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"text": "\n168871\nDonor heart selection and outcomes: An analysis of over 2,000 cases.\n\nAliabadi-Zuckermann, AZ\n\nGökler, J\n\nKaider, A\n\nRiebandt, J\n\nMoayedifar, R\n\nOsorio, E\n\nHaberl, T\n\nAngleitner, P\n\nLaufer, G\n\nForsythe, J\n\nKnezevic, I\n\nSkoric, B\n\nErasmus, M\n\nvan Cleemput, J\n\nCaliskan, K\n\nDe Jonge, N\n\nSzabolcs, Z\n\nProdán, Z\n\nWasler, A\n\nBara, C\n\nUdovičić, M\n\nSandhaus, T\n\nGarbade, J\n\nRuhparwar, A\n\nSchoenrath, F\n\nHirt, S\n\nAntretter, H\n\nSchulz, U\n\nRichter, M\n\nThul, J\n\nBarten, MJ\n\nHaneya, A\n\nAleksic, I\n\nEifert, S\n\nBerchtold-Herz, M\n\nSmits, J\n\nZuckermann, AO\n\nBeiträge in Fachzeitschriften\nISI:000441535600007\n29802081.0\n10.1016/j.healun.2018.04.014\nNone\nDecision-making when offered a donor heart for transplantation is complex, and supportive data describing outcomes according to acceptance or non-acceptance choices are sparse. Our aim was to analyze donor heart acceptance decisions and associated outcomes at a single center, and after subsequent acceptance elsewhere.\n This investigation was a retrospective analysis of data obtained from the University of Vienna Medical Center and Eurotransplant centers for the period 2001 to 2015.\n Our center accepted 31.8% (699 of 2, 99) of donor hearts offered. Unlike other centers, the acceptance rate, with or without transplantation, did not increase over time. Of the donor hearts rejected by our center, 38.1% (572 of 1, 00) were later accepted elsewhere. Acceptance rates were twice as high for donor hearts initially rejected for non-quality reasons (339 of 601, 56.4%) compared with initial rejection for quality reasons (233 of 899, 25.9%). Three-year patient survival rate was 79% at Vienna; for donor hearts initially rejected by Vienna for non-quality reasons or quality reasons, it was 73% and 63%, respectively (p < 0.001). Outcomes at other centers after transplantation of grafts rejected by Vienna varied according to the reason for rejection, with good 3-year survival rates for rejection due to positive virology (77%), high catecholamines (68%), long ischemic time (71%), or low ejection fraction (68%), but poor survival was observed for hearts rejected for hypernatremia (46%), cardiac arrest (21%), or valve pathology (50%).\n A less restrictive policy for accepting donor hearts at our center, particularly regarding rejection for non-quality reasons or for positive virology, high catecholamine levels, longer ischemic time, or low ejection fraction, could expand our donor pool while maintaining good outcomes.\n Copyright © 2018 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.\n\n\n"
},
{
"text": "\n169213\nQuality of life as a prognostic indicator of survival: A pooled analysis of individual patient data from canadian cancer trials group clinical trials.\n\nEdiebah, DE\n\nQuinten, C\n\nCoens, C\n\nRingash, J\n\nDancey, J\n\nZikos, E\n\nGotay, C\n\nBrundage, M\n\nTu, D\n\nFlechtner, HH\n\nGreimel, E\n\nReeve, BB\n\nTaphoorn, M\n\nReijneveld, J\n\nDirven, L\n\nBottomley, A\n\nCanadian Cancer Trials Group and the European Organization for Research and Treatment of Cancer\n\nBeiträge in Fachzeitschriften\nISI:000442572000018\n29905936.0\n10.1002/cncr.31556\nNone\nThe aims of this study were to externally validate an established association between baseline health-related quality of life (HRQOL) scores and survival and to assess the added prognostic value of HRQOL with respect to demographic and clinical indicators.\n Pooled data were analyzed from 17 randomized controlled trials opened by the Canadian Cancer Trials Group between 1991 and 2004; they included survival and baseline HRQOL data from 3606 patients with 8 different cancer sites. The models included sex, age (≤60 vs >60 years), World Health Organization performance status (0 or 1 vs 2-4), distant metastases (no vs yes), and 15 European Organization for Research and Treatment of Cancer (EORTC) Core Quality-of-Life Questionnaire (QLQ-C30) scales. Analyses were conducted with multivariate Cox proportional hazards models and were stratified by cancer site. Harrell's discrimination C-index was used to calculate the predictive accuracy of the model when HRQOL parameters were added to clinical and demographic variables. The added value of adding HRQOL scales to clinical and demographic variables was illustrated with Kaplan-Meier curves.\n In the stratified, multivariate model, HRQOL parameters-global health status (hazard ratio [HR], 0.97; 95% confidence interval [CI], 0.95-1.00; P < . 0001), dyspnea (HR, 1.04; 95% CI, 1.02-1.06; P < . 0002), and appetite loss (HR, 1.06; 95% CI, 1.04-1.08; P < . 0001)-were independent prognostic factors in addition to the demographic and clinical variables (all P values < .05). Adding these HRQOL variables to the clinical variables resulted in an added relative prognostic value for survival of 5%.\n These results confirm previous findings showing that baseline HRQOL scores on the EORTC QLQ-C30 provide prognostic information in addition to information from clinical measures. However, the impact of specific domains may differ across studies. Cancer 2018. © 2018 American Cancer Society.\n © 2018 American Cancer Society.\n\nGreimel, Elfriede Renate\n\n\n"
},
{
"text": "\n169751\nDesign and methodology of the screening for CKD among older patients across Europe (SCOPE) study: a multicenter cohort observational study.\n\nCorsonello, A\n\nTap, L\n\nRoller-Wirnsberger, R\n\nWirnsberger, G\n\nZoccali, C\n\nKostka, T\n\nGuligowska, A\n\nMattace-Raso, F\n\nGil, P\n\nFuentes, LG\n\nMeltzer, I\n\nYehoshua, I\n\nFormiga-Perez, F\n\nMoreno-González, R\n\nWeingart, C\n\nFreiberger, E\n\nÄrnlöv, J\n\nCarlsson, AC\n\nBustacchini, S\n\nLattanzio, F\n\nSCOPE investigators\n\nBeiträge in Fachzeitschriften\nISI:000447187600005\n30309342.0\n10.1186/s12882-018-1030-2\nPMC6180570\nDecline of renal function is common in older persons and the prevalence of chronic kidney disease (CKD) is rising with ageing. CKD affects different outcomes relevant to older persons, additionally to morbidity and mortality which makes CKD a relevant health burden in this population. Still, accurate laboratory measurement of kidney function is under debate, since current creatinine-based equations have a certain degree of inaccuracy when used in the older population. The aims of the study are as follows: to assess kidney function in a cohort of 75+ older persons using existing methodologies for CKD screening; to investigate existing and innovative biomarkers of CKD in this cohort, and to align laboratory and biomarker results with medical and functional data obtained from this cohort. The study was registered at ClinicalTrials.gov, identifier NCT02691546, February 25th 2016.\n An observational, multinational, multicenter, prospective cohort study in community dwelling persons aged 75 years and over, visiting the outpatient clinics of participating institutions. The study will enroll 2450 participants and is carried out in Austria, Germany, Israel, Italy, the Netherlands, Poland and Spain. Participants will undergo clinical and laboratory evaluations at baseline and after 12 and 24 months- follow-up. Clinical evaluation also includes a comprehensive geriatric assessment (CGA). Local laboratory will be used for 'basic' parameters (including serum creatinine and albumin-to-creatinine ratio), whereas biomarker assessment will be conducted centrally. An intermediate telephone follow-up will be carried out at 6 and 18 months.\n Combining the use of CGA and the investigation of novel and existing independent biomarkers within the SCOPE study will help to provide evidence in the development of European guidelines and recommendations in the screening and management of CKD in older people.\n This study was registered prospectively on the 25th February 2016 at clinicaltrials.gov ( NCT02691546 ).\n\nRoller-Wirnsberger, Regina\n\nWirnsberger, Gerhard\n\n\n"
},
{
"text": "\n173863\nAnaerobic microorganisms in astrobiological analogue environments: from field site to culture collection\n\nCockell, CS\n\nSchwendner, P\n\nPerras, A\n\nRettberg, P\n\nBeblo-Vranesevic, K\n\nBohmeier, M\n\nRabbow, E\n\nMoissl-Eichinger, C\n\nWink, L\n\nMarteinsson, V\n\nVannier, P\n\nGomez, F\n\nGarcia-Descalzo, L\n\nEhrenfreund, P\n\nMonaghan, EP\n\nWestall, F\n\nGaboyer, F\n\nAmils, R\n\nMalki, M\n\nPukall, R\n\nCabezas, P\n\nWalter, N\n\nBeiträge in Fachzeitschriften\nISI:000443950500006\nNone\n10.1017/S1473550417000246\nNone\nAstrobiology seeks to understand the limits of life and to determine the physiology of organisms in order to better assess the habitability of other worlds. To successfully achieve these goals we require microorganisms from environments on Earth that approximate to extraterrestrial environments in terms of physical and/or chemical conditions. The most challenging of these environments with respect to sample collection, isolation and cultivation of microorganisms are anoxic environments. In this paper, an approach to this challenge was implemented within the European Union's MASE (Mars Analogues for Space Exploration) project. In this review paper, we aim to provide a set of methods for future field work and sampling campaigns. A number of anoxic environment based on characteristics that make them analogous to past and present locations on Mars were selected. They included anoxic sulphur-rich springs (Germany), the salt-rich Boulby Mine (UK), a lake in a basaltic context (Iceland), acidic sediments in the Rio Tinto (Spain), glacier samples (Austria) and permafrost samples (Russia and Canada). Samples were collected under strict anoxic conditions to be used for cultivation and genomic community analysis. Using the samples, a culturing approach was implemented to enrich anaerobic organisms using a defined medium that would allow for organisms to be grown under identical conditions in future physiological comparisons. Anaerobic microorganisms were isolated and deposited with the DSMZ (Deutsche Sammlung von Mikroorganismen und Zellkulturen GmbH) culture collection to make them available to other scientists. In MASE, the selected organisms are studied with respect to survival and growth under Mars relevant stresses. They are artificially fossilized and the resulting biosignatures studied and used to investigate the efficacy of life detection instrumentation for planetary missions. Some of the organisms belong to genera with medical and environmental importance such as Yersinia spp., illustrating how astrobiology field research can be used to increase the availability of microbial isolates for applied terrestrial purposes.\n\nMoissl-Eichinger, Christine\n\nWink, Lisa\n\n\n"
},
{
"text": "\n173977\nMulticentre experience with two frozen elephant trunk prostheses in the treatment of acute aortic dissection†.\n\nBerger, T\n\nWeiss, G\n\nVoetsch, A\n\nArnold, Z\n\nKreibich, M\n\nRylski, B\n\nKrombholz-Reindl, P\n\nWinkler, A\n\nMach, M\n\nGeisler, D\n\nSeitelberger, R\n\nSiepe, M\n\nBeyersdorf, F\n\nGrabenwoeger, M\n\nCzerny, M\n\nGottardi, R\n\nBeiträge in Fachzeitschriften\nISI:000493091000021\n30844055.0\n10.1093/ejcts/ezz037\nNone\nThe aim of this study was to evaluate early- and mid-term outcome and aortic remodelling in patients undergoing implantation of 2 different frozen elephant trunk prostheses, either the Thoraflex™ hybrid (Vascutek, Inchinnan, UK) and the E-vita Open (Jotec Inc., Hechingen, Germany) for acute aortic dissection.\n All consecutive patients [n = 88; median age 59 (49-67) years; 69% male] undergoing surgery with a frozen elephant trunk prosthesis for acute aortic dissection from August 2005 until March 2018 were included in this study. The Thoraflex™ device was implanted in 55 patients and the E-vita Open graft in 33 patients.\n Preoperative characteristics did not differ significantly between groups. There was also no statistically significant difference in postoperative outcome: in-hospital mortality (11% vs 12%; P > 0.99), stroke (18% vs 6%; P = 0.12) and spinal cord injury (6% vs 6%; P > 0.99). While there was no statistically significant difference in the occurrence of distal stent graft-induced new entries (16% vs 18%; P = 0.77), there was a significantly higher rate of secondary endovascular aortic interventions in the Thoraflex™ hybrid group (22% vs 0%; P = 0.003). There was a trend towards a higher rate of false lumen thrombosis at the level of the stent graft (74% vs 95%; P = 0.085) and was comparable at the thoraco-abdominal transition (53% vs 80%; P = 0.36) 1 year after implantation of the prostheses.\n In this comparison of 2 frozen elephant trunk prostheses, there is no evidence that different surgical techniques influence in-hospital outcome. At 1-year follow-up, patients who underwent implantation of the E-vita Open prosthesis showed a significantly reduced rate of secondary aortic interventions and a trend towards a higher rate of false lumen thrombosis which might be attributed to a longer coverage of the descending aorta due to a longer stent graft design and significantly more frequent implantation in zone 3.\n © The Author(s) 2019. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.\n\n\n"
},
{
"text": "\n180906\nImpact of Epithelial-Stromal Interactions on Peritumoral Fibroblasts in Ductal Carcinoma in Situ.\n\nStrell, C\n\nPaulsson, J\n\nJin, SB\n\nTobin, NP\n\nMezheyeuski, A\n\nRoswall, P\n\nMutgan, C\n\nMitsios, N\n\nJohansson, H\n\nWickberg, SM\n\nSvedlund, J\n\nNilsson, M\n\nHall, P\n\nMulder, J\n\nRadisky, DC\n\nPietras, K\n\nBergh, J\n\nLendahl, U\n\nWärnberg, F\n\nÖstman, A\n\nBeiträge in Fachzeitschriften\nISI:000493067400014\n30816935.0\n10.1093/jnci/djy234\nPMC6748730\nA better definition of biomarkers and biological processes related to local recurrence and disease progression is highly warranted for ductal breast carcinoma in situ (DCIS). Stromal-epithelial interactions are likely of major importance for the biological, clinical, and pathological distinctions between high- and low-risk DCIS cases.\n Stromal platelet derived growth factor receptor (PDGFR) was immunohistochemically assessed in two DCIS patient cohorts (n = 458 and n = 80). Cox proportional hazards models were used to calculate the hazard ratios of recurrence. The molecular mechanisms regulating stromal PDGFR expression were investigated in experimental in vitro co-culture systems of DCIS cells and fibroblasts and analyzed using immunoblot and quantitative real-time PCR. Knock-out of JAG1 in DCIS cells and NOTCH2 in fibroblasts was obtained through CRISPR/Cas9. Experimental data were validated by mammary fat pad injection of DCIS and DCIS-JAG1 knock-out cells (10 mice per group). All statistical tests were two-sided.\n PDGFRα(low)/PDGFRβ(high) fibroblasts were associated with increased risk for recurrence in DCIS (univariate hazard ratio = 1.59, 95% confidence interval [CI] = 1.02 to 2.46; P = .04 Wald test; multivariable hazard ratio = 1.78, 95% CI = 1.07 to 2.97; P = .03). Tissue culture and mouse model studies indicated that this fibroblast phenotype is induced by DCIS cells in a cell contact-dependent manner. Epithelial Jagged1 and fibroblast Notch2 were identified through loss-of-function studies as key juxtacrine signaling components driving the formation of the poor prognosis-associated fibroblast phenotype.\n A PDGFRα(low)/PDGFRβ(high) fibroblast subset was identified as a marker for high-risk DCIS. The Jagged-1/Notch2/PDGFR stroma-epithelial pathway was described as a novel signaling mechanism regulating this poor prognosis-associated fibroblast subset. In general terms, the study highlights epithelial-stromal crosstalk in DCIS and contributes to ongoing efforts to define clinically relevant fibroblast subsets and their etiology.\n © The Author(s) 2019. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.\n\nMutgan, Ayse Ceren\n\n\n"
},
{
"text": "\n184027\nMonitoring and parenteral administration of micronutrients, phosphate and magnesium in critically ill patients: The VITA-TRACE survey.\n\nVankrunkelsven, W\n\nGunst, J\n\nAmrein, K\n\nBear, DE\n\nBerger, MM\n\nChristopher, KB\n\nFuhrmann, V\n\nHiesmayr, M\n\nIchai, C\n\nJakob, SM\n\nLasocki, S\n\nMontejo, JC\n\nOudemans-van Straeten, HM\n\nPreiser, JC\n\nBlaser, AR\n\nRousseau, AF\n\nSinger, P\n\nStarkopf, J\n\nvan Zanten, AR\n\nWeber-Carstens, S\n\nWernerman, J\n\nWilmer, A\n\nCasaer, MP\n\nBeiträge in Fachzeitschriften\nISI:000617044100030\n32624243.0\n10.1016/j.clnu.2020.06.005\nNone\nDespite the presumed importance of preventing and treating micronutrient and mineral deficiencies, it is still not clear how to optimize measurement and administration in critically ill patients. In order to design future comparative trials aimed at optimizing micronutrient and mineral management, an important first step is to gain insight in the current practice of micronutrient, phosphate and magnesium monitoring and administration.\n Within the metabolism-endocrinology-nutrition (MEN) section of the European Society of Intensive Care Medicine (ESICM), the micronutrient working group designed a survey addressing current practice in parenteral micronutrient and mineral administration and monitoring. Invitations were sent by the ESICM research department to all ESICM members and past members.\n Three hundred thirty-four respondents completed the survey, predominantly consisting of physicians (321 [96.1%]) and participants working in Europe (262 [78.4%]). Eighty-one (24.3%) respondents reported to monitor micronutrient deficiencies through clinical signs and/or laboratory abnormalities, and 148 (44.3%) reportedly measure blood micronutrient concentrations on a routine basis. Two hundred ninety-two (87.4%) participants provided specific data on parenteral micronutrient supplementation, of whom 150 (51.4%) reported early administration of combined multivitamin and trace element preparations at least in selected patients. Among specific parenteral micronutrient preparations, thiamine (146 [50.0%]) was reported to be the most frequently administered micronutrient, followed by vitamin B complex (104 [35.6%]) and folic acid (86 [29.5%]). One hundred twenty (35.9%) and 113 (33.8%) participants reported to perform daily measurements of phosphate and magnesium, respectively, whereas 173 (59.2%) and 185 (63.4%) reported to routinely supplement these minerals parenterally.\n The survey revealed a wide variation in current practices of micronutrient, phosphate and magnesium measurement and parenteral administration, suggesting a risk of insufficient prevention, diagnosis and treatment of deficiencies. These results provide the context for future comparative studies, and identify areas for knowledge translation and recommendations.\n Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.\n\nAmrein, Karin\n\n\n"
},
{
"text": "\n4436\nEarly experience and midterm follow-up results with a new, rotational thrombectomy catheter.\n\nBérczi, V\n\nDeutschmann, HA\n\nSchedlbauer, P\n\nTauss, J\n\nHausegger, KA\n\nBeiträge in Fachzeitschriften\nISI:000177871000003\n12042988.0\n10.1007/s00270-001-0095-6\nNone\nTo assess the efficacy and safety of the Rotarex rotational thrombectomy catheter in treating occlusions of the femoropopliteal arteries.\n The Rotarex catheter (Straub Medical, Switzerland) is a rotational thrombectomy device which is supposed to be able to remove fresh and partially organized clot material from an acutely or subacutely occluded vessel. Nineteen limbs of 18 patients (10 women, 8 men; mean age 72.9 +/- 7.3 years) with acute or subacute (23 +/- 16 days) occlusions of the middle or distal third of the superficial femoral artery or the popliteal artery were treated. The occlusions were 3-20 cm long.\n Thrombectomy was technically successful in 15 of 19 vessels (79%). The primary procedural success including additional procedures such as angioplasty and/or stent-graft placement in 17 limbs was 94%. The mean ankle-brachial index improved from 0.36 +/- 0.26 (before thrombectomy) to 0.81 +/- 0.21 (2 days after the procedure) (p = 0.012). Clinical symptoms shifted to at least one Fontaine stage lower in 13 limbs. As complications we observed two perforations (arteries showing heavily calcified plaques), one arteriovenous fistula and three distal embolizations. One perforation, the fistula and one intimal tear after percutaneous transluminal angioplasty were treated with covered stents; the three distal embolizations were treated successfully with aspiration or Rotarex thrombectomy. In the other perforation the intervention was terminated. None of the complications needed surgical treatment. The complication rate was 31.5%. Follow-up studies showed three early (4-11 days) and six late (1-6 months) reocclusions. The cumulative primary patency rate was 68 +/- 12% at 3 months, and 39 +/- 13% at 6, 12 and 19 months; the secondary patency rate was 68 +/- 12% at 3 months and 53 +/- 13% at 6, 12 and 20 months.\n The Rotarex thrombectomy catheter is effective and quick in treating acute and subacute occlusions of the superficial femoral and popliteal arteries. It should not be used in arteries with heavily calcified plaques because of the risk of perforation. Limited long-term patency is mainly due to the complexity of the underlying lesion. Our results suggest that the Rotarex mechanical thrombectomy catheter is effective and might serve as an alternative treatment modality to intra-arterial lysis.\n\nDeutschmann, Hannes\n\nHausegger, Klaus\n\n\n"
},
{
"text": "\n8719\nImmunohistochemical localization and characterization of a protein from the basolateral membrane of rat small intestine epithelium using monoclonal antibody GZ-1.\n\nSchiechl, H\n\nDohr, G\n\nEherer, A\n\nBeiträge in Fachzeitschriften\nISI:A1986E897000005\n3097119.0\n10.1177/34.12.3097119\nNone\nThe proteins of the basolateral membrane (BLM) of small intestine epithelial cell in rat have been less precisely described than those of the microvillus membrane (MVM). To identify BLM-specific proteins, Balb/c mice were immunized with isolated intestinal epithelial cells and monoclonal antibodies (MAb) to their cell membrane, produced with the hybridoma technique. One of the MAb so obtained (GZ-1), a class 1 IgG, is specifically directed to a surface membrane protein of intestinal epithelium (GZ-1-Ag). The MAb served to characterize the protein as follows. Light microscopic immunohistochemical FITC labeling and, still more clearly, electron microscopic labeling with colloidal gold on Lowicryl sections of small intestinal tissue, show that the GZ-1-Ag occurs only in BLM of the absorptive cell and the goblet cell. It is not present in the MVM, the tight-junction area, and probably in the desmosomal sections of the membrane. The crypt cells are more markedly labeled with GZ-1 than are the villus cells; the villus cells are also more clearly labeled from the duodenum to the ileum. Gross analysis of the position of the gold marker on the BLM indicates that GZ-1-Ag is probably integrated into the lipid bilayer. With immunoblotting (with HRP as marker), a single band of MW 42, 00 D can be identified as the corresponding GZ-1-Ag from the protein band pattern obtained with SDS-PAGE from BLM isolated in the presence of protease inhibitors (PI). In BLM fractions isolated without protease inhibition, a band of MW 30, 00 D can be labeled with GZ-1. These results are interpreted as follows: GZ-1-Ag is a protein of MW 42, 00 D. On isolation of the BLM without PI, a piece of this protein is broken off by proteolysis. The larger piece of the molecule (30, 00 D) is not accessible to the proteolytic enzyme owing to its localization in the BLM, and therefore remains intact (and recognizable by the Ab). The preferred position of the gold marker on the BLM is in agreement with this explanation.\n\nDohr, Gottfried\n\nEherer, Andreas\n\n\n"
},
{
"text": "\n117444\nUrsodeoxycholic acid in patients with chronic heart failure: a double-blind, randomized, placebo-controlled, crossover trial.\n\nvon Haehling, S\n\nSchefold, JC\n\nJankowska, EA\n\nSpringer, J\n\nVazir, A\n\nKalra, PR\n\nSandek, A\n\nFauler, G\n\nStojakovic, T\n\nTrauner, M\n\nPonikowski, P\n\nVolk, HD\n\nDoehner, W\n\nCoats, AJ\n\nPoole-Wilson, PA\n\nAnker, SD\n\nBeiträge in Fachzeitschriften\nISI:000300196500006\n22300693.0\n10.1016/j.jacc.2011.10.880\nNone\nOBJECTIVES: This study sought to assess the effects of ursodeoxycholic acid (UDCA) on endothelial function and inflammatory markers in patients with chronic heart failure (CHF). BACKGROUND: Endothelial dysfunction is commonly observed in patients with CHF, and it contributes to the limitation in exercise capacity that accompanies this condition. Bacterial lipopolysaccharide may trigger proinflammatory cytokine release and promote further endothelial dysfunction. UDCA, a bile acid used in the treatment of cholestatic liver disease, has anti-inflammatory and cytoprotective properties and may contribute to the formation of mixed micelles around lipopolysaccharide. These properties may help to improve peripheral blood flow in patients with CHF. METHODS: We performed a prospective, single-center, double-blind, randomized, placebo-controlled crossover study of UDCA in 17 clinically stable male patients with CHF (New York Heart Association functional class II/III, left ventricular ejection fraction <45%). Patients received in random order 500 mg UDCA twice daily for 4 weeks and placebo for another 4 weeks. The primary endpoint was post-ischemic peak peripheral arm blood flow as assessed by strain-gauge plethysmography. RESULTS: Sixteen patients completed the study. UDCA was well tolerated in all patients. Compared with placebo, UDCA improved peak post-ischemic blood flow in the arm (+18%, p = 0.038), and a trend for improved peak post-ischemic blood flow in the leg was found (+17%, p = 0.079). Liver function improved: compared with placebo, levels of ã-glutamyl transferase, aspartate transaminase, and soluble tumor necrosis factor á receptor 1 were lower after treatment with UDCA than after placebo (all p < 0.05). There was no change in 6-min walk test or New York Heart Association functional class, and levels of tumor necrosis factor á and interleukin-6 were unchanged or increased compared with placebo. CONCLUSIONS: UDCA is well tolerated in patients with CHF. UDCA improves peripheral blood flow and is associated with improved markers of liver function. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.\n\n\n"
},
{
"text": "\n117729\nEight genetic loci associated with variation in lipoprotein-associated phospholipase A2 mass and activity and coronary heart disease: meta-analysis of genome-wide association studies from five community-based studies.\n\nGrallert, H\n\nDupuis, J\n\nBis, JC\n\nDehghan, A\n\nBarbalic, M\n\nBaumert, J\n\nLu, C\n\nSmith, NL\n\nUitterlinden, AG\n\nRoberts, R\n\nKhuseyinova, N\n\nSchnabel, RB\n\nRice, KM\n\nRivadeneira, F\n\nHoogeveen, RC\n\nFontes, JD\n\nMeisinger, C\n\nKeaney, JF\n\nLemaitre, R\n\nAulchenko, YS\n\nVasan, RS\n\nEllis, S\n\nHazen, SL\n\nvan Duijn, CM\n\nNelson, JJ\n\nMärz, W\n\nSchunkert, H\n\nMcPherson, RM\n\nStirnadel-Farrant, HA\n\nPsaty, BM\n\nGieger, C\n\nSiscovick, D\n\nHofman, A\n\nIllig, T\n\nCushman, M\n\nYamamoto, JF\n\nRotter, JI\n\nLarson, MG\n\nStewart, AF\n\nBoerwinkle, E\n\nWitteman, JC\n\nTracy, RP\n\nKoenig, W\n\nBenjamin, EJ\n\nBallantyne, CM\n\nBeiträge in Fachzeitschriften\nISI:000299350500020\n22003152.0\n10.1093/eurheartj/ehr372\nPMC3258449\nAIMS: Lipoprotein-associated phospholipase A2 (Lp-PLA2) generates proinflammatory and proatherogenic compounds in the arterial vascular wall and is a potential therapeutic target in coronary heart disease (CHD). We searched for genetic loci related to Lp-PLA2 mass or activity by a genome-wide association study as part of the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium. METHODS AND RESULTS: In meta-analyses of findings from five population-based studies, comprising 13 664 subjects, variants at two loci (PLA2G7, CETP) were associated with Lp-PLA2 mass. The strongest signal was at rs1805017 in PLA2G7 [P = 2.4 Ã 10(-23), log Lp-PLA2 difference per allele (beta): 0.043]. Variants at six loci were associated with Lp-PLA2 activity (PLA2G7, APOC1, CELSR2, LDL, ZNF259, SCARB1), among which the strongest signals were at rs4420638, near the APOE-APOC1-APOC4-APOC2 cluster [P = 4.9 Ã 10(-30); log Lp-PLA2 difference per allele (beta): -0.054]. There were no significant gene-environment interactions between these eight polymorphisms associated with Lp-PLA2 mass or activity and age, sex, body mass index, or smoking status. Four of the polymorphisms (in APOC1, CELSR2, SCARB1, ZNF259), but not PLA2G7, were significantly associated with CHD in a second study. CONCLUSION: Levels of Lp-PLA2 mass and activity were associated with PLA2G7, the gene coding for this protein. Lipoprotein-associated phospholipase A2 activity was also strongly associated with genetic variants related to low-density lipoprotein cholesterol levels.\n\nMärz, Winfried\n\n\n"
},
{
"text": "\n136762\nImpact of mental and physical stress on blood pressure and pulse pressure under normobaric versus hypoxic conditions.\n\nTrapp, M\n\nTrapp, EM\n\nEgger, JW\n\nDomej, W\n\nSchillaci, G\n\nAvian, A\n\nRohrer, PM\n\nHörlesberger, N\n\nMagometschnigg, D\n\nCervar-Zivkovic, M\n\nKomericki, P\n\nVelik, R\n\nBaulmann, J\n\nBeiträge in Fachzeitschriften\nISI:000336838000001\n24817135.0\n10.1371/journal.pone.0089005\nPMC4015896\nHypobaric hypoxia, physical and psychosocial stress may influence key cardiovascular parameters including blood pressure (BP) and pulse pressure (PP). We investigated the effects of mild hypobaric hypoxia exposure on BP and PP reactivity to mental and physical stress and to passive elevation by cable car.\n 36 healthy volunteers participated in a defined test procedure consisting of a period of rest 1, mental stress task (KLT-R), period of rest 2, combined mental (KLT-R) and physical task (bicycle ergometry) and a last period of rest both at Graz, Austria (353 m asl) and at the top station Dachstein (2700 m asl). Beat-to-beat heart rate and BP were analysed both during the test procedures at Graz and at Dachstein and during passive 1000 m elevation by cable car (from 1702 m to 2700 m).\n A significant interaction of kind of stress (mental vs. combined mental and physical) and study location (Graz vs. Dachstein) was found in the systolic BP (p = .007) and PP (p = .002) changes indicating that during the combined mental and physical stress task sBP was significantly higher under hypoxic conditions whereas sBP and PP were similar during mental stress both under normobaric normoxia (Graz) and under hypobaric hypoxia (Dachstein). During the passive ascent in cable car less trivialization (psychological coping strategy) was associated with an increase in PP (p = .004).\n Our data show that combined mental and physical stress causes a significant higher raise in sBP and PP under hypoxic conditions whereas isolated mental stress did not affect sBP and PP under hypoxic conditions. PP-reaction to ascent in healthy subjects is not uniform. BP reactions to ascent that represents an accumulation of physical (mild hypobaric hypoxia) and psychological stressors depend on predetermined psychological traits (stress coping strategies). Thus divergent cardiovascular reactions can be explained by applying the multidimensional aspects of the biopsychosocial concept.\n\nAvian, Alexander\n\nCervar-Zivkovic, Mila\n\nDomej, Wolfgang\n\nEgger, Josef Wilhelm\n\nHörlesberger, Nina\n\nKomericki, Peter\n\nRohrer, Peter Michael\n\n\n"
},
{
"text": "\n167259\nIndividualized approach to the surgical management of fibrous dysplasia of the proximal femur.\n\nMajoor, BCJ\n\nLeithner, A\n\nvan de Sande, MAJ\n\nAppelman-Dijkstra, NM\n\nHamdy, NAT\n\nDijkstra, PDS\n\nBeiträge in Fachzeitschriften\nISI:000431528900004\n29720212.0\n10.1186/s13023-018-0805-7\nPMC5932767\nFibrous dysplasia of the proximal femur presents with heterogeneous clinical manifestations dictating different surgical approaches. However, to date there are no clear recommendations to guide the choice of surgical approach and no general guidelines for the optimal orthopedic management of these lesions. The objective of this study was to evaluate treatment outcomes of angled blade plates and intramedullary nails, using as outcome indicators revision-free survival, pain, function and femoral neck-shaft-angle. Based on a review of published literature and our study findings, we propose a treatment algorithm, taking into account different factors, which may play a role in the selection of one surgical approach over another.\n Data were evaluated in thirty-two patients (18 male) from a combined cohort from the Netherlands and Austria, who had a surgical intervention using an angled blade plate (n = 27) or an intramedullary nail (n = 5) between 1985 and 2015, and who had a minimal follow-up of one year. The primary outcome was success of the procedure according to the revised Henderson classification. Secondary outcomes, which were assessed at one year and at the end of follow-up included: function (as measured by walking ability), pain and change in femoral neck-shaft angle over time.\n Analysis of data showed that revision-free survival was 72% after a median follow-up of 4.1 years. Revision was necessary in two patients for structural failure due to a fracture distal to an angled blade plate and in 7 patients due to angled blade plate-induced iliotibial tract pain. At the end of follow-up 91% of all patients had good walking ability and 91% were pain free. There was no significant postoperative change in femoral neck shaft angle.\n Our data show that fibrous dysplasia of the proximal femur can be adequately and safely treated with angled blade plates or intramedullary nails, providing these are used according to specific characteristics of the individual patient. Based on published literature and our own experience, we propose an individualized, patient-tailored approach for the surgical management of fibrous dysplasia of the proximal femur.\n\nLeithner, Andreas\n\n\n"
},
{
"text": "\n173474\nPrevalence of Circulating Tumor Cells After Adjuvant Chemotherapy With or Without Anthracyclines in Patients With HER2-negative, Hormone Receptor-positive Early Breast Cancer.\n\nSchramm, A\n\nSchochter, F\n\nFriedl, TWP\n\nde Gregorio, N\n\nAndergassen, U\n\nAlunni-Fabbroni, M\n\nTrapp, E\n\nJaeger, B\n\nHeinrich, G\n\nCamara, O\n\nDecker, T\n\nOber, A\n\nMahner, S\n\nFehm, TN\n\nPantel, K\n\nFasching, PA\n\nSchneeweiss, A\n\nJanni, W\n\nRack, BK\n\nSUCCESS Study Group\n\nBeiträge in Fachzeitschriften\nISI:000405760900005\n28190761.0\n10.1016/j.clbc.2016.11.008\nNone\nUse of anthracycline-based chemotherapy in patients with early breast cancer (EBC) has been well-established but is often associated with cardiotoxicity. Based on data suggesting a limited benefit of anthracyclines in human epidermal growth factor receptor 2 (HER2)-negative patients, the Simultaneous Study of Docetaxel Based Anthracycline Free Adjuvant Treatment Evaluation, as well as Life Style Intervention Strategies (SUCCESS) C study randomized patients to either anthracycline-containing or anthracycline-free chemotherapy. Given the proven prognostic value of circulating tumor cells (CTCs) in EBC, we compared the prevalence of CTCs after chemotherapy between both treatment arms for a preliminary efficacy assessment.\n The SUCCESS C trial (NCT00847444) is an open-label, phase III study randomizing 3547 patients with HER2-negative EBC to either 3 cycles of epirubicin, 5-fluorouracil, and cyclophosphamide followed by 3 cycles of docetaxel (FEC-DOC) or 6 cycles of docetaxel and cyclophosphamide (DOC-C). CTC status was prospectively evaluated in hormone receptor-positive patients at the time of last chemotherapy cycle using the US Food and Drug Administration-approved CellSearch System (Janssen Diagnostics).\n Data on CTC status were available for 1766 patients. Overall, CTCs were found in 221 (12.5%) patients. Univariate analyses revealed that presence of CTCs at time of last chemotherapy cycle was not significantly associated with tumor or patient characteristics (all P > .1). There was no significant difference with respect to presence of CTCs between patients randomized to FEC-DOC or DOC-C (11.5% vs. 13.6%; P = .18).\n The comparable prevalence of CTCs at the time of last chemotherapy cycle may indicate that anthracycline-free chemotherapy is equally effective to anthracycline-containing chemotherapy in HER2-negative, hormone receptor-positive EBC. However, efficacy data from the final survival analysis of SUCCESS C have to be awaited to confirm these preliminary findings.\n Copyright © 2017 Elsevier Inc. All rights reserved.\n\nTrapp, Elisabeth Katharina\n\n\n"
},
{
"text": "\n177427\nPhysiological in vitro sacroiliac joint motion: a study on three-dimensional posterior pelvic ring kinematics.\n\nHammer, N\n\nScholze, M\n\nKibsgård, T\n\nKlima, S\n\nSchleifenbaum, S\n\nSeidel, T\n\nWerner, M\n\nGrunert, R\n\nBeiträge in Fachzeitschriften\nISI:000458542900006\n30536830.0\n10.1111/joa.12924\nPMC6365483\nThe sacroiliac joint (SIJ) is a well-known source of low back and pelvic pain, of increasing interest for both conservative and surgical treatment. Alterations in the kinematics of the pelvis have been hypothesized as a major cause of SIJ-related pain. However, definitions of both the range and the extent of physiological movement are controversial, and there are no clear baseline data for pathological alterations. The present study combined a novel biomechanical setup allowing for physiological motion of the lumbosacral transition and pelvis without restricting the SIJ movement in vitro, combined with optical image correlation. Six fresh human pelvises (81 ± 10 years, three females, three males) were tested, with bodyweight-adapted loading applied to the fifth lumbar vertebra and both acetabula. Deformation at the lumbopelvises was determined computationally from three-dimensional image correlation data. Sacroiliac joint motion under the loading of 100% bodyweight primarily consisted of a z-axis rotation (0.16°) and an inferior translation of the sacrum relative to the ilium (0.32 mm). Sacroiliac joint flexion-extension rotations were minute (< 0.02°). Corresponding movements of the SIJ were found at the lumbosacral transition, with an anterior translation of L5 relative to the sacrum of -0.97 mm and an inferior translation of 0.11 mm, respectively. Moreover, a flexion of 1.82° was observed at the lumbosacral transition. Within the innominate bone and at the pubic symphysis, small complementary rotations were seen around a vertical axis, accounting for -0.10° and 0.11°, respectively. Other motions were minute and accompanied by large interindividual variation. The present study provides evidence of different SIJ motions than reported previously when exerted by physiological loading. Sacroiliac joint kinematics were in the sub-degree and sub-millimeter range, in line with previous in vivo and in vitro findings, largely limited to the sagittal rotation and an inferior translation of the sacrum relative to the ilium. This given physiological loading scenario underlines the relevance of the lumbosacral transition when considering the overall motion of the lumbopelvis, and how relatively little the other segments contribute to overall motion.\n © 2018 Anatomical Society.\n\nHammer, Niels\n\n\n"
},
{
"text": "\n178141\nDevelopment of semiquantitative ultrasound scoring system to assess cartilage in rheumatoid arthritis.\n\nMandl, P\n\nStudenic, P\n\nFilippucci, E\n\nBachta, A\n\nBackhaus, M\n\nBong, D\n\nBruyn, GAW\n\nCollado, P\n\nDamjanov, N\n\nDejaco, C\n\nDelle-Sedie, A\n\nDe Miguel, E\n\nDuftner, C\n\nGessl, I\n\nGutierrez, M\n\nHammer, HB\n\nHernandez-Diaz, C\n\nIagnocco, A\n\nIkeda, K\n\nKane, D\n\nKeen, H\n\nKelly, S\n\nKővári, E\n\nMöller, I\n\nMøller-Dohn, U\n\nNaredo, E\n\nNieto, JC\n\nPineda, C\n\nPlatzer, A\n\nRodriguez, A\n\nSchmidt, WA\n\nSupp, G\n\nSzkudlarek, M\n\nTerslev, L\n\nThiele, R\n\nWakefield, RJ\n\nWindschall, D\n\nD'Agostino, MA\n\nBalint, PV\n\nOMERACT Ultrasound Cartilage Task Force Group\n\nBeiträge in Fachzeitschriften\nISI:000491255500016\n31034077.0\n10.1093/rheumatology/kez153\nNone\nTo develop and test the reliability of a new semiquantitative scoring system for the assessment of cartilage changes by ultrasound in a web-based exercise as well as a patient exercise of patients with RA.\n A taskforce of the Outcome Measures in Rheumatology Ultrasound Working Group performed a systematic literature review on the US assessment of cartilage in RA, followed by a Delphi survey on cartilage changes and a new semiquantitative US scoring system, and finally a web-based exercise as well as a patient exercise. For the web-based exercise, taskforce members scored a dataset of anonymized static images of MCP joints in RA patients and healthy controls, which also contained duplicate images. Subsequently, 12 taskforce members used the same US to score cartilage in MCP and proximal interphalangeal joints of six patients with RA in in a patient reliability exercise. Percentage agreement and prevalence of lesions were calculated, as intrareader reliability was assessed by weighted kappa and interreader reliability by Light's kappa.\n The three-grade semiquantitative scoring system demonstrated excellent intrareader reliability (kappa: 0.87 and 0.83) in the web-based exercise and the patient exercise, respectively. Interreader reliability was good in the web-based exercise (kappa: 0.64) and moderate (kappa: 0.48) in the patient exercise.\n Our study demonstrates that ultrasound is a reliable tool for evaluating cartilage changes in the MCP joints of patients with RA and supports further development of a new reliable semiquantitative ultrasound scoring system for evaluating cartilage involvement in RA.\n © The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.\n\nDejaco, Christian\n\n\n"
},
{
"text": "\n183599\nCurcumin and Photobiomodulation in Chronic Viral Hepatitis and Hepatocellular Carcinoma.\n\nAilioaie, LM\n\nLitscher, G\n\nBeiträge in Fachzeitschriften\nISI:000587235200001\n32998270.0\n10.3390/ijms21197150\nPMC7582680\nImmune modulation is a very modern medical field for targeting viral infections. In the race to develop the best immune modulator against viruses, curcumin, as a natural product, is inexpensive, without side effects, and can stimulate very well certain areas of the human immune system. As a bright yellow component of turmeric spice, curcumin has been the subject of thousands of scientific and clinical studies in recent decades to prove its powerful antioxidant properties and anticancer effects. Curcumin has been shown to influence inter- and intracellular signaling pathways, with direct effects on gene expression of the antioxidant proteins and those that regulate the immunity. Experimental studies have shown that curcumin modulates several enzyme systems, reduces nitrosative stress, increases the antioxidant capacity, and decreases the lipid peroxidation, protecting against fatty liver pathogenesis and fibrotic changes. Hepatitis B virus (HBV) affects millions of people worldwide, having sometimes a dramatic evolution to chronic aggressive infection, cirrhosis, and hepatocellular carcinoma. All up-to-date treatments are limited, there is still a gap in the scientific knowledge, and a sterilization cure may not yet be possible with the removal of both covalently closed circular DNA (cccDNA) and the embedded HBV DNA. With a maximum light absorption at 420 nm, the cytotoxicity of curcumin as photosensitizer could be expanded by the intravenous blue laser blood irradiation (IVBLBI) or photobiomodulation in patients with chronic hepatitis B infection, Hepatitis B e-antigen (HBeAg)-positive, noncirrhotic, but nonresponsive to classical therapy. Photobiomodulation increases DNA repair by the biosynthesis of complex molecules with antioxidant properties, the outset of repairing enzyme systems and new phospholipids for regenerating the cell membranes. UltraBioavailable Curcumin and blue laser photobiomodulation could suppress the virus and control better the disease by reducing inflammation/fibrosis and stopping the progression of chronic hepatitis, reversing fibrosis, and diminishing the progression of cirrhosis, and decreasing the incidence of hepatocellular carcinoma. Photodynamic therapy with blue light and curcumin opens new avenues for the effective prevention and cure of chronic liver infections and hepatocellular carcinoma. Blue laser light and UltraBioavailable Curcumin could be a new valuable alternative for medical applications in chronic B viral hepatitis and hepatocarcinoma, saving millions of lives.\n\nLitscher, Gerhard\n\n\n"
},
{
"text": "\n183719\nGlucose management for exercise using continuous glucose monitoring (CGM) and intermittently scanned CGM (isCGM) systems in type 1 diabetes: position statement of the European Association for the Study of Diabetes (EASD) and of the International Society for Pediatric and Adolescent Diabetes (ISPAD) endorsed by JDRF and supported by the American Diabetes Association (ADA).\n\nMoser, O\n\nRiddell, MC\n\nEckstein, ML\n\nAdolfsson, P\n\nRabasa-Lhoret, R\n\nvan den Boom, L\n\nGillard, P\n\nNørgaard, K\n\nOliver, NS\n\nZaharieva, DP\n\nBattelino, T\n\nde Beaufort, C\n\nBergenstal, RM\n\nBuckingham, B\n\nCengiz, E\n\nDeeb, A\n\nHeise, T\n\nHeller, S\n\nKowalski, AJ\n\nLeelarathna, L\n\nMathieu, C\n\nStettler, C\n\nTauschmann, M\n\nThabit, H\n\nWilmot, EG\n\nSourij, H\n\nSmart, CE\n\nJacobs, PG\n\nBracken, RM\n\nMader, JK\n\nBeiträge in Fachzeitschriften\nISI:000578669300001\n33047481.0\n10.1111/pedi.13105\nPMC7702152\nPhysical exercise is an important component in the management of type 1 diabetes across the lifespan. Yet, acute exercise increases the risk of dysglycaemia, and the direction of glycaemic excursions depends, to some extent, on the intensity and duration of the type of exercise. Understandably, fear of hypoglycaemia is one of the strongest barriers to incorporating exercise into daily life. Risk of hypoglycaemia during and after exercise can be lowered when insulin-dose adjustments are made and/or additional carbohydrates are consumed. Glycaemic management during exercise has been made easier with continuous glucose monitoring (CGM) and intermittently scanned continuous glucose monitoring (isCGM) systems; however, because of the complexity of CGM and isCGM systems, both individuals with type 1 diabetes and their healthcare professionals may struggle with the interpretation of given information to maximise the technological potential for effective use around exercise (ie, before, during and after). This position statement highlights the recent advancements in CGM and isCGM technology, with a focus on the evidence base for their efficacy to sense glucose around exercise and adaptations in the use of these emerging tools, and updates the guidance for exercise in adults, children and adolescents with type 1 diabetes.\n © 2020 The Authors. Pediatric Diabetes published by John Wiley & Sons Ltd.\n\nMader, Julia\n\nMoser, Othmar\n\nSourij, Harald\n\n\n"
},
{
"text": "\n187785\nImaging of myocardial infarction using ultrasmall superparamagnetic iron oxide nanoparticles: a human study using a multi-parametric cardiovascular magnetic resonance imaging approach.\n\nYilmaz, A\n\nDengler, MA\n\nvan der Kuip, H\n\nYildiz, H\n\nRösch, S\n\nKlumpp, S\n\nKlingel, K\n\nKandolf, R\n\nHelluy, X\n\nHiller, KH\n\nJakob, PM\n\nSechtem, U\n\nBeiträge in Fachzeitschriften\nNone\n23103659.0\n10.1093/eurheartj/ehs366\nNone\nThe purpose of this clinical trial was to investigate whether cardiovascular magnetic resonance imaging (CMR) using ferumoxytol (Feraheme™, FH), an ultrasmall superparamagnetic iron oxide nanoparticle (USPIO), allows more detailed characterization of infarct pathology compared with conventional gadolinium-based necrosis/fibrosis imaging in patients with acute myocardial infarction.\n Fourteen patients who had experienced an acute ST-elevation myocardial infarction were included in this study. Following coronary angiography, a first baseline study (pre-FH) was performed followed by subsequent CMR studies (post-FH) 48 h after intravenous ferumoxytol administration. The CMR studies comprised cine-CMR, T(2)-weighted short tau inversion recovery spin echo imaging, T(2)-mapping, and T(1)-weighted late gadolinium enhancement (LGE) imaging. The median extent of short-axis in-plane LGE was 30% [inter-quartile range (IQR) 26-40%]. The median in-plane extent of T(2)-weighted 'hypoenhancement' in the region of myocardial infarction, which was not present prior to ferumoxytol administration in any patient, was 19% (IQR 14-22%; P < 0.001 compared with the extent of LGE). The median in-plane extent of areas showing signal void in T(2)-mapping images post-FH in the region of myocardial infarction was 16% (IQR 12-18%; P < 0.001 compared with the extent of LGE; P = 0.34 compared with the extent of T(2)-weighted hypoenhancement). A substantial drop in absolute T(2)-values was observed not only in the infarct core and peri-infarct zone, but also in the remote 'healthy' myocardium, although there was only a minor change in the skeletal muscle. Substantial ferumoxytol uptake was detected only in cultured macrophages, but not in peripheral blood monocytes from study patients.\n We could demonstrate in humans that USPIO-based contrast agents enable a more detailed characterization of myocardial infarct pathology mainly by detecting infiltrating macrophages. Considering the multi-functionality of USPIO-based particles and their superior safety profile compared with gadolinium-based compounds, these observations open up new vistas for the clinical application of USPIO.\n\nDengler, Michael Andreas\n\n\n"
},
{
"text": "\n6806\nChemical nociception in the jejunum induced by capsaicin.\n\nSchmidt, B\n\nHammer, J\n\nHolzer, P\n\nHammer, HF\n\nBeiträge in Fachzeitschriften\nISI:000222554600012\n15247176.0\n10.1136/gut.2003.029793\nPMC1774157\nBACKGROUND AND AIMS: Chemonociception in the human small intestine has not been studied extensively. Although capsaicin can cause intestinal sensations, it is not known if this is due to stimulation of chemoreceptors or to motor changes. Our aims were to evaluate motor activity during capsaicin induced nociception and to compare qualities of jejunal nociception induced by capsaicin and mechanical distension. METHODS: Twenty nine healthy subjects swallowed a tube with a perfusion site at the ligament of Treitz and, 7 cm distally, a barostat balloon. Phasic motor activity was measured around the perfusion site and the balloon. Capsaicin solutions (40, 200, and 400 microg/ml) 2.5 ml/min were perfused for 60 minutes or until severe discomfort occurred. A graded questionnaire for seven different sensations was completed every 10 minutes and after capsaicin perfusion was replaced by saline perfusion because of severe discomfort. Sensations arising from pressure controlled distensions were assessed before and after capsaicin perfusion when sensations had stopped (n = 19), or during capsaicin administration when no discomfort was reported (n = 5). RESULTS: Capsaicin perfusion induced feelings of pressure, cramps, pain, and warmth. The quality and abdominal location of these sensations were similar to those induced by distension, except for warmth (p<0.01) and pressure (p<0.05). Seven of 12 subjects receiving 40 microg/ml capsaicin and all subjects receiving higher capsaicin concentrations developed discomfort. Perfusion had to be stopped after 55 (3.3), 15 (5.7), and 10 (2.2) minutes with 40, 200, and 400 microg/ml capsaicin, respectively, whereafter the sensations disappeared within 10 minutes. Repeated capsaicin (200 microg/ml) applications significantly reduced the time until discomfort occurred (p = 0.01). Jejunal tone was not altered by capsaicin but phasic activity proximal to the perfusion site was reduced during capsaicin induced discomfort (p<0.001). Pain thresholds during distensions were not different before and after capsaicin perfusion. CONCLUSION: Despite the similarities in abdominal localisation and perceptional quality of capsaicin and distension induced sensations, our results rule out the fact that abdominal discomfort evoked by capsaicin involves sensitisation of mechanoreceptors or an increase in phasic and tonic motor activity. Capsaicin evokes abdominal sensations by stimulation of chemoreceptors which proves the existence of chemonociception in the human small intestine.\n\nHammer, Heinz\n\nHolzer, Peter\n\n\n"
}
]
}