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"text": "\n70940\nMethod-related effects of adenovirus-mediated LacZ and SERCA1 gene transfer on contractile behavior of cultured failing human cardiomyocytes.\n\nWeisser-Thomas, J\n\nDieterich, E\n\nJanssen, PM\n\nSchmidt-Schweda, S\n\nMaier, LS\n\nSumbilla, C\n\nPieske, B\n\nBeiträge in Fachzeitschriften\nNone\n15767202.0\n10.1016/j.vascn.2004.10.005\nNone\nINTRODUCTION: Adenovirus-mediated gene transfer into cardiomyocytes has emerged as an interesting tool to study functional effects of single proteins. However, the functional consequences of cell isolation, cell culture per se and adenovirus-mediated transfer of the LacZ or SERCA1 gene in failing human cardiomyocytes warrant further investigation. METHODS: Primary cell culture was performed without or after adenovirus-mediated gene transfer of LacZ or SERCA1. Functional behavior of myocytes was assessed under basal conditions (field stimulation, 0.5 Hz, 37 degrees C), and during inotropic stimulation with isoproterenol (ISO; 10(-9)-10(-5) M), [Ca(2+)](o) (1.5-15 mM) or increasing stimulation rates (0.25-2.5 Hz). Results were compared to trabeculae from the same hearts. RESULTS: Freshly isolated myocytes showed full inotropic competence as compared to multicellular preparations. The response to stimulation with ISO and [Ca(2+)](o), as well as changes in stimulation rate resulted in a maximal increase in fractional cell shortening (FS) to 215+/-24% and 291+/-34%, and a frequency-dependent decline in FS to 46+/-5% of the basal value, respectively. After 48 h of cell culture, basal FS did not change significantly compared to fresh cells but both time to peak shortening and time to 50% relengthening were prolonged. After culture, the concentration-response curve for ISO was significantly shifted to the left (EC(50) 5.16 x 10(-8) vs. 1.12 x 10(-8) M, p<0.05). LacZ gene transfer caused efficient beta-Gal expression without affecting the inotropic responses to ISO or stimulation rate but impaired the contractile amplitude. SERCA1 gene transfer increased FS by 68% vs. LacZ and accelerated relengthening kinetics (+dL/dt 93+/-13 vs. 61+/-8 mum/s, p<0.05 vs. LacZ). DISCUSSION: Contractile responses of isolated human myocytes are comparable to multicellular preparations. The use of primary cell culture and adenovirus infection with CMV-promoter-mediated LacZ expression per se modulates contractile behavior in failing human myocytes. SERCA1 expression markedly improves contractile function. The method-related changes in contractile behavior observed here need to be taken into account in further studies.\n\n\n"
},
{
"text": "\n107577\nRapid maxillary expansion screws on the test bench--a pilot study.\n\nMuchitsch, AP\n\nWendl, B\n\nWinsauer, H\n\nPichelmayer, M\n\nPayer, M\n\nBeiträge in Fachzeitschriften\nISI:000291064000006\n20798210.0\n10.1093/ejo/cjq065\nNone\nIn order to apply high, short-term forces during rapid maxillary expansion (RME) to the sutures of the maxilla with minimum loss of force and without causing unwanted side-effects (dentoalveolar tipping, etc.), the appliance should be as rigid as possible. The retention arms of the RME screws, representing a particularly vulnerable and stressed weak point of RME appliances, were the focus of this laboratory technical study. Retention arms of 16 types of RME screws comprising four arms and one with eight arms were examined using a three-point bending test. According to their ability to absorb the applied bending loads, the screws were classified in product groups from 1 (highest) to 6 (lowest). Fifteen of the tested retention arms (stainless steel), despite having the same diameter (1.48-1.49 mm), differed up to 69.81 per cent between the highest (288.0 N) and lowest (169.6 N) maximum force parameters and up to 66.40 per cent between the highest (3325.9 N/mm(2)) and lowest (1998.7 N/mm(2)) maximum bending stress parameters. Due to optimum formability, though reduced rigidity, a titanium screw for nickel-sensitive patients (group 6) displayed the lowest force and bending tension values. The stainless steel double arms of the eight-arm screw device welded on both ends displayed the highest force data. The mean ductilities of the groups with the most and least rigid single steel arms differed by 22.77 per cent. Statistical analysis using the Pearson correlation coefficient revealed a significant indirect correlation between ductility and both maximum force (r = -0.780, P < 0.001) and maximum bending stress (r = -0.778, P < 0.001). The SUPERscrews, the Tiger Dental four-arm screw (group 1), and the eight-arm screw displayed the highest capacity to absorb an applied bending load. The screws in groups 3-6 appear acceptable for RME during the pre-pubertal period, whereas in the pubertal and post-pubertal period, groups 1 and 2 are sufficient. In early adulthood only the screws in group 1 and especially the eight-arm screw seem advisable, as mechanical demands increase with age.\n\nMuchitsch, Alfred\n\nPayer, Michael\n\nPichelmayer, Margit\n\nWendl, Brigitte\n\n\n"
},
{
"text": "\n129405\nHigh intestinal cholesterol absorption is associated with cardiovascular disease and risk alleles in ABCG8 and ABO: evidence from the LURIC and YFS cohorts and from a meta-analysis.\n\nSilbernagel, G\n\nChapman, MJ\n\nGenser, B\n\nKleber, ME\n\nFauler, G\n\nScharnagl, H\n\nGrammer, TB\n\nBoehm, BO\n\nMäkelä, KM\n\nKähönen, M\n\nCarmena, R\n\nRietzschel, ER\n\nBruckert, E\n\nDeanfield, JE\n\nMiettinen, TA\n\nRaitakari, OT\n\nLehtimäki, T\n\nMärz, W\n\nBeiträge in Fachzeitschriften\nISI:000322064100006\n23707316.0\n10.1016/j.jacc.2013.01.100\nNone\nThis study sought to determine whether high intestinal cholesterol absorption represents a cardiovascular risk factor and to link ABCG8 and ABO variants to cardiovascular disease (CVD).\n Plant sterol-enriched functional foods are widely used for cholesterol lowering. Their regular intake yields a 2-fold increase in circulating plant sterol levels that equally represent markers of cholesterol absorption. Variants in ABCG8 and ABO have been associated with circulating plant sterol levels and CVD, thereby suggesting atherogenic effects of plant sterols or of cholesterol uptake.\n The cholestanol-to-cholesterol ratio (CR) was used as an estimate of cholesterol absorption because it is independent of plant sterols. First, we investigated the associations of 6 single nucleotide polymorphisms in ABCG8 and ABO with CR in the LURIC (LUdwisghafen RIsk and Cardiovascular health study) and the YFS (Young Finns Study) cohorts. Second, we conducted a systematic review and meta-analysis to investigate whether CR might be related to CVD.\n In LURIC, the minor alleles of rs4245791 and rs4299376 and the major alleles of rs41360247, rs6576629, and rs4953023 of the ABCG8 gene and the minor allele of rs657152 of the ABO gene were significantly associated with higher CR. Consistent results were obtained for rs4245791, rs4299376, rs6576629, and rs4953023 in YFS. The meta-analysis, including 6 studies and 4, 62 individuals, found that CR was significantly increased in individuals with CVD.\n High cholesterol absorption is associated with risk alleles in ABCG8 and ABO and with CVD. Harm caused by elevated cholesterol absorption rather than by plant sterols may therefore mediate the relationships of ABCG8 and ABO variants with CVD.\n Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.\n\nMärz, Winfried\n\nScharnagl, Hubert\n\nSilbernagel, Günther\n\n\n"
},
{
"text": "\n132175\nDifferential survival trends of stage II colorectal cancer patients relate to promoter methylation status of PCDH10, SPARC, and UCHL1.\n\nHeitzer, E\n\nArtl, M\n\nFilipits, M\n\nResel, M\n\nGraf, R\n\nWeißenbacher, B\n\nLax, S\n\nGnant, M\n\nWrba, F\n\nGreil, R\n\nDietze, O\n\nHofbauer, F\n\nBöhm, G\n\nHöfler, G\n\nSamonigg, H\n\nSchaberl-Moser, R\n\nBalic, M\n\nDandachi, N\n\nBeiträge in Fachzeitschriften\nISI:000336884200014\n24309322.0\n10.1038/modpathol.2013.204\nNone\nSurgical excision of colorectal cancer at early clinical stages is highly effective, but 20-30% of patients relapse. Therefore, it is of clinical relevance to identify patients at high risk for recurrence, who would benefit from adjuvant chemotherapy. The objective of this study was to identify prognostic and/or predictive methylation markers in stage II colorectal cancer patients. Therefore, we selected six gene promoters (FZD9, PCDH10 (protocadherin 10), SFRP2, SPARC (secreted protein acidic and rich in cysteine), UCHL1 (ubiquitin carboxyl-terminal hydrolase 1), and WIF1) for methylation analysis in formalin-fixed, paraffin-embedded primary tumor samples of colorectal cancer patients (n=143) who were enrolled in a prospective randomized phase III trial of the Austrian Breast and Colorectal cancer Study Group. Patients were randomized to adjuvant chemotherapy with 5-fluorouracil and leucovorin or surveillance only. Survival analyses revealed that combined evaluation of three promoters (PCDH10, SPARC, and UCHL1) showed differential effects with regard to disease-free survival and overall survival in the two treatment groups (significance level 0.007). In the chemotherapy arm, a statistically insignificant trend for patients without methylation toward longer survival was observed (P=0.069 for disease-free survival and P=0.139 for overall survival). Contrary, patients in the surveillance arm without methylation in their gene promoters had shorter disease-free survival and overall survival (P=0.031 for disease-free survival and P=0.003 for overall survival), indicating a prognostic effect of methylation in this group (test for interaction, P=0.006 for disease-free survival and P=0.018 for overall survival). These results indicate that promoter methylation status of PCDH10, SPARC, and UCHL1 may be used both as prognostic and predictive molecular marker for colorectal cancer patients and, therefore, may facilitate treatment decisions for stage II colorectal cancer.\n\nBalic, Marija\n\nDandachi, Nadia\n\nGraf, Ricarda\n\nHeitzer, Ellen\n\nHöfler, Gerald\n\nResel, Margit\n\nSamonigg, Hellmut\n\nSchaberl-Moser, Renate\n\n\n"
},
{
"text": "\n144095\nInternational survey on the management of necrotizing enterocolitis.\n\nZani, A\n\nEaton, S\n\nPuri, P\n\nRintala, R\n\nLukac, M\n\nBagolan, P\n\nKuebler, JF\n\nHoellwarth, ME\n\nWijnen, R\n\nTovar, J\n\nPierro, A\n\nEUPSA Network\n\nBeiträge in Fachzeitschriften\nISI:000348524500008\n25344942.0\n10.1055/s-0034-1387942\nNone\nThe aim of this study is to define patterns in the management of necrotizing enterocolitis (NEC).\n A total of 80 delegates (81% senior surgeons) from 29 (20 European) countries completed a survey at the European Pediatric Surgeons' Association 2013 annual meeting.\n Overall, 59% surgeons work in centers where>10 cases of NEC are treated per year.\n 76% surgeons request both anteroposterior and lateral abdominal X-rays, which are performed at regular intervals by 66%; 50% surgeons also request Doppler ultrasonography; most frequently used biochemical markers are platelets (99% of surgeons), C-reactive protein (90%), and white cell count (83%). Laparoscopy is performed for diagnosis and/or treatment of NEC by only 8% surgeons. Overall, 43% surgeons reported being able to diagnose focal intestinal perforation preoperatively. Medical NEC: medical NEC is managed by surgical and neonatal teams together in most centers (84%). Most surgeons (67%) use a combination of two (51%) or three (48%) antibiotics for more than 7 days, and keep patients nil by mouth for 7 (41%) or 10 (49%) days. Surgical NEC: In extremely low-birth-weight infants (< 1, 00 g) with intestinal perforation, 27% surgeons opt for primary peritoneal drainage (PPD) as definitive treatment. Overall, 67% think that peritoneal drainage is important for stabilization and transport. At laparotomy, treatments vary according to NEC severity. About 75% surgeons always close the abdomen, and 29% leave a patch to prevent compartment syndrome.\n Infants are kept nil by mouth for 5 to 7 days by 46% surgeons, more than 7 days by 42%, and less than 5 days by 12% surgeons. Most surgeons (77%) restart infants on breast milk, 11.5% on aminoacid-based formulas, and 11.5% on hydrolyzed formulas. Most surgeons (92%) follow-up NEC patients after discharge, up to 5 years of life (56%) and 65% surgeons organize a neurodevelopmental follow-up.\n Many aspects of NEC management are lacking consensus and surgeons differ especially over surgical treatment of complex cases and postoperative management. Prospective multi-center studies are needed to guide an evidence-based management of NEC.\n Georg Thieme Verlag KG Stuttgart · New York.\n\nHöllwarth, Michael\n\n\n"
},
{
"text": "\n144645\nLength of the Mitral Isthmus But Not Anatomical Location of Ablation Line Predicts Bidirectional Mitral Isthmus Block in Patients Undergoing Catheter Ablation of Persistent Atrial Fibrillation: A Randomized Controlled Trial.\n\nScherr, D\n\nDerval, N\n\nSohal, M\n\nPascale, P\n\nWright, M\n\nJadidi, A\n\nKomatsu, Y\n\nRoten, L\n\nWilton, SB\n\nPedersen, M\n\nRamoul, K\n\nMiyazaki, S\n\nShah, A\n\nLinton, N\n\nManninger, M\n\nDenis, A\n\nHocini, M\n\nSacher, F\n\nHaissaguerre, M\n\nJais, P\n\nKnecht, S\n\nBeiträge in Fachzeitschriften\nISI:000355995200006\n25786517.0\n10.1111/jce.12667\nNone\nMitral isthmus (MI) ablation is an effective option in patients undergoing ablation for persistent atrial fibrillation (AF). Achieving bidirectional conduction block across the MI is challenging, and predictors of MI ablation success remain incompletely understood. We sought to determine the impact of anatomical location of the ablation line on the efficacy of MI ablation.\n A total of 40 consecutive patients (87% male; 54 ± 10 years) undergoing stepwise AF ablation were included. MI ablation was performed in sinus rhythm. MI ablation was performed from the left inferior PV to either the posterior (group 1) or the anterolateral (group 2) mitral annulus depending on randomization. The length of the MI line (measured with the 3D mapping system) and the amplitude of the EGMs at 3 positions on the MI were measured in each patient. MI block was achieved in 14/19 (74%) patients in group 1 and 15/21 (71%) patients in group 2 (P = NS). Total MI radiofrequency time (18 ± 7 min vs. 17 ± 8 min; P = NS) was similar between groups. Patients with incomplete MI block had a longer MI length (34 ± 6 mm vs. 24 ± 5 mm; P < 0.001), a higher bipolar voltage along the MI (1.75 ± 0.74 mV vs. 1.05 ± 0.69 mV; P < 0.01), and a longer history of continuous AF (19 ± 17 months vs. 10 ± 10 months; P < 0.05). In multivariate analysis, decreased length of the MI was an independent predictor of successful MI block (OR 1.5; 95% CI 1.1-2.1; P < 0.05).\n Increased length but not anatomical location of the MI predicts failure to achieve bidirectional MI block during ablation of persistent AF.\n © 2015 Wiley Periodicals, Inc.\n\nManninger-Wünscher, Martin\n\nScherr, Daniel\n\n\n"
},
{
"text": "\n148756\nImmunExplorer (IMEX): a software framework for diversity and clonality analyses of immunoglobulins and T cell receptors on the basis of IMGT/HighV-QUEST preprocessed NGS data.\n\nSchaller, S\n\nWeinberger, J\n\nJimenez-Heredia, R\n\nDanzer, M\n\nOberbauer, R\n\nGabriel, C\n\nWinkler, SM\n\nBeiträge in Fachzeitschriften\nISI:000359281500002\n26264428.0\n10.1186/s12859-015-0687-9\nPMC4531494\nToday's modern research of B and T cell antigen receptors (the immunoglobulins (IG) or antibodies and T cell receptors (TR)) forms the basis for detailed analyses of the human adaptive immune system. For instance, insights in the state of the adaptive immune system provide information that is essentially important in monitoring transplantation processes and the regulation of immune suppressiva. In this context, algorithms and tools are necessary for analyzing the IG and TR diversity on nucleotide as well as on amino acid sequence level, identifying highly proliferated clonotypes, determining the diversity of the cell repertoire found in a sample, comparing different states of the human immune system, and visualizing all relevant information.\n We here present IMEX, a software framework for the detailed characterization and visualization of the state of human IG and TR repertoires. IMEX offers a broad range of algorithms for statistical analysis of IG and TR data, CDR and V-(D)-J analysis, diversity analysis by calculating the distribution of IG and TR, calculating primer efficiency, and comparing multiple data sets. We use a mathematical model that is able to describe the number of unique clonotypes in a sample taking into account the true number of unique sequences and read errors; we heuristically optimize the parameters of this model. IMEX uses IMGT/HighV-QUEST analysis outputs and includes methods for splitting and merging to enable the submission to this portal and to combine the outputs results, respectively. All calculation results can be visualized and exported.\n IMEX is an user-friendly and flexible framework for performing clonality experiments based on CDR and V-(D)-J rearranged regions, diversity analysis, primer efficiency, and various different visualization experiments. Using IMEX, various immunological reactions and alterations can be investigated in detail. IMEX is freely available for Windows and Unix platforms at http://bioinformatics.fh-hagenberg.at/immunexplorer/.\n\n\n"
},
{
"text": "\n152460\nPlasma ceramides predict cardiovascular death in patients with stable coronary artery disease and acute coronary syndromes beyond LDL-cholesterol.\n\nLaaksonen, R\n\nEkroos, K\n\nSysi-Aho, M\n\nHilvo, M\n\nVihervaara, T\n\nKauhanen, D\n\nSuoniemi, M\n\nHurme, R\n\nMärz, W\n\nScharnagl, H\n\nStojakovic, T\n\nVlachopoulou, E\n\nLokki, ML\n\nNieminen, MS\n\nKlingenberg, R\n\nMatter, CM\n\nHornemann, T\n\nJüni, P\n\nRodondi, N\n\nRäber, L\n\nWindecker, S\n\nGencer, B\n\nPedersen, ER\n\nTell, GS\n\nNygård, O\n\nMach, F\n\nSinisalo, J\n\nLüscher, TF\n\nBeiträge in Fachzeitschriften\nISI:000379126000010\n27125947.0\n10.1093/eurheartj/ehw148\nPMC4929378\nThe aim was to study the prognostic value of plasma ceramides (Cer) as cardiovascular death (CV death) markers in three independent coronary artery disease (CAD) cohorts.\n Corogene study is a prospective Finnish cohort including stable CAD patients (n = 160). Multiple lipid biomarkers and C-reactive protein were measured in addition to plasma Cer(d18:1/16:0), Cer(d18:1/18:0), Cer(d18:1/24:0), and Cer(d18:1/24:1). Subsequently, the association between high-risk ceramides and CV mortality was investigated in the prospective Special Program University Medicine-Inflammation in Acute Coronary Syndromes (SPUM-ACS) cohort (n = 1637), conducted in four Swiss university hospitals. Finally, the results were validated in Bergen Coronary Angiography Cohort (BECAC), a prospective Norwegian cohort study of stable CAD patients. Ceramides, especially when used in ratios, were significantly associated with CV death in all studies, independent of other lipid markers and C-reactive protein. Adjusted odds ratios per standard deviation for the Cer(d18:1/16:0)/Cer(d18:1/24:0) ratio were 4.49 (95% CI, 2.24-8.98), 1.64 (1.29-2.08), and 1.77 (1.41-2.23) in the Corogene, SPUM-ACS, and BECAC studies, respectively. The Cer(d18:1/16:0)/Cer(d18:1/24:0) ratio improved the predictive value of the GRACE score (net reclassification improvement, NRI = 0.17 and ΔAUC = 0.09) in ACS and the predictive value of the Marschner score in stable CAD (NRI = 0.15 and ΔAUC = 0.02).\n Distinct plasma ceramide ratios are significant predictors of CV death both in patients with stable CAD and ACS, over and above currently used lipid markers. This may improve the identification of high-risk patients in need of more aggressive therapeutic interventions.\n © The Author 2016. Published by Oxford University Press on behalf of the European Society of Cardiology.\n\nMärz, Winfried\n\nScharnagl, Hubert\n\n\n"
},
{
"text": "\n152689\nPolyhydramnios, Transient Antenatal Bartter's Syndrome, and MAGED2 Mutations.\n\nLaghmani, K\n\nBeck, BB\n\nYang, SS\n\nSeaayfan, E\n\nWenzel, A\n\nReusch, B\n\nVitzthum, H\n\nPriem, D\n\nDemaretz, S\n\nBergmann, K\n\nDuin, LK\n\nGöbel, H\n\nMache, C\n\nThiele, H\n\nBartram, MP\n\nDombret, C\n\nAltmüller, J\n\nNürnberg, P\n\nBenzing, T\n\nLevtchenko, E\n\nSeyberth, HW\n\nKlaus, G\n\nYigit, G\n\nLin, SH\n\nTimmer, A\n\nde Koning, TJ\n\nScherjon, SA\n\nSchlingmann, KP\n\nBertrand, MJ\n\nRinschen, MM\n\nde Backer, O\n\nKonrad, M\n\nKömhoff, M\n\nBeiträge in Fachzeitschriften\nISI:000375746100008\n27120771.0\n10.1056/NEJMoa1507629\nNone\nThree pregnancies with male offspring in one family were complicated by severe polyhydramnios and prematurity. One fetus died; the other two had transient massive salt-wasting and polyuria reminiscent of antenatal Bartter's syndrome.\n To uncover the molecular cause of this possibly X-linked disease, we performed whole-exome sequencing of DNA from two members of the index family and targeted gene analysis of other members of this family and of six additional families with affected male fetuses. We also evaluated a series of women with idiopathic polyhydramnios who were pregnant with male fetuses. We performed immunohistochemical analysis, knockdown and overexpression experiments, and protein-protein interaction studies.\n We identified a mutation in MAGED2 in each of the 13 infants in our analysis who had transient antenatal Bartter's syndrome. MAGED2 encodes melanoma-associated antigen D2 (MAGE-D2) and maps to the X chromosome. We also identified two different MAGED2 mutations in two families with idiopathic polyhydramnios. Four patients died perinatally, and 11 survived. The initial presentation was more severe than in known types of antenatal Bartter's syndrome, as reflected by an earlier onset of polyhydramnios and labor. All symptoms disappeared spontaneously during follow-up in the infants who survived. We showed that MAGE-D2 affects the expression and function of the sodium chloride cotransporters NKCC2 and NCC (key components of salt reabsorption in the distal renal tubule), possibly through adenylate cyclase and cyclic AMP signaling and a cytoplasmic heat-shock protein.\n We found that MAGED2 mutations caused X-linked polyhydramnios with prematurity and a severe but transient form of antenatal Bartter's syndrome. MAGE-D2 is essential for fetal renal salt reabsorption, amniotic fluid homeostasis, and the maintenance of pregnancy. (Funded by the University of Groningen and others.).\n\nMache, Christoph\n\n\n"
},
{
"text": "\n153902\nDrug allergy passport and other documentation for patients with drug hypersensitivity - An ENDA/EAACI Drug Allergy Interest Group Position Paper.\n\nBrockow, K\n\nAberer, W\n\nAtanaskovic-Markovic, M\n\nBavbek, S\n\nBircher, A\n\nBilo, B\n\nBlanca, M\n\nBonadonna, P\n\nBurbach, G\n\nCalogiuri, G\n\nCaruso, C\n\nCelik, G\n\nCernadas, J\n\nChiriac, A\n\nDemoly, P\n\nOude Elberink, JN\n\nFernandez, J\n\nGomes, E\n\nGarvey, LH\n\nGooi, J\n\nGotua, M\n\nGrosber, M\n\nKauppi, P\n\nKvedariene, V\n\nLaguna, JJ\n\nMakowska, JS\n\nMosbech, H\n\nNakonechna, A\n\nPapadopolous, NG\n\nRing, J\n\nRomano, A\n\nRockmann, H\n\nSargur, R\n\nSedlackova, L\n\nSigurdardottir, S\n\nSchnyder, B\n\nStoraas, T\n\nTorres, M\n\nZidarn, M\n\nTerreehorst, I\n\nBeiträge in Fachzeitschriften\nISI:000386083700003\n27145347.0\n10.1111/all.12929\nNone\nThe strongest and best-documented risk factor for drug hypersensitivity (DH) is the history of a previous reaction. Accidental exposures to drugs may lead to severe or even fatal reactions in sensitized patients. Preventable prescription errors are common. They are often due to inadequate medical history or poor risk assessment of recurrence of drug reaction. Proper documentation is essential information for the doctor to make sound therapeutic decision. The European Network on Drug Allergy and Drug Allergy Interest Group of the European Academy of Allergy and Clinical Immunology have formed a task force and developed a drug allergy passport as well as general guidelines of drug allergy documentation. A drug allergy passport, a drug allergy alert card, a certificate, and a discharge letter after medical evaluation are adequate means to document DH in a patient. They are to be handed to the patient who is advised to carry the documentation at all times especially when away from home. A drug allergy passport should at least contain information on the culprit drug(s) including international nonproprietary name, clinical manifestations including severity, diagnostic measures, potential cross-reactivity, alternative drugs to prescribe, and where more detailed information can be obtained from the issuer. It should be given to patients only after full allergy workup. In the future, electronic prescription systems with alert functions will become more common and should include the same information as in paper-based documentation.\n © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.\n\nAberer, Werner\n\n\n"
},
{
"text": "\n158454\nPathological Complete Response to Neoadjuvant Trastuzumab Is Dependent on HER2/CEP17 Ratio in HER2-Amplified Early Breast Cancer.\n\nSinger, CF\n\nTan, YY\n\nFitzal, F\n\nSteger, GG\n\nEgle, D\n\nReiner, A\n\nRudas, M\n\nMoinfar, F\n\nGruber, C\n\nPetru, E\n\nBartsch, R\n\nTendl, KA\n\nFuchs, D\n\nSeifert, M\n\nExner, R\n\nBalic, M\n\nBago-Horvath, Z\n\nFilipits, M\n\nGnant, M\n\nAustrian Breast and Colorectal Cancer Study Group\n\nBeiträge in Fachzeitschriften\nISI:000405678400024\n28143867.0\n10.1158/1078-0432.CCR-16-2373\nNone\nPurpose: To evaluate whether pathologic complete response (pCR) to neoadjuvant trastuzumab is dependent on the level of HER2 amplification.Experimental Design: 114 HER2-overexpressing early breast cancer patients who had received neoadjuvant trastuzumab were included in this study. Absolute HER2 and chromosome 17 centromere (CEP17) were measured by in situ hybridization analysis, and associations were examined between HER2/CEP17 ratio and tumor pCR status (commonly defined by ypT0 ypN0, ypT0/is ypN0, and ypT0/is).Results: In trastuzumab-treated patients, ypT0 ypN0 was achieved in 69.0% of patients with high-level amplification (HER2/CEP17 ratio > 6), but only in 30.4% of tumors with low-level amplification (ratio ≤ 6; P = 0.001). When pCR was defined by ypT0/is ypN0 or ypTis, 75.9% and 82.8% of tumors with high-level amplification had a complete response, whereas only 39.1%, and 38.3% with low-level amplification achieved pCR (P = 0.002 and P < 0.001, respectively). Logistic regression revealed that tumors with high-level amplification had a significantly higher probability achieving ypT0 ypN0 (OR, 5.08; 95% confidence interval, 1.86-13.90; P = 0.002) than tumors with low-level amplification, whereas no other clinicopathologic parameters were predictive of pCR. The association between high-level HER2 amplification and pCR was almost exclusively confined to hormone receptor (HR)-positive tumors (ypT0 ypN0: 62.5% vs. 24.0%, P = 0.014; ypT0/is ypN0: 75.0% vs. 28.0%, P = 0.005; and ypT0/is: 87.5% vs. 28.0%, P < 0.001), and was largely absent in HR-negative tumors.Conclusions: An HER2/CEP17 ratio of >6 in the pretherapeutic tumor biopsy is associated with a significantly higher pCR rate, particularly in HER2/HR copositive tumors, and can be used as a biomarker to predict response before neoadjuvant trastuzumab is initiated. Clin Cancer Res; 23(14); 3676-83. ©2017 AACR.\n ©2017 American Association for Cancer Research.\n\nBalic, Marija\n\nMoinfar, Farid\n\nPetru, Edgar\n\n\n"
},
{
"text": "\n169912\nEvaluation of Galactomannan Testing, the <i>Aspergillus</i>-Specific Lateral-Flow Device Test and Levels of Cytokines in Bronchoalveolar Lavage Fluid for Diagnosis of Chronic Pulmonary Aspergillosis.\n\nSalzer, HJF\n\nPrattes, J\n\nFlick, H\n\nReimann, M\n\nHeyckendorf, J\n\nKalsdorf, B\n\nObersteiner, S\n\nGaede, KI\n\nHerzmann, C\n\nJohnson, GL\n\nLange, C\n\nHoenigl, M\n\nBeiträge in Fachzeitschriften\nISI:000446070600001\n30333797.0\n10.3389/fmicb.2018.02223\nPMC6176022\nBackground: Diagnosis of chronic pulmonary aspergillosis (CPA) is challenging. Symptoms are unspecific or missing, radiological findings are variable and proof of mycological evidence is limited by the accuracy of diagnostic tests. The goal of this study was to investigate diagnostic performance of galactomannan (GM), the newly formatted Aspergillus-specific lateral-flow-device test (LFD), and a number of cytokines in bronchoalveolar lavage fluid (BALF) samples obtained from patients with CPA, patients with respiratory disorders without CPA and healthy individuals. Methods: Patients with CPA (n = 27) and controls (n = 27 with underlying respiratory diseases but without CPA, and n = 27 healthy volunteers) were recruited at the Medical University of Graz, Austria and the Research Center Borstel, Germany between 2010 and 2018. GM, LFD and cytokine testing was performed retrospectively at the Research Center Borstel. Results: Sensitivity and specificity of GM testing from BALF with a cut off level of ≥0.5 optical density index (ODI) was 41 and 100% and 30 and 100% with a cut off level of ≥1.0 ODI. ROC curve analysis showed an AUC 0.718 (95% CI 0.581-0.855) for GM for differentiating CPA patients to patients with other respiratory diseases without CPA. The LFD resulted positive in only three patients with CPA (7%) and was highly specific. CPA patients did not differ significantly in the BALF cytokine profile compared to patients with respiratory disorders without CPA, but showed significant higher values for IFN-γ, IL-1b, IL-6, IL-8, and TNF-α compared to healthy individuals. Conclusion: Both GM and LFD showed insufficient performance for diagnosing CPA, with sensitivities of BALF GM below 50%, and sensitivity of the LFD below 10%. The high specificities may, however, result in a high positive predictive value and thereby help to identify semi-invasive or invasive disease.\n\nFlick, Holger\n\nHönigl, Martin\n\nPrattes, Jürgen\n\n\n"
},
{
"text": "\n175228\nLoss of RAF kinase inhibitor protein is involved in myelomonocytic differentiation and aggravates RAS-driven myeloid leukemogenesis.\n\nCaraffini, V\n\nGeiger, O\n\nRosenberger, A\n\nHatzl, S\n\nPerfler, B\n\nBerg, JL\n\nLim, C\n\nStrobl, H\n\nKashofer, K\n\nSchauer, S\n\nBeham-Schmid, C\n\nHoefler, G\n\nGeissler, K\n\nQuehenberger, F\n\nKolch, W\n\nAthineos, D\n\nBlyth, K\n\nWölfler, A\n\nSill, H\n\nZebisch, A\n\nBeiträge in Fachzeitschriften\nISI:000510846700028\n31097632.0\n10.3324/haematol.2018.209650\nPMC7012480\nRAS-signaling mutations induce the myelomonocytic differentiation and proliferation of hematopoietic stem and progenitor cells. Moreover, they are important players in the development of myeloid neoplasias. RAF kinase inhibitor protein (RKIP) is a negative regulator of RAS-signaling. As RKIP loss has recently been described in RAS-mutated myelomonocytic acute myeloid leukemia, we now aimed to analyze its role in myelomonocytic differentiation and RAS-driven leukemogenesis. Therefore, we initially analyzed RKIP expression during human and murine hematopoietic differentiation and observed that it is high in hematopoietic stem and progenitor cells and lymphoid cells but decreases in cells belonging to the myeloid lineage. By employing short hairpin RNA knockdown experiments in CD34+ umbilical cord blood cells and the undifferentiated acute myeloid leukemia cell line HL-60, we show that RKIP loss is indeed functionally involved in myelomonocytic lineage commitment and drives the myelomonocytic differentiation of hematopoietic stem and progenitor cells. These results could be confirmed in vivo, where Rkip deletion induced a myelomonocytic differentiation bias in mice by amplifying the effects of granulocyte macrophage-colony-stimulating factor. We further show that RKIP is of relevance for RAS-driven myelomonocytic leukemogenesis by demonstrating that Rkip deletion aggravates the development of a myeloproliferative disease in NrasG12D -mutated mice. Mechanistically, we demonstrate that RKIP loss increases the activity of the RAS-MAPK/ERK signaling module. Finally, we prove the clinical relevance of these findings by showing that RKIP loss is a frequent event in chronic myelomonocytic leukemia, and that it co-occurs with RAS-signaling mutations. Taken together, these data establish RKIP as novel player in RAS-driven myeloid leukemogenesis.\n Copyright© 2020 Ferrata Storti Foundation.\n\nBeham-Schmid, Christine\n\nCaraffini, Veronica\n\nGeiger, Olivia\n\nHatzl, Stefan\n\nHöfler, Gerald\n\nKashofer, Karl\n\nPerfler, Bianca\n\nQuehenberger, Franz\n\nSchauer, Silvia\n\nSchlacher, Angelika\n\nSill, Heinz\n\nStrobl, Herbert\n\nWoelfler, Albert\n\nZebisch, Armin\n\n\n"
},
{
"text": "\n175391\n[Qualitative analysis of lean management in healthcare: perspectives of Austrian and Swiss experts].\n\nHuhs, E\n\nGliebe, W\n\nSendlhofer, G\n\nBeiträge in Fachzeitschriften\nISI:000478576000002\n31153810.0\n10.1016/j.zefq.2019.05.003\nNone\nThe hospital sector is under considerable pressure to change. On the one hand, demographic change plays an important role and, on the other hand, the rapid development of medicine and nursing care can be attributed to the pressure to change. The Lean Management concept, which originated in the automotive sector, represents a successful management method for meeting these growing challenges. The aim of this work therefore was to use interviews with experts from the healthcare sector to find out which leadership philosophy hospitals need in order to successfully implement the lean management approach in their organisational culture.\n A semi-qualitative approach was chosen as a survey instrument for the present study of the expert interviews. The interview guideline was divided into four categories: hospital management, knowledge, practice and implementation. Four experts were interviewed for approx. 45minutes each. All four interviewees are male and hold intermediate- or top-level management positions in a hospital. The evaluation method used is based on the content analysis according to Mayring.\n In category 1, a high pressure for change was indicated. The reasons cited were different financing arrangements, changes in the framework and the unregulated flow of patients into the hospital. Managers in hospitals are not recruited for their management skills, but exclusively for their medical knowledge. Category 2 shows that managers in hospitals have never learned to lead or manage. The term 'Lean Management' is sometimes interpreted differently. In category 3, the interviewees cited different reasons for implementing the lean management approach. Among other things, they see the possibility of increasing quality for the patient, employee satisfaction and safety. In category 4, it was confirmed that employees and management play a key role in implementation. In a hospital, the 'patient-first' approach should be prioritised.\n A critical analysis of the results shows that implementing the lean management approach in a hospital will pose a major challenge. The functional, hierarchical structure as well as the understanding of leadership and the organizational culture are critical success factors.\n Copyright © 2019. Published by Elsevier GmbH.\n\nSendlhofer, Gerald\n\n\n"
},
{
"text": "\n178222\nEffects of a multispecies synbiotic on glucose metabolism, lipid marker, gut microbiome composition, gut permeability, and quality of life in diabesity: a randomized, double-blind, placebo-controlled pilot study.\n\nHorvath, A\n\nLeber, B\n\nFeldbacher, N\n\nTripolt, N\n\nRainer, F\n\nBlesl, A\n\nTrieb, M\n\nMarsche, G\n\nSourij, H\n\nStadlbauer, V\n\nBeiträge in Fachzeitschriften\nISI:000570760000014\n31729622.0\n10.1007/s00394-019-02135-w\nPMC7501130\nDiabesity, the combination of obesity and type 2 diabetes, is an ever-growing global health burden. Diabesity-associated dysbiosis of the intestinal microbiome has gained attention as a potential driver of disease and, therefore, a possible therapeutic target by means of pro- or prebiotic supplementation. This study tested the effects of a multispecies synbiotic (i.e. a combination of probiotics and prebiotics) on glucose metabolism, gut microbiota, gut permeability, neutrophil function and quality of life in treatment-experienced diabesity patients.\n A randomized, double-blind, placebo-controlled pilot study with 26 diabesity patients was conducted in which patients received a daily dose of a multispecies probiotic and a prebiotic (or a placebo) for 6 months.\n There were no changes in glucose metabolism or mixed meal tolerance test responses throughout the study. The analysis of secondary outcomes revealed beneficial effects on hip circumference [- 1 (95% CI - 4; 3) vs +3 (- 1; 8) cm, synbiotics vs. placebo, respectively, p = 0.04], serum zonulin [- 0.04 (- 0.2; 0.1) vs +0.3 (- 0.05; 0.6) ng/ml, p = 0.004)] and the physical role item of the SF36 quality of life assessment [+ 5.4 (- 1.7; 12.5) vs - 5.0 (- 10.1; 0.2) points, p = 0.02] after 3 months of intervention, and lipoprotein (a) [- 2.1 (- 5.7; 1.6) vs +3.4 (- 0.9; 7.9) mg/dl, p = 0.02] after 6 months. There were no significant differences in alpha or beta diversity of the microbiome between groups or time points.\n Glucose metabolism as the primary outcome was unchanged during the intervention with a multispecies synbiotic in patients with diabesity. Nevertheless, synbiotics improved some symptoms and biomarkers of type 2 diabetes and aspects of quality of life suggesting a potential role as adjuvant tool in the management of diabesity.\n\nBlesl, Andreas\n\nFeldbacher, Nicole\n\nHorvath, Angela\n\nLeber, Bettina\n\nMarsche, Gunther\n\nRainer, Florian\n\nSourij, Harald\n\nStadlbauer-Köllner, Vanessa\n\nTripolt, Norbert\n\n\n"
},
{
"text": "\n183416\nComparison of three commercial decision support platforms for matching of next-generation sequencing results with therapies in patients with cancer.\n\nPerakis, SO\n\nWeber, S\n\nZhou, Q\n\nGraf, R\n\nHojas, S\n\nRiedl, JM\n\nGerger, A\n\nDandachi, N\n\nBalic, M\n\nHoefler, G\n\nSchuuring, E\n\nGroen, HJM\n\nGeigl, JB\n\nHeitzer, E\n\nSpeicher, MR\n\nBeiträge in Fachzeitschriften\nISI:000576257800003\n32967919.0\n10.1136/esmoopen-2020-000872\nPMC7513637\nPrecision oncology depends on translating molecular data into therapy recommendations. However, with the growing complexity of next-generation sequencing-based tests, clinical interpretation of somatic genomic mutations has evolved into a formidable task. Here, we compared the performance of three commercial clinical decision support tools, that is, NAVIFY Mutation Profiler (NAVIFY; Roche), QIAGEN Clinical Insight (QCI) Interpret (QIAGEN) and CureMatch Bionov (CureMatch).\n In order to obtain the current status of the respective tumour genome, we analysed cell-free DNA from patients with metastatic breast, colorectal or non-small cell lung cancer. We evaluated somatic copy number alterations and in parallel applied a 77-gene panel (AVENIO ctDNA Expanded Panel). We then assessed the concordance of tier classification approaches between NAVIFY and QCI and compared the strategies to determine actionability among all three platforms. Finally, we quantified the alignment of treatment suggestions across all decision tools.\n Each platform varied in its mode of variant classification and strategy for identifying druggable targets and clinical trials, which resulted in major discrepancies. Even the frequency of concordant actionable events for tier I-A or tier I-B classifications was only 4.3%, 9.5% and 28.4% when comparing NAVIFY with QCI, NAVIFY with CureMatch and CureMatch with QCI, respectively, and the obtained treatment recommendations differed drastically.\n Treatment decisions based on molecular markers appear at present to be arbitrary and dependent on the chosen strategy. As a consequence, tumours with identical molecular profiles would be differently treated, which challenges the promising concepts of genome-informed medicine.\n © Author (s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ on behalf of the European Society for Medical Oncology.\n\nBalic, Marija\n\nDandachi, Nadia\n\nGeigl, Jochen Bernd\n\nGerger, Armin\n\nGraf, Ricarda\n\nHasenleithner, Samantha\n\nHeitzer, Ellen\n\nHöfler, Gerald\n\nRiedl, Jakob\n\nSpeicher, Michael\n\nWeber, Sabrina\n\nZhou, Qing\n\n\n"
},
{
"text": "\n186821\nSubregional areal bone mineral density (aBMD) is a better predictor of heterogeneity in trabecular microstructure of vertebrae in young and aged women than subregional trabecular bone score (TBS).\n\nVom Scheidt, A\n\nGrisolia Seifert, EF\n\nPokrant, C\n\nPüschel, K\n\nAmling, M\n\nBusse, B\n\nMilovanovic, P\n\nBeiträge in Fachzeitschriften\nNone\n30776500.0\n10.1016/j.bone.2019.02.014\nNone\nCurrently, bone densitometry fails to identify nearly half of those elderly patients at immediate fracture risk. To improve clinical assessment of vertebral fracture risk, we aimed to determine how the DXA-based 2D parameter Trabecular Bone Score (TBS) relates to subregional variability in 3D trabecular microstructure in young and elderly women compared to aBMD.\n T12 vertebrae from 29 women (11 young: 32 ± 6 years, 18 aged: 71 ± 5 years) were DXA-scanned ex vivo in anterior-posterior (AP) and lateral projection providing vertebral aBMD and TBS. Additionally, aBMD and TBS were measured for three horizontal (superior, mid-horizontal, inferior) and three vertical subregions (anterior, mid-vertical, posterior) and related to 3D microstructure indices, i.e. bone volume per tissue volume (BV/TV), trabecular number and thickness (Tb.N, Tb.Th), based on HRpQCT.\n Subregional high-resolution tomography showed significant differences in trabecular parameters for both age groups: In horizontal subregions, BV/TV was lowest superiorly, Tb.Th was highest mid-horizontally, and Tb.N was lowest mid-horizontally and highest inferiorly. Correspondingly, aBMD varied between horizontal subregions, with differences depending on projection direction. TBS varied only in lateral projections of the aged group, with lower values for the mid-horizontal subregion. In vertical subregions, BV/TV, Tb.N, and aBMD were highest posteriorly for both groups. TBS did not differ between vertical subregions. Regression analysis showed aBMD as a predictor explained more of the variance in subregional 3D microstructure compared to TBS. Stepwise multi-regression analysis revealed only three combinations of subregion, projection, and group where aBMD and TBS were both significant predictors.\n Subregional aBMD reflects variations in trabecular bone microstructure better than subregional TBS for trisected regions. Specifically, lateral aBMD identifies microstructural heterogeneities independent of age and may improve prediction of vertebral strength and susceptibility to specific fracture types.\n Copyright © 2019 Elsevier Inc. All rights reserved.\n\nvom Scheidt, Annika\n\n\n"
},
{
"text": "\n1147\nGlycated low-density lipoprotein attenuates shear stress-induced nitric oxide synthesis by inhibition of shear stress-activated L-arginine uptake in endothelial cells.\n\nPosch, K\n\nSimecek, S\n\nWascher, TC\n\nJürgens, G\n\nBaumgartner-Parzer, S\n\nKostner, GM\n\nGraier, WF\n\nBeiträge in Fachzeitschriften\nISI:000080567900018\n10342824.0\n10.2337/diabetes.48.6.1331\nNone\nLittle is known about the mechanism(s) of endothelial dysfunction in diabetes. In this study, the effect of nonenzymatic glycated LDL, a phenomenon induced by elevated D-glucose levels associated with diabetes, on porcine aortic endothelial cells was investigated. Two fractions of LDL from diabetic patients were separated by affinity column chromatography and are referred to herein as fraction alpha (nonglycated LDL) and fraction beta (glycated LDL). Incubation of endothelial cells for 24 h with total LDL isolated from diabetic subjects (dLDL) increased the release of superoxide anions (*O2-) by fivefold, while no effect of LDL isolated from healthy individuals (nLDL) was found. Fraction beta, but not fraction alpha, evoked the *O2- release. In vitro-glycated LDL mimicked the effect of dLDL/fraction beta on *O2- release that correlated with its degree of glycation (R2 = 0.96). Moreover, nitric oxide (NO) stability (measured with a porphyrinic-based electrode) and NO bioactivity (measured by its ability to elevate cellular cGMP levels) were reduced in cells treated with dLDL by 46 and 41%, respectively. dLDL (but not nLDL or fraction alpha) abolished shear stress-induced L-arginine uptake. The inhibitory effect of dLDL on shear stress-induced L-arginine uptake was mimicked by in vitro-glycated LDL. The efficiency of in vitro-glycated LDL to diminish shear stress-evoked L-arginine uptake correlated with the extent of glycation (R2 = 0.88). Moreover, dLDL, but not nLDL or fraction alpha, reduced shear stress-mediated cGMP formation and NOx production by 47 and 88%, respectively. This effect was also mimicked by in vitro-glycated LDL, correlating with its degree of glycation (R2 = 0.86). Under these experimental conditions, glycated LDL reduced shear stress-induced increase in NO synthesis by inhibition of shear stress-stimulated L-arginine uptake and NO bioactivity due to increased endothelial cell *O2- release. These properties may contribute to the reduced vasodilatory response and the vascular complications in diabetes.\n\nGraier, Wolfgang\n\nJürgens, Günther\n\nKostner, Gerhard\n\n\n"
},
{
"text": "\n7857\nThe effects of visual field changes and ocular hypertension on the visual evoked potential.\n\nBartl, G\n\nBeiträge in Fachzeitschriften\nISI:A1982PZ91200015\n6953870.0\n10.1111/j.1749-6632.1982.tb50794.x\nNone\nThe effects of visual field changes and ocular hypertension on visual evoked potentials were investigated by photopic ERG and by luminance and pattern-reversal EPs on 116 glaucomatous and on 7 normal eyes. The problem was approached by way of four investigations: Firstly, which nerve structures are affected by glaucoma and how do visual field defects caused by glaucoma influence the EP? The results show a functional diminution of all intraocular nerve structures in which the prelaminary part of the optic nerve is most affected. The EPs, especially the pattern-reversal EPs, are markedly diminished if the visual field defects extend inside the 10 degree boundary. Differences in the visual field defects of both eyes and the course of the sickness can be well observed by the EPs. Secondly, which preoperative prognosis for visual acuity produced by the EP can be given to patients who have a dense cataract in addition to glaucoma? A postoperative improvement of the visual acuity can be expected if the L-EPs are within the standard deviation. If the EP is distinctly diminished and does not increase with increasing stimulus intensity, then there is no hope for an improvement of the visual acuity after the operation. Thirdly, does a decrease of intraocular pressure in chronic and acute glaucoma influence the EP? In acute glaucoma with pressure levels of 50 mmHg or more, and sometimes in chronic glaucoma with pressure levels of about 30 mmHg, an increase of the amplitude of the EP and an improvement of the visual field could be noticed after pressure regulation. Fourthly, what is the behaviour of the EP in normal and glaucomatous eyes at experimentally elevated intraocular pressure? The amplitudes of the ERG components show a gradual decrease in normal as well as in glaucomatous eyes when intraocular pressure is increased and are maintained when intraocular pressure reaches systolic ophthalmic blood pressure. On the other hand, the EPs show a strong decrease in amplitude when intraocular pressure exceeds the mean ophthalmic blood pressure, particularly in the case of glaucomatous eyes.\n\n\n"
},
{
"text": "\n121374\nCardiac systolic rotation and contraction before and after valve replacement for aortic stenosis: A myocardial tagging study using MR imaging\n\nSandstede, JJW\n\nJohnson, T\n\nHarre, K\n\nBeer, M\n\nHofmann, S\n\nPabst, T\n\nKenn, W\n\nVoelker, W\n\nNeubauer, S\n\nHahn, D\n\nBeiträge in Fachzeitschriften\nISI:000174558200031\n11906882.0\n10.2214/ajr.178.4.1780953\nNone\nOBJECTIVE. Aortic stenosis leads to the derangement of cardiac function and contraction mode because of chronic pressure overload that is relieved after surgical valve replacement. The purpose of this study was to determine the changes in left ventricular systolic rotation and contraction using MR tagging in patients with aortic stenosis before and after surgical valve replacement compared with age-matched healthy volunteers. MATERIALS AND METHODS. Twelve patients with aortic stenosis were examined with an electrocardiographically triggered two-dimensional tagging sequence at 1.5 T before and 12 months after surgical valve replacement for the evaluation of wall function of the apical. mid ventricular, and basal levels. Eight healthy volunteers in the same age group served as the control group. RESULTS. Before surgery, all patients showed a significant increase of apical rotation (22.2degrees +/- 5.9degrees vs 10.3degrees +/- 2.5degrees, p < 0.0001) and overall left ventricular torsion (25.1degrees +/- 6.6degrees vs 14.5degrees +/- 3.7degrees, < 0.001); basal rotation was not significantly different (-2.9degrees +/- 2.1degrees vs -4.2degrees +/- 1.9degrees, p = not significant) compared with the volunteer group. Apical rotation and torsion were negatively correlated with left ventricular mass (r = -0, 3, p < 0.01, and (r = -0.64, p < 0.05, respectively) and end-diastolic volume r = -0.73, p < 0.01 and r = -0.64, p < 0.03, respectively). One year after surgery, basal rotation was reduced in the patients with aortic stenosis compared with the patients in the control group (-1.9degrees +/- 1.8degrees, p < 0.01). In comparison with preoperative values., apical rotation (14.2degrees +/- 3.6degrees, p < 0.01) also decreased but was still elevated, and this resulted in a normalization of left ventricular torsion (16.1degrees +/- 3.7degrees, p < 0.01). CONCLUSION. Surgical valve replacement for aortic stenosis leads to normalization of the left ventricular torsion I year after surgery. Pressure overload before surgery is associated with an increase of systolic left ventricular wringing motion, possibly serving as a compensatory mechanism. This mechanism declines with increasing left ventricular hypertrophy and dilatation.\n\n\n"
}
]
}