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Banerjee S, Barry EM, Baqar S, Louis Bourgeois A, Campo JJ, Choy RKM, Chakraborty S, Clifford A, Deal C, Estrada M, Fleckenstein J, Hasso-Agopsowicz M, Hausdorff W, Khalil I, Maier N, Mubanga C, Platts-Mills JA, Porter C, Qadri F, Simuyandi M, Walker R, White JA. The 2022 Vaccines Against Shigella and Enterotoxigenic Escherichia coli (VASE) Conference: Summary of abstract-based presentations. Vaccine 2024; 42:1454-1460. [PMID: 38030421 PMCID: PMC10953701 DOI: 10.1016/j.vaccine.2023.11.031] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 11/10/2023] [Accepted: 11/15/2023] [Indexed: 12/01/2023]
Abstract
The global nonprofit organization PATH hosted the third Vaccines Against Shigella and Enterotoxigenic Escherichia coli (VASE) Conference in Washington, DC, on November 29 to December 1, 2022. With a combination of plenary sessions and posters, keynote presentations, and breakout workshops, the 2022 VASE Conference featured key updates on research related to the development of vaccines against neglected diarrheal pathogens including Shigella, enterotoxigenic Escherichia coli (ETEC), Campylobacter, and Salmonella. The presentations and discussions highlighted the significant impact of these diarrheal pathogens, particularly on the health of infants and young children in low- and middle-income countries, reflecting the urgent need for the development and licensure of new enteric vaccines. Oral and poster presentations at the VASE Conference explored a range of topics, including: the global burden and clinical presentation of disease, epidemiology, and the impact of interventions; the assessment of the value of vaccines against enteric pathogens; preclinical evaluations of vaccine candidates and models of enteric diseases; vaccine candidates in clinical trials and human challenge models; host parameters and genomics that predict responses to infection and disease; the application of new omics technologies for characterization of emerging pathogens and host responses; novel adjuvants, vaccine delivery platforms, and immunization strategies; and strategies for combination/co-administered vaccines. The conference agenda also featured ten breakout workshop sessions on topics of importance to the enteric vaccine field, which are summarized separately. This article reviews key points and highlighted research presented in each of the plenary conference sessions and poster presentations at the 2022 VASE Conference.
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Affiliation(s)
| | - Eileen M Barry
- University of Maryland School of Medicine, United States
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- PATH, United States; Faculty of Medicine, Université Libre de Bruxelles, Belgium
| | | | | | | | - James A Platts-Mills
- Division of Infectious Diseases and International Health, University of Virginia, United States
| | - Chad Porter
- Naval Medical Research Command, United States
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Zaman A, Krug D, Eidinger L, Boda-Heggemann J, Rudic B, Mehrhof F, Boldt LH, Fleckenstein J, Kluge A, Siebert FA, Schweikard A, Vontlein R, Dunst J, Bonnemeier H, Blanck O. A step towards routine for stereotactic radioablation in refractory ventricular tachycardia – interim analysis on short term safety of the first prospective, multi-centre, multi-platform study RAVENTA. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.697] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Ventricular tachycardia (VT) is a potentially life-threatening heart rhythm disorder originating in heterogeneous conduction velocity in the ventricular myocardium, e.g. by scar formation in ischaemic or dilated cardiomyopathy. Current guideline-directed medical therapy comprises implantable cardioverter defibrillator (ICD), antiarrhythmic drugs, and endocardial/epicardial catheter ablation. There is a serious recurrence rate for example due to diffuse fibrosis, progress of disease, or insufficient ablation depth or volume.
In cases when Catheter ablation and antiarrhythmic medication failed to reduce VT burden, stereotactic body radiation therapy (SBRT) may become an additional treatment option. To date there have been several small retrospective case series and some single-centre prospective studies showing promising results.
Purpose
For the purpose of obtaining the authorization of a randomized trial, a feasibility study was designed. The primary objective is to demonstrate sufficient safety of cardiac SBRT for the non-invasive treatment of VT and whether the dose needed can be delivered while sparing sensitive surrounding structures (e.g. stomach, oesophagus, vena cava, coronary arteries, ICD). Secondarily, the effect on VT burden is reported.
Methods
The RAVENTA study (RAdiosurgery for VENtricular TAchycardias) is the first prospective, multicentre study on SBRT in patients suffering from refractory VTs worldwide. Patients were enrolled according to strict inclusion criteria. First, an electrophysiology study using a high definition mapping system was performed to identify the substrate (target region). In order to plan SBRT a planning computed tomography scan was obtained. Finally, a single dose of 25 Gy was administered to the target region. Neither sedation nor anaesthesia is necessary during SBRT.
Primary endpoint is feasibility defined as complete dose application and absence of severe (grade ≥3) treatment-related toxicity within 30 days of treatment. RAVENTA is powered to reject the hypothesis of 70% feasibility, if in fact feasibility is 95%. This is a pre-defined interim analysis with the aim of stopping early for futility.
Results
Between October 2019 and December 2021, the first 5 patients (characteristics shown in Table 1) could be enrolled and radiotherapy was delivered without major complications. Cardiac SBRT took on average 30 minutes. There was no treatment-related severe toxicity. Furthermore, we could not record any negative effect on functionality of the ICD: constant sensing amplitude and pacing capture threshold. In the short-term, patients showed a clear decrease in VT burden.
Conclusion
These preliminary data of the first multi-centre, multi-platform study on cardiac SBRT on refractory VT demonstrated sufficient short-term feasibility to continue the RAVENTA study. Meanwhile the study has been expanded to 6 centres in Germany.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Zaman
- University Medical Center of Schleswig-Holstein, Department of Internal Medicine III , Kiel , Germany
| | - D Krug
- University Medical Center of Schleswig-Holstein, Department of Radiation Oncology , Kiel , Germany
| | - L Eidinger
- University Medical Center of Schleswig-Holstein, Department of Radiation Oncology , Kiel , Germany
| | - J Boda-Heggemann
- University Medical Centre of Mannheim, Department of Radiation Oncology , Mannheim , Germany
| | - B Rudic
- University Medical Centre of Mannheim, First Department of Medicine , Mannheim , Germany
| | - F Mehrhof
- Charité - University Medicine Berlin, Department of Radiation Oncology , Berlin , Germany
| | - L H Boldt
- Charite - Campus Virchow-Klinikum (CVK), Department of Cardiology , Berlin , Germany
| | - J Fleckenstein
- University Medical Centre of Mannheim, Department of Radiation Oncology , Mannheim , Germany
| | - A Kluge
- Charité - University Medicine Berlin, Department of Radiation Oncology , Berlin , Germany
| | - F A Siebert
- University Medical Center of Schleswig-Holstein, Department of Radiation Oncology , Kiel , Germany
| | - A Schweikard
- University of Luebeck, Institute for Robotics and Cognitive Systems , Luebeck , Germany
| | - R Vontlein
- Schleswig-Holstein University Clinic, Lubeck Campus, Institut für Medizinische Biometrie und Statistik , Luebeck , Germany
| | - J Dunst
- University Medical Center of Schleswig-Holstein, Department of Radiation Oncology , Kiel , Germany
| | - H Bonnemeier
- University Medical Center of Schleswig-Holstein, Department of Internal Medicine III , Kiel , Germany
| | - O Blanck
- University Medical Center of Schleswig-Holstein, Department of Radiation Oncology , Kiel , Germany
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Eckl M, Hoppen L, Sarria G, Boda-Heggemann J, Springer S, Simeonova-Chergou A, Steil V, Ehmann M, Giordano F, Fleckenstein J. Evaluation of a cycle-generative adversarial network-based synthetic cone-beam CT generation method for adaptive radiation therapy and daily treatment planning. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00136-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Fleckenstein J, Milliken JT, Lee JS, Ballentine SJ. Cystic angiomatosis of the bone, liver, and spleen. Am J Clin Pathol 2021. [DOI: 10.1093/ajcp/aqab191.268] [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: 11/15/2022] Open
Abstract
Abstract
Introduction/Objective
Cystic angiomatosis is a very rare entity characterized by multifocal cystic angiomatous lesions of the skeletal system, occasionally involving visceral organ systems. Clinical presentation and progression are extremely variable. Cases with liver involvement are even rarer, and have been described as invariably fatal. The pathogenesis of this disorder is poorly understood, and no treatments are currently available.
Methods/Case Report
A 24 year old man with history of polysubstance abuse and untreated hepatitis C presented with acute abdominal pain. Imaging revealed hepatosplenomegaly and multiple liver, spleen, and skeletal lesions. Differential diagnoses included metastatic disease, lymphoma, and infection. Apart from known untreated chronic hepatitis C, all infectious, autoimmune and hypercoagulability work-ups were negative. Biopsies of the liver and iliac bone lesions showed areas of benign-appearing vascular proliferation in a background of fibrosis. The vascular endothelial cells were positive for CD34 and CD31 but negative for D2-40. On follow-up approximately eight months later, the patient was asymptomatic.
Results (if a Case Study enter NA)
NA
Conclusion
Liver involvement by cystic angiomatosis is exceedingly rare and has been associated with increased mortality. This case provides an example of a patient with incidentally discovered cystic angiomatosis involving liver, spleen, and bone who remains asymptomatic at follow-up. Additional cases are required to understand the pathophysiology and disease course in this group of patients, and to investigate possible therapeutic targets.
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Affiliation(s)
- J Fleckenstein
- Department of Medicine, Washington University, St. Louis, Missouri, UNITED STATES
| | - John T Milliken
- Department of Medicine, Washington University, St. Louis, Missouri, UNITED STATES
| | - J S Lee
- Department of Pathology & Immunology, Washington University, St. Louis, Missouri, UNITED STATES
| | - S J Ballentine
- Department of Pathology & Immunology, Washington University, St. Louis, Missouri, UNITED STATES
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Gkika E, Tanja S, Stephanie K, Schaefer-Schuler A, Mix M, Küsters A, Tosch M, Eschmann S, Bultel Y, Hass P, Fleckenstein J, Thieme A, Stockinger M, Dieckmann K, Miederer M, Holl G, Rischke C, Adebahr S, Lenz S, Broichhagen C, Binder H, König J, Grosu A, Nestle U. PD-0413: The role of different chemotherapy protocols for concurrent CRT in locally advanced NSCLC. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00435-7] [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: 10/22/2022]
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Gkika E, Schimek-Jasch T, Kremp S, Schaefer-Schuler A, Mix M, Kuesters A, Tosch M, Hehr T, Eschmann S, Bultel Y, Hass P, Fleckenstein J, Thieme A, Stockinger M, Dieckmann K, Miederer M, Holl G, Rischke H, Adebahr S, Broichhagen C, Lenz S, Koenig J, Binder H, Grosu A, Nestle U. The Role of Different Chemotherapy Protocols for Concurrent CRT in Locally Advanced NSCLC. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1216] [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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Mottram L, Chakraborty S, Cox E, Fleckenstein J. How genomics can be used to understand host susceptibility to enteric infection, aiding in the development of vaccines and immunotherapeutic interventions. Vaccine 2019; 37:4805-4810. [PMID: 30709726 PMCID: PMC6663652 DOI: 10.1016/j.vaccine.2019.01.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 12/26/2018] [Accepted: 01/10/2019] [Indexed: 12/27/2022]
Abstract
Thanks to the modern sequencing era, the extent to which infectious disease imposes selective pressures on the worldwide human population is being revealed. This is aiding our understanding of the underlying immunological and host mechanistic defenses against these pathogens, as well as potentially assisting in the development of vaccines and therapeutics to control them. As a consequence, the workshop "How genomics can be used to understand host susceptibility to enteric infection, aiding in the development of vaccines and immunotherapeutic interventions" at the VASE 2018 meeting, aimed to discuss how genomics and related tools could be used to assist Shigella and ETEC vaccine development. The workshop featured four short presentations which highlighted how genomic applications can be used to assist in the identification of genetic patterns related to the virulence of disease, or host genetic factors that could contribute to immunity or successful vaccine responses. Following the presentations, there was an open debate with workshop attendees to discuss the best ways to utilise such genomic studies, to improve or accelerate the process of both Shigella and ETEC vaccine development. The workshop concluded by making specific recommendations on how genomic research methods could be strengthened and harmonised within the ETEC and Shigella research communities.
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Affiliation(s)
- Lynda Mottram
- Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
| | - Subhra Chakraborty
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Eric Cox
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - James Fleckenstein
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, United States; Medicine Service, Veterans Affairs Medical Center, St. Louis, MO, United States
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Fleckenstein J, Baeumler P, Gurschler C, Weissenbacher T, Annecke T, Geisenberger T, Irnich D. Acupuncture reduces the time from extubation to 'ready for discharge' from the post anaesthesia care unit: results from the randomised controlled AcuARP trial. Sci Rep 2018; 8:15734. [PMID: 30356057 PMCID: PMC6200780 DOI: 10.1038/s41598-018-33459-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 04/30/2018] [Accepted: 09/25/2018] [Indexed: 12/11/2022] Open
Abstract
Acupuncture may improve peri-operative care as it reduces post-operative symptoms, such as pain, nausea and vomiting, or sedation. This patient-assessor blinded, randomised trial in 75 women undergoing gynaecologic laparoscopy evaluated the effects of acupuncture combined with a standardised anaesthetic regimen (ACU) on post-anaesthetic recovery, when compared to acupressure (APU) or standard anaesthesia alone (CON). Main outcome measure was the time from extubation to ‘ready for discharge’ from recovery as assessed by validated questionnaires. The main outcome differed significantly between groups (p = 0.013). Median time to ready for discharge in the ACU group (30 (IQR: 24–41) min) was 16 minutes (35%) shorter than in the CON group (46 (36–64) min; p = 0.015) and tended to be shorter than in the APU group (43 (31–58) min; p = 0.08). Compared to CON (p = 0.029), median time to extubation was approximately 7 minutes shorter in both, the ACU and the APU group. No acupuncture or acupressure-related side-effects could be observed. A difference in time to recovery of 16 minutes compared to standard alone can be considered clinically relevant. Thus, results of this study encourage the application of acupuncture in gynaecological laparoscopy as it improves post-anaesthetic recovery.
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Affiliation(s)
- J Fleckenstein
- Department of Anaesthesiology, Ludwig-Maximilians University (LMU), Marchioninistraße 15, D-81377, Munich, Germany. .,Department of Traditional Chinese Medicine/Acupuncture, Institute of Complementary Medicine IKOM, University of Bern, Personalhaus 4, Inselspital, CH-3010, Bern, Switzerland.
| | - P Baeumler
- Department of Anaesthesiology, Ludwig-Maximilians University (LMU), Marchioninistraße 15, D-81377, Munich, Germany
| | - C Gurschler
- Department of Anaesthesiology, Ludwig-Maximilians University (LMU), Marchioninistraße 15, D-81377, Munich, Germany
| | - T Weissenbacher
- Department of Obstetrics and Gynaecology, Ludwig-Maximillians-University (LMU) Hospital, Maistraße 11, D-80337, Munich, Germany
| | - T Annecke
- Department of Anaesthesiology, Ludwig-Maximilians University (LMU), Marchioninistraße 15, D-81377, Munich, Germany.,Department of Anaesthesiology and Intensive Care, University Hospital of Cologne, Uniklinik Köln, D-50924, Cologne, Germany
| | - T Geisenberger
- Department of Anaesthesiology, Ludwig-Maximilians University (LMU), Marchioninistraße 15, D-81377, Munich, Germany.,Department of Anaesthesiology, Ospidal Engiadina Bassa, Via da l'Ospidal 280, CH-7550, Scuol, Switzerland
| | - D Irnich
- Department of Anaesthesiology, Ludwig-Maximilians University (LMU), Marchioninistraße 15, D-81377, Munich, Germany
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Fleckenstein J, König M, Banzer W. Correction to: Neural therapy of an athlete's chronic plantar fasciitis: a case report and review of the literature. J Med Case Rep 2018; 12:289. [PMID: 30270815 PMCID: PMC6166294 DOI: 10.1186/s13256-018-1852-3] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 08/27/2018] [Indexed: 11/12/2022] Open
Affiliation(s)
- J Fleckenstein
- Department of Sports Medicine, Institute of Sports Sciences, Goethe-University Frankfurt, Ginnheimer Landstr. 39, 60487, Frankfurt am Main, Germany. .,Department of TCM/Acupuncture, Institute of Complementary Medicine, University of Bern, Freiburgstr. 46, CH-3010, Bern, Switzerland.
| | - M König
- Department of Sports Medicine, Institute of Sports Sciences, Goethe-University Frankfurt, Ginnheimer Landstr. 39, 60487, Frankfurt am Main, Germany.,Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, 103 Borough Rd, London, SE1 0AA, UK
| | - W Banzer
- Department of Sports Medicine, Institute of Sports Sciences, Goethe-University Frankfurt, Ginnheimer Landstr. 39, 60487, Frankfurt am Main, Germany
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Fleckenstein J, König M, Banzer W. Neural therapy of an athlete's chronic plantar fasciitis: a case report and review of the literature. J Med Case Rep 2018; 12:233. [PMID: 30126441 PMCID: PMC6102931 DOI: 10.1186/s13256-018-1770-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 02/12/2018] [Accepted: 07/15/2018] [Indexed: 11/22/2022] Open
Abstract
Background The focus of this case report is on the role of inflammation as a contributor to pain in plantar fasciitis and its cure by the injection of local anesthetics. Case presentation This is a case report on a 24-year-old white man, a middle-distance runner, with chronic unilateral plantar fasciitis and perceived heel pain for almost 1.5 years. He was treated with neural therapy (that is, injection of < 1 ml procaine 1% which is a local anesthetic with strong anti-inflammatory properties) of the surgical scar and along the surgical puncture channel. The follow-up period from the time of first presentation until publication was 2.5 years. At admission, pain intensity (visual analog scale) in the affected leg was severe (10 cm, visual analog scale; range 0–10 cm) when walking and moderate (5 cm, visual analog scale) when standing. After the first session of injections he could stand pain-free and pain when walking was markedly reduced (− 90%). After the third session, he reported no pain in the affected leg and could return to sports at his former level (no difference in training load compared to non-injured state). There was no recurrence of inflammatory signs or heel pain despite intense athletics training up to the date of publication. Conclusions In prolonged cases of plantar fasciitis, inflammation is an important component in the development of persistent pain. The results of our case describe the effects of three neural therapy sessions that abolished inflammation and associated heel pain. Neural therapy might be an effective and time-efficient approach in the treatment of plantar fasciitis, enabling an early return to sports.
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Affiliation(s)
- J Fleckenstein
- Department of Sports Medicine, Institute of Sports Sciences, Goethe-University Frankfurt, Ginnheimer Landstr. 39, D-60487, Frankfurt am Main, Germany. .,Department of TCM/Acupuncture, Institute of Complementary Medicine, University of Bern, Freiburgstr. 46, CH-3010, Bern, Switzerland.
| | - M König
- Department of Sports Medicine, Institute of Sports Sciences, Goethe-University Frankfurt, Ginnheimer Landstr. 39, D-60487, Frankfurt am Main, Germany.,Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, 103 Borough Rd, SE1 0AA, London, UK
| | - W Banzer
- Department of Sports Medicine, Institute of Sports Sciences, Goethe-University Frankfurt, Ginnheimer Landstr. 39, D-60487, Frankfurt am Main, Germany
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Stratmann C, Baeumler P, Kramer S, Fleckenstein J, Irnich D. Acupuncture for Acute Herpes Zoster – Secondary Outcomes of a Randomized Controlled Non-inferiority Trial. J Acupunct Meridian Stud 2018. [DOI: 10.1016/j.jams.2018.08.181] [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] Open
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Simma-Kletschka I, Simma L, Fleckenstein J. Craniomandibular Disorders: Muscular Diagnostics and Acupuncture - A Retrospective Analysis of 887 Treatments. J Acupunct Meridian Stud 2018. [DOI: 10.1016/j.jams.2018.08.041] [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] Open
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Nestle U, Schimek-Jasch T, Kremp S, Schaefer-Schuler A, Kuesters A, Tosch M, Hehr T, Eschmann S, Bultel Y, Hass P, Brunner T, Fleckenstein J, Thieme A, Stockinger M, Miederer M, Beck M, Holl G, Rischke H, Adebahr S, Lenz S, Koenig J, Grosu A. OC-0598: FDG-PET-guided target volume reduction for isotoxic dose escalation in LA NSCLC (PET-Plan study). Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30908-3] [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: 10/14/2022]
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Fleckenstein J, Budjan J, Arns A, Steil V, Schönberg S, Wenz F, Attenberger U, Ehmann M. OC-0292: Applicability of MR-only based radiation therapy treatment planning for intracranial target volumes. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30602-9] [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: 10/14/2022]
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Arns A, Fleckenstein J, Schneider F, Boda-Heggemann J, Abo-Madyan Y, Steil V, Wenz F, Wertz H. EP-2041: Registration accuracy of high-speed single breath-hold kV-CBCT lung cancer imaging. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32350-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Matura S, Fleckenstein J, Deichmann R, Engeroff T, Füzéki E, Hattingen E, Hellweg R, Lienerth B, Pilatus U, Schwarz S, Tesky VA, Vogt L, Banzer W, Pantel J. Effects of aerobic exercise on brain metabolism and grey matter volume in older adults: results of the randomised controlled SMART trial. Transl Psychiatry 2017; 7:e1172. [PMID: 28934191 PMCID: PMC5538117 DOI: 10.1038/tp.2017.135] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 04/21/2017] [Accepted: 05/08/2017] [Indexed: 01/29/2023] Open
Abstract
There is mounting evidence that aerobic exercise has a positive effect on cognitive functions in older adults. To date, little is known about the neurometabolic and molecular mechanisms underlying this positive effect. The present study used magnetic resonance spectroscopy and quantitative MRI to systematically explore the effects of physical activity on human brain metabolism and grey matter (GM) volume in healthy aging. This is a randomised controlled assessor-blinded two-armed trial (n=53) to explore exercise-induced neuroprotective and metabolic effects on the brain in cognitively healthy older adults. Participants (age >65) were allocated to a 12-week individualised aerobic exercise programme intervention (n=29) or a 12-week waiting control group (n=24). The main outcomes were the change in cerebral metabolism and its association to brain-derived neurotrophic factor (BDNF) levels as well as changes in GM volume. We found that cerebral choline concentrations remained stable after 12 weeks of aerobic exercise in the intervention group, whereas they increased in the waiting control group. No effect of training was seen on cerebral N-acetyl-aspartate concentrations, nor on markers of neuronal energy reserve or BDNF levels. Further, we observed no change in cortical GM volume in response to aerobic exercise. The finding of stable choline concentrations in the intervention group over the 3 month period might indicate a neuroprotective effect of aerobic exercise. Choline might constitute a valid marker for an effect of aerobic exercise on cerebral metabolism in healthy aging.
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Affiliation(s)
- S Matura
- Institute of General Practice, Goethe University, Frankfurt/Main, Germany,Institut für Allgemeinmedizin, Goethe Universität, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany. E-mail:
| | - J Fleckenstein
- Department of Sports Medicine, Institute of Sports Sciences, Goethe University, Frankfurt/Main, Germany
| | - R Deichmann
- Brain Imaging Center, Frankfurt/Main, Germany
| | - T Engeroff
- Department of Sports Medicine, Institute of Sports Sciences, Goethe University, Frankfurt/Main, Germany
| | - E Füzéki
- Department of Sports Medicine, Institute of Sports Sciences, Goethe University, Frankfurt/Main, Germany
| | - E Hattingen
- Institute of Neuroradiology, Goethe University Hospital Frankfurt, Frankfurt/Main, Germany
| | - R Hellweg
- Neurobiology and Neurotrophins Laboratory, Department of Psychiatry and Psychotherapy, Charité University Medicine, Berlin, Germany
| | - B Lienerth
- Brain Imaging Center, Frankfurt/Main, Germany
| | - U Pilatus
- Institute of Neuroradiology, Goethe University Hospital Frankfurt, Frankfurt/Main, Germany
| | - S Schwarz
- Department of Sports Medicine, Institute of Sports Sciences, Goethe University, Frankfurt/Main, Germany
| | - V A Tesky
- Institute of General Practice, Goethe University, Frankfurt/Main, Germany
| | - L Vogt
- Department of Sports Medicine, Institute of Sports Sciences, Goethe University, Frankfurt/Main, Germany
| | - W Banzer
- Department of Sports Medicine, Institute of Sports Sciences, Goethe University, Frankfurt/Main, Germany
| | - J Pantel
- Institute of General Practice, Goethe University, Frankfurt/Main, Germany
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Schneider F, Jimenez L, Bludau F, Jahnke A, Illana C, Fleckenstein J, Clausen S, Obertacke U, Wenz F. OC-0362: Precision IORT - image guided IORT including online CBCT based Monte Carlo treatment planning. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30804-6] [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: 11/15/2022]
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Dzierma Y, Bell K, Nuesken F, Palm J, Fleckenstein J, Licht N, Rübe C. EP-1672: mARC vs. IMRT treatment of prostate and head-and-neck cancer with flat and FFF energies. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32923-1] [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: 11/15/2022]
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Fogliata A, Fleckenstein J, Schneider F, Pachoud M, Ghandour S, Krauss H, Reggiori G, Stravato A, Lohr F, Scorsetti M, Cozzi L. PO-0809: FFF beams from TrueBeam and Versa HD units: evaluation of the parameters for quality assurance. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32059-x] [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: 10/21/2022]
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Wilke J, Niederer D, Fleckenstein J, Vogt L, Banzer W. Range of motion and cervical myofascial pain. J Bodyw Mov Ther 2016; 20:52-55. [PMID: 26891637 DOI: 10.1016/j.jbmt.2015.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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: 11/27/2014] [Revised: 03/27/2015] [Accepted: 04/13/2015] [Indexed: 10/23/2022]
Abstract
Several studies investigating myofascial pain syndrome include assessments of range of motion (ROM) as a diagnostic criterion. However, the value of ROM in this context has not yet been evaluated in controlled clinical studies. We aimed to examine whether patients with myofascial pain syndrome display alterations of ROM when compared to healthy subjects. Twenty-two individuals (13 females, 9 males; aged 33.4 ± 13.9 yrs) afflicted with active myofascial trigger points in the upper trapezius muscle as well as 22 age and sex matched healthy controls were included. All subjects underwent an examination of maximal active cervical ROM in flexion/extension assessed by means of a 3D ultrasonic movement analysis system (30 Hz; Zebris CMS 70). In the patients group, pressure pain threshold (PPT) of the trigger points was determined using a pressure algometer. Maximum range of motion in the sagittal plane did not differ between individuals with MTrP (125.9 ± 23.2°, 95% CI: 116.2-135.6°) and asymptomatic subjects (128.2 ± 20.4°, 95% CI: 119.7-136.7°; p > .05). In patients, PPT (1.7 ± .6, 95% CI: 1.5-1.9) was not correlated with cervical mobility (r = -.13; p > .05). Based on these pilot data, range of motion in flexion/extension is not a valid criterion for the detection of myofascial trigger points. Additional research incorporating movement amplitudes in other anatomical planes and additional afflicted muscles should be conducted in order to further delineate the relative impact of MTrP on range of motion.
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Affiliation(s)
- J Wilke
- Goethe University Frankfurt, Institute of Sports Sciences, Department Sports Medicine, Ginnheimer Landstraße 39, 60487 Frankfurt/Main, Germany.
| | - D Niederer
- Goethe University Frankfurt, Institute of Sports Sciences, Department Sports Medicine, Ginnheimer Landstraße 39, 60487 Frankfurt/Main, Germany
| | - J Fleckenstein
- Goethe University Frankfurt, Institute of Sports Sciences, Department Sports Medicine, Ginnheimer Landstraße 39, 60487 Frankfurt/Main, Germany
| | - L Vogt
- Goethe University Frankfurt, Institute of Sports Sciences, Department Sports Medicine, Ginnheimer Landstraße 39, 60487 Frankfurt/Main, Germany
| | - W Banzer
- Goethe University Frankfurt, Institute of Sports Sciences, Department Sports Medicine, Ginnheimer Landstraße 39, 60487 Frankfurt/Main, Germany
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Zhang R, Bai W, Fleckenstein J. SU-E-T-650: Quantification and Modeling of the Dosimetric Impact of the IBEAM Evo Treatment Couchtop EP (Elekta) in VMAT. Med Phys 2015. [DOI: 10.1118/1.4925013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Fleckenstein J, Kohls N, Evtouchenko E, Lehmeyer L, Kramer S, Lang P, Siebeck M, Mussack T, Hatz R, Heindl B, Conzen P, Rehm M, Czerner S, Zwißler B, Irnich D. No effect of the cyclooxygenase-2 inhibitor etoricoxib on pre-emptive and post-operative analgesia in visceral surgery: results of a randomized controlled trial. Eur J Pain 2015; 20:186-95. [DOI: 10.1002/ejp.699] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2015] [Indexed: 11/06/2022]
Affiliation(s)
- J. Fleckenstein
- Department of Anaesthesiology; University of Munich; Germany
| | - N. Kohls
- Division Integrative Health Promotion; University of Applied Sciences and Arts Coburg; Germany
- Brain, Mind & Healing Program; Samueli Institute; Alexandria USA
| | - E. Evtouchenko
- Department of Anaesthesiology; University of Munich; Germany
| | - L. Lehmeyer
- Department of Anaesthesiology; University of Munich; Germany
| | - S. Kramer
- Department of Anaesthesiology; University of Munich; Germany
| | - P.M. Lang
- Department of Anaesthesiology; University of Munich; Germany
| | - M. Siebeck
- Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery; Ludwig Maximilians University; Munich Germany
| | - T. Mussack
- Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery; Ludwig Maximilians University; Munich Germany
| | - R. Hatz
- Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery; Ludwig Maximilians University; Munich Germany
| | - B. Heindl
- Department of Anaesthesiology; University of Munich; Germany
| | - P. Conzen
- Department of Anaesthesiology; University of Munich; Germany
| | - M. Rehm
- Department of Anaesthesiology; University of Munich; Germany
| | - S. Czerner
- Department of Anaesthesiology; University of Munich; Germany
| | - B. Zwißler
- Department of Anaesthesiology; University of Munich; Germany
| | - D. Irnich
- Department of Anaesthesiology; University of Munich; Germany
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Felix M, Fleckenstein J, Kirschner S, Brockmann M, Wenz F, Giordano F, Glatting G. Converting a Standard Micro-CT Into an IGRT-Competent Small Animal Irradiation Device. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.2322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Fleckenstein J, Kemmler-Sack S, Rüdorff W. Notizen: Über zwei neue Alkaliuranoxidfluoride mit Uran in zwei Oxidationsstufen / On Two New Alkali-uranium-oxidfluorides with Uranium in Two Oxidation States. Zeitschrift für Naturforschung B 2014. [DOI: 10.1515/znb-1971-1232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- J. Fleckenstein
- Laboratorium für Anorganische und Analytische Chemie der Universität Tübingen
| | - S. Kemmler-Sack
- Laboratorium für Anorganische und Analytische Chemie der Universität Tübingen
| | - W. Rüdorff
- Laboratorium für Anorganische und Analytische Chemie der Universität Tübingen
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Tischer H, Mokhtari-Nejad R, Palm U, Fleckenstein J, Irnich D, Padberg F, Musil R. EPA-1774 – Observational study to assess the feasibility, practicality and effectiveness of ear acupuncture groups based on the nada-protocol in patients with severe mental illness. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78897-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Wenz F, Vaidya J, Pigorsch S, Feyer P, Roedel C, Belka C, Fleckenstein J, Bremer M, Joseph D, Baum M. Local Recurrence and Survival for the German Centers in the TARGIT-A (TARGeted Intraoperative Radiation Therapy - Alone) Trial. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
Gender differences can have a relevant influence on the perioperative outcome as male and female patients are affected differently by adverse events, e.g. side effects of drugs. Furthermore, differences relating to specific drug effects, comorbidities and outcome after anesthesia or intensive care have been demonstrated. There seems to be a gender bias in diagnosis and therapy. While the knowledge regarding this field is still growing certain aspects have already been integrated into clinical practice: prevention of postoperative nausea and vomiting (PONV), target controlled infusion (TCI) model and male only policy with production of blood products. There is a need to study the influence of gender, age and race in order to optimize treatment towards a more individualized therapy. This article highlights already identified differences and discusses potential underlying mechanisms.
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Affiliation(s)
- M Schopper
- Klinik für Anästhesiologie, Klinikum der Universität München, Campus Innenstadt, München, Deutschland.
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Koeck J, Abo-Madyan Y, Eich HT, Stieler F, Fleckenstein J, Kriz J, Mueller RP, Wenz F, Lohr F. Clinical relevance of different dose calculation strategies for mediastinal IMRT in Hodgkin's disease. Strahlenther Onkol 2012; 188:653-9. [PMID: 22740169 DOI: 10.1007/s00066-012-0144-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2012] [Accepted: 04/23/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND PURPOSE Conventional algorithms show uncertainties in dose calculation already for three-dimensional conformal radiotherapy (3D-CRT). Intensity-modulated radiotherapy (IMRT) might even increase these. We wanted to assess differences in dose distribution for pencil beam (PB), collapsed cone (CC), and Monte Carlo (MC) algorithm for both 3D-CRT and IMRT in patients with mediastinal Hodgkin lymphoma. PATIENTS AND METHODS Based on 20 computed tomograph (CT) datasets of patients with mediastinal Hodgkin lymphoma, we created treatment plans according to the guidelines of the German Hodgkin Study Group (GHSG) with PB and CC algorithm for 3D-CRT and with PB and MC algorithm for IMRT. Doses were compared for planning target volume (PTV) and organs at risk. RESULTS For 3D-CRT, PB overestimated PTV(95) and V(20) of the lung by 6.9% and 3.3% and underestimated V(10) of the lung by 5.8%, compared to the CC algorithm. For IMRT, PB overestimated PTV(95), V(20) of the lung, V(25) of the heart and V(10) of the female left/right breast by 8.1%, 25.8%, 14.0% and 43.6%/189.1%, and underestimated V(10) of the lung, V(4) of the heart and V(4) of the female left/right breast by 6.3%, 6.8% and 23.2%/15.6%, compared to MC. CONCLUSION The PB algorithm underestimates low doses to the organs at risk and overestimates dose to PTV and high doses to the organs at risk. For 3D-CRT, a well-modeled PB algorithm is clinically acceptable; for IMRT planning, however, an advanced algorithm such as CC or MC should be used at least for part of the plan optimization.
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Affiliation(s)
- J Koeck
- Klinik für Strahlentherapie und Radioonkologie, Universitätsmedizin Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68135, Mannheim, Germany.
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Jahnke L, Klabes A, Fleckenstein J, Wenz F, Hesser J. EP-1340 BENCHMARKING GMC FOR ELECTRON CALCULATIONS. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)71673-0] [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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Abstract
BACKGROUND Acupuncture (AP) might be indicated in emergency medicine. This case series was performed to demonstrate the practicability and possible effects of AP in emergency medical services (EMS) as a basis for randomized controlled trials (RCT). SUBJECTS AND METHODS A total of 60 patients (average age 55.4±23.0 years, 57% female) treated by the EMS received AP if applicable. Main outcome parameter was to rate the symptom alleviating effect of acupuncture treatment on a 4-point scale or by VAS. RESULTS Of the 60 patients 35 (58%) reported considerable improvement, 15 patients (25%) reported complete relief and 10 patients (17%) reported no changes in the cardinal symptom. The predominant symptoms alleviated by AP were nausea (n=31) and vomiting (n=21). Pericardium 3 and 6 (27%) and Spleen 6 and 9 were the most commonly used AP points. CONCLUSION This case series demonstrates that AP can alleviate certain symptoms in emergency patients. The results of the study provide data as a basis to perform clinical controlled trials on the effectiveness of AP in emergency medicine.
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Affiliation(s)
- J Fleckenstein
- Interdisziplinäre Schmerzambulanz, Klinik für Anaesthesiologie, Klinikum der Universität München, Innenstadt, München, Deutschland
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Huang W, Pach D, Napadow V, Park K, Long X, Neumann J, Maeda Y, Nierhaus T, Liang F, Witt CM, Fleckenstein J. Characterizing acupuncture stimuli using brain imaging with fMRI – a systematic review and meta-analysis of the literature. Deutsche Zeitschrift für Akupunktur 2012. [DOI: 10.1016/j.dza.2012.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Poeschel V, Murawski N, Glass B, Zeynalova S, Fleckenstein J, Ziepert M, Kempf B, Loeffler M, Schmitz N, Pfreundschuh M. Aggressive craniofacial lymphoma in the pre-rituximab and rituximab era. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.8038] [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: 11/20/2022] Open
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Niewald M, Berdel C, Fleckenstein J, Ketter R, Ruebe C. Remarkable Toxicity after Radiochemotherapy for Glioblastoma using Temozolomide. Clin Oncol (R Coll Radiol) 2011. [DOI: 10.1016/j.clon.2011.01.459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Niewald M, Al-Mukadam L, Fleckenstein J, Ketter R, Ruebe C. Hyperfractionated Radiotherapy for Glioblastoma: Shorter Treatment Time Without Affecting Prognosis. Clin Oncol (R Coll Radiol) 2011. [DOI: 10.1016/j.clon.2011.01.460] [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: 11/16/2022]
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Bäumler P, Wu L, Fleckenstein J, Irnich D. Acupuncture in the management of neck pain in China, Japan, and Germany: A qualitative intercultural study. Eur J Integr Med 2010. [DOI: 10.1016/j.eujim.2010.09.151] [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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Fleckenstein J, Salih N, Offenbächer M, Irnich D. Results of a RCT evaluating the validity of sham laser acupuncture as a placebo control in laser acupuncture studies. Eur J Integr Med 2010. [DOI: 10.1016/j.eujim.2010.09.057] [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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Fleckenstein J, Pfreundschuh M, Ziepert M, Zeynalova S, Both A, Loeffler M, Rübe C. The Role of Local Therapy (Surgery or Additive Radiotherapy) in Extranodal Involvement of Diffuse Large B-cell Lymphoma (DLBCL) in the Rituximab Era. Results from the RICOVER-60 Trial of the DSHNHL. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1270] [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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Jahnke L, Fleckenstein J, Hesser J, Wenz F. SU-GG-T-429: Implementation of a Geant4 Based GPU Monte Carlo Algorithm and Benchmarking of an IMRT Patient Plan. Med Phys 2010. [DOI: 10.1118/1.3468826] [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: 11/07/2022] Open
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Fleckenstein J, Irnich D, Goldman N, Chen M, Fujita T, Xu Q, Peng W, Liu W, Jensen T, Pei Y, Wang F, Han X, Chen J, Schnermann J, Takano T, Bekar L, Tieu K, Nedergaard M. Adenosine A1 receptors mediate local anti-nociceptive effects of acupuncture. Deutsche Zeitschrift für Akupunktur 2010. [DOI: 10.1016/j.dza.2010.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Rube C, Ziepert M, Schmidberger H, Poeschel V, Müller R, Sautter-Bihl M, Fritz P, Loeffler M, Pfreundschuh M, Fleckenstein J. The Impact of Radiotherapy to Bulky Disease after R-CHOP Chemotherapy in Aggressive Lymphoma: Results from Two Prospective Trials of the German High-grade Non-Hodgkin-Lymphoma Study Group (DSHNHL) for Elderly Patients with DLBCL. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.162] [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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Freysoldt A, Fleckenstein J, Lang PM, Irnich D, Grafe P, Carr RW. Low concentrations of amitriptyline inhibit nicotinic receptors in unmyelinated axons of human peripheral nerve. Br J Pharmacol 2009; 158:797-805. [PMID: 19694730 DOI: 10.1111/j.1476-5381.2009.00347.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND AND PURPOSE Amitriptyline is often prescribed as a first-line treatment for neuropathic pain but its precise mode of analgesic action remains uncertain. Amitriptyline is known to inhibit voltage-dependent ion channels and also to act as an antagonist at ligand-gated ion channels, such as nicotinic acetylcholine receptors (nAChRs). In the present study, we tested the effect of amitriptyline on nicotinic responses of unmyelinated axons in isolated segments of human peripheral nerve. In particular, a comparison was made between the concentrations of amitriptyline necessary for inhibition of nAChRs and those required for inhibition of the compound C-fibre action potential. EXPERIMENTAL APPROACH Isolated axon fascicles were prepared from short segments of human sural nerve, and multiple measures of axonal excitability were recorded using computer-controlled threshold tracking software. KEY RESULTS Amitriptyline (EC(50) 2.6 microM) reduced the nicotine-induced increase in C-fibre excitability but only slightly altered the amplitude and latency to onset of the compound action potential. In contrast, tetrodotoxin produced a clear reduction in the amplitude and a prolongation of action potential onset latency but was without effect on the nicotine-induced increase in axonal excitability. CONCLUSIONS AND IMPLICATIONS These data demonstrate that low concentrations of amitriptyline suppress the response of human peripheral C-type axons to nicotine by directly inhibiting nAChRs. Blockade of tetrodotoxin-sensitive, voltage-dependent sodium channels does not contribute to this effect. An inhibitory action of amitriptyline on nAChRs in unmyelinated nociceptive axons may be an important component of amitriptyline's therapeutic effect in the treatment of neuropathic pain.
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Affiliation(s)
- A Freysoldt
- Institute of Physiology, University of Munich, Munich, Germany
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Carr RW, Fleckenstein J, Lang P, Grafe P. Funktionelle Untersuchungen von Ionenkanälen in unmyelinisierten Axonen des Menschen. KLIN NEUROPHYSIOL 2009. [DOI: 10.1055/s-0029-1216104] [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: 10/21/2022]
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Grgic A, Moca N, Schaefer A, Kremp S, Hellwig D, Fleckenstein J, Kirsch CM, Ruebe C, Nestle U. FDG- based GTVs for radiotherapy planning in lung cancer: influence of coregistration on volume size. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-0028-1085910] [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: 10/21/2022]
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Johns D, Rose J, Fleckenstein J, Rohrich R. Use of MRI in Vocal Tract Imaging for Assessing Velopharyngeal Incompetency: Technique and Future Applications. Semin Plast Surg 2008. [DOI: 10.1055/s-2008-1080330] [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: 10/21/2022]
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Lang PM, Fleckenstein J, Passmore GM, Brown DA, Grafe P. Retigabine reduces the excitability of unmyelinated peripheral human axons. Neuropharmacology 2008; 54:1271-8. [PMID: 18474382 DOI: 10.1016/j.neuropharm.2008.04.006] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2008] [Revised: 04/10/2008] [Accepted: 04/11/2008] [Indexed: 01/03/2023]
Abstract
Enhancement of membrane K(+) conductance may reduce the abnormal excitability of primary afferent nociceptive neurons in neuropathic pain. It has been shown that retigabine, a novel anticonvulsant, activates Kv7 (KCNQ/M) channels in the axonal/nodal membrane of peripheral myelinated axons. In this study, we have tested the effects of retigabine on excitability parameters of C-type nerve fibers in isolated fascicles of human sural nerve. Application of retigabine (3-10 microM) produced an increase in membrane threshold. This effect was pronounced in depolarized axons and small in hyperpolarized axons. This finding indicates that retigabine produces a membrane hyperpolarization which is limited by the K(+) equilibrium potential. The retigabine-induced reduction in excitability was accompanied by modifications of the post-spike recovery cycle. Most notable is the development of a late subexcitability at 250-400 ms following a short burst of action potentials. All effects of retigabine were blocked in the presence of XE991 (10 microM). The data show that Kv7 channels are present on axons of unmyelinated, including nociceptive, peripheral human nerve fibers. It is likely that activation of these channels by retigabine may reduce the ectopic generation of action potentials in neuropathic pain.
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Affiliation(s)
- P M Lang
- Department of Physiology, University of Munich, Pettenkoferstrasse 12, D-80336 Munich, Germany
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