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"text": "\n4737\nLack of association of the Glu298Asp polymorphism of endothelial nitric oxide synthase with manifest coronary artery disease, carotid atherosclerosis and forearm vascular reactivity in two Austrian populations.\n\nSchmoelzer, I\n\nRenner, W\n\nPaulweber, B\n\nMalaimare, L\n\nIglseder, B\n\nSchmid, P\n\nSchallmoser, K\n\nWascher, TC\n\nBeiträge in Fachzeitschriften\nISI:000181632800004\n12641536.0\n10.1046/j.1365-2362.2003.01108.x\nNone\nOBJECTIVE: Conflicting data exists about the possible contribution of the homozygous Asp/Asp genotype of the Glu298Asp polymorphism of endothelial nitric oxide synthase to human atherosclerotic vascular disease. We investigated the polymorphism in two independent study populations: a case-control study including patients with angiographically verified coronary artery disease (CAD) on the one hand and a cross-sectional epidemiological study on the other hand. METHODS: The Glu298Asp polymorphism was determined by PCR-RFLP as established. In the case-control study (240 patients and 248 controls) a possible association between the polymorphism and CAD, and age of onset of CAD and myocardial infarction was investigated. In the cross-sectional epidemiological study (932 subjects) intima-media thickness (IMT) of the carotid artery as well as morphological plaque burden and forearm vascular reactivity (peak postischemic reactive hyperaemia, determined by venous occlusion plethysmography) were measured. RESULTS: In the case-control study genotype distribution (Glu/Glu; Glu/Asp; Asp/Asp) was not different between the CAD patients (43/46/11%) and the controls (49/41/10%, P = NS). No association of the polymorphism with age of onset of CAD or myocardial infarction was found. In the epidemiological study no influence of the genetic variant on IMT was observed after correction for classical determinants of IMT (average IMT: Asp/ Asp: 0.077 +/- 0.011 mm; Glu/Glu and Glu/Asp: 0.080 +/- 0.012 mm, P = NS). Forearm vascular reactivity was also not different between homozygous Asp/Asp subjects and Glu/Glu and Glu/Asp subjects (peak-reactive hyperaemia 20.1 +/- 7.3 mL min-1 100 mL-1 vs. 20.0 +/- 6.5 mL min-1 100 mL-1, P = NS). CONCLUSIONS: Our results suggest that there is no association of the Glu298Asp polymorphism with coronary or carotid atherosclerosis or forearm vascular reactivity in these populations recruited in a country with a rather high risk for atherosclerosis. We suggest additional investigations to be performed in populations at different risk for coronary events to further elucidate the possible contribution of this polymorphism to vascular disease.\n\nRenner, Wilfried\n\n\n"
},
{
"text": "\n12556\nAllelic imbalances in endometrial stromal neoplasms: frequent genetic alterations in the nontumorous normal-appearing endometrial and myometrial tissues.\n\nMoinfar, F\n\nKremser, ML\n\nMan, YG\n\nZatloukal, K\n\nTavassoli, FA\n\nDenk, H\n\nBeiträge in Fachzeitschriften\nISI:000225796300039\n15581979.0\n10.1016/j.ygyno.2004.08.016\nNone\nOBJECTIVES: Endometrial stromal sarcoma (ESS) is among the rarest primary malignant tumors of the uterus. The aim of this study was to examine the possibility of loss of heterozygosity (LOH) and microsatellite instability (MIS) in different tissue components of ESS. METHODS AND MATERIALS: Using PCR, we examined DNA extracts from microdissected tissues of 27 uterus samples containing malignant stromal cells of ESS (20 low grade and 3 high grade sarcomas), benign tumor cells of endometrial stromal nodules (ESN, 4 cases) as well as tumor-free myometrial and endometrial tissues close to and distant from the tumors. Normal cervical tissues (epithelial cells, stroma cells) were also microdissected and analyzed. Fifteen polymorphic DNA markers (chromosomes 2p, 3p, 5q, 10q, 11q, 13q, and 17p) were tested to identify possible genetic alterations. Samples from 10 women with prolapsed uteri without any histopathologic abnormalities were also selected as controls. RESULTS: While no genetic alterations could be identified in 12 (44.5%) ESS cases, 15 (55.5%) revealed LOH with at least one polymorphic DNA marker. LOH were found in 3 (100%) high-grade sarcomas, 10 (50%) low-grade ESS, and 2 (50%) benign ESN. Although LOH was found more often in the neoplastic stromal cells, several cases showed concurrent and independent LOH in the tumor-free myometrial or endometrial tissues either close to or distant from the tumors. The most common genetic abnormality (LOH) was observed at PTEN, a tumor suppressor gene located on chromosome 10q. No tumor was associated with microsatellite instability (MSI). The control group without any histologic abnormalities did not show LOH or MSI. CONCLUSIONS: The frequent occurrence of LOH and the lack of MSI suggest that loss of function(s) of tumor suppressor genes and not mismatch repair deficiency plays a key role in the pathogenesis of endometrial stromal neoplasms. The concurrent and independent occurrence of LOH in the stromal tumor cells and the tumor-free and normal-appearing myometrial and endometrial tissues strongly support the concept of genetic alterations in microenvironmental tissues and the interaction(s) between different tissue components in the development and progression of endometrial stromal neoplasms.\n\nDenk, Helmut\n\nMoinfar, Farid\n\nZatloukal, Kurt\n\n\n"
},
{
"text": "\n16716\nDecrease in thoracic vertebral bone attenuation with calcium-based phosphate binders in hemodialysis.\n\nRaggi, P\n\nJames, G\n\nBurke, SK\n\nBommer, J\n\nChasan-Taber, S\n\nHolzer, H\n\nBraun, J\n\nChertow, GM\n\nBeiträge in Fachzeitschriften\nISI:000228679800007\n15824849.0\n10.1359/JBMR.041221\nNone\nWe performed a post hoc analysis of a 52-week randomized trial conducted in adult hemodialysis patients that compared the effects of calcium-based phosphate binders and sevelamer, a nonabsorbable polymer, on parameters of mineral metabolism and vascular calcification by electron beam tomography. In this analysis, we evaluated the relative effects of calcium and sevelamer on thoracic vertebral attenuation by CT and markers of bone turnover. Subjects randomized to calcium salts experienced a significant reduction in trabecular bone attenuation and a trend toward reduction in cortical bone attenuation, in association with higher concentrations of serum calcium, lower concentrations of PTH, and reduced total and bone-specific alkaline phosphatase. INTRODUCTION: In patients with chronic kidney disease, hyperphosphatemia is associated with osteodystrophy, vascular and soft tissue calcification, and mortality. Calcium-based phosphate binders are commonly prescribed to reduce intestinal phosphate absorption and to attenuate secondary hyperparathyroidism. Clinicians and investigators have presumed that, in hemodialysis patients, calcium exerts beneficial effects on bone. MATERIALS AND METHODS: We performed a post hoc analysis of a 52-week randomized trial conducted in adult hemodialysis patients that compared the effects of calcium-based phosphate binders and sevelamer, a nonabsorbable polymer, on parameters of mineral metabolism and vascular calcification by electron beam tomography. In this analysis, we evaluated the relative effects of calcium and sevelamer on thoracic vertebral attenuation by CT and markers of bone turnover. RESULTS AND CONCLUSIONS: The average serum phosphorus and calcium x phosphorus products were similar for both groups, although the average serum calcium concentration was significantly higher in the calcium-treated group. Compared with sevelamer-treated subjects, calcium-treated subjects showed a decrease in thoracic vertebral trabecular bone attenuation (p = 0.01) and a trend toward decreased cortical bone attenuation. More than 30% of calcium-treated subjects experienced a 10% or more decrease in trabecular and cortical bone attenuation. On study, sevelamer-treated subjects had higher concentrations of total and bone-specific alkaline phosphatase, osteocalcin, and PTH (p < 0.001). When used to correct hyperphosphatemia, calcium salts lead to a reduction in thoracic trabecular and cortical bone attenuation. Calcium salts may paradoxically decrease BMD in hemodialysis patients.\n\nHolzer, Herwig\n\n\n"
},
{
"text": "\n64540\nInfluence of physical activity on vertebral deformity in men and women: results from the European Vertebral Osteoporosis Study.\n\nSilman, AJ\n\nO'Neill, TW\n\nCooper, C\n\nKanis, J\n\nFelsenberg, D\n\nand the the European Vertebral Osteoporosis Study Group\n\nBeiträge in Fachzeitschriften\nISI:A1997WW90700014\n9144348.0\n10.1359/jbmr.1997.12.5.813\nNone\nPhysical activity is associated with an increased bone mass and a reduced risk of hip fracture. There are, however, no data from population samples of men and women concerning the effect of regular levels of physical activity on the risk of vertebral deformity. The aim of this study was to determine the relationship between regular physical activity and vertebral deformity in European men and women. A population survey method was used. Thirty-six centers from 19 European countries participated. Each center recruited a population sample of men and women aged 50 years and over. Those who took part received an interviewer-administered questionnaire and lateral thoracolumbar radiographs. Subjects were asked about two dimensions of physical activity: (1) the level of physical activity undertaken either at work or at home on a daily basis at three different age periods: 15-25 years, 25-50 years, and 50+ years; and (2) the amount of time spent walking or cycling out of doors each day. Spinal radiographs were evaluated morphometrically and the presence of vertebral deformity was defined according to the McCloskey method. In total, 14, 61 subjects, aged 50-79 years, from 30 centers were studied, of whom 809 (12.0%) men and 884 (11.7%) women had one or more deformities. After adjusting for age, center, smoking, and body mass index, very heavy levels of activity in all three age groups were associated with an increased risk of vertebral deformity in men (odds ratios, age adjusted [OR], 1.5-1.7; with all 95% confidence intervals [CI] excluding unity). No increased risk was observed in women. Current walking or cycling more than 1/2 h/day was associated with a reduced risk of vertebral deformity in women (OR 0.8; 95% CI 0.7-1.0). We conclude that regular walking in middle-aged and elderly women is associated with a reduced risk of vertebral deformity. By contrast, heavy levels of physical activity in early and middle adult life are associated with an increased risk in men. These differences are of relevance in understanding the epidemiology of vertebral deformity and planning programs of prevention.\n\nWeber, Kurt\n\n\n"
},
{
"text": "\n95907\nNonsteroidal anti-inflammatory drug hypersensitivity syndrome. A multicenter study. I. Clinical findings and in vitro diagnosis.\n\nDe Weck, AL\n\nSanz, ML\n\nGamboa, PM\n\nAberer, W\n\nBlanca, M\n\nCorreia, S\n\nErdman, S\n\nJermann, JM\n\nKanny, G\n\nKowalski, M\n\nMayorga, L\n\nMedrala, W\n\nMerk, A\n\nSturm, GJ\n\nSainte-Laudy, J\n\nSchneider, MS\n\nSczczeklik, A\n\nWeber, JM\n\nWedi, A\n\nBeiträge in Fachzeitschriften\nISI:000270836600002\n19862935.0\nNone\nNone\nBackground. We present the results obtained from the largest series of in vitro diagnostic tests ever reported in patients with clinically validated hypersensitivity to acetylsalicylic acid (ASA)/nonsteroidal anti-inflammatory drugs (NSAID) compared with various categories of controls tolerating ASA/NSAIDs. This multicenter study, which was performed within the framework of the European Network for Drug Allergy (ENDA) group, showed that the basophil activation test (BAT), particularly when used with the 3 NSAIDs aspirin (ASA), diclofenac (DIC), and naproxen (NAP), allows us to confirm the diagnosis of NSAID hypersensitivity syndrome. The results of the cellular allergen stimulation test (CAST) frequently correlate with those of the BAT, although not always. An unexpected finding was that basophil activation by NSAIDs is not an all-or-nothing phenomenon restricted to clinically hypersensitive patients, but that it also occurs in a dose-related manner in some NSAID-tolerant control individuals. Therefore, NSAID hypersensitivity appears as a shift in the normal pharmacological response to NSAIDs. These findings allow us to formulate a new rational hypothesis about the mechanism of NSAID hypersensitivity syndrome, a mechanism that most authors continue to describe as "unknown." Methods:We enrolled 152 patients with a history of hypersensitivity to NSAIDs and 136 control participants in 11 different centers between spring 2003 and spring 2006. Flowcytometric BAT was performed. Results: The most noteworthy results of our study were that 57% of 140 patients presented very clear-cut positive BAT results to multiple NSAIDs, and 16% were entirely negative. In about 27% of cases, positive results were obtained with 1 or 2 concentrations of a single NSAID. There is clearly a correlation between the results of BAT and CAST. Conclusions: BAT seems particularly indicated in patients with a clinical history of NSAID intolerance, and in whom a provocation test is not advisable for ethical, clinical, or other reasons. Clear-cut positive results can be considered as confirming a history of NSAID hypersensitivity, although negative results may not exclude it.\n\nAberer, Werner\n\nSturm, Gunter\n\n\n"
},
{
"text": "\n99260\nA cardiovascular-respiratory control system model including state delay with application to congestive heart failure in humans.\n\nBatzel, JJ\n\nKappel, F\n\nTimischl-Teschl, S\n\nBeiträge in Fachzeitschriften\nISI:000227442700003\n15480669.0\n10.1007/s00285-004-0293-3\nNone\nThis paper considers a model of the human cardiovascular-respiratory control system with one and two transport delays in the state equations describing the respiratory system. The effectiveness of the control of the ventilation rate is influenced by such transport delays because blood gases must be transported a physical distance from the lungs to the sensory sites where these gases are measured. The short term cardiovascular control system does not involve such transport delays although delays do arise in other contexts such as the baroreflex loop (see [46]) for example. This baroreflex delay is not considered here. The interaction between heart rate, blood pressure, cardiac output, and blood vessel resistance is quite complex and given the limited knowledge available of this interaction, we will model the cardiovascular control mechanism via an optimal control derived from control theory. This control will be stabilizing and is a reasonable approach based on mathematical considerations as well as being further motivated by the observation that many physiologists cite optimization as a potential influence in the evolution of biological systems (see, e.g., Kenner [29] or Swan [62]). In this paper we adapt a model, previously considered (Timischl [63] and Timischl et al. [64]), to include the effects of one and two transport delays. We will first implement an optimal control for the combined cardiovascular-respiratory model with one state space delay. We will then consider the effects of a second delay in the state space by modeling the respiratory control via an empirical formula with delay while the the complex relationships in the cardiovascular control will still be modeled by optimal control. This second transport delay associated with the sensory system of the respiratory control plays an important role in respiratory stability. As an application of this model we will consider congestive heart failure where this transport delay is larger than normal and the transition from the quiet awake state to stage 4 (NREM) sleep. The model can be used to study the interaction between cardiovascular and respiratory function in various situations as well as to consider the influence of optimal function in physiological control system performance.\n\n\n"
},
{
"text": "\n115693\nHyperbaric oxygenation of UW Solution positively impacts on the energy state of porcine pancreatic tissue.\n\nStiegler, P\n\nStadlbauer-Köllner, V\n\nSereinigg, M\n\nHackl, F\n\nPuntschart, A\n\nSchweiger, M\n\nPrenner, G\n\nSchaffellner, S\n\nIberer, F\n\nLackner, C\n\nJürgens, G\n\nHallström, S\n\nMatzi, V\n\nSmolle-Jüttner, FM\n\nTscheliessnigg, KH\n\n\n\nBeiträge in Fachzeitschriften\nISI:000299004700008\nNone\n10.1007/s10353-011-0053-8\nNone\nBACKGROUND: Pancreatic islet transplantation is a promising option for the treatment of diabetic patients; xenotransplantation of porcine islet cells would be a possibility to overcome the shortage of donor organs. Usually the donor pancreas is preserved with University of Wisconsin (UW) solution. A large number of reports have shown that the two-layer method (TLM), which employs oxygenated perfluorochemical and UW solution, is superior to simple cold storage. However, the extensive use of TLM is cost intensive and there is evidence that TLM only oxygenates small parts of the organ preserved. Another possibility to increase the oxygen supply during organ preservation would be the use of hyperbaric oxygenation (HBO) which increases the oxygen tension in fluids. The aim of this study was to evaluate the effect of pre-oxygenation of different preservation solutions on organ quality in terms of high energy phosphate levels as well as the occurrence of apoptosis and the induction of heat shock proteins and nitrosative stress induced cell death in porcine pancreatic tissue. METHODS: Porcine pancreatic tissue was preserved in different preservation solutions with or without pre-oxygenation for 6 hours of cold ischemic time (CIT). Then, tissue specimens were harvested and high energy phosphate levels were determined by HPLC. Moreover, immunohistochemistry was performed in order to detect occurrence of apoptosis, heat shock protein 70 (HSP70) as well as nitrosative stress induced cell death. RESULTS: Organs stored in pre-oxygenated UW solution showed best results in terms of high energy phosphate levels; apoptotic cells per islet as well as HSP70 positivity were significantly less when compared to simple UW storage and all other organ preservation solutions with or without pre-oxygenation. CONCLUSIONS: Pre-oxygenation of UW solution is a simple and promising method to improve islet cell quality after cold organ storage. However, further in vitro experiments have to be performed in order to confirm these findings.\n\nHallström, Seth\n\nJürgens, Günther\n\nLackner, Karoline\n\nMatzi, Veronika\n\nPrenner, Günther\n\nSchaffellner, Silvia\n\nSereinigg, Michael\n\nSmolle-Juettner, Freyja-Maria\n\nStadlbauer-Köllner, Vanessa\n\nStiegler, Philipp\n\n\n"
},
{
"text": "\n127820\nThe International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS)-quality of life during the first 4 months after fracture.\n\nBorgstrom, F\n\nLekander, I\n\nIvergard, M\n\nStrom, O\n\nSvedbom, A\n\nAlekna, V\n\nBianchi, ML\n\nClark, P\n\nCuriel, MD\n\nDimai, HP\n\nJurisson, M\n\nKallikorm, R\n\nLesnyak, O\n\nMcCloskey, E\n\nNassonov, E\n\nSanders, KM\n\nSilverman, S\n\nTamulaitiene, M\n\nThomas, T\n\nTosteson, ANA\n\nJonsson, B\n\nKanis, JA\n\n\n\nBeiträge in Fachzeitschriften\nISI:000314889100008\n23306819.0\n10.1007/s00198-012-2240-2\nNone\nThe quality of life during the first 4 months after fracture was estimated in 2, 08 fractured patients from 11 countries. Analysis showed that there were significant differences in the quality of life (QoL) loss between countries. Other factors such as QoL prior fracture and hospitalisation also had a significant impact on the QoL loss. The International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS) was initiated in 2007 with the objective of estimating costs and quality of life related to fractures in several countries worldwide. The ICUROS is ongoing and enrols patients in 11 countries (Australia, Austria, Estonia, France, Italy, Lithuania, Mexico, Russia, Spain, UK and the USA). The objective of this paper is to outline the study design of ICUROS and present results regarding the QoL (measured using the EQ-5D) during the first 4 months after fracture based on the patients that have been thus far enrolled ICUROS. ICUROS uses a prospective study design where data (costs and quality of life) are collected in four phases over 18 months after fracture. All countries use the same core case report forms. Quality of life was collected using the EQ-5D instrument and a time trade-off questionnaire. The total sample for the analysis was 2, 08 patients (1, 73 hip, 987 distal forearm and 548 vertebral fracture). For all fracture types and countries, the QoL was reduced significantly after fracture compared to pre-fracture QoL. A regression analysis showed that there were significant differences in the QoL loss between countries. Also, a higher level of QoL prior to the fracture significantly increased the QoL loss and patients who were hospitalised for their fracture also had a significantly higher loss compared to those who were not. The findings in this study indicate that there appear to be important variations in the QoL decrements related to fracture between countries.\n\nDimai, Hans\n\n\n"
},
{
"text": "\n129910\nA new scoring system derived from base excess and platelet count at presentation predicts mortality in paediatric meningococcal sepsis.\n\nCouto-Alves, A\n\nWright, VJ\n\nPerumal, K\n\nBinder, A\n\nCarrol, ED\n\nEmonts, M\n\nde Groot, R\n\nHazelzet, J\n\nKuijpers, T\n\nNadel, S\n\nZenz, W\n\nRamnarayan, P\n\nLevin, M\n\nCoin, L\n\nInwald, DP\n\nBeiträge in Fachzeitschriften\nISI:000327887300033\n23577792.0\n10.1186/cc12609\nPMC3672696\nThe aim of this study was to derive a novel prognostic score for mortality in paediatric meningococcal sepsis (MS) based on readily available laboratory markers.\n A multicentre retrospective cohort study for the consortium set and a single centre retrospective study for replication set. The consortium set were 1, 73 children (age 1 week to 17.9 years) referred over a 15-year period (1996 to 2011), who had an admission diagnosis of MS, referred to paediatric intensive care units (PICUs) in six different European centres. The consortium set was split into a development set and validation set to derive the score. The replication set were 134 children with MS (age 2 weeks to 16 years) referred over a 4-year period (2007 to 2011) to PICUs via the Children's Acute Transport Service (CATS), London.\n A total of 85/1, 73 (7.9%) children in the consortium set died. A total of 16/134 (11.9%) children in the replication set died. Children dying in the consortium set had significantly lower base excess, C-reactive protein (CRP), platelet and white cell count, more deranged coagulation and higher lactate than survivors. Paediatric risk of mortality (PRISM) score, Glasgow meningococcal septicaemia prognosis score (GMSPS) and Rotterdam score were also higher. Using the consortium set, a new scoring system using base excess and platelet count at presentation, termed the BEP score, was mathematically developed and validated. BEP predicted mortality with high sensitivity and specificity scores (area under the curve (AUC) in the validation set=0.86 and in the replication set=0.96). In the validation set, BEP score performance (AUC=0.86, confidence interval (CI): 0.80 to 0.91) was better than GMSPS (AUC=0.77, CI: 0.68, 0.85), similar to Rotterdam (AUC=0.87, CI: 0.81 to 0.93) and not as good as PRISM (AUC=0.93, CI: 0.85 to 0.97).\n The BEP score, relying on only two variables that are quickly and objectively measurable and readily available at presentation, is highly sensitive and specific in predicting death from MS in childhood.\n\nBinder, Alexander\n\nZenz, Werner\n\n\n"
},
{
"text": "\n132682\nVascularized medial femoral trochlea osteocartilaginous flap reconstruction of proximal pole scaphoid nonunions.\n\nBürger, HK\n\nWindhofer, C\n\nGaggl, AJ\n\nHiggins, JP\n\nBeiträge in Fachzeitschriften\nISI:000317246100009\n23474156.0\n10.1016/j.jhsa.2013.01.036\nNone\nPurpose The descending geniculate artery's branching pattern includes periosteal vessels supplying the cartilage-bearing trochlea of the medial patellofemoral joint. Previous cadaveric studies described anatomic similarities between the greater curvature of the proximal scaphoid and the convex surface of the medial femoral trochlea (MFT). We describe the technique and report our first 16 consecutive cases of vascularized osteocartilaginous arthroplasty for chronic scaphoid proximal pole nonunions using the MFT, with a minimum of 6 months of follow-up. Methods Chart reviews of 16 consecutive cases of osteocartilaginous MFT flap transfers for scaphoid reconstruction were performed at 2 institutions. Follow-up data were recorded at a minimum of 6 months, with an average of 14 months (range, 6-72 mo). Patient age and sex, duration of nonunion, number of previous surgical procedures, surgical technique, achievement of osseous union, preoperative and postoperative scapholunate angles, preoperative and postoperative range of motion, and pain relief were recorded. Results Computed tomography imaging confirmed healing in 15 of 16 reconstructed scaphoids. Mean patient age was 30 years (range, 18-47 y). The average number of previous surgical procedures was 1 (range, 0-3). All patients experienced some wrist pain improvement (12/16 complete relief, 4/16 incomplete relief). Wrist range of motion at follow-up averaged 46 degrees extension (range, 28 degrees to 80 degrees) and 44 degrees flexion (range, 10 degrees to 80 degrees), which was similar to preoperative measurements (average 46 degrees extension and 43 degrees flexion). Scapholunate relationship remained unchanged with average scapholunate angles of 52 degrees before surgery and 49 degrees after surgery. Conclusions Osteochondral vascularized MFT flaps provide a reliable means of achieving resolution of difficult proximal pole scaphoid nonunions. These flaps allow resection of the proximal portion of the unhealed scaphoid and reconstruction with an anatomically analogous convex segment of cartilage-bearing bone. This technique provides the advantages of vascularized bone and ease of fixation. Early follow-up demonstrates a high rate of union with acceptable motion and pain relief. Clinical relevance Early follow-up suggests that the vascularized MFT osteocartilaginous flap is a valuable tool for treating challenging proximal pole scaphoid nonunions. (J Hand Surg 2013;38A:690-700. Copyright (C) 2013 by the American Society for Surgery of the Hand. All rights reserved.)\n\n\n"
},
{
"text": "\n132997\nEvidence for a U-shaped relationship between prehospital vitamin D status and mortality: a cohort study.\n\nAmrein, K\n\nQuraishi, SA\n\nLitonjua, AA\n\nGibbons, FK\n\nPieber, TR\n\nCamargo, CA\n\nGiovannucci, E\n\nChristopher, KB\n\nBeiträge in Fachzeitschriften\nISI:000342283500071\n24423347.0\n10.1210/jc.2013-3481\nPMC3973775\nThe objective of the study was to examine the association between prehospital serum 25-hydroxyvitamin D [25(OH)D]and the risk of mortality after hospital admission.\n We performed a retrospective cohort study of adults hospitalized for acute care between 1993 and 2011.\n The study was conducted at two Boston teaching hospitals.\n A total of 24, 94 adult inpatients participated in the study.\n There was no intervention.\n All patients had serum 25(OH)D measured before hospitalization. The exposure of interest was 25(OH)D categorized as less than 10 ng/mL, 10-19.9 ng/mL, 20-29.9 ng/mL, 30-49.9 ng/mL, 50-59.9 ng/mL, 60-69.9 ng/mL, and 70 ng/mL or greater. The main outcome measure was 90-day mortality. Adjusted odds ratios (ORs) were estimated by multivariable logistic regression with inclusion of potential confounders.\n After adjustment for age, gender, race (white vs nonwhite), patient type (surgical vs medical), season of 25(OH)D draw, and the Deyo-Charlson index, patients with 25(OH)D levels less than 30 ng/mL or 60 ng/mL or greater had higher odds of 90-day mortality compared with patients with levels of 30-49.9 ng/mL [adjusted OR (95% confidence interval) for 25(OH)D <10 ng/mL, 10-19.9 ng/mL, 20-29.9 ng/mL, 50-59.9 ng/mL, 60-69.9 ng/mL, and ≥70 ng/mL was 2.01 (1.68-2.40), 1.89 (1.64-2.18), 1.34 (1.16-1.56), 0.94 (0.69-1.26), 1.52 (1.03-2.25), and 1.69 (1.09-2.61), respectively, compared with patients with 25(OH)D levels 30-49.9 ng/mL].\n A causal relationship between either low or high 25(OH)D levels and increased mortality can not necessarily be inferred from this observational study.\n Analysis of 24 094 adult patients showed that 25(OH)D levels less than 20 ng/mL and 60 ng/mL or greater before hospitalization were associated with an increased odds of 90-day mortality. Although previous reports have suggested an association between low vitamin D status and mortality, these data raise the issue of potential harm from high serum 25(OH)D levels, provide a rationale for an upper limit to supplementation, and emphasize the need for caution in the use of extremely high doses of vitamin D among patients.\n\nAmrein, Karin\n\nPieber, Thomas\n\n\n"
},
{
"text": "\n144452\nMortality after surgery in Europe: a 7 day cohort study.\n\nPearse, RM\n\nMoreno, RP\n\nBauer, P\n\nPelosi, P\n\nMetnitz, P\n\nSpies, C\n\nVallet, B\n\nVincent, JL\n\nHoeft, A\n\nRhodes, A\n\nEuropean Surgical Outcomes Study (EuSOS) group for the Trials groups of the European Society of Intensive Care Medicine and the European Society of Anaesthesiology\n\nBeiträge in Fachzeitschriften\nISI:000308916400026\n22998715.0\n10.1016/S0140-6736(12)61148-9\nPMC3493988\nClinical outcomes after major surgery are poorly described at the national level. Evidence of heterogeneity between hospitals and health-care systems suggests potential to improve care for patients but this potential remains unconfirmed. The European Surgical Outcomes Study was an international study designed to assess outcomes after non-cardiac surgery in Europe.\n We did this 7 day cohort study between April 4 and April 11, 2011. We collected data describing consecutive patients aged 16 years and older undergoing inpatient non-cardiac surgery in 498 hospitals across 28 European nations. Patients were followed up for a maximum of 60 days. The primary endpoint was in-hospital mortality. Secondary outcome measures were duration of hospital stay and admission to critical care. We used χ(2) and Fisher's exact tests to compare categorical variables and the t test or the Mann-Whitney U test to compare continuous variables. Significance was set at p<0·05. We constructed multilevel logistic regression models to adjust for the differences in mortality rates between countries.\n We included 46, 39 patients, of whom 1855 (4%) died before hospital discharge. 3599 (8%) patients were admitted to critical care after surgery with a median length of stay of 1·2 days (IQR 0·9-3·6). 1358 (73%) patients who died were not admitted to critical care at any stage after surgery. Crude mortality rates varied widely between countries (from 1·2% [95% CI 0·0-3·0] for Iceland to 21·5% [16·9-26·2] for Latvia). After adjustment for confounding variables, important differences remained between countries when compared with the UK, the country with the largest dataset (OR range from 0·44 [95% CI 0·19-1·05; p=0·06] for Finland to 6·92 [2·37-20·27; p=0·0004] for Poland).\n The mortality rate for patients undergoing inpatient non-cardiac surgery was higher than anticipated. Variations in mortality between countries suggest the need for national and international strategies to improve care for this group of patients.\n European Society of Intensive Care Medicine, European Society of Anaesthesiology.\n Copyright © 2012 Elsevier Ltd. All rights reserved.\n\nMetnitz, Philipp\n\n\n"
},
{
"text": "\n159881\nDoes a complex intervention increase patient knowledge about oral anticoagulation? - a cluster-randomised controlled trial.\n\nMaikranz, V\n\nSiebenhofer, A\n\nUlrich, LR\n\nMergenthal, K\n\nSchulz-Rothe, S\n\nKemperdick, B\n\nRauck, S\n\nPregartner, G\n\nBerghold, A\n\nGerlach, FM\n\nPetersen, JJ\n\nBeiträge in Fachzeitschriften\nISI:000397341500001\n28166725.0\n10.1186/s12875-017-0588-2\nPMC5295216\nOral anticoagulation therapy (OAT) is a challenge in general practice, especially for high-risk groups such as the elderly. Insufficient patient knowledge about safety-relevant aspects of OAT is considered to be one of the main reasons for complications. The research question addressed in this manuscript is whether a complex intervention that includes practice-based case management, self-management of OAT and additional patient and practice team education improves patient knowledge about anticoagulation therapy compared to a control group of patients receiving usual care (as a secondary objective of the Primary Care Management for Optimised Antithrombotic Treatment (PICANT) trial).\n The cluster-randomised controlled PICANT trial was conducted in 52 general practices in Germany, between 2012 and 2015. Trial participants were patients with a long-term indication for oral anticoagulation. A questionnaire was used to assess knowledge at baseline, after 12, and after 24 months. The questionnaire consists of 13 items (with a range of 0 to 13 sum-score points) covering topics related to intervention. Differences in the development of patient knowledge between intervention and control groups compared to baseline were assessed for each follow-up by means of linear mixed-effects models.\n Seven hundred thirty-six patients were included at baseline, of whom 95.4% continued to participate after 12 months, and 89.3% after 24 months. The average age of patients was 73.5 years (SD 9.4), and they mainly suffered from atrial fibrillation (81.1%). Patients in the intervention and control groups had similar knowledge about oral anticoagulation at baseline (5.6 (SD 2.3) in both groups). After 12 months, the improvement in the level of knowledge (compared to baseline) was significantly larger in the intervention group than in the control group (0.78 (SD 2.5) vs. 0.04 (SD 2.3); p = 0.0009). After 24 months, the difference between both groups was still statistically significant (0.6 (SD 2.6) vs. -0.3 (SD 2.3); p = 0.0001).\n Since this intervention was effective, it should be established in general practice as a means of improving patient knowledge about oral anticoagulation.\n Current controlled trials ISRCTN41847489 ; Date of registration: 13/04/2012.\n\nBerghold, Andrea\n\nPregartner, Gudrun\n\nSiebenhofer-Kroitzsch, Andrea\n\n\n"
},
{
"text": "\n169887\n[Therapy of Dupuytren's contracture with collagenase - Evidence-based Consensus Statement of Austrian Surgical Societies].\n\nGirsch, W\n\nArora, R\n\nBaur, EM\n\nGabl, M\n\nHager, D\n\nHintringer, T\n\nKamolz, LP\n\nKoller, R\n\nKrasny, C\n\nLeixnering, M\n\nLick-Schiffer, W\n\nRab, M\n\nSchlenz, I\n\nWechselberger, G\n\nWeigel, G\n\nZadra, A\n\nZimmermann, R\n\nBeiträge in Fachzeitschriften\nISI:000481431800006\n30332699.0\n10.1055/a-0627-7333\nNone\nDupuytren's contracture (DC) or Dupuytren's disease (DD) is a progressive fibro-proliferative disease of palmoplantar connective tissue, resulting in characteristic nodal and/or cord formation from collagen disposition. When the disease progresses, the thickening and shortening of the cords eventually leads the affected fingers to being pulled into flexion, which may be associated with marked disability, especially with bilateral disease. DD is relatively common in Europe, with the highest prevalence in Nordic countries. In Austria approx. 200 000 people are affected. The incidence increases with increasing age, with men being more often and earlier affected than women. The aetiology of DC is not completely clear, but it seems to be multifactorial; twin and familial studies confirm a genetic predisposition. The natural course of the disease can vary between relatively benign and massive progression and recurrence. In most cases, there is a fluctuating course. The DC is not curable; treatment methods range from minimally invasive to open surgical procedures. Collagenase Clostridium histolyticum (CCH) is a nonsurgical, enzymatic injection treatment for adult patients (≥ 18 years) with a palpable cord and has been approved in Europe since 2011. Clinical studies and practical experience of individual centres confirm the efficacy and safety of CCH treatment of DC. The present consensus statement was prepared under the auspices of the Austrian Society of Hand Surgery with the participation of the Austrian Society for Trauma Surgery, the Society of Orthopaedics and Orthopaedic Surgery as well as the Society for Plastic, Aesthetic and Reconstructive Surgery. On the basis of current literature and the experts' experience, it describes the various surgical procedures, with particular reference to collagenase treatment and provides guidance for their use. The statement is intended not only to illustrate the state of the art of current treatment, but also to support the achievement of uniform high quality standards in the treatment of DC in surgical centres and specialised medical practices throughout Austria.\n © Georg Thieme Verlag KG Stuttgart · New York.\n\nKamolz, Lars-Peter\n\n\n"
},
{
"text": "\n181408\nChronic nodular prurigo: clinical profile and burden. A European cross-sectional study.\n\nPereira, MP\n\nHoffmann, V\n\nWeisshaar, E\n\nWallengren, J\n\nHalvorsen, JA\n\nGarcovich, S\n\nMisery, L\n\nBrenaut, E\n\nSavk, E\n\nPotekaev, N\n\nLvov, A\n\nBobko, S\n\nSzepietowski, JC\n\nReich, A\n\nBozek, A\n\nLegat, FJ\n\nMetz, M\n\nStreit, M\n\nSerra-Baldrich, E\n\nGonçalo, M\n\nStorck, M\n\nGreiwe, I\n\nNau, T\n\nSteinke, S\n\nDugas, M\n\nStänder, S\n\nZeidler, C\n\nEPP Consensus Conference Participants 2017\n\nBeiträge in Fachzeitschriften\nISI:000531605900001\n32078192.0\n10.1111/jdv.16309\nNone\nChronic nodular prurigo (CNPG) is a condition characterized by chronic itch, a prolonged scratching behaviour and the presence of pruriginous nodules. A comprehensive understanding of this condition, especially regarding its clinical characteristics and impact on quality of life is still lacking.\n Aim of this pan-European multicentre cross-sectional study was to establish the clinical profile of CNPG, including its associated burden.\n Fifteen centres from 12 European countries recruited CNPG patients presenting at the centre or using the centres' own databases. Patients were asked to complete a questionnaire in paper or electronic format. Demography, current co-morbidities, underlying disease, itch intensity, additional sensory symptoms, quality of life, highest burden and emotional experience of itch were assessed.\n A total of 509 patients (210 male, median age: 64 years [52; 72]) were enrolled. Of these, 406 reported itch and CNPG lesions in the previous 7 days and qualified to complete the whole questionnaire. We recorded moderate to severe worst itch intensity scores in the previous 24 h. Scores were higher in patients with lower educational levels and those coming from Eastern or Southern Europe. Most patients experience itch often or always (71%) and report that their everyday life is negatively affected (53%). Itch intensity was considered to be the most burdensome aspect of the disease by 49% of the patients, followed by the visibility of skin lesions (21%) and bleeding of lesions (21%). The majority of patients was unaware of an underlying condition contributing to CNPG (64%), while psychiatric diseases were the conditions most often mentioned in association with CNPG (19%).\n This multicentre cross-sectional study shows that itch is the dominant symptom in CNPG and reveals that the profile of the disease is similar throughout Europe.\n © 2020 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.\n\nLegat, Franz\n\n\n"
},
{
"text": "\n181473\nHematopoietic Cell Transplantation in Patients With Primary Immune Regulatory Disorders (PIRD): A Primary Immune Deficiency Treatment Consortium (PIDTC) Survey.\n\nChan, AY\n\nLeiding, JW\n\nLiu, X\n\nLogan, BR\n\nBurroughs, LM\n\nAllenspach, EJ\n\nSkoda-Smith, S\n\nUzel, G\n\nNotarangelo, LD\n\nSlatter, M\n\nGennery, AR\n\nSmith, AR\n\nPai, SY\n\nJordan, MB\n\nMarsh, RA\n\nCowan, MJ\n\nDvorak, CC\n\nCraddock, JA\n\nProckop, SE\n\nChandrakasan, S\n\nKapoor, N\n\nBuckley, RH\n\nParikh, S\n\nChellapandian, D\n\nOshrine, BR\n\nBednarski, JJ\n\nCooper, MA\n\nShenoy, S\n\nDavila Saldana, BJ\n\nForbes, LR\n\nMartinez, C\n\nHaddad, E\n\nShyr, DC\n\nChen, K\n\nSullivan, KE\n\nHeimall, J\n\nWright, N\n\nBhatia, M\n\nCuvelier, GDE\n\nGoldman, FD\n\nMeyts, I\n\nMiller, HK\n\nSeidel, MG\n\nVander Lugt, MT\n\nBacchetta, R\n\nWeinacht, KG\n\nAndolina, JR\n\nCaywood, E\n\nChong, H\n\nde la Morena, MT\n\nAquino, VM\n\nShereck, E\n\nWalter, JE\n\nDorsey, MJ\n\nSeroogy, CM\n\nGriffith, LM\n\nKohn, DB\n\nPuck, JM\n\nPulsipher, MA\n\nTorgerson, TR\n\nBeiträge in Fachzeitschriften\nISI:000523701100001\n32153572.0\n10.3389/fimmu.2020.00239\nPMC7046837\nPrimary Immune Regulatory Disorders (PIRD) are an expanding group of diseases caused by gene defects in several different immune pathways, such as regulatory T cell function. Patients with PIRD develop clinical manifestations associated with diminished and exaggerated immune responses. Management of these patients is complicated; oftentimes immunosuppressive therapies are insufficient, and patients may require hematopoietic cell transplant (HCT) for treatment. Analysis of HCT data in PIRD patients have previously focused on a single gene defect. This study surveyed transplanted patients with a phenotypic clinical picture consistent with PIRD treated in 33 Primary Immune Deficiency Treatment Consortium centers and European centers. Our data showed that PIRD patients often had immunodeficient and autoimmune features affecting multiple organ systems. Transplantation resulted in resolution of disease manifestations in more than half of the patients with an overall 5-years survival of 67%. This study, the first to encompass disorders across the PIRD spectrum, highlights the need for further research in PIRD management.\n Copyright © 2020 Chan, Leiding, Liu, Logan, Burroughs, Allenspach, Skoda-Smith, Uzel, Notarangelo, Slatter, Gennery, Smith, Pai, Jordan, Marsh, Cowan, Dvorak, Craddock, Prockop, Chandrakasan, Kapoor, Buckley, Parikh, Chellapandian, Oshrine, Bednarski, Cooper, Shenoy, Davila Saldana, Forbes, Martinez, Haddad, Shyr, Chen, Sullivan, Heimall, Wright, Bhatia, Cuvelier, Goldman, Meyts, Miller, Seidel, Vander Lugt, Bacchetta, Weinacht, Andolina, Caywood, Chong, de la Morena, Aquino, Shereck, Walter, Dorsey, Seroogy, Griffith, Kohn, Puck, Pulsipher and Torgerson.\n\nSeidel, Markus\n\n\n"
},
{
"text": "\n105\nA tungsten supplemented diet attenuates bacterial translocation in chronic portal hypertensive and cholestatic rats: role of xanthine dehydrogenase and xanthine oxidase.\n\nSchimpl, G\n\nPabst, MA\n\nFeierl, G\n\nKuesz, A\n\nOzbey, H\n\nTakahashi, S\n\nHöllwarth, ME\n\nBeiträge in Fachzeitschriften\nISI:000083947700022\n10562591.0\n10.1136/gut.45.6.904\nPMC1727743\nBACKGROUND: Bacterial translocation (BT) plays a major role in the pathophysiological process of spontaneous infections in portal hypertension (PH) and cholestatic jaundice. The major mechanisms promoting BT in experimental animal models are the disruption of the intestinal ecological equilibrium and disruption of the intestinal mucosal barrier. The enzymes xanthine dehydrogenase (XD) and xanthine oxidase (XO) are often implicated as a significant source of oxidants which have a major impact on the impairment of intestinal barrier function. AIM: To investigate the incidence of BT in rats with PH and obstructive jaundice, and to evaluate the impact of XD and XO. METHODS: Animals were subjected to sham laparotomy (SL), PH by calibrated stenosis of the portal vein, and common bile duct ligation (CBDL). They were fed either a standard pellet diet or a tungsten supplemented molybdenum-free diet. Four weeks after the operative procedure, intestinal colonisation and BT to portal vein, vena cava, mesenteric lymph nodes, liver, and spleen were determined. Intestinal XD and XO activity were measured enzymatically and histochemically. RESULTS: Significant (p<0.01) intestinal bacterial overgrowth was present in all PH and CBDL groups compared with the SL group. In normally fed animals after SL, BT occurred in 12%. In PH and after CBDL, the rate of BT increased significantly (p<0.05) to 28% and 54% respectively. In the jejunum of normally fed animals subjected to PH or CBDL, a significant increase in XO was observed (p<0.01). Animals fed a tungsten supplemented diet showed a significant attenuation of BT to 14% in PH and 22% after CBDL (p<0. 05). Tungsten treatment completely suppressed jejunal XD and XO activities. CONCLUSIONS: Significant intestinal bacterial overgrowth, BT, and XD to XO conversion occurred in PH and after CBDL. XD and XO inactivation by a tungsten supplemented molybdenum-free diet significantly reduced the incidence of BT without affecting intestinal bacterial overgrowth. These data strongly support the hypothesis that increased XD to XO conversion may contribute to intestinal barrier failure in PH and after CBDL.\n\nFeierl, Gebhard\n\nHöllwarth, Michael\n\nPabst, Maria-Anna\n\n\n"
},
{
"text": "\n1195\nHigh-level expression of various apolipoprotein(a) isoforms by transferrinfection: the role of kringle IV sequences in the extracellular association with low-density lipoprotein.\n\nFrank, S\n\nKrasznai, K\n\nDurovic, S\n\nLobentanz, EM\n\nDieplinger, H\n\nWagner, E\n\nZatloukal, K\n\nCotten, M\n\nUtermann, G\n\nKostner, GM\n\nBeiträge in Fachzeitschriften\nISI:A1994PL35800041\n7918455.0\n10.1021/bi00206a041\nNone\nCharacterization of the assembly of lipoprotein(a) [Lp(a)] is of fundamental importance to understanding the biosynthesis and metabolism of this atherogenic lipoprotein. Since no established cell lines exist that express Lp(a) or apolipoprotein(a) [apo(a)], a "transferrinfection" system for apo(a) was developed utilizing adenovirus receptor- and transferrin receptor-mediated DNA uptake into cells. Using this method, different apo(a) cDNA constructions of variable length, due to the presence of 3, 5, 7, 9, 15, or 18 internal kringle IV sequences, were expressed in cos-7 cells or CHO cells. All constructions contained kringle IV-36, which includes the only unpaired cysteine residue (Cys-4057) in apo(a). r-Apo(a) was synthesized as a precursor and secreted as mature apolipoprotein into the medium. When medium containing r-apo(a) with 9, 15, or 18 kringle IV repeats was mixed with normal human plasma LDL, stable complexes formed that had a bouyant density typical of Lp(a). Association was substantially decreased if Cys-4057 on r-apo(a) was replaced by Arg by site-directed mutagenesis or if Cys-4057 was chemically modified. Lack of association was also observed with r-apo(a) containing only 3, 5, or 7 kringle IV repeats without "unique kringle IV sequences", although Cys-4057 was present in all of these constructions. Synthesis and secretion of r-apo(a) was not dependent on its sialic acid content. r-Apo(a) was expressed even more efficiently in sialylation-defective CHO cells than in wild-type CHO cells. In transfected CHO cells defective in the addition of N-acetylglucosamine, apo(a) secretion was found to be decreased by 50%. Extracellular association with LDL was not affected by the carbohydrate moiety of r-apo(a), indicating a protein-protein interaction between r-apo(a) and apoB. These results show that, besides kringle IV-36, other kringle IV sequences are necessary for the extracellular association of r-apo(a) with LDL. Changes in the carbohydrate moiety of apo(a), however, do not affect complex formation.\n\nFrank, Sasa\n\nKostner, Gerhard\n\nZatloukal, Kurt\n\n\n"
},
{
"text": "\n3934\nBone loss in patients with untreated chronic obstructive pulmonary disease is mediated by an increase in bone resorption associated with hypercapnia.\n\nDimai, HP\n\nDomej, W\n\nLeb, G\n\nLau, KH\n\nBeiträge in Fachzeitschriften\nISI:000171695800023\n11697811.0\n10.1359/jbmr.2001.16.11.2132\nNone\nThis study sought to determine whether the bone loss in untreated chronic obstructive pulmonary disease (COPD) is associated with hypercapnia and/or respiratory acidosis. Bone mineral density (BMD) measured at the distal forearm of the nondominant arm (with peripheral quantitative computed tomography [pQCT]) and serum markers of bone turnover were determined in 71 male patients with untreated COPD and 40 healthy male subjects who matched the patients in age, weight, and body mass index (BMI). The COPD patients, compared with controls, had reduced pulmonary functions, lower arterial pH, and elevated arterial partial pressure of CO2 (PCO2) The BMD (in T score) was significantly lower in COPD patients than that in control subjects (-1.628 +/- 0.168 vs. -0.058 +/- 0.157; p < 0.001). The BMD of COPD patients correlated positively with arterial pH (r = 0.582; p < 0.001), negatively with PCO2 (r = -0.442; p < 0.001), and negatively with serum cross-linked telopeptide of type I collagen (ICTP), a bone resorption marker (r = -0.444; p < 0.001) but not with serum osteocalcin, a bone formation marker. Serum ICTP, but not osteocalcin, correlated with PCO2 (r = 0.593; p < 0.001) and arterial pH (r = -0.415; p < 0.001). To assess the role of hypercapnia, COPD patients were divided into the hypercapnic (PCO2 > 45 mm Hg; n = 35) and eucapnic (PCO2 = 35-45 mm Hg) group (n = 36). Patients with hypercapnia had lower BMD, lower arterial pH, and higher serum ICTP than did patients with eucapnia. Arterial pH and serum ICTP of eucapnic patients were not different from those of controls. To evaluate the role of uncompensated respiratory acidosis, COPD patients with hypercapnia were subdivided into those with compensatory respiratory acidosis (pH > or = 7.35; n = 20) and those with uncompensated respiratory acidosis (pH < 7.35; n = 15). The BMD and serum ICTP were not different among the two subgroups. In conclusion, this study presents the first associative evidence that the bone loss in COPD is at least in part attributed to an increased bone resorption that is associated primarily with hypercapnia rather than uncompensated respiratory acidosis.\n\nDimai, Hans\n\nDomej, Wolfgang\n\n\n"
},
{
"text": "\n5146\nReconstructed mass-spectrometric pattern for characterization of carbon compounds in smoker's lung in situ.\n\nFöldes-Papp, Z\n\nDomej, W\n\nWippel, R\n\nSchlagenhaufen, C\n\nIrgolic, KJ\n\nDemel, U\n\nDimai, HP\n\nTilz, GP\n\nBeiträge in Fachzeitschriften\nISI:000186730800002\n14690022.0\n10.1065/espr2003.08.171\nNone\nBACKGROUND: Cigarette smoke is a major anthropogenic pollutant and contributes to the permanent load of ambient particulate matter in the air, particularly indoors. It is the leading risk factor for premature loss of life due to chronic bronchitis, emphysema and lung cancer. Smoker's lung and graphite pneumoconiosis are pathological states characterized by the deposition of carbonaceous particles. METHODS: Mass spectrometry was used to evaluate unstained lung sections obtained in vivo from a heavy smoker and a patient with occupationally acquired graphite pneumoconiosis. RESULTS AND DISCUSSION: The composition of carbon compounds deposited in lung tissue samples is demonstrated here for the first time. Thirty carbonaceous-containing microareas from ten biopsies (three areas per biopsy) of lung tissues were analyzed mass-spectrometrically. In each case, the samples were taken from a smoker's lung or those demonstrating a graphite pneumoconiosis. The lung-tissue samples were selected by light microscopy before they were evaporated for mass spectrometry. First-order criteria were anionic and cationic mass peaks which occur within the mass patterns in lung tissues of smoker's lung, although not in graphite pneumoconiosis. Second-order criteria were mass peaks from smoker's lung with standard deviations SD < or = 14% of the mean value. First and second-order mass peaks matched the mass peaks of experimental cigarette-smoke condensate in 9 out of 11 peaks. A software program was developed that enabled fast, automated recognition of the typical mass peaks, and thereby confirmed the histological diagnosis of smoker's lung. CONCLUSIONS: The analysis of carbonaceous particles within lung biopsies from a heavy smoker corresponded to the spectra of tobacco condensate and not to the investigated biopsies of graphite peneumoconiosis. RECOMMENDATION AND OUTLOOK: The analyses were performed in order to find out whether mass-spectrometric criteria exist for the differentiation of carbonaceous lung-tissue deposits. Mass spectrometry may be a valuable tool in determining the composition of carbon compounds deposited in human lung tissue. So far, qualitative assessment of the composition of deposits in lung tissue is only possible after the patient is deceased (autopsy).\n\nDemel, Ulrike\n\nDimai, Hans\n\nDomej, Wolfgang\n\nTilz, Gernot\n\n\n"
}
]
}