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Audinot B, Drubay D, Gaspar N, Mohr A, Cordero C, Marec-Bérard P, Lervat C, Piperno-Neumann S, Jimenez M, Mansuy L, Castex MP, Revon-Riviere G, Marie-Cardine A, Berger C, Piguet C, Massau K, Job B, Moquin-Beaudry G, Le Deley MC, Tabone MD, Berlanga P, Brugières L, Crompton BD, Marchais A, Abbou S. ctDNA quantification improves estimation of outcomes in patients with high-grade osteosarcoma: a translational study from the OS2006 trial. Ann Oncol 2023:S0923-7534(23)05113-X. [PMID: 38142939 DOI: 10.1016/j.annonc.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 12/26/2023] Open
Abstract
BACKGROUND Osteosarcoma stratification relies on clinical parameters and histological response. We developed a new personalized stratification using less invasive circulating tumor DNA (ctDNA) quantification. PATIENTS AND METHODS Plasma from patients homogeneously treated in the prospective protocol OS2006, at diagnosis, before surgery and end of treatment, were sequenced using low-passage whole-genome sequencing (lpWGS) for copy number alteration detection. We developed a prediction tool including ctDNA quantification and known clinical parameters to estimate patients' individual risk of event. RESULTS ctDNA quantification at diagnosis (diagCPA) was evaluated for 183 patients of the protocol OS2006. diagCPA as a continuous variable was a major prognostic factor, independent of other clinical parameters, including metastatic status [diagCPA hazard ratio (HR) = 3.5, P = 0.002 and 3.51, P = 0.012, for progression-free survival (PFS) and overall survival (OS)]. At the time of surgery and until the end of treatment, diagCPA was also a major prognostic factor independent of histological response (diagCPA HR = 9.2, P < 0.001 and 11.6, P < 0.001, for PFS and OS). Therefore, the addition of diagCPA to metastatic status at diagnosis or poor histological response after surgery improved the prognostic stratification of patients with osteosarcoma. We developed the prediction tool PRONOS to generate individual risk estimations, showing great performance ctDNA quantification at the time of surgery and the end of treatment still required improvement to overcome the low sensitivity of lpWGS and to enable the follow-up of disease progression. CONCLUSIONS The addition of ctDNA quantification to known risk factors improves the estimation of prognosis calculated by our prediction tool PRONOS. To confirm its value, an external validation in the Sarcoma 13 trial is underway.
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Affiliation(s)
- B Audinot
- National Institute for Health and Medical Research (INSERM) U1015, Gustave Roussy, Villejuif
| | - D Drubay
- Gustave Roussy, Office of Biostatistics and Epidemiology, Université Paris-Saclay, Villejuif; Inserm, Université Paris-Saclay, CESP U1018, Oncostat, labeled Ligue Contre le Cancer, Villejuif
| | - N Gaspar
- National Institute for Health and Medical Research (INSERM) U1015, Gustave Roussy, Villejuif; Gustave Roussy Cancer Campus, Children and Adolescent Oncology Department, Villejuif; French Cancer Society (SFCE), Bordeaux
| | - A Mohr
- National Institute for Health and Medical Research (INSERM) U1015, Gustave Roussy, Villejuif
| | - C Cordero
- Pediatric Department, Institut Curie, Paris; French Cancer Society (SFCE), Bordeaux
| | - P Marec-Bérard
- Department of Oncology for Child and Adolescent, Centre Léon Bérard, Pediatric Oncology and Hematology Institute (IHOPe), Lyon; French Cancer Society (SFCE), Bordeaux
| | - C Lervat
- Department of Pediatric Oncology, Adolescents and Young Adults, Centre Oscar Lambret, Lille; French Cancer Society (SFCE), Bordeaux
| | | | - M Jimenez
- Research and Development Department, Unicancer, Paris
| | - L Mansuy
- Department of Pediatric Hematology and Oncology, Nancy University Hospital, Vandœuvre-lès-Nancy; French Cancer Society (SFCE), Bordeaux
| | - M-P Castex
- Pediatric Oncology Immunology Hematology Unit, Children's University Hospital, Toulouse; French Cancer Society (SFCE), Bordeaux
| | - G Revon-Riviere
- Department of Pediatric Hematology and Oncology, La Timone Children's Hospital, Marseille; French Cancer Society (SFCE), Bordeaux
| | - A Marie-Cardine
- Department of Pediatric Hematology and Oncology, Rouen University Hospital, Rouen; French Cancer Society (SFCE), Bordeaux
| | - C Berger
- Department of Pediatric Oncology, North Hospital, University Hospital of Saint Etienne, Saint Etienne; French Cancer Society (SFCE), Bordeaux
| | - C Piguet
- Pediatric Oncology Hematology Unit, Limoges University Hospital, Limoges; French Cancer Society (SFCE), Bordeaux
| | - K Massau
- National Institute for Health and Medical Research (INSERM) U1015, Gustave Roussy, Villejuif
| | - B Job
- National Institute for Health and Medical Research (INSERM) US23, Gustave Roussy, Villejuif
| | - G Moquin-Beaudry
- National Institute for Health and Medical Research (INSERM) U1015, Gustave Roussy, Villejuif
| | - M-C Le Deley
- Gustave Roussy, Office of Biostatistics and Epidemiology, Université Paris-Saclay, Villejuif; Clinical Research Department, Centre Oscar Lambret, Lille
| | - M-D Tabone
- Pediatric Hematology Department, Trousseau Hospital, Sorbonne Université, Paris, France; French Cancer Society (SFCE), Bordeaux
| | - P Berlanga
- Gustave Roussy Cancer Campus, Children and Adolescent Oncology Department, Villejuif; French Cancer Society (SFCE), Bordeaux
| | - L Brugières
- Gustave Roussy Cancer Campus, Children and Adolescent Oncology Department, Villejuif; French Cancer Society (SFCE), Bordeaux
| | - B D Crompton
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston; Broad Institute of Harvard and MIT, Cambridge, USA
| | - A Marchais
- National Institute for Health and Medical Research (INSERM) U1015, Gustave Roussy, Villejuif
| | - S Abbou
- National Institute for Health and Medical Research (INSERM) U1015, Gustave Roussy, Villejuif; Gustave Roussy Cancer Campus, Children and Adolescent Oncology Department, Villejuif; French Cancer Society (SFCE), Bordeaux.
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Stadler S, Mohr A, Wagner A, Bäßler A, Fischer M, Putz FJ, Strack C, Li J, Arzt M. Weight loss induced alleviation of sleep-disordered breathing is associated with improvement of non-alcoholic fatty liver disease. Sleep Med 2023; 112:159-164. [PMID: 37866211 DOI: 10.1016/j.sleep.2023.10.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 10/04/2023] [Accepted: 10/16/2023] [Indexed: 10/24/2023]
Abstract
INTRODUCTION Sleep-disordered breathing (SDB) and non-alcoholic fatty liver disease (NAFLD) are both common comorbidities in obese patients. Structured weight loss programs are effective and can reduce the incidence and severity of obesity-related comorbidities. The objective of the present analysis is to test whether weight loss induced alleviation of SDB is a predictor for improvement of NAFLD. METHODS Obese participants underwent a standardized non-surgical 3 months weight reduction program (800 kilocalories per day with low carbohydrate and fat content). Abdominal sonography for NAFLD (grade 0 to 3) and monitoring for SDB (defined as apnea-hypopnea index [AHI] ≥ 15/h) were performed at baseline and after 3 months. Alleviation of SDB was defined as a shift from AHI≥ 15/h to <15/h. RESULTS 48 patients (48% female, age 42 ± 12 years, body-mass index 40.3 ± 8.1 kg/m2, AHI 14 ± 17/h, 85% NAFLD grade ≥1) participated in the weight loss program. In contrast to the no SDB group, in patients with SDB weight loss of 27.1 ±0 .9 kg (8.4 ± 2.8 kg/m2) after three months was paralleled by a reduction in AHI (-22 ± 17/h), prevalence of SDB (from 31% to 13%), and oxidized low-density lipoprotein (-13 ± 11 U/l). In individuals with preexisting SDB NAFLD grade improved more (2 versus 1, p<0.001) and was at a lower degree at 3 months than in those without SDB (0 versus 1, p = 0.015). In multivariable analysis models, SDB at baseline was associated with improvement of NAFLD grade (B 0.908; 95% CI 0.125, 1.691; p = 0.024), independently of age, sex, and BMI (each p>0.05, respectively). Decreasing BMI (B 0.16 [95%-CI 0.08; 0.23], p<0.001) and alleviation of SDB (B 0.90 [95%-CI 0.21; 1.58], p = 0.012) were independently associated with improvement of NAFLD grade. CONCLUSION Preexisting SDB and weight loss induced alleviation of SDB are predictors for improvement in NAFLD grade, independent of the extent of weight loss. SDB may contribute to the pathogenesis of NAFLD via SDB-induced oxidative stress and inflammation, but the causal mechanism remains unclear.
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Affiliation(s)
- S Stadler
- Department of Internal Medicine II, University Hospital Regensburg, Germany.
| | - A Mohr
- Department of Pneumology, Clinic Donaustauf, Germany
| | - A Wagner
- Department of Internal Medicine II, University Hospital Regensburg, Germany
| | - A Bäßler
- Department of Internal Medicine II, University Hospital Regensburg, Germany
| | - M Fischer
- Department of Internal Medicine II, University Hospital Regensburg, Germany; Department of Internal Medicine II, Clinic Kelheim, Germany
| | - F J Putz
- Department of Nephrology, University Hospital Regensburg, Germany
| | - C Strack
- Department of Internal Medicine II, University Hospital Regensburg, Germany
| | - J Li
- Department of Cardiothoracic Surgery, University Hospital Regensburg, Germany
| | - M Arzt
- Department of Internal Medicine II, University Hospital Regensburg, Germany
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Torka P, Groman A, Wong J, Baysal B, Nichols J, Kader A, Mavis C, Jani Sait S, Block A, Przespolewski E, Mohr A, Lund I, McWhite K, Kostrewa J, DeMarco J, Johnson M, Darrall A, Thomas R, Sundaram S, Ghione P, Hutson A, Hernandez‐Ilizaliturri F. A PHASE 1 STUDY OF CARFILZOMIB WITH RITUXIMAB, IFOSFAMIDE, CARBOPLATIN AND ETOPOSIDE (C‐RICE) IN TRANSPLANT‐ELIGIBLE RELAPSED/REFRACTORY DIFFUSE LARGE B‐CELL LYMPHOMA. Hematol Oncol 2021. [DOI: 10.1002/hon.83_2881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- P. Torka
- Roswell Park Comprehensive Cancer Center Medicine Buffalo USA
| | - A. Groman
- Roswell Park Comprehensive Cancer Center Biostatistics Buffalo USA
| | - J. Wong
- Roswell Park Comprehensive Cancer Center Pathology Buffalo USA
| | - B. Baysal
- Roswell Park Comprehensive Cancer Center Pathology Buffalo USA
| | - J. Nichols
- Roswell Park Comprehensive Cancer Center Clinical Research Services Buffalo USA
| | - A. Kader
- Roswell Park Comprehensive Cancer Center Clinical Research Services Buffalo USA
| | - C. Mavis
- Roswell Park Comprehensive Cancer Center Immunology Buffalo USA
| | - S. Jani Sait
- Roswell Park Comprehensive Cancer Center Cytogenetics Buffalo USA
| | - A. Block
- Roswell Park Comprehensive Cancer Center Cytogenetics Buffalo USA
| | | | - A. Mohr
- Roswell Park Comprehensive Cancer Center Medicine Buffalo USA
| | - I. Lund
- Roswell Park Comprehensive Cancer Center Medicine Buffalo USA
| | - K. McWhite
- Roswell Park Comprehensive Cancer Center Medicine Buffalo USA
| | - J. Kostrewa
- Roswell Park Comprehensive Cancer Center Medicine Buffalo USA
| | - J. DeMarco
- Roswell Park Comprehensive Cancer Center Medicine Buffalo USA
| | - M. Johnson
- Roswell Park Comprehensive Cancer Center Medicine Buffalo USA
| | - A. Darrall
- Roswell Park Comprehensive Cancer Center Medicine Buffalo USA
| | - R.‐N. Thomas
- Roswell Park Comprehensive Cancer Center Medicine Buffalo USA
| | - S. Sundaram
- Roswell Park Comprehensive Cancer Center Medicine Buffalo USA
| | - P. Ghione
- Roswell Park Comprehensive Cancer Center Medicine Buffalo USA
| | - A. Hutson
- Roswell Park Comprehensive Cancer Center Biostatistics Buffalo USA
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Mohr A, Tianyuan C, Brooke G, Zwacka R. Soluble trail has better efficacy than full-length membrane-bound trail, and in combination with akti blocks pro-metastatic cytokine production in prostate cancer cells. Cytotherapy 2021. [DOI: 10.1016/s1465324921003121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Mohr A, Tianyuan C, Clarkson C, Brooke G, Teif V, Zwacka R. Fas-threshold signalling in MSCs causes tumour progression and metastasis. Cytotherapy 2021. [DOI: 10.1016/s1465324921002735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mathian A, Sterlin D, Miyara M, Mohr A, Anna F, Quentric P, Fadlallah J, Devilliers H, Bruel T, Schwartz O, Parizot C, Dorgham K, Charneau P, Amoura Z, Gorochov G. Les Immunoglobulines A dominent la réponse anticorps neutralisante précoce anti-SARS-CoV-2. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mohr A, Langan EA, Terheyden P. Sequentielle Immuncheckpoint-Inhibition beim Merkelzellkarzinom. Akt Dermatol 2020. [DOI: 10.1055/a-1015-4218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
ZusammenfassungDas Merkelzellkarzinom (MCC) ist der Hauttumor mit der höchsten Mortalität. Auf eine Therapie mit Immuncheckpoint-Inhibitoren spricht zwar mehr als die Hälfte der metastasierten Patienten an, es ist aber nicht bekannt, wie bei Patienten, die nur unzureichend oder nicht mehr von einer PD-1- oder PD-L1-Blockade profitieren, vorzugehen ist.Wir stellen einen 67-jährigen Patienten mit multiplen Lebermetastasen eines MCC vor. Die Erstdiagnose wurde 5 Jahre vor Auftreten der Fernmetastasierung gestellt. Nachdem es unter einer Chemotherapie mit Paclitaxel und Carboplatin als Erstlinientherapie zu einem Progress der Lebermetastasen gekommen war, wurde eine Therapie mit dem Immuncheckpoint-Inhibitor Avelumab (anti-PD-L1-Antikörper) eingeleitet. Unter dieser Therapie zeigte sich trotz initialen guten Ansprechens im 1. Staging nach 6 Gaben ein Progress einer Lebermetastase bei stabilem Befund weiterer Lebermetastasen. Der Patient wurde wegen der progredienten Lebermetastase hemihepatektomiert. In der Folge bildeten sich weitere Lebermetastasen, sodass eine Therapie mit dem PD-1-Inhibitor Pembrolizumab eingeleitet wurde. Unter dieser Therapie zeigte sich nun eine über mehr als 2 Jahre anhaltende und fortbestehende komplette Remission.Dieser Fall könnte darauf hinweisen, dass beide Moleküle unterschiedliche Wirkmechanismen haben und ein sequentielles Vorgehen eine sinnvolle Strategie sein kann. Wir empfehlen, zu dieser Frage eine gezielte klinische Studie durchzuführen.
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Affiliation(s)
- A. Mohr
- Klinik für Dermatologie, Universität zu Lübeck, Lübeck
| | - E. A. Langan
- Klinik für Dermatologie, Universität zu Lübeck, Lübeck
- Dermatological Science, University of Manchester, Manchester, UK
| | - P. Terheyden
- Klinik für Dermatologie, Universität zu Lübeck, Lübeck
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Abstract
BACKGROUND Merkel cell carcinoma (MCC) is a rare but aggressive form of skin cancer in which Merkel cell polyomavirus infection and chronic exposure to ultraviolet radiation are key risk factors. Immune checkpoint inhibition has revolutionized the treatment of locally advanced, inoperable and metastatic MCC. AIM To outline the modern management of MCC based on advances in our understanding of MCC tumour biology and the development of immune checkpoint inhibitors, namely inhibitors of programmed cell death protein (PD)-1- and PD‑1 ligand 1 (PD-L1). METHODS A review of the scientific literature listed in PubMed. RESULTS First line therapy with the PD-L1 blocking antibody avelumab is associated with a response rate of 62%. In the second line setting, for example after chemotherapy, the response rate only reaches 33%. However, in patients who responded in the second line setting, 69% remained relapse free after 2 years. Treatment responses occurred on average after 6.1 weeks of therapy. First line treatment with pembrolizumab (anti-PD‑1 antibody) is associated with a 2-year survival rate of 69% and the median survival rate has not been reached. Whilst the various chemotherapy regimens are associated with similar response rates, these are typically short lived. DISCUSSION Checkpoint inhibition offers an effective treatment option for patients with MCC. Avelumab is currently licensed as a treatment for metastatic disease. Chemotherapy remains an option to reduce tumor load, or in the context of resistance and/or contraindications to immune checkpoint therapy. Adjuvant and neoadjuvant use of checkpoint inhibition in MCC may represent a future treatment strategy pending the results of on-going clinical trials.
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Affiliation(s)
- P Terheyden
- Klinik für Dermatologie, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.
| | - A Mohr
- Klinik für Dermatologie, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
| | - E A Langan
- Klinik für Dermatologie, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
- Dermatological Science, University of Manchester, Manchester, Großbritannien
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Bluemel B, Goelz H, Goldmann B, Grüger J, Hamel H, Loley K, Ludolph T, Meyer J, Miehlke S, Mohr A, Tüffers K, Usadel H, Wagner S, Wenzel H, Wiemer L, Vorreiter J, Eisele B, Hofreuter D, Glocker EO. Antimicrobial resistance of Helicobacter pylori in Germany, 2015 to 2018. Clin Microbiol Infect 2019; 26:235-239. [PMID: 31212078 DOI: 10.1016/j.cmi.2019.06.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 05/31/2019] [Accepted: 06/05/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES National and international guidelines recommend empiric first-line treatments of individuals infected with Helicobacter pylori without prior antimicrobial susceptibility testing. For this reason, knowledge of primary resistance to first-line antibiotics such as clarithromycin is essential. We assessed the primary resistance of H. pylori in Germany to key antibiotics by molecular genetic methods and evaluated risk factors for the development of resistance. METHODS Gastric tissue samples of 1851 yet treatment-naïve H. pylori-positive patients were examined with real-time PCR or PCR and Sanger sequencing for mutations conferring resistance to clarithromycin, levofloxacin and tetracycline. Clinical and epidemiological data were documented and univariable and multivariable logistic regression analyses were conducted. RESULTS Overall primary resistances were 11.3% (210/1851) to clarithromycin, and 13.4% (201/1497) to levofloxacin; resistance to tetracycline (2.5%, 38/1497) was as low as combined resistance to clarithromycin/levofloxacin (2.6%, 39/1497). Female sex and prior antimicrobial therapies owing to unrelated bacterial infections were risk factors for clarithromycin resistance (adjusted OR (aOR) 2.3, 95% CI 1.6-3.4; and 2.6, 95% CI 1.5-4.5, respectively); older age was associated with levofloxacin resistance (aOR for those ≥65 years compared with those 18-35 years: 6.6, 95% CI 3.1-14.2). CONCLUSIONS Clarithromycin might still be recommended in first-line eradication therapies in yet untreated patients, but as nearly every tenth patient may carry clarithromycin-resistant H. pylori it may be advisable to rule out resistance ahead of treatment by carrying out susceptibility testing or prescribing an alternative therapy.
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Affiliation(s)
- B Bluemel
- Institute of Medical Microbiology and Hygiene, Medical Center-University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - H Goelz
- Institute of Medical Microbiology and Hygiene, Medical Center-University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | | | - J Grüger
- Department of Internal Medicine, Heilig-Geist-Hospital, Bensheim, Germany
| | - H Hamel
- Department of Internal Medicine, German Armed Forces Hospital Berlin, Berlin, Germany
| | - K Loley
- Medical Centre for Internal Medicine, Bocholt, Germany
| | - T Ludolph
- Department of Internal Medicine, District Hospital of Frankenberg, Frankenberg, Germany
| | - J Meyer
- Praxis für Gastroenterologie, Berlin, Germany
| | - S Miehlke
- University Centre for Oesophageal Diseases, University Hospital Eppendorf, Hamburg, Germany; Centre of Digestive Diseases, Internal Medicine Center Eppendorf, Hamburg, Germany
| | - A Mohr
- Internistische Gemeinschaftspraxis, Lübeck-Travemünde, Germany
| | - K Tüffers
- Department of Internal Medicine, St Johannes Hospital Dortmund, Dortmund, Germany
| | - H Usadel
- Department of Internal Medicine, Spital Schiers, Schiers, Switzerland
| | - S Wagner
- Department of Internal Medicine, Donau-Isar Clinical Centre, Deggendorf, Germany
| | - H Wenzel
- Gemeinschaftspraxis für Gastroenterologie, Wuppertal, Germany
| | - L Wiemer
- Department of Internal Medicine and Oncology, St Agnes Hospital, Bocholt, Germany
| | - J Vorreiter
- Institute of Medical Microbiology and Hygiene, Medical Center-University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - B Eisele
- Institute of Medical Microbiology and Hygiene, Medical Center-University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - D Hofreuter
- Institute of Laboratory Medicine, Brandenburg Hospital, Brandenburg Medical School, Brandenburg, Germany; German Federal Institute for Risk Assessment, Department of Biological Safety, Berlin, Germany
| | - E-O Glocker
- Institute of Medical Microbiology and Hygiene, Medical Center-University of Freiburg, Faculty of Medicine, Freiburg, Germany; Institute of Laboratory Medicine, Brandenburg Hospital, Brandenburg Medical School, Brandenburg, Germany.
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Mohr A, Atif M, Balderas R, Gorochov G, Miyara M. The role of FOXP3 + regulatory T cells in human autoimmune and inflammatory diseases. Clin Exp Immunol 2019; 197:24-35. [PMID: 30830965 DOI: 10.1111/cei.13288] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2019] [Indexed: 02/06/2023] Open
Abstract
CD4+ regulatory T cells (Treg ) expressing the forkhead box protein 3 (FOXP3) transcription factor (Tregs ) are instrumental for the prevention of autoimmune diseases. There is increasing evidence that the human T regulatory population is highly heterogeneous in phenotype and function. Numerous studies conducted in human autoimmune diseases have shown that Treg cells are impaired either in their suppressive function, in number, or both. However, the contribution of the FOXP3+ Treg subpopulations to the development of autoimmunity has not been delineated in detail. Rare genetic disorders that involve deficits in Treg function can be studied to develop a global idea of the impact of partial or complete deficiency in a specific molecular mechanism involved in Treg function. In patients with reduced Treg numbers (but no functional deficiency), the expansion of autologous Treg cells could be a suitable therapeutic approach: either infusion of in-vitro autologous expanded cells, infusion of interleukin (IL)-2/anti-IL-2 complex, or both. Treg biology-based therapies may not be suitable in patients with deficits of Treg function, unless their deficit can be corrected in vivo/in vitro. Finally, it is critical to consider the appropriate stage of autoimmune diseases at which administration of Treg cellular therapy can be most effective. We discuss conflicting data regarding whether Treg cells are more effectual at preventing the initiation of autoimmunity, ameliorating disease progression or curing autoimmunity itself.
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Affiliation(s)
- A Mohr
- Sorbonne Université, Inserm, Centre d'immunologie et des maladies infectieuses, Paris (Cimi-Paris), Paris, France
| | - M Atif
- Sorbonne Université, Inserm, Centre d'immunologie et des maladies infectieuses, Paris (Cimi-Paris), Paris, France
| | | | - G Gorochov
- Sorbonne Université, Inserm, Centre d'immunologie et des maladies infectieuses, Paris (Cimi-Paris), Paris, France.,Sorbonne Université, Inserm, Centre d'immunologie et des maladies infectieuses, Paris, France (Cimi-Paris), AP-HP Hôpital Pitié-Salpêtrière, Paris, France
| | - M Miyara
- Sorbonne Université, Inserm, Centre d'immunologie et des maladies infectieuses, Paris (Cimi-Paris), Paris, France.,Sorbonne Université, Inserm, Centre d'immunologie et des maladies infectieuses, Paris, France (Cimi-Paris), AP-HP Hôpital Pitié-Salpêtrière, Paris, France
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Schneider MM, Mohr A, Reith G, Zimmerer A, Miehlke W, Sobau C. Das femoroacetabuläre Impingement. Manuelle Medizin 2017. [DOI: 10.1007/s00337-017-0305-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Kremeike K, Mohr A, Karow B, Reinhardt D. [Not Available]. Kinderkrankenschwester 2016; 35:422-427. [PMID: 30387945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Schuppert C, Mohr A, Schwahofer A, Nill S, Debus J, Sterzing F. Optimized Strategy for Multimodality Treatment Planning of Single-Beam Heavy Ion Therapy Plus Photon Intensity Modulated Radiation Therapy, Exemplified by Pelvic Bone Sarcomas. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.2135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mohr A, Heiss C, Bergmann I, Schrader C, Roemer FW, Lynch JA, Muhle C, Genant HK, Heller M. Value of micro-CT as an investigative tool for osteochondritis dissecans: A preliminary study with comparison to histology. Acta Radiol 2016; 44:532-7. [PMID: 14510761 DOI: 10.1080/j.1600-0455.2003.00113.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Purpose: To evaluate micro computed tomography (micro-CT) for the assessment of osteochondritis dissecans in comparison with histology. Material and Methods: Osteochondritis dissecans lesions of 3 patients were evaluated using micro-CT (0.125 mA, 40 keV, 60 μm slice thickness, 60 μm isotropic resolution, entire sample) and light microscopy (toluidine blue, 3–5 μm slice thickness). The methods were compared regarding preparation time, detectability of tissue types and morphologic features of bone and cartilage. Results: Non-destructive micro-CT imaging of the entire sample was faster than histologic preparation of a single slice for light microscopy. Morphologic features of bone and cartilage could be imaged in a comparable way to histology. It was not possible to image cells or different tissue types of bone and cartilage with micro-CT. Conclusion: Micro-CT is a fast, non-destructive tool that may be a supplement or, if detailed histologic information is not necessary, an alternative to light microscopy for the investigation of osteochondritis dissecans.
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Affiliation(s)
- A Mohr
- Department of Diagnostic Radiology, Christian-Albrechts-University, Kiel, Germany.
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Muhle C, Ahn JM, Biederer J, Schäfer FKW, Frahm CH, Mohr A, Brossmann J, Resnick D. MR imaging of the neural foramina of the cervical spine: Comparison of 3D-DESS and 3D-FISP sequences. Acta Radiol 2016; 43:96-100. [PMID: 11972470 DOI: 10.1080/028418502127347510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To assess whether a single three-dimensional double-echo steady state (3D-DESS) sequence can produce equivalent results when compared to a 3D free induction with steady precession (3D-FISP) sequence for the evaluation of the neural foraminal diameter and structures. Material and Methods: Five phantoms were imaged on CT with 3-mm axial slices followed by reformatted axial 3D-DESS and 3D-FISP sequences. In addition, 3D-DESS and 3D-FISP sequences of 20 healthy subjects were compared with regard to image quality, differentiation between vertebrae and discs, differentiation between discs and neural foramina, and differentiation between vertebrae and neural foramina. Results: Compared with CT, 3D-DESS and 3D-FISP sequences consistently underestimated the diameters of the neural foramina. The mean difference values for the 3D-DESS was 12.8%, compared to 9.5% for the 3D-FISP sequence. Concerning the in vivo studies, the 3D-DESS sequence was superior but not statistical significant to the 3D-FISP sequence with regard to image quality, differentiation between vertebrae and discs, differentiation between discs and neural formina, and identification of the nerve roots. Conclusion: The 3D-DESS sequence is moderately accurate in the evaluation of the neural foraminal size. Compared to the 3D-FISP sequence, the 3D-DESS sequence is compatible concerning the image quality, differentiation between the cervical vertebrae and discs, and between the discs and neural foramina.
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Affiliation(s)
- Claus Muhle
- Department of Nuclear Medicine, Christian-Albrechts University of Kiel, Arnold-Heller-Strasse 9, DE-24105 Kiel, Germany
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Harrabi SB, Bougatf N, Mohr A, Haberer T, Herfarth K, Combs SE, Debus J, Adeberg S. Dosimetric advantages of proton therapy over conventional radiotherapy with photons in young patients and adults with low-grade glioma. Strahlenther Onkol 2016; 192:759-769. [PMID: 27363701 PMCID: PMC5080304 DOI: 10.1007/s00066-016-1005-9] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 05/20/2016] [Indexed: 12/26/2022]
Abstract
Background and purpose Low-grade glioma (LGG) is a very common brain tumor in pediatric patients typically associated with a very good prognosis. This prognosis makes it imperative that the risk of long-term treatment-related side effects be kept at an absolute minimum. Proton therapy (PRT) provides a radiation technique that has the potential to further reduce the genesis of radiogenic impairment. Materials and methods We retrospectively assessed 74 patients with LGG who underwent PRT. Conventional three-dimensional photon and PRT plans were generated after contouring structures of neurogenesis, crucial neuronal structures, and areas susceptible to secondary malignancies. Target volume coverage was evaluated using the homogeneity index (HI) and inhomogeneity coefficient (IC). Results were compared using the Wilcoxon-signed rank test, with p < 0.05 being statistically significant. Results Target volume coverage was comparable for the photon and proton plans. Overall, we could show an essential reduction in maximal, mean, and integral doses in critical neurologic structures, areas of neurogenesis, and structures of neurocognitive function. The study indicated specifically how contralaterally located structures could be spared with PRT. Conclusion PRT is a highly conformal radiation technique offering superior dosimetric advantages over conventional radiotherapy by allowing significant dose reduction for organs at risk (OAR) that are essential for neurologic function, neurocognition, and quality of life, thus demonstrating the potential of this technique for minimizing long-term sequelae.
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Affiliation(s)
- S B Harrabi
- Heidelberg Institute of Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center (HIT), Im Neuenheimer Feld 450, 69120, Heidelberg, Germany.,Dept. of Radiation Oncology, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - N Bougatf
- Heidelberg Institute of Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.,Dept. of Radiation Oncology, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.,Department of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - A Mohr
- Heidelberg Institute of Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.,Dept. of Radiation Oncology, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - T Haberer
- Heidelberg Institute of Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center (HIT), Im Neuenheimer Feld 450, 69120, Heidelberg, Germany
| | - K Herfarth
- Heidelberg Institute of Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center (HIT), Im Neuenheimer Feld 450, 69120, Heidelberg, Germany.,Dept. of Radiation Oncology, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - S E Combs
- Department of Radiation Sciences (DRS), Institute of Innovative Radiotherapy (iRT), Helmholtz Zentrum München, Ingolstädter Landstraße 1, 85764, Oberschleißheim, Germany.,Partner Site Munich, Deutsches Konsortium für Translationale Krebsforschung (dktk), Munich, Germany
| | - J Debus
- Heidelberg Institute of Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center (HIT), Im Neuenheimer Feld 450, 69120, Heidelberg, Germany.,Dept. of Radiation Oncology, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.,Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - S Adeberg
- Heidelberg Institute of Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120, Heidelberg, Germany. .,Heidelberg Ion-Beam Therapy Center (HIT), Im Neuenheimer Feld 450, 69120, Heidelberg, Germany. .,Dept. of Radiation Oncology, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany. .,Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.
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Völker F, Kühnle I, Edler J, Schildhaus HU, Vokuhl C, Mohr A, Sahlmann C, Kramm CM. How to Treat INI1 Negative Non-Rhabdoid Tumours in Adolescents: Following Genotype or Histological Phenotype? Klin Padiatr 2016; 228:341-343. [PMID: 27246730 DOI: 10.1055/s-0042-103328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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18
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Hackl C, Schacherer D, Anders M, Wiedemann LM, Mohr A, Schlitt HJ, Stroszczynski C, Tranquart F, Jung EM. Improved Detection of preclinical Colorectal Liver Metastases by High Resolution Ultrasound including Molecular Ultrasound Imaging using the targeted Contrast Agent BR55. Ultraschall Med 2016; 37:290-296. [PMID: 27112624 DOI: 10.1055/s-0041-111838] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE Aim of the present study was to investigate the sensitivity of high resolution ultrasound (HRU), standard contrast-enhanced ultrasound (CEUS) and CEUS using a novel vascular endothelial growth factor receptor 2 (VEGFR2)-targeted contrast agent for the detection of hepatic metastases in a mouse model of colorectal cancer using clinical standard technology. MATERIALS AND METHODS The human colon cancer cell line HT29, transfected with luciferase cDNA for in vivo bioluminescence monitoring, was injected intrasplenically into CB17.SCID mice. Mice were monitored weekly by bioluminescence and after 2 and 4.5 weeks by HRU and CEUS. Contrast media (untargeted BR1, targeted BR55) was applied and digital cine loops from the arterial phase (15 - 45 sec), portal venous phase (50 - 120 s) and late phases (3 - 5 min, 1hour) of the whole liver were analyzed. Data were correlated with postmortem histopathology. RESULTS Without contrast enhancement, lesions > 4 mm were reliably detected. After use of untargeted CEUS, lesions > 2 mm were reliably detected and enhanced rim vascularization and late-phase wash-out was shown. With BR55, lesions > 0.8 mm were reliably detected with excellent documentation of vascularization. A persistent contrast enhancement was seen > 30 min after injection. Contrast-enhancement patterns with BR55 significantly correlated with CD31 (R2 = 0.74) and VEGFR2-immunohistochemistry (R2 = 0.66). CONCLUSION Detection of metastases by HRU and CEUS was earlier and more accurate than monitoring via bioluminescence. In vivo monitoring of hepatic micrometastases can thus be performed without prior modification of cancer cells using standard technology.
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Affiliation(s)
- C Hackl
- Surgery, University Hospital Regensburg, Germany
| | - D Schacherer
- Internal Medicine I, University Hospital Regensburg, Germany
| | - M Anders
- Surgery, University Hospital Regensburg, Germany
| | | | - A Mohr
- Internal Medicine II, University Hospital Regensburg, Germany
| | - H J Schlitt
- Surgery, University Hospital Regensburg, Germany
| | | | - F Tranquart
- Geneva Research Center and Manufacturing Site, Bracco Suisse SA, Geneva, Switzerland
| | - E M Jung
- Radiology, University Hospital Regensburg, Germany
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Kremeike K, Mohr A, Kampschulte R, Bergmann J, Beil S, Neuhaus U, Dierks ML, Driftmann C, Duhr A, Groeneveld S, Kaspar M, Kowollik G, Miest HH, Schene I, Reinhardt D. [Network for Oncological Advisory Service (NOF) - a Pilot Project for (Long-Term) Follow-Up Care of Pediatric Cancer Patients]. Klin Padiatr 2016; 228:325-331. [PMID: 27171924 DOI: 10.1055/s-0042-105651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: In Germany some 2 000 children and adolescent are diagnosed with cancer every year. Curing rates are increasing and therewith also the number of survivors is growing. Survivors frequently suffer from long-term effects of the disease and its treatment, but long-term follow-up care shows deficits. Method: The Network for oncological advisory service (NOF) started in 11/2013, researching and building up a network of available support in Lower Saxony. A telephone hotline was installed in 01/2014 in order to advice survivors on their problems. At the same time, an interview study on survivors needs was conducted throughout Germany. Results: In the first 2 years, the NOF gave advice to 79 patients. Whilst enquiries of medical or psychological nature were transferred to the cooperation partner, requests on psychosocial and social legal issues are being deled by the NOF due to lack of appropriate partners. The evaluation of 25 interviews shows key issues in long-term after-care: (1) transition from acute therapy to everyday life, (2) problems due to pediatric cancer and therapy, (3) patients perception of own disposition, (4) social reactions towards survivors, (5) structure of long-term follow-up care, (6) information flow. Conclusion: Many survivors suffer from long-term effects of cancer and treatment. The lack of available contact person and being in limbo between cured and simultaneously affected by the cancer treatment and chronic diseases is perceived as being problematic. This translates to various requirements on a patient-oriented long-term care, mainly in the psychosocial field.
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Affiliation(s)
- K Kremeike
- Netzwerk für die Versorgung schwerkranker Kinder und Jugendlicher e.V., Hannover Medical School, Hannover
| | - A Mohr
- Netzwerk für die Versorgung schwerkranker Kinder und Jugendlicher e.V., Hannover Medical School, Hannover
| | - R Kampschulte
- Netzwerk für die Versorgung schwerkranker Kinder und Jugendlicher e.V., Hannover Medical School, Hannover
| | | | - S Beil
- Netzwerk für die Versorgung schwerkranker Kinder und Jugendlicher e.V., Hannover Medical School, Hannover
| | - U Neuhaus
- Netzwerk für die Versorgung schwerkranker Kinder und Jugendlicher e.V., Hannover Medical School, Hannover
| | - M-L Dierks
- Institute of Epidemiology Social Medicine and Health System Research, Hannover Medical School, Hannover
| | - C Driftmann
- Mühlenkreis Clinics, Initiative Eltern krebskranker Kinder Minden e.V., Minden
| | - A Duhr
- Paediatric Hematology and Oncology, Bremen Central Hospital, Bremen
| | - S Groeneveld
- Clinic of Paediatric and Youth Medicine and Psychosomatics, City Hospital Wolfsburg, Wolfsburg
| | - M Kaspar
- Department of Paediatric Haematology and Oncology, Hospital Oldenburg, Oldenburg
| | - G Kowollik
- Department of Paediatric Haematology and Oncology, Hannover Medical School, Hannover
| | - H-H Miest
- Parents` house Göttingen, Elterninitiative für das krebskranke Kind Göttingen e.V., Göttingen
| | - I Schene
- Department of Paediatric Haematology and Oncology, Municipal Clinic of Braunschweig, Braunschweig
| | - D Reinhardt
- Clinic for Pediatrics III, University Hospital Essen, Essen, Germany
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Behme D, Malinova V, Kallenberg K, Knauth M, Mohr A. Unenhanced Time-of-Flight MR Angiography versus Gadolinium-Enhanced Time-of-Flight MR Angiography in the Follow-Up of Coil-Embolized Aneurysms. J Neurol Surg A Cent Eur Neurosurg 2016; 77:400-5. [DOI: 10.1055/s-0036-1582014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- D. Behme
- Department of Neuroradiology, Georg-August-University Göttingen, University Medical Center, Göttingen, Germany
| | - V. Malinova
- Department of Neurosurgery, Georg-August-University Göttingen, University Medical Center, Göttingen, Germany
| | - K. Kallenberg
- Department of Neuroradiology, Georg-August-University Göttingen, University Medical Center, Göttingen, Germany
| | - M. Knauth
- Department of Neuroradiology, Georg-August-University Göttingen, University Medical Center, Göttingen, Germany
| | - A. Mohr
- Department of Neuroradiology, Georg-August-University Göttingen, University Medical Center, Göttingen, Germany
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Stephani C, Pfeifenbring S, Mohr A, Stadelmann C. Late-onset leukoencephalopathy with cerebral calcifications and cysts: case report and review of the literature. BMC Neurol 2016; 16:19. [PMID: 26852234 PMCID: PMC4744425 DOI: 10.1186/s12883-016-0543-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 02/03/2016] [Indexed: 11/10/2022] Open
Abstract
Background Leukoencephalopathy with calcifications and cysts (LCC or Labrune disease) is a relatively recently defined and exceptionally rare disease in which parenchymal cysts and calcifications within a widespread leukoencephalopathy can cause a broad spectrum of neurological symptoms. The cause of the disease is unknown. Manifestation is usually in childhood or adolescence, while onset in adulthood has been described in 19 cases. Case presentation Here we report a case of an adult-onset LCC of a Caucasian woman who became symptomatic at age 70 as confirmed by typical neuroimaging and neuropathological findings. After resection of left mesioparietal space-occupying cystic brain tissue the patient has so far remained clinically stable during one year of follow-up with a continuous treatment with glucocorticosteroids. Conclusion To our knowledge this report of a patient who became symptomatic at age 70 represents the oldest age-at-onset case of LCC described so far.
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Affiliation(s)
- C Stephani
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany.
| | - S Pfeifenbring
- Department of Neuropathology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany.
| | - A Mohr
- Department of Neuroradiology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany.
| | - C Stadelmann
- Department of Neuropathology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany.
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Szántó-Egész R, Jánosi A, Mohr A, Szalai G, Szabó EK, Micsinai A, Sipos R, Rátky J, Anton I, Zsolnai A. Breed-Specific Detection of Mangalica Meat in Food Products. FOOD ANAL METHOD 2015. [DOI: 10.1007/s12161-015-0261-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Adeberg S, Kehle D, Mohr A, Rieken S, Bostel T, Koelsche C, Diehl C, Debus J. EP-1331: Diabetes and metformin influence survival in glioblastoma patients. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41323-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kremeike K, Mohr A, Nachtmann J, Reinhardt D, Geraedts M, Sander A. [Evaluation of Specialised Paediatric Palliative Home Care in Lower Saxony, Germany - A Qualitative Study on Parents' Perspectives]. Gesundheitswesen 2014; 78:306-12. [PMID: 25397908 DOI: 10.1055/s-0034-1390451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND In 2007 the children's right to specialised paediatric palliative home care became law in Germany. This claim should be met in Lower Saxony by the establishment of a comprehensive specialised paediatric home care (SPPHC). Since April 2010, a central office undertakes the coordination and administration throughout the federal state. Regional teams comprising nursing, medical and psychosocial specialists care for the children and adolescents suffering from complex conditions due to life-limiting conditions - subsidiary to regional health care providers. The aim of the study was to evaluate SPPHC in Lower Saxony. METHODOLOGY From June 2012 to February 2013, semi-structured interviews were conducted with 20 parents of children aged from 3 to 18 years. The young patients fulfilled all criteria to be eligible for SPPHC. 13 of the families experienced SPPHC. 7 families did not utilise the specialised care, mostly because the palliative situation occurred before the implementation of specialised care. Data were analysed using content analysis (Mayring). Therefore, key aspects of paediatric palliative home care were summarised in main categories. The evaluation of parent's satisfaction with palliative home care was performed by an evaluation scheme developed for the main categories (very good - good - bad- very bad) and operated for every case. RESULTS 6 dimensions of paediatric palliative home care were identified: (i) benefit of care, (ii) continuity of care, (iii) perception of care providers as a team, (iv) dealing with the issues death and dying/hospice and palliative, (v) care provider's communication/cooperation with parents, and (vi) parent's Information. As all parents clearly indicated a rating on the first 3 categories, these categories were selected for the evaluation of parent's satisfaction with the received home care. The evaluation revealed that parents experienced in SPPHC looked upon these 3 main categories more favourably than parents without the experience of SPPHC. As room for improvement, the respondents requested the extension of physician's presence and communication with the families as well as with each other, efforts to better meet the needs of psycho-social support of the families and to optimise follow up-care. CONCLUSION The implementation of SAPPV was rated positively by the concerned families. In addition, options for improvement could be identified.
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Affiliation(s)
- K Kremeike
- Pädiatrische Hämatologie und Onkologie, Medizinische Hochschule Hannover, Hannover
| | - A Mohr
- Pädiatrische Hämatologie und Onkologie, Medizinische Hochschule Hannover, Hannover
| | - J Nachtmann
- Fachbereich Soziales, Gesundheit und Umwelt, Landeshauptstadt Potsdam, Potsdam
| | - D Reinhardt
- Klinik für Kinderheilkunde III, Universitätsklinikum Essen, Essen
| | - M Geraedts
- Fakultät für Gesundheit, Institut für Gesundheitssystemforschung, Universität Witten/Herdecke, Witten
| | - A Sander
- Pädiatrische Hämatologie und Onkologie, Medizinische Hochschule Hannover, Hannover
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Mohr A, Jung EM, Stroszczynski C, Schacherer D, Klebl F. New economic training model for installing ultrasound-guided drainages. Z Gastroenterol 2014; 52:1257-62. [PMID: 25390212 DOI: 10.1055/s-0034-1385134] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Abscesses and circumscribed collections of fluid are frequently found as complications of infectious diseases or surgery. Drainage is often indicated. We have established a new, economic, easy-to-make model to learn and improve competence in installing ultrasound-guided drainage. Up to fifteen water balloons (size 30 - 50 mm) were placed in a plastic box which then was filled with instant custard powder mixed with water. Spiral computed tomography (CT) of this box was performed. Experienced (n = 8) and inexperienced examiners (n = 8) drained the balloons via a direct puncture technique using either ultrasound-guidance alone or volume navigation with image fusion (ultrasound and CT) with needle tracking. Trainees filled out a questionnaire (before and after training) asking for information on their experience in ultrasound, in installing drainages and evaluating the new model. The time needed for installing the drainage was measured. None of the participants had ever attended a course on drainage installation. Only a few of the experienced examiners (n = 3) would autonomously install a drainage into a fluid collection with a size exceeding 4 cm before training. After training all participants felt more confident in ultrasound and in installing drainages into abscesses or other fluid collections. Most of the participants rated additional volume navigation with image fusion as a helpful tool. Ultrasound-guided drainage of abscesses can be trained easily with this new and economic model. Students and physicians can improve their skills and gain confidence in performing ultrasound-guided interventions.
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Affiliation(s)
- A Mohr
- Innere Medizin I, Universitätsklinikum Regensburg
| | - E M Jung
- Institut für Röntgendiagnostik, Universitätsklinikum Regensburg
| | - C Stroszczynski
- Institut für Röntgendiagnostik, Universitätsklinikum Regensburg
| | - D Schacherer
- Innere Medizin I, Universitätsklinikum Regensburg
| | - F Klebl
- Innere Medizin I, Universitätsklinikum Regensburg
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Mohr A, Stahl-Arnsberger C, Rittinghausen E, Debus J, Sterzing F. Evaluation of Automatic Segmentation Tools for Thoracic Organs in Radiation Therapy Planning. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Liu X, Caffrey TC, Steele MM, Mohr A, Singh PK, Radhakrishnan P, Kelly DL, Wen Y, Hollingsworth MA. MUC1 regulates cyclin D1 gene expression through p120 catenin and β-catenin. Oncogenesis 2014; 3:e107. [PMID: 24979278 PMCID: PMC4150213 DOI: 10.1038/oncsis.2014.19] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 05/01/2014] [Accepted: 05/06/2014] [Indexed: 12/16/2022] Open
Abstract
MUC1 interacts with β-catenin and p120 catenin to modulate WNT signaling. We investigated the effect of overexpressing MUC1 on the regulation of cyclin D1, a downstream target for the WNT/β-catenin signaling pathway, in two human pancreatic cancer cell lines, Panc-1 and S2-013. We observed a significant enhancement in the activation of cyclin D1 promoter-reporter activity in poorly differentiated Panc1.MUC1F cells that overexpress recombinant MUC1 relative to Panc-1.NEO cells, which express very low levels of endogenous MUC1. In stark contrast, cyclin D1 promoter activity was not affected in moderately differentiated S2-013.MUC1F cells that overexpressed recombinant MUC1 relative to S2-013.NEO cells that expressed low levels of endogenous MUC1. The S2-013 cell line was recently shown to be deficient in p120 catenin. MUC1 is known to interact with P120 catenin. We show here that re-expression of different isoforms of p120 catenin restored cyclin D1 promoter activity. Further, MUC1 affected subcellular localization of p120 catenin in association with one of the main effectors of P120 catenin, the transcriptional repressor Kaiso, supporting the hypothesis that p120 catenin relieved transcriptional repression by Kaiso. Thus, full activation of cyclin D1 promoter activity requires β-catenin activation of TCF-lef and stabilization of specific p120 catenin isoforms to relieve the repression of KAISO. Our data show MUC1 enhances the activities of both β-catenin and p120 catenin.
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Affiliation(s)
- X Liu
- Eppley Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha, NE, USA
| | - T C Caffrey
- Eppley Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha, NE, USA
| | - M M Steele
- Eppley Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha, NE, USA
| | - A Mohr
- Eppley Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha, NE, USA
| | - P K Singh
- Eppley Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha, NE, USA
| | - P Radhakrishnan
- Eppley Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha, NE, USA
| | - D L Kelly
- Eppley Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha, NE, USA
| | - Y Wen
- Department of Gynecologic Oncology and Cancer Biology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M A Hollingsworth
- 1] Eppley Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha, NE, USA [2] Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE, USA
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Mohr A. Moderne Techniken der biologisch-adaptiven Strahlentherapie. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mohr A, Thiel A, Hahnel A, Manka M, Agha A, Müller M, Schacherer D, Girlich C. [A 43-year-old patient with character changes, recurrent impaired consciousness and retrograde amnesia]. Internist (Berl) 2014; 55:84-7. [PMID: 24429640 DOI: 10.1007/s00108-013-3407-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A 43-year-old male patient with recurring impaired consciousness and retrograde amnesia was admitted to the department of neurology. During the neurological evaluation no pathological findings could initially be revealed but one day the patient was confused again and presented with inadequate behavior: at this time a blood glucose value of 40 mg/dl was measured. For further evaluation the patient was transferred to our department. As the reason for the impaired consciousness was suspected to be of neuroglucopenic origin a rapid adrenocorticotropic hormone (ACTH) stimulation test was first performed to rule out adrenal insufficiency. For further evaluation a fasting test was conducted: after 48 h an episode with neuroglucopenic symptoms occurred again which disappeared after intravenous administration of glucose. The laboratory results of glucose, insulin and c-peptide determined at this point in time led to the diagnosis of an insulinoma. By ultrasound examination a hypoechogenic lesion 1.5 cm in size could be shown in the head of the pancreas and was confirmed by magnetic resonance imaging (MRI). After duodenum-preserving partial pancreatic head resection with enucleation of the insulinoma no further neuroglucopenic symptoms occurred.
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Affiliation(s)
- A Mohr
- Klinik und Poliklinik für Innere Medizin I, Universitätsklinikum Regensburg, 93042, Regensburg, Deutschland,
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Abstract
BACKGROUND The national second opinion project of the German Testicular Cancer Study Group (GTCSG) has served to improve the quality of care provided to testicular cancer patients since 2006. AIM A recent online survey was carried out to characterize the users of the second opinion offer and clarify their motivation for participating in the project. Furthermore, the aim was to identify weaknesses of the project which could be improved. A total of 440 users of the second opinion project were contacted of whom 192 participated in the survey. RESULTS In summary, the data collected showed a high degree of satisfaction among the participants who appreciated the second opinions received. Some issues with a need for improvement, predominantly in the structural organisational area, were disclosed. These served as a basis for a recently completed revision of the project immanent internet-based communication platform with a new data mask facilitating the introduction of patients with relapsed tumors. Interestingly, a high proportion of survey participants expressed the desire for establishment of a similar second opinion project for patients with penile cancer (77.1% of the participants).
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Pehlke JR, Venkataramani V, Emmert S, Mohr A, Zoll B, Nau R. [X-linked recessive ichthyosis (XRI), cerebellar ataxia and neuropsychiatric symptoms]. Fortschr Neurol Psychiatr 2013; 81:40-3. [PMID: 23340970 DOI: 10.1055/s-0032-1330280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
X-Linked ichthyosis (XRI) is a keratinisation disorder caused by a mutation of the steroid sulfatase gene. An association with mental retardation and epilepsy has been reported earlier. Here, we report on a patient suffering from cerebellar symptoms such as yes/yes head tremor, scanning dysarthria, pronounced dysmetria and intention tremor, without any abnormalities of the cerebellum in MRI, in addition to XRI proven by molecular genetics. Furthermore, the patient suffered from anxiety disorder, depression, and a male pattern baldness. One of the patient' s brothers and a nephew showed a similar clinical presentation. Because of the fact that several members of the patient's family suffered from similar symptoms, we consider a syndromic link between XRI and cerebellar disorder to be possible.
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Affiliation(s)
- J R Pehlke
- Abt. für Suchtkrankheiten, LWL-Klinik Münster
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Russo S, Cremer S, Eich C, Jipp M, Cohnen J, Strack M, Quintel M, Mohr A. Magnetic resonance imaging study of the in vivo position of the extraglottic airway devices i-gel™ and LMA-Supreme™ in anaesthetized human volunteers. Br J Anaesth 2012; 109:996-1004. [DOI: 10.1093/bja/aes314] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Focke NK, Kallenberg K, Mohr A, Djukic M, Nau R, Schmidt H. Distributed, limbic gray matter atrophy in patients after bacterial meningitis. AJNR Am J Neuroradiol 2012. [PMID: 23194831 DOI: 10.3174/ajnr.a3351] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The structural basis of cognitive sequelae after bacterial meningitis in humans is still poorly understood. In animal models and human autopsy cases, neuronal apoptosis of the hippocampal formation in particular seems to play an important role. Here, we aimed to analyze if BM entails MR imaging structural consequences in humans in vivo. MATERIALS AND METHODS We applied voxel-based morphometry in a cohort of BM survivors with normal conventional MR imaging after resolution of the acute inflammation to assess morphologic differences. RESULTS We found clear gray matter volume loss in the limbic system including the hippocampal formation, thalamus, and cingulate gyri bilaterally as well as in the temporal lobe. These results were corroborated by an alternative atlas-based method. CONCLUSIONS Even in patients with normal routine MR imaging results, clear-cut gray matter atrophy with a mesial temporal/limbic pattern was evident. The anatomic distribution is compatible with the neuropsychological deficit commonly observed in patients after BM. The similarity of the observed atrophy may point to causal link between BM and mesial temporal epilepsy.
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Affiliation(s)
- N K Focke
- Department of Clinical Neurophysiology, University of Go¨ttingen, Robert-Koch-Str 40, Go¨ttingen, 37099, Germany.
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Psychogios MN, Kreusch A, Wasser K, Mohr A, Gröschel K, Knauth M. Recanalization of large intracranial vessels using the penumbra system: a single-center experience. AJNR Am J Neuroradiol 2012; 33:1488-93. [PMID: 22460339 DOI: 10.3174/ajnr.a2990] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The PS is an innovative mechanical device designed to recanalize large-vessel occlusions by thrombus aspiration. The purpose of this study was to evaluate the effectiveness and neurologic outcome of patients treated with the PS in the setting of acute ischemic stroke. MATERIALS AND METHODS A total of 91 patients with acute ischemic stroke due to large-vessel occlusion were treated with the PS and were included in our retrospective study. In 14 patients, only the PS was used for treatment; in 77 patients, mechanical recanalization was combined with IA and/or IV thrombolysis. Outcome was measured by using the mRS; recanalization was assessed with the TICI score. RESULTS Mean patient age was 62 ± 19.4 years; the average NIHSS score at hospital admission was 17. Successful recanalization was achieved in 77% of patients. Median time from arterial puncture to recanalization was 49 minutes (quartiles, 31-86 minutes). At follow-up, 36% of the patients showed an NIHSS improvement of ≥10%, and 34% of the patients with an anterior circulation occlusion had an mRS score of ≤2, whereas only 7% of the patients with a posterior occlusion had a favorable outcome at follow-up. In total, 20 patients died during hospitalization; none of these deaths were device-related. CONCLUSIONS In this study, the PS was an effective device for mechanical recanalization. Successful recanalization with the PS was associated with significant improvement of functional outcome in patients experiencing ischemic stroke secondary to anterior circulation occlusions.
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Affiliation(s)
- M-N Psychogios
- Department of Neuroradiology, University Medicine Goettingen, Goettingen, Germany.
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Molnár J, Tóth G, Stéger V, Zsolnai A, Jánosi A, Mohr A, Szántó-Egész R, Tóth P, Micsinai A, Rátky J, Marincs F. Mitochondrial D-loop analysis reveals low diversity in Mangalica pigs and their relationship to historical specimens. J Anim Breed Genet 2012; 130:312-20. [PMID: 23855633 DOI: 10.1111/j.1439-0388.2012.01014.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Accepted: 06/04/2012] [Indexed: 11/28/2022]
Abstract
The genetic relationship between 195 Mangalica and 79 non-Mangalica pigs was studied using mitochondrial D-loop SNP genotyping. Altogether, 35 polymorphic sites and 27 haplotypes were identified. Of the haplotypes, eight and 16 are Mangalica and non-Mangalica specific, respectively, while three contain both Mangalica and non-Mangalica individuals. Genetic distance values and phylogenetic analysis indicate that Mangalica individuals are very closely related, and five haplotypes represent approximately 92% of the Mangalica pigs involved in the study, thus determining the major maternal lineages. In contrast to previous microsatellite studies, individuals of Mangalica could not be distinguished as three separate breeds using mtDNA genotyping. Comparing modern and archaeological mtDNA sequences revealed that present day Mangalica is related to pigs that lived in the Carpathian basin where postulated ancestors of Mangalica also lived. This is the first DNA-based genetic evidence to support the described breeding history of Mangalica.
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Buchbinder A, Krebs M, Ott J, Bausch B, Hiesgen C, Reichert M, Hecker M, Mohr A, Seeger W, Barnes M, Mayer K. Modulation of acute lung injury (ALI) by lipid emulsions - dependency of the chemerin 23 receptor (ChemR23)? Pneumologie 2012. [DOI: 10.1055/s-0032-1315463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Kallenberg K, Mohr A, Kermer P, Turowski B, Jansen O, Knauth M. Erste Erfahrungen mit dem neuen Aperio® Clotretriever bei 10 Schlaganfall-Patienten. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Schmidt H, Mohr A, Djukic M, Nau R, Focke N. Voxel- und Atlas-basierte Morphometrie bei Patienten nach bakterieller Meningitis. KLIN NEUROPHYSIOL 2012. [DOI: 10.1055/s-0032-1301565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Psychogios MN, Wachter D, Mohr A, Schramm P, Frölich AM, Jung K, Rohde V, Knauth M. Feasibility of flat panel angiographic CT after intravenous contrast agent application in the postoperative evaluation of patients with clipped aneurysms. AJNR Am J Neuroradiol 2011; 32:1956-62. [PMID: 21852377 DOI: 10.3174/ajnr.a2611] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND PURPOSE Important findings, such as aneurysm remnants or major arterial occlusion, can be detected on intra- or postoperative angiography after surgical clipping of intracranial aneurysms. The purpose of this study was to evaluate the feasibility of IV-ACT for the postoperative detection of residual aneurysms and parent vessel patency compared with IA-DSA, which was selected as the standard reference method. MATERIALS AND METHODS Twenty-two patients with 27 aneurysms treated by surgical clipping were examined by using both IA-DSA and IV-ACT. Both diagnostic procedures were performed on an FPD-equipped angiography system. Postprocessing of IV-ACT acquisitions was performed on a dedicated workstation producing multiplanar reformations and maximum intensity projections of the clip region and other intracranial arteries. Three interventional neuroradiologists independently evaluated both procedures. RESULTS A residual aneurysm was delineated in 10 cases with IA-DSA. Sufficient opacification of the intracranial vessels was assigned in 26 IV-ACT cases. Due to metal artifacts, IV-ACT images were tagged as "not diagnostic" on 8 occasions. In the other 19 aneurysms, a residual aneurysm was delineated in 6 cases-all 6 being true-positive compared with IA-DSA-and was excluded in the remaining 13 cases-all true-negative. Even small aneurysm remnants with a diameter of 1.5 mm were detected with IV-ACT. CONCLUSIONS Currently IV-ACT cannot be recommended as a routine tool for postoperative evaluation of clipped aneurysms due to metal artifacts in 30% of the examinations. These artifacts appear with multiple normal-sized or large clips. In patients with single or multiple small clips, IV-ACT can reliably show aneurysm remnants.
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Affiliation(s)
- M-N Psychogios
- Department of Neuroradiology, University Medicine Goettingen, Germany.
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Hellen P, Mohr A, Schramm P, Knauth M. Leukoencephalophathy with Brain Stem an Spinal Cord Involvement and Lactate Elevation (LBSL). ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Wüstenberg T, Begemann M, Bartels C, Gefeller O, Stawicki S, Hinze-Selch D, Mohr A, Falkai P, Aldenhoff JB, Knauth M, Nave KA, Ehrenreich H. Recombinant human erythropoietin delays loss of gray matter in chronic schizophrenia. Mol Psychiatry 2011; 16:26-36, 1. [PMID: 20479759 DOI: 10.1038/mp.2010.51] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Neurodevelopmental abnormalities together with neurodegenerative processes contribute to schizophrenia, an etiologically heterogeneous, complex disease phenotype that has been difficult to model in animals. The neurodegenerative component of schizophrenia is best documented by magnetic resonance imaging (MRI), demonstrating progressive cortical gray matter loss over time. No treatment exists to counteract this slowly proceeding atrophy. The hematopoietic growth factor erythropoietin (EPO) is neuroprotective in animals. Here, we show by voxel-based morphometry in 32 human subjects in a placebo-controlled study that weekly high-dose EPO for as little as 3 months halts the progressive atrophy in brain areas typically affected in schizophrenia, including hippocampus, amygdala, nucleus accumbens, and several neocortical areas. Specifically, gray matter protection is highly associated with improvement in attention and memory functions. These findings suggest that a neuroprotective strategy is effective against common pathophysiological features of schizophrenic patients, and strongly encourage follow-up studies to optimize EPO treatment dose and duration.
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Affiliation(s)
- T Wüstenberg
- Department of Neuroradiology, Georg-August-University, Göttingen, Germany
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Engelhart P, Wendt J, Schulze A, Klenke C, Mohr A, Petter K, Stenzel F, Hörnlein S, Kauert M, Junghänel M, Barkenfelt B, Schmidt S, Rychtarik D, Fischer M, Müller J, Wawer P. R&D pilot line production of multi-crystalline Si solar cells exceeding cell efficiencies of 18%. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.egypro.2011.06.142] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Rieken S, Mohr A, Zipp L, Lindel K, Debus J, Combs S. Treatment Outcome and Prognostic Factors in Medulloblastomas after Radiation Therapy. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Psychogios MN, Buhk JH, Schramm P, Xyda A, Mohr A, Knauth M. Feasibility of angiographic CT in peri-interventional diagnostic imaging: a comparative study with multidetector CT. AJNR Am J Neuroradiol 2010; 31:1226-31. [PMID: 20360343 DOI: 10.3174/ajnr.a2086] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The ability to perform neuroimaging on the angiography suite is important in making decisions during neurointerventions. Our aim was the evaluation of ACT as a fast available diagnostic tool during and after neuroendovascular procedures and the comparison of ACT with postinterventional MDCT. MATERIALS AND METHODS Eighty-four peri-interventional ACT acquisitions were obtained and evaluated: 38 after coil embolization of cerebral aneurysms, 16 after intracranial angioplasty with stent placement, and 30 after endovascular mechanical thrombectomy and lysis. Interventions and ACTs were performed on a biplane angiography system equipped with flat panel detectors. Postprocessing was performed on a dedicated workstation, and multiplanar reformations were generated. Reference studies were performed on a 16- or 128-section MDCT scanner. All studies were independently evaluated by 3 blinded neuroradiologists. The Wilcoxon test was applied for the statistical analysis. RESULTS ACT and MDCT images were of equal diagnostic quality in most cases related to the supratentorial ventricular system and the detection of hemorrhages (subarachnoidal, intraparenchymal, and intraventricular). Regarding the supratentorial ventricular system, an adequate diagnostic quality was assigned to 94% of the ACT acquisitions. For the detection of hemorrhage, no statistically significant difference was noted between ACT and MDCT. However, for the infratentorial region, ACT performed relatively poorly compared with MDCT. The diagnostic evaluation of gray matter (basal ganglia, insular cortex, and central cortex) by ACT is not sufficient, with <20% of the acquisitions scoring a diagnostic value. CONCLUSIONS After neuroendovascular procedures and within the angiography suite, ACT enables an immediate detection of peri-interventional hemorrhage or hydrocephalus. However, for the detection of cerebral infarction, ACT is not yet reliable.
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Affiliation(s)
- M-N Psychogios
- Department of Neuroradiology, University Medicine Goettingen, Goettingen, Germany.
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Pauleikhoff D, Scheider A, Wiedmann P, Gelisken F, Scholl HPN, Roider I, Mohr A, Zlateva G, Xu X. [Neovascular age-related macular degeneration in Germany. Encroachment on the quality of life and the financial implications]. Ophthalmologe 2009; 106:242-51. [PMID: 18709375 DOI: 10.1007/s00347-008-1797-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Approximately 35,000 cases of neovascular age-related macular degeneration (AMD) occur annually in Germany. The neovascular form of AMD (NV-AMD) is responsible for severe vision loss associated with the disease in 90% of the cases. This study was conducted to assess the humanistic and economic burden of NV-AMD in the German population. METHODS A cross-sectional, observational study of subject self-reported functional health, well-being, and disease burden among elderly subjects with (n=83) and without (n=93) NV-AMD in Germany was conducted. Patients participated in telephone surveys involving the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25), the EuroQol (EQ-5D), the Hospital Anxiety and Depression Scale (HADS), and also reported history of falls, fractures, and healthcare resource utilization. Furthermore, the healthcare utilization and unit costs for the NV-AMD patients were calculated. RESULTS The mean age of NV-AMD patients was 77.2 years and 64% were female. NV-AMD patients reported significantly worse vision-related function and overall well-being than controls (adjusted mean scores: NEI-VFQ-25 overall scale: 51.3 vs 96.3; p<0.0001) and significantly more depression symptoms than controls (HADS depression: 6.2 vs. 2.7; p<0.0001). NV-AMD patients also reported that the need for assistance with daily activities was more than 10 times greater compared to controls (26.5% vs. 2.2%; p<0.0001) and the prevalence of falls was 3 times that of the control group (13.3% vs 4.3%; p=0.031). Annual NV-AMD costs per patient were <euro> 9871, 6 times that of elderly patients without NV-AMD (<euro> 1559). Of the NV-AMD costs one-half were direct non-medical-related costs (assistance of ADL or social benefit) and one-third were direct medical costs. CONCLUSIONS NV-AMD is associated with decreased functional abilities and quality of life, which result in an increase in healthcare resource utilization. Consequently, costs were higher for NV-AMD patients compared to controls. These findings emphasize the need for new NV-AMD treatments that will prevent vision loss and progression to blindness, and lessen the ensuing economic burden. Sponsored by Pfizer Inc. New York, US.
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Affiliation(s)
- D Pauleikhoff
- Augenabteilung am St. Franziskus-Hospital, Münster, Deutschland.
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Roemer FW, Guermazi A, Hunter DJ, Niu J, Zhang Y, Englund M, Javaid MK, Lynch JA, Mohr A, Torner J, Lewis CE, Nevitt MC, Felson DT. The association of meniscal damage with joint effusion in persons without radiographic osteoarthritis: the Framingham and MOST osteoarthritis studies. Osteoarthritis Cartilage 2009; 17:748-53. [PMID: 19008123 PMCID: PMC2740855 DOI: 10.1016/j.joca.2008.09.013] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2008] [Accepted: 09/27/2008] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess the cross-sectional association between meniscal status and joint effusion on magnetic resonance imaging (MRI) in knees without radiographic osteoarthritis (OA). DESIGN Knees without OA (Kellgren/Lawrence grade 0) from the Framingham and MOST studies were examined by MRI. Meniscal status was assessed with a score of 0-4 in the anterior horn/body/posterior horn of the medial/lateral meniscus and effusion was assessed using a score of 0-3. The odds ratios (ORs) of joint effusion in those with meniscal damage were estimated using a logistic regression model. A subanalysis was performed for knees without MRI-detected cartilage damage. RESULTS Of 1368 knees, 296 (21.6%) showed meniscal pathology in at least one subregion. Effusion was present in 133 (44.9%) of knees with meniscal damage vs 328 (30.6%) in those without meniscal damage. The adjusted OR of effusion in a knee with meniscal damage was 1.8, 95% confidence intervals (CI) [1.4, 2.4]. The OR of effusion for the group with meniscal pathology in two compartments was 5.4, 95% CI [2.1, 14.3]. For knees without any cartilage lesions but with meniscal damage in any compartment the OR was 2.3, 95% CI [1.1, 4.5]. CONCLUSIONS Knees without OA but with meniscal pathology exhibit joint effusion to a significantly higher degree than knees without meniscal damage. The association persists for knees without cartilage damage. The prevalence of effusion is further increased when present in two compartments. Concomitant occurrence of synovial activation and meniscal damage contributes to understanding the pathophysiology of early degenerative joint disease.
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Affiliation(s)
- F W Roemer
- Quantitative Imaging Center (QIC), Department of Radiology, Boston University Medical Center, Boston, MA 02118, USA.
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Abbasi R, Abdou Y, Ackermann M, Adams J, Ahlers M, Andeen K, Auffenberg J, Bai X, Baker M, Barwick SW, Bay R, Bazo Alba JL, Beattie K, Beatty JJ, Bechet S, Becker JK, Becker KH, Benabderrahmane ML, Berdermann J, Berghaus P, Berley D, Bernardini E, Bertrand D, Besson DZ, Bissok M, Blaufuss E, Boersma DJ, Bohm C, Bolmont J, Böser S, Botner O, Bradley L, Braun J, Breder D, Burgess T, Castermans T, Chirkin D, Christy B, Clem J, Cohen S, Cowen DF, D'Agostino MV, Danninger M, Day CT, De Clercq C, Demirörs L, Depaepe O, Descamps F, Desiati P, de Vries-Uiterweerd G, Deyoung T, Diaz-Velez JC, Dreyer J, Dumm JP, Duvoort MR, Edwards WR, Ehrlich R, Eisch J, Ellsworth RW, Engdegård O, Euler S, Evenson PA, Fadiran O, Fazely AR, Feusels T, Filimonov K, Finley C, Foerster MM, Fox BD, Franckowiak A, Franke R, Gaisser TK, Gallagher J, Ganugapati R, Gerhardt L, Gladstone L, Goldschmidt A, Goodman JA, Gozzini R, Grant D, Griesel T, Gross A, Grullon S, Gunasingha RM, Gurtner M, Ha C, Hallgren A, Halzen F, Han K, Hanson K, Hasegawa Y, Heise J, Helbing K, Herquet P, Hickford S, Hill GC, Hoffman KD, Hoshina K, Hubert D, Huelsnitz W, Hülss JP, Hulth PO, Hultqvist K, Hussain S, Imlay RL, Inaba M, Ishihara A, Jacobsen J, Japaridze GS, Johansson H, Joseph JM, Kampert KH, Kappes A, Karg T, Karle A, Kelley JL, Kenny P, Kiryluk J, Kislat F, Klein SR, Klepser S, Knops S, Kohnen G, Kolanoski H, Köpke L, Kowalski M, Kowarik T, Krasberg M, Kuehn K, Kuwabara T, Labare M, Lafebre S, Laihem K, Landsman H, Lauer R, Leich H, Lennarz D, Lucke A, Lundberg J, Lünemann J, Madsen J, Majumdar P, Maruyama R, Mase K, Matis HS, McParland CP, Meagher K, Merck M, Mészáros P, Middell E, Milke N, Miyamoto H, Mohr A, Montaruli T, Morse R, Movit SM, Münich K, Nahnhauer R, Nam JW, Niessen P, Nygren DR, Odrowski S, Olivas A, Olivo M, Ono M, Panknin S, Patton S, Pérez de Los Heros C, Petrovic J, Piegsa A, Pieloth D, Pohl AC, Porrata R, Potthoff N, Price PB, Prikockis M, Przybylski GT, Rawlins K, Redl P, Resconi E, Rhode W, Ribordy M, Rizzo A, Rodrigues JP, Roth P, Rothmaier F, Rott C, Roucelle C, Rutledge D, Ryckbosch D, Sander HG, Sarkar S, Satalecka K, Schlenstedt S, Schmidt T, Schneider D, Schukraft A, Schulz O, Schunck M, Seckel D, Semburg B, Seo SH, Sestayo Y, Seunarine S, Silvestri A, Slipak A, Spiczak GM, Spiering C, Stamatikos M, Stanev T, Stephens G, Stezelberger T, Stokstad RG, Stoufer MC, Stoyanov S, Strahler EA, Straszheim T, Sulanke KH, Sullivan GW, Swillens Q, Taboada I, Tarasova O, Tepe A, Ter-Antonyan S, Terranova C, Tilav S, Tluczykont M, Toale PA, Tosi D, Turcan D, van Eijndhoven N, Vandenbroucke J, Van Overloop A, Voigt B, Walck C, Waldenmaier T, Walter M, Wendt C, Westerhoff S, Whitehorn N, Wiebusch CH, Wiedemann A, Wikström G, Williams DR, Wischnewski R, Wissing H, Woschnagg K, Xu XW, Yodh G, Yoshida S. Limits on a muon flux from neutralino annihilations in the sun with the IceCube 22-string detector. Phys Rev Lett 2009; 102:201302. [PMID: 19519015 DOI: 10.1103/physrevlett.102.201302] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2009] [Revised: 03/27/2009] [Indexed: 05/27/2023]
Abstract
A search for muon neutrinos from neutralino annihilations in the Sun has been performed with the IceCube 22-string neutrino detector using data collected in 104.3 days of live time in 2007. No excess over the expected atmospheric background has been observed. Upper limits have been obtained on the annihilation rate of captured neutralinos in the Sun and converted to limits on the weakly interacting massive particle (WIMP) proton cross sections for WIMP masses in the range 250-5000 GeV. These results are the most stringent limits to date on neutralino annihilation in the Sun.
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Affiliation(s)
- R Abbasi
- Department of Physics, University of Wisconsin, Madison, Wisconsin 53706, USA
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Dohm C, Pilgram S, Liman J, Bähr M, Mohr A, Kermer P. Differenzialdiagnostische Maßnahmen bei Parkinsonsyndromen – eine Übersicht. Dtsch Med Wochenschr 2009; 134:892-6. [DOI: 10.1055/s-0029-1220245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pilgram-Pastor SM, Weber P, Frölich AM, Mohr A, Knauth M. Einfluss der präprozeduralen Stententlüftung auf das Auftreten embolischer Komplikationen während CAS. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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