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Warias JE, Reise F, Hövelmann SC, Giri RP, Röhrl M, Kuhn J, Jacobsen M, Chatterjee K, Arnold T, Shen C, Festersen S, Sartori A, Jordt P, Magnussen OM, Lindhorst TK, Murphy BM. Photoinduced bidirectional switching in lipid membranes containing azobenzene glycolipids. Sci Rep 2023; 13:11480. [PMID: 37455299 PMCID: PMC10350456 DOI: 10.1038/s41598-023-38336-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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 07/06/2023] [Indexed: 07/18/2023] Open
Abstract
Following the reaction of biological membranes to external stimuli reveals fundamental insights into cellular function. Here, self-assembled lipid monolayers act as model membranes containing photoswitchable azobenzene glycolipids for investigating structural response during isomerization by combining Langmuir isotherms with X-ray scattering. Controlled in-situ trans/cis photoswitching of the azobenzene N = N double bond alters the DPPC monolayer structure, causing reproducible changes in surface pressure and layer thickness, indicating monolayer reorientation. Interestingly, for monolayers containing azobenzene glycolipids, along with the expected DPPC phase transitions an additional discontinuity is observed. The associated reorintation represents a crossover point, with the surface pressure and layer thickness changing in opposite directions above and below. This is evidence that the azobenzene glycolipids themselves change orientation within the monolayer. Such behaviour suggests that azobenzene glycolipids can act as a bidirectional switch in DPPC monolayers providing a tool to investigate membrane structure-function relationships in depth.
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Affiliation(s)
- Jonas E Warias
- Institute of Experimental and Applied Physics, Kiel University, Leibnizstr. 19, 24118, Kiel, Germany
| | - Franziska Reise
- Otto Diels Institute of Organic Chemistry, Kiel University, Otto-Hahn-Platz 3-4, 24118, Kiel, Germany
| | - Svenja C Hövelmann
- Institute of Experimental and Applied Physics, Kiel University, Leibnizstr. 19, 24118, Kiel, Germany
- Deutsches Elektronen-Synchrotron DESY, Notkestraße 85, 22607, Hamburg, Germany
- Ruprecht Haensel Laboratory, Kiel University, 24118, Kiel, Germany
| | - Rajendra P Giri
- Institute of Experimental and Applied Physics, Kiel University, Leibnizstr. 19, 24118, Kiel, Germany
- Ruprecht Haensel Laboratory, Kiel University, 24118, Kiel, Germany
| | - Michael Röhrl
- Otto Diels Institute of Organic Chemistry, Kiel University, Otto-Hahn-Platz 3-4, 24118, Kiel, Germany
| | - Jule Kuhn
- Institute of Experimental and Applied Physics, Kiel University, Leibnizstr. 19, 24118, Kiel, Germany
| | - Malte Jacobsen
- Institute of Experimental and Applied Physics, Kiel University, Leibnizstr. 19, 24118, Kiel, Germany
| | - Kuntal Chatterjee
- Institute of Experimental and Applied Physics, Kiel University, Leibnizstr. 19, 24118, Kiel, Germany
- Molecular Biophysics and Integrated Bioimaging Division, Lawrence Barkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA, 94720, USA
| | - Thomas Arnold
- Diamond Light Source, Harwell Science and Innovation Campus, Didcot, OX11 ODE, UK
- ISIS Neutron and Muon Source, Rutherford Appleton Laboratory, Didcot, OX11 0QX, UK
- Department of Chemistry, University of Bath, Claverton Down, Bath, BA2 7AY, UK
- European Spallation Source ERIC, P.O Box 176, 221 00, Lund, Sweden
| | - Chen Shen
- Deutsches Elektronen-Synchrotron DESY, Notkestraße 85, 22607, Hamburg, Germany
| | - Sven Festersen
- Institute of Experimental and Applied Physics, Kiel University, Leibnizstr. 19, 24118, Kiel, Germany
| | - Andrea Sartori
- Institute of Experimental and Applied Physics, Kiel University, Leibnizstr. 19, 24118, Kiel, Germany
- ESRF-The European Synchrotron, 38043, Grenoble, France
| | - Philipp Jordt
- Institute of Experimental and Applied Physics, Kiel University, Leibnizstr. 19, 24118, Kiel, Germany
| | - Olaf M Magnussen
- Institute of Experimental and Applied Physics, Kiel University, Leibnizstr. 19, 24118, Kiel, Germany
- Ruprecht Haensel Laboratory, Kiel University, 24118, Kiel, Germany
| | - Thisbe K Lindhorst
- Otto Diels Institute of Organic Chemistry, Kiel University, Otto-Hahn-Platz 3-4, 24118, Kiel, Germany
| | - Bridget M Murphy
- Institute of Experimental and Applied Physics, Kiel University, Leibnizstr. 19, 24118, Kiel, Germany.
- Ruprecht Haensel Laboratory, Kiel University, 24118, Kiel, Germany.
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Schmidt AB, Bowers CR, Buckenmaier K, Chekmenev EY, de Maissin H, Eills J, Ellermann F, Glöggler S, Gordon JW, Knecht S, Koptyug IV, Kuhn J, Pravdivtsev AN, Reineri F, Theis T, Them K, Hövener JB. Instrumentation for Hydrogenative Parahydrogen-Based Hyperpolarization Techniques. Anal Chem 2022; 94:479-502. [PMID: 34974698 PMCID: PMC8784962 DOI: 10.1021/acs.analchem.1c04863] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Andreas B. Schmidt
- Department of Radiology – Medical Physics, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Killianstr. 5a, Freiburg 79106, Germany
- German Cancer Consortium (DKTK), partner site Freiburg and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120, Germany
| | - C. Russell Bowers
- Department of Chemistry, University of Florida, 2001 Museum Road, Gainesville, Florida 32611, USA
- National High Magnetic Field Laboratory, 1800 E. Paul Dirac Drive, Tallahassee, Florida 32310, USA
| | - Kai Buckenmaier
- High-Field Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, Max-Planck-Ring 11, 72076, Tübingen, Germany
| | - Eduard Y. Chekmenev
- Intergrative Biosciences (Ibio), Department of Chemistry, Karmanos Cancer Institute (KCI), Wayne State University, 5101 Cass Ave, Detroit, MI 48202, United States
- Russian Academy of Sciences (RAS), Leninskiy Prospect, 14, 119991 Moscow, Russia
| | - Henri de Maissin
- Department of Radiology – Medical Physics, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Killianstr. 5a, Freiburg 79106, Germany
- German Cancer Consortium (DKTK), partner site Freiburg and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120, Germany
| | - James Eills
- Institute for Physics, Johannes Gutenberg University, D-55090 Mainz, Germany
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Helmholtz-Institut Mainz, 55128 Mainz, Germany
| | - Frowin Ellermann
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center Kiel, Kiel University, Am Botanischen Garten 14, 24118, Kiel, Germany
| | - Stefan Glöggler
- NMR Signal Enhancement Group Max Planck Institutefor Biophysical Chemistry Am Fassberg 11, 37077 Göttingen, Germany
- Center for Biostructural Imaging of Neurodegeneration of UMG Von-Siebold-Str. 3A, 37075 Göttingen, Germany
| | - Jeremy W. Gordon
- Department of Radiology & Biomedical Imaging, University of California San Francisco, 185 Berry St., San Francisco, CA, 94158, USA
| | | | - Igor V. Koptyug
- International Tomography Center, SB RAS, 3A Institutskaya St., Novosibirsk 630090, Russia
| | - Jule Kuhn
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center Kiel, Kiel University, Am Botanischen Garten 14, 24118, Kiel, Germany
| | - Andrey N. Pravdivtsev
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center Kiel, Kiel University, Am Botanischen Garten 14, 24118, Kiel, Germany
| | - Francesca Reineri
- Dept. Molecular Biotechnology and Health Sciences, Via Nizza 52, University of Torino, Italy
| | - Thomas Theis
- Departments of Chemistry, Physics and Biomedical Engineering, North Carolina State University, Raleigh, NC, 27695, USA
| | - Kolja Them
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center Kiel, Kiel University, Am Botanischen Garten 14, 24118, Kiel, Germany
| | - Jan-Bernd Hövener
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center Kiel, Kiel University, Am Botanischen Garten 14, 24118, Kiel, Germany
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Kuhn J, Kuntz B, Moser G. Infektionen und die Ordnung der Gesellschaft. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732150] [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: 10/20/2022]
Affiliation(s)
- J Kuhn
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit
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Schröder-Bäck P, Gille F, Brall C, Martakis K, Kuhn J. Vaccination, Autonomy, Complexity, Solidarity - Ethical analyses of a German policy discourse. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.529] [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: 11/14/2022] Open
Abstract
Abstract
Background
Currently, measles immunization is high on the agenda of academic and public discourses - on both sides of the Atlantic. In Germany, the discussion of mandatory (measles) immunization was intensively publicly discussed in Spring 2019. Many stakeholders, including federal politicians, plea for mandatory measles immunization. In our paper we analyse the discourse from an ethical point of view.
Methods
Statements and arguments from German stakeholders in the public debate in 2019 are analysed (among them statements of the federal minister of health, the German Medical Association, NGOs and the National Ethics Council). A vaccination ethics framework and a public trust framework are applied in the analysis.
Results
Politicians and other public stakeholders debate (measles) immunization and increasingly demand mandatory (measles) vaccination. However, frequently it is unclear which vaccinations or immunization programmes they refer to. They often do ignore the epidemiological situation of immunization rates in Germany, regional differences, relevant target groups and implementation mechanisms, including potential sanctions. This way they simplify the complex problem and offer (populist) simplistic solutions. Normative arguments of stakeholders repeatedly use conceptions of ’autonomy’ and ’harm’; but sometimes also ’solidarity’ is mentioned.
Conclusions
The call for mandatory measles immunization of school and kindergarten children is offering no adequate and sufficient solution to the problem of elimination of measles. Nevertheless, it contributes to reducing infection risks for the children in care and schooling facilities. Rather, the problem has to be understood in its complexity before discussing the ethical challenges and making effective policy recommendations. When discussing ways to increase immunization rates, ethical values like public trust and solidarity have to be in the foreground - not (only) the debate of autonomy and its restriction.
Key messages
In German policy discourses 2019, the discussion of “mandatory (measles) vaccination” often shows inaccuracies regarding definitions and facts. These have to be clarified before ethical analysis. Ethical issues regarding the voluntariness of measles vaccination relate also to the ethical concepts of solidarity and public trust and not only to autonomy.
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Affiliation(s)
- P Schröder-Bäck
- Department of International Health, Maastricht University, International Health, Maastricht, Netherlands
| | - F Gille
- Health Ethics and Policy Lab, D-HEST, ETH Zürich, Zürich, Switzerland
| | - C Brall
- Health Ethics and Policy Lab, D-HEST, ETH Zürich, Zürich, Switzerland
| | - K Martakis
- Department of International Health, Maastricht University, International Health, Maastricht, Netherlands
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Uniklinik Köln, Köln, Germany
- Department of Child Neurology, Justus-Liebig University Gießen, Gießen, Germany
| | - J Kuhn
- Abteilung Gesundheit, Landesamt für Gesundheit und Lebensmittelsicherheit, Oberschleißheim, Germany
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Faust I, Weile J, Fujita B, Kandolf R, Hendig D, Vollmer T, Stan AC, Kellner U, Kuhn J, Gummert JF, Knabbe C. Heart Transplantation in Systemic Sclerosis: New Impulses for Conventional Scleroderma Transplantation Regimen and Scleroderma Diagnostic Monitoring: 2 Case Reports. Transplant Proc 2019; 51:865-870. [PMID: 30979477 DOI: 10.1016/j.transproceed.2019.01.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 01/04/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Although low (but increasing) rates of lung/lung-heart transplantations of scleroderma (systemic sclerosis [SSc]) patients have been reported, exclusive heart transplantation is a rare approach for treatment of heart failure due to SSc. CASES We report on 2 cases of SSc patients receiving a heart transplantation (HTx) due to severe and progressive right heart failure without pulmonary artery hypertension. One patient received a hepatitis C virus (HCV)-positive donor heart and recovered excellently from viral transmission after administration of a direct-acting antiviral (DAA) regimen. This is the first published case of an SSc patient who underwent HTx using an HCV-positive donor heart. The clinical course of both patients was monitored by different serum SSc biomarkers. Only xylosyltransferase activity proved to be a promising biomarker for disease stage determination and therapeutic monitoring, precisely reflecting fibrotic remodeling and successful organ recovery. CONCLUSIONS Successful implementation of the 2 cases described here demonstrates that HTx is a safe and effective therapeutic option for defined SSc sub-patient groups despite the progressive character of the underlying disease. In the future, xylosyltransferase activity might be conducive to simplify the identification of patients with low systemic involvement but a strong indication for single heart transplantation. Finally, we demonstrate that treatment of HCV viral transmission from HCV-positive donor to organ recipient using DAA gives us new opportunities to consider HCV-positive donor organs for HTx and might reveal new possibilities to ease the lack of donor organs.
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Affiliation(s)
- I Faust
- Institute for Laboratory and Transfusion Medicine, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr University Bochum, Bad Oeynhausen, Germany.
| | - J Weile
- Institute for Laboratory and Transfusion Medicine, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - B Fujita
- Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - R Kandolf
- Abteilung für Molekulare Pathologie, Institut für Pathologie und Neuropathologie, Universitätsklinikum Tübingen, Tübingen, Germany
| | - D Hendig
- Institute for Laboratory and Transfusion Medicine, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - T Vollmer
- Institute for Laboratory and Transfusion Medicine, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - A-C Stan
- Institut für Pathologie, Johannes Wesling Klinikum Minden, Minden, Germany
| | - U Kellner
- Institut für Pathologie, Johannes Wesling Klinikum Minden, Minden, Germany
| | - J Kuhn
- Institute for Laboratory and Transfusion Medicine, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - J F Gummert
- Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - C Knabbe
- Institute for Laboratory and Transfusion Medicine, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr University Bochum, Bad Oeynhausen, Germany
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Kuhn J, Bremm C, Quevedo da Rosa F, Díaz S, Jaurena M, Lattanzi F, de Faccio Carvalho P. PSXI-12 Non-destructive assessment of green biomass in natural grasslands for precision livestock in the Pampa Biome. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.481] [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: 11/12/2022] Open
Affiliation(s)
- J Kuhn
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - C Bremm
- Universidade Federal do Rio Grande do Sul,Porto Alegre, Brazil
| | - F Quevedo da Rosa
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - S Díaz
- Instituto Nacional de Investigación Agropecuaria, Tacuarembó, Tacuarembo, Uruguay
| | - M Jaurena
- Instituto Nacional de Investigación Agropecuaria, Tacuarembó, Tacuarembo, Uruguay
| | - F Lattanzi
- Instituto Nacional de Investigación Agropecuaria, Tacuarembó, Tacuarembo, Uruguay
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Kuhn J, Mandjes M, Taimre T. Practical Aspects of False Alarm Control for Change Point Detection: Beyond Average Run Length. Methodol Comput Appl Probab 2018. [DOI: 10.1007/s11009-018-9636-1] [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: 11/29/2022]
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Kuhn J, Noda C, Massey GV. Successful multi-modal immune tolerance induction for factor IX deficiency with inhibitors and allergic reactions. Haemophilia 2018; 24:e133-e136. [DOI: 10.1111/hae.13457] [Citation(s) in RCA: 5] [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] [Indexed: 11/28/2022]
Affiliation(s)
- J. Kuhn
- Internal Medicine; Virginia Commonwealth University; Richmond VA USA
| | - C. Noda
- Department of Pharmacy; Virginia Commonwealth University Health System; Richmond VA USA
| | - G. V. Massey
- Internal Medicine; Virginia Commonwealth University; Richmond VA USA
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Zittermann A, Ernst JB, Prokop S, Fuchs U, Dreier J, Kuhn J, Berthold HK, Pilz S, Gouni-Berthold I, Gummert JF. Vitamin D supplementation and bone turnover in advanced heart failure: the EVITA trial. Osteoporos Int 2018; 29:579-586. [PMID: 29260292 DOI: 10.1007/s00198-017-4312-9] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 11/10/2017] [Indexed: 11/30/2022]
Abstract
UNLABELLED Low vitamin D status is common in patients with heart failure and may influence bone health. A daily vitamin D dose of 4000 IU (moderately high dose) for 3 years had however no effect on parameters of bone metabolism, even in patients with very low vitamin D status. INTRODUCTION Low vitamin D status is common in patients with heart failure (HF) and has been related to disturbed bone turnover. The present study investigated the effect of a daily vitamin D3 dose of 4000 IU on bone turnover markers (BTMs) in patients with advanced HF and 25-hydroxyvitamin D (25OHD) concentrations < 75 nmol/L. METHODS In this pre-specified secondary analysis of a randomized controlled trial, we assessed in 158 male HF patients (vitamin D group: n = 80; placebo group: n = 78) between-group differences in calciotropic hormones (25OHD, 1,25-dihydroxyvitamin D [1,25(OH)2D], intact parathyroid hormone [iPTH]), and BTMs (cross-linked C-telopeptide of type I collagen, bone-specific alkaline phosphatase, undercarboxylated osteocalcin). Comparisons were performed at the end of a 3-year vitamin D supplementation period with adjustments for baseline values. RESULTS Compared with placebo, vitamin D increased 25OHD on average by 54.3 nmol/L. At study termination, 25OHD and 1,25(OH)2D were significantly higher (P < 0.001 and P = 0.007, respectively), whereas iPTH tended to be lower in the vitamin D group than in the placebo group (P = 0.083). BTMs were initially within their reference ranges and did not differ significantly between groups at study termination, neither in the entire study cohort nor when data analysis was restricted to the subgroup of patients with initial 25OHD concentrations < 30 nmol/L (n = 54) or to patients with initial hyperparathyroidism (n = 65) (all P values > 0.05). CONCLUSIONS A daily vitamin D3 dose of 4000 IU did not influence BTMs. Data indicate that vitamin D supplementation will not lower bone turnover in male patients with heart failure.
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Affiliation(s)
- A Zittermann
- Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, Ruhr University Bochum, Georgstraße 11, 32545, Bad Oeynhausen, Germany.
| | - J B Ernst
- Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, Ruhr University Bochum, Georgstraße 11, 32545, Bad Oeynhausen, Germany
| | - S Prokop
- Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, Ruhr University Bochum, Georgstraße 11, 32545, Bad Oeynhausen, Germany
| | - U Fuchs
- Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, Ruhr University Bochum, Georgstraße 11, 32545, Bad Oeynhausen, Germany
| | - J Dreier
- Institute for Laboratory and Transfusion Medicine, Herz- und Diabeteszentrum NRW, Ruhr University Bochum, Georgstraße 11, 32545, Bad Oeynhausen, Germany
| | - J Kuhn
- Institute for Laboratory and Transfusion Medicine, Herz- und Diabeteszentrum NRW, Ruhr University Bochum, Georgstraße 11, 32545, Bad Oeynhausen, Germany
| | - H K Berthold
- Department of Internal Medicine and Geriatrics, Bethel Clinic (EvKB), Bielefeld, Germany
| | - S Pilz
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - I Gouni-Berthold
- Polyclinic for Endocrinology, Diabetes and Preventive Medicine (PEDP), University of Cologne, Cologne, Germany
| | - J F Gummert
- Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, Ruhr University Bochum, Georgstraße 11, 32545, Bad Oeynhausen, Germany
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Affiliation(s)
- S. Pemberton
- Dept. of Nuclear Engineering University of California Berkeley, CA 94720-1730
| | - C. Jantzen
- Dept. of Nuclear Engineering University of California Berkeley, CA 94720-1730
| | - J. Kuhn
- Dept. of Nuclear Engineering University of California Berkeley, CA 94720-1730
| | - P.F. Peterson
- Dept. of Nuclear Engineering University of California Berkeley, CA 94720-1730
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Szagun B, Kuhn J, Starke D. Kommunale Gesundheitsförderungspolitik, das Präventionsgesetz und der ÖGD. Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1601916] [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: 10/19/2022]
Affiliation(s)
- B Szagun
- Hochschule Ravensburg-Weingarten, Weingarten
| | - J Kuhn
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Oberschleißheim
| | - D Starke
- Akademie für öffentliches Gesundheitswesen, Düsseldorf
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Reisig V, Kuhn J, Poppe F, Caselmann WH. Aufbau einer Präventionsberichterstattung in Bayern – Konzept und erste Produkte. Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1601962] [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: 10/19/2022]
Affiliation(s)
- V Reisig
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Oberschleißheim
| | - J Kuhn
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Oberschleißheim
| | - F Poppe
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Oberschleißheim
| | - WH Caselmann
- Bayerisches Staatsministerium für Gesundheit und Pflege, München
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Davila-Gonzalez D, Choi DS, Kuhn J, Granados SM, Rosato RR, Dave B, Chang JC. Abstract P3-03-02: Inhibition of NOS promotes ER stress response and augments docetaxel-mediated apoptosis in TNBC. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p3-03-02] [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: 11/16/2022]
Abstract
Abstract
Introduction: Chemoresistance in triple negative breast cancer (TNBC) is related to an activation of a survival response orchestrated by endoplasmic reticulum (ER) stress. We hypothesize that attenuation of nitric oxide (NO) signaling pathway can overcome treatment resistance, preventing relapse, ultimately improving survival of TNBC patients. Here, we aimed to investigate the effects of pharmacological iNOS (inducible nitric oxide synthase) inhibition by L-NMMA on docetaxel-meditated ER stress response and to determine whether the therapeutic NOS inhibition may improve chemotherapy-based response.
Methods: BT-549, SUM-149, MDA-MB-436, and MDA-MD-468 TNBC cell lines were treated with docetaxel (D; 5 nm)/ L-NMMA (L; 4mM)/ amlodipine (A; 5 µm) daily for 48 and 72 hours. Cell death and proliferation were assayed by Annexin V and ATP quantification, respectively. Western Blot (WB) was used to measure ER stress markers. In vivo regimen treatment followed three 2-weekscycles of D (20 mg/kg intraperitoneal [IP] on day 1) and L (200 mg/kg oral gavage on day 2-6); A (10 mg/kg IP on day 2-6) A was administered together with L to counteract the well-known effects of L on blood pressure (hypertension). TNBC Patient derived xenograft (PDX) models #2147, #5998, #3107 and #4664 were transplanted into the mammary fat pad of SCID Beige mice. PDX #2147 received either, single drug (vehicle, L, A, D), double (L+A, D+L, D+A), or triple drug combination (L+A+D). Models #4664, #3107 and #5998 received only vehicle, D or D+ L+A. Mice weight and tumor volumes were recorded twice weekly. D concentration was measured by mass spectrometry.
Results: Studies on SUM-159 cell line showed that, when compared to the docetaxel-treated group, D+L+A increased cell death significantly, as indicated by a rise in annexin V/propidium iodide-positive cells. Increase in cell death by D+L+A was further demonstrated by accumulation of mitochondrial cleaved BAX. The enhanced apoptotic effects of D+L+A in MDA MD 468, BT 549 and MDA MD TNBC cell lines were confirmed by a decrease in ATP levels compared to D alone. WB revealed a survival stress response activated by docetaxel. When it was coupled with NOS inhibition, ER stress response showed higher expression of ATF4 and CHOP, triggering a proapoptotic response by pASK1/JNK pathway and cleaved caspases (CC3 and CC9). PDX #2147 showed that L, A and L+A treatment groups had similar tumor volume growth as the untreated group. However, combination therapy, D+L+A, significantly reduced the tumor volume and increased survival proportions compared with vehicle and docetaxel. Combination therapy also dramatically reduced tumor size on TNBC #4664 and #3107, and significantly improved response on #5998 compared with docetaxel alone. Intratumoral docetaxel concentration was 5.3-fold higher in mice receiving D+L+A than in those receiving docetaxel alone (#5998). In both groups, docetaxel was not detected in the plasma one week after injection.
Conclusion: The present data suggest that iNOS may be a critical target for docetaxel resistance in TNBC. iNOS inhibition enhanced chemotherapy response in TNBC PDX models indicating that addition of iNOS inhibitor may improve prognosis and prevent relapse in TNBC patients who have failed conventional chemotherapy.
Citation Format: Davila-Gonzalez D, Choi DS, Kuhn J, Granados SM, Rosato RR, Dave B, Chang JC. Inhibition of NOS promotes ER stress response and augments docetaxel-mediated apoptosis in TNBC [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-03-02.
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Affiliation(s)
- D Davila-Gonzalez
- Methodist Cancer Center, Houston Methodist Hospital, Houston, TX; Tecnologico de Monterrey, Campus Monterrey, Monterrey, Nuevo Leon, Mexico; UT College of Pharmacy, UTHSCSA, San Antonio, TX; Hospital Complex of Jaen, Jaen, Spain; GENYO, Centre for Genomics and Oncological Research, Granada, Spain
| | - DS Choi
- Methodist Cancer Center, Houston Methodist Hospital, Houston, TX; Tecnologico de Monterrey, Campus Monterrey, Monterrey, Nuevo Leon, Mexico; UT College of Pharmacy, UTHSCSA, San Antonio, TX; Hospital Complex of Jaen, Jaen, Spain; GENYO, Centre for Genomics and Oncological Research, Granada, Spain
| | - J Kuhn
- Methodist Cancer Center, Houston Methodist Hospital, Houston, TX; Tecnologico de Monterrey, Campus Monterrey, Monterrey, Nuevo Leon, Mexico; UT College of Pharmacy, UTHSCSA, San Antonio, TX; Hospital Complex of Jaen, Jaen, Spain; GENYO, Centre for Genomics and Oncological Research, Granada, Spain
| | - SM Granados
- Methodist Cancer Center, Houston Methodist Hospital, Houston, TX; Tecnologico de Monterrey, Campus Monterrey, Monterrey, Nuevo Leon, Mexico; UT College of Pharmacy, UTHSCSA, San Antonio, TX; Hospital Complex of Jaen, Jaen, Spain; GENYO, Centre for Genomics and Oncological Research, Granada, Spain
| | - RR Rosato
- Methodist Cancer Center, Houston Methodist Hospital, Houston, TX; Tecnologico de Monterrey, Campus Monterrey, Monterrey, Nuevo Leon, Mexico; UT College of Pharmacy, UTHSCSA, San Antonio, TX; Hospital Complex of Jaen, Jaen, Spain; GENYO, Centre for Genomics and Oncological Research, Granada, Spain
| | - B Dave
- Methodist Cancer Center, Houston Methodist Hospital, Houston, TX; Tecnologico de Monterrey, Campus Monterrey, Monterrey, Nuevo Leon, Mexico; UT College of Pharmacy, UTHSCSA, San Antonio, TX; Hospital Complex of Jaen, Jaen, Spain; GENYO, Centre for Genomics and Oncological Research, Granada, Spain
| | - JC Chang
- Methodist Cancer Center, Houston Methodist Hospital, Houston, TX; Tecnologico de Monterrey, Campus Monterrey, Monterrey, Nuevo Leon, Mexico; UT College of Pharmacy, UTHSCSA, San Antonio, TX; Hospital Complex of Jaen, Jaen, Spain; GENYO, Centre for Genomics and Oncological Research, Granada, Spain
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Bodatsch M, Kuhn J. [Alienation: Differential Psychopathology of Ego-Disturbances]. Fortschr Neurol Psychiatr 2016; 84:699-708. [PMID: 27846655 DOI: 10.1055/s-0042-115180] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Alienation, i. e. disorders of the inner experience of integrity, continuity, and agency, represents a feature of both psychotic and non-psychotic disorders. Thereby, ego disturbances are thought to be specific for schizophrenia. Depersonalisation, in contrast, has been reported in schizophrenia as well as a neurotic, probably distinct syndrome. The differentiation of psychotic vs. non-psychotic alienation is often all but trivial. The present paper provides an overview of the historical roots and the psychopathological conceptualizations of alienation. Clinically relevant features of psychotic alienation are highlighted. Experience of passivity, loss of authenticity and disturbances of striving and volition appear as psychotic characteristics.
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Affiliation(s)
- M Bodatsch
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Evangelisches und Johanniter Klinikum Niederrhein, Oberhausen
| | - J Kuhn
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Köln
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Hashemiyoon R, Tomescu M, Coito A, Schüller T, Sildatke E, Kuhn J, Visser-Vandewalle V, Michel C. EP 115. Effective connectivity of subcortical–cortical networks revealed by simultaneous scalp and depth EEG recordings in humans. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.05.158] [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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Kohl S, Baldermann J, Huys D, Visser-Vandewalle V, Kuhn J. EP 16. Nucleus accumbens stimulation in severe obsessive compulsive disorder. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.05.209] [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: 11/28/2022]
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Baldermann J, Hardenacke K, Zilles K, Freund HJ, Visser-Vandewalle V, Sturm V, Jessen F, Kuhn J. EP 17. Preserved frontoparietal brain morphology correlates with beneficial response to deep brain stimulation of the Nucleus basalis of Meynert in patients with Alzheimer’s disease. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.05.210] [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: 11/26/2022]
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Hardenacke K, Hashemiyoon R, Visser-Vandewalle V, Zapf A, Freund HJ, Sturm V, Hellmich M, Kuhn J. Deep Brain Stimulation of the Nucleus Basalis of Meynert in Alzheimer's Dementia: Potential Predictors of Cognitive Change and Results of a Long-Term Follow-Up in Eight Patients. Brain Stimul 2016; 9:799-800. [PMID: 27522168 DOI: 10.1016/j.brs.2016.05.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 05/30/2016] [Indexed: 12/28/2022] Open
Affiliation(s)
- K Hardenacke
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - R Hashemiyoon
- Department of Functional Neurosurgery and Stereotaxy, University of Cologne, Cologne, Germany
| | - V Visser-Vandewalle
- Department of Functional Neurosurgery and Stereotaxy, University of Cologne, Cologne, Germany
| | - A Zapf
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - H J Freund
- Research Centre Juelich, Institute of Neuroscience and Medicine (INM-1), Juelich, Germany
| | - V Sturm
- Department of Neurosurgery, University Clinic of Würzburg, Würzburg, Germany
| | - M Hellmich
- Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany
| | - J Kuhn
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.
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Reisig V, Kuhn J, Loos S, Nennstiel-Ratzel U, Wildner M, Caselmann WH. [Primary Prevention And Health Promotion in Bavaria: Taking Stock]. Gesundheitswesen 2016; 79:238-246. [PMID: 27315233 DOI: 10.1055/s-0042-108585] [Citation(s) in RCA: 5] [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: 10/21/2022]
Abstract
Background: Health promotion and prevention are key elements of Bavarian health policy and are currently being re-oriented along the framework of the "Bavarian Prevention Plan". In this context, a stock taking of prevention and health promotion in Bavaria was conducted with the aim to contribute to the continued strategic and quality-orientated development of this field. Methods: The investigation was restricted to activities of primary prevention and health promotion with a focus on the action areas of the Bavarian Prevention Plan. The prevention actors, not projects, were the smallest units that were surveyed. During the 3-month field phase in 2014/2015, 595 prevention players were contacted and asked to complete an online questionnaire on their activities and target groups as well as quality and structural aspects. In addition, 9 expert interviews were conducted in an urban and a rural area in order to explore the field of small commercial and civic prevention actors. Results: 135 prevention players took part in the survey (return rate 23%). The most commonly cited themes of activities are health literacy (62% of players) and mental health (58%). The target groups are often broadly defined, gender specific measures and those for socially disadvantaged groups are comparatively rare. Provision of health-related information is the most commonly used approach (58-69% of players depending on the action area), least used are community work approaches (9-12%). 77% of the respondents state to use models of best practice and 55% scientific results in the development of measures; 43% conduct outcome evaluations and 80% take part in committee work and networks. The latter are mainly used to exchange information (90% of actors), 55 and 54% state to use them for joint planning and delivery of interventions, respectively. Conclusions: The most important prevention players took part in the survey. Methodologically it proved difficult to achieve a meaningful depiction of central aspects of the prevention scene via a quantitative survey approach. There is a lack of well-tried instruments and approaches for such cross-agency surveys. Nevertheless, the study allows trend statements on the spectrum, structure and quality of prevention in Bavaria. Thus, a starting line for the implementation of the Bavarian Prevention Plan as well as the basis of prevention reporting as intended by the new national prevention law could be established.
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Affiliation(s)
- V Reisig
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Oberschleißheim
| | - J Kuhn
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Oberschleißheim
| | - S Loos
- IGES Institut GmbH, Berlin
| | - U Nennstiel-Ratzel
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Oberschleißheim
| | - M Wildner
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Oberschleißheim
| | - W H Caselmann
- Bayerisches Staatsministerium für Gesundheit und Pflege, München
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Söhl K, Schulz R, Kuhn J. Ratenbildung bei KV-Daten mit GKV-Versicherten auf Kreisebene – ein empirisches Schätzmodell auf der Basis des Mikrozensus. Gesundheitswesen 2016; 79:514-520. [DOI: 10.1055/s-0042-100617] [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: 10/21/2022]
Abstract
Zusammenfassung
Hintergrund: Daten aus der kassenärztlichen Versorgung werden u. a. in der Gesundheitsberichterstattung und der Versorgungsforschung auf Kreisebene genutzt. Für eine korrekte Ratenbildung müsste die Zahl der GKV-Versicherten im Nenner zugrunde gelegt werden, diese steht aber in einigen Bundesländern auf Kreisebene nicht zur Verfügung. Die Raten werden daher im kassenärztlichen System mit einer Surrogatgröße (definiert über die Arztkontakte) gebildet. Dies führt zu Unschärfen, sodass kleinräumige Regionalvergleiche nur bedingt möglich sind. Ziel der vorliegenden Arbeit ist ein besseres Schätzmodell für die Zahl der GKV-Versicherten auf Kreisebene.
Methodik: Der Anteil der GKV-Versicherten in den bayerischen Kreisen wird durch ein multiples lineares Regressionsmodell geschätzt. Im Modell wird der Anteil der GKV-Versicherten in den Anpassungsschichten des Mikrozensus (einer Zusammenfassung von mehreren Kreisen) erklärt durch Einflussfaktoren auf den Versicherungsstatus, die auf Kreisebene vorliegen (verfügbares Einkommen, Beamten- und Selbständigenanteil). Die durch das Modell berechneten GKV-Versichertenzahlen werden mit der Surrogatgröße verglichen. Eine konkrete Anwendung erfolgt am Beispiel der regionalen Diabetesdiagnosen aus den Daten der Kassenärztlichen Vereinigung Bayerns.
Ergebnisse: Durch das Regressionsmodell werden für die bayerischen Kreise GKV-Versichertenanteile zwischen 74,7 und 91,6% geschätzt. Der Unterschied zu der bisher genutzten Ersatzgröße beträgt bis zu 18,6 Prozentpunkte. Dies spiegelt sich dementsprechend in den Behandlungsprävalenzen wider, hier am Beispiel des Diabetes mellitus veranschaulicht.
Schlussfolgerung: Die vorliegende Analyse zeigt, mit welchen Unsicherheiten die Ratenbildung bei Daten aus der kassenärztlichen Versorgung derzeit behaftet ist und was daraus für kleinräumige Vergleiche, etwa in der Gesundheitsberichterstattung, folgt. Die Aufbereitung valider Nennerdaten im Rahmen der Datentransparenzregelung nach SGB V ist anzustreben.
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Affiliation(s)
- K. Söhl
- Institut für medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität München
| | - R. Schulz
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Landesinstitut für Gesundheit, Oberschleißheim
| | - J. Kuhn
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Landesinstitut für Gesundheit, Oberschleißheim
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Reisig V, Kuhn J, Täger S, Ochmann R, Loos S, Nennstiel-Ratzel U, Wildner M, Caselmann W. Präventionserhebung 2015 Bayern. Der ÖGD vor Ort – ein Akteur unter vielen? Gesundheitswesen 2016. [DOI: 10.1055/s-0036-1578900] [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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Kuhn J, Bolte G. Der Öffentliche Gesundheitsdienst in der Prävention – wie wird er wahrgenommen? Gesundheitswesen 2016. [DOI: 10.1055/s-0036-1578961] [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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Zittermann A, Kuhn J, Ernst J, Becker T, Dreier J, Knabbe C, Gummert J. Independent Associations of 25-Hydroxyvitamin D and 1,25-Dihydroxyvitamin D with Postoperative Infections in Cardiac Surgical Patients. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571527] [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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Kohl S, Gruendler TOJ, Huys D, Sildatke E, Dembek TA, Hellmich M, Vorderwulbecke M, Timmermann L, Ahmari SE, Klosterkoetter J, Jessen F, Sturm V, Visser-Vandewalle V, Kuhn J. Effects of deep brain stimulation on prepulse inhibition in obsessive-compulsive disorder. Transl Psychiatry 2015; 5:e675. [PMID: 26556284 PMCID: PMC5068764 DOI: 10.1038/tp.2015.171] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [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: 06/22/2015] [Revised: 09/14/2015] [Accepted: 09/19/2015] [Indexed: 11/09/2022] Open
Abstract
Owing to a high response rate, deep brain stimulation (DBS) of the ventral striatal area has been approved for treatment-refractory obsessive-compulsive disorder (tr-OCD). Many basic issues regarding DBS for tr-OCD are still not understood, in particular, the mechanisms of action and the origin of side effects. We measured prepulse inhibition (PPI) in treatment-refractory OCD patients undergoing DBS of the nucleus accumbens (NAcc) and matched controls. As PPI has been used in animal DBS studies, it is highly suitable for translational research. Eight patients receiving DBS, eight patients with pharmacological treatment and eight age-matched healthy controls participated in our study. PPI was measured twice in the DBS group: one session with the stimulator switched on and one session with the stimulator switched off. OCD patients in the pharmacologic group took part in a single session. Controls were tested twice, to ensure stability of data. Statistical analysis revealed significant differences between controls and (1) patients with pharmacological treatment and (2) OCD DBS patients when the stimulation was switched off. Switching the stimulator on led to an increase in PPI at a stimulus-onset asynchrony of 200 ms. There was no significant difference in PPI between OCD patients being stimulated and the control group. This study shows that NAcc-DBS leads to an increase in PPI in tr-OCD patients towards a level seen in healthy controls. Assuming that PPI impairments partially reflect the neurobiological substrates of OCD, our results show that DBS of the NAcc may improve sensorimotor gating via correction of dysfunctional neural substrates. Bearing in mind that PPI is based on a complex and multilayered network, our data confirm that DBS most likely takes effect via network modulation.
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Affiliation(s)
- S Kohl
- Department of Psychiatry and Psychotherapy, University Hospital Cologne, University of Cologne, Cologne, Germany,Department of Psychiatry and Psychotherapy, University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50935 Cologne, Germany. E-mail:
| | - T O J Gruendler
- Department of Psychiatry and Psychotherapy, University Hospital Cologne, University of Cologne, Cologne, Germany,Faculty of Economics, Otto-von-Guericke-University, Magdeburg, Germany,Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - D Huys
- Department of Psychiatry and Psychotherapy, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - E Sildatke
- Department of Psychiatry and Psychotherapy, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - T A Dembek
- Department of Neurology, University of Cologne, Cologne, Germany
| | - M Hellmich
- Institute of Medical Statistics, Informatics, and Epidemiology, University of Cologne, Cologne, Germany
| | - M Vorderwulbecke
- Department of Psychiatry and Psychotherapy, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - L Timmermann
- Department of Neurology, University of Cologne, Cologne, Germany
| | - S E Ahmari
- Department of Psychiatry, Center for Neuroscience Program, Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, USA
| | - J Klosterkoetter
- Department of Psychiatry and Psychotherapy, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - F Jessen
- Department of Psychiatry and Psychotherapy, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - V Sturm
- Department of Neurosurgery, University of Würzburg, Würzburg, Germany
| | - V Visser-Vandewalle
- Department of Stereotactic and Functional Neurosurgery, University of Cologne, Cologne, Germany
| | - J Kuhn
- Department of Psychiatry and Psychotherapy, University Hospital Cologne, University of Cologne, Cologne, Germany
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Noreik M, Kuhn J, Hardenacke K, Lenartz D, Bauer A, Bührle CP, Häussermann P, Hellmich M, Klosterkötter J, Wiltfang J, Maarouf M, Freund HJ, Visser-Vandewalle V, Sturm V, Schulz RJ. Changes in Nutritional Status after Deep Brain Stimulation of the Nucleus Basalis of Meynert in Alzheimer's Disease--Results of a Phase I Study. J Nutr Health Aging 2015; 19:812-8. [PMID: 26412285 DOI: 10.1007/s12603-015-0595-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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: 01/03/2023]
Abstract
OBJECTIVE The progression of Alzheimer's disease (AD) is associated with impaired nutritional status. New methods, such as deep brain stimulation (DBS), are currently being tested to decrease the progression of AD. DBS is an approved method in the treatment of Parkinson's disease, and its suitability for the treatment of AD patients is currently under experimental investigation. To evaluate the advantages and disadvantages of this new treatment, it is important to assess potential side effects of DBS regarding the nucleus basalis of Meynert; this new treatment is thought to positively affect cognition and might counteract the deterioration of nutritional status and progressive weight loss observed in AD. This study aims to assess the nutritional status of patients with AD before receiving DBS of the nucleus basalis of Meynert and after 1 year, and to analyze potential associations between changes in cognition and nutritional status. DESIGN A 1-year phase I proof-of-concept study. SETTING The Department of Psychiatry and Psychotherapy at the University of Cologne. PARTICIPANTS We assessed a consecutive sample of patients with mild to moderate AD (n=6) who fulfilled the inclusion criteria and provided written informed consent. INTERVENTION Bilateral low-frequency DBS of the nucleus basalis of Meynert. MEASUREMENTS Nutritional status was assessed using a modified Mini Nutritional Assessment, bioelectrical impedance analysis, a completed 3-day food diary, and analysis of serum levels of vitamin B12 and folate. RESULTS With a normal body mass index (BMI) at baseline (mean 23.75 kg/m²) and after 1 year (mean 24.59 kg/m²), all but one patient gained body weight during the period of the pilot study (mean 2.38 kg, 3.81% of body weight). This was reflected in a mainly stable or improved body composition, assessed by bioelectrical impedance analysis, in five of the six patients. Mean energy intake increased from 1534 kcal/day (min 1037, max 2370) at baseline to 1736 kcal/day (min 1010, max 2663) after 1 year, leading to the improved fulfillment of energy needs in four patients. The only nutritional factors that were associated with changes in cognition were vitamin B12 level at baseline (Spearman's rho = 0.943, p = 0.005) and changes in vitamin B12 level (Spearman's rho = -0.829, p = 0.042). CONCLUSION Patients with AD that received DBS of the nucleus basalis of Meynert demonstrated a mainly stable nutritional status within a 1-year period. Whether DBS is causative regarding these observations must be investigated in additional studies.
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Affiliation(s)
- M Noreik
- M. Noreik, University of Cologne, Medical Faculty, Geriatrics Department, Cologne, Germany,
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Schulz R, Zollikofer S, Kuhn J. Berichtsschablone, Gesundheitsprofile & Co.: Ressourcen für die kommunale Gesundheitsberichterstattung in Bayern. Gesundheitswesen 2015. [DOI: 10.1055/s-0035-1563136] [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: 10/23/2022]
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Reisig V, Ludwig MS, Nennstiel-Ratzel U, Kuhn J, Wildner M. Evidence and health policy: how linked can they be? Examples from Bavaria. Gesundheitswesen 2015. [DOI: 10.1055/s-0035-1563234] [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: 10/23/2022]
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Schulz R, Kuhn J. Regionale Unterschiede der Lebenserwartung in Bayern – ein 10-Jahres-Vergleich. Gesundheitswesen 2015. [DOI: 10.1055/s-0035-1563101] [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: 10/23/2022]
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Reisig V, Taeger S, Loos S, Kuhn J, Nennstiel-Ratzel U, Wildner M, Caselmann W. (Un)Fassbar (un)erfassbar? – Eine Untersuchung der Präventionslandschaft in Bayern. Gesundheitswesen 2015. [DOI: 10.1055/s-0035-1563013] [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: 10/23/2022]
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Kuhn J, Enke M, Schubert I, Köster I, Donnachie E, Wildner M, Caselmann W. Der Bayerische Diabetesbericht: Gesundheitsberichterstattung im gesundheitspolitischen Kontext. Gesundheitswesen 2015. [DOI: 10.1055/s-0035-1563223] [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: 10/23/2022]
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Walter U, Nöcker G, Pawils S, Robra BP, Trojan A, Franz M, Grossmann B, Schmidt TA, Lehmann H, Bauer U, Göpel E, Janz A, Kuhn J, Naegele G, Müller-Kohlenberg H, Plaumann M, Stender KP, Stolzenberg R, Süß W, Trenker M, Wanek V, Wildner M. [Memorandum on sustainable reinforcement of prevention and health promotion: challenges at the federal, state and local level]. Gesundheitswesen 2015; 77:382-8. [PMID: 26018541 DOI: 10.1055/s-0035-1549949] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Research-based evidence and practice-based experience are core requirements for the effective implementation of preventive interventions. The knowledge gained in the Prevention Research Funding Initiative of the German Federal Ministry of Education and Research (2004-2013) was therefore amalgamated, reflected and consolidated in the Cooperation for Sustainable Prevention Research (KNP) meta-project. In annual strategy meetings, researchers and practitioners from the field and other experts developed 3 memoranda providing recommendations for the further development of research and practice in the field of prevention and health promotion. Memorandum III is primarily aimed at decision-makers in politics and administration at the federal, state and local level, in civil society and in the workplace. Its recommendations show that structuring efforts are urgently needed to achieve sustainable policy, particularly in the fields of health, education, employment and social affairs. Memorandum III brings together the knowledge extracted and problems identified in research projects. More so than its 2 predecessors, Memorandum III abstracts knowledge from the individual projects and attempts to derive guidance for action and decision-making, as shown by the 7 recommendations that appear to useful for consensus-building in practice and research. Value judgments are inevitable. Prevention and health promotion are an investment in the future: of social health, social capital and social peace. Improvement of the framework conditions is needed to achieve the harmonized awareness and the sustained effectiveness of these structure-building efforts in different policy areas, spheres of life, fields of action, and groups of actors. This includes the implementation of an overall national strategy as well as the expansion of sources of funding, extension of the legal framework, overarching coordination, and the establishment of a National Center of Excellence to develop and safeguard prevention and health promotion. The memorandum is intended to stimulate a discourse resulting in structure-building and stabilizing measures designed to ensure the sustainability of prevention and health promotion.
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Affiliation(s)
- U Walter
- Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Medizinische Hochschule Hannover
| | - G Nöcker
- Bundeszentrale für gesundheitliche Aufklärung, Köln
| | - S Pawils
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf
| | - B-P Robra
- Institut für Sozialmedizin und Gesundheitsökonomie, Otto-von-Guericke-Universität Magdeburg
| | - A Trojan
- Institut für Medizinische Soziologie, Universitätsklinikum Hamburg-Eppendorf
| | - M Franz
- Klinisches Institut für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Düsseldorf
| | - B Grossmann
- Bundesvereinigung für Prävention und Gesundheitsförderung e.V., Bonn
| | - T-A Schmidt
- Referat 402 Gesundheitsförderung, Arzneimittel, Medizinprodukte, Biotechnologie, Niedersächsisches Ministerium für Soziales, Gesundheit und Gleichstellung, Hannover
| | | | - U Bauer
- Zentrum für Prävention und Intervention im Kindes- und Jugendalter, Fakultät für Erziehungswissenschaft, Universität Bielefeld
| | - E Göpel
- Kooperationsverbund Hochschulen für Gesundheit e.V., Berlin
| | - A Janz
- Stadt Kassel, Deutscher Städtetag Gesundheitsausschuss
| | - J Kuhn
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Oberschleißheim
| | - G Naegele
- Forschungsgesellschaft für Gerontologie e.V., Institut für Gerontologie an der Technischen Universität Dortmund
| | | | - M Plaumann
- Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Medizinische Hochschule Hannover
| | - K-P Stender
- Behörde für Gesundheit und Verbraucherschutz, Freie und Hansestadt Hamburg
| | - R Stolzenberg
- Charité - Universitätsmedizin Berlin, Berlin School of Public Health
| | - W Süß
- Institut für Medizinische Soziologie, Universitätsklinikum Hamburg-Eppendorf
| | - M Trenker
- Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Medizinische Hochschule Hannover
| | - V Wanek
- Spitzenverband der Gesetzlichen Krankenversicherung, Berlin
| | - M Wildner
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Oberschleißheim/Pettenkofer School of Public Health
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Socher M, Schulz R, Kuhn J, Nennstiel-Ratzel U, Wildner M, Hierl W, Zapf A. Evaluation des elektronischen Handbuchs des Öffentlichen Gesundheitsdienstes (ÖGD) in Bayern. Gesundheitswesen 2015. [DOI: 10.1055/s-0035-1546855] [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: 10/23/2022]
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Lee H, Kuhn J, Hardenacke K, Gruendler T, Schueller T, Sturm V, Fell J, Axmacher N. Effects of deep brain stimulation of the nucleus basalis of Meynert in EEG resting-state oscillatory power and phase synchronization. Brain Stimul 2015. [DOI: 10.1016/j.brs.2015.01.205] [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] Open
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Kuhn J, Hardenacke K, Lenartz D, Gruendler T, Ullsperger M, Bartsch C, Mai JK, Zilles K, Bauer A, Matusch A, Schulz RJ, Noreik M, Bührle CP, Maintz D, Woopen C, Häussermann P, Hellmich M, Klosterkötter J, Wiltfang J, Maarouf M, Freund HJ, Sturm V. Deep brain stimulation of the nucleus basalis of Meynert in Alzheimer's dementia. Mol Psychiatry 2015; 20:353-60. [PMID: 24798585 DOI: 10.1038/mp.2014.32] [Citation(s) in RCA: 157] [Impact Index Per Article: 17.4] [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] [Received: 11/05/2013] [Revised: 02/06/2014] [Accepted: 02/24/2014] [Indexed: 11/09/2022]
Abstract
Cholinergic neurons of the medial forebrain are considered important contributors to brain plasticity and neuromodulation. A reduction of cholinergic innervation can lead to pathophysiological changes of neurotransmission and is observed in Alzheimer's disease. Here we report on six patients with mild to moderate Alzheimer's disease (AD) treated with bilateral low-frequency deep brain stimulation (DBS) of the nucleus basalis of Meynert (NBM). During a four-week double-blind sham-controlled phase and a subsequent 11-month follow-up open label period, clinical outcome was assessed by neuropsychological examination using the Alzheimer's Disease Assessment Scale-cognitive subscale as the primary outcome measure. Electroencephalography and [(18)F]-fluoro-desoxyglucose positron emission tomography were, besides others, secondary endpoints. On the basis of stable or improved primary outcome parameters twelve months after surgery, four of the six patients were considered responders. No severe or non-transitional side effects related to the stimulation were observed. Taking into account all limitations of a pilot study, we conclude that DBS of the NBM is both technically feasible and well tolerated.
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Affiliation(s)
- J Kuhn
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - K Hardenacke
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - D Lenartz
- Department of Functional Neurosurgery and Stereotaxy, University of Cologne, Cologne, Germany
| | - T Gruendler
- 1] Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany [2] Faculty of Economics, Otto-von-Guericke University Magdeburg, Magdeburg, Germany [3] Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - M Ullsperger
- 1] Center for Behavioral Brain Sciences, Magdeburg, Germany [2] Institute of Psychology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - C Bartsch
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - J K Mai
- Department of Neuroanatomy, University of Düsseldorf, Düsseldorf, Germany
| | - K Zilles
- 1] Institute of Neuroscience and Medicine, Research Centre Juelich, Juelich, Germany [2] University Hospital of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany
| | - A Bauer
- 1] Institute of Neuroscience and Medicine, Research Centre Juelich, Juelich, Germany [2] Department of Neurology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - A Matusch
- Institute of Neuroscience and Medicine, Research Centre Juelich, Juelich, Germany
| | - R-J Schulz
- University of Cologne, Department of Geriatrics and St. Marien-Hospital, Cologne, Germany
| | - M Noreik
- University of Cologne, Department of Geriatrics and St. Marien-Hospital, Cologne, Germany
| | - C P Bührle
- Department of Functional Neurosurgery and Stereotaxy, University of Cologne, Cologne, Germany
| | - D Maintz
- University of Cologne, Department for Radiology, Cologne, Germany
| | - C Woopen
- University of Cologne, Research Unit Ethics, Institute for the History of Medicine and Medical Ethics, Cologne, Germany
| | - P Häussermann
- LVR Clinic Cologne, Department of Gerontopsychiatry, Cologne, Germany
| | - M Hellmich
- University of Cologne, Institute of Medical Statistics, Informatics and Epidemiology, Cologne, Germany
| | - J Klosterkötter
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - J Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Georg-August-University, Göttingen, Germany
| | - M Maarouf
- Department of Stereotaxy and Functional Neurosurgery, Klinikum Merheim, Cologne, Germany
| | - H-J Freund
- Department of Neuroanatomy, University of Düsseldorf, Düsseldorf, Germany
| | - V Sturm
- Department of Functional Neurosurgery and Stereotaxy, University of Cologne, Cologne, Germany
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Ernst JB, Kuhn J, Becker T, Dreier J, Börgermann J, Knabbe C, Gummert JF, Zittermann A. Association between circulating 25-hydroxyvitamin D levels and medication use in patients scheduled for cardiac surgery. Nutr Metab Cardiovasc Dis 2015; 25:280-286. [PMID: 25466599 DOI: 10.1016/j.numecd.2014.10.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 06/25/2014] [Revised: 09/30/2014] [Accepted: 10/27/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIM Low vitamin D status, i.e. circulating 25-hydroxyvitamin D (25OHD) levels <50 nmol/l, is independently associated with increased CVD risk. Medication use may influence 25OHD levels. We therefore investigated the association of circulating 25OHD with medication use in patients scheduled for cardiac surgery. METHODS AND RESULTS A total of 11,256 patients were included in this cross-sectional study. We compared 25OHD levels of medication users (18 groups of continuously used and 5 groups of intermittently used medications) with levels of non-users. Moreover, we assessed variables (medications, demographic and clinical parameters) that were independently associated with 25OHD levels <50 nmol/l. The prevalence of 25OHD levels <50 nmol/l was 65.7%. The use of statins and immunosuppressive agents was significantly associated with higher 25OHD levels and lower odds ratios of 25OHD levels <50 nmol/l. The use of ACE-inhibitors, catecholamines and antibiotics was associated with lower 25OHD levels and higher odds ratios of 25OHD levels <50 nmol/l. However, only use of antibiotics, immunosuppressive agents and catecholamines showed clinically relevant differences in 25OHD levels, i.e. differences of more than +4 nmol/l or -4 nmol/l, compared with respective non-users. These medications were prescribed either intermittently (antibiotics, catecholamines) and/or infrequently (<2%; immunosuppressive agents, catecholamines) and/or its causal relationship with circulating 25OHD is questionable (antibiotics). Female sex and blood drawing during wintertime were associated with the highest odds ratios of 25OHD levels <50 nmol/l. CONCLUSION Data indicate that in patients with high cardiovascular risk profile medication use does not substantially contribute to 25OHD levels <50 nmol/l.
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Affiliation(s)
- J B Ernst
- Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - J Kuhn
- Institute for Laboratory and Transfusion Medicine, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - T Becker
- Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - J Dreier
- Institute for Laboratory and Transfusion Medicine, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - J Börgermann
- Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - C Knabbe
- Institute for Laboratory and Transfusion Medicine, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - J F Gummert
- Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - A Zittermann
- Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany.
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Zittermann A, Morshuis M, Kuhn J, Pilz S, Ernst JB, Oezpeker C, Dreier J, Knabbe C, Gummert JF, Milting H. Vitamin D metabolites and fibroblast growth factor-23 in patients with left ventricular assist device implants: association with stroke and mortality risk. Eur J Nutr 2015; 55:305-13. [PMID: 25657014 DOI: 10.1007/s00394-015-0847-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [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: 09/24/2014] [Accepted: 01/27/2015] [Indexed: 12/29/2022]
Abstract
PURPOSE Stroke and mortality risk in patients with left ventricular assist device (LVAD) implants continue to be high. Whether nonclassical cardiovascular risk markers such as vitamin D metabolites and fibroblast growth factor (FGF)-23 contribute to this risk remains to be studied, and this was the objective of our work. METHODS In 154 LVAD patients (91 HeartWare and 63 HeartMate II implants), we measured circulating 25-hydroxyvitamin D (25OHD), 1,25-dihydroxyvitamin D3 (1,25[OH]2D3), parathyroid hormone (PTH) and FGF-23 shortly before LVAD implantation and investigated their association with stroke and mortality risk during 1-year follow-up. RESULTS Of the study cohort, 34.4 and 92.2%, respectively, had deficient 25OHD (<25 nmol/l) and 1,25(OH)2D3 (<41 pmol/l) values, whereas 42.6 and 98.7%, respectively, had elevated PTH levels (>6.7 pmol/l) and FGF-23 values above the reference range (100 RU/ml). One-year freedom from stroke was 80.9 %, and 1-year survival was 64.3%. The multivariable-adjusted hazard ratio of stroke was 2.44 (95% CI: 1.09-5.45; P = 0.03) for the subgroup of 25OHD levels <25 nmol/l (reference group: 25OHD levels ≥25 nmol/l). The multivariable-adjusted hazard ratio of 1-year mortality was 2.78 (95% CI: 1.52-5.09; P = 0.001) for patients with 25OHD levels <25 nmol/l compared with patients with 25OHD levels ≥25 nmol/l. PTH, FGF-23 and 1,25(OH)2D3 were not associated with stroke or mortality risk. CONCLUSIONS In LVAD patients, deficient 25OHD levels are independently associated with high stroke and mortality risk. If confirmed in randomized controlled trials, preoperative correction of deficient vitamin D status could be a promising measure to reduce stroke and mortality risk in LVAD patients.
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Affiliation(s)
- A Zittermann
- Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Centre NRW, Ruhr University Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Germany.
| | - M Morshuis
- Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Centre NRW, Ruhr University Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Germany
| | - J Kuhn
- Institute for Laboratory and Transfusion Medicine, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - S Pilz
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - J B Ernst
- Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Centre NRW, Ruhr University Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Germany
| | - C Oezpeker
- Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Centre NRW, Ruhr University Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Germany
| | - J Dreier
- Institute for Laboratory and Transfusion Medicine, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - C Knabbe
- Institute for Laboratory and Transfusion Medicine, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - J F Gummert
- Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Centre NRW, Ruhr University Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Germany
| | - H Milting
- Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Centre NRW, Ruhr University Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Germany.,Erich and Hanna Klessmann Institute for Cardiovascular Research and Development, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany
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Zittermann A, Morshuis M, Kuhn J, Pilz S, Ernst J, Oezpeker C, Dreier J, Knabbe C, Gummert J, Milting H. Vitamin D Metabolites and Fibroblast Growth Factor-23 in Patients with Left Ventricular Assist Device Implants: Association with Stroke and Mortality Risk. Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1544325] [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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Lewis CJ, Maier F, Horstkötter N, Zywczok A, Witt K, Eggers C, Meyer TD, Dembek TA, Maarouf M, Moro E, Zurowski M, Woopen C, Kuhn J, Timmermann L. Subjectively perceived personality and mood changes associated with subthalamic stimulation in patients with Parkinson's disease. Psychol Med 2015; 45:73-85. [PMID: 25066623 DOI: 10.1017/s0033291714001081] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Clinical and ethical implications of personality and mood changes in Parkinson's disease (PD) patients treated with subthalamic deep brain stimulation (STN-DBS) are under debate. Although subjectively perceived personality changes are often mentioned by patients and caregivers, few empirical studies concerning these changes exist. Therefore, we analysed subjectively perceived personality and mood changes in STN-DBS PD patients. METHOD In this prospective study of the ELSA-DBS group, 27 PD patients were assessed preoperatively and 1 year after STN-DBS surgery. Two categories, personality and mood changes, were analysed with semi-structured interviews. Patients were grouped into personality change yes/no, as well as positive/negative mood change groups. Caregivers were additionally interviewed about patients' personality changes. Characteristics of each group were assessed with standard neurological and psychiatric measurements. Predictors for changes were analysed. RESULTS Personality changes were perceived by six of 27 (22%) patients and by 10 of 23 caregivers (44%). The preoperative hypomania trait was a significant predictor for personality change perceived by patients. Of 21 patients, 12 (57%) perceived mood as positively changed. Higher apathy and anxiety ratings were found in the negative change group. CONCLUSIONS Our results show that a high proportion of PD patients and caregivers perceived personality changes under STN-DBS, emphasizing the relevance of this topic. Mood changed in positive and negative directions. Standard measurement scales failed to adequately reflect personality or mood changes subjectively perceived by patients. A more individualized preoperative screening and preparation for patients and caregivers, as well as postoperative support, could therefore be useful.
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Affiliation(s)
- C J Lewis
- Department of Neurology,University of Cologne,Cologne,Germany
| | - F Maier
- Department of Neurology,University of Cologne,Cologne,Germany
| | - N Horstkötter
- Research Unit Ethics, Institute for the History of Medicine and Medical Ethics,University of Cologne,Cologne,Germany
| | - A Zywczok
- Department of Neurology,University of Cologne,Cologne,Germany
| | - K Witt
- Research Unit Ethics, Institute for the History of Medicine and Medical Ethics,University of Cologne,Cologne,Germany
| | - C Eggers
- Department of Neurology,University of Cologne,Cologne,Germany
| | - T D Meyer
- Institute of Neuroscience,Newcastle University,Newcastle upon Tyne,UK
| | - T A Dembek
- Department of Neurology,University of Cologne,Cologne,Germany
| | - M Maarouf
- Department of Stereotaxy and Functional Neurosurgery,University of Cologne,Cologne,Germany
| | - E Moro
- Movement Disorders Unit, Department of Psychiatry and Neurology,University Hospital Center (CHU) of Grenoble,Grenoble,France
| | - M Zurowski
- Department of Psychiatry,University of Toronto, University Health Network,Toronto,Canada
| | - C Woopen
- Research Unit Ethics, Institute for the History of Medicine and Medical Ethics,University of Cologne,Cologne,Germany
| | - J Kuhn
- Department of Psychiatry and Psychotherapy,University of Cologne,Cologne,Germany
| | - L Timmermann
- Department of Neurology,University of Cologne,Cologne,Germany
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Hollederer A, Braun GE, Dahlhoff G, Drexler H, Engel J, Gräßel E, Häusler E, Heide H, Heuschmann PU, Hörl G, Imhof H, Kaplan M, Kasperbauer R, Klemperer D, Kolominsky-Rabas P, Kuhn J, Lang M, Langejürgen R, Lankes A, Leidl R, Liebl B, Loss J, Ludewig K, Mansmann U, Melcop N, Nagels K, Nowak D, Pfundner H, Reuschenbach B, Schneider A, Schneider W, Schöffski O, Schreiber W, Voigtländer S, Wildner M, Zapf A, Zellner A. [Memorandum 'Development of health services research in Bavaria from the perspective of the Bavarian State Working Group 'Health Services Research (LAGeV)': status quo - potential - strategies']. Gesundheitswesen 2014; 77:180-5. [PMID: 25422951 DOI: 10.1055/s-0034-1389915] [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
The aim of the memorandum on the development of health services research (HSR) in Bavaria is to operationalise the global objectives of the State Working Group "Health Services Research" (LAGeV) and to collectively define future topics, specific implementation steps, methods as well as ways of working for the future course of the LAGeV. The LAGeV is an expert committee that integrates and links the competencies of different actors from science, politics and health care regarding HSR and facilitates their cooperation. The memorandum is based on an explorative survey among the LAGeV members, which identified the status quo of health services research in Bavaria, potential for development, important constraints, promoting factors, specific recommendations as well as future topics for the further development of HSR in Bavaria. From the perspective of the LAGeV members, the 12 most important future topics are: 1) Interface and networking research, 2) Innovative health care concepts, 3) Health care for multimorbid patients, 4)Health care for chronically ill patients, 5) Evaluation of innovations, processes and technologies, 6) Patient orientation and user focus, 7) Social and regional inequalities in health care, 8) Health care for mentally ill patients, 9) Indicators of health care quality, 10) Regional needs planning, 11) Practical effectiveness of HSR and 12) Scientific use of routine data. Potential for development of HSR in Bavaria lies a) in the promotion of networking and sustainable structures, b) the establishment of an HSR information platform that bundles information and results in regard to current topics and aims to facilitate cooperation as well as c) in the initiation of measures and projects. The latter ought to pinpoint health care challenges and make recommendations regarding the improvement of health care and its quality. The cooperation and networking structures that were established with the LAGeV should be continuously expanded and be used to work on priority topics in order to achieve the global objectives of the LAGeV.
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Affiliation(s)
- A Hollederer
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Nürnberg, Oberschleißheim
| | - G E Braun
- Forschungszentrum für Management im Gesundheitswesen, Universität der Bundeswehr München, Neubiberg
| | | | - H Drexler
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Friedrich-Alexander-Universität (FAU), Erlangen
| | - J Engel
- Tumorregister München (TRM), Ludwig-Maximilians-Universität (LMU), München
| | - E Gräßel
- Zentrum für Medizinische Versorgungsforschung, Psychiatrische und Psychotherapeutische Klinik, Friedrich-Alexander-Universität (FAU), Erlangen
| | - E Häusler
- Deutsche Rentenversicherung, Bayern Süd, München
| | - H Heide
- Bayerisches Staatsministerium für Gesundheit und Pflege (StMGP), München
| | - P U Heuschmann
- Institut für Klinische Epidemiologie und Biometrie, Julius-Maximilians-Universität Würzburg
| | - G Hörl
- Bayerisches Staatsministerium für Gesundheit und Pflege (StMGP), München
| | - H Imhof
- Bayerische Staatsregierung, Patienten- und Pflegebeauftragter, München
| | - M Kaplan
- Bayerische Landesärztekammer, München
| | | | - D Klemperer
- Fakultät Angewandte Sozialwissenschaften, Hochschule Regensburg
| | - P Kolominsky-Rabas
- Interdisziplinäres Zentrum für Health Technology Assessment (HTA) und Public Health, Friedrich-Alexander-Universität (FAU), Erlangen
| | - J Kuhn
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Nürnberg, Oberschleißheim
| | - M Lang
- Bayerisches Staatsministerium für Bildung und Kultus, Wissenschaft und Kunst (StMBW), München
| | - R Langejürgen
- Verband der Ersatzkassen e.V. (vdek), Landesvertretung Bayern, München
| | - A Lankes
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Nürnberg, Oberschleißheim
| | - R Leidl
- Institut für Gesundheitsökonomie und Management im Gesundheitswesen, Helmholtz Zentrum München, Neuherberg
| | - B Liebl
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Nürnberg, Oberschleißheim
| | - J Loss
- Medizinische Soziologie, Institut für Epidemiologie und Präventivmedizin, Universität Regensburg
| | | | - U Mansmann
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität (LMU), München
| | - N Melcop
- Bayerische Landeskammer der Psychologischen Psychotherapeuten und der Kinder- und Jugendlichenpsychotherapeuten, München
| | - K Nagels
- Institut für Medizinmanagement und Gesundheitswissenschaften (IMG), Universität Bayreuth
| | - D Nowak
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Klinikum der Universität München
| | - H Pfundner
- Wirtschaftsverband der forschenden Pharma-Unternehmen (vfa), Berlin
| | - B Reuschenbach
- Katholische Stiftungsfachhochschule, Fachbereich Pflege, München
| | - A Schneider
- Institut für Allgemeinmedizin, Klinikum rechts der Isar, Technische Universität München
| | - W Schneider
- Zentrum für Interdisziplinäre Gesundheitsforschung (ZIG), Universität Augsburg
| | - O Schöffski
- Lehrstuhl für Gesundheitsmanagement, Friedrich-Alexander-Universität (FAU), Nürnberg
| | - W Schreiber
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Bezirksklinikum Mainkofen, Deggendorf
| | - S Voigtländer
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Nürnberg, Oberschleißheim
| | - M Wildner
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Nürnberg, Oberschleißheim
| | - A Zapf
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Nürnberg, Oberschleißheim
| | - A Zellner
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Nürnberg, Oberschleißheim
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Söhl K, Schulz R, Kuhn J. Ratenbildung bei KV-Daten mit GKV-Versicherten auf Landkreisebene – ein empirisches Schätzmodell auf der Basis des Mikrozensus. Gesundheitswesen 2014. [DOI: 10.1055/s-0034-1387045] [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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41
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Schulz R, Schneider T, Nennstiel-Ratzel U, Kuhn J. Kategorisierung von Adipositas bei Einschulungskindern nach verschiedenen Referenzsystemen: Sind Rangreihen-Unterschiede real oder statistisches Artefakt? Gesundheitswesen 2014. [DOI: 10.1055/s-0034-1387019] [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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42
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Schüller T, Huys D, Blum M, Lenartz D, Shubina E, Visser-Vandewalle V, Kuhn J. Tiefe Hirnstimulation beim Tourette-Syndrom. KLIN NEUROPHYSIOL 2014. [DOI: 10.1055/s-0034-1372629] [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: 10/25/2022]
Affiliation(s)
- T. Schüller
- Klinik für Psychiatrie und Psychotherapie, Uniklinik Köln
| | - D. Huys
- Klinik für Psychiatrie und Psychotherapie, Uniklinik Köln
| | - M. Blum
- Klinik für Psychiatrie und Psychotherapie, Uniklinik Köln
| | - D. Lenartz
- Klinik für Stereotaxie und Neurochirurgie, Uniklinik Köln
| | - E. Shubina
- Klinik für Psychiatrie und Psychotherapie, Uniklinik Köln
| | | | - J. Kuhn
- Klinik für Psychiatrie und Psychotherapie, Uniklinik Köln
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Kuhn J, Rauschert S, Pabst M, Annuss R, Wildner M, Göb R. Regionalvergleiche mit altersstandardisierten Kennziffern in der kommunalen Gesundheitsberichterstattung: Der Einfluss von Standardisierungsmethoden. Gesundheitswesen 2014. [DOI: 10.1055/s-0034-1371598] [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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44
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Ackermans L, Neuner I, Temel Y, Duits A, Kuhn J, Visser-Vandewalle V. Thalamic deep brain stimulation for Tourette syndrome. Behav Neurol 2014; 27:133-8. [PMID: 23242353 PMCID: PMC5215756 DOI: 10.3233/ben-120301] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- L Ackermans
- Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, The Netherlands
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Rauschert S, Scholz S, Annuss R, Kuhn J. Rangreihenprobleme bei Kommunaldaten mit altersstandardisierten Kennziffern - eine empirische Analyse. Gesundheitswesen 2013. [DOI: 10.1055/s-0033-1354175] [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: 10/26/2022]
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46
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Faust I, Roch C, Kuhn J, Prante C, Knabbe C, Hendig D. Human xylosyltransferase-I - a new marker for myofibroblast differentiation in skin fibrosis. Biochem Biophys Res Commun 2013; 436:449-54. [PMID: 23747722 DOI: 10.1016/j.bbrc.2013.05.125] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 05/29/2013] [Indexed: 01/09/2023]
Abstract
Skin fibrosis is a severe type of fibrotic disorder emerging in terms of hypertrophic scars or systemic sclerosis. Key event of fibrogenesis is the transition of fibroblasts to matrix-producing myofibroblasts. In the presence of fibrotic triggers, for instance secretion of profibrotic growth factors like transforming growth factor-β1 (TGF-β1) or mechanical strain, myofibroblasts persist. Current research focuses on discovering innovative myofibroblast biomarkers which are regulated in fibrotic development and accessible for antifibrotic inhibition. Here, we consider the suitability of xylosyltransferase-I (XT-I) as a myofibroblast biomarker in skin fibrosis. XT-I catalyzes the initial step of glycosaminoglycan biosynthesis. Its increase in enzymatic activity is known to refer only to manifested diseases which are characterized by an abnormal rate of proteoglycan biosynthesis. In this study, treatment of normal human dermal fibroblasts (NHDF) with TGF-β1 was followed by increased relative XYLT1 mRNA expression. Remarkably, this upregulation was strongly dependent on myofibroblast content, increasing during fibrogenesis. Moreover, XT activity increased time-dependently in response to progressive myofibroblast transformation. XYLT1 expression was inhibited by TGF-β receptor I (ALK5) inhibitor SB431542. In contrast, XYLT2 expression was only marginally affected by TGF-β1 as well as ALK5 inhibition. Our results strengthen the significance of XT expression and activity in fibrotic remodeling. Therefore, we propose XT activity, in addition to α-SMA expression, as a new biomarker for myofibroblast differentiation and fibrotic development. Further studies are now needed to evaluate the option to control and inhibit fibrotic remodeling by interfering with XT expression.
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Affiliation(s)
- I Faust
- Institut für Laboratoriums- und Transfusionsmedizin, Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitätsklinik der Ruhr-Universität Bochum, Bad Oeynhausen, Germany
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47
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Huys D, Bartsch C, Poppe P, Lenartz D, Huff W, Prütting J, Timmermann L, Klosterkötter J, Maarouf M, Rommel T, Hartmann A, Sturm V, Kuhn J. Management and outcome of pallidal deep brain stimulation in severe Huntington's disease. Fortschr Neurol Psychiatr 2013; 81:202-5. [PMID: 23589113 DOI: 10.1055/s-0033-1335097] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [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
Neurodegenerative movement disorders, such as Huntington's disease (HD), have become a promising field for Deep Brain Stimulation (DBS). This study aims to contribute to the establishment of a well-grounded database including both expected and unexpected effects of pallidal DBS in HD, and to discuss the ethical and legal restrictions of DBS in cognitively limited patients. Evaluation of the outcome data indicates that pallidal DBS exerted an independent effect on motor symptoms but probably also on the patient's cognitive and affective state. The cognitive decline, however, that characterizes the late stage of neurodegenerative disorders implicates ethical and legal problems given the patients' inability to give informed consent to DBS.
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Affiliation(s)
- D Huys
- Department of Psychiatry and Psychotherapy, University-Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany.
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Schulz R, Scholz S, Kuhn J. „Gesundheitsprofile Bayern“ - Interaktive Gesundheitsberichterstattung auf Basis des „Gesundheitsatlas Bayern“. Gesundheitswesen 2013. [DOI: 10.1055/s-0033-1337458] [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: 10/27/2022]
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Kuhn J, Hölscher G, Schulz R, Ludwig M, Schmidt A, Nennstiel-Ratzel U. Impfaufklärung ohne Chance? Denialistische Argumentationsmuster beim Impfen. Gesundheitswesen 2013. [DOI: 10.1055/s-0033-1337570] [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: 10/27/2022]
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Kohl S, Heekeren K, Klosterkötter J, Kuhn J. Prepulse inhibition in psychiatric disorders--apart from schizophrenia. J Psychiatr Res 2013; 47:445-52. [PMID: 23287742 DOI: 10.1016/j.jpsychires.2012.11.018] [Citation(s) in RCA: 225] [Impact Index Per Article: 20.5] [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] [Received: 05/01/2012] [Revised: 11/30/2012] [Accepted: 11/30/2012] [Indexed: 11/29/2022]
Abstract
Prepulse inhibition (PPI) is a robust operational measure of sensorimotor gating. In schizophrenic patients PPI is deficient. The aim of our review was to investigate the state of science regarding PPI and psychiatric disorders aside from schizophrenia. We used the online database PubMed in order to search for original published reports on PPI studies. The terms "prepulse inhibition", "sensorimotor gating", "blink recovery", and "blink reflex excitability" have been combined with the names of psychiatric disorders. We found that PPI is deficient in obsessive compulsive disorder (OCD) and Gilles de la Tourette's syndrome (GTS). In bipolar disorder dysfunctional PPI seems to be rather state dependent. Studies on depression and attention deficit/hyperactivity disorder (ADHD) consistently report no alterations. Evidence regarding sensorimotor gating in anxiety, autism, fragile X syndrome, posttraumatic stress disorder (PTSD), substance disorders, and Huntington's disease is still poor. There is a strong need for further studies on PPI in psychiatric disorders. PPI is highly applicable for translational research and might also be a very useful tool to investigate the mode of action of innovative, neuro-modulative techniques. Future PPI studies should control for influencing variables such as smoking, sex, or medication.
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Affiliation(s)
- S Kohl
- University of Cologne, Department of Psychiatry and Psychotherapy, Kerpener Straße 62, 50937 Cologne, Germany
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