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Piel S, Kreuter M, Herth F, Kauczor HU, Heußel CP. [Pulmonary granulomatous diseases and pulmonary manifestations of systemic granulomatous disease : Including tuberculosis and nontuberculous mycobacteriosis]. Radiologe 2016; 56:874-884. [PMID: 27638826 PMCID: PMC7095880 DOI: 10.1007/s00117-016-0165-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
CLINICAL/METHODICAL ISSUE Granulomas as signs of specific inflammation of the lungs are found in various diseases with pulmonary manifestations and represent an important imaging finding. STANDARD RADIOLOGICAL METHODS The standard imaging modality for the work-up of granulomatous diseases of the lungs is most often thin-slice computed tomography (CT). There are a few instances, e. g. tuberculosis, sarcoidosis and silicosis, where a chest radiograph still plays an important role. METHODICAL INNOVATIONS Further radiological modalities are usually not needed in the routine work-up of granulomatous diseases of the chest. In special cases magnetic resonance imaging (MRI) and positron emission tomography (PET)-CT scans play an important role, e. g. detecting cardiac sarcoidosis by cardiac MRI or choline C‑11 PET-CT in diagnosing lung carcinoma in scar tissue after tuberculosis. PERFORMANCE The accuracy of thin-slice CT is very high for granulomatous diseases. ACHIEVEMENTS In cases of chronic disease and fibrotic interstitial lung disease it is important to perform thin-slice CT in order to diagnose a specific disease pattern. Thin-slice CT is also highly sensitive in detecting disease complications and comorbidities, such as malignancies. Given these indications thin-slice CT is generally accepted in the routine daily practice. PRACTICAL RECOMMENDATIONS A thin-slice CT and an interdisciplinary discussion are recommended in many cases with a suspected diagnosis of pulmonary granulomatous disease due to clinical or radiographic findings.
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Affiliation(s)
- S Piel
- Zentrum für interstitielle und seltene Lungenerkrankungen, Pneumologie und Beatmungsmedizin, Thoraxklinik, Universität Heidelberg, Heidelberg, Deutschland.
| | - M Kreuter
- Zentrum für interstitielle und seltene Lungenerkrankungen, Pneumologie und Beatmungsmedizin, Thoraxklinik, Universität Heidelberg, Heidelberg, Deutschland
- Translational Lung Research Center (TLRC), Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - F Herth
- Zentrum für interstitielle und seltene Lungenerkrankungen, Pneumologie und Beatmungsmedizin, Thoraxklinik, Universität Heidelberg, Heidelberg, Deutschland
- Translational Lung Research Center (TLRC), Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - H-U Kauczor
- Abteilung für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
- Translational Lung Research Center (TLRC), Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - C-P Heußel
- Abteilung für Diagnostische und Interventionelle Radiologie mit Nuklearmedizin, Thoraxklinik, Universität Heidelberg, Heidelberg, Deutschland
- Translational Lung Research Center (TLRC), Universitätsklinikum Heidelberg, Heidelberg, Deutschland
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Livingstone E, Hillen U, Hafner C, Piel S, Groesser L, Schadendorf D, Happle R. Segmentally arranged seborrhoeic keratoses with impending atypia and squamous cell carcinoma in an elderly woman. Br J Dermatol 2015; 172:1642-1645. [PMID: 25420590 DOI: 10.1111/bjd.13562] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2014] [Indexed: 11/29/2022]
Abstract
Epidermal naevi (EN) are considered mosaic disorders. Postzygotic mutations are thought to occur during early embryogenesis. They are usually arranged along Blaschko's lines and tend to be noted either at birth or shortly thereafter. Skin tumours arising on EN are occasionally reported, with ongoing discussion as to whether these are collision tumours or a malignant transformation of the EN. We describe a 76-year-old woman with segmentally arranged seborrhoeic keratoses that showed impending atypia and, in one lesion, even overt malignant transformation. In biopsies from various lesions we found FGFR3 and PIK3CA hotspot mutations but there was no consistent pattern of mutations explaining the premalignant or malignant growth. So far it is unclear whether the precancerous changes as noted in this elderly patient can be taken as an unusual manifestation of one of the established types of EN, or whether this may represent a separate disorder that could be called 'SASKIA naevus'. The acronym would stand for segmentally arranged seborrhoeic keratoses with impending atypia.
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Affiliation(s)
- E Livingstone
- Department of Dermatology and Skin Tumor Center, University Hospital Duisburg-Essen, Essen, Germany
| | - U Hillen
- Department of Dermatology and Skin Tumor Center, University Hospital Duisburg-Essen, Essen, Germany
| | - C Hafner
- Department of Dermatology, University of Regensburg, Regensburg, Germany
| | - S Piel
- Department of Dermatology and Skin Tumor Center, University Hospital Duisburg-Essen, Essen, Germany
| | - L Groesser
- Department of Dermatology, University of Regensburg, Regensburg, Germany
| | - D Schadendorf
- Department of Dermatology and Skin Tumor Center, University Hospital Duisburg-Essen, Essen, Germany
| | - R Happle
- Department of Dermatology, Freiburg University Medical Center, Freiburg, Germany
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Piel S, Ehinger JK, Elmér E, Hansson MJ. Metformin induces lactate production in peripheral blood mononuclear cells and platelets through specific mitochondrial complex I inhibition. Acta Physiol (Oxf) 2015; 213:171-80. [PMID: 24801139 DOI: 10.1111/apha.12311] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 11/21/2013] [Accepted: 04/26/2014] [Indexed: 12/25/2022]
Abstract
AIM Metformin is a widely used antidiabetic drug associated with the rare side effect of lactic acidosis which has been proposed to be linked to drug-induced mitochondrial dysfunction. Using respirometry, the aim of this study was to evaluate mitochondrial toxicity of metformin to human blood cells in relation to that of phenformin, a biguanide analogue withdrawn in most countries due to a high incidence of lactic acidosis. METHODS Peripheral blood mononuclear cells and platelets were isolated from healthy volunteers, and integrated mitochondrial function was studied in permeabilized and intact cells using high-resolution respirometry. A wide concentration range of metformin (0.1-100 mm) and phenformin (25-500 μm) was investigated for dose- and time-dependent effects on respiratory capacities, lactate production and pH. RESULTS Metformin induced respiratory inhibition at complex I in peripheral blood mononuclear cells and platelets (IC50 0.45 mm and 1.2 mm respectively). Phenformin was about 20-fold more potent in complex I inhibition of platelets than metformin. Metformin further demonstrated a dose- and time-dependent respiratory inhibition and augmented lactate release at a concentration of 1 mm and higher. CONCLUSION Respirometry of human peripheral blood cells readily detected respiratory inhibition by metformin and phenformin specific to complex I, providing a suitable model for probing drug toxicity. Lactate production was increased at concentrations relevant for clinical metformin intoxication, indicating mitochondrial inhibition as a direct causative pathophysiological mechanism. Relative to clinical dosing, phenformin displayed a more potent respiratory inhibition than metformin, possibly explaining the higher incidence of lactic acidosis in phenformin-treated patients.
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Affiliation(s)
- S. Piel
- Mitochondrial Medicine; Department of Clinical Sciences; Lund University; Lund Sweden
- NeuroVive Pharmaceutical AB; Lund Sweden
| | - J. K. Ehinger
- Mitochondrial Medicine; Department of Clinical Sciences; Lund University; Lund Sweden
- NeuroVive Pharmaceutical AB; Lund Sweden
- Department of Otorhinolaryngology; Head and Neck Surgery; Skåne University Hospital; Lund Sweden
| | - E. Elmér
- Mitochondrial Medicine; Department of Clinical Sciences; Lund University; Lund Sweden
- NeuroVive Pharmaceutical AB; Lund Sweden
- Department of Clinical Neurophysiology; Skåne University Hospital & Lund University; Lund Sweden
| | - M. J. Hansson
- Mitochondrial Medicine; Department of Clinical Sciences; Lund University; Lund Sweden
- NeuroVive Pharmaceutical AB; Lund Sweden
- Department of Clinical Physiology; Skåne University Hospital & Lund University; Lund Sweden
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Thomas O, Jung AV, Causse J, Louyer MV, Piel S, Baurès E, Thomas MF. Revealing organic carbon-nitrate linear relationship from UV spectra of freshwaters in agricultural environment. Chemosphere 2014; 107:115-120. [PMID: 24875878 DOI: 10.1016/j.chemosphere.2014.03.034] [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] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 02/14/2014] [Accepted: 03/01/2014] [Indexed: 06/03/2023]
Abstract
A strong non linear relationship between nitrate and organic matter (assessed by dissolved organic carbon, DOC) has been recently demonstrated by Taylor and Townsend (2010), namely for freshwaters. In this context, our study explores this relation from the behavior of sets of normalized UV spectra (same area under each spectrum) of different water samples showing a hidden isosbestic point (HIP) around 225 nm. This HIP is linked to the existence of a simple relation between nitrate and DOC, the proportions of which vary according to the sampling location and environmental factors. In a second step, a simple linear model is proposed for nitrate-DOC relationship (α⋅NO3+β⋅DOC=1) and a validation is proposed for more than 150 samples of different Brittany rivers and lakes. For samples of the largest watershed, a complementary exploitation from data acquired during the different campaigns confirmed the seasonal evolution between spring (high nitrate/low DOC) and autumn (high DOC/low nitrate). Further investigation on other freshwater samples is needed in order to improve the limits of this linear model.
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Affiliation(s)
- O Thomas
- EHESP Rennes, Sorbonne Paris Cité - CS 74312, 35043 Rennes Cedex, France; Inserm, U 1085 (IRSET), LERES - CS 74312, 35043 Rennes Cedex, France; European University of Brittany (UEB), France.
| | - A V Jung
- EHESP Rennes, Sorbonne Paris Cité - CS 74312, 35043 Rennes Cedex, France; Inserm, U 1085 (IRSET), LERES - CS 74312, 35043 Rennes Cedex, France; School of Environmental Engineering (EME), Campus de Ker Lann, 35170 Bruz, France; European University of Brittany (UEB), France
| | - J Causse
- EHESP Rennes, Sorbonne Paris Cité - CS 74312, 35043 Rennes Cedex, France; Inserm, U 1085 (IRSET), LERES - CS 74312, 35043 Rennes Cedex, France; European University of Brittany (UEB), France
| | - M V Louyer
- EHESP Rennes, Sorbonne Paris Cité - CS 74312, 35043 Rennes Cedex, France; Inserm, U 1085 (IRSET), LERES - CS 74312, 35043 Rennes Cedex, France; European University of Brittany (UEB), France
| | - S Piel
- Saur R&D - Les Cyclades, 1 rue Antoine Lavoisier, 78280 Guyancourt, France
| | - E Baurès
- EHESP Rennes, Sorbonne Paris Cité - CS 74312, 35043 Rennes Cedex, France; Inserm, U 1085 (IRSET), LERES - CS 74312, 35043 Rennes Cedex, France; European University of Brittany (UEB), France
| | - M F Thomas
- School of Environmental Engineering (EME), Campus de Ker Lann, 35170 Bruz, France; European University of Brittany (UEB), France
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Abstract
Chronic wounds occur in 1-2% of the population. After the age of 80 the incidence raises up to 4-5%. Leg ulcers are the most frequent diagnosed chronic wound. In this most often affected age group malnutrition develops more frequently compared to the total population. The combined presence of chronic wounds and malnutrition suggests a potential causative connection. In this clinical investigation, data evaluating the nutritional status in patients with chronic leg ulcers, derived from clinical examination, medical history and laboratory tests was analyzed for the first time for a German patient collective. Over a time period of one year we evaluated 41 patients for body mass index, diabetes mellitus, restricted mobility, diet, nicotine and alcohol use, and blood levels of vitamins, trace elements, lipids and HbA1c. We further employed the MNA-questionnaire for malnutrition. We rarely found deficiencies but often improper nutritional practices. Thus we consider that it important to evaluate nutritional status even in obese patients with leg ulcers and poorly healing wounds.
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Affiliation(s)
- N Graue
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen
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Eingartner C, Piel S, Weise K. Results of a cemented straight titanium alloy femoral stem after mean follow-up of 13 years. Eur J Orthop Surg Traumatol 2007. [DOI: 10.1007/s00590-007-0232-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bunetel L, Guérin J, Agnani G, Piel S, Pinsard H, Corbel JC, Bonnaure-Mallet M. In vitro study of the effect of titanium on porphyromonas gingivalis in the presence of metronidazole and spiramycin. Biomaterials 2001; 22:3067-72. [PMID: 11575482 DOI: 10.1016/s0142-9612(01)00054-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Septic peri-implantitis is the main clinical complication encountered following the insertion of titanium implants. It may be resistant to conventional antibiotic treatments. Reports in the literature about antibiotic behavior in the presence of titanium remain controversial. They vary from a bacteriostat to a decreased effect of antibiotic. This study examined, in vitro, the viability of Porphyromonas gingivalis, frequently associated with periodontal diseases, in the presence of titanium and antibiotics (spiramycin and metronidazole alone or in combination). Viability of P. gingivalis was determined, versus a standard curve using the Live/dead Baclight Bacteria Viability Kit on 96 well microplates. The results of 48 experiments (60 measurements each) were compiled in a database and compared to each other using the chi2p < 0.05 test. When used alone, titanium enhanced bacterial growth as the nickel-chrome control. However, when titanium was used in the presence of antibiotics, antibiotics kept their own effects. Even more, titanium was shown to potentialize the effect of metronidazole. The strengthening of effectiveness of metronidazole by titanium may be due to the oxidation potential of the metal. This chemical property could explain the conflicting data reported in the literature.
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Affiliation(s)
- L Bunetel
- Equipe de Biologie Buccale, UPRES-EA 1256, Université de Rennes 1, France.
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Seitz RJ, Piel S, Arnold S, Schlaug G, Ebner A, Holthausen H, Tuxhorn I, Witte OW. Cerebellar hypometabolism in focal epilepsy is related to age of onset and drug intoxication. Epilepsia 1996; 37:1194-9. [PMID: 8956851 DOI: 10.1111/j.1528-1157.1996.tb00552.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE We wished to investigate the cerebellar depression of regional cerebral glucose metabolism (rCMRGlu) in patients with focal epilepsy. METHOD In 170 consecutive patients with medically refractory, focal epilepsy the rCMRGlu was measured in cerebellum and brain. RESULTS rCMRGlu was markedly decreased in both cerebellar hemispheres and slightly in brain. The cerebellum to brain rCMRGlu ratio was significantly decreased in patients with seizure manifestation in infancy, but was normal due to a progressive decrease in brain rCMRGlu in later age. A subgroup of patients with focal epilepsy involving the frontal lobe had a reduced cerebellum/brain rCMRGlu ratio, whereas in patients with mesiotemporal lobe epilepsy (MTLE), the rCMRGlu was decreased to the same degree in cerebellum and brain. The difference in the cerebellum/brain rCMRGlu ratio between the two groups was accounted for by the younger age of the patients with focal epilepsy involving the frontal lobe, however. In another subgroup of patients with a documented history of critical drug intoxications, the cerebellar rCMRGlu was severely decreased, resulting in a significantly reduced cerebellum/brain rCMRGlu ratio. CONCLUSION Our retrospective study suggests that the cerebellum is particularly vulnerable in infancy to ongoing epileptic activity and high dosage of antiepileptic drugs (AEDs).
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Affiliation(s)
- R J Seitz
- Department of Neurology, Heinrich-Heine-University Düsseldorf, Germany
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