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Terpe P, Ruhs S, Dubourg V, Bucher M, Gekle M. The synergism of cytosolic acidosis and reduced NAD +/NADH ratio is responsible for lactic acidosis-induced vascular smooth muscle cell impairment in sepsis. J Biomed Sci 2024; 31:3. [PMID: 38195466 PMCID: PMC10775599 DOI: 10.1186/s12929-023-00992-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/21/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND During sepsis, serve vascular dysfunctions lead to life-threatening multiple organ failure, due to vascular smooth muscle cells (VSMC) impairments, resulting in vasoplegia, hypotension and hypoperfusion. In addition, septic patients have an altered cell metabolism that leads to lactic acidosis. Septic patients suffering from lactic acidosis have a high risk of mortality. In addition, septic survivors are at risk of secondary vascular disease. The underlying mechanisms of whether and how lactic acidosis leads to the changes in VSMCs is not well understood. The aim of this study was to comprehensively investigate the effect of lactic acidosis on VSMCs and additionally compare the effects with those induced by pure acidosis and sodium lactate. METHODS Primary human aortic smooth muscle cells (HAoSMCs) were treated for 48 h with lactic acidosis (LA_pH 6.8), hydrochloric acid (HCl_pH 6.8), sodium lactate (Na+-lactate_pH 7.4) and the respective controls (ctrl._pH 7.4; hyperosmolarity control: mannitol_pH 7.4) and comparatively analyzed for changes in (i) transcriptome, (ii) energy metabolism, and (iii) phenotype. RESULTS Both types of acidosis led to comparable and sustained intracellular acidification without affecting cell viability. RNA sequencing and detailed transcriptome analysis revealed more significant changes for lactic acidosis than for hydrochloric acidosis, with lactate being almost ineffective, suggesting qualitative and quantitative synergism of acidosis and lactate. Bioinformatic predictions in energy metabolism and phenotype were confirmed experimentally. Lactic acidosis resulted in strong inhibition of glycolysis, glutaminolysis, and altered mitochondrial respiration which reduced cellular ATP content, likely due to increased TXNIP expression and altered NAD+/NADH ratio. Hydrochloric acidosis induced significantly smaller effects without changing the NAD+/NADH ratio, with the ATP content remaining constant. These metabolic changes led to osteo-/chondrogenic/senescent transdifferentiation of VSMCs, with the effect being more pronounced in lactic acidosis than in pure acidosis. CONCLUSIONS Overall, lactic acidosis exerted a much stronger effect on energy metabolism than pure acidosis, whereas lactate had almost no effect, reflecting the qualitative and quantitative synergism of acidosis and lactate. As a consequence, lactic acidosis may lead to acute functional impairments of VSMC, sustained perturbations of the transcriptome and cellular dedifferentiation. Moreover, these effects may contribute to the acute and prolonged vascular pathomechanisms in septic patients.
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Affiliation(s)
- Philipp Terpe
- Julius-Bernstein-Institute of Physiology, Martin Luther University Halle-Wittenberg, 06112, Halle (Saale), Germany
- Department of Anesthesiology and Surgical Intensive Care, University Hospital Halle (Saale), 06120, Halle (Saale), Germany
| | - Stefanie Ruhs
- Department of Anesthesiology and Surgical Intensive Care, University Hospital Halle (Saale), 06120, Halle (Saale), Germany.
| | - Virginie Dubourg
- Julius-Bernstein-Institute of Physiology, Martin Luther University Halle-Wittenberg, 06112, Halle (Saale), Germany
| | - Michael Bucher
- Department of Anesthesiology and Surgical Intensive Care, University Hospital Halle (Saale), 06120, Halle (Saale), Germany
| | - Michael Gekle
- Julius-Bernstein-Institute of Physiology, Martin Luther University Halle-Wittenberg, 06112, Halle (Saale), Germany
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Walker AC, Bhargava R, Bucher M, Brust AS, Czy DM. Identification of proteotoxic and proteoprotective bacteria that non-specifically affect proteins associated with neurodegenerative diseases. bioRxiv 2023:2023.10.24.563685. [PMID: 37961318 PMCID: PMC10634778 DOI: 10.1101/2023.10.24.563685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Neurodegenerative protein conformational diseases (PCDs), such as Alzheimer's, Parkinson's, and Huntington's, are a leading cause of death and disability worldwide and have no known cures or effective treatments. Emerging evidence suggests a role for the gut microbiota in the pathogenesis of neurodegenerative PCDs; however, the influence of specific bacteria on the culprit proteins associated with each of these diseases remains elusive, primarily due to the complexity of the microbiota. In the present study, we employed a single-strain screening approach to identify human bacterial isolates that enhance or suppress the aggregation of culprit proteins and the associated toxicity in Caenorhabditis elegans expressing Aβ1-42, α-synuclein, and polyglutamine tracts. Here, we reveal the first comprehensive analysis of the human microbiome for its effect on proteins associated with neurodegenerative diseases. Our results suggest that bacteria affect the aggregation of metastable proteins by modulating host proteostasis rather than selectively targeting specific disease-associated proteins. These results reveal bacteria that potentially influence the pathogenesis of PCDs and open new promising prevention and treatment opportunities by altering the abundance of beneficial and detrimental microbes.
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Affiliation(s)
- Alyssa C Walker
- Department of Microbiology and Cell Science, University of Florida, Gainesville, FL 32611, USA
| | - Rohan Bhargava
- Department of Microbiology and Cell Science, University of Florida, Gainesville, FL 32611, USA
| | - Michael Bucher
- Department of Microbiology and Cell Science, University of Florida, Gainesville, FL 32611, USA
| | - Amanda S Brust
- Department of Microbiology and Cell Science, University of Florida, Gainesville, FL 32611, USA
| | - Daniel M Czy
- Department of Microbiology and Cell Science, University of Florida, Gainesville, FL 32611, USA
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3
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Port M, Barquinero JF, Endesfelder D, Moquet J, Oestreicher U, Terzoudi G, Trompier F, Vral A, Abe Y, Ainsbury L, Alkebsi L, Amundson S, Badie C, Baeyens A, Balajee A, Balázs K, Barnard S, Bassinet C, Beaton-Green L, Beinke C, Bobyk L, Brochard P, Brzoska K, Bucher M, Ciesielski B, Cuceu C, Discher M, D,Oca M, Domínguez I, Doucha-Senf S, Dumitrescu A, Duy P, Finot F, Garty G, Ghandhi S, Gregoire E, Goh V, Güçlü I, Hadjiiska L, Hargitai R, Hristova R, Ishii K, Kis E, Juniewicz M, Kriehuber R, Lacombe J, Lee Y, Lopez Riego M, Lumniczky K, Mai T, Maltar-Strmečki N, Marrale M, Martinez J, Marciniak A, Maznyk N, McKeever S, Meher P, Milanova M, Miura T, Gil OM, Montoro A, Domene MM, Mrozik A, Nakayama R, O’Brien G, Oskamp D, Ostheim P, Pajic J, Pastor N, Patrono C, Pujol-Canadell M, Rodriguez MP, Repin M, Romanyukha A, Rößler U, Sabatier L, Sakai A, Scherthan H, Schüle S, Seong K, Sevriukova O, Sholom S, Sommer S, Suto Y, Sypko T, Szatmári T, Takahashi-Sugai M, Takebayashi K, Testa A, Testard I, Tichy A, Triantopoulou S, Tsuyama N, Unverricht-Yeboah M, Valente M, Van Hoey O, Wilkins R, Wojcik A, Wojewodzka M, Younghyun L, Zafiropoulos D, Abend M. RENEB Inter-Laboratory Comparison 2021: Inter-Assay Comparison of Eight Dosimetry Assays. Radiat Res 2023; 199:535-555. [PMID: 37310880 PMCID: PMC10508307 DOI: 10.1667/rade-22-00207.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/10/2023] [Indexed: 06/15/2023]
Abstract
Tools for radiation exposure reconstruction are required to support the medical management of radiation victims in radiological or nuclear incidents. Different biological and physical dosimetry assays can be used for various exposure scenarios to estimate the dose of ionizing radiation a person has absorbed. Regular validation of the techniques through inter-laboratory comparisons (ILC) is essential to guarantee high quality results. In the current RENEB inter-laboratory comparison, the performance quality of established cytogenetic assays [dicentric chromosome assay (DCA), cytokinesis-block micronucleus assay (CBMN), stable chromosomal translocation assay (FISH) and premature chromosome condensation assay (PCC)] was tested in comparison to molecular biological assays [gamma-H2AX foci (gH2AX), gene expression (GE)] and physical dosimetry-based assays [electron paramagnetic resonance (EPR), optically or thermally stimulated luminescence (LUM)]. Three blinded coded samples (e.g., blood, enamel or mobiles) were exposed to 0, 1.2 or 3.5 Gy X-ray reference doses (240 kVp, 1 Gy/min). These doses roughly correspond to clinically relevant groups of unexposed to low exposed (0-1 Gy), moderately exposed (1-2 Gy, no severe acute health effects expected) and highly exposed individuals (>2 Gy, requiring early intensive medical care). In the frame of the current RENEB inter-laboratory comparison, samples were sent to 86 specialized teams in 46 organizations from 27 nations for dose estimation and identification of three clinically relevant groups. The time for sending early crude reports and more precise reports was documented for each laboratory and assay where possible. The quality of dose estimates was analyzed with three different levels of granularity, 1. by calculating the frequency of correctly reported clinically relevant dose categories, 2. by determining the number of dose estimates within the uncertainty intervals recommended for triage dosimetry (±0.5 Gy or ±1.0 Gy for doses <2.5 Gy or >2.5 Gy), and 3. by calculating the absolute difference (AD) of estimated doses relative to the reference doses. In total, 554 dose estimates were submitted within the 6-week period given before the exercise was closed. For samples processed with the highest priority, earliest dose estimates/categories were reported within 5-10 h of receipt for GE, gH2AX, LUM, EPR, 2-3 days for DCA, CBMN and within 6-7 days for the FISH assay. For the unirradiated control sample, the categorization in the correct clinically relevant group (0-1 Gy) as well as the allocation to the triage uncertainty interval was, with the exception of a few outliers, successfully performed for all assays. For the 3.5 Gy sample the percentage of correct classifications to the clinically relevant group (≥2 Gy) was between 89-100% for all assays, with the exception of gH2AX. For the 1.2 Gy sample, an exact allocation to the clinically relevant group was more difficult and 0-50% or 0-48% of the estimates were wrongly classified into the lowest or highest dose categories, respectively. For the irradiated samples, the correct allocation to the triage uncertainty intervals varied considerably between assays for the 1.2 Gy (29-76%) and 3.5 Gy (17-100%) samples. While a systematic shift towards higher doses was observed for the cytogenetic-based assays, extreme outliers exceeding the reference doses 2-6 fold were observed for EPR, FISH and GE assays. These outliers were related to a particular material examined (tooth enamel for EPR assay, reported as kerma in enamel, but when converted into the proper quantity, i.e. to kerma in air, expected dose estimates could be recalculated in most cases), the level of experience of the teams (FISH) and methodological uncertainties (GE). This was the first RENEB ILC where everything, from blood sampling to irradiation and shipment of the samples, was organized and realized at the same institution, for several biological and physical retrospective dosimetry assays. Almost all assays appeared comparably applicable for the identification of unexposed and highly exposed individuals and the allocation of medical relevant groups, with the latter requiring medical support for the acute radiation scenario simulated in this exercise. However, extreme outliers or a systematic shift of dose estimates have been observed for some assays. Possible reasons will be discussed in the assay specific papers of this special issue. In summary, this ILC clearly demonstrates the need to conduct regular exercises to identify research needs, but also to identify technical problems and to optimize the design of future ILCs.
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Affiliation(s)
- M. Port
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | | | | | - J. Moquet
- UK Health Security Agency, Radiation, Chemical and Environmental Hazards Division, Oxfordshire, United Kingdom
| | | | - G. Terzoudi
- National Centre for Scientific Research “Demokritos”, Health Physics, Radiobiology & Cytogenetics Laboratory, Agia Paraskevi, Greece
| | - F. Trompier
- Institut de Radioprotection et de Surete Nucleaire, Fontenay aux Roses, France
| | - A. Vral
- Ghent University, Radiobiology Research Unit, Gent, Belgium
| | - Y. Abe
- Department of Radiation Biology and Protection, Nagasaki University, Japan
| | - L. Ainsbury
- UK Health Security Agency and Office for Health Improvement and Disparities, Cytogenetics and Pathology Group, Oxfordshire, England
| | - L Alkebsi
- Department of Radiation Measurement and Dose Assessment, National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - S.A. Amundson
- Columbia University, Irving Medical Center, Center for Radiological Research, New York, New York
| | - C. Badie
- UK Health Security Agency, Radiation, Chemical and Environmental Hazards Division, Oxfordshire, United Kingdom
| | - A. Baeyens
- Ghent University, Radiobiology Research Unit, Gent, Belgium
| | - A.S. Balajee
- Cytogenetic Biodosimetry Laboratory, Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - K. Balázs
- Radiation Medicine Unit, Department of Radiobiology and Radiohygiene, National Public Health Centre, Budapest, Hungary
| | - S. Barnard
- UK Health Security Agency, Radiation, Chemical and Environmental Hazards Division, Oxfordshire, United Kingdom
| | - C. Bassinet
- Institut de Radioprotection et de Surete Nucleaire, Fontenay aux Roses, France
| | | | - C. Beinke
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - L. Bobyk
- Institut de Recherche Biomédicale des Armées (IRBA), Bretigny Sur Orge, France
| | | | - K. Brzoska
- Institute of Nuclear Chemistry and Technology, Warsaw, Poland
| | - M. Bucher
- Bundesamt für Strahlenschutz, Oberschleißheim, Germany
| | - B. Ciesielski
- Medical University of Gdansk, Department of Physics and Biophysics, Gdansk, Poland
| | - C. Cuceu
- Genevolution, Porcheville, France
| | - M. Discher
- Paris-Lodron-University of Salzburg, Department of Environment and Biodiversity, 5020 Salzburg, Austria
| | - M.C. D,Oca
- Università Degli Studi di Palermo, Dipartimento di Fisica e Chimica “Emilio Segrè,” Palermo, Italy
| | - I. Domínguez
- Universidad de Sevilla, Departamento de Biología Celular, Sevilla, Spain
| | | | - A. Dumitrescu
- National Institute of Public Health, Radiation Hygiene Laboratory, Bucharest, Romania
| | - P.N. Duy
- Dalat Nuclear Research Institute, Radiation Technlogy & Biotechnology Center, Dalat City, Vietnam
| | - F. Finot
- Genevolution, Porcheville, France
| | - G. Garty
- Columbia University, Irving Medical Center, Center for Radiological Research, New York, New York
| | - S.A. Ghandhi
- Columbia University, Irving Medical Center, Center for Radiological Research, New York, New York
| | - E. Gregoire
- Institut de Radioprotection et de Surete Nucleaire, Fontenay aux Roses, France
| | - V.S.T. Goh
- Department of Radiobiology, Singapore Nuclear Research and Safety Initiative (SNRSI), National University of Singapore, Singapore
| | - I. Güçlü
- TENMAK, Nuclear Energy Research Institute, Technology Development and Nuclear Research Department, Türkey
| | - L. Hadjiiska
- National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria
| | - R. Hargitai
- Radiation Medicine Unit, Department of Radiobiology and Radiohygiene, National Public Health Centre, Budapest, Hungary
| | - R. Hristova
- National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria
| | - K. Ishii
- Department of Radiation Measurement and Dose Assessment, National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - E. Kis
- Radiation Medicine Unit, Department of Radiobiology and Radiohygiene, National Public Health Centre, Budapest, Hungary
| | - M. Juniewicz
- Medical University of Gdansk, Department of Physics and Biophysics, Gdansk, Poland
| | - R. Kriehuber
- Department of Safety and Radiation Protection, Forschungszentrum Jülich, Jülich, Germany
| | - J. Lacombe
- University of Arizona, Center for Applied Nanobioscience & Medicine, Phoenix, Arizona
| | - Y. Lee
- Laboratory of Biological Dosimetry, Korea Institute of Radiological & Medical Sciences, Seoul, Republic of Korea
| | | | - K. Lumniczky
- Radiation Medicine Unit, Department of Radiobiology and Radiohygiene, National Public Health Centre, Budapest, Hungary
| | - T.T. Mai
- Dalat Nuclear Research Institute, Radiation Technlogy & Biotechnology Center, Dalat City, Vietnam
| | - N. Maltar-Strmečki
- Ruðer Boškovic Institute, Division of Physical Chemistry, Zagreb, Croatia
| | - M. Marrale
- Università Degli Studi di Palermo, Dipartimento di Fisica e Chimica “Emilio Segrè,” Palermo, Italy
| | - J.S. Martinez
- Institut de Radioprotection et de Surete Nucleaire, Fontenay aux Roses, France
| | - A. Marciniak
- Medical University of Gdansk, Department of Physics and Biophysics, Gdansk, Poland
| | - N. Maznyk
- Radiation Cytogenetics Laboratory, S.P. Grigoriev Institute for Medical Radiology and Oncology of Ukrainian National Academy of Medical Science, Kharkiv, Ukraine
| | - S.W.S. McKeever
- Radiation Dosimetry Laboratory, Oklahoma State University, Stillwater, Oklahoma
| | | | - M. Milanova
- University of Defense, Faculty of Military Health Sciences, Hradec Králové, Czech Republic
| | - T. Miura
- Institute of Radiation Emergency Medicine, Hirosaki University, Hirosaki, Japan
| | - O. Monteiro Gil
- Instituto Superior Técnico/ Campus Tecnológico e Nuclear, Lisbon, Portugal
| | - A. Montoro
- Servicio de Protección Radiológica. Laboratorio de Dosimetría Biológica, Valencia, Spain
| | - M. Moreno Domene
- Hospital General Universitario Gregorio Marañón, Laboratorio de dosimetría biológica, Madrid, Spain
| | - A. Mrozik
- Institute of Nuclear Physics, Polish Academy of Sciences, Krakow, Poland
| | - R. Nakayama
- Institute of Radiation Emergency Medicine, Hirosaki University, Hirosaki, Japan
| | - G. O’Brien
- UK Health Security Agency, Radiation, Chemical and Environmental Hazards Division, Oxfordshire, United Kingdom
| | - D. Oskamp
- Department of Safety and Radiation Protection, Forschungszentrum Jülich, Jülich, Germany
| | - P. Ostheim
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - J. Pajic
- Serbian Institute of Occupational Health, Belgrade, Serbia
| | - N. Pastor
- Universidad de Sevilla, Departamento de Biología Celular, Sevilla, Spain
| | - C. Patrono
- Italian National Agency for New Technologies, Energy and Sustainable Economic Development, Rome, Italy
| | | | - M.J. Prieto Rodriguez
- Hospital General Universitario Gregorio Marañón, Laboratorio de dosimetría biológica, Madrid, Spain
| | - M. Repin
- Columbia University, Irving Medical Center, Center for Radiological Research, New York, New York
| | | | - U. Rößler
- Bundesamt für Strahlenschutz, Oberschleißheim, Germany
| | | | - A. Sakai
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - H. Scherthan
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - S. Schüle
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - K.M. Seong
- Laboratory of Biological Dosimetry, Korea Institute of Radiological & Medical Sciences, Seoul, Republic of Korea
| | | | - S. Sholom
- Radiation Dosimetry Laboratory, Oklahoma State University, Stillwater, Oklahoma
| | - S. Sommer
- Institute of Nuclear Chemistry and Technology, Warsaw, Poland
| | - Y. Suto
- Department of Radiation Measurement and Dose Assessment, National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - T. Sypko
- Radiation Cytogenetics Laboratory, S.P. Grigoriev Institute for Medical Radiology and Oncology of Ukrainian National Academy of Medical Science, Kharkiv, Ukraine
| | - T. Szatmári
- Radiation Medicine Unit, Department of Radiobiology and Radiohygiene, National Public Health Centre, Budapest, Hungary
| | - M. Takahashi-Sugai
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - K. Takebayashi
- Institute of Radiation Emergency Medicine, Hirosaki University, Hirosaki, Japan
| | - A. Testa
- Italian National Agency for New Technologies, Energy and Sustainable Economic Development, Rome, Italy
| | - I. Testard
- CEA-Saclay, Gif-sur-Yvette Cedex, France
| | - A. Tichy
- University of Defense, Faculty of Military Health Sciences, Hradec Králové, Czech Republic
| | - S. Triantopoulou
- National Centre for Scientific Research “Demokritos”, Health Physics, Radiobiology & Cytogenetics Laboratory, Agia Paraskevi, Greece
| | - N. Tsuyama
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - M. Unverricht-Yeboah
- Department of Safety and Radiation Protection, Forschungszentrum Jülich, Jülich, Germany
| | - M. Valente
- CEA-Saclay, Gif-sur-Yvette Cedex, France
| | - O. Van Hoey
- Belgian Nuclear Research Center SCK CEN, Mol, Belgium
| | | | - A. Wojcik
- Stockholm University, Stockholm, Sweden
| | - M. Wojewodzka
- Institute of Nuclear Chemistry and Technology, Warsaw, Poland
| | - Lee Younghyun
- Laboratory of Biological Dosimetry, Korea Institute of Radiological & Medical Sciences, Seoul, Republic of Korea
| | - D. Zafiropoulos
- Laboratori Nazionali di Legnaro - Istituto Nazionale di Fisica Nucleare, Legnaro, Italy
| | - M. Abend
- Bundeswehr Institute of Radiobiology, Munich, Germany
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Endesfelder D, Oestreicher U, Bucher M, Beinke C, Siebenwirth C, Ainsbury E, Moquet J, Gruel G, Gregoire E, Martinez JS, Vral A, Baeyens A, Valente M, Montoro A, Terzoudi G, Triantopoulou S, Pantelias A, Gil OM, Prieto MJ, Domene MM, Zafiropoulos D, Barquinero JF, Pujol-Canadell M, Lumniczky K, Hargitai R, Kis E, Testa A, Patrono C, Sommer S, Hristova R, Kostova N, Atanasova M, Sevriukova O, Domínguez I, Pastor N, Güçlü I, Pajic J, Sabatier L, Brochard P, Tichy A, Milanova M, Finot F, Petrenci CC, Wilkins RC, Beaton-Green LA, Seong KM, Lee Y, Lee YH, Balajee AS, Maznyk N, Sypko T, Pham ND, Tran TM, Miura T, Suto Y, Akiyamam M, Tsuyama N, Abe Y, Goh VST, Chua CEL, Abend M, Port M. RENEB Inter-Laboratory Comparison 2021: The Dicentric Chromosome Assay. Radiat Res 2023:492028. [PMID: 37018160 DOI: 10.1667/rade-22-00202.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 02/03/2023] [Indexed: 04/06/2023]
Abstract
After large-scale radiation accidents where many individuals are suspected to be exposed to ionizing radiation, biological and physical retrospective dosimetry assays are important tools to aid clinical decision making by categorizing individuals into unexposed/minimally, moderately or highly exposed groups. Quality-controlled inter-laboratory comparisons of simulated accident scenarios are regularly performed in the frame of the European legal association RENEB (Running the European Network of Biological and Physical retrospective Dosimetry) to optimize international networking and emergency readiness in case of large-scale radiation events. In total 33 laboratories from 22 countries around the world participated in the current RENEB inter-laboratory comparison 2021 for the dicentric chromosome assay. Blood was irradiated in vitro with X rays (240 kVp, 13 mA, ∼75 keV, 1 Gy/min) to simulate an acute, homogeneous whole-body exposure. Three blood samples (no. 1: 0 Gy, no. 2: 1.2 Gy, no. 3: 3.5 Gy) were sent to each participant and the task was to culture samples, to prepare slides and to assess radiation doses based on the observed dicentric yields from 50 manually or 150 semi-automatically scored metaphases (triage mode scoring). Approximately two-thirds of the participants applied calibration curves from irradiations with γ rays and about 1/3 from irradiations with X rays with varying energies. The categorization of the samples in clinically relevant groups corresponding to individuals that were unexposed/minimally (0-1 Gy), moderately (1-2 Gy) or highly exposed (>2 Gy) was successfully performed by all participants for sample no. 1 and no. 3 and by ≥74% for sample no. 2. However, while most participants estimated a dose of exactly 0 Gy for the sham-irradiated sample, the precise dose estimates of the samples irradiated with doses >0 Gy were systematically higher than the corresponding reference doses and showed a median deviation of 0.5 Gy (sample no. 2) and 0.95 Gy (sample no. 3) for manual scoring. By converting doses estimated based on γ-ray calibration curves to X-ray doses of a comparable mean photon energy as used in this exercise, the median deviation decreased to 0.27 Gy (sample no. 2) and 0.6 Gy (sample no. 3). The main aim of biological dosimetry in the case of a large-scale event is the categorization of individuals into clinically relevant groups, to aid clinical decision making. This task was successfully performed by all participants for the 0 Gy and 3.5 Gy samples and by 74% (manual scoring) and 80% (semi-automatic scoring) for the 1.2 Gy sample. Due to the accuracy of the dicentric chromosome assay and the high number of participating laboratories, a systematic shift of the dose estimates could be revealed. Differences in radiation quality (X ray vs. γ ray) between the test samples and the applied dose effect curves can partly explain the systematic shift. There might be several additional reasons for the observed bias (e.g., donor effects, transport, experimental conditions or the irradiation setup) and the analysis of these reasons provides great opportunities for future research. The participation of laboratories from countries around the world gave the opportunity to compare the results on an international level.
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Affiliation(s)
- D Endesfelder
- Bundesamt für Strahlenschutz, BfS, Oberschleissheim, Germany
| | - U Oestreicher
- Bundesamt für Strahlenschutz, BfS, Oberschleissheim, Germany
| | - M Bucher
- Bundesamt für Strahlenschutz, BfS, Oberschleissheim, Germany
| | - C Beinke
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - C Siebenwirth
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - E Ainsbury
- UK Health Security Agency, Radiation, Chemicals and Environmental Hazards Directorate, Chilton, Oxfordshire, United Kingdom
| | - J Moquet
- UK Health Security Agency, Radiation, Chemicals and Environmental Hazards Directorate, Chilton, Oxfordshire, United Kingdom
| | - G Gruel
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-Santé, SERAMED, LRAcc Fontenay-aux-Roses 92262, France
| | - E Gregoire
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-Santé, SERAMED, LRAcc Fontenay-aux-Roses 92262, France
| | - J S Martinez
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-Santé, SERAMED, LRAcc Fontenay-aux-Roses 92262, France
| | - A Vral
- Faculty of Medicine and Health Sciences, Universiteit Gent, Gent, Belgium
| | - A Baeyens
- Faculty of Medicine and Health Sciences, Universiteit Gent, Gent, Belgium
| | - M Valente
- Armed Forces Biomedical Research Institute, Department of Radiation Biological, Effects Brétigny-sur-Orge, France
| | - A Montoro
- Laboratorio de Dosimetría Biológica Servicio de Protección Radiológica Hospital Universitario Politécnico la Fe, Spain
| | - G Terzoudi
- National Centre for Scientific Research "Demokritos," Health Physics, Radiobiology & Cytogenetics Laboratory, Athens, Greece
| | - S Triantopoulou
- National Centre for Scientific Research "Demokritos," Health Physics, Radiobiology & Cytogenetics Laboratory, Athens, Greece
| | - A Pantelias
- National Centre for Scientific Research "Demokritos," Health Physics, Radiobiology & Cytogenetics Laboratory, Athens, Greece
| | - O Monteiro Gil
- Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico (IST), Universidade de Lisboa, Lisboa, Portugal
| | - M J Prieto
- Hospital General Universitario Gregorio Marañón; Servicio de Oncología Radioterápica; Laboratorio de dosimetría biológica, Madrid, Spain
| | - M M Domene
- Hospital General Universitario Gregorio Marañón; Servicio de Oncología Radioterápica; Laboratorio de dosimetría biológica, Madrid, Spain
| | - D Zafiropoulos
- Laboratori Nazionali di Legnaro - Istituto Nazionale di Fisica Nucleare, Legnaro, Italy
| | | | | | - K Lumniczky
- Radiation Medicine Unit, Department of Radiobiology and Radiohygiene, National Public Health Centre, Budapest, Hungary
| | - R Hargitai
- Radiation Medicine Unit, Department of Radiobiology and Radiohygiene, National Public Health Centre, Budapest, Hungary
| | - E Kis
- Radiation Medicine Unit, Department of Radiobiology and Radiohygiene, National Public Health Centre, Budapest, Hungary
| | - A Testa
- Agenzia nazionale per le nuove tecnologie, l'energia e lo sviluppo economico sostenibile, Rome, Italy
| | - C Patrono
- Agenzia nazionale per le nuove tecnologie, l'energia e lo sviluppo economico sostenibile, Rome, Italy
| | - S Sommer
- Institute of Nuclear Chemistry and Technology, Warsaw, Poland
| | - R Hristova
- National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria
| | - N Kostova
- National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria
| | - M Atanasova
- National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria
| | - O Sevriukova
- Laboratori Nazionali di Legnaro - Istituto Nazionale di Fisica Nucleare, Legnaro, Italy
| | - I Domínguez
- Universidad de Sevilla, Departamento de Biología Celular, Facultad de Biología, Sevilla, Spain
| | - N Pastor
- Universidad de Sevilla, Departamento de Biología Celular, Facultad de Biología, Sevilla, Spain
| | - I Güçlü
- Nükleer Arş Ens. Yarımburgaz mah. Nükleer Arş yolu, Turkey
| | - J Pajic
- Serbian Institute of Occupational Health, Belgrade, Serbia
| | - L Sabatier
- PROCyTOX, Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Fontenay-aux-Roses, France and Université Paris-Saclay, France
| | - P Brochard
- PROCyTOX, Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Fontenay-aux-Roses, France and Université Paris-Saclay, France
| | - A Tichy
- Department of Radiobiology, Faculty of Military Health Sciences, University of Defence, Hradec Králové, Czech Republic
| | - M Milanova
- Department of Radiobiology, Faculty of Military Health Sciences, University of Defence, Hradec Králové, Czech Republic
| | - F Finot
- Genevolution, Porcheville, France
| | | | - R C Wilkins
- Consumer and Clinical Radiation Protection Bureau, Health Canada, Ottawa, Canada
| | - L A Beaton-Green
- Consumer and Clinical Radiation Protection Bureau, Health Canada, Ottawa, Canada
| | - K M Seong
- Lab of Biological Dosimetry, National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, Seoul, Republic of Korea
| | - Y Lee
- Lab of Biological Dosimetry, National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, Seoul, Republic of Korea
| | - Y H Lee
- Lab of Biological Dosimetry, National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, Seoul, Republic of Korea
| | - A S Balajee
- Cytogenetic Biodosimetry Laboratory; Radiation Emergency Assistance Center/Training Site (REAC/TS); Oak Ridge Institute for Science and Education; Oak Ridge Associated Universities; Oak Ridge, Tennessee
| | - N Maznyk
- aa Radiation Cytogenetics Laboratory; S.P. Grigoriev Institute for Medical Radiology and Oncology of Ukrainian National Academy of Medical Science, Kharkiv, Ukraine
| | - T Sypko
- aa Radiation Cytogenetics Laboratory; S.P. Grigoriev Institute for Medical Radiology and Oncology of Ukrainian National Academy of Medical Science, Kharkiv, Ukraine
| | - N D Pham
- bb Biodosimetry Laboratory, Center for Radiation Technology & Biotechnology; Dalat Nuclear Research Institute; Dalat City, Vietnam
| | - T M Tran
- bb Biodosimetry Laboratory, Center for Radiation Technology & Biotechnology; Dalat Nuclear Research Institute; Dalat City, Vietnam
| | - T Miura
- cc Department of Risk Analysis and Biodosimetry Institute of Radiation Emergency Medicine, Hirosaki University, Hirosaki, Japan
| | - Y Suto
- dd National Institutes for Quantum Science and Technology, Chiba, Japan
| | - M Akiyamam
- dd National Institutes for Quantum Science and Technology, Chiba, Japan
| | - N Tsuyama
- ee Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Y Abe
- ff Department of Radiation Biology and Protection, Atomic Bomb Disease Institute, Nagasaki University, Japan
| | - V S T Goh
- ff Department of Radiation Biology and Protection, Atomic Bomb Disease Institute, Nagasaki University, Japan
| | - C E L Chua
- gg Department of Radiobiology, Singapore Nuclear Research and Safety Initiative (SNRSI), National University of Singapore, Singapore
| | - M Abend
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - M Port
- Bundeswehr Institute of Radiobiology, Munich, Germany
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5
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Dinse CM, Bucher M, Burgdorff AM, Christel A, Flöther L. Pain management in surgical intensive care patients: A retrospective observational research. Medicine (Baltimore) 2022; 101:e31297. [PMID: 36401417 PMCID: PMC9678561 DOI: 10.1097/md.0000000000031297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Sepsis and septic shock are the most common causes of death in non-cardiac surgical intensive care units (ICU). Adequate analgesia is essential to achieve positive outcomes. There were differences in pain management between patients with and without sepsis or septic shock. The release of inflammatory mediators, especially cytokines, in sepsis or septic shock decreases the pain threshold. Septic intensive care patients probably require higher doses of opioids than do non-septic patients. A retrospective observational study was carried out in an anesthesiologic intensive care unit from January 1, 2014 to June 30, 2016. Patients were divided into 4 groups according to the following criteria: sepsis ("yes/no" and communication ability "yes/no"). After adjusting for the number of cases using the pairing method, a total of 356 patients were recruited. The endpoint of our study was defined as the "total opioid dose". Statistical evaluations were performed using t tests and 2-factor analysis of variance. There was a significant difference in opioid doses between communicative and non-communicative ICU patients F(1, 352) = 55.102, P < .001). This effect was observed in the ICU patients with and without sepsis. The mean sufentanil dose was significantly higher in non-communicative patients than in communicative patients group (E(1, 352) = 51.435, P < .001, partial ƞ2 = 0.144). The effect of higher opioid- (F(1, 352) = 1.941, P = .161) and sufentanil (F(1, 352) = 1.798, P = .342) requirement was not statistically significant due to sepsis. The hypothesis that sepsis decreases the pain threshold could not be proven in this study. The effect of a higher opioid requirement is not directly caused by sepsis but by communication ability. Furthermore, we were able to show through our investigations and especially through the data of the pain recording instruments that the septic and non-septic intensive care patients receive sufficient pain therapy treatment in our ICU. Regular pain evaluations should be performed on patients in the ICUs who are able to communicate and those who are not.
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Affiliation(s)
- Christoph Moritz Dinse
- Department of Anesthesiology, Intensive Care, Rescue and Pain Medicine, BG Klinikum Hamburg, Germany
- * Correspondence: Christoph Moritz Dinse, Department of Anesthesiology, Intensive Care, Rescue and Pain Medicine, BG Klinikum Hamburg, Bergedorfer Str. 10, 21033 Hamburg, Germany (e-mail: )
| | - Michael Bucher
- Department of Anesthesiology and Surgical Intensive Care Medicine, University Hospital Halle (Saale), Halle (Saale), Germany
| | - Anna-Maria Burgdorff
- Department of Anesthesiology and Intensive Care Medicine, Helios Kliniken Mansfeld-Südharz, Hettstedt, Germany
| | - Annett Christel
- Department of Anesthesiology, Intensive Care, Rescue and Pain Medicine, BG Klinikum Hamburg, Germany
| | - Lilit Flöther
- Department of Anesthesiology and Surgical Intensive Care Medicine, University Hospital Halle (Saale), Halle (Saale), Germany
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Bär J, Popp Y, Bucher M, Mikhaylova M. Direct and indirect effects of tubulin post-translational modifications on microtubule stability: Insights and regulations. Biochim Biophys Acta Mol Cell Res 2022; 1869:119241. [PMID: 35181405 DOI: 10.1016/j.bbamcr.2022.119241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 01/28/2022] [Accepted: 01/28/2022] [Indexed: 12/17/2022]
Abstract
Microtubules (MTs) mediate various cellular functions such as structural support, chromosome segregation, and intracellular transport. To achieve this, the pivotal properties of MTs have to be changeable and tightly controlled. This is enabled by a high variety of tubulin posttranslational modifications, which influence MT properties directly, via altering the MT lattice structurally, or indirectly by changing MT interaction partners. Here, the distinction between these direct and indirect effects of MT PTMs are exemplified by acetylation of the luminal α-tubulin K40 resulting in decreased rigidity of MTs, and by MT detyrosination which decreases interaction with depolymerizing proteins, thus causing more stable MTs. We discuss how these PTMs are reversed and regulated, e.g. on the level of enzyme transcription, localization, and activity via various signalling pathways including the conventional calcium-dependent proteases calpains and how advances in microscopy techniques and development of live-sensors facilitate the understanding of MT PTM interaction and effects.
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Affiliation(s)
- Julia Bär
- RG Optobiology, Institute of Biology, Humboldt Universität zu Berlin, Invalidenstr. 42, 10115 Berlin, Germany; Guest Group "Neuronal Protein Transport", Center for Molecular Neurobiology, ZMNH, University Medical Center Hamburg-Eppendorf, Falkenried 94, 20251 Hamburg, Germany.
| | - Yannes Popp
- RG Optobiology, Institute of Biology, Humboldt Universität zu Berlin, Invalidenstr. 42, 10115 Berlin, Germany; Guest Group "Neuronal Protein Transport", Center for Molecular Neurobiology, ZMNH, University Medical Center Hamburg-Eppendorf, Falkenried 94, 20251 Hamburg, Germany.
| | - Michael Bucher
- RG Optobiology, Institute of Biology, Humboldt Universität zu Berlin, Invalidenstr. 42, 10115 Berlin, Germany; Guest Group "Neuronal Protein Transport", Center for Molecular Neurobiology, ZMNH, University Medical Center Hamburg-Eppendorf, Falkenried 94, 20251 Hamburg, Germany.
| | - Marina Mikhaylova
- RG Optobiology, Institute of Biology, Humboldt Universität zu Berlin, Invalidenstr. 42, 10115 Berlin, Germany; Guest Group "Neuronal Protein Transport", Center for Molecular Neurobiology, ZMNH, University Medical Center Hamburg-Eppendorf, Falkenried 94, 20251 Hamburg, Germany.
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Konietzny A, Grendel J, Kadek A, Bucher M, Han Y, Hertrich N, Dekkers DHW, Demmers JAA, Grünewald K, Uetrecht C, Mikhaylova M. Caldendrin and myosin V regulate synaptic spine apparatus localization via ER stabilization in dendritic spines. EMBO J 2022; 41:e106523. [PMID: 34935159 PMCID: PMC8844991 DOI: 10.15252/embj.2020106523] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 11/08/2021] [Accepted: 11/19/2021] [Indexed: 11/21/2022] Open
Abstract
Excitatory synapses of principal hippocampal neurons are frequently located on dendritic spines. The dynamic strengthening or weakening of individual inputs results in structural and molecular diversity of dendritic spines. Active spines with large calcium ion (Ca2+ ) transients are frequently invaded by a single protrusion from the endoplasmic reticulum (ER), which is dynamically transported into spines via the actin-based motor myosin V. An increase in synaptic strength correlates with stable anchoring of the ER, followed by the formation of an organelle referred to as the spine apparatus. Here, we show that myosin V binds the Ca2+ sensor caldendrin, a brain-specific homolog of the well-known myosin V interactor calmodulin. While calmodulin is an essential activator of myosin V motor function, we found that caldendrin acts as an inhibitor of processive myosin V movement. In mouse and rat hippocampal neurons, caldendrin regulates spine apparatus localization to a subset of dendritic spines through a myosin V-dependent pathway. We propose that caldendrin transforms myosin into a stationary F-actin tether that enables the localization of ER tubules and formation of the spine apparatus in dendritic spines.
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Affiliation(s)
- Anja Konietzny
- RG OptobiologyInstitute of BiologyHumboldt Universität zu BerlinBerlinGermany
- Guest Group Neuronal Protein TransportCenter for Molecular NeurobiologyZMNHUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Jasper Grendel
- RG OptobiologyInstitute of BiologyHumboldt Universität zu BerlinBerlinGermany
- Guest Group Neuronal Protein TransportCenter for Molecular NeurobiologyZMNHUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Alan Kadek
- Leibniz Institute for Experimental Virology (HPI)HamburgGermany
- European XFEL GmbHSchenefeldGermany
| | - Michael Bucher
- RG OptobiologyInstitute of BiologyHumboldt Universität zu BerlinBerlinGermany
- Guest Group Neuronal Protein TransportCenter for Molecular NeurobiologyZMNHUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Yuhao Han
- RG OptobiologyInstitute of BiologyHumboldt Universität zu BerlinBerlinGermany
- Guest Group Neuronal Protein TransportCenter for Molecular NeurobiologyZMNHUniversity Medical Center Hamburg‐EppendorfHamburgGermany
- Centre for Structural Systems BiologyHamburgGermany
| | - Nathalie Hertrich
- RG OptobiologyInstitute of BiologyHumboldt Universität zu BerlinBerlinGermany
- Guest Group Neuronal Protein TransportCenter for Molecular NeurobiologyZMNHUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | | | | | - Kay Grünewald
- Leibniz Institute for Experimental Virology (HPI)HamburgGermany
- Centre for Structural Systems BiologyHamburgGermany
- Department of ChemistryUniversity of HamburgHamburgGermany
| | - Charlotte Uetrecht
- Leibniz Institute for Experimental Virology (HPI)HamburgGermany
- European XFEL GmbHSchenefeldGermany
- Centre for Structural Systems BiologyHamburgGermany
| | - Marina Mikhaylova
- RG OptobiologyInstitute of BiologyHumboldt Universität zu BerlinBerlinGermany
- Guest Group Neuronal Protein TransportCenter for Molecular NeurobiologyZMNHUniversity Medical Center Hamburg‐EppendorfHamburgGermany
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8
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Koppenberg J, Stoevesandt D, Watzke S, Schwappach D, Bucher M. Analysis of 30 anaesthesia-related deaths in Germany between 2006 and 2015: An analysis of a closed claims database. Eur J Anaesthesiol 2022; 39:33-41. [PMID: 34397508 DOI: 10.1097/eja.0000000000001586] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Anaesthesiology is one of the safest fields in medicine today in relation to mortality. Deaths directly because of anaesthesia have fortunately now become rare exceptions. Nevertheless, important findings can still be drawn from the rare deaths that still occur. OBJECTIVE The aim of this study was to identify and analyse the causes of deaths related to anaesthesia alone over a 10-year period. DESIGN Retrospective structured analysis of a database of medical liability claims. SETTING Hospitals at all levels of care in Germany. PATIENTS The database of a large insurance broker included data for 81 413 completed liability claims over the 10-year period from 2006 to 2015. Among 1914 cases associated with anaesthetic procedures, 56 deaths were identified. Of these, 30 clearly involved anaesthesia (Edwards category 1) and were included in the evaluation. INTERVENTIONS None (retrospective database analysis). MAIN OUTCOME MEASURES Causes of anaesthesia-related death identified from medical records, court records, expert opinions and autopsy reports. RESULTS The 30 deaths were analysed in detail at the case and document level. They included high proportions of 'potentially avoidable' deaths, at 86.6%, and what are termed 'never events', at 66.7%. Problems with the airway were the cause in 40% and problems with correct monitoring in 20%. In addition, communication problems were identified as a 'human factor' in 50% of the cases. CONCLUSION The majority of the anaesthesia-related deaths investigated could very probably have been avoided with simple anaesthesiological measures if routine guidelines had been followed and current standards observed. Actions to be taken are inferred from these results, and recommendations are made. In future, greater care must be taken to ensure that the level of safety already achieved in anaesthesiology can be maintained despite demographic developments and increasing economic pressures.
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Affiliation(s)
- Joachim Koppenberg
- Department of Anaesthesiology, Pain Therapy and Emergency Medicine, Lower Engadine Hospital and Health Centre, Scuol, Switzerland (JK), Dorothea Erxleben Lernzentrum Halle, Medical Faculty of Martin Luther University of Halle-Wittenberg, Halle, Germany (DS), Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital of Halle (Saale), Germany (SW), Stiftung Patientensicherheit Schweiz, Zurich, Switzerland (DS), Institute for Social and Preventive Medicine (ISPM), University of Bern, Switzerland (DS) and Department of Anaesthesiology and Surgical Intensive Care Medicine, University Hospital of Halle (Saale), Germany (MB)
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9
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Ebert D, Mungard N, Mensch A, Homeister L, Willsch J, Ibe R, Baust H, Stiller M, Rebelo A, Ukkat J, Rigopoulos AG, Weber E, Bucher M, Noutsias M. Cardiogenic shock with highly complicated course after influenza A virus infection treated with vva-ECMO and Impella CP (ECMELLA): a case report. BMC Cardiovasc Disord 2021; 21:528. [PMID: 34743690 PMCID: PMC8572692 DOI: 10.1186/s12872-021-02346-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 04/09/2021] [Accepted: 10/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The value of mechanical circulatory support (MCS) in cardiogenic shock, especially the combination of the ECMELLA approach (Impella combined with ECMO), remains controversial. CASE PRESENTATION A previously healthy 33-year-old female patient was submitted to a local emergency department with a flu-like infection and febrile temperatures up to 39 °C. The patient was tested positive for type-A influenza, however negative for SARS-CoV-2. Despite escalated invasive ventilation, refractory hypercapnia (paCO2: 22 kPa) with severe respiratory acidosis (pH: 6.9) and a rising norepinephrine rate occurred within a few hours. Due to a Horovitz-Index < 100, out-of-centre veno-venous extracorporeal membrane oxygenation (vv-ECMO)-implantation was performed. A CT-scan done because of anisocoria revealed an extended dissection of the right vertebral artery. While the initial left ventricular function was normal, echocardiography revealed severe global hypokinesia. After angiographic exclusion of coronary artery stenoses, we geared up LV unloading by additional implantation of an Impella CP and expanded the vv-ECMO to a veno-venous-arterial ECMO (vva-ECMO). Clinically relevant bleeding from the punctured femoral arteries resulted in massive transfusion and was treated by vascular surgery later on. Under continued MCS, LVEF increased to approximately 40% 2 days after the initiation of ECMELLA. After weaning, the Impella CP was explanted at day 5 and the vva-ECMO was removed on day 9, respectively. The patient was discharged in an unaffected neurological condition to rehabilitation 25 days after the initial admission. CONCLUSIONS This exceptional case exemplifies the importance of aggressive MCS in severe cardiogenic shock, which may be especially promising in younger patients with non-ischaemic cardiomyopathy and potentially reversible causes of cardiogenic shock. This case impressively demonstrates that especially young patients may achieve complete neurological restoration, even though the initial prognosis may appear unfavourable.
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Affiliation(s)
- Daniel Ebert
- Department of Anesthesiology, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Nils Mungard
- Department of Anesthesiology, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Alexander Mensch
- Department of Neurology, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Lorenz Homeister
- Department of Anesthesiology, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Jan Willsch
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Richard Ibe
- Department of Neurology, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Henning Baust
- Department of Anesthesiology, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Markus Stiller
- Department of Cardiac Surgery, Mid-German Heart Center, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Artur Rebelo
- Department of Vascular Surgery, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Joerg Ukkat
- Department of Vascular Surgery, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Angelos G Rigopoulos
- Division of Cardiology, Angiology and Intensive Medical Care, Department of Internal Medicine III (KIM III), Mid-German Heart Center, Faculty of Medicine, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany.,Department of Adult Cardiology, Mitera General Hospital, Hygeia Group, 6 Erythrou Stavrou Street, 15123, Marousi, Athens, Greece
| | - Elke Weber
- Department of Anesthesiology, St. Elisabeth & St. Barbara Hospital Halle, Mauerstrasse 5, 06110, Halle (Saale), Germany
| | - Michael Bucher
- Department of Anesthesiology, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Michel Noutsias
- Division of Cardiology, Angiology and Intensive Medical Care, Department of Internal Medicine III (KIM III), Mid-German Heart Center, Faculty of Medicine, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany.
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10
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Li X, Inhester L, Robatjazi SJ, Erk B, Boll R, Hanasaki K, Toyota K, Hao Y, Bomme C, Rudek B, Foucar L, Southworth SH, Lehmann CS, Kraessig B, Marchenko T, Simon M, Ueda K, Ferguson KR, Bucher M, Gorkhover T, Carron S, Alonso-Mori R, Koglin JE, Correa J, Williams GJ, Boutet S, Young L, Bostedt C, Son SK, Santra R, Rolles D, Rudenko A. Pulse Energy and Pulse Duration Effects in the Ionization and Fragmentation of Iodomethane by Ultraintense Hard X Rays. Phys Rev Lett 2021; 127:093202. [PMID: 34506178 DOI: 10.1103/physrevlett.127.093202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 01/24/2021] [Accepted: 07/02/2021] [Indexed: 06/13/2023]
Abstract
The interaction of intense femtosecond x-ray pulses with molecules sensitively depends on the interplay between multiple photoabsorptions, Auger decay, charge rearrangement, and nuclear motion. Here, we report on a combined experimental and theoretical study of the ionization and fragmentation of iodomethane (CH_{3}I) by ultraintense (∼10^{19} W/cm^{2}) x-ray pulses at 8.3 keV, demonstrating how these dynamics depend on the x-ray pulse energy and duration. We show that the timing of multiple ionization steps leading to a particular reaction product and, thus, the product's final kinetic energy, is determined by the pulse duration rather than the pulse energy or intensity. While the overall degree of ionization is mainly defined by the pulse energy, our measurement reveals that the yield of the fragments with the highest charge states is enhanced for short pulse durations, in contrast to earlier observations for atoms and small molecules in the soft x-ray domain. We attribute this effect to a decreased charge transfer efficiency at larger internuclear separations, which are reached during longer pulses.
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Affiliation(s)
- X Li
- J. R. Macdonald Laboratory, Department of Physics, Kansas State University, Manhattan, Kansas, USA
| | - L Inhester
- Center for Free-Electron Laser Science, DESY, Hamburg, Germany
- The Hamburg Centre for Ultrafast Imaging, Hamburg, Germany
| | - S J Robatjazi
- J. R. Macdonald Laboratory, Department of Physics, Kansas State University, Manhattan, Kansas, USA
| | - B Erk
- Deutsches Elektronen-Synchrotron (DESY), Hamburg, Germany
| | - R Boll
- Max Planck Institute for Nuclear Physics, Heidelberg, Germany
- European XFEL, Schenefeld, Germany
| | - K Hanasaki
- Center for Free-Electron Laser Science, DESY, Hamburg, Germany
- The Hamburg Centre for Ultrafast Imaging, Hamburg, Germany
| | - K Toyota
- Center for Free-Electron Laser Science, DESY, Hamburg, Germany
- The Hamburg Centre for Ultrafast Imaging, Hamburg, Germany
| | - Y Hao
- Center for Free-Electron Laser Science, DESY, Hamburg, Germany
- The Hamburg Centre for Ultrafast Imaging, Hamburg, Germany
- Institute of Theoretical Physics and Department of Physics, University of Science and Technology Beijing, Beijing, People's Republic of China
| | - C Bomme
- Deutsches Elektronen-Synchrotron (DESY), Hamburg, Germany
| | - B Rudek
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig, Germany
| | - L Foucar
- Max Planck Institute for Medical Research, Heidelberg, Germany
| | - S H Southworth
- Chemical Sciences and Engineering Division, Argonne National Laboratory, Lemont, Illinois, USA
| | - C S Lehmann
- Chemical Sciences and Engineering Division, Argonne National Laboratory, Lemont, Illinois, USA
- Fachbereich Chemie, Philipps-Universität Marburg, Marburg, Germany
| | - B Kraessig
- Chemical Sciences and Engineering Division, Argonne National Laboratory, Lemont, Illinois, USA
| | - T Marchenko
- Sorbonne Université, CNRS, Laboratoire de Chimie Physique-Matière et Rayonnement, LCPMR, Paris, France
| | - M Simon
- Sorbonne Université, CNRS, Laboratoire de Chimie Physique-Matière et Rayonnement, LCPMR, Paris, France
| | - K Ueda
- Institute of Multidisciplinary Research for Advanced Materials, Tohoku University, Sendai, Japan
| | - K R Ferguson
- LCLS, SLAC National Accelerator Laboratory, Menlo Park, California, USA
| | - M Bucher
- Chemical Sciences and Engineering Division, Argonne National Laboratory, Lemont, Illinois, USA
- LCLS, SLAC National Accelerator Laboratory, Menlo Park, California, USA
| | - T Gorkhover
- LCLS, SLAC National Accelerator Laboratory, Menlo Park, California, USA
- Institut für Optik und Atomare Physik, Technische Universität Berlin, Berlin, Germany
| | - S Carron
- LCLS, SLAC National Accelerator Laboratory, Menlo Park, California, USA
| | - R Alonso-Mori
- LCLS, SLAC National Accelerator Laboratory, Menlo Park, California, USA
| | - J E Koglin
- LCLS, SLAC National Accelerator Laboratory, Menlo Park, California, USA
| | - J Correa
- Center for Free-Electron Laser Science, DESY, Hamburg, Germany
- Deutsches Elektronen-Synchrotron (DESY), Hamburg, Germany
| | - G J Williams
- LCLS, SLAC National Accelerator Laboratory, Menlo Park, California, USA
- NSLS-II, Brookhaven National Laboratory, Upton New York, USA
| | - S Boutet
- LCLS, SLAC National Accelerator Laboratory, Menlo Park, California, USA
| | - L Young
- Chemical Sciences and Engineering Division, Argonne National Laboratory, Lemont, Illinois, USA
- Department of Physics and James Franck Institute, The University of Chicago, Chicago, Illinois, USA
| | - C Bostedt
- Chemical Sciences and Engineering Division, Argonne National Laboratory, Lemont, Illinois, USA
- Paul Scherrer Institut, Villigen-PSI, Villigen, Switzerland
- Institute of Chemical Sciences and Engineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - S-K Son
- Center for Free-Electron Laser Science, DESY, Hamburg, Germany
- The Hamburg Centre for Ultrafast Imaging, Hamburg, Germany
| | - R Santra
- Center for Free-Electron Laser Science, DESY, Hamburg, Germany
- The Hamburg Centre for Ultrafast Imaging, Hamburg, Germany
- Department of Physics, Universität Hamburg, Hamburg, Germany
| | - D Rolles
- J. R. Macdonald Laboratory, Department of Physics, Kansas State University, Manhattan, Kansas, USA
- Deutsches Elektronen-Synchrotron (DESY), Hamburg, Germany
| | - A Rudenko
- J. R. Macdonald Laboratory, Department of Physics, Kansas State University, Manhattan, Kansas, USA
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11
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Bucher M, Niebling S, Han Y, Molodenskiy D, Hassani Nia F, Kreienkamp HJ, Svergun D, Kim E, Kostyukova AS, Kreutz MR, Mikhaylova M. Autism-associated SHANK3 missense point mutations impact conformational fluctuations and protein turnover at synapses. eLife 2021; 10:66165. [PMID: 33945465 PMCID: PMC8169116 DOI: 10.7554/elife.66165] [Citation(s) in RCA: 6] [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: 12/30/2020] [Accepted: 05/01/2021] [Indexed: 12/18/2022] Open
Abstract
Members of the SH3- and ankyrin repeat (SHANK) protein family are considered as master scaffolds of the postsynaptic density of glutamatergic synapses. Several missense mutations within the canonical SHANK3 isoform have been proposed as causative for the development of autism spectrum disorders (ASDs). However, there is a surprising paucity of data linking missense mutation-induced changes in protein structure and dynamics to the occurrence of ASD-related synaptic phenotypes. In this proof-of-principle study, we focus on two ASD-associated point mutations, both located within the same domain of SHANK3 and demonstrate that both mutant proteins indeed show distinct changes in secondary and tertiary structure as well as higher conformational fluctuations. Local and distal structural disturbances result in altered synaptic targeting and changes of protein turnover at synaptic sites in rat primary hippocampal neurons.
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Affiliation(s)
- Michael Bucher
- AG Optobiology, Institute of Biology, Humboldt-University, Berlin, Germany.,DFG Emmy Noether Guest Group 'Neuronal Protein Transport', Institute for Molecular Neurogenetics, Center for Molecular Neurobiology (ZMNH), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.,RG Neuroplasticity, Leibniz-Institute for Neurobiology (LIN), Magdeburg, Germany
| | - Stephan Niebling
- Molecular Biophysics and High-Throughput Crystallization, European Molecular Biology Laboratory (EMBL), Hamburg, Germany
| | - Yuhao Han
- DFG Emmy Noether Guest Group 'Neuronal Protein Transport', Institute for Molecular Neurogenetics, Center for Molecular Neurobiology (ZMNH), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.,Structural Cell Biology of Viruses, Centre for Structural Systems Biology (CSSB) and Leibniz Institute for Experimental Virology, Hamburg, Germany
| | - Dmitry Molodenskiy
- European Molecular Biology Laboratory (EMBL) Hamburg Unit, DESY, Hamburg, Germany
| | - Fatemeh Hassani Nia
- Institute of Human Genetics, Center for Obstetrics and Pediatrics, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Hans-Jürgen Kreienkamp
- Institute of Human Genetics, Center for Obstetrics and Pediatrics, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Dmitri Svergun
- European Molecular Biology Laboratory (EMBL) Hamburg Unit, DESY, Hamburg, Germany
| | - Eunjoon Kim
- Center for Synaptic Brain Dysfunctions, Institute for Basic Science (IBS) and Department of Biological Sciences, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - Alla S Kostyukova
- DFG Emmy Noether Guest Group 'Neuronal Protein Transport', Institute for Molecular Neurogenetics, Center for Molecular Neurobiology (ZMNH), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.,The Gene and Linda Voiland School of Chemical Engineering and Bioengineering, Washington State University (WSU), Pullman, United States
| | - Michael R Kreutz
- RG Neuroplasticity, Leibniz-Institute for Neurobiology (LIN), Magdeburg, Germany.,Leibniz Group 'Dendritic Organelles and Synaptic Function', Center for Molecular Neurobiology (ZMNH), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.,German Center for Neurodegenerative Diseases, Magdeburg, Germany.,Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Marina Mikhaylova
- AG Optobiology, Institute of Biology, Humboldt-University, Berlin, Germany.,DFG Emmy Noether Guest Group 'Neuronal Protein Transport', Institute for Molecular Neurogenetics, Center for Molecular Neurobiology (ZMNH), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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12
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Flöther L, Pötzsch B, Jung M, Jung R, Bucher M, Glowka A, Medenwald D. Treatment effects of palliative care consultation and patient contentment: A monocentric observational study. Medicine (Baltimore) 2021; 100:e24320. [PMID: 33761631 PMCID: PMC9282054 DOI: 10.1097/md.0000000000024320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 12/03/2020] [Accepted: 12/22/2020] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT Palliative care is a central component of the therapy in terminally ill patients. During treatment in non-palliative departments this can be realized by consultation.To analyze the change in symptom burden during palliative care consultation.In this observational study, we enrolled all cancer cases (n = 163) receiving inpatient treatment for 2015 to 2018 at our institution. We used the MDASI-questionnaire (0 = 'not present' and 10 = "as bad as you can imagine") and the FAMCARE-6 (1 = very satisfied, 5 = very dissatisfied) to analyze the treatment effect and patient satisfaction, respectively.We examined the association of symptom burden and patient satisfaction using Spearman-correlation. Comparing mean values, we applied the Wilcoxon-test and one-way ANOVA.An improvement in MDASI-core-items after treatment completion was significant (P < .05) in 14/18 symptoms. The change in perception of pain showed the strongest improvement (median: 5 to 3). Initially the MDASI-items "activity" (median = 8) and emotional distress (median = 5 and 6) were viewed as especially incriminating. There was no evidence for a correlation between patients' age, the type of diagnosis and time since diagnosis.The analysis of FAMCARE-6 patient contentment was lower or equal to two in all of the six items. There was a weak negative association between the change in symptom burden of psycho-emotional items "distress/feeling upset" (P = .006, rSp = -0,226), "sadness" and patient satisfaction in FAMCARE-6.A considerable improvement of the extensive symptom burden particularly of pain relief was achieved by integrating palliative consultation in clinical practice.
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Affiliation(s)
- Lilit Flöther
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinik und Poliklinik für Strahlentherapie
- Institut für Medizinische Epidemiologie, Biometrie und Informatik Universitätsmedizin Halle (Saale), Germany
| | - Barabara Pötzsch
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinik und Poliklinik für Strahlentherapie
- Institut für Medizinische Epidemiologie, Biometrie und Informatik Universitätsmedizin Halle (Saale), Germany
| | - Maria Jung
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinik und Poliklinik für Strahlentherapie
- Institut für Medizinische Epidemiologie, Biometrie und Informatik Universitätsmedizin Halle (Saale), Germany
| | - Robert Jung
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinik und Poliklinik für Strahlentherapie
- Institut für Medizinische Epidemiologie, Biometrie und Informatik Universitätsmedizin Halle (Saale), Germany
| | - Michael Bucher
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinik und Poliklinik für Strahlentherapie
- Institut für Medizinische Epidemiologie, Biometrie und Informatik Universitätsmedizin Halle (Saale), Germany
| | - André Glowka
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinik und Poliklinik für Strahlentherapie
- Institut für Medizinische Epidemiologie, Biometrie und Informatik Universitätsmedizin Halle (Saale), Germany
| | - Daniel Medenwald
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinik und Poliklinik für Strahlentherapie
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13
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Fleischmann-Struzek C, Kesselmeier M, Ouart D, Hartog CS, Bauer M, Bercker S, Bucher M, Meier-Hellmann A, Petros S, Schreiber T, Simon P, Weidhase L, Born S, Braune A, Chkirni H, Eichhorn C, Fiedler S, Gampe C, König C, Platzer S, Romeike H, Töpfer K, Reinhart K, Scherag A. Mid-German Sepsis Cohort (MSC): a prospective observational study of sepsis survivorship. BMJ Open 2021; 11:e043352. [PMID: 33737430 PMCID: PMC7978081 DOI: 10.1136/bmjopen-2020-043352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
PURPOSE The Mid-German Sepsis Cohort (MSC) aims to investigate mid-term and long-term functional disabilities in sepsis survivors from intensive care unit (ICU) discharge until 1 year after. Secondary, post-acute mortality and morbidity, health-related quality of life and healthcare utilisation will be investigated. PARTICIPANTS The MSC comprises adult (aged ≥18 years) patients who were treated for (severe) sepsis or septic shock on ICU. The participants were recruited between 15 April 2016 and 30 November 2018 from five German centres. Three thousand two hundred and ten patients with sepsis were identified, of which 1968 survived their ICU stay and were eligible for enrolment in the follow-up cohort. Informed consent for follow-up assessment was provided by 907 patients (46.1% of eligible patients). FINDINGS TO DATE The recruitment of the participants for follow-up assessments and the baseline data collection is completed. Incidence of sepsis was 116.7 patients per 1000 ICU patients. In this cohort profile, we provide an overview of the demographics and the clinical characteristics of both the overall sepsis cohort and the ICU survivors who provided informed consent for follow-up assessment (907 out of 1968 ICU survivors (46.1%)). FUTURE PLANS The follow-ups are conducted 3, 6 and 12 months after ICU discharge. Another yearly follow-up up to 5 years after ICU discharge is pursued. Several cooperation and satellite projects were initiated. This prospective cohort offers a unique resource for research on long-term sequelae of sepsis survivors. TRIAL REGISTRATION NUMBER German Clinical Trials Registry (DRKS00010050).
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Affiliation(s)
- Carolin Fleischmann-Struzek
- Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
| | - Miriam Kesselmeier
- Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
- Research Group Clinical Epidemiology, CSCC, Jena University Hospital, Jena, Germany
- Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital, Jena, Germany
| | - Dominique Ouart
- Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
- Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany
| | - Christiane S Hartog
- Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
- Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany
- Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Klinik Bavaria Kreischa, Kreischa, Germany
| | - Michael Bauer
- Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
- Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany
| | - Sven Bercker
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Michael Bucher
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle, Germany
| | | | - Sirak Petros
- Medical Intensive Care Unit, University Hospital Leipzig, Leipzig, Germany
| | - Torsten Schreiber
- Zentrum für Anästhesie, Intensivmedizin und Notfallmedizin, Zentralklinik Bad Berka GmbH, Bad Berka, Germany
| | - Philipp Simon
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Lorenz Weidhase
- Medical Intensive Care Unit, University Hospital Leipzig, Leipzig, Germany
| | - Sebastian Born
- Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
| | - Anke Braune
- Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
- Center for Clinical Studies, Jena University Hospital, Jena, Germany
| | - Hicham Chkirni
- Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
- Center for Clinical Studies, Jena University Hospital, Jena, Germany
| | - Cornelia Eichhorn
- Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
- Center for Clinical Studies, Jena University Hospital, Jena, Germany
| | - Sandra Fiedler
- Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
- Center for Clinical Studies, Jena University Hospital, Jena, Germany
| | - Christin Gampe
- Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
- Center for Clinical Studies, Jena University Hospital, Jena, Germany
| | - Christian König
- Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
- Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany
| | - Stephanie Platzer
- Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
- Center for Clinical Studies, Jena University Hospital, Jena, Germany
| | - Heike Romeike
- Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
| | - Kristin Töpfer
- Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
| | - Konrad Reinhart
- Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
- Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - André Scherag
- Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
- Research Group Clinical Epidemiology, CSCC, Jena University Hospital, Jena, Germany
- Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital, Jena, Germany
- Center for Clinical Studies, Jena University Hospital, Jena, Germany
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14
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Eisenmann S, Stangl F, Lambrecht N, Wollschläger B, Böhm S, Brill R, Vogt I, Baust H, Bucher M, Wohlgemuth WA. Interventional Radiology and Pulmonology in Life-Threatening Aneurysm of the Left Pulmonary Artery. Am J Respir Crit Care Med 2021; 203:366-367. [PMID: 33058729 DOI: 10.1164/rccm.202008-3263im] [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: 11/16/2022] Open
Affiliation(s)
| | - Franz Stangl
- Department of Diagnostic and Interventional Radiology, and.,Department of Anaesthesiology, University Hospital Halle, Halle, Germany; and
| | | | | | | | - Richard Brill
- Department of Diagnostic and Interventional Radiology, and
| | | | - Henning Baust
- Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Augsburg, Germany
| | - Michael Bucher
- Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Augsburg, Germany
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15
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Feurle P, Abentung A, Cera I, Wahl N, Ablinger C, Bucher M, Stefan E, Sprenger S, Teis D, Fischer A, Laighneach A, Whitton L, Morris DW, Apostolova G, Dechant G. SATB2-LEMD2 interaction links nuclear shape plasticity to regulation of cognition-related genes. EMBO J 2021; 40:e103701. [PMID: 33319920 PMCID: PMC7849313 DOI: 10.15252/embj.2019103701] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 10/22/2020] [Accepted: 11/06/2020] [Indexed: 01/22/2023] Open
Abstract
SATB2 is a schizophrenia risk gene and is genetically associated with human intelligence. How it affects cognition at molecular level is currently unknown. Here, we show that interactions between SATB2, a chromosomal scaffolding protein, and the inner nuclear membrane protein LEMD2 orchestrate the response of pyramidal neurons to neuronal activation. Exposure to novel environment in vivo causes changes in nuclear shape of CA1 hippocampal neurons via a SATB2-dependent mechanism. The activity-driven plasticity of the nuclear envelope requires not only SATB2, but also its protein interactor LEMD2 and the ESCRT-III/VPS4 membrane-remodeling complex. Furthermore, LEMD2 depletion in cortical neurons, similar to SATB2 ablation, affects neuronal activity-dependent regulation of multiple rapid and delayed primary response genes. In human genetic data, LEMD2-regulated genes are enriched for de novo mutations reported in intellectual disability and schizophrenia and are, like SATB2-regulated genes, enriched for common variants associated with schizophrenia and cognitive function. Hence, interactions between SATB2 and the inner nuclear membrane protein LEMD2 influence gene expression programs in pyramidal neurons that are linked to cognitive ability and psychiatric disorder etiology.
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Affiliation(s)
- Patrick Feurle
- Institute for NeuroscienceMedical University of InnsbruckInnsbruckAustria
| | - Andreas Abentung
- Institute for NeuroscienceMedical University of InnsbruckInnsbruckAustria
| | - Isabella Cera
- Institute for NeuroscienceMedical University of InnsbruckInnsbruckAustria
| | - Nico Wahl
- Institute for NeuroscienceMedical University of InnsbruckInnsbruckAustria
| | - Cornelia Ablinger
- Institute for NeuroscienceMedical University of InnsbruckInnsbruckAustria
| | - Michael Bucher
- Institute of Biochemistry and Center for Molecular BiosciencesUniversity of InnsbruckInnsbruckAustria
| | - Eduard Stefan
- Institute of Biochemistry and Center for Molecular BiosciencesUniversity of InnsbruckInnsbruckAustria
| | - Simon Sprenger
- Institute for Cell BiologyMedical University of InnsbruckInnsbruckAustria
| | - David Teis
- Institute for Cell BiologyMedical University of InnsbruckInnsbruckAustria
| | - Andre Fischer
- Department of Systems Medicine and EpigeneticsGerman Center for Neurodegenerative Diseases (DZNE)GoettingenGermany
- Department of Psychiatry and PsychotherapyUniversity Medical CenterGoettingenGermany
| | - Aodán Laighneach
- Neuroimaging, Cognition & Genomics (NICOG) CentreSchool of Psychology and Discipline of BiochemistryNational University of Ireland GalwayGalwayIreland
| | - Laura Whitton
- Neuroimaging, Cognition & Genomics (NICOG) CentreSchool of Psychology and Discipline of BiochemistryNational University of Ireland GalwayGalwayIreland
| | - Derek W Morris
- Neuroimaging, Cognition & Genomics (NICOG) CentreSchool of Psychology and Discipline of BiochemistryNational University of Ireland GalwayGalwayIreland
| | - Galina Apostolova
- Institute for NeuroscienceMedical University of InnsbruckInnsbruckAustria
| | - Georg Dechant
- Institute for NeuroscienceMedical University of InnsbruckInnsbruckAustria
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16
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Fischer HG, Schmidtbauer C, Seiffart A, Bucher M, Plontke SK, Rahne T. Contribution of ambient noise and hyperbaric atmosphere to olfactory and gustatory function. PLoS One 2020; 15:e0240537. [PMID: 33048988 PMCID: PMC7553350 DOI: 10.1371/journal.pone.0240537] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/28/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction Taste and smell are important for occupational performance and quality of life. Previous studies suggested that the function of these senses might be influenced by ambient pressure and noise. This knowledge would be helpful for divers, submarine crews, or mine workers. The present study aimed to investigate the effects of noise and hyperbaric pressure on olfactory and gustatory functions. Methods This prospective controlled study included 16 healthy male divers. Inside a hyperbaric chamber, participants performed olfactory and gustatory function tests at sea level pressure and at 2 bar pressure. The olfaction threshold, and the discrimination and identification of odorants were measured with validated ´Sniffin sticks´. Taste identification and the gustation threshold scores were examined with validated filter paper strips. Tests were performed under two conditions: noise reduction (silence) and white noise stimulation presented at 70 dB sound pressure level. Results The results showed that normobaric and hyperbaric ambient pressures did not significantly affect olfactory or gustatory function. Moreover, noise had no relevant impact on taste or odor sensation. The odor identification score was not influenced in hyperbaric conditions, and the odor threshold score was not influenced by ambient noise or both barometric conditions. The only taste modality affected by hyperbaric conditions was the sensitivity to salty taste, but it was not significant. Conclusion We concluded that hyperbaric and noisy environments have no influence on gustatory and olfactory function. From a practical point of view, the influence of pressure in moderate hyperbaric occupations should be negligible.
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Affiliation(s)
- Hans-Georg Fischer
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
- Department of Otorhinolaryngology (ENT), Head and Neck Surgery, Military Hospital Hamburg, Hamburg, Germany
| | - Christopher Schmidtbauer
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
- * E-mail:
| | - Annett Seiffart
- University Clinic for Anesthesiology and Operative Intensive Care, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Michael Bucher
- University Clinic for Anesthesiology and Operative Intensive Care, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Stefan K. Plontke
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Torsten Rahne
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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17
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Floether L, Bucher M, Benndorf R, Burgdorff AM. Necrotizing fasciitis caused by the treatment of chronic non-specific back pain. BMC Anesthesiol 2020; 20:245. [PMID: 32979925 PMCID: PMC7519487 DOI: 10.1186/s12871-020-01161-0] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 09/15/2020] [Indexed: 12/02/2022] Open
Abstract
Background Chronic back pain is a multifactorial disease that occurs particularly in adults and has many negative effects on the quality of daily life. Therapeutic strategies are often multimodal and designed for a long-term therapy period. In some cases, one option is joint infiltration or intrathecal injection with local anaesthetics. An adverse effect of this intervention may be necrotic fasciitis, a disease with high mortality and few therapeutic options. Case presentation This case shows a 53-year-old female patient who developed necrotic fasciitis after infiltrations of the sacroiliac joint and after epidural-sacral and intrathecal injections. Conclusion Thanks to early and aggressive surgical intervention, antibiotic treatment and hyperbaric oxygenation, she survived this serious complication and was able to return to life.
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Affiliation(s)
- Lilit Floether
- Department of Anesthesiology and Surgical Intensive Care, University Hospital Halle (Saale), Ernst-Grube-Straße 40, 06120, Halle (Saale), Germany.
| | - Michael Bucher
- Department of Anesthesiology and Surgical Intensive Care, University Hospital Halle (Saale), Ernst-Grube-Straße 40, 06120, Halle (Saale), Germany
| | - Ralf Benndorf
- Department of Clinical Pharmacy and Pharmacotherapy, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Anna-Maria Burgdorff
- Department of Anesthesiology and Surgical Intensive Care, University Hospital Halle (Saale), Ernst-Grube-Straße 40, 06120, Halle (Saale), Germany
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18
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Brunkhorst FM, Weigand MA, Pletz M, Gastmeier P, Lemmen SW, Meier-Hellmann A, Ragaller M, Weyland A, Marx G, Bucher M, Gerlach H, Salzberger B, Grabein B, Welte T, Werdan K, Kluge S, Bone HG, Putensen C, Rossaint R, Quintel M, Spies C, Weiß B, John S, Oppert M, Jörres A, Brenner T, Elke G, Gründling M, Mayer K, Weimann A, Felbinger TW, Axer H, Heller T, Gagelmann N. [S3 guideline sepsis-prevention, diagnosis, treatment, and aftercare : Summary of the strong recommendations]. Med Klin Intensivmed Notfmed 2020; 115:178-188. [PMID: 32185422 DOI: 10.1007/s00063-020-00671-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- F M Brunkhorst
- Zentrum für Klinische Studien, Integriertes Forschungs- und Behandlungszentrum (IFB) Sepsis und Sepsisfolgen, Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Jena, Salvador-Allende-Platz 27, 07747, Jena, Deutschland.
| | - M A Weigand
- Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - M Pletz
- Institut für Infektionsmedizin und Krankenhaushygiene, Universitätsklinikum Jena, Jena, Deutschland
| | - P Gastmeier
- Institut für Hygiene und Umweltmedizin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - S W Lemmen
- Zentralbereich für Krankenhaushygiene und Infektiologie, Universitätsklinikum Aachen, Aachen, Deutschland
| | - A Meier-Hellmann
- Klinik für Anästhesie, Intensivmedizin und Schmerztherapie, Helios-Klinikum Erfurt GmbH, Erfurt, Deutschland
| | - M Ragaller
- Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Dresden, Dresden, Deutschland
| | - A Weyland
- Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie, Klinikum Oldenburg gGmbH, Oldenburg, Deutschland
| | - G Marx
- Klinik für Operative Intensivmedizin und Intermediate Care, Universitätsklinikum Aachen, Aachen, Deutschland
| | - M Bucher
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Halle, Halle, Deutschland
| | - H Gerlach
- Klinik für Anästhesie, operative Intensivmedizin und Schmerztherapie, Vivantes Klinikum Neukölln, Berlin, Deutschland
| | - B Salzberger
- Abteilung für Krankenhaushygiene und Infektiologie, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - B Grabein
- Stabsstelle Klinische Mikrobiologie und Krankenhaushygiene, Klinikum der Universität München, München, Deutschland
| | - T Welte
- Klinik für Pneumologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - K Werdan
- Universitätsklinik und Poliklinik für Innere Medizin III, Klinikum der MLU Halle-Wittenberg, Halle, Deutschland
| | - S Kluge
- Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - H G Bone
- Zentrum für Anästhesiologie, Intensivmedizin und Schmerztherapie, Knappschaftskrankenhaus Recklinghausen, Recklinghausen, Deutschland
| | - C Putensen
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Bonn, Bonn, Deutschland
| | - R Rossaint
- Klinik für Anästhesiologie, Universitätsklinikum Aachen, Aachen, Deutschland
| | - M Quintel
- Klinik für Anästhesiologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - C Spies
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - B Weiß
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - S John
- Klinik für Innere Medizin 8, Schwerpunkt Kardiologie, Klinikum Nürnberg, Nürnberg, Deutschland
| | - M Oppert
- Klinik für Notfall- und Internistische Intensivmedizin, Klinikum Ernst von Bergmann Potsdam, Potsdam, Deutschland
| | - A Jörres
- Medizinische Klinik I, Klinik für Nephrologie, Transplantationsmedizin und internistische Intensivmedizin, Krankenhaus Merheim, Klinikum der Universität Witten/Herdecke, Köln, Deutschland
| | - T Brenner
- Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - G Elke
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Kiel, Kiel, Deutschland
| | - M Gründling
- Klinik für Anästhesiologie - Anästhesie, Intensiv‑, Notfall- und Schmerzmedizin, Universitätsklinikum Greifswald, Greifswald, Deutschland
| | - K Mayer
- Medizinische Klinik und Poliklinik II, Klinikum der Justus-Liebig-Universität Gießen, Gießen, Deutschland
| | - A Weimann
- Klinik für Allgemein‑, Viszeral- und Onkologische Chirurgie, Klinikum "St. Georg" Leipzig gGmbH, Leipzig, Deutschland
| | - T W Felbinger
- Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie, Städtisches Klinikum München, München, Deutschland
| | - H Axer
- Klinik für Neurologie, Universitätsklinikum Jena, Jena, Deutschland
| | - T Heller
- Universitätsklinikum Jena, Jena, Deutschland
| | - N Gagelmann
- Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
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19
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Affiliation(s)
- C Raspé
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Halle (Saale), Medizinische Fakultät der Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Straße 40, 06120, Halle (Saale), Deutschland.
| | - M Bucher
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Halle (Saale), Medizinische Fakultät der Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Straße 40, 06120, Halle (Saale), Deutschland
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20
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Bucher M, Fanutza T, Mikhaylova M. Cytoskeletal makeup of the synapse: Shaft versus spine. Cytoskeleton (Hoboken) 2019; 77:55-64. [PMID: 31762205 DOI: 10.1002/cm.21583] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [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: 08/19/2019] [Revised: 11/20/2019] [Accepted: 11/21/2019] [Indexed: 12/13/2022]
Abstract
The ability of neurons to communicate and store information depends on the activity of synapses which can be located on small protrusions (dendritic spines) or directly on the dendritic shaft. The formation, plasticity, and stability of synapses are regulated by the neuronal cytoskeleton. Actin filaments together with microtubules, neurofilaments, septins, and scaffolding proteins orchestrate the structural organization of both shaft and spine synapses, enabling their efficacy in response to synaptic activation. Synapses critically depend on several factors, which are also mediated by the cytoskeleton, including transport and delivery of proteins from the soma, protein synthesis, as well as surface diffusion of membrane proteins. In this minireview, we focus on recent progress made in the field of cytoskeletal elements of the postsynapse and discuss the differences and similarities between synapses located in the spines versus dendritic shaft.
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Affiliation(s)
- Michael Bucher
- DFG Emmy Noether Group 'Neuronal Protein Transport', Center for Molecular Neurobiology, ZMNH, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tomas Fanutza
- DFG Emmy Noether Group 'Neuronal Protein Transport', Center for Molecular Neurobiology, ZMNH, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marina Mikhaylova
- DFG Emmy Noether Group 'Neuronal Protein Transport', Center for Molecular Neurobiology, ZMNH, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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21
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Koppenberg J, Albrecht R, Bucher M. [Red Flags and Shock Symptoms]. Praxis (Bern 1994) 2019; 108:845-849. [PMID: 31571542 DOI: 10.1024/1661-8157/a003313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Red Flags and Shock Symptoms Abstract. The term 'red flags' is often used in emergency medicine. However, there is no clear medical definition in German for 'red flag'. In most cases, 'red flags' are warning symptoms that indicate a potentially harmful threat to a patient's health. This article wants to explain and define the term 'red flags'. Red flags are explained in emergency medicine and especially in shock in the context of their basic pathophysiological causes. The aim is to improve the understanding of the timely recognition and the exact interpretation of these warning symptoms in the preclinical environment, in order to immediately start a sufficient therapy.
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Affiliation(s)
- Joachim Koppenberg
- Abteilung für Anästhesiologie, Schmerztherapie und Rettungsmedizin, Ospidal - Gesundheitszentrum Unterengadin, Scuol
| | | | - Michael Bucher
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Halle (Saale), Deutschland
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22
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Flöther L, Peitek K, Bucher M, Benndorf RA. [Medical Cannabis-Related Relapse in a Patient with a History of Alcohol Abuse]. Dtsch Med Wochenschr 2019; 144:1135-1137. [PMID: 31416105 DOI: 10.1055/a-0805-1973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
HISTORY AND CLINICAL FINDINGS In this report, a 60-year old patient with a history of mixed nociceptive and neuropathic chronic pain after successful removal of oral squamous cell cancer is described who received outpatient pain treatment in our clinic. Moreover, the patient presented with a history of alcohol abuse as well as anorexia and weight loss. EXAMINATIONS AND DIAGNOSIS The patient was in reduced general condition and cachectic nutritional status. In addition, he suffered from oral pain that radiated to both ears and a related loss of appetite. TREATMENT In the light of progressive cachexia, we started regular medical cannabis (Sativex®, contains i. e. delta-9-tetrahydrocannabinol and cannabidiol). Despite good initial tolerability, medical cannabis was stopped early due to alcohol relapse of the patient. After termination of medical cannabis, the patient regained control of alcohol consumption and achieved sobriety. CONCLUSIONS We suggest that medical cannabis only be prescribed with particular caution in patients with a history of alcohol abuse.
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Affiliation(s)
- Lilit Flöther
- Universitätsklinik für Anästhesiologie und Operative Intensivmedizin
| | - Kathrin Peitek
- Universitätsklinik für Anästhesiologie und Operative Intensivmedizin
| | - Michael Bucher
- Universitätsklinik für Anästhesiologie und Operative Intensivmedizin
| | - Ralf A Benndorf
- Abteilung für Klinische Pharmazie und Pharmakotherapie, Institut für Pharmazie, Martin-Luther-Universität Halle-Wittenberg
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23
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Koppenberg J, Ittner KP, Albrecht R, Bucher M. [Safety of Pharmacotherapy in Emergencies]. Praxis (Bern 1994) 2019; 108:419-423. [PMID: 31039701 DOI: 10.1024/1661-8157/a003217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Safety of Pharmacotherapy in Emergencies Abstract. Emergency pharmacotherapy is one of the most commonly used medical procedures. At the same time, pharmacotherapy in an emergency is always a potentially dangerous action. Medication errors are even among the most frequently registered errors in medicine. Due to the special circumstances in emergency medicine, special precautions are required to ensure the safety of drug therapy. In addition to the important background information, this article presents procedures that are recognized and applicable in daily routine to increase safety in pharmacotherapy.
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Affiliation(s)
- Joachim Koppenberg
- 1 Abteilung für Anästhesiologie, Schmerztherapie und Rettungsmedizin, Ospidal - Gesundheitszentrum Unterengadin, Scuol
- 3 Schweizerische Rettungsflugwacht (Rega), Zürich-Flughafen
| | - Karl-Peter Ittner
- 2 Lehreinheit Pharmakologie am Klinikum der Universität Regensburg, Universitätsklinikum Regensburg, Deutschland
| | | | - Michael Bucher
- 4 Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Halle (Saale), Deutschland
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24
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Tchirikov M, Saling E, Bapayeva G, Bucher M, Thews O, Seliger G. Hyperbaric oxygenation and glucose/amino acids substitution in human severe placental insufficiency. Physiol Rep 2019. [PMID: 29536649 PMCID: PMC5849598 DOI: 10.14814/phy2.13589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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] [Indexed: 12/13/2022] Open
Abstract
In the first case, the AA and glucose were infused through a perinatal port system into the umbilical vein at 30 weeks' gestation due to severe IUGR. The patient received daily hyperbaric oxygenation (HBO, 100% O2) with 1.4 atmospheres absolute for 50 min for 7 days. At 31+4 weeks' gestation, the patient gave birth spontaneously to a newborn weighing 1378 g, pH 7.33, APGAR score 4/6/intubation. In follow‐up examinations at 5 years of age, the boy was doing well without any neurological disturbance or developmental delay. In the second case, the patient presented at 25/5 weeks' gestation suffering from severe IUGR received HBO and maternal AA infusions. The cardiotocography was monitored continuously during HBO treatment. The short‐time variations improved during HBO from 2.9 to 9 msec. The patient developed pathologic CTG and uterine contractions 1 day later and gave birth to a hypotrophic newborn weighing 420 g. After initial adequate stabilization, the extremely preterm newborn unfortunately died 6 days later. Fetal nutrition combined with HBO is technically possible and may allow the prolongation of the pregnancy. Fetal‐specific amino‐acid composition would facilitate the treatment options of IUGR fetuses and extremely preterm newborn.
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Affiliation(s)
- Michael Tchirikov
- Center of Fetal Surgery, University Clinic of Obstetrics and Fetal Medicine, University Medical Center Halle (Saale), Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Erich Saling
- Saling Institute of Perinatal Medicine, Berlin, Germany
| | - Gauri Bapayeva
- National Research Center for Mother and Child Health, Nazarbayev University, Astana, Republic of Kazakhstan
| | - Michael Bucher
- Center of HBO, University Clinic of Anesthesiology, University Medical Center Halle (Saale), Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Oliver Thews
- Institute of Physiology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Gregor Seliger
- Center of Fetal Surgery, University Clinic of Obstetrics and Fetal Medicine, University Medical Center Halle (Saale), Martin Luther University Halle-Wittenberg, Halle, Germany
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25
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Chen Z, Higley DJ, Beye M, Hantschmann M, Mehta V, Hellwig O, Mitra A, Bonetti S, Bucher M, Carron S, Chase T, Jal E, Kukreja R, Liu T, Reid AH, Dakovski GL, Föhlisch A, Schlotter WF, Dürr HA, Stöhr J. Ultrafast Self-Induced X-Ray Transparency and Loss of Magnetic Diffraction. Phys Rev Lett 2018; 121:137403. [PMID: 30312105 DOI: 10.1103/physrevlett.121.137403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Indexed: 06/08/2023]
Abstract
Using ultrafast ≃2.5 fs and ≃25 fs self-amplified spontaneous emission pulses of increasing intensity and a novel experimental scheme, we report the concurrent increase of stimulated emission in the forward direction and loss of out-of-beam diffraction contrast for a Co/Pd multilayer sample. The experimental results are quantitatively accounted for by a statistical description of the pulses in conjunction with the optical Bloch equations. The dependence of the stimulated sample response on the incident intensity, coherence time, and energy jitter of the employed pulses reveals the importance of increased control of x-ray free electron laser radiation.
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Affiliation(s)
- Z Chen
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - D J Higley
- Department of Applied Physics, Stanford University, Stanford, California 94305, USA
| | - M Beye
- Department of Photon Science, DESY, Notkestraße 85, D-22607 Hamburg, Germany
| | - M Hantschmann
- Department of Materials and Energy Science, Helmholtz Zentrum Berlin, D-14109 Berlin, Germany
| | - V Mehta
- San Jose Research Center, HGST a Western Digital company, San Jose, California 95135, USA
| | - O Hellwig
- Institute of Physics, Technische Universität Chemnitz, D-09107 Chemnitz, Germany
- Institute of Ion Beam Physics and Materials Research, Helmholtz-Zentrum Dresden-Rossendorf, 01328 Dresden, Germany
| | - A Mitra
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94025, USA
- Department of Physics, University of Warwick, CV4 7AL Coventry, United Kingdom
| | - S Bonetti
- Department of Physics, Stockholm University, S-10691 Stockholm, Sweden
| | - M Bucher
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94025, USA
| | - S Carron
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94025, USA
| | - T Chase
- Department of Applied Physics, Stanford University, Stanford, California 94305, USA
| | - E Jal
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94025, USA
| | - R Kukreja
- Department of Materials Science and Engineering, University of California Davis, Davis, California 95616, USA
| | - T Liu
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - A H Reid
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94025, USA
| | - G L Dakovski
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94025, USA
| | - A Föhlisch
- Department of Materials and Energy Science, Helmholtz Zentrum Berlin, D-14109 Berlin, Germany
| | - W F Schlotter
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94025, USA
| | - H A Dürr
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94025, USA
- Department of Physics and Astronomy, Uppsala University, Box 516, 75120 Uppsala, Sweden
| | - J Stöhr
- SLAC National Accelerator Laboratory and Department of Photon Science, Stanford, California 94035, USA
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Raspé C, Besch M, Charitos EI, Flöther L, Bucher M, Rückert F, Treede H. Rotational Thromboelastometry for Assessing Bleeding Complications and Factor XIII Deficiency in Cardiac Surgery Patients. Clin Appl Thromb Hemost 2018; 24:136S-144S. [PMID: 30198311 PMCID: PMC6714825 DOI: 10.1177/1076029618797472] [Citation(s) in RCA: 12] [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] [Indexed: 01/22/2023] Open
Abstract
We aimed to detect alterations and deficits in hemostasis during cardiac surgery with
cardiopulmonary bypass (CPB) using point-of-care-supported coagulation analysis
(rotational thromboelastometry, impedance aggregometry), in addition to single factor
assays for the measurement of fibrinogen (FI) and factor XIII (FXIII) levels. Forty-one
patients scheduled for elective cardiac surgery with CPB were enrolled in this
observational study. Perioperative measurement (pre-, postheparin, 30-minutes before the
end of bypass, 1-hourpostoperatively) of standard laboratory variables, additional
rotational thromboelastometry (ROTEM; International GmbH, Munich, Germany), Multiplate
analysis (Roche, Switzerland), and an assay of FXIII activity were performed as well as
the collection of epidemiological data and blood loss. The FI and FXIII levels as well as
the measured ROTEM and Multiplate parameters correlated weakly with the blood loss.
Clotting time and maximum clot firmness (MCF) of the intrinsically activated ROTEM showed
a good correlation (rCT-INTEM = 0.378; P <
.05, rMCF-INTEM = 0.305; P < .05) with
postoperative drainage loss, suggesting a dependence of blood loss on the initial
intrinsic activity. Additionally, perioperative FI or FIBTEM levels and the FXIII levels
correlated with each other. Intrinsically activated ROTEM showed a good correlation with
postoperative drainage loss, thus suggesting a dependence of blood loss on the initial
intrinsic activity and therefore facilitating clinicians to assess postoperative bleeding
complications. Based on the FI level or the MCFFIBTEM measured by ROTEM, it may
also be possible to assess the FXIII concentration. Especially in chronically ill and
massive bleeding cardiac surgery patients with significantly decreased FXIII levels, the
knowledge of FXIII deficiency may help clinicians to treat coagulation disorders more
adequately.
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Affiliation(s)
- Christoph Raspé
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle, Germany
| | - Maximilian Besch
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle, Germany
| | | | - Lilit Flöther
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle, Germany
| | - Michael Bucher
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle, Germany
| | - Florian Rückert
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle, Germany
| | - Hendrik Treede
- Department of Cardiac Surgery, Halle-Wittenberg University, Halle, Germany
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Abstract
Sepsis is one of the most frequent causes of death among patients in intensive care units. Many therapeutic strategies have been assessed without the desired success rates. A key risk factor for death is hypotension due to vasodilatation with vascular hyposensitivity. However, the pathways underlying this process remain unclear. Endotoxemia induces inflammatory mediators, and this is followed by vasoplegia and decreased cardiac contractility. Although inhibition of these mediators diminishes mortality rates in animal models, this phenomenon has not been confirmed in humans. Downregulation of vasoconstrictive receptors such as angiotensin receptors, adrenergic and vasopressin receptors is seen in sepsis, which is associated with a hyporesponsiveness to vasoconstrictive mediators. Animal studies have verified that receptor downregulation is linked to the above-mentioned inflammatory mediators. Anti-inflammatory therapy with glucocorticoids reportedly improves responsiveness to catecholamines with higher survival in rats, although this has not been shown to be clinically significant in humans. Hence, there is an urgent need for in-depth studies investigating the underlying mechanisms of vasoplegia to allow for development of effective therapeutic strategies for the treatment of sepsis.
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Affiliation(s)
- A-M Burgdorff
- Department of Anesthesiology and Surgical Intensive Care, University Hospital Halle (Saale), Halle (Saale), Germany
| | - M Bucher
- Department of Anesthesiology and Surgical Intensive Care, University Hospital Halle (Saale), Halle (Saale), Germany
| | - J Schumann
- Department of Anesthesiology and Surgical Intensive Care, University Hospital Halle (Saale), Halle (Saale), Germany
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Trommer S, Leimert A, Bucher M, Schumann J. Polyunsaturated Fatty Acids Induce ROS Synthesis in Microvascular Endothelial Cells. Advances in Experimental Medicine and Biology 2018; 1072:393-397. [DOI: 10.1007/978-3-319-91287-5_63] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Trommer S, Leimert A, Bucher M, Schumann J. Impact of Unsaturated Fatty Acids on Cytokine-Driven Endothelial Cell Dysfunction. Int J Mol Sci 2017; 18:ijms18122739. [PMID: 29258201 PMCID: PMC5751340 DOI: 10.3390/ijms18122739] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 12/08/2017] [Accepted: 12/15/2017] [Indexed: 12/21/2022] Open
Abstract
Polyunsaturated fatty acids (PUFA) are reported to exert prophylactic and acute therapeutic effects in diseases linked to endothelial dysfunction. In the present study, the consequences of a PUFA enrichment of endothelial cells (cell line TIME) on cell viability, expression of the cytokines interleukin-6 (IL-6), interleukin-8 (IL-8), granulocyte-macrophage colony-stimulating factor (GM-CSF), and monocyte chemoattractant protein 1 (MCP-1), synthesis of the adhesion molecules intercellular adhesion molecule 1 (ICAM-1) and vascular adhesion molecule 1 (VCAM-1), and production of the coagulation factors plasminogen activator inhibitor-1 (PAI-1), von Willebrand factor (vWF), and tissue factor (TF) was analyzed in parallel. PUFA of both the n3 and the n6 family were investigated in a physiologically relevant concentration of 15 µM, and experiments were performed in both the presence and the absence of the pro-inflammatory cytokines interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ). Supplementation of the culture medium with particular fatty acids was found to have a promoting effect on cellular production of the cytokines IL-6, IL-8, GM-CSF, and MCP-1. Further on, PUFA treatment in the absence of a stimulant diminished the percentage of endothelial cells positive for ICAM-1, and adversely affected the stimulation-induced upregulation of VCAM-1. Cell viability and production of coagulation factors were not or only marginally affected by supplemented fatty acids. Altogether, the data indicate that PUFA of either family are only partially able to counterbalance the destructive consequences of an endothelial dysfunction.
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Affiliation(s)
- Simon Trommer
- Clinic for Anesthesiology and Surgical Intensive Care, University Hospital Halle (Saale), 06120 Halle (Saale), Germany.
| | - Anja Leimert
- Clinic for Anesthesiology and Surgical Intensive Care, University Hospital Halle (Saale), 06120 Halle (Saale), Germany.
| | - Michael Bucher
- Clinic for Anesthesiology and Surgical Intensive Care, University Hospital Halle (Saale), 06120 Halle (Saale), Germany.
| | - Julia Schumann
- Clinic for Anesthesiology and Surgical Intensive Care, University Hospital Halle (Saale), 06120 Halle (Saale), Germany.
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30
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Rückert F, Steinke T, Flöther L, Bucher M, Metz D, Frantz S, Charitos EI, Treede H, Raspé C. Predictors for quality of life of patients with a portable out-of-centre-implanted extracorporeal membrane oxygenation device. Interact Cardiovasc Thorac Surg 2017; 24:542-548. [PMID: 28040752 DOI: 10.1093/icvts/ivw398] [Citation(s) in RCA: 2] [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: 06/03/2016] [Accepted: 09/19/2016] [Indexed: 11/13/2022] Open
Abstract
Objectives Despite progress in the treatment of cardiopulmonary organ failure, the mortality rate for patients with acute respiratory distress syndrome (ARDS) and cardiogenic shock remains high. Extracorporeal membrane oxygenation (ECMO) is a promising treatment option, but long-term outcomes and health-related quality of life (HRQOL) are unknown. Methods Detailed information related to pre- and post-device data and outcomes from a consecutive sample of 71 patients treated with ECMO was analysed. Long-term survivors were given a detailed follow-up examination after a median time of 31 months that included multiple scoring systems for HRQOL assessment. Results Seventy-one patients received a portable out-of-centre-implanted ECMO system. The survival rate at hospital discharge was 48%. Median HRQOL scores were 80% on the Karnofsky index (normal ≥80%), 80% on the Euroqol-5D (normal ≥75%) and 73.1% on the quality-of-life index (normal ≥70%). Mental scores were 96.7% on the Mini-Mental State Examination (normal ≥90.0%), 77.8% on the DemTect (normal ≥72.0%), 87.0% on the test for early detection of dementia with depression demarcation (TFDD; normal ≥74.0%) and confirmed good mental state and HRQOL for patients at follow-up. Univariate analysis for in-hospital mortality indicated that ventilation time before device implantation, higher Acute Physiology and Chronic Health Evaluation (APACHE) II score, higher lactate level at the time of ECMO implantation and female gender were associated with adverse outcomes. Conclusions In our cohort of patients, survivors of out-of-hospital ECMO implantation demonstrated good mental and quality-of-life conditions with well-recovered cardiopulmonary function during long-term follow-up. The indicators for adverse outcomes, pre-implantation lactate levels, pre-ventilation time and APACHE II score, should be considered before implantation of an ECMO device. Clinical trial This study is registered at DRKS (Deutsches Register Klinischer Studien) under the code DRKS00009735 and was submitted to the WHO.
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Affiliation(s)
- Florian Rückert
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany.,Department of Cardiac Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - Thomas Steinke
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany
| | - Lilit Flöther
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany
| | - Michael Bucher
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany
| | - Dietrich Metz
- Department of Cardiac Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - Stefan Frantz
- Department of Internal Medicine III, Halle-Wittenberg University, Halle (Saale), Germany
| | | | - Hendrik Treede
- Department of Cardiac Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - Christoph Raspé
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany
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Raspè C, Wilbring M, Baust H, Charitos E, Treede H, Bucher M, Metz D. Effect of INHALED ILOMEDIN on Biventricular Function in Postcardiotomic Patients with Low Cardiac Output Syndrome. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598686] [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: 10/20/2022]
Affiliation(s)
- C. Raspè
- Universitätsklinik und Poliklinik für Anästhesie und operative Intensivmedizin, Universitätsklinikum Halle (Saale), Halle, Germany
| | - M. Wilbring
- Universitätsklinik und Poliklinik für Herzchirurgie, Universitätsklinikum Halle (Saale), Halle, Germany
| | - H. Baust
- Universitätsklinik und Poliklinik für Anästhesie und operative Intensivmedizin, Universitätsklinikum Halle (Saale), Halle, Germany
| | - E. Charitos
- Universitätsklinik und Poliklinik für Herzchirurgie, Universitätsklinikum Halle (Saale), Halle, Germany
| | - H. Treede
- Universitätsklinik und Poliklinik für Herzchirurgie, Universitätsklinikum Halle (Saale), Halle, Germany
| | - M. Bucher
- Universitätsklinik und Poliklinik für Anästhesie und operative Intensivmedizin, Universitätsklinikum Halle (Saale), Halle, Germany
| | - D. Metz
- Universitätsklinik und Poliklinik für Herzchirurgie, Universitätsklinikum Halle (Saale), Halle, Germany
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Rückert F, Steinke T, Flöther L, Bucher M, Metz D, Frantz S, Charitos E, Treede H, Raspé C. Out-of-Center Extracorporeal Membrane Oxygenation: Predictors for Outcome and Quality of Life. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598689] [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: 10/20/2022]
Affiliation(s)
- F. Rückert
- Department of Cardiac Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - T. Steinke
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany
| | - L. Flöther
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany
| | - M. Bucher
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany
| | - D. Metz
- Department of Cardiac Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - S. Frantz
- Department of Internal Medicine III, Halle-Wittenberg University, Halle (Saale), Germany
| | - E.I. Charitos
- Department of Cardiac Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - H. Treede
- Department of Cardiac Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - C. Raspé
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany
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MacDonald MJ, Gorkhover T, Bachmann B, Bucher M, Carron S, Coffee RN, Drake RP, Ferguson KR, Fletcher LB, Gamboa EJ, Glenzer SH, Göde S, Hau-Riege SP, Kraus D, Krzywinski J, Levitan AL, Meiwes-Broer KH, O'Grady CP, Osipov T, Pardini T, Peltz C, Skruszewicz S, Swiggers M, Bostedt C, Fennel T, Döppner T. Measurement of high-dynamic range x-ray Thomson scattering spectra for the characterization of nano-plasmas at LCLS. Rev Sci Instrum 2016; 87:11E709. [PMID: 27910491 DOI: 10.1063/1.4960502] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Atomic clusters can serve as ideal model systems for exploring ultrafast (∼100 fs) laser-driven ionization dynamics of dense matter on the nanometer scale. Resonant absorption of optical laser pulses enables heating to temperatures on the order of 1 keV at near solid density conditions. To date, direct probing of transient states of such nano-plasmas was limited to coherent x-ray imaging. Here we present the first measurement of spectrally resolved incoherent x-ray scattering from clusters, enabling measurements of transient temperature, densities, and ionization. Single shot x-ray Thomson scattering signals were recorded at 120 Hz using a crystal spectrometer in combination with a single-photon counting and energy-dispersive pnCCD. A precise pump laser collimation scheme enabled recording near background-free scattering spectra from Ar clusters with an unprecedented dynamic range of more than 3 orders of magnitude. Such measurements are important for understanding collective effects in laser-matter interactions on femtosecond time scales, opening new routes for the development of schemes for their ultrafast control.
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Affiliation(s)
- M J MacDonald
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - T Gorkhover
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - B Bachmann
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - M Bucher
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - S Carron
- California Lutheran University, Thousand Oaks, California 91360, USA
| | - R N Coffee
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - R P Drake
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - K R Ferguson
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - L B Fletcher
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - E J Gamboa
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - S H Glenzer
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - S Göde
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - S P Hau-Riege
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - D Kraus
- University of California, Berkeley, California 94720, USA
| | - J Krzywinski
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - A L Levitan
- Franklin W. Olin College of Engineering, Needham, Massachusetts 02492, USA
| | | | - C P O'Grady
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - T Osipov
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - T Pardini
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - C Peltz
- Universität Rostock, D-18051 Rostock, Germany
| | | | - M Swiggers
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - C Bostedt
- Argonne National Lab, Lemont, Illinois 60439, USA
| | - T Fennel
- Universität Rostock, D-18051 Rostock, Germany
| | - T Döppner
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
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Raspé C, Flöther L, Schneider R, Bucher M, Piso P. Best practice for perioperative management of patients with cytoreductive surgery and HIPEC. Eur J Surg Oncol 2016; 43:1013-1027. [PMID: 27727026 DOI: 10.1016/j.ejso.2016.09.008] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 09/01/2016] [Accepted: 09/13/2016] [Indexed: 12/17/2022] Open
Abstract
Due to the significantly improved outcome and quality of life of patients with different tumor entities after cytoreductive surgery (CRS) and HIPEC, there is an increasing number of centers performing CRS and HIPEC procedures. As this procedure is technically challenging with potential high morbidity and mortality, respectively, institutional experience also in the anesthetic and intensive care departments is essential for optimal treatment and prevention of adverse events. Clinical pathways have to be developed to achieve also good results in more comorbid patients with border line indications and extensive surgical procedures. The anesthesiologist has deal with relevant fluid, blood and protein losses, increased intraabdominal pressure, systemic hypo-/hyperthermia, and increased metabolic rate in patients undergoing cytoreductive surgery with HIPEC. It is of utmost importance to maintain or restore an adequate volume by aggressive substitution of intravenous fluids, which counteracts the increased fluid loss and venous capacitance during this procedure. Supplementary thoracic epidural analgesia, non-invasive ventilation, and physiotherapy are recommended to guarantee adequate pain therapy and postoperative extubation as well as fast-track concepts. Advanced hemodynamic monitoring is essential to help the anesthesiologist picking up information about the real-time fluid status of the patient. Preoperative preconditioning is mandatory in patients scheduled for HIPEC surgery and will result in improved outcome. Postoperatively, volume status optimization, early nutritional support, sufficient anticoagulation, and point of care coagulation management are essential. This is an extensive update on all relevant topics for anesthetists and intensivists dealing with CRS and HIPEC.
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Affiliation(s)
- C Raspé
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Germany.
| | - L Flöther
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Germany
| | - R Schneider
- Department of General- and Visceral Surgery, Halle-Wittenberg University, Germany
| | - M Bucher
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Germany
| | - P Piso
- Department for General- and Visceral Surgery, Hospital Barmherzige Brüder, Regensburg, Germany
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Picón A, Lehmann CS, Bostedt C, Rudenko A, Marinelli A, Osipov T, Rolles D, Berrah N, Bomme C, Bucher M, Doumy G, Erk B, Ferguson KR, Gorkhover T, Ho PJ, Kanter EP, Krässig B, Krzywinski J, Lutman AA, March AM, Moonshiram D, Ray D, Young L, Pratt ST, Southworth SH. Hetero-site-specific X-ray pump-probe spectroscopy for femtosecond intramolecular dynamics. Nat Commun 2016; 7:11652. [PMID: 27212390 PMCID: PMC4879250 DOI: 10.1038/ncomms11652] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [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: 09/22/2015] [Accepted: 04/18/2016] [Indexed: 11/09/2022] Open
Abstract
New capabilities at X-ray free-electron laser facilities allow the generation of two-colour femtosecond X-ray pulses, opening the possibility of performing ultrafast studies of X-ray-induced phenomena. Particularly, the experimental realization of hetero-site-specific X-ray-pump/X-ray-probe spectroscopy is of special interest, in which an X-ray pump pulse is absorbed at one site within a molecule and an X-ray probe pulse follows the X-ray-induced dynamics at another site within the same molecule. Here we show experimental evidence of a hetero-site pump-probe signal. By using two-colour 10-fs X-ray pulses, we are able to observe the femtosecond time dependence for the formation of F ions during the fragmentation of XeF2 molecules following X-ray absorption at the Xe site.
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Affiliation(s)
- A. Picón
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - C. S. Lehmann
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - C. Bostedt
- Argonne National Laboratory, Argonne, Illinois 60439, USA
- Department of Physics and Astronomy, Northwestern University, Evanston, Illinois 60208, USA
| | - A. Rudenko
- J.R. Macdonald Laboratory, Department of Physics, Kansas State University, Manhattan, Kansas 66506, USA
| | - A. Marinelli
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - T. Osipov
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - D. Rolles
- J.R. Macdonald Laboratory, Department of Physics, Kansas State University, Manhattan, Kansas 66506, USA
- Deutsches Elektronen-Synchrotron (DESY), Hamburg 22607, Germany
| | - N. Berrah
- Department of Physics, University of Connecticut, Storrs, Connecticut 06269, USA
| | - C. Bomme
- Deutsches Elektronen-Synchrotron (DESY), Hamburg 22607, Germany
| | - M. Bucher
- Argonne National Laboratory, Argonne, Illinois 60439, USA
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - G. Doumy
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - B. Erk
- Deutsches Elektronen-Synchrotron (DESY), Hamburg 22607, Germany
| | - K. R. Ferguson
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - T. Gorkhover
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - P. J. Ho
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - E. P. Kanter
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - B. Krässig
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - J. Krzywinski
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - A. A. Lutman
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - A. M. March
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - D. Moonshiram
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - D. Ray
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - L. Young
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - S. T. Pratt
- Argonne National Laboratory, Argonne, Illinois 60439, USA
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Ache J, Rath S, Schneider R, Dralle H, Bucher M, Raspé C. [Key Points of Intraoperative Diagnostic Measures Performed by Anaesthesiologists]. Zentralbl Chir 2016; 142:375-385. [PMID: 27135866 DOI: 10.1055/s-0041-109987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The main focus of surgeons and anaesthesiologists during a surgical procedure is on safety and optimal treatment of the patient. Within the scope of interdisciplinary collaboration, the intraoperative communication between surgeons and anaesthesiologists is the basis of case-, findings- and surgery-phases-adapted patient management. The perioperative monitoring of patients and the implementation of diagnostic measures by anaesthesiologists are essential for optimal patient management. The results of the examinations may significantly determine the course of surgery. Therefore, it is important for surgeons to be familiar with the relevant intraoperative diagnostic measures.
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Affiliation(s)
- J Ache
- Universitätsklinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Halle, Deutschland
| | - S Rath
- Universitätsklinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Halle, Deutschland
| | - R Schneider
- Universitätsklinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Halle, Deutschland
| | - H Dralle
- Universitätsklinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Halle, Deutschland
| | - M Bucher
- Universitätsklinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Halle, Deutschland
| | - C Raspé
- Universitätsklinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Halle, Deutschland
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Flöther L, Raspé C, Bucher M, Benndorf RA. [Multimodal pain management in a patient with atypical cervicogenic headache]. Med Monatsschr Pharm 2015; 38:448-450. [PMID: 26742212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A 45-year-old patient presented with an eight-year history of persistent unilateral headache associated with recurrent episodes of ipsilateral conjunctival injections, eyelid edema and ptosis. Prior ineffective pharmacological treatment strategies included tramadol, non-steroidal anti-inflammatory drugs and triptans. Palpation of right suboccipital trigger points revealed tenderness in the area of the greater occipital nerve and reinforced the symptoms. The diagnosis of cervicogenic headache was confirmed by symptom resolution following right greater occipital nerve blockade. A multimodal treatment strategy (physical therapy, nerve blockade, pharmacological treatment) was chosen and an emphasis was put on optimizing pharmacological pain relief using the opioid analgesic tapentadol and the tricyclic antidepressant amitriptyline as an adjuvant analgesic. Importantly, the patient reported a substantial and consistent pain reduction and considerable quality of life improvement during implementation of the treatment regimen.
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Schröder J, Bucher M, Meyer O. Effect of the laryngeal tube on the no-flow-time in a simulated two rescuer basic life support setting with inexperienced users. Med Klin Intensivmed Notfmed 2015; 111:493-500. [PMID: 26374339 DOI: 10.1007/s00063-015-0088-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 07/21/2015] [Accepted: 08/28/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Intubation with a laryngeal tube (LT) is a recommended alternative to endotracheal intubation during advanced life support (ALS). LT insertion is easy; therefore, it may also be an alternative to bag-mask ventilation (BMV) for untrained personnel performing basic life support (BLS). Data from manikin studies support the influence of LT on no-flow-time (NFT) during ALS. METHODS We performed a prospective, randomized manikin study using a two-rescuer model to compare the effects of ventilation using a LT and BMV on NFT during BLS. Participants were trained in BMV and were inexperienced in the use of a LT. RESULTS There was no significant difference in total NFT with the use of a LT and BMV (LT: mean 83.1 ± 37.3 s; BMV: mean 78.7 ± 24.5 s; p = 0.313), but we found significant differences in the progression of the scenario: in the BLS-scenario, the proportion of time spent performing chest compressions was higher when BMV was used compared to when a LT was used. The quality of chest compressions and the ventilation rate did not differ significantly between the two groups. The mean tidal volume and mean minute volume were significantly larger with the use of a LT compared with the use of BMV. CONCLUSIONS In conclusion, in a two-rescuer BLS scenario, NFT is longer with the use of a LT (without prior training) than with the use of BMV (with prior training). The probable reasons for this result are higher tidal volumes with the use of a LT leading to longer interruptions without chest compressions.
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Affiliation(s)
- J Schröder
- Department of Medicine III, University Hospital of the Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle/Saale, Germany.
| | - M Bucher
- Department of Anesthesiology, University Hospital of the Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle/Saale, Germany
| | - O Meyer
- Institute for Emergency Medicine and Management in Medicine-INM, Klinikum der Universität München, Schillerstr. 53, 80336, Munich, Germany
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Preising C, Schneider R, Bucher M, Gekle M, Sauvant C. Regulation of Expression of Renal Organic Anion Transporters OAT1 and OAT3 in a Model of Ischemia/Reperfusion Injury. Cell Physiol Biochem 2015; 37:1-13. [PMID: 26277839 DOI: 10.1159/000430328] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Recently, we gained evidence that impairment of rOat1 and rOat3 expression induced by ischemic acute kidney injury (AKI) is mediated by COX metabolites and this suppression might be critically involved in renal damage. METHODS (i) Basolateral organic anion uptake into proximal tubular cells after model ischemia and reperfusion (I/R) was investigated by fluorescein uptake. The putative promoter sequences from hOAT1 (SLC22A6) and hOAT3 (SCL22A8) were cloned into a reporter plasmid, transfected into HEK cells and (ii) transcriptional activity was determined after model ischemia and reperfusion as a SEAP reporter gen assay. Inhibitors or antagonists were applied with the beginning of reperfusion. RESULTS By using inhibitors of PKA (H89) and PLC (U73122), antagonists of E prostanoid receptor type 2 (AH6809) and type 4 (L161,982), we gained evidence that I/R induced down regulation of organic anion transport is mediated by COX1 metabolites via E prostanoid receptor type 4. The latter signaling was confirmed by application of butaprost (EP2 agonist) or TCS2510 (EP4 agonist) to control cells. In brief, the latter signaling was verified for the transcriptional activity in the reporter gen assay established. Therein, selective inhibitors for COX1 (SC58125) and COX2 (SC560) were also applied. CONCLUSION Our data show (a) that COX1 metabolites are involved in the regulation of renal organic anion transport(ers) after I/R via the EP4 receptor and (b) that this is due to transcriptional regulation of the respective transporters. As the promoter sequences cloned were of human origin and expressed in a human renal epithelial cell line we (c) hypothesize that the regulatory mechanisms described after I/R is meaningful for humans as well.
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Affiliation(s)
- Christina Preising
- Klinik fx00FC;r Anx00E4;sthesie und Operative Intensivmedizin, Universitx00E4;tsklinikum Halle (Saale), Halle (Saale), Germany
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40
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Al-Ahmad A, Bucher M, Anderson AC, Tennert C, Hellwig E, Wittmer A, Vach K, Karygianni L. Antimicrobial Photoinactivation Using Visible Light Plus Water-Filtered Infrared-A (VIS + wIRA) Alters In Situ Oral Biofilms. PLoS One 2015; 10:e0132107. [PMID: 26162100 PMCID: PMC4498738 DOI: 10.1371/journal.pone.0132107] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [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: 04/20/2015] [Accepted: 06/10/2015] [Indexed: 11/18/2022] Open
Abstract
Recently, growing attention has been paid to antimicrobial photodynamic therapy (aPDT) in dentistry. Changing the microbial composition of initial and mature oral biofilm by aPDT using visible light plus water-filtered infrared-A wavelengths (VIS + wIRA) has not yet been investigated. Moreover, most aPDT studies have been conducted on planktonic bacterial cultures. Therefore, in the present clinical study we cultivated initial and mature oral biofilms in six healthy volunteers for 2 hours or 3 days, respectively. The biofilms were treated with aPDT using VIS+wIRA (200 mW cm-2), toluidine blue (TB) and chlorine e6 (Ce6) for 5 minutes. Chlorhexidine treated biofilm samples served as positive controls, while untreated biofilms served as negative controls. After aPDT treatment the colony forming units (CFU) of the biofilm samples were quantified, and the surviving bacteria were isolated in pure cultures and identified using MALDI-TOF, biochemical tests and 16S rDNA-sequencing. aPDT killed more than 99.9% of the initial viable bacterial count and 95% of the mature oral biofilm in situ, independent of the photosensitizer. The number of surviving bacterial species was highly reduced to 6 (TB) and 4 (Ce6) in the treated initial oral biofilm compared to the 20 different species of the untreated biofilm. The proportions of surviving bacterial species were also changed after TB- and Ce6-mediated aPDT of the mature oral biofilm, resulting in a shift in the microbial composition of the treated biofilm compared to that of the control biofilm. In conclusion, aPDT using VIS + wIRA showed a remarkable potential to eradicate both initial and mature oral biofilms, and also to markedly alter the remaining biofilm. This encourages the clinical use of aPDT with VIS + wIRA for the treatment of periimplantitis and periodontitis.
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Affiliation(s)
- A. Al-Ahmad
- Department of Operative Dentistry and Periodontology, Center for Dental Medicine, Albert-Ludwigs-University, Freiburg, Germany
- * E-mail:
| | - M. Bucher
- Department of Operative Dentistry and Periodontology, Center for Dental Medicine, Albert-Ludwigs-University, Freiburg, Germany
| | - A. C. Anderson
- Department of Operative Dentistry and Periodontology, Center for Dental Medicine, Albert-Ludwigs-University, Freiburg, Germany
| | - C. Tennert
- Department of Operative Dentistry and Periodontology, Center for Dental Medicine, Albert-Ludwigs-University, Freiburg, Germany
| | - E. Hellwig
- Department of Operative Dentistry and Periodontology, Center for Dental Medicine, Albert-Ludwigs-University, Freiburg, Germany
| | - A. Wittmer
- Institute of Medical Microbiology and Hygiene, Albert-Ludwigs-University, Freiburg, Germany
| | - K. Vach
- Institute for Medical Biometry and Statistics, Center for Medical Biometry and Medical Informatics, Albert-Ludwigs-University, Freiburg, Germany
| | - L. Karygianni
- Department of Operative Dentistry and Periodontology, Center for Dental Medicine, Albert-Ludwigs-University, Freiburg, Germany
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Preising C, Schneider R, Bucher M, Gekle M, Sauvant C. FP026COX1 METABOLITES ALTER EXPRESSION OF RENAL ORGANIC ANION TRANSPORTERS OAT1 AND OAT3 IN ISCHEMIA/REPERFUSION INJURY VIA E PROSTANOID RECEPTOR 4. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv166.14] [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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Hilbert-Carius P, Hofmann GO, Lefering R, Stuttmann R, Bucher M, Goebel P, Gronwald GH. [Whole-body-CT in Severely Injured Children. Results of Retrospective, Multicenter Study with Patients from the TraumaRegsiter DGU®]. Klin Padiatr 2015; 227:206-12. [PMID: 25875400 DOI: 10.1055/s-0035-1547311] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND A fast and comprehensive diagnostic by means of whole-body CT has been shown to reduce mortality in the adult trauma population. Therefore whole-body CT seems to be the standard in adult trauma-patients. Due to the higher radiation exposure of whole-body CT the use of this diagnostic toll in pediatric trauma patients is still under debate. It is not yet clear if whole-body CT in children can increase the probability of survival. METHOD In a retrospective, multicenter study, we used the data recorded in the TraumaRegister DGU(®) to calculate the probability of survival according to the revised injury severity classification (RISC) and standardized mortality ratio (SMR). The SMR reflects the ratio of recorded to expected mortality. Included in the study were all children (1-15 years) and adults (16-50 years) with an Injury Severity Score (ISS)>9, who were directly admitted to the hospital from the scene of accident. We compared the groups of patients given whole-body CT or non-whole-body CT. Subgroup analysis was performed for children 1-9 years, children 10-15 years and adults. RESULTS A total of 1,456 pediatric trauma patients (mean age 9.9 years) and 20,796 adults (mean age 32.7 years) were included in the study. In contrast to adult trauma patients, were the SMR in the whole-body CT group was significant lower; we observed no advantage for the whole-body CT in pediatric trauma patients. CONCLUSION Due to the missing advantage of whole-body CT in the pediatric trauma population and the higher radiation exposure of whole-body CT a non-whole-body CT approach seems equivalent with a lower radiation exposure.
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Affiliation(s)
- P Hilbert-Carius
- Klinik für Anästhesiologie, Intensiv- u. Notfallmedizin, BG-Kliniken Bergmannstrost, Halle (Saale)
| | - G O Hofmann
- Klinik für Unfall- und Wiederherstellungschirurgie, BG-Kliniken Bergmannstrost, Halle (Saale) und Friedrich Schiller Universität Jena
| | - R Lefering
- Institut für Forschung in der operativen Medizin (IFOM), Universität Witten/Herdecke, Campus Köln
| | - R Stuttmann
- Klinik für Anästhesiologie, Intensiv- u. Notfallmedizin, BG-Kliniken Bergmannstrost, Halle (Saale)
| | - M Bucher
- Klinik für Anästhesiologie und operative Intensivmedizin, Universität Halle (Saale)
| | - P Goebel
- Klinik für Kinderchirurgie und Kinder Urologie, St. Elisabeth Krankenhaus, Halle (Saale)
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Ade PAR, Aghanim N, Ahmed Z, Aikin RW, Alexander KD, Arnaud M, Aumont J, Baccigalupi C, Banday AJ, Barkats D, Barreiro RB, Bartlett JG, Bartolo N, Battaner E, Benabed K, Benoît A, Benoit-Lévy A, Benton SJ, Bernard JP, Bersanelli M, Bielewicz P, Bischoff CA, Bock JJ, Bonaldi A, Bonavera L, Bond JR, Borrill J, Bouchet FR, Boulanger F, Brevik JA, Bucher M, Buder I, Bullock E, Burigana C, Butler RC, Buza V, Calabrese E, Cardoso JF, Catalano A, Challinor A, Chary RR, Chiang HC, Christensen PR, Colombo LPL, Combet C, Connors J, Couchot F, Coulais A, Crill BP, Curto A, Cuttaia F, Danese L, Davies RD, Davis RJ, de Bernardis P, de Rosa A, de Zotti G, Delabrouille J, Delouis JM, Désert FX, Dickinson C, Diego JM, Dole H, Donzelli S, Doré O, Douspis M, Dowell CD, Duband L, Ducout A, Dunkley J, Dupac X, Dvorkin C, Efstathiou G, Elsner F, Enßlin TA, Eriksen HK, Falgarone E, Filippini JP, Finelli F, Fliescher S, Forni O, Frailis M, Fraisse AA, Franceschi E, Frejsel A, Galeotta S, Galli S, Ganga K, Ghosh T, Giard M, Gjerløw E, Golwala SR, González-Nuevo J, Górski KM, Gratton S, Gregorio A, Gruppuso A, Gudmundsson JE, Halpern M, Hansen FK, Hanson D, Harrison DL, Hasselfield M, Helou G, Henrot-Versillé S, Herranz D, Hildebrandt SR, Hilton GC, Hivon E, Hobson M, Holmes WA, Hovest W, Hristov VV, Huffenberger KM, Hui H, Hurier G, Irwin KD, Jaffe AH, Jaffe TR, Jewell J, Jones WC, Juvela M, Karakci A, Karkare KS, Kaufman JP, Keating BG, Kefeli S, Keihänen E, Kernasovskiy SA, Keskitalo R, Kisner TS, Kneissl R, Knoche J, Knox L, Kovac JM, Krachmalnicoff N, Kunz M, Kuo CL, Kurki-Suonio H, Lagache G, Lähteenmäki A, Lamarre JM, Lasenby A, Lattanzi M, Lawrence CR, Leitch EM, Leonardi R, Levrier F, Lewis A, Liguori M, Lilje PB, Linden-Vørnle M, López-Caniego M, Lubin PM, Lueker M, Macías-Pérez JF, Maffei B, Maino D, Mandolesi N, Mangilli A, Maris M, Martin PG, Martínez-González E, Masi S, Mason P, Matarrese S, Megerian KG, Meinhold PR, Melchiorri A, Mendes L, Mennella A, Migliaccio M, Mitra S, Miville-Deschênes MA, Moneti A, Montier L, Morgante G, Mortlock D, Moss A, Munshi D, Murphy JA, Naselsky P, Nati F, Natoli P, Netterfield CB, Nguyen HT, Nørgaard-Nielsen HU, Noviello F, Novikov D, Novikov I, O'Brient R, Ogburn RW, Orlando A, Pagano L, Pajot F, Paladini R, Paoletti D, Partridge B, Pasian F, Patanchon G, Pearson TJ, Perdereau O, Perotto L, Pettorino V, Piacentini F, Piat M, Pietrobon D, Plaszczynski S, Pointecouteau E, Polenta G, Ponthieu N, Pratt GW, Prunet S, Pryke C, Puget JL, Rachen JP, Reach WT, Rebolo R, Reinecke M, Remazeilles M, Renault C, Renzi A, Richter S, Ristorcelli I, Rocha G, Rossetti M, Roudier G, Rowan-Robinson M, Rubiño-Martín JA, Rusholme B, Sandri M, Santos D, Savelainen M, Savini G, Schwarz R, Scott D, Seiffert MD, Sheehy CD, Spencer LD, Staniszewski ZK, Stolyarov V, Sudiwala R, Sunyaev R, Sutton D, Suur-Uski AS, Sygnet JF, Tauber JA, Teply GP, Terenzi L, Thompson KL, Toffolatti L, Tolan JE, Tomasi M, Tristram M, Tucci M, Turner AD, Valenziano L, Valiviita J, Van Tent B, Vibert L, Vielva P, Vieregg AG, Villa F, Wade LA, Wandelt BD, Watson R, Weber AC, Wehus IK, White M, White SDM, Willmert J, Wong CL, Yoon KW, Yvon D, Zacchei A, Zonca A. Joint analysis of BICEP2/keck array and Planck Data. Phys Rev Lett 2015; 114:101301. [PMID: 25815919 DOI: 10.1103/physrevlett.114.101301] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Indexed: 06/04/2023]
Abstract
We report the results of a joint analysis of data from BICEP2/Keck Array and Planck. BICEP2 and Keck Array have observed the same approximately 400 deg^{2} patch of sky centered on RA 0 h, Dec. -57.5°. The combined maps reach a depth of 57 nK deg in Stokes Q and U in a band centered at 150 GHz. Planck has observed the full sky in polarization at seven frequencies from 30 to 353 GHz, but much less deeply in any given region (1.2 μK deg in Q and U at 143 GHz). We detect 150×353 cross-correlation in B modes at high significance. We fit the single- and cross-frequency power spectra at frequencies ≥150 GHz to a lensed-ΛCDM model that includes dust and a possible contribution from inflationary gravitational waves (as parametrized by the tensor-to-scalar ratio r), using a prior on the frequency spectral behavior of polarized dust emission from previous Planck analysis of other regions of the sky. We find strong evidence for dust and no statistically significant evidence for tensor modes. We probe various model variations and extensions, including adding a synchrotron component in combination with lower frequency data, and find that these make little difference to the r constraint. Finally, we present an alternative analysis which is similar to a map-based cleaning of the dust contribution, and show that this gives similar constraints. The final result is expressed as a likelihood curve for r, and yields an upper limit r_{0.05}<0.12 at 95% confidence. Marginalizing over dust and r, lensing B modes are detected at 7.0σ significance.
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Affiliation(s)
- P A R Ade
- School of Physics and Astronomy, Cardiff University, Queens Buildings, The Parade, Cardiff, CF24 3AA, United Kingdom
| | - N Aghanim
- Institut d'Astrophysique Spatiale, CNRS (UMR8617) Université Paris-Sud 11, Bâtiment 121, Orsay, France
| | - Z Ahmed
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - R W Aikin
- California Institute of Technology, Pasadena, California, USA
| | - K D Alexander
- Harvard-Smithsonian Center for Astrophysics, 60 Garden Street MS 42, Cambridge, Massachusetts 02138, USA
| | - M Arnaud
- Laboratoire AIM, IRFU/Service d'Astrophysique-CEA/DSM-CNRS-Université Paris Diderot, Bâtiment 709, CEA-Saclay, F-91191 Gif-sur-Yvette Cedex, France
| | - J Aumont
- Institut d'Astrophysique Spatiale, CNRS (UMR8617) Université Paris-Sud 11, Bâtiment 121, Orsay, France
| | - C Baccigalupi
- SISSA, Astrophysics Sector, via Bonomea 265, 34136, Trieste, Italy
| | - A J Banday
- Université de Toulouse, UPS-OMP, IRAP, F-31028 Toulouse cedex 4, France
- CNRS, IRAP, 9 Avenue colonel Roche, BP 44346, F-31028 Toulouse cedex 4, France
| | - D Barkats
- Joint ALMA Observatory, Vitacura, Santiago, Chile
| | - R B Barreiro
- Instituto de Física de Cantabria (CSIC-Universidad de Cantabria), Avenida de los Castros s/n, Santander, Spain
| | - J G Bartlett
- APC, AstroParticule et Cosmologie, Université Paris Diderot, CNRS/IN2P3, CEA/lrfu, Observatoire de Paris, Sorbonne Paris Cité, 10, rue Alice Domon et Léonie Duquet, 75205 Paris Cedex 13, France
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
| | - N Bartolo
- Dipartimento di Fisica e Astronomia G. Galilei, Università degli Studi di Padova, via Marzolo 8, 35131 Padova, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Padova, via Marzolo 8, I-35131 Padova, Italy
| | - E Battaner
- University of Granada, Departamento de Física Teórica y del Cosmos, Facultad de Ciencias, Granada, Spain
- University of Granada, Instituto Carlos I de Física Teórica y Computacional, Granada, Spain
| | - K Benabed
- Institut d'Astrophysique de Paris, CNRS (UMR7095), 98 bis Boulevard Arago, F-75014, Paris, France
- UPMC Université de Paris 06, UMR7095, 98 bis Boulevard Arago, F-75014, Paris, France
| | - A Benoît
- Institut Néel, CNRS, Université Joseph Fourier Grenoble I, 25 rue des Martyrs, Grenoble, France
| | - A Benoit-Lévy
- Institut d'Astrophysique de Paris, CNRS (UMR7095), 98 bis Boulevard Arago, F-75014, Paris, France
- UPMC Université de Paris 06, UMR7095, 98 bis Boulevard Arago, F-75014, Paris, France
- Department of Physics and Astronomy, University College London, London WC1E 6BT, United Kingdom
| | - S J Benton
- Department of Physics, University of Toronto, Toronto, Ontario, M5S 1A7, Canada
| | - J-P Bernard
- Université de Toulouse, UPS-OMP, IRAP, F-31028 Toulouse cedex 4, France
- CNRS, IRAP, 9 Avenue colonel Roche, BP 44346, F-31028 Toulouse cedex 4, France
| | - M Bersanelli
- Dipartimento di Fisica, Università degli Studi di Milano, Via Celoria, 16, Milano, Italy
- INAF/IASF Milano, Via E. Bassini 15, Milano, Italy
| | - P Bielewicz
- SISSA, Astrophysics Sector, via Bonomea 265, 34136, Trieste, Italy
- Université de Toulouse, UPS-OMP, IRAP, F-31028 Toulouse cedex 4, France
- CNRS, IRAP, 9 Avenue colonel Roche, BP 44346, F-31028 Toulouse cedex 4, France
| | - C A Bischoff
- Harvard-Smithsonian Center for Astrophysics, 60 Garden Street MS 42, Cambridge, Massachusetts 02138, USA
| | - J J Bock
- California Institute of Technology, Pasadena, California, USA
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
| | - A Bonaldi
- Jodrell Bank Centre for Astrophysics, Alan Turing Building, School of Physics and Astronomy, The University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
| | - L Bonavera
- Instituto de Física de Cantabria (CSIC-Universidad de Cantabria), Avenida de los Castros s/n, Santander, Spain
| | - J R Bond
- CITA, University of Toronto, 60 St. George Street, Toronto, Ontario M5S 3H8, Canada
| | - J Borrill
- Computational Cosmology Center, Lawrence Berkeley National Laboratory, Berkeley, California, USA
- Space Sciences Laboratory, University of California, Berkeley, California, USA
| | - F R Bouchet
- Institut d'Astrophysique de Paris, CNRS (UMR7095), 98 bis Boulevard Arago, F-75014, Paris, France
- Sorbonne Université-UPMC, UMR7095, Institut d'Astrophysique de Paris, 98 bis Boulevard Arago, F-75014, Paris, France
| | - F Boulanger
- Institut d'Astrophysique Spatiale, CNRS (UMR8617) Université Paris-Sud 11, Bâtiment 121, Orsay, France
| | - J A Brevik
- California Institute of Technology, Pasadena, California, USA
| | - M Bucher
- APC, AstroParticule et Cosmologie, Université Paris Diderot, CNRS/IN2P3, CEA/lrfu, Observatoire de Paris, Sorbonne Paris Cité, 10, rue Alice Domon et Léonie Duquet, 75205 Paris Cedex 13, France
| | - I Buder
- Harvard-Smithsonian Center for Astrophysics, 60 Garden Street MS 42, Cambridge, Massachusetts 02138, USA
| | - E Bullock
- Minnesota Institute for Astrophysics, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - C Burigana
- INAF/IASF Bologna, Via Gobetti 101, Bologna, Italy
- Dipartimento di Fisica e Scienze della Terra, Università di Ferrara, Via Saragat 1, 44122 Ferrara, Italy
- INFN, Sezione di Bologna, Via Irnerio 46, I-40126, Bologna, Italy
| | - R C Butler
- INAF/IASF Bologna, Via Gobetti 101, Bologna, Italy
| | - V Buza
- Harvard-Smithsonian Center for Astrophysics, 60 Garden Street MS 42, Cambridge, Massachusetts 02138, USA
| | - E Calabrese
- Sub-Department of Astrophysics, University of Oxford, Keble Road, Oxford OX1 3RH, United Kingdom
| | - J-F Cardoso
- APC, AstroParticule et Cosmologie, Université Paris Diderot, CNRS/IN2P3, CEA/lrfu, Observatoire de Paris, Sorbonne Paris Cité, 10, rue Alice Domon et Léonie Duquet, 75205 Paris Cedex 13, France
- Institut d'Astrophysique de Paris, CNRS (UMR7095), 98 bis Boulevard Arago, F-75014, Paris, France
- Laboratoire Traitement et Communication de l'Information, CNRS (UMR 5141) and Télécom ParisTech, 46 rue Barrault F-75634 Paris Cedex 13, France
| | - A Catalano
- Laboratoire de Physique Subatomique et Cosmologie, Université Grenoble-Alpes, CNRS/IN2P3, 53, rue des Martyrs, 38026 Grenoble Cedex, France
- LERMA, CNRS, Observatoire de Paris, 61 Avenue de l'Observatoire, Paris, France
| | - A Challinor
- Institute of Astronomy, University of Cambridge, Madingley Road, Cambridge CB3 0HA, United Kingdom
- Kavli Institute for Cosmology Cambridge, Madingley Road, Cambridge, CB3 0HA, United Kingdom
- Centre for Theoretical Cosmology, DAMTP, University of Cambridge, Wilberforce Road, Cambridge CB3 0WA, United Kingdom
| | - R-R Chary
- Infrared Processing and Analysis Center, California Institute of Technology, Pasadena, California 91125, USA
| | - H C Chiang
- Department of Physics, Princeton University, Princeton, New Jersey, USA
- Astrophysics & Cosmology Research Unit, School of Mathematics, Statistics & Computer Science, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, Durban 4000, South Africa
| | - P R Christensen
- Niels Bohr Institute, Blegdamsvej 17, Copenhagen, Denmark
- Discovery Center, Niels Bohr Institute, Blegdamsvej 17, Copenhagen, Denmark
| | - L P L Colombo
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
- Department of Physics and Astronomy, Dana and David Dornsife College of Letter, Arts and Sciences, University of Southern California, Los Angeles, California 90089, USA
| | - C Combet
- Laboratoire de Physique Subatomique et Cosmologie, Université Grenoble-Alpes, CNRS/IN2P3, 53, rue des Martyrs, 38026 Grenoble Cedex, France
| | - J Connors
- Harvard-Smithsonian Center for Astrophysics, 60 Garden Street MS 42, Cambridge, Massachusetts 02138, USA
| | - F Couchot
- LAL, Université Paris-Sud, CNRS/IN2P3, Orsay, France
| | - A Coulais
- LERMA, CNRS, Observatoire de Paris, 61 Avenue de l'Observatoire, Paris, France
| | - B P Crill
- California Institute of Technology, Pasadena, California, USA
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
| | - A Curto
- Instituto de Física de Cantabria (CSIC-Universidad de Cantabria), Avenida de los Castros s/n, Santander, Spain
- Astrophysics Group, Cavendish Laboratory, University of Cambridge, J J Thomson Avenue, Cambridge CB3 0HE, United Kingdom
| | - F Cuttaia
- INAF/IASF Bologna, Via Gobetti 101, Bologna, Italy
| | - L Danese
- SISSA, Astrophysics Sector, via Bonomea 265, 34136, Trieste, Italy
| | - R D Davies
- Jodrell Bank Centre for Astrophysics, Alan Turing Building, School of Physics and Astronomy, The University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
| | - R J Davis
- Jodrell Bank Centre for Astrophysics, Alan Turing Building, School of Physics and Astronomy, The University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
| | - P de Bernardis
- Dipartimento di Fisica, Università La Sapienza, Piazzale Aldo Moro 2, Roma, Italy
| | - A de Rosa
- INAF/IASF Bologna, Via Gobetti 101, Bologna, Italy
| | - G de Zotti
- SISSA, Astrophysics Sector, via Bonomea 265, 34136, Trieste, Italy
- INAF-Osservatorio Astronomico di Padova, Vicolo dell'Osservatorio 5, Padova, Italy
| | - J Delabrouille
- APC, AstroParticule et Cosmologie, Université Paris Diderot, CNRS/IN2P3, CEA/lrfu, Observatoire de Paris, Sorbonne Paris Cité, 10, rue Alice Domon et Léonie Duquet, 75205 Paris Cedex 13, France
| | - J-M Delouis
- Institut d'Astrophysique de Paris, CNRS (UMR7095), 98 bis Boulevard Arago, F-75014, Paris, France
- UPMC Université de Paris 06, UMR7095, 98 bis Boulevard Arago, F-75014, Paris, France
| | - F-X Désert
- IPAG: Institut de Planétologie et d'Astrophysique de Grenoble, Université Grenoble Alpes, IPAG, F-38000 Grenoble, France, CNRS, IPAG, F-38000 Grenoble, France
| | - C Dickinson
- Jodrell Bank Centre for Astrophysics, Alan Turing Building, School of Physics and Astronomy, The University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
| | - J M Diego
- Instituto de Física de Cantabria (CSIC-Universidad de Cantabria), Avenida de los Castros s/n, Santander, Spain
| | - H Dole
- Institut d'Astrophysique Spatiale, CNRS (UMR8617) Université Paris-Sud 11, Bâtiment 121, Orsay, France
- Institut Universitaire de France, 103, bd Saint-Michel, 75005, Paris, France
| | - S Donzelli
- INAF/IASF Milano, Via E. Bassini 15, Milano, Italy
| | - O Doré
- California Institute of Technology, Pasadena, California, USA
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
| | - M Douspis
- Institut d'Astrophysique Spatiale, CNRS (UMR8617) Université Paris-Sud 11, Bâtiment 121, Orsay, France
| | - C D Dowell
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
| | - L Duband
- Service des Basses Températures, Commissariat à l'Energie Atomique, 38054 Grenoble, France
| | - A Ducout
- Institut d'Astrophysique de Paris, CNRS (UMR7095), 98 bis Boulevard Arago, F-75014, Paris, France
- Imperial College London, Astrophysics group, Blackett Laboratory, Prince Consort Road, London, SW7 2AZ, United Kingdom
| | - J Dunkley
- Sub-Department of Astrophysics, University of Oxford, Keble Road, Oxford OX1 3RH, United Kingdom
| | - X Dupac
- European Space Agency, ESAC, Planck Science Office, Camino bajo del Castillo, s/n, Urbanización Villafranca del Castillo, Villanueva de la Cañada, Madrid, Spain
| | - C Dvorkin
- Harvard-Smithsonian Center for Astrophysics, 60 Garden Street MS 42, Cambridge, Massachusetts 02138, USA
| | - G Efstathiou
- Institute of Astronomy, University of Cambridge, Madingley Road, Cambridge CB3 0HA, United Kingdom
| | - F Elsner
- Institut d'Astrophysique de Paris, CNRS (UMR7095), 98 bis Boulevard Arago, F-75014, Paris, France
- UPMC Université de Paris 06, UMR7095, 98 bis Boulevard Arago, F-75014, Paris, France
- Department of Physics and Astronomy, University College London, London WC1E 6BT, United Kingdom
| | - T A Enßlin
- Max-Planck-Institut für Astrophysik, Karl-Schwarzschild-Strasse 1, 85741 Garching, Germany
| | - H K Eriksen
- Institute of Theoretical Astrophysics, University of Oslo, Blindern, Oslo, Norway
| | - E Falgarone
- LERMA, CNRS, Observatoire de Paris, 61 Avenue de l'Observatoire, Paris, France
| | - J P Filippini
- California Institute of Technology, Pasadena, California, USA
- Department of Physics, University of Illinois at Urbana-Champaign, 1110 West Green Street, Urbana, Illinois, USA
| | - F Finelli
- INAF/IASF Bologna, Via Gobetti 101, Bologna, Italy
- INFN, Sezione di Bologna, Via Irnerio 46, I-40126, Bologna, Italy
| | - S Fliescher
- School of Physics and Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - O Forni
- Université de Toulouse, UPS-OMP, IRAP, F-31028 Toulouse cedex 4, France
- CNRS, IRAP, 9 Avenue colonel Roche, BP 44346, F-31028 Toulouse cedex 4, France
| | - M Frailis
- INAF-Osservatorio Astronomico di Trieste, Via G.B. Tiepolo 11, Trieste, Italy
| | - A A Fraisse
- Department of Physics, Princeton University, Princeton, New Jersey, USA
| | - E Franceschi
- INAF/IASF Bologna, Via Gobetti 101, Bologna, Italy
| | - A Frejsel
- Niels Bohr Institute, Blegdamsvej 17, Copenhagen, Denmark
| | - S Galeotta
- INAF-Osservatorio Astronomico di Trieste, Via G.B. Tiepolo 11, Trieste, Italy
| | - S Galli
- Institut d'Astrophysique de Paris, CNRS (UMR7095), 98 bis Boulevard Arago, F-75014, Paris, France
| | - K Ganga
- APC, AstroParticule et Cosmologie, Université Paris Diderot, CNRS/IN2P3, CEA/lrfu, Observatoire de Paris, Sorbonne Paris Cité, 10, rue Alice Domon et Léonie Duquet, 75205 Paris Cedex 13, France
| | - T Ghosh
- Institut d'Astrophysique Spatiale, CNRS (UMR8617) Université Paris-Sud 11, Bâtiment 121, Orsay, France
| | - M Giard
- Université de Toulouse, UPS-OMP, IRAP, F-31028 Toulouse cedex 4, France
- CNRS, IRAP, 9 Avenue colonel Roche, BP 44346, F-31028 Toulouse cedex 4, France
| | - E Gjerløw
- Institute of Theoretical Astrophysics, University of Oslo, Blindern, Oslo, Norway
| | - S R Golwala
- California Institute of Technology, Pasadena, California, USA
| | - J González-Nuevo
- SISSA, Astrophysics Sector, via Bonomea 265, 34136, Trieste, Italy
- Instituto de Física de Cantabria (CSIC-Universidad de Cantabria), Avenida de los Castros s/n, Santander, Spain
| | - K M Górski
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
- Warsaw University Observatory, Aleje Ujazdowskie 4, 00-478 Warszawa, Poland
| | - S Gratton
- Institute of Astronomy, University of Cambridge, Madingley Road, Cambridge CB3 0HA, United Kingdom
- Kavli Institute for Cosmology Cambridge, Madingley Road, Cambridge, CB3 0HA, United Kingdom
| | - A Gregorio
- INAF-Osservatorio Astronomico di Trieste, Via G.B. Tiepolo 11, Trieste, Italy
- Dipartimento di Fisica, Università degli Studi di Trieste, via Alfonso Valerio 2, Trieste, Italy
- INFN/National Institute for Nuclear Physics, Via Valerio 2, I-34127 Trieste, Italy
| | - A Gruppuso
- INAF/IASF Bologna, Via Gobetti 101, Bologna, Italy
| | - J E Gudmundsson
- Department of Physics, Princeton University, Princeton, New Jersey, USA
| | - M Halpern
- Department of Physics & Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, British Columbia, Canada
| | - F K Hansen
- Institute of Theoretical Astrophysics, University of Oslo, Blindern, Oslo, Norway
| | - D Hanson
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
- CITA, University of Toronto, 60 St. George Street, Toronto, Ontario M5S 3H8, Canada
- McGill Physics, Ernest Rutherford Physics Building, McGill University, 3600 rue University, Montréal, Quebec, H3A 2T8, Canada
| | - D L Harrison
- Institute of Astronomy, University of Cambridge, Madingley Road, Cambridge CB3 0HA, United Kingdom
- Kavli Institute for Cosmology Cambridge, Madingley Road, Cambridge, CB3 0HA, United Kingdom
| | - M Hasselfield
- Department of Physics & Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, British Columbia, Canada
| | - G Helou
- California Institute of Technology, Pasadena, California, USA
| | | | - D Herranz
- Instituto de Física de Cantabria (CSIC-Universidad de Cantabria), Avenida de los Castros s/n, Santander, Spain
| | - S R Hildebrandt
- California Institute of Technology, Pasadena, California, USA
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
| | - G C Hilton
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - E Hivon
- Institut d'Astrophysique de Paris, CNRS (UMR7095), 98 bis Boulevard Arago, F-75014, Paris, France
- UPMC Université de Paris 06, UMR7095, 98 bis Boulevard Arago, F-75014, Paris, France
| | - M Hobson
- Astrophysics Group, Cavendish Laboratory, University of Cambridge, J J Thomson Avenue, Cambridge CB3 0HE, United Kingdom
| | - W A Holmes
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
| | - W Hovest
- Max-Planck-Institut für Astrophysik, Karl-Schwarzschild-Strasse 1, 85741 Garching, Germany
| | - V V Hristov
- California Institute of Technology, Pasadena, California, USA
| | - K M Huffenberger
- Department of Physics, Florida State University, Keen Physics Building, 77 Chieftan Way, Tallahassee, Florida, USA
| | - H Hui
- California Institute of Technology, Pasadena, California, USA
| | - G Hurier
- Institut d'Astrophysique Spatiale, CNRS (UMR8617) Université Paris-Sud 11, Bâtiment 121, Orsay, France
| | - K D Irwin
- Department of Physics, Stanford University, Stanford, California 94305, USA
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
- Kavli Institute for Particle Astrophysics and Cosmology, SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94025, USA
| | - A H Jaffe
- Imperial College London, Astrophysics group, Blackett Laboratory, Prince Consort Road, London, SW7 2AZ, United Kingdom
| | - T R Jaffe
- Université de Toulouse, UPS-OMP, IRAP, F-31028 Toulouse cedex 4, France
- CNRS, IRAP, 9 Avenue colonel Roche, BP 44346, F-31028 Toulouse cedex 4, France
| | - J Jewell
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
| | - W C Jones
- Department of Physics, Princeton University, Princeton, New Jersey, USA
| | - M Juvela
- Department of Physics, Gustaf Hällströmin katu 2a, University of Helsinki, Helsinki, Finland
| | - A Karakci
- APC, AstroParticule et Cosmologie, Université Paris Diderot, CNRS/IN2P3, CEA/lrfu, Observatoire de Paris, Sorbonne Paris Cité, 10, rue Alice Domon et Léonie Duquet, 75205 Paris Cedex 13, France
| | - K S Karkare
- Harvard-Smithsonian Center for Astrophysics, 60 Garden Street MS 42, Cambridge, Massachusetts 02138, USA
| | - J P Kaufman
- Department of Physics, University of California at San Diego, La Jolla, California 92093, USA
| | - B G Keating
- Department of Physics, University of California at San Diego, La Jolla, California 92093, USA
| | - S Kefeli
- California Institute of Technology, Pasadena, California, USA
| | - E Keihänen
- Department of Physics, Gustaf Hällströmin katu 2a, University of Helsinki, Helsinki, Finland
| | - S A Kernasovskiy
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - R Keskitalo
- Computational Cosmology Center, Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - T S Kisner
- Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - R Kneissl
- European Southern Observatory, ESO Vitacura, Alonso de Cordova 3107, Vitacura, Casilla 19001, Santiago, Chile
- Atacama Large Millimeter/submillimeter Array, ALMA Santiago Central Offices, Alonso de Cordova 3107, Vitacura, Casilla 763 0355, Santiago, Chile
| | - J Knoche
- Max-Planck-Institut für Astrophysik, Karl-Schwarzschild-Strasse 1, 85741 Garching, Germany
| | - L Knox
- Department of Physics, University of California, One Shields Avenue, Davis, California, USA
| | - J M Kovac
- Harvard-Smithsonian Center for Astrophysics, 60 Garden Street MS 42, Cambridge, Massachusetts 02138, USA
| | - N Krachmalnicoff
- Dipartimento di Fisica, Università degli Studi di Milano, Via Celoria, 16, Milano, Italy
| | - M Kunz
- Institut d'Astrophysique Spatiale, CNRS (UMR8617) Université Paris-Sud 11, Bâtiment 121, Orsay, France
- Département de Physique Théorique, Université de Genève, 24, Quai E. Ansermet, 1211 Genève 4, Switzerland
- African Institute for Mathematical Sciences, 6-8 Melrose Road, Muizenberg, Cape Town, South Africa
| | - C L Kuo
- Department of Physics, Stanford University, Stanford, California 94305, USA
- Kavli Institute for Particle Astrophysics and Cosmology, SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94025, USA
| | - H Kurki-Suonio
- Department of Physics, Gustaf Hällströmin katu 2a, University of Helsinki, Helsinki, Finland
- Helsinki Institute of Physics, Gustaf Hällströmin katu 2, University of Helsinki, Helsinki, Finland
| | - G Lagache
- Institut d'Astrophysique Spatiale, CNRS (UMR8617) Université Paris-Sud 11, Bâtiment 121, Orsay, France
- Aix Marseille Université, CNRS, LAM (Laboratoire d'Astrophysique de Marseille) UMR 7326, 13388, Marseille, France
| | - A Lähteenmäki
- Helsinki Institute of Physics, Gustaf Hällströmin katu 2, University of Helsinki, Helsinki, Finland
- Aalto University Metsähovi Radio Observatory and Department of Radio Science and Engineering, P.O. Box 13000, FI-00076 AALTO, Finland
| | - J-M Lamarre
- LERMA, CNRS, Observatoire de Paris, 61 Avenue de l'Observatoire, Paris, France
| | - A Lasenby
- Kavli Institute for Cosmology Cambridge, Madingley Road, Cambridge, CB3 0HA, United Kingdom
- Astrophysics Group, Cavendish Laboratory, University of Cambridge, J J Thomson Avenue, Cambridge CB3 0HE, United Kingdom
| | - M Lattanzi
- Dipartimento di Fisica e Scienze della Terra, Università di Ferrara, Via Saragat 1, 44122 Ferrara, Italy
| | - C R Lawrence
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
| | - E M Leitch
- University of Chicago, Chicago, Illinois 60637, USA
| | - R Leonardi
- European Space Agency, ESAC, Planck Science Office, Camino bajo del Castillo, s/n, Urbanización Villafranca del Castillo, Villanueva de la Cañada, Madrid, Spain
| | - F Levrier
- LERMA, CNRS, Observatoire de Paris, 61 Avenue de l'Observatoire, Paris, France
| | - A Lewis
- Department of Physics and Astronomy, University of Sussex, Brighton BN1 9QH, United Kingdom
| | - M Liguori
- Dipartimento di Fisica e Astronomia G. Galilei, Università degli Studi di Padova, via Marzolo 8, 35131 Padova, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Padova, via Marzolo 8, I-35131 Padova, Italy
| | - P B Lilje
- Institute of Theoretical Astrophysics, University of Oslo, Blindern, Oslo, Norway
| | - M Linden-Vørnle
- DTU Space, National Space Institute, Technical University of Denmark, Elektrovej 327, DK-2800 Kongens Lyngby, Denmark
| | - M López-Caniego
- Instituto de Física de Cantabria (CSIC-Universidad de Cantabria), Avenida de los Castros s/n, Santander, Spain
- European Space Agency, ESAC, Planck Science Office, Camino bajo del Castillo, s/n, Urbanización Villafranca del Castillo, Villanueva de la Cañada, Madrid, Spain
| | - P M Lubin
- Department of Physics, University of California, Santa Barbara, California, USA
| | - M Lueker
- California Institute of Technology, Pasadena, California, USA
| | - J F Macías-Pérez
- Laboratoire de Physique Subatomique et Cosmologie, Université Grenoble-Alpes, CNRS/IN2P3, 53, rue des Martyrs, 38026 Grenoble Cedex, France
| | - B Maffei
- Jodrell Bank Centre for Astrophysics, Alan Turing Building, School of Physics and Astronomy, The University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
| | - D Maino
- Dipartimento di Fisica, Università degli Studi di Milano, Via Celoria, 16, Milano, Italy
- INAF/IASF Milano, Via E. Bassini 15, Milano, Italy
| | - N Mandolesi
- INAF/IASF Bologna, Via Gobetti 101, Bologna, Italy
- Dipartimento di Fisica e Scienze della Terra, Università di Ferrara, Via Saragat 1, 44122 Ferrara, Italy
| | - A Mangilli
- Institut d'Astrophysique Spatiale, CNRS (UMR8617) Université Paris-Sud 11, Bâtiment 121, Orsay, France
- LAL, Université Paris-Sud, CNRS/IN2P3, Orsay, France
| | - M Maris
- INAF-Osservatorio Astronomico di Trieste, Via G.B. Tiepolo 11, Trieste, Italy
| | - P G Martin
- CITA, University of Toronto, 60 St. George Street, Toronto, Ontario M5S 3H8, Canada
| | - E Martínez-González
- Instituto de Física de Cantabria (CSIC-Universidad de Cantabria), Avenida de los Castros s/n, Santander, Spain
| | - S Masi
- Dipartimento di Fisica, Università La Sapienza, Piazzale Aldo Moro 2, Roma, Italy
| | - P Mason
- California Institute of Technology, Pasadena, California, USA
| | - S Matarrese
- Dipartimento di Fisica e Astronomia G. Galilei, Università degli Studi di Padova, via Marzolo 8, 35131 Padova, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Padova, via Marzolo 8, I-35131 Padova, Italy
- Gran Sasso Science Institute, INFN, viale F. Crispi 7, 67100L'Aquila, Italy
| | - K G Megerian
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
| | - P R Meinhold
- Department of Physics, University of California, Santa Barbara, California, USA
| | - A Melchiorri
- Dipartimento di Fisica, Università La Sapienza, Piazzale Aldo Moro 2, Roma, Italy
- INFN, Sezione di Roma 1, Università di Roma Sapienza, Piazzale Aldo Moro 2, 00185, Roma, Italy
| | - L Mendes
- European Space Agency, ESAC, Planck Science Office, Camino bajo del Castillo, s/n, Urbanización Villafranca del Castillo, Villanueva de la Cañada, Madrid, Spain
| | - A Mennella
- Dipartimento di Fisica, Università degli Studi di Milano, Via Celoria, 16, Milano, Italy
- INAF/IASF Milano, Via E. Bassini 15, Milano, Italy
| | - M Migliaccio
- Institute of Astronomy, University of Cambridge, Madingley Road, Cambridge CB3 0HA, United Kingdom
- Kavli Institute for Cosmology Cambridge, Madingley Road, Cambridge, CB3 0HA, United Kingdom
| | - S Mitra
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
- IUCAA, Post Bag 4, Ganeshkhind, Pune University Campus, Pune 411 007, India
| | - M-A Miville-Deschênes
- Institut d'Astrophysique Spatiale, CNRS (UMR8617) Université Paris-Sud 11, Bâtiment 121, Orsay, France
- CITA, University of Toronto, 60 St. George Street, Toronto, Ontario M5S 3H8, Canada
| | - A Moneti
- Institut d'Astrophysique de Paris, CNRS (UMR7095), 98 bis Boulevard Arago, F-75014, Paris, France
| | - L Montier
- Université de Toulouse, UPS-OMP, IRAP, F-31028 Toulouse cedex 4, France
- CNRS, IRAP, 9 Avenue colonel Roche, BP 44346, F-31028 Toulouse cedex 4, France
| | - G Morgante
- INAF/IASF Bologna, Via Gobetti 101, Bologna, Italy
| | - D Mortlock
- Imperial College London, Astrophysics group, Blackett Laboratory, Prince Consort Road, London, SW7 2AZ, United Kingdom
| | - A Moss
- School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, United Kingdom
| | - D Munshi
- School of Physics and Astronomy, Cardiff University, Queens Buildings, The Parade, Cardiff, CF24 3AA, United Kingdom
| | - J A Murphy
- National University of Ireland, Department of Experimental Physics, Maynooth, County Kildare, Ireland
| | - P Naselsky
- Niels Bohr Institute, Blegdamsvej 17, Copenhagen, Denmark
- Discovery Center, Niels Bohr Institute, Blegdamsvej 17, Copenhagen, Denmark
| | - F Nati
- Department of Physics, Princeton University, Princeton, New Jersey, USA
| | - P Natoli
- INAF/IASF Bologna, Via Gobetti 101, Bologna, Italy
- Dipartimento di Fisica e Scienze della Terra, Università di Ferrara, Via Saragat 1, 44122 Ferrara, Italy
- Agenzia Spaziale Italiana Science Data Center, Via del Politecnico snc, 00133, Roma, Italy
| | - C B Netterfield
- Department of Astronomy and Astrophysics, University of Toronto, 50 Saint George Street, Toronto, Ontario, Canada
| | - H T Nguyen
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
| | - H U Nørgaard-Nielsen
- DTU Space, National Space Institute, Technical University of Denmark, Elektrovej 327, DK-2800 Kongens Lyngby, Denmark
| | - F Noviello
- Jodrell Bank Centre for Astrophysics, Alan Turing Building, School of Physics and Astronomy, The University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
| | - D Novikov
- Lebedev Physical Institute of the Russian Academy of Sciences, Astro Space Centre, 84/32 Profsoyuznaya st., Moscow, GSP-7, 117997, Russia
| | - I Novikov
- Niels Bohr Institute, Blegdamsvej 17, Copenhagen, Denmark
- Lebedev Physical Institute of the Russian Academy of Sciences, Astro Space Centre, 84/32 Profsoyuznaya st., Moscow, GSP-7, 117997, Russia
| | - R O'Brient
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
| | - R W Ogburn
- Department of Physics, Stanford University, Stanford, California 94305, USA
- Kavli Institute for Particle Astrophysics and Cosmology, SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94025, USA
| | - A Orlando
- Department of Physics, University of California at San Diego, La Jolla, California 92093, USA
| | - L Pagano
- Dipartimento di Fisica, Università La Sapienza, Piazzale Aldo Moro 2, Roma, Italy
- INFN, Sezione di Roma 1, Università di Roma Sapienza, Piazzale Aldo Moro 2, 00185, Roma, Italy
| | - F Pajot
- Institut d'Astrophysique Spatiale, CNRS (UMR8617) Université Paris-Sud 11, Bâtiment 121, Orsay, France
| | - R Paladini
- Infrared Processing and Analysis Center, California Institute of Technology, Pasadena, California 91125, USA
| | - D Paoletti
- INAF/IASF Bologna, Via Gobetti 101, Bologna, Italy
- INFN, Sezione di Bologna, Via Irnerio 46, I-40126, Bologna, Italy
| | - B Partridge
- Haverford College Astronomy Department, 370 Lancaster Avenue, Haverford, Pennsylvania, USA
| | - F Pasian
- INAF-Osservatorio Astronomico di Trieste, Via G.B. Tiepolo 11, Trieste, Italy
| | - G Patanchon
- APC, AstroParticule et Cosmologie, Université Paris Diderot, CNRS/IN2P3, CEA/lrfu, Observatoire de Paris, Sorbonne Paris Cité, 10, rue Alice Domon et Léonie Duquet, 75205 Paris Cedex 13, France
| | - T J Pearson
- California Institute of Technology, Pasadena, California, USA
- Infrared Processing and Analysis Center, California Institute of Technology, Pasadena, California 91125, USA
| | - O Perdereau
- LAL, Université Paris-Sud, CNRS/IN2P3, Orsay, France
| | - L Perotto
- Laboratoire de Physique Subatomique et Cosmologie, Université Grenoble-Alpes, CNRS/IN2P3, 53, rue des Martyrs, 38026 Grenoble Cedex, France
| | - V Pettorino
- HGSFP and University of Heidelberg, Theoretical Physics Department, Philosophenweg 16, 69120, Heidelberg, Germany
| | - F Piacentini
- Dipartimento di Fisica, Università La Sapienza, Piazzale Aldo Moro 2, Roma, Italy
| | - M Piat
- APC, AstroParticule et Cosmologie, Université Paris Diderot, CNRS/IN2P3, CEA/lrfu, Observatoire de Paris, Sorbonne Paris Cité, 10, rue Alice Domon et Léonie Duquet, 75205 Paris Cedex 13, France
| | - D Pietrobon
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
| | | | - E Pointecouteau
- Université de Toulouse, UPS-OMP, IRAP, F-31028 Toulouse cedex 4, France
- CNRS, IRAP, 9 Avenue colonel Roche, BP 44346, F-31028 Toulouse cedex 4, France
| | - G Polenta
- Agenzia Spaziale Italiana Science Data Center, Via del Politecnico snc, 00133, Roma, Italy
- INAF-Osservatorio Astronomico di Roma, via di Frascati 33, Monte Porzio Catone, Italy
| | - N Ponthieu
- Institut d'Astrophysique Spatiale, CNRS (UMR8617) Université Paris-Sud 11, Bâtiment 121, Orsay, France
- IPAG: Institut de Planétologie et d'Astrophysique de Grenoble, Université Grenoble Alpes, IPAG, F-38000 Grenoble, France, CNRS, IPAG, F-38000 Grenoble, France
| | - G W Pratt
- Laboratoire AIM, IRFU/Service d'Astrophysique-CEA/DSM-CNRS-Université Paris Diderot, Bâtiment 709, CEA-Saclay, F-91191 Gif-sur-Yvette Cedex, France
| | - S Prunet
- Institut d'Astrophysique de Paris, CNRS (UMR7095), 98 bis Boulevard Arago, F-75014, Paris, France
- UPMC Université de Paris 06, UMR7095, 98 bis Boulevard Arago, F-75014, Paris, France
| | - C Pryke
- Minnesota Institute for Astrophysics, University of Minnesota, Minneapolis, Minnesota 55455, USA
- School of Physics and Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - J-L Puget
- Institut d'Astrophysique Spatiale, CNRS (UMR8617) Université Paris-Sud 11, Bâtiment 121, Orsay, France
| | - J P Rachen
- Max-Planck-Institut für Astrophysik, Karl-Schwarzschild-Strasse 1, 85741 Garching, Germany
- Department of Astrophysics/IMAPP, Radboud University Nijmegen, P.O. Box 9010, 6500 GL Nijmegen, The Netherlands
| | - W T Reach
- Universities Space Research Association, Stratospheric Observatory for Infrared Astronomy, MS 232-11, Moffett Field, California 94035, USA
| | - R Rebolo
- Instituto de Astrofísica de Canarias, C/Vía Láctea s/n, La Laguna, Tenerife, Spain
- Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
- Departamento Astrofísica, Universidad de La Laguna (ULL), E-38206 La Laguna, Tenerife, Spain
| | - M Reinecke
- Max-Planck-Institut für Astrophysik, Karl-Schwarzschild-Strasse 1, 85741 Garching, Germany
| | - M Remazeilles
- Institut d'Astrophysique Spatiale, CNRS (UMR8617) Université Paris-Sud 11, Bâtiment 121, Orsay, France
- APC, AstroParticule et Cosmologie, Université Paris Diderot, CNRS/IN2P3, CEA/lrfu, Observatoire de Paris, Sorbonne Paris Cité, 10, rue Alice Domon et Léonie Duquet, 75205 Paris Cedex 13, France
- Jodrell Bank Centre for Astrophysics, Alan Turing Building, School of Physics and Astronomy, The University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
| | - C Renault
- Laboratoire de Physique Subatomique et Cosmologie, Université Grenoble-Alpes, CNRS/IN2P3, 53, rue des Martyrs, 38026 Grenoble Cedex, France
| | - A Renzi
- Dipartimento di Matematica, Università di Roma Tor Vergata, Via della Ricerca Scientifica, 1, Roma, Italy
- INFN, Sezione di Roma 2, Università di Roma Tor Vergata, Via della Ricerca Scientifica, 1, Roma, Italy
| | - S Richter
- Harvard-Smithsonian Center for Astrophysics, 60 Garden Street MS 42, Cambridge, Massachusetts 02138, USA
| | - I Ristorcelli
- Université de Toulouse, UPS-OMP, IRAP, F-31028 Toulouse cedex 4, France
- CNRS, IRAP, 9 Avenue colonel Roche, BP 44346, F-31028 Toulouse cedex 4, France
| | - G Rocha
- California Institute of Technology, Pasadena, California, USA
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
| | - M Rossetti
- Dipartimento di Fisica, Università degli Studi di Milano, Via Celoria, 16, Milano, Italy
- INAF/IASF Milano, Via E. Bassini 15, Milano, Italy
| | - G Roudier
- APC, AstroParticule et Cosmologie, Université Paris Diderot, CNRS/IN2P3, CEA/lrfu, Observatoire de Paris, Sorbonne Paris Cité, 10, rue Alice Domon et Léonie Duquet, 75205 Paris Cedex 13, France
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
- LERMA, CNRS, Observatoire de Paris, 61 Avenue de l'Observatoire, Paris, France
| | - M Rowan-Robinson
- Imperial College London, Astrophysics group, Blackett Laboratory, Prince Consort Road, London, SW7 2AZ, United Kingdom
| | - J A Rubiño-Martín
- Instituto de Astrofísica de Canarias, C/Vía Láctea s/n, La Laguna, Tenerife, Spain
- Departamento Astrofísica, Universidad de La Laguna (ULL), E-38206 La Laguna, Tenerife, Spain
| | - B Rusholme
- Infrared Processing and Analysis Center, California Institute of Technology, Pasadena, California 91125, USA
| | - M Sandri
- INAF/IASF Bologna, Via Gobetti 101, Bologna, Italy
| | - D Santos
- Laboratoire de Physique Subatomique et Cosmologie, Université Grenoble-Alpes, CNRS/IN2P3, 53, rue des Martyrs, 38026 Grenoble Cedex, France
| | - M Savelainen
- Department of Physics, Gustaf Hällströmin katu 2a, University of Helsinki, Helsinki, Finland
- Helsinki Institute of Physics, Gustaf Hällströmin katu 2, University of Helsinki, Helsinki, Finland
| | - G Savini
- Optical Science Laboratory, University College London, Gower Street, London, United Kingdom
| | - R Schwarz
- School of Physics and Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - D Scott
- Department of Physics & Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, British Columbia, Canada
| | - M D Seiffert
- California Institute of Technology, Pasadena, California, USA
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
| | - C D Sheehy
- School of Physics and Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
- Kavli Institute for Cosmological Physics, University of Chicago, Chicago, Illinois 60637, USA
| | - L D Spencer
- School of Physics and Astronomy, Cardiff University, Queens Buildings, The Parade, Cardiff, CF24 3AA, United Kingdom
| | - Z K Staniszewski
- California Institute of Technology, Pasadena, California, USA
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
| | - V Stolyarov
- Kavli Institute for Cosmology Cambridge, Madingley Road, Cambridge, CB3 0HA, United Kingdom
- Astrophysics Group, Cavendish Laboratory, University of Cambridge, J J Thomson Avenue, Cambridge CB3 0HE, United Kingdom
- Special Astrophysical Observatory, Russian Academy of Sciences, Nizhnij Arkhyz, Zelenchukskiy region, Karachai-Cherkessian Republic, 369167, Russia
| | - R Sudiwala
- School of Physics and Astronomy, Cardiff University, Queens Buildings, The Parade, Cardiff, CF24 3AA, United Kingdom
| | - R Sunyaev
- Max-Planck-Institut für Astrophysik, Karl-Schwarzschild-Strasse 1, 85741 Garching, Germany
- Space Research Institute (IKI), Russian Academy of Sciences, Profsoyuznaya Street, 84/32, Moscow, 117997, Russia
| | - D Sutton
- Institute of Astronomy, University of Cambridge, Madingley Road, Cambridge CB3 0HA, United Kingdom
- Kavli Institute for Cosmology Cambridge, Madingley Road, Cambridge, CB3 0HA, United Kingdom
| | - A-S Suur-Uski
- Department of Physics, Gustaf Hällströmin katu 2a, University of Helsinki, Helsinki, Finland
- Helsinki Institute of Physics, Gustaf Hällströmin katu 2, University of Helsinki, Helsinki, Finland
| | - J-F Sygnet
- Institut d'Astrophysique de Paris, CNRS (UMR7095), 98 bis Boulevard Arago, F-75014, Paris, France
| | - J A Tauber
- European Space Agency, ESTEC, Keplerlaan 1, 2201 AZ Noordwijk, The Netherlands
| | - G P Teply
- California Institute of Technology, Pasadena, California, USA
| | - L Terenzi
- INAF/IASF Bologna, Via Gobetti 101, Bologna, Italy
- Facoltà di Ingegneria, Università degli Studi e-Campus, Via Isimbardi 10, Novedrate (CO), 22060, Italy
| | - K L Thompson
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - L Toffolatti
- Instituto de Física de Cantabria (CSIC-Universidad de Cantabria), Avenida de los Castros s/n, Santander, Spain
- INAF/IASF Bologna, Via Gobetti 101, Bologna, Italy
- Departamento de Física, Universidad de Oviedo, Avda. Calvo Sotelo s/n, Oviedo, Spain
| | - J E Tolan
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - M Tomasi
- Dipartimento di Fisica, Università degli Studi di Milano, Via Celoria, 16, Milano, Italy
- INAF/IASF Milano, Via E. Bassini 15, Milano, Italy
| | - M Tristram
- LAL, Université Paris-Sud, CNRS/IN2P3, Orsay, France
| | - M Tucci
- Département de Physique Théorique, Université de Genève, 24, Quai E. Ansermet, 1211 Genève 4, Switzerland
| | - A D Turner
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
- University of Chicago, Chicago, Illinois 60637, USA
| | - L Valenziano
- INAF/IASF Bologna, Via Gobetti 101, Bologna, Italy
| | - J Valiviita
- Department of Physics, Gustaf Hällströmin katu 2a, University of Helsinki, Helsinki, Finland
- Helsinki Institute of Physics, Gustaf Hällströmin katu 2, University of Helsinki, Helsinki, Finland
| | - B Van Tent
- Laboratoire de Physique Théorique, Université Paris-Sud 11 & CNRS, Bâtiment 210, 91405 Orsay, France
| | - L Vibert
- Institut d'Astrophysique Spatiale, CNRS (UMR8617) Université Paris-Sud 11, Bâtiment 121, Orsay, France
| | - P Vielva
- Instituto de Física de Cantabria (CSIC-Universidad de Cantabria), Avenida de los Castros s/n, Santander, Spain
| | - A G Vieregg
- Kavli Institute for Cosmological Physics, University of Chicago, Chicago, Illinois 60637, USA
- Department of Physics, Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - F Villa
- INAF/IASF Bologna, Via Gobetti 101, Bologna, Italy
| | - L A Wade
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
| | - B D Wandelt
- Institut d'Astrophysique de Paris, CNRS (UMR7095), 98 bis Boulevard Arago, F-75014, Paris, France
- UPMC Université de Paris 06, UMR7095, 98 bis Boulevard Arago, F-75014, Paris, France
- Department of Physics, University of Illinois at Urbana-Champaign, 1110 West Green Street, Urbana, Illinois, USA
| | - R Watson
- Jodrell Bank Centre for Astrophysics, Alan Turing Building, School of Physics and Astronomy, The University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
| | - A C Weber
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
| | - I K Wehus
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California, USA
| | - M White
- Department of Physics, University of California, Berkeley, California, USA
| | - S D M White
- Max-Planck-Institut für Astrophysik, Karl-Schwarzschild-Strasse 1, 85741 Garching, Germany
| | - J Willmert
- School of Physics and Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - C L Wong
- Harvard-Smithsonian Center for Astrophysics, 60 Garden Street MS 42, Cambridge, Massachusetts 02138, USA
| | - K W Yoon
- Department of Physics, Stanford University, Stanford, California 94305, USA
- Kavli Institute for Particle Astrophysics and Cosmology, SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94025, USA
| | - D Yvon
- DSM/Irfu/SPP, CEA-Saclay, F-91191 Gif-sur-Yvette Cedex, France
| | - A Zacchei
- INAF-Osservatorio Astronomico di Trieste, Via G.B. Tiepolo 11, Trieste, Italy
| | - A Zonca
- Department of Physics, University of California, Santa Barbara, California, USA
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Kellner P, Nestler F, Leimert A, Bucher M, Czeslick E, Sablotzki A, Raspè C. Antithrombin III, but not C1 esterase inhibitor reduces inflammatory response in lipopolysaccharide-stimulated human monocytes in an ex-vivo whole blood setting. Cytokine 2014; 70:173-8. [PMID: 25148723 DOI: 10.1016/j.cyto.2014.07.253] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [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: 02/13/2014] [Revised: 06/30/2014] [Accepted: 07/29/2014] [Indexed: 12/19/2022]
Abstract
In order to examine the immunomodulatory effects of antithrombin III (AT-III) and C1 esterase inhibitor (C1-INH) in human monocytes, we investigated the intracellular expression of interleukin (IL)-6, IL-8, and tumor necrosis factor (TNF)-α in an ex-vivo laboratory study in a whole blood setting. Heparinized whole blood samples from 23 healthy male and female volunteers (mean age: 27±7years) were pre-incubated with clinically relevant concentrations of AT-III (n=11) and C1-INH (n=12), then stimulated with 0.2 ng/mL lipopolysaccharide (LPS) for 3h. After phenotyping CD14⁺ monocytes, intracellular expression of IL-6, IL-8, and TNF-α was assessed using flow cytometry. In addition, 12 whole blood samples (AT-III and C1-INH, n=6 each) were examined using hirudin for anticoagulation; all samples were processed in the same way. To exclude cytotoxicity effects, 7-amino-actinomycin D and Nonidet P40 staining were used to investigate probes. This study is the first to demonstrate the influence of C1-INH and AT-III on the monocytic inflammatory response in a whole blood setting, which mimics the optimal physiological setting. Cells treated with AT-III exhibited significant downregulation of the proportion of gated CD14⁺ monocytes for IL-6 and IL-8, in a dose-dependent manner; downregulation for TNF-α did not reach statistical significance. There were no significant effects on mean fluorescence intensity (MFI). In contrast, C1-INH did not significantly reduce the proportion of gated CD14⁺ monocytes or the MFI regarding IL-6, TNF-α, and IL-8. When using hirudin for anticoagulation, no difference in the anti-inflammatory properties of AT-III and C1-INH in monocytes occurs. Taken together, in contrast to TNF-α, IL-6 and IL-8 were significantly downregulated in monocytes in an ex-vivo setting of human whole blood when treated with AT-III. This finding implicates monocytes as an important point of action regarding the anti-inflammatory properties of AT-III in sepsis. C1-INH was unable to attenuate the monocytic response, which supports the hypothesis that other cellular components in whole blood (e.g., neutrophils) might be responsible for the known effects of C1-INH in inflammation.
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Affiliation(s)
- Patrick Kellner
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Germany
| | - Frank Nestler
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Germany
| | - Anja Leimert
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Germany
| | - Michael Bucher
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Germany
| | - Elke Czeslick
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Germany; Department of Anesthesiology, Critical Care and Pain Therapy, St. Georg Medical Center, Leipzig, Germany
| | - Armin Sablotzki
- Department of Anesthesiology, Critical Care and Pain Therapy, St. Georg Medical Center, Leipzig, Germany
| | - Christoph Raspè
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Germany.
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Raspé C, Rückert F, Metz D, Hofmann B, Neitzel T, Stiller M, Gielen S, Nestler F, Ebbighausen N, Steinke T, Bucher M, Bushnaq H. Inter-hospital transfer of ECMO-assisted patients with a portable miniaturized ECMO device: 4 years of experience. Perfusion 2014; 30:52-9. [PMID: 24743549 DOI: 10.1177/0267659114531611] [Citation(s) in RCA: 20] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Extracorporeal membrane oxygenation (ECMO) in patients with severe pulmonary failure is able to keep patients alive until organ regeneration, until shunting out for further diagnostic and therapeutic options or until transportation to specialized centers. Nonetheless, extracorporeal techniques require a high degree of expertise, so that a confinement to specialized centers is meaningful. Following from this requirement, the need for inter-hospital transfer of patients with severely compromised pulmonary function is rising. METHODS We report about our experience with a portable ECMO system during inter-hospital air or ground transfer of patients with cardiopulmonary failure. RESULTS The portable ECMO system was used for transportation to the center and in-hospital treatment in 36 patients with an average age of 53 years suffering from respiratory failure. Accordingly, the ECMO system was implanted as a veno-venous extracorporeal system. Pre-ECMO ventilation time was 5.2 (2-9) days. Twelve patients were transported to our institution by ground and 24 patients by air ambulance over a median distance of 46 km. With the assistance of the ECMO device, prompt stabilization of cardiopulmonary function could be achieved in all patients without any technical complications. Post-ECMO ventilation was 9.8 days. Weaning from the ECMO system was successful in 61% of all patients after a median device working period of 12.7 days; median ICU stay was 34 days and a survival rate of 64% of patients was achieved. Technical (8%) and device-associated bleeding (11%)/thromboembolic (8%) complication rates showed very acceptable levels. CONCLUSION Our experience demonstrates that miniaturized, portable ECMO therapy allows location-independent, out-of-center stabilization of pulmonary compromised patients with consecutive inter-hospital transfer and further in-house treatment, so that sophisticated ECMO therapy can be offered to every patient, even in hospitals with primary healthcare.
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Affiliation(s)
- C Raspé
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany
| | - F Rückert
- Department of Cardiac and Thoracic Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - D Metz
- Department of Cardiac and Thoracic Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - B Hofmann
- Department of Cardiac and Thoracic Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - T Neitzel
- Department of Cardiac and Thoracic Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - M Stiller
- Department of Cardiac and Thoracic Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - S Gielen
- Department of Internal Medicine III, Halle-Wittenberg University, Germany
| | - F Nestler
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany
| | - N Ebbighausen
- HSD Luftrettung gemeinnützige GmbH, non-profit organisation, Landsberg-Oppin, Germany
| | - T Steinke
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany
| | - M Bucher
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany
| | - H Bushnaq
- Department of Cardiac and Thoracic Surgery, Halle-Wittenberg University, Halle (Saale), Germany
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Bischoff A, Bucher M, Gekle M, Sauvant C. PAH clearance after renal ischemia and reperfusion is a function of impaired expression of basolateral Oat1 and Oat3. Physiol Rep 2014; 2:e00243. [PMID: 24744908 PMCID: PMC3966241 DOI: 10.1002/phy2.243] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 01/29/2014] [Indexed: 11/29/2022] Open
Abstract
Determination of renal plasma flow (RPF) by para‐aminohippurate (PAH) clearance leads to gross underestimation of this respective parameter due to impaired renal extraction of PAH after renal ischemia and reperfusion injury. However, no mechanistic explanation for this phenomenon is available. Based on our own previous studies we hypothesized that this may be due to impairment of expression of the basolateral rate limiting organic anion transporters Oat1 and Oat3. Thus, we investigated this phenomenon in a rat model of renal ischemia and reperfusion by determining PAH clearance, PAH extraction, PAH net secretion, and the expression of rOat1 and rOat3. PAH extraction was seriously impaired after ischemia and reperfusion which led to a threefold underestimation of RPF when PAH extraction ratio was not considered. PAH extraction directly correlated with the expression of basolateral Oat1 and Oat3. Tubular PAH secretion directly correlated with PAH extraction. Consequently, our data offer an explanation for impaired renal PAH extraction by reduced expression of the rate limiting basolateral organic anion transporters Oat1 and Oat3. Moreover, we show that determination of PAH net secretion is suitable to correct PAH clearance for impaired extraction after ischemia and reperfusion in order to get valid results for RPF. Determination of renal plasma flow by PAH clearance leads to gross underestimation of this respective parameter due to impaired renal extraction of PAH after renal ischemia and reperfusion injury. However, no mechanistic explanation for this phenomenon was available up to now. Consequently, our data offer an explanation for impaired renal PAH extraction by reduced expression of the rate limiting basolateral organic anion transporters Oat1 and Oat3.
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Affiliation(s)
- Ariane Bischoff
- Klinik für Anästhesie und Operative Intensivmedizin, Universitätsklinikum Halle, Halle (Saale), Germany
| | - Michael Bucher
- Klinik für Anästhesie und Operative Intensivmedizin, Universitätsklinikum Halle, Halle (Saale), Germany
| | - Michael Gekle
- Julius-Bernstein-Institut für Physiologie, Universität Halle-Wittenberg, Halle (Saale), Germany
| | - Christoph Sauvant
- Klinik für Anästhesie und Operative Intensivmedizin, Universitätsklinikum Halle, Halle (Saale), Germany
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Bischoff A, Bucher M, Gekle M, Sauvant C. Differential effect of COX1 and COX2 inhibitors on renal outcomes following ischemic acute kidney injury. Am J Nephrol 2014; 40:1-11. [PMID: 24943263 DOI: 10.1159/000363251] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 04/23/2014] [Indexed: 01/11/2023]
Abstract
BACKGROUND/AIMS We have previously shown that 1 mg/kg indomethacin improves expression and functionality of renal organic anion transporters Oat1 and Oat3 after renal ischemia and furthermore improves renal outcome after ischemia. As we detected differential effects of COX1 or COX2 inhibitors on organic anion transport after ischemia and reperfusion in culture, we investigated the effect of the SC560 (COX1 inhibitor) and SC58125 (COX2 inhibitor) on expression of Oat1/3 and renal outcome after ischemic acute kidney injury (iAKI). METHODS iAKI was induced in rats by bilateral clamping of renal arteries for 45 min. SC560 or SC58125 (1 mg/kg each) were given intraperitoneally as soon as reperfusion started. Sham-treated animals served as controls. Oat1/3 were determined by qPCR and Western blot. Glomerular filtration rate (GFR), p-aminohippurate (PAH) clearance and PAH extraction ratio was determined. All parameters were detected 24 h after ischemia. Renal plasma flow was calculated. RESULTS In clamped animals SC560 (COX1 inhibitor) restored expression of Oat1/3, as well as renal perfusion. Additionally, SC560 substantially improved kidney function as measured by GFR. Application of the COX2 inhibitor SC58125 did not exert these beneficial effects. CONCLUSION Our study indicates that COX1 inhibitor SC560 applied after ischemia prevents ischemia-induced downregulation of Oat1/3 during reperfusion and has a substantial protective effect on kidney function. Whether and to what particular extent this apparent improvement of function is mechanistically due to beneficial effects on tubular function, renal perfusion or glomerular filtration will be the scope of future studies.
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Affiliation(s)
- Ariane Bischoff
- Klinik für Anästhesie und Operative Intensivmedizin, Universität Halle-Wittenberg, Halle, Germany
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Gauthier S, Buddeberg-Fischer B, Bucher M, Thali M, Bartsch C. Pilot study on doctors working in departments of forensic medicine in German-speaking areas. J Forensic Leg Med 2013; 20:1069-74. [PMID: 24237822 DOI: 10.1016/j.jflm.2013.09.029] [Citation(s) in RCA: 3] [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: 05/10/2013] [Revised: 09/13/2013] [Accepted: 09/29/2013] [Indexed: 10/26/2022]
Abstract
Several directors of institutes of forensic and legal medicine in German-speaking areas have noticed a lack of young doctors with specialty qualifications (full board certification) in forensic medicine during recent years. The pilot study was intended to brainstorm the possible reasons for this shortage, by carrying out a survey of doctors working in departments of forensic medicine, paying particular attention to job satisfaction and opinions as to why there are fewer forensic specialists. We sent the link to an online questionnaire to all members of the societies of forensic medicine in Germany, Switzerland and Austria. Altogether, 129 respondents completed the questionnaire and were included in the study. Slightly more men than women replied; the mean age of all respondents was 41. Most respondents had completed their specialty training and worked full-time. In general, participants were moderately satisfied with their careers. Men reported greater career success than women, as determined by objective criteria. Career support was considered to be suboptimal. For most of the respondents, the level of enjoyment of working in forensic medicine was either higher than or approximately the same as the level recalled from five years earlier. Possible reasons for the lack of qualified doctors in forensic medicine institutes are the non-availability of both senior posts and specialty training posts. Career opportunities in forensic medicine are not considered to be attractive.
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Affiliation(s)
- S Gauthier
- Institution of Legal Medicine, University of Zurich, Wintherthurerstrasse 190, CH-8057 Zürich, Switzerland.
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Moravec R, Neitzel T, Stiller M, Hofmann B, Metz D, Bucher M, Silber R, Bushnaq H, Raspé C. First experiences with a combined usage of veno-arterial and veno-venous ECMO in therapy-refractory cardiogenic shock patients with cerebral hypoxemia. Perfusion 2013; 29:200-9. [PMID: 23996694 DOI: 10.1177/0267659113502832] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The use of extracorporeal membrane oxygenation (ECMO) is becoming a popular tool in the treatment of cardiogenic shock. We present two case reports where classical veno-arterial peripherally cannulated ECMO therapy proved insufficient with profuse cerebral hypoxemia. After augmenting the setting into veno-veno-arterial ECMO, we achieved a remarkable improvement of all oxygenation parameters. The simultaneous use of veno-venous and veno-arterial ECMO might display as a novel strategy to counteract the coronary and cerebral hypoxemia in veno-arterial ECMO therapy in patients with therapy-refractory cardiogenic shock or in combined cardiopulmonary failure. In this manuscript, the veno-veno-arterial ECMO setup is described in full detail and different venous cannulas are discussed.
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Affiliation(s)
- R Moravec
- Department of Anesthesiology and Critical care medicine, Halle-Wittenberg University, Germany
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