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Abstract
Following the successful application of the da Vinci robot in minimally invasive radical prostatectomy, several surgeries are now being performed with the assistance of the robot. These include both upper tract and lower tract surgeries such as nephrectomy, pyeloplasty and sacrocolpopexy and both ablative and reconstructive procedures. This article attempts to put into perspective the current role of the da Vinci Surgical system in urologic surgery and discusses in brief new developments in robotic technology that are on the horizon. A MEDLINE search was performed and published data on robot-assisted urologic procedures were reviewed. Abstracts presented at major international conferences in the last two years were also reviewed. Studies presenting operative and functional data for more than five patients were used in the review. There has been an explosive increase in the number of urologic procedures being attempted using Da Vinci assistance. Many, such as partial nephrectomy, donor nephrectomy, cystoprostatectomy, ureteral reimplantation and vasovasostomy are in the phase of feasibility studies, however others such as radical prostatectomy and pyeloplasty have one year functional results available which are comparable to those of other minimally invasive approaches. We believe that robotic technology represents the future of minimally invasive surgery and applications for the robot will expand as more centers report their results.
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Koliogiannis D, Fersis N, Sohn S, Kaul S. Zirkulierende Tumorzellen: Quantitative Genexpressionsanalyse bei Patienten mit Brustkrebs. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-984658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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103
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Aggarwal M, Kaul S, Sohn C, Fersis N. Neue Anreicherungs- und molekulardiagnostische Nachweismethoden für die Detektion disseminierter Tumorzellen (DTC) im Knochenmark von Patientinnen mit Brustkrebs. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-984635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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104
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Sisic L, Kaul S, Sohn C, Fersis N. Neue Methode zur immunmagnetischen Anreicherung für den molekularen Nachweis von zirkulierenden Tumorzellen im Blut bei Patientinnen mit Mammakarzinom. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-984678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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105
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Aggarwal M, Kaul S, Sohn C, Fersis N. Standardisierung molekulardiagnostischer Methoden für die Detektion disseminierter Tumorzellen (DTC) im Knochenmark von Patientinnen mit Brustkrebs. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-983509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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106
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Sisic L, Kaul S, Sohn C, Fersis N. Neue immunmagnetische Anreicherungsmethode für den molekularen Nachweis von zirkulierenden Tumorzellen im Blut bei Patientinnen mit Mammakarzinom. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-983510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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107
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Koliogiannis D, Fersis N, Sohn C, Kaul S. Quantitative Genexpressionsanalyse zirkulierender Tumorzellen bei Patienten mit Mammakarzinom. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-983434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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108
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Brown P, Peterson J, Khashab M, Kaul S, Fisher A, Kahn J. O142 Once daily, levofloxacin 750 mg for 5 days in the treatment of acute pyelonephritis and associated bacteraemia. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)70092-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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109
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Kaul S, Mentzer D, Vieths S, Hirsch T, Niggemann B. Symposium 12: Spezifische Immuntherapie im Kindes- und Jugendalter. ALLERGO JOURNAL 2007. [DOI: 10.1007/bf03370587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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110
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Steier J, Kaul S, Seymour J, Jolley C, Man W, Rafferty G, Luo Y, Polkey M, Moxham J. Der Wert einer Kombination von Atemmuskeltests. Pneumologie 2007. [DOI: 10.1055/s-2007-973240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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111
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Kaul S, Lüttkopf D, Kastner B, Vogel L, Höltz G, Vieths S, Hoffmann A. Mediator release assays based on human or murine immunoglobulin E in allergen standardization. Clin Exp Allergy 2007; 37:141-50. [PMID: 17210052 DOI: 10.1111/j.1365-2222.2006.02618.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The biological potency of allergens can be measured by provoking mediator release from effector cells. As established immunochemical methods in allergen standardization only determine inhibition potency or major allergen content, routine tests for biological potency may enhance standardization and batch control of allergen products. OBJECTIVE The general performance and application potential of biological in vitro assays in batch control and standardization of allergens and as a tool for verifying activity and stability of allergen standards were analysed. METHODS Allergen extracts of five clinically relevant allergens from three to five different manufacturers were investigated. A CAP-IgE-inhibition assay was compared with mediator release assay (MRA)s based on murine or human basophils. Rat basophilic leukaemia (RBL) cells were passively sensitized with pooled murine allergen-specific IgE-containing sera. Humanized RBL cells and human-stripped basophils were sensitized with pooled patient's sera, which were also used for the CAP-IgE-inhibition assay. Allergen specificity of the sera was determined by immunoblotting. RESULTS A good batch-to-batch consistency was found with each assay among all manufacturers and allergens tested. Between different manufacturers, the products showed differences in activity and the various assays indicated an almost identical ranking. However, the biological assays revealed qualitative differences of biological activity or composition of allergen preparations undetectable by IgE-inhibition assay. CONCLUSIONS MRAs provide refined information on allergen activity, either confirming the results of IgE-inhibition assay, or indicating differences requiring further investigation, and represent a highly sensitive novel tool in allergen standardization. By using permanently cultivated cell lines, repeated venepuncture to obtain human basophils is avoided. As in the RBL assay, the coefficient of variation for the release values were below 15% and for the ED50 below 25%, the assay is suitable to determine differences that are relevant for batch control purposes.
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Kaul S, Stell I, Chinn S, Polkey M, Moxham J. The effect of entrainment site and inspiratory pressure on the delivery of oxygen therapy during non-invasive mechanical ventilation (NIMV) in acute COPD patients. Eur Respir Rev 2006. [DOI: 10.1183/09059180.00010122] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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113
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Kaul S, Sharma SS, Mehta IK. Free radical scavenging potential of L-proline: evidence from in vitro assays. Amino Acids 2006; 34:315-20. [PMID: 17086481 DOI: 10.1007/s00726-006-0407-x] [Citation(s) in RCA: 140] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2005] [Accepted: 06/20/2006] [Indexed: 10/23/2022]
Abstract
An assessment of the potential of proline to scavenge free radicals was made in a couple of in vitro assay systems, namely graft co-polymerization and autooxidation of pyrogallol. Both these assays are essentially dependent upon free radical mechanisms. Graft co-polymerization involved a ceric (Ce(4+)) ion- or gamma-radiation-induced grafting of methyl acrylate (MA) onto a cellulose backbone. The degree of grafting, measured gravimetrically, was taken as a measure of free radical generation. The gamma-radiation-dependent grafting was far greater than that due to Ce(4+) ions. Inclusion of proline in the assay, irrespective of the initiator used, led to suppression of grafting in a concentration-dependent manner indicating the ability of proline to scavenge free radicals. The gamma-radiation-dependent grafting was also suppressed by hydroquinone and glutathione but not by ascorbate, glycine and spermine. In contrast to graft co-polymerization, proline did not inhibit the autooxidation of pyrogallol, a reaction involving superoxide radical generation. A subset of data constitutes an evidence for the ability of proline to scavenge free radicals in vitro. It is implied by extension that free proline, known to accumulate in plant tissues during abiotic stresses, would contribute to scavenging of surplus free radicals produced under a variety of abiotic stresses.
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May S, Kaul S, Schröder C, Vieths S. Therapieallergene zur spezifischen Immuntherapie. Hautarzt 2006; 57:867-74. [PMID: 16977441 DOI: 10.1007/s00105-006-1201-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The marketing authorization of allergen preparations for specific immunotherapy (SIT) for subcutaneous injection (SCIT) and sublingual immunotherapy (SLIT) at the Paul-Ehrlich-Institut (PEI) insures that the quality, safety, and efficacy of these medicinal products is proven. As finished products, these medicinal products are subject to official batch control tests, which provide evidence that only those products are marketed which conform to the specifications laid down in the marketing authorization procedure. Products for SIT prepared for a patient on the basis of the physician's prescription - so-called named patient products - cannot be subjected to a marketing authorization review. Therefore, they are not subject to the pharmaco-surveillance by the PEI regarding quality, safety and efficacy. This article describes the different marketing authorization procedures in the European Union (EU) and addresses the problems related to the marketing authorization requirements.
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Fersis N, Deckwart V, Leitz A, Böcher O, Sohn C, Kaul S. Klinische Signifikanz zirkulierender Tumorzellen im peripheren Blut bei Patientinnen mit primärem und metastatischem Mammakarzinom. Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-952267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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116
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Deckwart V, Leitz A, Kaul S, Böcher O, Eichler A, Sohn C. Nachweis von zirkulierenden Tumorzellen im peripheren Blut bei Patientinnen mit primärem Mammakarzinom mittels neuer Multiplex-PCR Ansätze für die Marker Cytokeratin-19 und Survivin sowie Mammaglobin und PSE. Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-952506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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117
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Eichbaum MHR, Loebl C, Kaul S, Steinborn A, Schneeweiss A, Sohn C. Unterschiedliche Zytokinsekretionsprofile bei humanen Mammakarzinomzelllinien – Einfluss auf das Tumor/Host microenvironment und damit auf die Metastasierung? Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-952538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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118
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Kaul S, Fersis N, Fersis N, Sohn C. Micrometastatische Tumorzellen im Knochenmark–Vergleich der Immunzytologie mit einer Multimarker RT-PCR-Analyse nach Präanalytischer Tumorzellanreicherung. Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-952199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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119
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Sundaram C, Umabala P, Laxmi V, Purohit AK, Prasad VSSV, Panigrahi M, Sahu BP, Sarathi MV, Kaul S, Borghain R, Meena AK, Jayalakshmi SS, Suvarna A, Mohandas S, Murthy JMK. Pathology of fungal infections of the central nervous system: 17 years' experience from Southern India. Histopathology 2006; 49:396-405. [PMID: 16978203 DOI: 10.1111/j.1365-2559.2006.02515.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS To describe the pathology of central nervous system (CNS) fungal infections with particular reference to India. METHODS AND RESULTS This was a retrospective study from 1988 to 2004 constituting 130 cases. The diagnosis was based on morphology of biopsy/autopsy material. These included aspergillosis (n=73), zygomycosis (n=40), cryptococcosis (n=2), rhodotorulosis (n=1), candidiasis (n=5), maduramycosis (n=1), pheohyphomycosis (n=3) and mixed infections (n=5). Predisposing risk factors were present in 49 (38%) patients only. The majority of the patients were immunocompetent. The commonest risk factor was diabetes mellitus, the commonest route of infection was from a contiguous site and the commonest pathology was granuloma. Culture positivity was seen in only 31%. CONCLUSION Environmental factors in tropical countries such as India play a significant role in the pathogenesis of CNS fungal infections.
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120
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Fersis N, Deckwart V, Leitz A, Weber M, Rom J, Böcher O, Albert WH, Bastert G, Sohn C, Kaul S. Molecular profiling of circulating tumor cells in the peripheral blood of patients with primary and metastatic breast cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.20033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
20033 Background: The purpose of this study was detection and expression profiling of circulating tumor cells (CTC) in breast cancer patients. Methods: Two separate probes of 5 mL peripheral EDTA-blood from patients with primary breast cancer (n=167) and metastatic disease (n=111) were used for immunomagnetic tumor cell selection. Targets for preanalytical enrichment were the antigens EpCAM and MUC-1. Separated cells were lysed and used for mRNA isolation and c-DNA synthesis. The breast carcinoma-associated transcripts EpCAM, MUC-1, HER-2, claudin7, cytokeratin 19, mammaglobin 1, prostate-specific ets factor (PSE) and survivin were amplified by three separate multiplex RT-PCR reactions. Amplicons were analysed by capillary electrophoresis with the Agilent Bioanalyzer 2100. Specificity of the RT-PCR was confirmed by examination of blood of healthy donors. Results: Sensitivity for every single transcript was adjusted to 2 tumor cells per 5 ml blood. Tumor-associated transcripts were detected in 31 of of 167 (18.5%) patients with primary breast cancer and in 46 of 111 (41%) patients with metastatic disease. The marker with the highest incidence in both groups was MUC-1, with a positivity rate of 81%. Tumor-associated transcripts were heterogenouosly expressed, however multiple markers were identified in more than 50% of the positive samples. Conclusion: Using a combination of preanalytical immunomagnetic tumor cell enrichment followed by a multigen RT-PCR approach we describe a sensitive detection system for breast carcinoma cells. In this study a panel of 8 genes overexpressed at high levels in metastatic breast cancer was selected for the identification of disseminated tumor cells in the peripheral blood of breast cancer patients. HER-2, survivin as a unique member of the inhibitor of apotosis protein family, as well as PSE identified in circulating breast cancer cells may serve as prognostic indicators of tumor progression and could represent valid targets for new individualized therapeutic interventions. No significant financial relationships to disclose.
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Kohli V, Nooreyazdan S, Das BN, Kaul S, Singh J, Parmar V. Surgical reconstruction for absence of sternum and pericardium in a newborn. Indian J Pediatr 2006; 73:367-8. [PMID: 16816503 DOI: 10.1007/bf02825837] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We report the surgical management of a 3 day old baby with absent sternum and pericardium with impending rupture of the skin cover. The repair described is innovative and may be used in place of primary repair by bringing the ribs together. Review of embryology and various modalities of closure are provided.
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Klibanov A, Rychak J, Yang W, Li B, Acton S, Lindner J, Ley K, Kaul S. CMR 2005: 8.03: Targeted ultrasound contrast agents for molecular imaging in high-shear flow. CONTRAST MEDIA & MOLECULAR IMAGING 2006. [DOI: 10.1002/cmmi.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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123
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Klibanov AL, Rychak JJ, Yang WC, Alikhani S, Li B, Acton S, Lindner JR, Ley K, Kaul S. Targeted ultrasound contrast agent for molecular imaging of inflammation in high-shear flow. CONTRAST MEDIA & MOLECULAR IMAGING 2006; 1:259-66. [PMID: 17191766 DOI: 10.1002/cmmi.113] [Citation(s) in RCA: 136] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Targeted ultrasound contrast materials (gas-filled microbubbles carrying ligands to endothelial selectins or integrins) have been investigated as potential molecular imaging agents. Such microbubbles normally exhibit good targeting capability at the slower flow conditions. However, in the conditions of vigorous flow, binding may be limited. Here, we describe a microbubble capable of efficient binding to targets both in slow and fast flow (exceeding 4 dyne/cm(2) wall shear stress) using a clustered polymeric form of the fast-binding selectin ligand sialyl Lewis(X). Microbubbles were prepared from decafluorobutane gas and stabilized with a monolayer of phosphatidylcholine, PEG stearate and biotin-PEG-lipid. Biotinylated PSLe(x) (sialyl Lewis(X) polyacrylamide) or biotinylated anti-P-selectin antibody (RB40.34) was attached to microbubbles via a streptavidin bridge. In a parallel plate flow chamber targeted adhesion model, PSLe(x) bubbles demonstrated specific adhesion, retention and slow rolling on P-selectin-coated plates. Efficiency of firm targeted adhesion to a P-selectin surface (140 molecules/microm(2)) was comparable for antibody-carrying bubbles and PSLe(x)-targeted bubbles at 0.68 dyne/cm(2) shear stress. At fast flow (4.45 dyne/cm(2)), PSLe(x)-targeted bubbles maintained their ability to bind, while antibody-mediated targeting dropped more than 20-fold. At lower surface density of P-selectin (7 molecules/microm(2)), targeting via PSLe(x) was more efficient than via antibody under all the flow conditions tested. Negative control casein-coated plates did not retain bubbles in the range of flow conditions studied. To confirm echogenicity, targeted PSLe(x)-bubbles were visualized on P-selectin-coated polystyrene plates by ultrasound imaging with a clinical scanner operated in pulse inversion mode; control plates lacking targeted bubbles did not show significant acoustic backscatter. In vivo, in a murine model of inflammation in the femoral vein setting, targeting efficacy of intravenously administered PSLe(x)-microbubbles was comparable with targeting mediated by anti-P-selectin antibody, and significantly exceeded the accumulation of non-targeted control bubbles. In the inflamed femoral artery setting, PSLe(x)-mediated microbubble targeting was superior to antibody-mediated targeting.
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Kumar SP, Kaul S, Saha PK, Miller MJ. Images in cardiology. Angiographic appearance of "tumour blush" produced by a large right atrial myxoma. Heart 2005; 92:48. [PMID: 16365350 PMCID: PMC1860983 DOI: 10.1136/hrt.2005.067744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Kumar SP, Kaul S, Saha PK, Miller MJ. Angiographic appearance of "tumour blush" produced by a large right atrial myxoma. BRITISH HEART JOURNAL 2005; 92:751. [PMID: 16698829 PMCID: PMC1860640 DOI: 10.1136/hrt.2005.073684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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