76
|
Uribe M, Buckel E, Ferrario M, Segovia R, González G, Hunter B, Godoy J, Berwart F, Brahm J, Silva G, Cavallieri S, Calabrán L, Santander MT, Herzog C. ABO-incompatible liver transplantation: a new therapeutic option for patients with acute liver failure in Chile. Transplant Proc 2005; 37:1567-8. [PMID: 15866675 DOI: 10.1016/j.transproceed.2004.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Different ways have been suggested to expand donor numbers for liver transplantation. Transplantation using ABO-incompatible hepatic grafts has recently been a controversial issue due to the high risk of hyperacute rejection mediated by preformed anti-ABO antibodies. We report three patients with acute liver failure who were transplanted with ABO-incompatible livers: A to O in two patients and A to B in one case. We used pre- and posttransplant total plasma exchange, splenectomy, and triple immunosuppression. All three patients are alive; one graft was lost, probably secondary to thrombotic microangiopathy with low isohemagglutinin titers of 1:8. One patient developed acute cellular rejection that was reversed with a bolus of methylprednisolone. No antibody-mediated rejection occurred. Financial and infectious considerations have to be considered. In our series, the final liver transplantation cost was higher than average for acute liver failure. Plasmapheresis has the highest cost of all the additional procedures. ABO-incompatible liver transplantation, because of the splenectomy it requires, has been associated with more infections due to encapsulated organisms. However, with splenectomy in our three patients, none had infections due to these bacteria. In our country, we do not consider ABO-incompatible liver transplantation as a first-line option, except for highly selected patients.
Collapse
|
77
|
Zangos S, Eichler K, Wetter A, Lehnert T, Hammerstingl R, Diebold T, Reichel P, Herzog C, Hansmann ML, Mack MG, Vogl TJ. MR-guided biopsies of lesions in the retroperitoneal space: technique and results. Eur Radiol 2005; 16:307-12. [PMID: 16059677 DOI: 10.1007/s00330-005-2870-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2005] [Revised: 06/06/2005] [Accepted: 07/04/2005] [Indexed: 10/25/2022]
Abstract
The purpose of this study was to evaluate the safety and precision of MRI-guided biopsies of retroperitoneal space-occupying tumors in an open low-field system. In 30 patients with indistinct retroperitoneal tumors [paraaortic lesion (n=20), kidney (n=2), suprarenal gland (n=3) and pancreas (n=5)] MR-guided biopsies were performed using a low-field system (0.2 T, Magnetom Concerto, Siemens, Germany). For the monitoring of the biopsies T1-weighted FLASH sequences (TR/TE=160/5 ms; 90 degrees ) were used in all patients and modified FLASH sequences (TR/TE=160/13 ms; 90 degrees ) in ten patients. After positioning of the needle in the tumors 114 biopsy specimens were acquired in coaxial technique with 16-gauge cutting needles (Somatex, Germany). The biopsies were successfully performed in all patients without vascular or organ injuries. The visualization of the aortic blood flow with MRI facilitated the biopsy procedures of paraaortic lesions. The size of the lesions ranged from 1.6 to 7.5 cm. The median distance of the biopsy access path was 10.4 cm. Adequate specimens were obtained in 28 cases (93.3%) resulting in a correct histological classification of 27 lesions (90%). In conclusion, MR-guided biopsies of retroperitoneal lesions using an open low-field system can be performed safely and accurately and is an alternative to CT-guided biopsies.
Collapse
|
78
|
Khan F, Herzog C, Landenberger K, Adel AM, Martens S, Jessen G, Vogl TJ. Nichtinvasive Koronarbypass-Bildgebung: 4-Zeiler vs. 16-Zeiler-MDCT. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
79
|
Zangos S, Brieske T, Kissler S, Eichler K, Lehnert T, Herzog C, Straub R, Vogl TJ. Beurteilung der Uteruskontraktionen sowie Uterusmorphologie im Zyklusverlauf mittels hochauflösenderer MRT. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
80
|
Zangos S, Abedini A, Hammerstingl R, Eichler K, Mack M, Heller M, Herzog C, Vogl TJ. Präinterventionelle pelvine kontrastmittelverstärkte MR-Angiographie (ceMRA): Wertigkeit differenter Kontrastmittel zur Planung der arteriellen Embolisation von Myomen. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
81
|
Schwarz VR, Hammerstingl R, Herzog C, Eichler K, Zangos S, Heller M, Harth M, Vogl TJ. „ALL-IN-ONE-MRT der Leber“: Abklärung von Veränderungen des Leberparenchyms, des Gefäßsystems und der Gallenwege in einer MRT-Untersuchung. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
82
|
Proschek DP, Vogl TJ, Hochmuth K, Mack M, Herzog C, Schwarz W. Perkutane Vertebroplastie in der Therapie von osteoporotischen Wirbelkörperfrakturen. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-868352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
83
|
Zangos S, Vetter T, Mack M, Eichler K, Lehnert T, Herzog C, Heller M, Vogl TJ. MR-gesteuerte perkutane Biopsien am MR-Open: Erste klinische Ergebnisse einer neuen kabellosen Spule. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
84
|
Bisdas S, Donnerstag F, Weissenborn K, Herzog C, Harth M, Becker H, Vogl TJ. Der Einfluss der arteriellen Input-Funktion auf den zerebralen Blutfluss bei hyperakuten und chronischen hämodynamischen Störungen in der Perfusions-CT. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
85
|
Gurung J, Khan MF, Maataoui A, Herzog C, Bux R, Bratzke H, Ackermann H, Vogl TJ. Multislice CT of the pelvis: dose reduction with regard to image quality using 16-row CT. Eur Radiol 2005; 15:1898-905. [PMID: 15806366 DOI: 10.1007/s00330-005-2720-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2004] [Accepted: 02/15/2005] [Indexed: 10/25/2022]
Abstract
To optimize examination protocols of 16-row multi-detector CT (MDCT) of pelvis for dose reduction with regard to image quality. MDCT of pelvis was performed on 12 cadaver specimens with stepwise reduction of tube current from 160 mA (113, 80, 56, 40, 28) to 20 mA at 120 kV. Scan parameters were 16 x 1.5 mm collimation. Reconstructions of axial and coronal images were used for evaluation of cortex, trabeculum, image quality, image noise, acetabulum and iliosacral (ISJ) joints. After data were blinded, evaluation of images was done by three radiologists according to 5-point Likert scale. Accuracy of the observers in sorting films according to dose reduction was determined with kappa coefficient. Mean values of image evaluation were determined. Pronounced deterioration of image quality for all criteria was observed between 80 and 28 mA. Adequate image quality was obtained at 40 mA [effective dose (E): 2.2 mSv, CTDI(w): 2.8 mGy] for criterion detailed definition of acetabulum and ISJ and at 80 mA (E: 4.4 mSv, CTDI(w): 5.6 mGy) for remaining criteria. Moderate agreement was observed between the three observers (kappa coefficient: 0.31). All observers were excellent in arranging images according to decreasing dose. Using 16-row MDCT image quality of pelvis is acceptable at 80 mA and 120 kV. This translates into a dose reduction of 33% of average value of the nationwide survey of the German Roentgen Society (1999) for this type of examination.
Collapse
|
86
|
Leyten E, Soonawala D, Schultsz C, Herzog C, Ligthelm R, Wijnands S, Visser L. WITHDRAWN: CVD 103-HgR live oral cholera vaccine failed to prevent travellers' diarrhoea in a randomised, double-blind, placebo-controlled study. Vaccine 2005. [DOI: 10.1016/j.vaccine.2005.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
87
|
Zangos S, Kissler S, Mueller A, Siebzehnruebl E, Kaufmann M, Hamscho N, Grünwald F, Eichler K, Herzog C, Marquardt F, Peters J, Jacobi V, Mack MG, Vogl TJ. MRT der uterinen Adenomyose bei infertilen Patientinnen: Ergebnisse und klinische Rückschlüsse. ROFO-FORTSCHR RONTG 2004; 176:1641-7. [PMID: 15497083 DOI: 10.1055/s-2004-813644] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To evaluate the clinical value of magnetic resonance imaging (MRI) of the uterus and the pelvis in infertile female with symptomatic endometriosis for the assessment of uterine morphology and function. MATERIALS AND METHODS Forty-one infertile women (mean age: 33.2 years) with symptomatic endometriosis documented by laparoscopy were evaluated with high-field MRI (Sonata, Siemens) using T2- and T1-weighted sequences. In addition, the patients underwent hysterosalpingoscintigraphy (HSSG) for evaluation of the uterotubal transport capacity. Pathologic findings of the uterine junction zone were correlated with the laparoscopic results, clinical symptoms and uterotubal transport capacity. RESULTS Adenomyosis was diagnosed on T2-weigthed MR-images in 35 (85.4 %) patients (focal adenomatosis in 26 patients and diffuse adenomatosis in 9). Patients showing signs of adenomyosis tended to be older than patients without adenomyosis (mean age 34.1 years vs. 30.1 years) and showed a longer history of symptomatic endometriosis. A positive transport capacity in HSSG was observed in 73.1 % (19/26) of the patients with focal adenomyosis and in only 22.2 % (2/9) of patients with diffuse adenomyosis. In 83.3 % (5/6) of the patients without signs of adenomyosis, a positive uterotubal transport was documented. CONCLUSION MRI of the uterus is a helpful diagnostic tool for the diagnosis of adenomyosis and for planning further therapies. Patients with the diagnosis of adenomyosis showed a reduced uterotubal transport capacity that depended on the severity of adenomyotic changes and might be a possible cause of infertility.
Collapse
|
88
|
Dogan S, Aybek T, Risteski P, Mierdl S, Stein H, Herzog C, Khan MF, Dzemali O, Moritz A, Wimmer-Greinecker G. Totally endoscopic coronary artery bypass graft: initial experience with an additional instrument arm and an advanced camera system. Surg Endosc 2004; 18:1587-91. [PMID: 15931491 DOI: 10.1007/s00464-003-9193-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2003] [Accepted: 04/07/2004] [Indexed: 11/25/2022]
Abstract
BACKGROUND Robotically enhanced telemanipulation for totally endoscopic coronary artery bypass does not provide adequate tactile feedback, traction, or countertraction. The exposition of coronary target sites is difficult, the visual field is limited, and the epicardial stabilization may be troublesome. A fourth robotic arm for endothoracic instrumentation has been added to the da Vinci surgical system to facilitate totally endoscopic operations. The stereoendoscope was upgraded with a wide-angle feature. METHODS The procedure was performed in five patients. Four of these patients had left internal thoracic artery (LITA) to left anterior descending artery (LAD) grafting on the beating heart and the fifth had sequential bypass grafting (LITA to diagonal branch and LAD) on an arrested heart. The additional effector arm of the da Vinci surgical system was brought into the operative field beneath the operating table and used as a second right arm. The wide-angle view was activated by either the console or the patient side surgeon. RESULTS The mean operative, port placement, and anastomotic times for a beating-heart totally endoscopic coronary artery bypass were 195 +/- 58, 25 +/- 10, and 18 +/- 5 min, respectively. All procedures were free of morbidity and mortality, with satisfactory angiographic control. The sequential arterial bypass grafting procedure was fully completed in totally endoscopic technique. CONCLUSIONS The additional instrumentation arm and wide-angle visualization are useful technical improvements of the da Vinci surgical system, solving the problem of traction, countertraction, and facilitated exposition of target sites as well as visualization of the surgical field. They provide potential for wider acceptance of totally endoscopic coronary artery bypass grafting in a larger surgical community.
Collapse
|
89
|
Herzog C, Ahle H, Mack MG, Maier B, Schwarz W, Zangos S, Jacobi V, Thalhammer A, Peters J, Ackermann H, Vogl TJ. Traumatic injuries of the pelvis and thoracic and lumbar spine: does thin-slice multidetector-row CT increase diagnostic accuracy? Eur Radiol 2004; 14:1751-60. [PMID: 15300395 DOI: 10.1007/s00330-004-2424-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2004] [Revised: 06/15/2004] [Accepted: 06/22/2004] [Indexed: 11/28/2022]
Abstract
The objective is to evaluate different multidetector-row CT (MDCT) strategies for adequate classification of spinal and pelvic injuries. Seventy intubated patients after multiple trauma underwent conventional radiography (CR) and MDCT. Examinations included the pelvis (P), the lumbar spine (LS) and the thoracic spine (TS). Conventional radiographs, 3-mm (CT5) and 5-mm scans (CT3) and 3-mm and 5-mm scans combined with MPR (CT3R/CT5R) were compared to surgery, autopsy and clinical course. MDCT led to significantly better results than CR (P<0.01). Correlation coefficients were r=1.0 (CT3R), r=0.96 [TS] to r=1.0 [P/LS] (CT5R), r=0.8 [P] to r=1.0 [TS] (CT3), r=0.80 [P] to r=0.86 [TS] (CT5) and r=0.3 [TS] to r=0.69 [P] (CR). Fractures were identified by CT3R in 100% of cases, by CT5R in 95%, by CT3 in 90% [P]-100% [TS], by CT5 in 83.3% [LS]-90% [P] and by CR in 57.1% [TS]-87.2% [P]. Unstable fractures were identified in 100% by CT3R, CT5R and CT3, 85.7% [TS]-100% [P/LS] by CT5 and 57.1% [TS]-80% [P] by CR. Only overlapping thin-slice multiplanar reformation allows for an adequate classification of spinal and pelvic injuries and thus is highly emphasized in patients after severe blunt trauma.
Collapse
|
90
|
Pappo A, Ries L, Herzog C, Bleyer A. Malignant melanoma in the first three decades of life: A report from the U.S. Surveillance, Epidemiology and End Results (SEER) Program. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.7557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
91
|
Vogl TJ, Eichler K, Mack MG, Balzer JO, Herzog C, Söllner O, Zangos S, Thalhammer A. A phase I study of hepatic arterial infusion (HAI) of irinotecan in patients with inoperable liver metastases of colorectal cancer. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.3714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
92
|
Eichler K, Zangos S, Mack MG, Balzer JO, Söllner O, Herzog C, Engelmann K, Vogl TJ. Hepatic intra-arterial chemotherapy with gemcitabine: An ongoing phase II study in patients with liver metastases of breast cancer. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
93
|
Koontz SE, Mohassel LR, Jaffe N, Pearson M, Herzog C, Ramirez I, Raney RB. Safety and efficacy of pegfilgrastim in pediatric oncology patients: The M.D. Anderson Cancer Center experience. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.8272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
94
|
Uribe M, Buckel E, Ferrario M, Godoy J, González G, Hunter B, Ceresa S, Cavallieri S, Berwart F, Blanco A, Smok G, Calabrán L, Santander MT, Herzog C. LIVING RELATED LIVER TRANSPLANTATION INDICATED IN EMERGENCY SITUATIONS IN A PEDIATRIC LIVER TRANSPLANT PROGRAM IN CHILE. Transplantation 2004. [DOI: 10.1097/00007890-200407271-01210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
95
|
Ambrosch F, Finkel B, Herzog C, Koren A, Kollaritsch H. Rapid Antibody Response after Vaccination with a Virosomal Hepatitis A Vaccine. Infection 2004; 32:149-52. [PMID: 15188074 DOI: 10.1007/s15010-004-3147-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2003] [Accepted: 01/13/2004] [Indexed: 11/27/2022]
Abstract
BACKGROUND This study was designed to assess the early antibody kinetics after a priming dose, and the extent of the antibody increase after a booster dose of an inactivated virosomal hepatitis A virus (HAV) vaccine (Epaxal). PATIENTS AND METHODS This was an open, uncontrolled study in 30 healthy subjects. The vaccine was injected intramuscularly on day 1 and month 12. Serum antibody titers were measured by ELISA on day 1 (pre dose) and at various time points thereafter until month 12 (pre-booster dose). After the booster dose, antibody titers were measured at various intervals until month 24. Neutralizing antibody titers were measured in 12 subjects a number of times during the 1st month by an antibody neutralization assay. Titers > or = 10 mIU/ml were considered seroprotective. RESULTS ELISA antibody titers showed a rapid increase post vaccination. By day 15, 96% of subjects were seroprotected, which increased to 100% by day 22 (n = 27 evaluable subjects, aged 18-43 years; 13 male, 14 female). All subjects achieved seroprotective HAV-neutralizing antibody titers by day 11 (n = 12). The booster vaccination at month 12 resulted in a strong response in all subjects, with a sustained anti-HAV antibody titer (1,155 mIU/ml) at month 24. Both the priming and booster doses were well tolerated. CONCLUSION Primary vaccination with this virosomal HAV vaccine is well tolerated and induces a rapid HAV-neutralizing antibody response resulting in seroprotection in all subjects within 10 days. In addition, the booster vaccination results in prolonged seroprotective antibody levels.
Collapse
|
96
|
Usonis V, Bakasénas V, Valentelis R, Katiliene G, Vidzeniene D, Herzog C. Antibody titres after primary and booster vaccination of infants and young children with a virosomal hepatitis A vaccine (Epaxal). Vaccine 2004; 21:4588-92. [PMID: 14575771 DOI: 10.1016/s0264-410x(03)00509-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
To evaluate the immunogenicity and tolerability of Epaxal in infants and children, 30 infants (aged 6-7 months) and 30 children (aged 5-7 years) received a single intramuscular dose of the aluminium-free virosomal hepatitis A virus (HAV) vaccine Epaxal and a booster dose after 12 months. Anti-HAV antibody titres were measured at baseline (before injection), at 1 and 12 months after primary vaccination, and 1 month after the booster vaccination. Sixteen evaluable infants had maternal anti-HAV antibodies at baseline. Complete seroprotection (titre >/= 20 mIU/ml) was achieved by all infants and children at Month 1 and at Month 12. Additionally, all subjects showed a strong antibody response to booster vaccination. In infants without maternal anti-HAV antibodies, the response was four-fold higher than in those with maternal anti-HAV antibodies. Both doses of Epaxal were well tolerated. These preliminary data suggest that Epaxal is an effective hepatitis A vaccine for children and infants from 6 months of age.
Collapse
|
97
|
Durrer P, Glück U, Spyr C, Lang AB, Zurbriggen R, Herzog C, Glück R. Mucosal antibody response induced with a nasal virosome-based influenza vaccine. Vaccine 2004; 21:4328-34. [PMID: 14505915 DOI: 10.1016/s0264-410x(03)00457-2] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A vaccination against influenza that elicits both a systemic antibody and a mucosal IgA response would improve on the protective efficacy of currently available vaccines. Previous studies have shown the safety and efficacy of virosomes as delivery systems in vaccination. This study was a controlled, randomised, double-blind, single centre, phase II trial assessing an intranasal virosome vaccine, adjuvanted with heat-labile toxin (HLT) from enterotoxigenic Escherichia coli, versus an intranasal without HLT and comparing it open to an intramuscular vaccine in a total of 88 healthy adults. The development of a new technique enabled for the first time the detection of neutralising IgA antibodies in very dilute nasal wash samples. It was demonstrated that intranasally administered inactivated influenza vaccine, adjuvanted with HLT, not only elicits a spectrum of humoral and cell-mediated responses in healthy adults, critical for the protection and recovery from influenza virus infection, but is also highly effective in eliciting IgA neutralising antibodies at the mucosa. Intranasal virosome-formulated, HLT-adjuvanted, influenza vaccine was effective and well tolerated in this study. Its potential to offer a high level of mucosal protection, not provided by conventional parenteral vaccination, could play a significant role in preventing morbidity and mortality associated with influenza.
Collapse
|
98
|
Herzog C, Salès N, Etchegaray N, Charbonnier A, Freire S, Dormont D, Deslys JP, Lasmézas CI. Tissue distribution of bovine spongiform encephalopathy agent in primates after intravenous or oral infection. Lancet 2004; 363:422-8. [PMID: 14962521 DOI: 10.1016/s0140-6736(04)15487-1] [Citation(s) in RCA: 115] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The disease-associated form of prion protein (PrP(res)) has been noted in lymphoreticular tissues in patients with variant Creutzfeldt-Jakob disease (vCJD). Thus, the disease could be transmitted iatrogenically by surgery or use of blood products. We aimed to assess transmissibility of the bovine spongiform encephalopathy (BSE) agent to primates by the intravenous route and study its tissue distribution compared with infection by the oral route. METHODS Cynomolgus macaques were infected either intravenously or orally with brain homogenates from first-passage animals with BSE. They were clinically monitored for occurrence of neurological signs and killed humanely at the terminal stage of the disease. Brain, lymphoreticular tissues, digestive tract, and peripheral nerves were obtained and analysed by sandwich ELISA and immunohistochemistry for quantitative and qualitative assessment of their PrP(res) content. FINDINGS Incubation periods after intravenous transmission of BSE were much shorter than after oral infection. We noted that PrP(res) was present in lymphoreticular tissues such as spleen and tonsils and in the entire gut from the duodenum to the rectum. In the gut, PrP(res) was present in Peyer's patches and in the enteric nervous system and nerve fibres of intestinal mucosa. Furthermore, PrP(res) was found in locomotor peripheral nerves and the autonomic nervous system. Amount of PrP(res) ranged from 0.02% to more than 10% of that recorded in brain. Distribution of PrP(res) was similar in animals infected by the intravenous or oral route. INTERPRETATION Our findings suggest that the possible risk of vCJD linked to endoscopic procedures might be currently underestimated. Human iatrogenic vCJD cases infected intravenously raise the same public-health concerns as primary cases and need the same precautionary measures with respect to blood and tissue donations and surgical procedures.
Collapse
|
99
|
Herzog C, Abolmaali N, Balzer J, Baunach S, Ackermann H, Dogan S, Schaechinger V, Vogl TJ. Frequenzadaptierte Bildrekonstruktion in der kardialen Computertomographie. ROFO-FORTSCHR RONTG 2004. [DOI: 10.1055/s-2004-827785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
100
|
Luboldt W, Kroll M, Hoepffner N, Herzog C, Wetter A, Vogl TJ. Kontrastbasierte automatische Detektion von kolorektalen Tumoren in der CT Colonographie: Bestimmung eines phasenabhängigen HU-Schwellenwertes. ROFO-FORTSCHR RONTG 2004. [DOI: 10.1055/s-2004-827816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|