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Stiegler H, Brandl R. [Acute occlusion of limb arteries]. MMW Fortschr Med 2004; 146:44-7. [PMID: 15373132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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Wolf O, Heider P, Heinz M, Poppert H, Schmidt-Thieme T, Sander D, Gräfin von Einsiedel H, Brandl R. Frequency, Clinical Significance and Course of Cerebral Ischemic Events after Carotid Endarterectomy Evaluated by Serial Diffusion Weighted Imaging. Eur J Vasc Endovasc Surg 2004; 27:167-71. [PMID: 14718899 DOI: 10.1016/j.ejvs.2003.11.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Neurological deficit defines the outcome of Carotid Endarterectomy (CEA) that is mainly caused by cerebral ischemia. Diffusion-weighted imaging (DWI) is a sensitive method for demonstrating even small ischemic lesions. The aim of this study was to evaluate the frequency, clinical significance and course of ischemic lesions after CEA using serial DWI. METHODS DWI was performed within 1 day before and after CEA in 88 patients. Postoperative lesions were analyzed by their quantity, volume and distribution. To differentiate temporary ischemia from definite cerebral infarction (blood brain barrier disruption) all patients with a positive postoperative DWI were reexamined with contrast-enhanced T1-MRI 7-10 days after the procedure. All patients were examined by a neurologist within 2 days before and after CEA. RESULTS Two patients showed a postoperative neurological deficit. Postoperative DWI revealed ipsilateral ischemic lesions in 15 patients. In seven of these patients a brain infarction was diagnosed on the T1-MRI during follow-up. A significant correlation between the number of DWI lesions (p=0.031) as well as the volume of DWI lesions (p=0.023) and definite infarction was found. Symptomatic patients preoperatively showed significantly more DWI lesions (p=0.036) and cerebral infarcts (p=0.003). CONCLUSION DWI is a sensitive method of demonstrating ischemic events after CEA. The number and volume of DWI lesions after CEA are highly predictive of brain infarction.
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Hänfling B, Durka W, Brandl R. Impact of habitat fragmentation on genetic population structure of roach, Rutilus rutilus, in a riparian ecosystem. CONSERV GENET 2004. [DOI: 10.1023/b:coge.0000030008.20492.2c] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Kühn I, Brandl R, May R, Klotz S. Plant distribution patterns in Germany– Will aliens match natives? ACTA ACUST UNITED AC 2003. [DOI: 10.1002/fedr.200311015] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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55
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Eber S, Brandl R. Genetic differentiation of the tephritid fly
Urophora cardui
in Europe as evidence for its biogeographical history. Mol Ecol 2003. [DOI: 10.1046/j.1365-294x.1997.00236.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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56
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Rother E, Brandl R, Baker DL, Goyal P, Gebhard H, Tigyi G, Siess W. Subtype-selective antagonists of lysophosphatidic Acid receptors inhibit platelet activation triggered by the lipid core of atherosclerotic plaques. Circulation 2003; 108:741-7. [PMID: 12885756 DOI: 10.1161/01.cir.0000083715.37658.c4] [Citation(s) in RCA: 131] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Lysophosphatidic acid (LPA) is a platelet-activating component of mildly oxidized LDL (mox-LDL) and lipids isolated from human atherosclerotic plaques. Specific antagonists of platelet LPA receptors could be useful inhibitors of thrombus formation in patients with cardiovascular disease. METHODS AND RESULTS Short-chain analogs of phosphatidic acid (PA) were examined for their effect on two initial platelet responses, platelet shape change and Ca2+ mobilization. Dioctylglycerol pyrophosphate [DGPP(8:0)] and dioctylphosphatidic acid [PA(8:0)], recently described selective antagonists of the LPA1 and LPA3 receptors, inhibited platelet activation evoked by LPA but not by other platelet stimuli. DGPP(8:0) was more potent than PA(8:0). DGPP(8:0) also inhibited platelet shape change induced by mox-LDL and lipid extracts from human atherosclerotic plaques. Notably, we demonstrate for the first time that the lipid-rich core isolated from soft plaques was able to directly induce shape change. This effect was completely abrogated by prior incubation of platelets with DGPP(8:0). Moreover, coapplication of the lipid-rich core or LPA together with subthreshold concentrations of ADP or epinephrine synergistically induced platelet aggregation; this effect was inhibited by DGPP(8:0). Analysis by liquid chromatography-mass spectrometry revealed the presence of LPA alkyl- and acyl-molecular species with high platelet-activating potency (16:0-alkyl-LPA, 20:4-acyl-LPA). CONCLUSIONS LPA molecules present in the core region of atherosclerotic plaques trigger rapid platelet activation through the stimulation of LPA1 and LPA3 receptors. Antagonists of platelet LPA receptors might provide a new strategy to prevent thrombus formation in patients with cardiovascular diseases.
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Novotny AR, Brauer RB, Brandl R, Gerauer KE, Stangl MJ. Successful renal transplantation after intimal dissection of the renal artery secondary to trauma. Transplantation 2003; 75:1077-9. [PMID: 12698108 DOI: 10.1097/01.tp.0000058468.94019.26] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Organ shortage increasingly forces surgeons to consider the use of marginal organs. METHODS The authors report a case in which a kidney with traumatic dissection of the renal artery and marginal perfusion by means of collaterals was successfully transplanted into a 63-year-old patient. A computed tomographic scan of the donor showed a marginally perfused left kidney, suggestive of renal artery dissection. After surgical reconstruction of the renal artery, transplantation followed the usual course. RESULTS The organ started clearing shortly after the operation and was homogeneously perfused in a postoperative scan. Creatinine and blood urea nitrogen levels dropped to normal values within a couple of days after the transplantation. During 1 year of follow-up, organ function was always excellent and retention parameters were within the normal range. CONCLUSIONS This case illustrates that marginally perfused kidneys can be successfully used for transplantation in certain cases.
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Wessely R, Hengst L, Jaschke B, Wegener F, Richter T, Lupetti R, Paschalidis M, Schömig A, Brandl R, Neumann FJ. A central role of interferon regulatory factor-1 for the limitation of neointimal hyperplasia. Hum Mol Genet 2003; 12:177-87. [PMID: 12499398 DOI: 10.1093/hmg/ddg018] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Neointima formation, the leading cause of restenosis after catheter angioplasty, is a paradigm for vascular proliferative responses. Neointima formation is self-limiting after a variable degree of tissue growth, causing significant renarrowing in a substantial number of patients. To investigate the mechanisms that limit neointima formation we studied the role of the transcription factor IRF-1, which is a regulator of interferons and a tumor suppressor. We demonstrate that IRF-1 is highly regulated in human vascular lesions and exhibits a growth inhibitory function in coronary artery smooth muscle cells (CASMC). IRF-1 deficient mice display a high grade of susceptibility towards neointima formation following vessel injury. IRF-1 leads to G(1) cell cycle arrest in CASMC and induces the CDK inhibitor p21. In addition, IRF-1 induces NO production, which is known to attenuate endothelial dysfunction. Mitogen-mediated cellular migration is abrogated by IRF-1. In conclusion, IRF-1 displays pleiotropic anti-restenotic activities in vascular restenosis through transcriptional activation of several relevant mechanisms that limit neointima formation. These findings suggest an important role of this transcription factor as an endogenous inhibitor of neointimal growth following vessel injury and it is likely that IRF-1 regulation also plays a role in the pathophysiology of primary atherosclerosis. In addition, IRF-1 may be an interesting target for interventions to prevent neointimal hyperplasia.
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Novotny AR, Brauer RB, Brandl R, Matevossian E, Stangl MJ. Posterior fossa stroke during cardiopulmonary resuscitation secondary to haemodialysis arterio-venous fistula. Nephrol Dial Transplant 2003; 18:221-3. [PMID: 12480997 DOI: 10.1093/ndt/18.1.221-a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Haussermann P, Conrad B, Richter TH, Brandl R. Progressive stroke following soccer playing: successful treatment by emergency carotid endarterectomy. ARCHIVES OF NEUROLOGY 2002; 59:1484-5. [PMID: 12223038 DOI: 10.1001/archneur.59.9.1484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Rock C, Kotsianos D, Linsenmaier U, Fischer T, Brandl R, Vill F, Wirth S, Kaltschmidt R, Euler E, Pfeifer KJ, Reiser M. [Studies on image quality, high contrast resolution and dose for the axial skeleton and limbs with a new, dedicated CT system (ISO-C-3 D)]. ROFO-FORTSCHR RONTG 2002; 174:170-6. [PMID: 11898078 DOI: 10.1055/s-2002-20107] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE Evaluation of 3D-CT imaging of the axial skeleton and different joints of the lower and upper extremities with a new dedicated CT system (ISO-C-3D) based on a mobile isocentric C-arm image amplifier. MATERIAL AND METHODS 27 cadaveric specimes of different joints of the lower and upper extremities and of the spinal column were examined with 3D-CT imaging (ISO-C-3D). All images were evaluated by 3 radiologists for image quality using a semiquantitative score (score value 1: poor quality; score value 4: excellent quality). In addition, dose measurements and measurements of high contrast resolution were performed in comparison to conventional and low-dose spiral CT using a high contrast phantom (Catphan, Phantom Laboratories). RESULTS Adequate image quality (mean score values 3 - 4) could be achieved with an applied dose comparable to low-dose CT in smaller joints such as wrist, elbow, ankle and knee. A remarkably inferior image quality resulted in imaging of the hip, lumbar and thoracic spine (mean score values 2 - 3) in spite of almost doubling the dose (dose increased by 85 percent). The image quality of shoulder examinations was insufficient (mean score value 1). Phantom studies showed a high-contrast resolution comparable to helical CT in the xy-axis (9 lp/cm). CONCLUSION Preliminary results show, that image quality of C-arm-based CT-imaging (ISO-C-3D) seems to be adequate in smaller joints. ISO-C-3D images of the hip and axial skeleton show a decreased image quality, which does not seem to be sufficient for diagnosing subtle fractures.
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Kotsianos D, Rock C, Wirth S, Linsenmaier U, Brandl R, Fischer T, Euler E, Mutschler W, Pfeifer KJ, Reiser M. [Detection of tibial condylar fractures using 3D imaging with a mobile image amplifier (Siemens ISO-C-3D): Comparison with plain films and spiral CT]. ROFO-FORTSCHR RONTG 2002; 174:82-7. [PMID: 11793290 DOI: 10.1055/s-2002-19549] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
PURPOSE To analyze a prototype mobile C-arm 3D image amplifier in the detection and classification of experimental tibial condylar fractures with multiplanar reconstructions (MPR). METHOD Human knee specimens (n = 22) with tibial condylar fractures were examined with a prototype C-arm (ISO-C-3D, Siemens AG), plain films (CR) and spiral CT (CT). The motorized C-arm provides fluoroscopic images during a 190 degrees orbital rotation computing a 119 mm data cube. From these 3D data sets MP reconstructions were obtained. All images were evaluated by four independent readers for the detection and assessment of fracture lines. All fractures were classified according to the Müller AO classification. To confirm the results, the specimens were finally surgically dissected. RESULTS 97 % of the tibial condylar fractures were easily seen and correctly classified according to the Müller AO classification on MP reconstruction of the ISO-C-3D. There is no significant difference between ISO-C and CT in detection and correct classification of fractures, but ISO-CD-3D is significant by better than CR. CONCLUSION The evaluation of fractures with the ISO-C is better than with plain films alone and comparable to CT scans. The three-dimensional reconstruction of the ISO-C can provide important information which cannot be obtained from plain films. The ISO-C-3D may be useful in planning operative reconstructions and evaluating surgical results in orthopaedic surgery of the limbs.
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Prinzing A, Durka W, Klotz S, Brandl R. The niche of higher plants: evidence for phylogenetic conservatism. Proc Biol Sci 2001; 268:2383-9. [PMID: 11703879 PMCID: PMC1088890 DOI: 10.1098/rspb.2001.1801] [Citation(s) in RCA: 349] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A species' ecological niche depends on the species' adaptations to its present habitat, but also on the legacy from its ancestors. Most authors argue that such a phylogenetic niche conservatism is of minor importance, although no quantitative analyses across a major taxon is available. Higher plants from central Europe offer a unique opportunity for such an exercise, as the niche positions along various environmental gradients are available for most species. We quantified niche conservatism by two approaches. First, we used a phylogenetic tree and quantified the degree of retention of niches across the tree. Depending on the gradient, the values ranged from 0.43 to 0.22. This was significantly greater than the null expectation. Second, we used a taxonomy and quantified the amount of variance among species that could be explained at higher taxonomic levels. The values ranged from 25 to 72%. Again, this was significantly higher than the null expectation. Thus, both approaches indicated a clear niche conservatism. The distribution of conservatism across taxonomic levels differed considerably among environmental gradients. The differences among environmental gradients could be correlated with the palaeoenvironmental conditions during the radiation of the phylogenetic lineages. Thus, niche conservatism among extant plant species may reflect the opportunities of their ancestors during their diversification.
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Rock C, Linsenmaier U, Brandl R, Kotsianos D, Wirth S, Kaltschmidt R, Euler E, Mutschler W, Pfeifer KJ. [Introduction of a new mobile C-arm/CT combination equipment (ISO-C-3D). Initial results of 3-D sectional imaging]. Unfallchirurg 2001; 104:827-33. [PMID: 11572124 DOI: 10.1007/s001130170053] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Preclinical evaluation of a new mobile C-arm image amplifier with an option for three-dimensional computed tomography (CT) imaging (prototype Iso-C3D) with respect to high-contrast resolution and possible clinical applications. Cadaveric specimens (n = 30) of different joints of the lower and upper extremities and specimens of the spinal column were examined with the Iso-C3D and evaluated for image quality. In addition, using a high-contrast phantom (Catphan, Phantom Laboratory, Salem, N.Y., USA) and a fracture model of the femoral bone, measurements of high-contrast resolution were performed in comparison to spiral CT. With the exception of the shoulder, all joint regions including the entire spinal column could be examined. Adequate image quality could be achieved in smaller joints such as the wrist, elbow, ankle, and knee, whereas a remarkably decreased image quality was found when imaging the hip as well as the lumbar and thoracic spine. Images of the phantom study and high-contrast fracture model showed a high-contrast resolution comparable to helical CT (9 Lp/cm in xy-axis). In smaller joints, the image quality of the mobile C-arm CT imaging system (Iso-C3D) is comparable to that of helical CT. Image quality in examinations of the hip and lumbar and thoracic spine seems to be sufficient for intraoperative control studies of osteosynthesis. Problems still occur in shoulder examinations.
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Kotsianos D, Rock C, Euler E, Wirth S, Linsenmaier U, Brandl R, Mutschler W, Pfeifer KJ. [3-D imaging with a mobile surgical image enhancement equipment (ISO-C-3D). Initial examples of fracture diagnosis of peripheral joints in comparison with spiral CT and conventional radiography]. Unfallchirurg 2001; 104:834-8. [PMID: 11572125 DOI: 10.1007/s001130170054] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
To analyze a prototype mobile C-arm image amplifier (Iso-C3D) in the evaluation of different joint fractures of the upper and lower limbs using multiplanar reconstruction (MPR). Different cadaver joint specimens (n = 14) were examined with a prototype (Iso-C3D, Siemens AG, Erlangen, Germany), plain radiographs (CR), and spiral computed tomography (CT). The motorized C-arm provides fluoroscopic images during a 190 degrees orbital rotation computing a 119-mm data cube. These three-dimensional data sets yielded MPR images, which were evaluated by two readers for the detection and extent of fracture lines. Initial data show that fractures were easily depicted and correctly classified on MPR images with the Iso-C3D and that there was no difference between the Iso-C and CT in the detection of fractures. The preliminary results suggest a remarkably good detection of joint fractures with the Iso-C3D. Studies in an adequate number of patients are required to elucidate whether these promising results can also be obtained in a clinical setting.
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Auge H, Neuffer B, Erlinghagen F, Grupe R, Brandl R. Demographic and random amplified polymorphic DNA analyses reveal high levels of genetic diversity in a clonal violet. Mol Ecol 2001; 10:1811-9. [PMID: 11472548 DOI: 10.1046/j.0962-1083.2001.01311.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We performed demographic and molecular investigations on woodland populations of the clonal herb Viola riviniana in central Germany. We investigated the pattern of seedling recruitment, the amount of genotypic (clonal) variation and the partitioning of genetic variation among and within populations. Our demographic study was carried out in six violet populations of different ages and habitat conditions. It revealed that repeated seedling recruitment takes place in all of these populations, and that clonal propagation is accompanied by high ramet mortality. Our molecular investigations were performed on a subset of three of these six violet populations. Random amplified polymorphic DNA analyses using six primers yielded 45 scorable bands that were used to identify multilocus genotypes, i.e. putative clones. Consistent with our demographic results and independent of population age, we found a large genotypic diversity with a mean proportion of distinguishable genotypes of 0.93 and a mean Simpson's diversity index of 0.99. Using AMOVA we found a strong genetic differentiation among these violet populations with a PhiST value of 0.41. We suggest that a high selfing rate, limited gene flow due to short seed dispersal distances and drift due to founder effects are responsible for this pattern. Although Viola riviniana is a clonal plant, traits associated with sexual reproduction rather than clonality per se are moulding the pattern of genetic variation in this species.
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Wirth S, Euler E, Linsenmaier U, Rock C, Kotsianos D, Brandl R, Mutschler W, Pfeifer K. C-arm based computed tomography—A comparative study. ACTA ACUST UNITED AC 2001. [DOI: 10.1016/s0531-5131(01)00094-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Zohlnhöfer D, Richter T, Neumann F, Nührenberg T, Wessely R, Brandl R, Murr A, Klein CA, Baeuerle PA. Transcriptome analysis reveals a role of interferon-gamma in human neointima formation. Mol Cell 2001; 7:1059-69. [PMID: 11389852 DOI: 10.1016/s1097-2765(01)00239-8] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The most effective immediate cure for coronary stenosis is stent-supported angioplasty. Restenosis due to neointima proliferation represents a major limitation. We investigated the expression of 2435 genes in atherectomy specimens and blood cells of patients with restenosis, normal coronary artery specimens, and cultured human smooth muscle cells (SMCs). Of the 223 differentially expressed genes, 37 genes indicated activation of interferon-gamma (IFN-gamma) signaling in neointimal SMCs. In cultured SMCs, IFN-gamma inhibited apoptosis. Genetic disruption of IFN-gamma signaling in a mouse model of restenosis significantly reduced the vascular proliferative response. Our data suggest an important role of IFN-gamma in the control of neointima proliferation.
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Abstract
BACKGROUND Carotid endarterectomy (CEA) is well established as the elective treatment for moderate or severe carotid stenoses with a history of neurologic symptoms. In contrast, the merits of carotid revascularisation performed in emergency in patients with acute stroke or fluctuating neurological deficit remain controversial. PATIENTS AND METHODS A total of 445 CEAs were performed on 424 patients for 212 (48%) asymptomatic and 233 (52%) symptomatic carotid stenoses within a 5 years period between January, 1995, and December, 1999. Of the latter, CEA was performed in emergency on 16 patients (3.8%) within 4 to 24 hours after the onset of symptoms. Patients selected for urgent surgery fulfilled the following criteria: acute onset of fluctuating hemispheric neurological symptoms, significant carotid pathology, absence of cerebral hemorrhage, uncompromised vigilance and stable cardiopulmonary conditions. Selected patients presented with a crescendo-TIA (n = 7) or fluctuating neurological deficits (n = 9) corresponding to a contralateral carotid stenosis. RESULTS Following CEA, the neurological deficits improved instantaneously to complete recovery in 9 patients. The symptoms of 4 patients improved to non-disabling deficits, remained unchanged in one and worsened in 2 patients from hemihypaesthesia to hemiparesis. 14/16 patients were discharged within 8 days after admission. The neurologic status after discharge did not deteriorate in any of the patients during follow up of 19.3 +/- 13 months, but improved in 4 of the patients. CONCLUSION Our retrospective study suggests that rescue CEA may be beneficial for selected patients with stroke in evolution and fluctuating neurological deficits. Careful adherence to selection criteria, intraoperative shunting, intensive care post surgery surveillance and an experienced team are recommended.
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Zohlnhöfer D, Klein CA, Richter T, Brandl R, Murr A, Nührenberg T, Schömig A, Baeuerle PA, Neumann FJ. Gene expression profiling of human stent-induced neointima by cDNA array analysis of microscopic specimens retrieved by helix cutter atherectomy: Detection of FK506-binding protein 12 upregulation. Circulation 2001; 103:1396-402. [PMID: 11245643 DOI: 10.1161/01.cir.103.10.1396] [Citation(s) in RCA: 89] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Restenosis due to neointima formation is the major limitation of stent-supported balloon angioplasty. Despite abundant animal data, molecular mechanisms of neointima formation have been investigated on only a limited basis in patients. This study sought to establish a method for profiling gene expression in human in-stent neointima and to identify differentially expressed genes that may serve as novel therapeutic targets. METHODS AND RESULTS We retrieved tissue specimens from patients with symptomatic in-stent restenosis using a novel helix cutter atherectomy device. cDNA samples prepared from neointima (n=10) and, as a control, from the media of normal arteries (n=14) were amplified using a novel polymerase chain reaction protocol and hybridized to cDNA arrays. Immunohistochemistry characterized the atherectomy material as neointima. cDNA arrays readily identified differentially expressed genes. Some of the differentially expressed genes complied with expected gene expression patterns of neointima, including downregulation of desmin and upregulation of thrombospondin-1, cyclooxygenase-1, and the 70-kDa heat shock protein B. Additionally, we discovered previously unknown gene expression patterns, such as downregulation of mammary-derived growth inhibitor and upregulation of FK506-binding protein 12 (FKBP12). Upregulation of FKBP12 was confirmed at the protein level in neointimal smooth muscle cells. CONCLUSIONS Gene expression patterns of human neointima retrieved by helix-cutter atherectomy can be reliably analyzed by cDNA array technology. This technique can identify therapeutic targets in patients, as exemplified by the findings regarding FKBP12. FKBP12 is the receptor for Rapamycin (sirolimus), which in animal models reduced neointima formation. Our study thus yields a rationale for the use of Rapamycin to prevent restenosis in patients.
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Brandl R. [Vascular biological aspects of thrombendarterectomy and alloplastic vascular replacement]. KONGRESSBAND. DEUTSCHE GESELLSCHAFT FUR CHIRURGIE. KONGRESS 2001; 118:471-4. [PMID: 11824300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
Abstract
Irrespective of vascular approach and mode of repair any arterial reconstruction is charged by a procedural trauma and a desintegration of the vascular wall in its pathoanatomic structure. A number of specific repair mechanisms are set in motion by cellular and humoral mediators when non-endothelial layers get exposed to the lumen. Platelet deposition, local activation of hemostatic factors, intramural and wall-adjacent thrombus formation as well as subsequent proliferation of myofibroblasts are determinants of this process that may be characterized as a generalized wound healing response resulting in neointima formation. Exemplarily, the valency of endarterectomy and prosthetic grafting in the femoral axis is discussed on the background of recent experience in vascular biology.
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Coppenrath E, Schmid C, Brandl R, Szeimies U, Hahn K. [Spiral CT of the abdomen: weight-adjusted dose reduction]. ROFO-FORTSCHR RONTG 2001; 173:52-6. [PMID: 11225418 DOI: 10.1055/s-2001-10226] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
AIM OF THE STUDY The influence of weight-adjusted current application in spiral CT of the abdomen on noise was investigated in a clinical study. PATIENTS AND METHODS In 77 routine abdominal CT investigations (120 kV, 8 mm, pitch 1.5) the patients were divided into three body-weight groups A (< 60 kg), B (60-80 kg), and C (> 80 kg). The tube current was randomized prospectively in low weight group A, either 125 mA or 150 mA, in middle and high weight groups B and C, 150, 175 or 200 mA, with a tube revolution time of one second. The noise was measured in liver, skeleton muscle, fat tissue, and bladder content for evaluation of image quality. RESULTS The bodyweight groups differ significantly in noise, e.g., in the liver (150 mA): group A: 15.8 HU, group B: 18.9 HU, group C: 21.5 HU. The increase of tube current (150, 175, 200 mA) within a body weight group resulted in a minor decrease of noise (18.9 HU, 17.6 HU, 17.5 HU, respectively, in group B). There is a good correlation of noise with body weight, body mass index and body cross section, but not with body size. CONCLUSION A body weight adjusted reduction of tube current is possible without an increase of noise.
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Kaib M, Hacker M, Over I, Hardt C, Epplen JT, Baginess RK, Brandl R. Microsatellite loci in Macrotermes michaelseni (Isoptera: termitidae). Mol Ecol 2000; 9:502-4. [PMID: 10736060 DOI: 10.1046/j.1365-294x.2000.00871-9.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Siess W, Essler M, Brandl R. Lysophosphatidic Acid and Sphingosine 1-Phosphate: Two Lipid Villains Provoking Cardiovascular Diseases? ACTA ACUST UNITED AC 2000. [DOI: 10.1080/152165400306151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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