary tumour in the duodenum with a diameter of approximately 5 cm. Endoscopic ultrasonography showed no evidence of tumour infiltration of the tunica muscularis and of locoregional lymph node metastasis. Therefore, complete endoscopic resection of the tumour was achieved after ligating the tumour base by an endoloop using a dual channel endoscope. In a second step, the tumour base was resected by endoscopic submucosal dissection (ESD) and revealed no residual tumour. The histological evaluation showed a gangliocytic paranganglioma consisting of three specific cell types: epithelioid cells arranged in typical carcinoid-like patterns, spindle cells wrapped around nests of epithelioid cells and ganglion cells. All cell types expressed neuron-specific enolase (NSE) as a neuroendocrine marker. Synaptophysine was expressed mainly by the epithelioid and ganglion cells while the protein S 100 was expressed mainly by the spindle cells, which surround the epithelioid cell nests as a sustentacular network. The proliferation rate determined by Ki67 staining was only < 5 %. CONCLUSION Gangliocytic gangliocytomas of the duodenum can be safely removed by endoscopic submucosal dissection as long as there is no evidence of infiltration of the tunica muscularis or of local lymph node metastasis. Because of the unknown malignant potential, these patients have to be controlled by regular ultrasonographic and endosonographic procedures.
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Affiliation(s)
- M Sandmann
- Medizinische Klinik, Gastroenterologie und Interventionelle Endoskopie, Klinikum Dortmund, Beurhausstraße 40, Dortmund.
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Lorenzen M, Wedegärtner U, Weber C, Adam G, Lorenzen J. Postoperative Monitoring of Distal Intraarticular Radial Fractures Treated with Osteosynthesis by means of Multislice CT. ROFO-FORTSCHR RONTG 2010; 183:120-5. [DOI: 10.1055/s-0029-1245569] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Lorenzen J, David S, Bahlmann FH, de Groot K, Bahlmann E, Kielstein JT, Haller H, Fliser D. Endothelial progenitor cells and cardiovascular events in patients with chronic kidney disease--a prospective follow-up study. PLoS One 2010; 5:e11477. [PMID: 20628606 PMCID: PMC2900210 DOI: 10.1371/journal.pone.0011477] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2010] [Accepted: 06/06/2010] [Indexed: 11/19/2022] Open
Abstract
Background Endothelial progenitor cells (EPCs) mediate vascular repair and regeneration. Their number in peripheral blood is related to cardiovascular events in individuals with normal renal function. Methods We evaluated the association between functionally active EPCs (cell culture) and traditional cardiovascular risk factors in 265 patients with chronic kidney disease stage V receiving hemodialysis therapy. Thereafter, we prospectively assessed cardiovascular events, e.g. myocardial infarction, percutaneous transluminal coronary angioplasty (including stenting), aorto-coronary bypass, stroke and angiographically verified stenosis of peripheral arteries, and cardiovascular death in this cohort. Results In our patients EPCs were related only to age (r = 0.154; p = 0.01). During a median follow-up period of 36 months 109 (41%) patients experienced a cardiovascular event. In a multiple Cox regression analysis, we identified EPCs (p = 0.03) and patient age (p = 0.01) as the only independent variables associated with incident cardiovascular events. Moreover, a total of 70 patients died during follow-up, 45 of those due to cardiovascular causes. Log rank test confirmed statistical significance for EPCs concerning incident cardiovascular events (p = 0.02). Conclusions We found a significant association between the number of functionally active EPCs and cardiovascular events in patients with chronic kidney disease. Thus, defective vascular repair and regeneration may be responsible, at least in part, for the enormous cardiovascular morbidity in this population.
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Affiliation(s)
- Johan Lorenzen
- Division of Nephrology, Department of Internal Medicine, Hannover Medical School, Hannover, Germany
| | - Sascha David
- Division of Nephrology, Department of Internal Medicine, Hannover Medical School, Hannover, Germany
| | - Ferdinand H. Bahlmann
- Department of Internal Medicine IV, Saarland University Medical Centre, Homburg/Saar, Germany
| | - Kirsten de Groot
- Division of Nephrology, Department of Internal Medicine, Hannover Medical School, Hannover, Germany
| | - Elisabeth Bahlmann
- Division of Nephrology, Department of Internal Medicine, Hannover Medical School, Hannover, Germany
| | - Jan T. Kielstein
- Division of Nephrology, Department of Internal Medicine, Hannover Medical School, Hannover, Germany
| | - Hermann Haller
- Division of Nephrology, Department of Internal Medicine, Hannover Medical School, Hannover, Germany
| | - Danilo Fliser
- Department of Internal Medicine IV, Saarland University Medical Centre, Homburg/Saar, Germany
- * E-mail:
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Lorenzen J, Lovric S, Krämer R, Haller H, Haubitz M. Osteopontin in antineutrophil cytoplasmic autoantibody-associated vasculitis: relation to disease activity, organ manifestation and immunosuppressive therapy. Ann Rheum Dis 2010; 69:1169-71. [DOI: 10.1136/ard.2009.113621] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundOsteopontin is a pleiotropic cytokine involved in the recruitment and retention of neutrophils to sites of inflammation, which are the primary targets cells in antineutrophil cytoplasmic autoantibody-associated vasculitis (AAV). Osteopontin may play a role in the pathogenesis of AAV.Methods24 patients with systemic AAV and six patients with limited granulomatous disease were included. 19 patients were followed up at 6 and 12 months after the initiation of immunosuppressive therapy. 21 matched healthy volunteers and 20 body mass index and glomerular filtration rate-matched patients with IgA nephropathy were included as controls. Plasma levels of osteopontin were measured by ELISA. Disease activity was gauged by the Birmingham vasculitis activity score (BVAS) and C-reactive protein (CRP).ResultsOsteopontin levels are elevated compared with controls (healthy p<0.001; IgA p<0.001).Osteopontin levels decrease significantly during follow-up (p=0.02). Osteopontin levels correlate with disease activity (BVAS r=0.93; CRP r=0.73; all p<0.001) as well as erythrocyturia (r=0.7, p<0.001) and proteinuria (r=0.54, p=0.007).ConclusionsActive AAV is characterised by increased plasma levels of osteopontin, which decrease dramatically with successful therapy. Osteopontin may mediate the inflammatory process in AAV through the recruitment of neutrophils.
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Lorenzen J, Krämer R, Kliem V, Bode-Boeger SM, Veldink H, Haller H, Fliser D, Kielstein JT. Circulating levels of osteopontin are closely related to glomerular filtration rate and cardiovascular risk markers in patients with chronic kidney disease. Eur J Clin Invest 2010; 40:294-300. [PMID: 20486990 DOI: 10.1111/j.1365-2362.2010.02271.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [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: 12/23/2022]
Abstract
BACKGROUND The pleiotropic cytokine osteopontin (OPN) is thought to be involved in the pathogenesis of atherosclerosis. However, the relationship between OPN and renal function, a cardiovascular risk factor itself, is not known. Therefore, we assessed the relationship between OPN plasma levels and renal function in patients at different stages of chronic kidney disease (CKD). METHODS We studied 49 non-diabetic and non-smoking patients with primary kidney disease at different CKD stages (K/DOQI 1-5). True glomerular filtration rate (GFR) in patients was assessed using the inulin-clearance technique. To examine the role of an abrupt change in GFR on circulating OPN, 15 living related kidney donors were studied before and after unilateral nephrectomy. Twenty matched non-smoking healthy subjects served as controls. RESULTS OPN plasma levels in patients with CKD stage 1 (i.e. GFR above 90 mL min(-1) 1.73 m(-2)) were comparable with controls. OPN levels increase in a linear fashion with declining GFR (r = -0.9, P < 0.0001), so that the increase in OPN mirrors the severity of renal impairment. After unilateral nephrectomy, circulating OPN increased significantly in parallel to the decrease in GFR. We found a direct association between OPN and other markers of renal function (serum-creatinine, homocysteine and symmetric dimethylarginine,) as well as with cardiovascular risk factors such as asymmetric dimethylarginine (r = 0.36, P = 0.0213). CONCLUSION There is a close inverse association between GFR and circulating OPN in patients with CKD. Furthermore, OPN plasma levels correlate with established cardiovascular risk markers in patients with CKD. Assessment of renal function is important for the interpretation of OPN levels in patients with atherosclerotic disease.
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Affiliation(s)
- Johan Lorenzen
- Department of Internal Medicine, Division of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany.
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Sagredo B, Balbyshev N, Lafta A, Casper H, Lorenzen J. A QTL that confers resistance to Colorado potato beetle (Leptinotarsa decemlineata [Say]) in tetraploid potato populations segregating for leptine. Theor Appl Genet 2009; 119:1171-1181. [PMID: 19693483 DOI: 10.1007/s00122-009-1118-y] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 02/19/2009] [Accepted: 07/20/2009] [Indexed: 05/28/2023]
Abstract
Genetic resistance to Colorado potato beetle (Leptinotarsa decemlineata [Say]) from Solanum chacoense has been incorporated in the tetraploid potato selection, ND4382-19, which is highly resistant and contains moderate level of foliar leptines. We recently reported using ND4382-19 progeny, population ND5873 (ND4382-19 x Chipeta), to map two genes that segregated as complementary epistatic genes that allow accumulation of leptinidine (Lep) and acetyl-leptinidine (AL) on chromosomes 2 and 8, respectively. We describe here the characterization of a second half-sib population NDG116 (ND4382-19 x N142-72). In this population, solasodine from parent N142-72, which has Solanum berthaultii in its background, was predominant over solanidine-based alkaloids. Concentrations of solanidine, leptinidine, and acetyl-leptinidine were 15-, 5-, and 14-fold lower than in the ND5873 population. Nevertheless, Lep and AL mapped to the same locations on chromosomes 2 and 8 of parent ND4382-19, respectively. The two populations were evaluated for resistance to Leptinotarsa in field assays, and by detached leaf assay for population NDG116. In both families, QTL analysis identified a major QTL from ND4382-19 on the distal end of chromosome 2, close to the Lep locus. The contribution of this QTL to resistance ranged from 11 to 34% for ND5873 at four field sites. Contribution to resistance from the linkage group that contains the gene AL for the accumulation of leptine was not detected. In family NDG116, the same chromosome 2 QTL was detected for field and detached leaf assays, explaining 26 and 12% of the variance for defoliation and larval development, respectively. These data may indicate another resistance mechanism besides leptine in the Leptinotarsa resistance observed in these populations.
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Affiliation(s)
- Boris Sagredo
- Instituto de Investigaciones Agropecuarias (INIA), CRI-Rayentué, Casilla 13, Rengo, Chile.
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Kraemer R, Lorenzen J, Rotter R, Vogt PM, Knobloch K. Achilles tendon suture deteriorates tendon capillary blood flow with sustained tissue oxygen saturation - an animal study. J Orthop Surg Res 2009; 4:32. [PMID: 19674439 PMCID: PMC2731078 DOI: 10.1186/1749-799x-4-32] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2008] [Accepted: 08/12/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Treatment of ruptured Achilles tendons currently constitutes of conservative early functional treatment or surgical treatment either by open or minimal invasive techniques. We hypothesize that an experimental Achilles tendon suture in an animal model significantly deteriorates Achilles tendon microcirculation immediately following suturing. METHODS Fifteen Achilles tendons of eight male Wistar rats (275-325 g) were included. After preparation of the Achilles tendon with a medial paratendinous approach, Achilles tendon microcirculation was assessed using combined Laser-Doppler and spectrophotometry (Oxygen-to-see) regarding:- tendinous capillary blood flow [arbitrary units AU]- tendinous tissue oxygen saturation [%]- tendinous venous filling pressure [rAU]The main body of the Achilles tendon was measured in the center of the suture with 50 Hz. 10 minutes after Achilles tendon suture (6-0 Prolene), a second assessment of microcirculatory parameters was performed. RESULTS Achilles tendon capillary blood flow decreased by 57% following the suture (70 +/- 30 AU vs. 31 +/- 16 AU; p < 0.001). Tendinous tissue oxygen saturation remained at the same level before and after suture (78 +/- 17% vs. 77 +/- 22%; p = 0.904). Tendinous venous filling pressure increased by 33% (54 +/- 16 AU vs. 72 +/- 20 AU; p = 0.019) after suture. CONCLUSION Achilles tendon suture in anaesthetised rats causes an acute loss of capillary perfusion and increases postcapillary venous filling pressures indicating venous stasis. The primary hypothesis of this study was confirmed. In contrast, tendinous tissue oxygen saturation remains unchanged excluding acute intratendinous hypoxia within the first 10 minutes after suture. Further changes of oxygen saturation remain unclear. Furthermore, it remains to be determined to what extent reduced capillary blood flow as well as increased postcapillary stasis might influence tendon healing from a microcirculatory point of view in this animal setting.
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Affiliation(s)
- Robert Kraemer
- Plastic, Hand and Reconstructive Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.
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Jost E, Lorenzen J, Haage P, Bos G, Beelen D, Galm O, Gehbauer G, Osieka R. Heart and muscle involvement by extra-medullary myeloid leukemia: A case report and review of the literature. Leuk Lymphoma 2009; 46:1819-24. [PMID: 16263587 DOI: 10.1080/10428190500233830] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Extra-medullary myeloid tumours (EMT) have been described after curative treatment for acute myeloid leukaemia (AML) in increasing numbers after allogeneic stem cell transplantation. The sites of manifestations are ubiquitous and the discovery is most frequently guided by symptoms reported by the patient or by findings on clinical examination. This study reports a case of EMT in muscles and the heart 1.5 years after allogeneic transplantation for an AML with t(8;21)(q22;23) who achieved a complete remission by use of an idarubicine-based combination chemotherapy. Pathological and imaging findings are presented and treatment options are discussed.
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Affiliation(s)
- E Jost
- Medizinische Klinik IV, Universitaetsklinikum Aachen, RWTH Aachen, Germany.
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Lorenzen J, Habermann C, Utler C, Grzyska U, Weber C, Adam G, Koops A. [Certified quality management according to DIN ISO 9001 in a radiology department at a university hospital: measurable changes in academic quality indicators?]. ROFO-FORTSCHR RONTG 2009; 181:970-8. [PMID: 19517336 DOI: 10.1055/s-0028-1109392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To evaluate the changes in academic quality indicators after implementation of a quality management system according to DIN ISO 9001:2000. MATERIALS AND METHODS After implementation and certification of a quality management system, the actual state based on quality indicators from the fields of student teaching, research, continuing education and the satisfaction of referring physician was determined. After implementation of an action plan for the individual areas, the temporal changes in the ratios were documented in the follow-up. RESULTS The evaluation of teaching performance obtained by questionnaire among the students of the radiology course showed a steady increase in satisfaction (mean value 2003: 2.7; 2007: 3.9). In the field of research an increase in scientific output was achieved based on the number of an internal publication score (2002: 99 points; 2006: 509). Repeated opinion surveys among our referring physicians found improvements in indicators for the appointment of investigations, consulting service and waiting times for the investigation, while the waiting times for internal transport service did not improve. Exemplary measurements of the success of the advanced training of the staff demonstrated the need for continuing education for quality improvement. CONCLUSION The evaluation of quality indicators showed over time a measurable positive impact on processes of a radiological University Hospital after implementation of a QM system according to DIN ISO 9001:2000.
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Affiliation(s)
- J Lorenzen
- Diagnostikzentrum, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg.
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Lorenzen M, Iken C, Braun C, Püschel K, Lorenzen J, Adam G, Weber C. Was leistet die postmortale MRT-Diagnostik des Thorax in Korrelation zur klassischen Autopsie in der Abklärung der Todesursache? ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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