HTTP 200 OK
Allow: GET, HEAD, OPTIONS
Content-Type: application/json
Vary: Accept
{
"count": 127182,
"next": "https://api-test.medunigraz.at/v1/research/search/publication/?format=api&limit=20&offset=125800",
"previous": "https://api-test.medunigraz.at/v1/research/search/publication/?format=api&limit=20&offset=125760",
"results": [
{
"text": "\n184486\nInteraction of the Joining Region in Junctophilin-2 With the L-Type Ca<sup>2+</sup> Channel Is Pivotal for Cardiac Dyad Assembly and Intracellular Ca<sup>2+</sup> Dynamics.\n\nGross, P\n\nJohnson, J\n\nRomero, CM\n\nEaton, DM\n\nPoulet, C\n\nSanchez-Alonso, J\n\nLucarelli, C\n\nRoss, J\n\nGibb, AA\n\nGarbincius, JF\n\nLambert, J\n\nVarol, E\n\nYang, Y\n\nWallner, M\n\nFeldsott, EA\n\nKubo, H\n\nBerretta, RM\n\nYu, D\n\nRizzo, V\n\nElrod, J\n\nSabri, A\n\nGorelik, J\n\nChen, X\n\nHouser, SR\n\nBeiträge in Fachzeitschriften\nISI:000639316500013\n33092464.0\n10.1161/CIRCRESAHA.119.315715\nPMC7790862\nCa2+-induced Ca2+ release (CICR) in normal hearts requires close approximation of L-type calcium channels (LTCCs) within the transverse tubules (T-tubules) and RyR (ryanodine receptors) within the junctional sarcoplasmic reticulum. CICR is disrupted in cardiac hypertrophy and heart failure, which is associated with loss of T-tubules and disruption of cardiac dyads. In these conditions, LTCCs are redistributed from the T-tubules to disrupt CICR. The molecular mechanism responsible for LTCCs recruitment to and from the T-tubules is not well known. JPH (junctophilin) 2 enables close association between T-tubules and the junctional sarcoplasmic reticulum to ensure efficient CICR. JPH2 has a so-called joining region that is located near domains that interact with T-tubular plasma membrane, where LTCCs are housed. The idea that this joining region directly interacts with LTCCs and contributes to LTCC recruitment to T-tubules is unknown.\n To determine if the joining region in JPH2 recruits LTCCs to T-tubules through direct molecular interaction in cardiomyocytes to enable efficient CICR.\n Modified abundance of JPH2 and redistribution of LTCC were studied in left ventricular hypertrophy in vivo and in cultured adult feline and rat ventricular myocytes. Protein-protein interaction studies showed that the joining region in JPH2 interacts with LTCC-α1C subunit and causes LTCCs distribution to the dyads, where they colocalize with RyRs. A JPH2 with induced mutations in the joining region (mutPG1JPH2) caused T-tubule remodeling and dyad loss, showing that an interaction between LTCC and JPH2 is crucial for T-tubule stabilization. mutPG1JPH2 caused asynchronous Ca2+-release with impaired excitation-contraction coupling after β-adrenergic stimulation. The disturbed Ca2+ regulation in mutPG1JPH2 overexpressing myocytes caused calcium/calmodulin-dependent kinase II activation and altered myocyte bioenergetics.\n The interaction between LTCC and the joining region in JPH2 facilitates dyad assembly and maintains normal CICR in cardiomyocytes.\n\nWallner, Markus\n\n\n"
},
{
"text": "\n4498\nInterventional occlusion of foramen ovale and atrial septal defects after paradoxical embolism incidents\n\nBeitzke, A\n\nSchuchlenz, H\n\nBeitzke, M\n\nGamillscheg, A\n\nStein, HI\n\nZartner, P\n\nBeiträge in Fachzeitschriften\nISI:000178661300004\n12448068.0\n10.1007/s00392-002-0835-x\nNone\nTwo hundred and fifty-one patients with a persistent foramen ovale (PFO), mean age 43.3 +/- 12.4 years, underwent catheter closure between 6/1995 and 6/2001. One hundred and forty-one had an ischemic stroke, 99 a transient ischemic attack (TIA) or prolonged reversible ischemic neurologic deficit, 5 peripheral arterial embolism, 4 suffered from decompression sickness after diving and 2 had transient global amnesia. Fifty-nine of them had multiple events in spite of antiplatelet or anticoagulant therapy. The patients received five different devices: 13 Rashkind Occluders, 20 Amplatzer septal Occluders, 109 Amplatzer PFO-Occluders, 73 CardioSEAL and 36 STAR-Flex devices. Time of fluoroscopy was 8.3 +/- 4.5 min. In three patients a device embolized and had to be removed from the groin vessels. We saw five inguinal or retroperitoneal venous hematomas with the need for operation in one patient. One early and one late perforation of the left atrium caused by a guide wire and a left-atrial disc, respectively, also needed surgery. Fourteen patients had documented late arrhythmias. Six patients with atrial fibrillation needed drugs or cardioversion while the other patients with runs of supraventricular tachycardia, atrial flutter and multiple extrasystoles needed no therapy. On transesophageal echocardiography (TEE) 6 months after implantation we found four significant residual leaks. These patients had the defect closed with a second device. In addition a secundum atrial septal defect (ASD) was closed in 17 patients (mean age 38 +/- 10.5 years) with Amplatzer septal Occluders (12) and CardioSEAL devices (5). These patients had experienced eight strokes and nine TIAs, 3 of them had had multiple events. Two of these patients had a significant residual defect and one had atrial flutter following the procedure. Two hundred and two PFO-patients and 12 ASD patients were followed for 6-62 (24.6 +/- 14.2) months; 2 died due to a traffic accident and a myocardial infarction, respectively. Four patients had another neurologic event following PFO-closure. We now overlook 210 patients with 348.6 symptom-free patient years and have a 1-year recurrence rate of neurologic events of 1.9%. Catheter closure of the PFO and atrial septal defect is a simple, effective and quick method which ensures a high closure rate, avoids life-long anticoagulation and has a low recurrence rate of neurologic events.\n\nGamillscheg, Andreas\n\n\n"
},
{
"text": "\n29982\nStrontium ranelate: a novel concept for the treatment of osteoporosis\n\nDimai, HP\n\nBeiträge in Fachzeitschriften\nISI:000233983200002\n16416353.0\n10.1007/s00508-005-0471-3\nNone\nThe di-strontium salt strontium ranelate, a novel orally active agent consisting of two atoms of stable strontium and the organic moiety ranelic acid, has been developed for the treatment of osteoporosis. It has been shown to enhance osteoblastic cell replication and increase collagen synthesis while decreasing pre-osteoclast differentiation and bone-resorbing activity of mature osteoclasts in vitro. Studies performed in healthy animals have shown that strontium ranelate not only increases bone mass at various skeletal sites but also improves mechanical properties of femoral, humeral and vertebral bones. In estrogen-deficient animals, strontium ranelate effectively inhibits increased bone resorption while maintaining bone formation. Similar results have been obtained from studies in hind limb-immobilized animals. Strontium ranelate has been investigated in a large phase III program which includes two extensive multinational, randomized, double-blind, placebo-controlled clinical trials for the treatment of severe postmenopausal osteoporosis. Before inclusion in these two studies, patients were subjected to a run-in study in order to initiate normalization of their calcium and vitamin D status. The SOTI study, aimed at assessing strontium ranelate's effect on the risk of vertebral fractures, revealed a significant reduction in the risk of new vertebral fractures in the group treated with strontium ranelate. The TROPOS study, which aimed at evaluating the effect of strontium ranelate on nonvertebral fractures, showed a significant reduction in the risk of new nonvertebral fractures and also, in a high-risk subgroup, a significant reduction in the risk of hip fractures. In both studies, the reduction in fracture risk was accompanied by an increase in bone mineral density. The increase remained significant also after correction of the bone mineral density for the higher atomic mass of strontium compared to calcium. Furthermore, an increase in serum levels of a bone formation marker and a decrease in serum levels of a bone resorption marker were observed. The spectrum of side effects comprised mild diarrhea, particularly within the first weeks of treatment, and also a slightly increased risk of venous thromboembolic events. Strontium ranelate thus appears to be a new, effective treatment to prevent fractures in postmenopausal osteoporosis with a novel mechanism of action. It can be expected for the near future that strontium ranelate will also be evaluated for other types of osteoporosis, such as male osteoporosis.\n\nDimai, Hans\n\n\n"
},
{
"text": "\n90860\nNitric oxide activates ATP-sensitive potassium channels in mammalian sensory neurons: action by direct S-nitrosylation.\n\nKawano, T\n\nZoga, V\n\nKimura, M\n\nLiang, MY\n\nWu, HE\n\nGemes, G\n\nMcCallum, JB\n\nKwok, WM\n\nHogan, QH\n\nSarantopoulos, CD\n\nBeiträge in Fachzeitschriften\nISI:000266323200001\n19284878.0\n10.1186/1744-8069-5-12\nPMC2673211\nBackground: ATP-sensitive potassium (K-ATP) channels in neurons regulate excitability, neurotransmitter release and mediate protection from cell-death. Furthermore, activation of K-ATP channels is suppressed in DRG neurons after painful-like nerve injury. NO-dependent mechanisms modulate both K-ATP channels and participate in the pathophysiology and pharmacology of neuropathic pain. Therefore, we investigated NO modulation of K-ATP channels in control and axotomized DRG neurons. Results: Cell-attached and cell-free recordings of K-ATP currents in large DRG neurons from control rats (sham surgery, SS) revealed activation of K-ATP channels by NO exogenously released by the NO donor SNAP, through decreased sensitivity to [ATP]i. This NO-induced K-ATP channel activation was not altered in ganglia from animals that demonstrated sustained hyperalgesia-type response to nociceptive stimulation following spinal nerve ligation. However, baseline opening of K-ATP channels and their activation induced by metabolic inhibition was suppressed by axotomy. Failure to block the NO-mediated amplification of K-ATP currents with specific inhibitors of sGC and PKG indicated that the classical sGC/cGMP/PKG signaling pathway was not involved in the activation by SNAP. NO-induced activation of K-ATP channels remained intact in cell-free patches, was reversed by DTT, a thiol-reducing agent, and prevented by NEM, a thiol-alkylating agent. Other findings indicated that the mechanisms by which NO activates K-ATP channels involve direct S-nitrosylation of cysteine residues in the SUR1 subunit. Specifically, current through recombinant wild-type SUR1/Kir6.2 channels expressed in COS7 cells was activated by NO, but channels formed only from truncated isoform Kir6.2 subunits without SUR1 subunits were insensitive to NO. Further, mutagenesis of SUR1 indicated that NO-induced K-ATP channel activation involves interaction of NO with residues in the NBD1 of the SUR1 subunit. Conclusion: NO activates K-ATP channels in large DRG neurons via direct S-nitrosylation of cysteine residues in the SUR1 subunit. The capacity of NO to activate K-ATP channels via this mechanism remains intact even after spinal nerve ligation, thus providing opportunities for selective pharmacological enhancement of K-ATP current even after decrease of this current by painful-like nerve injury.\n\n\n"
},
{
"text": "\n130031\nPermanent lesion of the lateral femoral cutaneous nerve after low-volume ethanol 96%application on the lumbar sympathetic chain.\n\nPennekamp, W\n\nKrumova, EK\n\nFeigl, GP\n\nFrombach, E\n\nNicolas, V\n\nSchwarzer, A\n\nMaier, C\n\nBeiträge in Fachzeitschriften\nISI:000324037000027\n23877455.0\nNone\nNone\nLumbar sympathetic blocks and chemical sympathectomies are used for the pain treatment of peripheral arterial occlusive disease or sympathetically maintained pain syndrome after nerve injury or complex regional pain syndrome (CRPS). A 30-year-old patient was referred to the pain department with all the clinical signs and symptoms of a CRPS of the right foot one and a half years after being surgically treated for rupture of the achilles tendon. An inpatient admission was necessary due to insufficient pain reduction upon the current treatment, strong allodynia in the medial distal right lower leg and decreased load-bearing capacity of the right foot. A computed tomography (CT)-guided lumbar sympathetic block at the right L3 (Bupivacaine 0.5%, 4 mL) led to a skin temperature increase from 21° C before block to > 34° C for about 5 hours after the intervention. The patient experienced significant pain relief, indicating sympathetically maintained pain. Thus, we performed a CT-guided lumbar sympathetic neurolysis at the same level (ethanol 96%, 2 mL) 5 days later, achieving again a significant skin temperature increase of the right foot and a slight reduction of his pain intensity from numeric rating scale (NRS) 7 prior to the intervention to NRS 4 after 8 hours (NRS, 0 = no pain, 10 = strongest pain imaginable). Eight months later a repeated inpatient admission was necessary due to considerable pain relapse and decreased load-bearing capacity of his right foot. A CT-guided lumbar sympathetic neurolysis was repeated at the L4 level on the right side and was successful, inducing a significant skin temperature increase. Despite a temporary irritation of the genitofemoral nerve 8 hours after the intervention, a delayed irritation of the lateral femoral cutaneous nerve occurred. This was a long-lasting lesion of the lateral femoral cutaneous nerve following a CT-guided chemical sympathectomy with a low-volume ethanol 96% application - a complication which has not been described in literature until now. This is probably caused by broad dissemination of the neurolytic agent along the psoas muscle despite a correct needle position and spread of contrast agent. The development of this nerve injury even after injection of a small volume of ethanol (2 mL) may be delayed.\n\n\n"
},
{
"text": "\n133367\nSubareolar subcutaneous injection of blue dye versus peritumoral injection of technetium-labeled human albumin to identify sentinel lymph nodes in breast cancer patients.\n\nReitsamer, R\n\nPeintinger, F\n\nRettenbacher, L\n\nProkop, E\n\nSedlmayer, F\n\nBeiträge in Fachzeitschriften\nISI:000187173600003\n14574485.0\n10.1007/s00268-003-7001-0\nNone\nLymphatic mapping in breast cancer patients is a widely used technique for axillary staging, though the optimal technique is not yet established. The purpose of this study was to show that subareolar and subcutaneous injection of blue dye drains to the same sentinel lymph node (SLN) in the axillary basin as does peritumoral injection of technetium (Tc)-labeled albumin. Two injection methods were compared in 154 consecutive patients with newly diagnosed pT1 or pT2 breast cancers (tumor size 5-45 mm). The diagnosis of invasive breast cancer was confirmed by core needle biopsy. Peritumoral injection of 40 to 60 MBq 99Tc-labeled colloidal albumin was performed 18 to 20 hours prior to surgery. In addition, 2 ml of blue dye was injected subcutaneously into the subareolar plexus of the same patients exactly 5 minutes prior to incision and dissection of the SLNs. The blue and hot SLNs were identified by searching for the blue lymphatic vessel and the blue lymph node and by counting the radioactivity with a gamma probe. The correlation between the blue nodes and the hot nodes was examined. Altogether, 154 patients were enrolled in the study. Three patients had bilateral breast cancer, and a total of 157 sentinel lymph node biopsies (SLNBs) were performed. The SLNs could be identified in 155 of the 157 SLNBs (98.7%), and the hot node clearly corresponded to the blue node in 151 of the 155 SLNBs (97.4%). Neither a hot node nor a blue node could be identified in 2 of the 157 SLNBs (1.3%). No concordance between the blue node and the hot node could be achieved in 4 of the 155 SLNBs (2.6%). Injection of blue dye into the subareolar lymphatic plexus shows excellent correlation with peritumoral injection of technetium-labeled albumin concerning the identification of SLNs. Our results support the hypothesis that the lymphatic drainage of the breast parenchyma and the subareolar plexus leads to the same sentinel lymph node. It is a rapid, reliable method for identifying SLNs in breast cancer patients. It is easy to perform, especially in nonpalpable tumors, and it does not disturb surgery by discoloring peritumoral tissue.\n\nPeintinger, Florentia\n\n\n"
},
{
"text": "\n151676\nHow often are interventions in cluster-randomised controlled trials of complex interventions in general practices effective and reasons for potential shortcomings? Protocol and results of a feasibility project for a systematic review.\n\nSiebenhofer, A\n\nErckenbrecht, S\n\nPregartner, G\n\nBerghold, A\n\nMuth, C\n\nBeiträge in Fachzeitschriften\nNone\n26892789.0\n10.1136/bmjopen-2015-009414\nPMC4762123\nMost studies conducted at general practices investigate complex interventions and increasingly use cluster-randomised controlled trail (c-RCT) designs to do so. Our primary objective is to evaluate how frequently complex interventions are shown to be more, equally or less effective than routine care in c-RCTs with a superior design. The secondary aim is to discover whether the quality of a c-RCT determines the likelihood of the complex intervention being effective.\n All c-RCTs of any design that have a patient-relevant primary outcome and with a duration of at least 1 year will be included. The search will be performed in three electronic databases (MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews (CDSR)). The screening process, data collection, quality assessment and statistical data analyses (if suitably similar and of adequate quality) will be performed in accordance with requirements of the Cochrane Handbook for Systematic Reviews of Interventions. A feasibility project was carried out that was restricted to a search in MEDLINE and the CCTR for c-RCTs published in 1 of the 8 journals that are most relevant to general practice. The process from trial selection to data collection, assessment and results presentation was piloted. Of the 512 abstracts identified during the feasibility search, 21 studies examined complex interventions in a general practice setting. Extrapolating the preliminary search to include all relevant c-RCTs in three databases, about 5000 abstracts and 150 primary studies are expected to be identified in the main study. 14 studies included in the feasibility project (67%) did not show a positive effect on a primary patient-relevant end point.\n Ethical approval is not being sought for this review. Findings will be disseminated via peer-reviewed journals that frequently publish articles on the results of c-RCTs and through presentations at international conferences.\n PROSPERO CRD201400923.\n Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/\n\nBerghold, Andrea\n\nPregartner, Gudrun\n\nSiebenhofer-Kroitzsch, Andrea\n\n\n"
},
{
"text": "\n155889\nIndications for liver transplantation in patients with amyloidosis: a single-center experience with 11 cases.\n\nSinger, R\n\nMehrabi, A\n\nSchemmer, P\n\nKashfi, A\n\nHegenbart, U\n\nGoldschmidt, H\n\nSchönland, S\n\nKristen, A\n\nDengler, T\n\nMüller-Schilling, M\n\nSauer, P\n\nDogan, A\n\nHund, E\n\nHelmke, B\n\nSchnabel, P\n\nAltland, K\n\nLinke, R\n\nFriess, H\n\nSchmidt, J\n\nBüchler, MW\n\nKraus, TW\n\nBeiträge in Fachzeitschriften\nISI:000233015900015\n16286896.0\n10.1097/01.tp.0000186910.09213.bf\nNone\nFamilial amyloidotic polyneuropathy (FAP) is an inherited disorder with the systemic deposition of amyloid fibrils containing mutant transthyretin variants. The mutant form of transthyretin amyloidosis is produced mainly in the liver. Successful liver transplantation (LTx) could eliminate the source of the variant transthyretin molecule, and is now the only known curative treatment. The aim of this study is to evaluate the results of LTx for FAP at the University of Heidelberg. Eleven patients who underwent LTx between 1985 and 2004 with the diagnosis of FAP were evaluated. Of 11 patients, seven (64%) were male and four (36%) were female. The mean age was 49.5 years (range 27-70). Met 30 (n=5) was the most common type of amyloidosis followed by Arg 50 (n=3), Val 107 (n=2), and Phe 33 (n=1). All of the patients were selected for LTx and Domino LTx was performed in six patients. The majority (80%) of the patients with type Met 30 amyloidosis are alive, whereas in other types of amyloidosis only 33% are living. This finding emphasizes better prognosis of Met 30 variant of FAP in comparison to other variants such as Arg 50, Val 107, and Phe 33. After LTx, improvement of clinical symptoms (completely or partially) was observed in six patients (55%). In conclusion, LTx is considered as the only therapeutic alternative in patients with amyloidosis accompanied by hepatic synthesis of the amyloid protein. The most important risk factors for LTx can be predicted by assessing the nutritional condition of the patient, the duration of the disease, and the amyloid variant. Therefore, precise diagnostic measures are required before listing a patient for LTx. Domino LTx is an acceptable form of LTx that can preserve the pool of organ donors. In order to stop the progression of FAP, LTx would be justified in a subgroup of patients with amyloidosis. Based on our results, we support the idea that the effectiveness of extended preoperative period before LTx or the transplantation of other transthyretin variants other than Met 30 is questionable.\n\nSchemmer, Peter\n\n\n"
},
{
"text": "\n161275\nInflammatory bowel disease in pediatric patients: Characteristics of newly diagnosed patients from the CEDATA-GPGE Registry.\n\nBuderus, S\n\nScholz, D\n\nBehrens, R\n\nClassen, M\n\nDe Laffolie, J\n\nKeller, KM\n\nZimmer, KP\n\nKoletzko, S\n\nCEDATA-GPGE Study Group\n\nBeiträge in Fachzeitschriften\nISI:000351348200001\n25759978.0\n10.3238/arztebl.2015.0121\nPMC4361801\nInflammatory bowel disease (IBD) can arise at any age, with peak incidence in adolescence and young adulthood. A registry of pediatric cases of IBD offers the opportunity to document their diagnosis and treatment, with the ultimate aim of improving diagnosis and treatment in the future.\n In the German-language CEDATA-GPGE registry, 3991 cases of IBD in patients less than 18 years of age were documented from 2004 to 2014. The 1257 patients who were prospectively included in the registry upon diagnosis and whose further course was documented for at least three months were analyzed in two separate groups--under 10 years old, and 10 years and above--with respect to the type and duration of their symptoms until diagnosis, the completeness of the diagnostic evaluation, the disease phenotype, and the initial treatment.\n Of the 958 patients for whom full documentation was available, 616 (64.3%) had Crohn's disease (CD), 278 (29%) had ulcerative colitis (UC), 64 (6.7%) had an unclassified IBD, and 23.2% were under 10 years old. The latency to diagnosis was longer for CD than for UC (0.5 versus 0.3 years), regardless of age. 62.5% of the CD patients had ileocolonic involvement, and more than half had involvement of the upper gastrointestinal tract. 71% of the patients with UC had subtotal colitis or pancolitis. Continuous improvement was seen in diagnostic assessment according to published guidelines. For example, in 2004/2005, 69% of patients were evaluated endoscopically with ileocolonoscopy and esophagogastroduodenoscopy; this fraction had risen to nearly 100% by 2013/2014. Similarly, the percentage of patients who underwent a diagnostic evaluation of the small intestine, as recommended, rose from 41.2% to 60.9% over the same period. The most common initial treatments were 5- amino - salicylates (86.8% CD, 100% UC) and glucocorticoids (60.6% CD, 65.6% UC). 32% of the patients with CD received exclusive enteral nutrition therapy.\n Most of these pediatric patients with IBD, whether in the younger or the older age group, had extensive bowel involvement at the time of diagnosis. The registry data imply that improvement in clinical course may be achieved by shortening the time to diagnosis and by closer adherence to the diagnostic and therapeutic guidelines.\n\nHauer, Almuthe\n\n\n"
},
{
"text": "\n166330\nConventional Primary Central Chondrosarcoma of the Pelvis: Prognostic Factors and Outcome of Surgical Treatment in 162 Patients.\n\nBus, MPA\n\nCampanacci, DA\n\nAlbergo, JI\n\nLeithner, A\n\nvan de Sande, MAJ\n\nGaston, CL\n\nCaff, G\n\nMettelsiefen, J\n\nCapanna, R\n\nTunn, PU\n\nJeys, LM\n\nDijkstra, PDS\n\nBeiträge in Fachzeitschriften\nISI:000428144000013\n29462035.0\n10.2106/JBJS.17.00105\nNone\nStudies focusing on the oncological outcome after treatment of conventional primary central chondrosarcoma of pelvic bone are lacking. We conducted this retrospective study at 5 referral centers to gain insight in the outcome of treatment for this tumor type and to identify risk factors for impaired oncological outcome.\n One hundred and sixty-two consecutive patients (118 male patients [73%]) who underwent resection of a conventional primary central chondrosarcoma of pelvic bone from 1985 to 2013 were evaluated. The median age was 51 years (range, 15 to 78 years). The median follow-up was 12.6 years (95% confidence interval [CI], 8.4 to 16.9 years). There were 30 grade-I lesions (19%), 93 grade-II lesions (57%), and 39 grade-III lesions (24%).\n Sixty-two patients (38%) experienced local recurrence: 9 grade-I lesions (30%), 31 grade-II lesions (33%), and 22 grade-III lesions (56%). Forty-eight patients (30%) developed metastases. The risk of disease-related death was 3% for grade-I tumors (1 of 30; this patient had a grade-II recurrence and died of metastases), 33% (31 of 93) for grade-II tumors, and 54% (21 of 39) for grade-III tumors. Identified risk factors for impaired disease-specific survival were tumor grade (grade II: hazard ratio [HR], 20.18; p = 0.003; and grade III: HR, 58.94; p < 0.001), resection margins (marginal: HR, 3.21; p = 0.001; and intralesional: HR, 3.56; p < 0.001), and maximal tumor size (HR, 1.08 per cm; p = 0.026). Deep infection (19% [n = 31]) was the predominant complication.\n This study offers a standard for survival rates for conventional primary central chondrosarcoma of the pelvis. The survival for grade-I tumors was excellent. Wide resection margins were associated with a significant survival advantage for higher-grade tumors. Because of the inability to reliably distinguish low-grade and high-grade tumors preoperatively, we conclude that any central pelvic chondrosarcoma should be treated with aggressive primary resection with the aim of obtaining wide resection margins. There may be aggressive biologic features in some tumors for which a surgical procedure alone may not be adequate to improve outcomes.\n Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.\n\nLeithner, Andreas\n\n\n"
},
{
"text": "\n175587\nBig Data Approaches to Phenotyping Acute Ischemic Stroke Using Automated Lesion Segmentation of Multi-Center Magnetic Resonance Imaging Data.\n\nWu, O\n\nWinzeck, S\n\nGiese, AK\n\nHancock, BL\n\nEtherton, MR\n\nBouts, MJRJ\n\nDonahue, K\n\nSchirmer, MD\n\nIrie, RE\n\nMocking, SJT\n\nMcIntosh, EC\n\nBezerra, R\n\nKamnitsas, K\n\nFrid, P\n\nWasselius, J\n\nCole, JW\n\nXu, H\n\nHolmegaard, L\n\nJiménez-Conde, J\n\nLemmens, R\n\nLorentzen, E\n\nMcArdle, PF\n\nMeschia, JF\n\nRoquer, J\n\nRundek, T\n\nSacco, RL\n\nSchmidt, R\n\nSharma, P\n\nSlowik, A\n\nStanne, TM\n\nThijs, V\n\nVagal, A\n\nWoo, D\n\nBevan, S\n\nKittner, SJ\n\nMitchell, BD\n\nRosand, J\n\nWorrall, BB\n\nJern, C\n\nLindgren, AG\n\nMaguire, J\n\nRost, NS\n\nBeiträge in Fachzeitschriften\nISI:000477012300033\n31177973.0\n10.1161/STROKEAHA.119.025373\nPMC6728139\nBackground and Purpose- We evaluated deep learning algorithms' segmentation of acute ischemic lesions on heterogeneous multi-center clinical diffusion-weighted magnetic resonance imaging (MRI) data sets and explored the potential role of this tool for phenotyping acute ischemic stroke. Methods- Ischemic stroke data sets from the MRI-GENIE (MRI-Genetics Interface Exploration) repository consisting of 12 international genetic research centers were retrospectively analyzed using an automated deep learning segmentation algorithm consisting of an ensemble of 3-dimensional convolutional neural networks. Three ensembles were trained using data from the following: (1) 267 patients from an independent single-center cohort, (2) 267 patients from MRI-GENIE, and (3) mixture of (1) and (2). The algorithms' performances were compared against manual outlines from a separate 383 patient subset from MRI-GENIE. Univariable and multivariable logistic regression with respect to demographics, stroke subtypes, and vascular risk factors were performed to identify phenotypes associated with large acute diffusion-weighted MRI volumes and greater stroke severity in 2770 MRI-GENIE patients. Stroke topography was investigated. Results- The ensemble consisting of a mixture of MRI-GENIE and single-center convolutional neural networks performed best. Subset analysis comparing automated and manual lesion volumes in 383 patients found excellent correlation (ρ=0.92; P<0.0001). Median (interquartile range) diffusion-weighted MRI lesion volumes from 2770 patients were 3.7 cm3 (0.9-16.6 cm3). Patients with small artery occlusion stroke subtype had smaller lesion volumes ( P<0.0001) and different topography compared with other stroke subtypes. Conclusions- Automated accurate clinical diffusion-weighted MRI lesion segmentation using deep learning algorithms trained with multi-center and diverse data is feasible. Both lesion volume and topography can provide insight into stroke subtypes with sufficient sample size from big heterogeneous multi-center clinical imaging phenotype data sets.\n\nSchmidt, Reinhold\n\n\n"
},
{
"text": "\n177247\n[Complex ligament instabilities after "open book"-fractures of the pelvic ring - finite element computer simulation and crack simulation].\n\nBöhme, J\n\nSteinke, H\n\nHuelse, R\n\nHammer, N\n\nKlink, T\n\nSlowik, V\n\nJosten, C\n\nBeiträge in Fachzeitschriften\nISI:000287450100013\n21080314.0\n10.1055/s-0030-1250471\nNone\nInstability of pelvic ring fractures is also caused by ligament disruption. Classifications are based on the major forces leading to fracture. Data from injury mechanisms as well as clinical and radiological criteria are used to determine the degree of instability. The major aim of all kinds of stabilisation is the anatomic reconstruction of the bony pelvic ring. The injured ligamentous apparatus is still ignored. Some clinical trials assume that soft-tissue injuries may be the reason for the poor patient outcome in "open book" pelvic ring fractures. The aim of the study was to develop a realistic finite element (FE) computer model to simulate "open book" fractures and predict injury-associated instabilities for osteosynthesis planning. PATIENTS/MATERIAL: We developed a realistic FE computer model of the pelvic ring based on CT data. With anatomic studies a computer model of the ligamentous apparatus was created and inserted into the pelvic ring to complete the bone-ligament complex. Numerical simulations were performed to identify the influence of single pelvic ligaments on the shifting at the intact anterior and posterior pelvic ring. Additionally, a biomechanical validated virtual crack simulation with anterior-posterior compression forces was undertaken to predict complex instabilities in "open book" pelvic ring fractures.\n The pelvic ligaments have local and general stabilising functions. The sacrospinous and sacrotuberous ligaments are providing the vertical load transfer, whereas the ligaments of the iliosacral joint and the iliolumbal ligament are necessary for the horizontal load transfer. In "open book" fractures ligaments are ruptured stepwise from anterior to posterior. If the intraosseous and posterior ligaments of the iliosacral joint are intact, only single rotational instability along the ipsilateral iliosacral joint occurs. If the ligaments at the posterior pelvic ring are ruptured too, a second axis across both iliosacral joints was measured. In this particular case additional stabilisation of the posterior pelvic ring should be performed.\n With numerical simulations, prediction of injury-associated instabilities is possible. Because of incomplete radiological data the implementation of patient-specific FE pelvic computer models into the clinical routine is still not realistic.\n © Georg Thieme Verlag KG Stuttgart · New York.\n\nHammer, Niels\n\n\n"
},
{
"text": "\n182363\nDRH1 - a novel blood-based HPV tumour marker.\n\nWeiland, T\n\nEckert, A\n\nTomazic, PV\n\nWolf, A\n\nPondorfer, P\n\nVasicek, S\n\nGraupp, M\n\nHolzmeister, C\n\nMoser, U\n\nAndrianakis, A\n\nKangler, G\n\nKiss, P\n\nBrcic, L\n\nKappler, M\n\nWickenhauser, C\n\nHaak, A\n\nKrüger, M\n\nAl-Nawas, B\n\nBlatt, S\n\nBrockmeyer, N\n\nSkaletz-Rorowski, A\n\nPotthoff, A\n\nFrench, LE\n\nCharnowski, S\n\nReinholz, M\n\nKaufmann, AM\n\nThies, S\n\nLambrecht, HG\n\nSeliger, B\n\nWild, DC\n\nThurnher, D\n\nBeiträge in Fachzeitschriften\nISI:000546651000014\n32535546.0\n10.1016/j.ebiom.2020.102804\nPMC7300133\nTo date, no studies have successfully shown that a highly specific, blood-based tumour marker to detect clinically relevant HPV-induced disease could be used for screening, monitoring therapy response or early detection of recurrence. This study aims to assess the clinical performance of a newly developed HPV16-L1 DRH1 epitope-specific serological assay.\n In a multi-centre study sera of 1486 patients (301 Head and Neck Squamous Cell Carcinoma (HNSCC) patients, 12 HIV+ anal cancer patients, 80 HIV-positive patients, 29 Gardasil-9-vaccinees, 1064 healthy controls) were tested for human HPV16-L1 DRH1 antibodies. Analytical specificity was determined using WHO reference-sera for HPV16/18 and 29 pre- and post-immune sera of Gardasil-9-vaccinees. Tumour-tissue was immunochemically stained for HPV-L1-capsidprotein-expression.\n The DRH1-competitive-serological-assay showed a sensitivity of 95% (95% CI, 77.2-99.9%) for HPV16-driven HNSCC, and 90% (95% CI, 55.5-99.7%) for HPV16-induced anal cancer in HIV-positives. Overall diagnostic specificity was 99.46% for men and 99.29% for women ≥ 30 years. After vaccination, antibody level increased from average 364 ng/ml to 37, 00 ng/ml. During post-therapy-monitoring, HNSCC patients showing an antibody decrease in the range of 30-100% lived disease free over a period of up to 26 months. The increase of antibodies from 2750 to 12, 00 ng/ml mirrored recurrent disease. We can also show that the L1-capsidprotein is expressed in HPV16-DNA positive tumour-tissue.\n HPV16-L1 DRH1 epitope-specific antibodies are linked to HPV16-induced malignant disease. As post-treatment biomarker, the assay allows independent post-therapy monitoring as well as early diagnosis of tumour recurrence. An AUC of 0.96 indicates high sensitivity and specificity for early detection of HPV16-induced disease.\n The manufacturer provided assays free of charge.\n Copyright © 2020 The Author(s). Published by Elsevier B.V. All rights reserved.\n\nAndrianakis, Alexandros\n\nBrcic, Luka\n\nGraupp, Matthias\n\nHolzmeister, Clemens\n\nKangler, Georg Josef\n\nKiss, Peter\n\nMoser, Ulrich Christian\n\nPondorfer-Schäfer, Prisca\n\nThurnher, Dietmar\n\nTomazic, Peter Valentin\n\nVasicek, Sarah Marvis\n\nWeiland, Thomas\n\nWild, Dominik\n\nWolf, Axel\n\n\n"
},
{
"text": "\n1316\nIncreased selective uptake in vivo and in vitro of oxidized cholesteryl esters from high-density lipoprotein by rat liver parenchymal cells.\n\nFluiter, K\n\nVietsch, H\n\nBiessen, EA\n\nKostner, GM\n\nvan Berkel, TJ\n\nSattler, W\n\nBeiträge in Fachzeitschriften\nISI:A1996VN23800021\n8912683.0\n10.1042/bj3190471\nPMC1217792\nOxidation of low-density lipoprotein (LDL) leads initially to the formation of LDL-associated cholesteryl ester hydroperoxides (CEOOH). LDL-associated CEOOH can be transferred to high-density lipoprotein (HDL), and HDL-associated CEOOH are rapidly reduced to the corresponding hydroxides (CEOH) by an intrinsic peroxidase-like activity. We have now performed in vivo experiments to quantify the clearance rates and to identify the uptake sites of HDL-associated [3H]Ch18:2-OH in rats. Upon injection into rats, HDL-associated [3H]Ch18:2-OH is removed more rapidly from the circulation than HDL-associated [3H]Ch18:2. Two minutes after administration of [3H]Ch18:2-OH-HDL, 19.6 +/- 2.6% (S.E.M.; n = 4) of the label was taken up by the liver as compared with 2.4 +/- 0.25% (S.E.M.; n = 4) for [3H]Ch18:2-HDL. Organ distribution studies indicated that only the liver and adrenals exhibited preferential uptake of [3H]Ch18:2-OH as compared with [3H]Ch18:2, with the liver as the major site of uptake. A cell-separation procedure, employed 10 min after injection of [3H]Ch18:2-OH-HDL or [3H]Ch18:2-HDL, demonstrated that within the liver only parenchymal cells take up HDL-CE by the selective uptake pathway. Selective uptake by parenchymal cells of [3H]Ch18:2-OH was 3-fold higher than that of [3H]Ch18:2, while Kupffer and endothelial cell uptake of the lipid tracers reflected HDL holoparticle uptake (as analysed with iodinated versus cholesteryl ester-labelled HDL). The efficient uptake of [3H]Ch18:2-OH by parenchymal cells was coupled to a 3-fold increase in rate of radioactive bile acid secretion from [3H]Ch18:2-OH-HDL as compared with [3H]Ch18:2-HDL. In vitro studies with freshly isolated parenchymal cells showed that the association of [3H]Ch18:2-OH-HDL at 37 degrees C exceeded [3H]Ch18:2-HDL uptake almost 4-fold. Our results indicate that HDL-associated CEOH are efficiently and selectively removed from the blood circulation by the liver in vivo. The selective liver uptake is specifically exerted by parenchymal cells and coupled to a rapid biliary secretion pathway. The liver uptake and biliary secretion route may allow HDL to function as an efficient protection system against potentially atherogenic CEOOH.\n\nKostner, Gerhard\n\nSattler, Wolfgang\n\n\n"
},
{
"text": "\n80005\nOsteoclast formation in bone marrow cultures from two inbred strains of mice with different bone densities.\n\nLinkhart, TA\n\nLinkhart, SG\n\nKodama, Y\n\nFarley, JR\n\nDimai, HP\n\nWright, KR\n\nWergedal, JE\n\nSheng, M\n\nBeamer, WG\n\nDonahue, LR\n\nRosen, CJ\n\nBaylink, DJ\n\nBeiträge in Fachzeitschriften\nISI:000077715800007\n9893064.0\n10.1359/jbmr.1999.14.1.39\nNone\nFor the purpose of identifying genes that affect bone volume, we previously identified two inbred mouse strains (C57BL/6J and C3H/HeJ) with large differences in femoral bone density and medullary cavity volume. The lower density and larger medullary cavity volume in C57BL/6J mice could result from either decreased formation or increased resorption or both. We recently reported evidence suggesting that bone formation was increased in vivo and that osteoblast progenitor cells are more numerous in the bone marrow of C3H/HeJ compared with C57BL/6J mice. In the present study, we determined whether osteoclast numbers in vivo and osteoclast formation from bone marrow cells in vitro might also differ between the two mouse strains. We have found that the number of osteoclasts on bone surfaces of distal humerus secondary spongiosa was 2-fold higher in 5.5-week-old C57BL/6J mice than in C3H/HeJ mice of the same age (p < 0.001). Bone marrow cells of C57BL/6J mice cocultured with Swiss/Webster mouse osteoblasts consistently produced more osteoclasts than did C3H/HeJ bone marrow cells at all ages tested from 3.5-14 weeks of age (p < 0.001). Osteoclast formation was also greater from spleen cells of 3.5-week-old C57BL/6J mice than C3H/HeJ mice. The distribution of nuclei per osteoclast and the 1, 25-dihydroxyvitamin D3 dose dependence of osteoclast production from bone marrow cells were similar. Osteoclasts that developed from both C57BL/6J and C3H/HeJ marrow cells formed pits in dentin slices. Cultures from C57BL/6J marrow cells formed 2.5-fold more pits than cultures from C3H/HeJ marrow cells (p < 0.02). We compared the abilities of C57BL/6J and C3H/HeJ osteoblasts to support osteoclast formation. When bone marrow cells from either C57BL/6J or C3H/HeJ mice were cocultured with osteoblasts from either C57BL/6J or C3H/HeJ newborn calvaria, the strain from which osteoblasts were derived did not affect the number of osteoclasts formed from marrow cells of either strain. Together, these observations suggest that genes affecting the bone marrow osteoclast precursor population may contribute to the relative differences in bone density that occur between C3H/HeJ and C57BL/6J mouse strains.\n\nDimai, Hans\n\n\n"
},
{
"text": "\n122252\nCardiovascular risk management in patients with coronary heart disease in primary care: variation across countries and practices. An observational study based on quality indicators.\n\nvan Lieshout, J\n\nGrol, R\n\nCampbell, S\n\nFalcoff, H\n\nCapell, EF\n\nGlehr, M\n\nGoldfracht, M\n\nKumpusalo, E\n\nKünzi, B\n\nLudt, S\n\nPetek, D\n\nVanderstighelen, V\n\nWensing, M\n\nBeiträge in Fachzeitschriften\nISI:000311937300001\n23035928.0\n10.1186/1471-2296-13-96\nPMC3515459\nBackground: Primary care has an important role in cardiovascular risk management (CVRM) and a minimum size of scale of primary care practices may be needed for efficient delivery of CVRM. We examined CVRM in patients with coronary heart disease (CHD) in primary care and explored the impact of practice size.\nMethods: In an observational study in 8 countries we sampled CHD patients in primary care practices and collected data from electronic patient records. Practice samples were stratified according to practice size and urbanisation; patients were selected using coded diagnoses when available. CVRM was measured on the basis of internationally validated quality indicators. In the analyses practice size was defined in terms of number of patients registered of visiting the practice. We performed multilevel regression analyses controlling for patient age and sex.\nResults: We included 181 practices (63% of the number targeted). Two countries included a convenience sample of practices. Data from 2960 CHD patients were available. Some countries used methods supplemental to coded diagnoses or other inclusion methods introducing potential inclusion bias. We found substantial variation on all CVRM indicators across practices and countries. We computed aggregated practice scores as percentage of patients with a positive outcome. Rates of risk factor recording varied from 55% for physical activity as the mean practice score across all practices (sd 32%) to 94% (sd 10%) for blood pressure. Rates for reaching treatment targets for systolic blood pressure, diastolic blood pressure and LDL cholesterol were 46% (sd 21%), 86% (sd 12%) and 48% (sd 22%) respectively. Rates for providing recommended cholesterol lowering and antiplatelet drugs were around 80%, and 70% received influenza vaccination. Practice size was not associated to indicator scores with one exception: in Slovenia larger practices performed better. Variation was more related to differences between practices than between countries.\nConclusions: CVRM measured by quality indicators showed wide variation within and between countries and possibly leaves room for improvement in all countries involved. Few associations of performance scores with practice size were found.\n\nGlehr, Mathias\n\n\n"
},
{
"text": "\n131800\nCross-validation analysis of the prognostic significance of mucin expression in patients with resected non-small cell lung cancer treated with adjuvant chemotherapy: results from IALT, JBR.10 and ANITA.\n\nGraziano, SL\n\nLacas, B\n\nVollmer, R\n\nKratzke, R\n\nPopper, H\n\nFilipits, M\n\nSeymour, L\n\nShepherd, FA\n\nRosell, R\n\nVeillard, AS\n\nTaron, M\n\nPignon, JP\n\nBeiträge in Fachzeitschriften\nISI:000325833600023\n23920379.0\n10.1016/j.lungcan.2013.06.015\nPMC3804220\nIntroduction: CALGB 9633 was a randomized trial of observation versus adjuvant chemotherapy for patients with stage IB non-small cell lung cancer (NSCLC). In CALGB 9633, the presence of mucin in the primary tumor was associated with shorter disease-free survival (DFS; hazard ratio (HR) = 1.9, p = 0.002) and overall survival (OS; HR = 1.9, p = 0.004). Methods: To validate these results, mucin staining was performed on primary tumor specimens from 780 patients treated on IALT, 351 on JBR.10 and 150 on ANITA. The histochemical technique using mucicarmine was performed. The prognostic value of mucin for DFS and OS was tested in a Cox model stratified by trial and adjusted for clinical and pathological factors. A pooled analysis of all 4 trials was performed for the predictive value of mucin for benefit from adjuvant chemotherapy. Results: The cross-validation group had 48% squamous, 37% adenocarcinoma and 15% other NSCLC compared with 29%, 56%, and 15%, respectively in CALGB. Among 1262 patients with assessable results, mucin was positive in IALT 24%, JBR.10 30%, ANITA 22% compared with 45% in CALGB. Histology was the only significant covariate (p < 0.0001) in multivariate analysis with mucin seen more commonly in adenocarcinoma (56%) compared with squamous (5%) and other NSCLC (15%). Mucin was a borderline negative prognostic factor for DFS (HR = 1.2 [1.0-1.5], p = 0.06) but not significantly so for OS (HR = 1.1 [0.9-1.4], p = 0.25). Prognostic value did not vary according to histology: HR = 1.3 [1.0-1.6] in adenocarcinoma vs. 1.6 [1.2-2.2] for DFS in other histology (interaction p = 0.69). Mucin status was not predictive for benefit from adjuvant chemotherapy (test of interaction: DFS p = 0.27; OS p = 0.49). Conclusions: Mucin was less frequent in the cross-validation group due to its higher percentage of squamous cell carcinomas. The negative impact of mucin was confirmed for DFS but not for OS. Mucin expression was not predictive of overall survival benefit from adjuvant chemotherapy. (C) 2013 Elsevier Ireland Ltd. All rights reserved.\n\nPopper, Helmuth\n\n\n"
},
{
"text": "\n162120\nBenefit of Adjuvant Radiotherapy for Local Control, Distant Metastasis, and Survival Outcomes in Patients with Localized Soft Tissue Sarcoma: Comparative Effectiveness Analysis of an Observational Cohort Study.\n\nPosch, F\n\nPartl, R\n\nDöller, C\n\nRiedl, JM\n\nSmolle, M\n\nLeitner, L\n\nBergovec, M\n\nLiegl-Atzwanger, B\n\nStotz, M\n\nBezan, A\n\nGerger, A\n\nPichler, M\n\nKapp, KS\n\nStöger, H\n\nLeithner, A\n\nSzkandera, J\n\nBeiträge in Fachzeitschriften\nISI:000423533300026\n28895087.0\n10.1245/s10434-017-6080-3\nPMC5814515\nThis study aimed to quantify the benefit of adjuvant radiotherapy (AXRT) for local control, distant metastasis, and long-term survival outcomes in patients with localized soft tissue sarcoma (STS).\n This single-center retrospective observational study enrolled 433 STS patients who underwent surgery with curative intent. An inverse probability of treatment-weighted (IPTW) analysis was implemented to account rigorously for imbalances in prognostic variables between the adjuvant treatment groups.\n During a median follow-up period of 5.5 years, the study observed 38 local recurrences (9%), 73 occurrences of distant metastasis (17%), 63 STS-related deaths (15%), and 57 deaths from other causes (13%). As expected, patients receiving AXRT (n = 258, 60%) were more likely to have high-grade G3 tumors (p < 0.0001) than patients not receiving AXRT. A crude analysis showed that AXRT was not associated with improved recurrence-free survival [hazard ratio (HR) 1.00; 95% confidence interval (CI) 0.72-1.38; p = 0.98]. However, after IPTW, AXRT was associated with a 38% relative reduction in the risk of recurrence or death (HR 0.62; 95% CI 0.39-1.00; p = 0.05). This benefit was driven by a strong reduction in the risk of local recurrence (HR 0.42; 95% CI 0.19-0.91; p = 0.03), whereas the relative risk of distant metastasis (HR 0.69; 95% CI 0.39-1.25; p = 0.22) and overall survival (HR 0.76; 95% CI 0.44-1.30; p = 0.32) were only nonsignificantly in favor of AXRT. An exploratory analysis showed an overall survival benefit of AXRT for patients with high-grade G3 tumors (HR 0.51; 95% CI 0.33-0.78; p = 0.002). However, this finding may have been attributable to residual confounding.\n In this observational cohort, AXRT was associated with a 58% reduction in the relative risk of local recurrence. No consistent association between AXRT and lower risks of distant metastasis or death was observed.\n\nBergovec, Marko\n\nDöller, Carmen\n\nGerger, Armin\n\nLeithner, Andreas\n\nLeitner, Lukas\n\nLiegl-Atzwanger, Bernadette\n\nPartl, Richard\n\nPichler, Martin\n\nPosch, Florian\n\nRiedl, Jakob\n\nSmolle, Maria Anna\n\nStoeger, Herbert\n\nSzkandera, Joanna\n\nTerbuch, Angelika\n\n\n"
},
{
"text": "\n182856\nRenal Denervation in High-Risk Patients With Hypertension.\n\nMahfoud, F\n\nMancia, G\n\nSchmieder, R\n\nNarkiewicz, K\n\nRuilope, L\n\nSchlaich, M\n\nWhitbourn, R\n\nZirlik, A\n\nZeller, T\n\nStawowy, P\n\nCohen, SA\n\nFahy, M\n\nBöhm, M\n\nBeiträge in Fachzeitschriften\nISI:000542941900004\n32527396.0\n10.1016/j.jacc.2020.04.036\nNone\nRenal denervation (RDN) is under investigation for treatment of uncontrolled hypertension and might represent an attractive treatment for patients with high cardiovascular (CV) risk. It is important to determine whether baseline CV risk affects the efficacy of RDN.\n The purpose of this study was to assess blood pressure (BP) reduction and event rates after RDN in patients with various comorbidities, testing the hypothesis that RDN is effective and durable in these high-risk populations.\n BP reduction and adverse events over 3 years were evaluated for several high-risk subgroups in the GSR (Global proSpective registrY for syMPathetic renaL denervatIon in seleCted IndicatIons Through 3 Years Registry), an international registry of RDN in patients with uncontrolled hypertension (n = 2, 52). Comparisons were made for patients age ≥65 years versus age <65 years, with versus without isolated systolic hypertension, with versus without atrial fibrillation, and with versus without diabetes mellitus. Baseline cardiovascular risk was estimated using the American Heart Association (AHA)/American College of Cardiology (ACC) atherosclerosis cardiovascular disease (ASCVD) risk score.\n Reduction in 24-h systolic BP at 3 years was -8.9 ± 20.1 mm Hg for the overall cohort, and for high-risk subgroups, BP reduction was -10.4 ± 21.0 mm Hg for resistant hypertension, -8.7 ± 17.4 mm Hg in patients age ≥65 years, -10.2 ± 17.9 mm Hg in patients with diabetes, -8.6 ± 18.7 mm Hg in isolated systolic hypertension, -10.1 ± 20.3 mm Hg in chronic kidney disease, and -10.0 ± 19.1 mm Hg in atrial fibrillation (p < 0.0001 compared with baseline for all). BP reduction in patients with measurements at 6, 12, 24, and 36 months showed similar reductions in office and 24-h BP for patients with varying baseline ASCVD risk scores, which was sustained to 3 years. Adverse event rates at 3 years were higher for patients with higher baseline CV risk.\n BP reduction after RDN was similar for patients with varying high-risk comorbidities and across the range of ASCVD risk scores. The impact of baseline risk on clinical event reduction by RDN-induced BP changes could be evaluated in further studies. (Global proSpective registrY for syMPathetic renaL denervatIon in seleCted IndicatIons Through 3 Years Registry; NCT01534299).\n Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.\n\nZirlik, Andreas\n\n\n"
},
{
"text": "\n4237\nThoracic wall reconstruction using both portions of the latissimus dorsi previously divided in the course of posterolateral thoracotomy.\n\nKoch, H\n\nTomaselli, F\n\nPierer, G\n\nSchwarzl, F\n\nHaas, F\n\nSmolle-Jüttner, FM\n\nScharnagl, E\n\nBeiträge in Fachzeitschriften\nISI:000175655800019\n12062278.0\n10.1016/S1010-7940(02)00070-2\nNone\nOBJECTIVE: Besides other factors, the choice of reconstructive method for full thickness thoracic wall defects depends on the morbidity of preceding surgical procedures. The pedicled latissimus dorsi flap is a reliable and safe option for reconstruction of the thorax. A posterolateral thoracotomy, however, results in division of the muscle. Both parts of the muscle can be employed to close full thickness defects of the chest wall. The proximal part can be pedicled on the thoracodorsal vessels or the serratus branch; the distal part can be pedicled on paravertebral or intercostal perforators. This retrospective study was undertaken to evaluate the reconstructive potential of both parts of the latissimus dorsi in thoracic wall reconstruction after posterolateral thoracotomy. METHODS: Between 1987 and 1999, 36 consecutive patients underwent reconstruction of full-thickness thoracic wall defects with latissimus dorsi-flaps after posterolateral thoracotomies. The defects resulted from infection and open window thoracostomy (n=31), trauma (n=3) and resection of tumours (n=2). The patients' average age was 57 years (range 22-76 years). Twenty-five patients were male, 11 were female. In 31 cases the split latissimus dorsi alone was employed; in five cases additional flaps had to be used due to the size of the defects, additional intrathoracic problems or neighbouring defects. RESULTS: In 34 cases defect closure could be achieved without major complications. Empyema recurred in the pleural cavity in one case and one patient died of septicaemia. The 15 patients who had required a respirator in the preoperative phase could be extubated 4.8 days (average) after thoracic wall reconstruction. Postoperative hospital stay averaged 16 days. CONCLUSIONS: Different methods are available for reconstruction of full thickness defects of the thoracic wall. After posterolateral thoracotomy in the surgical treatment of empyema, oncologic surgery and traumatology, the latissimus dorsi muscle still retains some reconstructive potential. Advantages are low additional donor site morbidity and anatomical reliability. As it is located near the site of the defect, there is no need for additional surgical sites or intraoperative repositioning. In our service, the split latissimus dorsi muscle flap has proven to be a valuable and reliable option in thoracic wall reconstruction.\n\nKoch, Horst\n\nSmolle-Juettner, Freyja-Maria\n\n\n"
}
]
}