1
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Tsivitis A, Kozlowski P, Corrado T, Chesler D, Moore R, Al Bizri E. Traumatic carotid artery injury caused by a metal sipping straw in a pediatric patient: Anesthetic management and considerations. Trauma Case Rep 2023; 48:100965. [PMID: 37920807 PMCID: PMC10618748 DOI: 10.1016/j.tcr.2023.100965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2023] [Indexed: 11/04/2023] Open
Abstract
CNS injury following a traumatic intraoral injury is a rare but potentially catastrophic occurrence in pediatrics. For example, intraoral trauma resulting in acute ischemic stroke (AIS) secondary to carotid artery dissection has only been described by a limited number of case reports [1]. We report the case of a 4-year-old boy who suffered a penetrating right internal carotid injury after a fall resulting in a metal straw perforating the neck and oropharynx. The patient presented in hemorrhagic shock with altered consciousness. CT Angiography revealed a right internal carotid traumatic rupture with flow occlusion and right cerebral hemispheric hypoperfusion. The patient underwent emergent neuroradiologic intervention under general anesthesia with successful reconstruction of the right carotid artery through the use of five flow diverting pipeline stents. The patient was extubated one week later with the only neurologic sequala being slight left upper extremity weakness. Anesthetic management played a vital part in this outstanding outcome. Thoughtful management is required to ensure both survival and the best possible neurologic recovery. Despite the rarity of these events, there is sufficient evidence from similar interventions and neurophysiology to guide sound management. This case report highlights these principles and areas for further investigation. Our experience may be instructive in the support of safe care under similarly rare but challenging circumstances.
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Affiliation(s)
- Alexandra Tsivitis
- Department of Anesthesiology, Stony Brook Medicine, Stony Brook, NY 11794, USA
| | - Paul Kozlowski
- Department of Anesthesiology, Stony Brook Medicine, Stony Brook, NY 11794, USA
| | - Thomas Corrado
- Department of Anesthesiology, Stony Brook Medicine, Stony Brook, NY 11794, USA
| | - David Chesler
- Department of Neurosurgery, Stony Brook Medicine, Stony Brook, NY 11794, USA
| | - Robert Moore
- Department of Anesthesiology, Stony Brook Medicine, Stony Brook, NY 11794, USA
| | - Ehab Al Bizri
- Department of Anesthesiology, Stony Brook Medicine, Stony Brook, NY 11794, USA
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2
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Allan A, Creech J, Hausner C, Krajcarski P, Gunawan B, Poulin N, Kozlowski P, Clark CW, Dow R, Saraithong P, Mair DB, Block T, Monteiro da Rocha A, Kim DH, Herron TJ. High-throughput longitudinal electrophysiology screening of mature chamber-specific hiPSC-CMs using optical mapping. iScience 2023; 26:107142. [PMID: 37416454 PMCID: PMC10320609 DOI: 10.1016/j.isci.2023.107142] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 06/01/2023] [Accepted: 06/12/2023] [Indexed: 07/08/2023] Open
Abstract
hiPSC-CMs are being considered by the Food and Drug Administration and other regulatory agencies for in vitro cardiotoxicity screening to provide human-relevant safety data. Widespread adoption of hiPSC-CMs in regulatory and academic science is limited by the immature, fetal-like phenotype of the cells. Here, to advance the maturation state of hiPSC-CMs, we developed and validated a human perinatal stem cell-derived extracellular matrix coating applied to high-throughput cell culture plates. We also present and validate a cardiac optical mapping device designed for high-throughput functional assessment of mature hiPSC-CM action potentials using voltage-sensitive dye and calcium transients using calcium-sensitive dyes or genetically encoded calcium indicators (GECI, GCaMP6). We utilize the optical mapping device to provide new biological insight into mature chamber-specific hiPSC-CMs, responsiveness to cardioactive drugs, the effect of GCaMP6 genetic variants on electrophysiological function, and the effect of daily β-receptor stimulation on hiPSC-CM monolayer function and SERCA2a expression.
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Affiliation(s)
- Andrew Allan
- Cairn Research, Graveney Road, Faversham, Kent ME13 8UP UK
| | - Jeffery Creech
- University of Michigan, Frankel Cardiovascular Regeneration Core Laboratory, Ann Arbor, MI 48109, USA
| | - Christian Hausner
- University of Michigan, Frankel Cardiovascular Regeneration Core Laboratory, Ann Arbor, MI 48109, USA
| | - Peyton Krajcarski
- University of Michigan, Frankel Cardiovascular Regeneration Core Laboratory, Ann Arbor, MI 48109, USA
| | - Bianca Gunawan
- University of Michigan, Frankel Cardiovascular Regeneration Core Laboratory, Ann Arbor, MI 48109, USA
| | - Noah Poulin
- University of Michigan, Frankel Cardiovascular Regeneration Core Laboratory, Ann Arbor, MI 48109, USA
| | - Paul Kozlowski
- Michigan Medicine, Internal Medicine-Cardiology, Ann Arbor, MI 48109, USA
| | - Christopher Wayne Clark
- University of Michigan, School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI 48109, USA
| | - Rachel Dow
- University of Michigan, Frankel Cardiovascular Regeneration Core Laboratory, Ann Arbor, MI 48109, USA
| | - Prakaimuk Saraithong
- University of Michigan, Frankel Cardiovascular Regeneration Core Laboratory, Ann Arbor, MI 48109, USA
- Michigan Medicine, Internal Medicine-Cardiology, Ann Arbor, MI 48109, USA
| | - Devin B. Mair
- Department of Biomedical Engineering, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Travis Block
- StemBioSys, Inc, 3463 Magic Drive, Suite 110, San Antonio, TX 78229, USA
| | - Andre Monteiro da Rocha
- University of Michigan, Frankel Cardiovascular Regeneration Core Laboratory, Ann Arbor, MI 48109, USA
- Michigan Medicine, Internal Medicine-Cardiology, Ann Arbor, MI 48109, USA
| | - Deok-Ho Kim
- Department of Biomedical Engineering, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Todd J. Herron
- University of Michigan, Frankel Cardiovascular Regeneration Core Laboratory, Ann Arbor, MI 48109, USA
- Michigan Medicine, Internal Medicine-Cardiology, Ann Arbor, MI 48109, USA
- Michigan Medicine, Molecular & Integrative Physiology, Ann Arbor, MI 48109, USA
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3
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Archibald J, MacMillan EL, Graf C, Kozlowski P, Laule C, Kramer JLK. Metabolite activity in the anterior cingulate cortex during a painful stimulus using functional MRS. Sci Rep 2020; 10:19218. [PMID: 33154474 PMCID: PMC7645766 DOI: 10.1038/s41598-020-76263-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 10/14/2020] [Indexed: 02/07/2023] Open
Abstract
To understand neurochemical brain responses to pain, proton magnetic resonance spectroscopy (1H-MRS) is used in humans in vivo to examine various metabolites. Recent MRS investigations have adopted a functional approach, where acquisitions of MRS are performed over time to track task-related changes. Previous studies suggest glutamate is of primary interest, as it may play a role during cortical processing of noxious stimuli. The objective of this study was to examine the metabolic effect (i.e., glutamate) in the anterior cingulate cortex during noxious stimulation using fMRS. The analysis addressed changes in glutamate and glutamate + glutamine (Glx) associated with the onset of pain, and the degree by which fluctuations in metabolites corresponded with continuous pain outcomes. Results suggest healthy participants undergoing tonic noxious stimulation demonstrated increased concentrations of glutamate and Glx at the onset of pain. Subsequent reports of pain were not accompanied by corresponding changes in glutamate of Glx concentrations. An exploratory analysis on sex revealed large effect size changes in glutamate at pain onset in female participants, compared with medium-sized effects in male participants. We propose a role for glutamate in the ACC related to the detection of a noxious stimulus.
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Affiliation(s)
- J Archibald
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada.
- Department of Experimental Medicine, University of British Columbia, Vancouver, Canada.
| | - E L MacMillan
- Department of Radiology, University of British Columbia, Vancouver, Canada
- ImageTech Lab, Simon Fraser University, Surrey, Canada
- Philips Healthcare Canada, Markham, Canada
| | - C Graf
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
- Department of Physics and Astronomy, University of British Columbia, Vancouver, Canada
| | - P Kozlowski
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
- Hughill Center, Vancouver, Canada
- Department of Radiology, University of British Columbia, Vancouver, Canada
- UBC MRI Research Centre, University of British Columbia, Vancouver, Canada
| | - C Laule
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
- Hughill Center, Vancouver, Canada
- Department of Radiology, University of British Columbia, Vancouver, Canada
- Department of Physics and Astronomy, University of British Columbia, Vancouver, Canada
- UBC MRI Research Centre, University of British Columbia, Vancouver, Canada
- Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - J L K Kramer
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
- Department of Anesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Djavad Mowafaghian Center for Brain Health (DMCH), Vancouver, Canada
- Hughill Center, Vancouver, Canada
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4
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Stamm A, Ferenczi B, Porter C, Kozlowski P, Donahue R, Corman J. Impact of catheter size on pain and continence following robotic prostatectomy. Can J Urol 2020; 27:10363-10368. [PMID: 33049188] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
UNLABELLED INTRODUCTION Continence and catheter related pain following prostatectomy are significant patient concerns, and it is unknown whether catheter size impacts these variables. In this study, patients undergoing prostatectomy were randomized to receive either a 16 French or 20 French catheter to assess the impact of catheter size on postoperative continence and pain. MATERIALS AND METHODS Patients were prospectively randomized to receive either a 16 French or a 20 French latex catheter at the completion of prostatectomy. Subjects were asked on postoperative day 7 to report their average catheter-related pain and the amount of opioid medication used. International Prostate Symptom Score, Quality of Life score and pads per day were recorded 6 and 12 weeks postoperatively. RESULTS Fifty-two patients were randomized. Seven were excluded: surgeon catheter preference (3) or withdrawal of consent (4). Demographic and pathologic data did not differ between groups (all p > 0.20). Catheter pain scores and postoperative opioid use were not different between groups (all p > 0.78). Postoperative subjective urinary symptom scores, and pads per day did not differ between groups at both 6 and 12 weeks (all p > 0.16). CONCLUSIONS Catheter size did not impact postoperative urethral and bladder pain or continence prostatectomy. These data suggest that surgeon preference should guide catheter selection between 16-20 French. Future studies might investigate precise intraoperative anastomosis size measurement and the impact of catheter size on pain scores in a nonoperative population.
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Affiliation(s)
- Andrew Stamm
- Virginia Mason Medical Center, Seattle, Washington, USA
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5
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Stamm A, Conti N, Olgac S, Flores JP, Wagner MJ, Kozlowski P. Intraperitoneal Rupture of a Synovial Sarcoma of the Kidney. Rev Urol 2019; 21:136-140. [PMID: 31768144 PMCID: PMC6864906] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Primary renal synovial sarcoma is an aggressive, extremely rare disease. Nearly all reported cases are characterized by SYT-SSX gene translocation (X;18)(p11;q11). We describe the case of a 43-year-old woman who presented with an intraperitoneal rupture of this rare sarcoma followed by a right radical nephrectomy. Follow-up imaging 1 month after surgery revealed peritoneal carcinomatosis. She began systemic chemotherapy with doxorubicin and dacarbazine, progressed after 3 months, and is currently receiving single-agent ifosfamide. Only one instance of intraperitoneal rupture has been reported previously. This case report contributes to the characterization of this rare disease.
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Affiliation(s)
| | - Neal Conti
- Virginia Mason Medical Center Seattle, WA
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6
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Friebe-Hoffmann U, Dobravsky L, Friedl TWP, Janni W, Knippel A, Siegmann HJ, Kozlowski P. Der (zu) kurze Femur in der Pränataldiagnostik – Analyse von 1376 Feten. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671146] [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: 10/28/2022] Open
Affiliation(s)
| | - L Dobravsky
- Universitätsfrauenklinik, Pränatalmedizin, Ulm, Deutschland
| | - TWP Friedl
- Universitätsfrauenklinik, Biostatistik, Ulm, Deutschland
| | - W Janni
- Universitätsfrauenklinik, Pränatalmedizin, Ulm, Deutschland
| | - A Knippel
- praenatal.de, Düsseldorf, Deutschland
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7
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Meyer JP, Kozlowski P, Jackson J, Cunanan KM, Adumeau P, Dilling TR, Zeglis BM, Lewis JS. Exploring Structural Parameters for Pretargeting Radioligand Optimization. J Med Chem 2017; 60:8201-8217. [PMID: 28857566 DOI: 10.1021/acs.jmedchem.7b01108] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Pretargeting offers a way to enhance target specificity while reducing off-target radiation dose to healthy tissue during payload delivery. We recently reported the development of an 18F-based pretargeting strategy predicated on the inverse electron demand Diels-Alder reaction as well as the use of this approach to visualize pancreatic tumor tissue in vivo as early as 1 h postinjection. Herein, we report a comprehensive structure: pharmacokinetic relationship study of a library of 25 novel radioligands that aims to identify radiotracers with optimal pharmacokinetic and dosimetric properties. This investigation revealed key relationships between molecular structure and in vivo behavior and produced two lead candidates exhibiting rapid tumor targeting with high target-to-background activity concentration ratios at early time points. We believe this knowledge to be of high value for the design and clinical translation of next-generation pretargeting agents for the diagnosis and treatment of disease.
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Affiliation(s)
- Jan-Philip Meyer
- Department of Radiology, Memorial Sloan Kettering Cancer Center , New York, New York 10065, United States
| | - Paul Kozlowski
- Department of Radiology, Memorial Sloan Kettering Cancer Center , New York, New York 10065, United States
| | - James Jackson
- Department of Radiology, Memorial Sloan Kettering Cancer Center , New York, New York 10065, United States
| | - Kristen M Cunanan
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center , New York, New York 10065, United States
| | - Pierre Adumeau
- Department of Chemistry, Hunter College of the City University of New York , New York, New York 10065, United States
| | - Thomas R Dilling
- Department of Radiology, Memorial Sloan Kettering Cancer Center , New York, New York 10065, United States
| | - Brian M Zeglis
- Department of Radiology, Memorial Sloan Kettering Cancer Center , New York, New York 10065, United States.,Department of Chemistry, Hunter College of the City University of New York , New York, New York 10065, United States.,Ph.D. Program in Chemistry, Graduate Center of the City University of New York , New York, New York 10016, United States.,Departments of Radiology and Pharmacology, Weill Cornell Medical College , New York, New York 10065, United States
| | - Jason S Lewis
- Department of Radiology, Memorial Sloan Kettering Cancer Center , New York, New York 10065, United States.,Program in Molecular Pharmacology, Memorial Sloan Kettering Cancer Center , New York, New York 10065, United States.,Departments of Radiology and Pharmacology, Weill Cornell Medical College , New York, New York 10065, United States
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8
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Rempen A, Chaoui R, Häusler M, Kagan KO, Kozlowski P, von Kaisenberg C, Wisser J. Quality Requirements for Ultrasound Examination in Early Pregnancy (DEGUM Level I) between 4+0 and 13+6 Weeks of Gestation. Ultraschall Med 2016; 37:579-583. [PMID: 27626239 DOI: 10.1055/s-0042-115581] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- A Rempen
- Clinic of Gynecology and Obstetrics, Diakonie-Klinikum, Schwaebisch Hall, Germany
| | - R Chaoui
- Practice of Prenatal Medicine, Berlin, Germany
| | - M Häusler
- Department of Obstetrics, University Clinic, Graz, Austria
| | - K-O Kagan
- University Clinic of Obstetrics and Gynecology, Tübingen, Germany
| | - P Kozlowski
- Prenatal Medicine and Genetics, Duesseldorf, Germany
| | - C von Kaisenberg
- Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany
| | - J Wisser
- Clinic of Obstetrics, University Hospital, Zurich, Switzerland
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9
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Thiessen JD, Shams E, Stortz G, Schellenberg G, Bishop D, Khan MS, Kozlowski P, Retière F, Sossi V, Thompson CJ, Goertzen AL. MR-compatibility of a high-resolution small animal PET insert operating inside a 7 T MRI. Phys Med Biol 2016; 61:7934-7956. [DOI: 10.1088/0031-9155/61/22/7934] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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10
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Friebe-Hoffmann U, Hiltmann A, Lato K, Friedl TWP, Janni W, Hammer R, Kozlowski P. Analyse von 1486 Feten mit singulärer Nabelschnurarterie (SUA). Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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11
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de la Torre JC, Fortin T, Park GA, Saunders JK, Kozlowski P, Butler K, de Socarraz H, Pappas B, Richard M. Aged but not young rats develop metabolic, memory deficits after chronic brain ischaemia. Neurol Res 2016; 14:177-80. [PMID: 1355882 DOI: 10.1080/01616412.1992.11740045] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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12
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Kozlowski P. Allgemeine Geburtshilfe – Ultraschall in der Schwangerschaft: Mutterschafts-Richtlinien sind Minimum an guter Vorsorge. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0042-104856] [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] Open
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13
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Meyer JP, Edwards KJ, Kozlowski P, Backer MV, Backer JM, Lewis JS. Selective Imaging of VEGFR-1 and VEGFR-2 Using 89Zr-Labeled Single-Chain VEGF Mutants. J Nucl Med 2016; 57:1811-1816. [PMID: 27390161 DOI: 10.2967/jnumed.116.173237] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 05/16/2016] [Indexed: 11/16/2022] Open
Abstract
Vascular endothelial growth factor-A (VEGF-A) acts via 2 vascular endothelial growth factor receptors, VEGFR-1 and VEGFR-2, that play important and distinct roles in tumor biology. We reasoned that selective imaging of these receptors could provide unique information for diagnostics and for monitoring and optimizing responses to anticancer therapy, including antiangiogenic therapy. Herein, we report the development of 2 first-in-class 89Zr-labeled PET tracers that enable the selective imaging of VEGFR-1 and VEGFR-2. METHODS Functionally active mutants of scVEGF (an engineered single-chain version of pan-receptor VEGF-A with an N-terminal cysteine-containing tag for site-specific conjugation), named scVR1 and scVR2 with enhanced affinity to, respectively, VEGFR-1 and VEGFR-2, were constructed. Parental scVEGF and its receptor-specific mutants were site-specifically derivatized with the 89Zr chelator desferroxamine B via a 3.4-kDa PEG linker. 89Zr labeling of the desferroxamine B conjugates furnished scV/Zr, scVR1/Zr, and scVR2/Zr tracers with high radiochemical yield (>87%), high specific activity (≥9.8 MBq/nmol), and purity (>99%). Tracers were tested in an orthotopic breast cancer model using 4T1luc-bearing syngeneic BALB/c mice. For testing tracer specificity, tracers were coinjected with an excess of cold proteins of the same or opposite receptor specificity or pan-receptor scVEGF. PET imaging, biodistribution, and dosimetry studies in mice, as well as immunohistochemical analysis of harvested tumors, were performed. RESULTS All tracers rapidly accumulated in orthotopic 4T1luc tumors, allowing for the successful PET imaging of the tumors as early as 2 h after injection. Blocking experiments with an excess of pan-receptor or receptor-specific cold proteins indicated that more than 80% of tracer tumor uptake is VEGFR-mediated, whereas uptake in all major organs is not affected by blocking within the margin of error. Critically, blocking experiments indicated that VEGFR-mediated tumor uptake of scVR1/Zr and scVR2/Zr was mediated exclusively by the corresponding receptor, VEGFR-1 or VEGFR-2, respectively. In contrast, uptake of pan-receptor scV/Zr was mediated by both VEGFR-1 and VEGFR-2 at an approximately 2:1 ratio. CONCLUSION First-in-class selective PET tracers for imaging VEGFR-1 and VEGFR-2 were constructed and successfully validated in an orthotopic murine tumor model.
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Affiliation(s)
- Jan-Philip Meyer
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kimberly J Edwards
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Paul Kozlowski
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | | | - Jason S Lewis
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York .,Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, New York; and.,Weill Cornell Medical College, New York, New York
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14
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von Kaisenberg C, Chaoui R, Häusler M, Kagan KO, Kozlowski P, Merz E, Rempen A, Steiner H, Tercanli S, Wisser J, Heling KS. Quality Requirements for the early Fetal Ultrasound Assessment at 11-13+6 Weeks of Gestation (DEGUM Levels II and III). Ultraschall Med 2016; 37:297-302. [PMID: 27093520 DOI: 10.1055/s-0042-105514] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The early fetal ultrasound assessment at 11 - 13(+6) weeks of gestation remains the cornerstone of care despite the progress in diagnosing fetal chromosomal defects using cell-free fetal DNA (cffDNA) from the maternal circulation. The measurement of nuchal translucency (NT) allows the risk calculation for the fetal trisomies 21, 18 and 13 but also gives information on those fetal chromosomal defects which are at present unable to be detected using cffDNA. Nuchal translucency is the only auditable parameter at 11 - 13(+6) weeks and gives thus information on the quality of the first trimester anomaly scan. In addition it gives indirect information on the risks for fetal defects and for cardiac anomalies. Also the chances for a healthy live baby can be estimated. As experience with first trimester anomaly scanning increases, and the resolution of the ultrasound equipment has increased substantially, more and more details of the fetal anatomy become accessible at the first trimester scan. Therefore fetal anatomical defects and complex anomalies have become amenable to examination in the first trimester. This guideline describes compulsory and optional parameters for investigation at the first trimester scan and outlines a structured method of examining a first trimester fetus at 11 - 13(+6) weeks of gestation.
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Affiliation(s)
- C von Kaisenberg
- Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany
| | - R Chaoui
- Praxis für Pränatalmedizin, Berlin, Germany
| | - M Häusler
- Obstetrics and Gynecology, University of Graz, Graz, Austria
| | - K O Kagan
- Obstetrics and Gynecology, University of Tübingen, Germany
| | - P Kozlowski
- Praenatal-Medizin und Genetik, Düsseldorf, Germany
| | - E Merz
- Obstetrics and Gynecology, Krankenhaus Nordwest, Frankfurt/Main, Germany
| | - A Rempen
- Frauenklinik, Evangelisches Diakoniekrankenhaus, Schwäbisch-Hall, Germany
| | - H Steiner
- Ordination Salzburg, Salzburg, Austria
| | - S Tercanli
- Pränatalmedizin, Ultraschallpraxis Freie Straße, Basel, Switzerland
| | - J Wisser
- Obstetrics and Gynecology, University of Zurich, Zurich, Switzerland
| | - K-S Heling
- Praxis für Pränatalmedizin, Berlin, Germany
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15
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Deri MA, Ponnala S, Kozlowski P, Burton-Pye BP, Cicek HT, Hu C, Lewis JS, Francesconi LC. p-SCN-Bn-HOPO: A Superior Bifunctional Chelator for (89)Zr ImmunoPET. Bioconjug Chem 2015; 26:2579-91. [PMID: 26550847 DOI: 10.1021/acs.bioconjchem.5b00572] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Zirconium-89 has an ideal half-life for use in antibody-based PET imaging; however, when used with the chelator DFO, there is an accumulation of radioactivity in the bone, suggesting that the (89)Zr(4+) cation is being released in vivo. Therefore, a more robust chelator for (89)Zr could reduce the in vivo release and the dose to nontarget tissues. Evaluation of the ligand 3,4,3-(LI-1,2-HOPO) demonstrated efficient binding of (89)Zr(4+) and high stability; therefore, we developed a bifunctional derivative, p-SCN-Bn-HOPO, for conjugation to an antibody. A Zr-HOPO crystal structure was obtained showing that the Zr is fully coordinated by the octadentate HOPO ligand, as expected, forming a stable complex. p-SCN-Bn-HOPO was synthesized through a novel pathway. Both p-SCN-Bn-HOPO and p-SCN-Bn-DFO were conjugated to trastuzumab and radiolabeled with (89)Zr. Both complexes labeled efficiently and achieved specific activities of approximately 2 mCi/mg. PET imaging studies in nude mice with BT474 tumors (n = 4) showed good tumor uptake for both compounds, but with a marked decrease in bone uptake for the (89)Zr-HOPO-trastuzumab images. Biodistribution data confirmed the lower bone activity, measuring 17.0%ID/g in the bone at 336 h for (89)Zr-DFO-trastuzumab while (89)Zr-HOPO-trastuzumab only had 2.4%ID/g. We successfully synthesized p-SCN-Bn-HOPO, a bifunctional derivative of 3,4,3-(LI-1,2-HOPO) as a potential chelator for (89)Zr. In vivo studies demonstrate the successful use of (89)Zr-HOPO-trastuzumab to image BT474 breast cancer with low background, good tumor to organ contrast, and, importantly, very low bone uptake. The reduced bone uptake seen with (89)Zr-HOPO-trastuzumab suggests superior stability of the (89)Zr-HOPO complex.
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Affiliation(s)
- Melissa A Deri
- Department of Radiology and the Program in Molecular Pharmacology, Memorial Sloan Kettering Cancer Center , 1275 York Avenue, New York, New York 10065, United States.,Department of Chemistry, Hunter College of the City University of New York , 695 Park Avenue, New York, New York 10065, United States.,Ph.D. Program in Chemistry, The Graduate Center of the City University of New York , 365 Fifth Ave, New York, New York 10016, United States
| | - Shashikanth Ponnala
- Department of Radiology and the Program in Molecular Pharmacology, Memorial Sloan Kettering Cancer Center , 1275 York Avenue, New York, New York 10065, United States.,Department of Chemistry, Hunter College of the City University of New York , 695 Park Avenue, New York, New York 10065, United States
| | - Paul Kozlowski
- Department of Radiology and the Program in Molecular Pharmacology, Memorial Sloan Kettering Cancer Center , 1275 York Avenue, New York, New York 10065, United States.,Department of Chemistry, Hunter College of the City University of New York , 695 Park Avenue, New York, New York 10065, United States
| | - Benjamin P Burton-Pye
- Department of Chemistry, Hunter College of the City University of New York , 695 Park Avenue, New York, New York 10065, United States
| | - Huseyin T Cicek
- Department of Chemistry, Hunter College of the City University of New York , 695 Park Avenue, New York, New York 10065, United States
| | - Chunhua Hu
- Department of Chemistry, New York University , 100 Washington Square East, New York, New York 10003, United States
| | - Jason S Lewis
- Department of Radiology and the Program in Molecular Pharmacology, Memorial Sloan Kettering Cancer Center , 1275 York Avenue, New York, New York 10065, United States
| | - Lynn C Francesconi
- Department of Chemistry, Hunter College of the City University of New York , 695 Park Avenue, New York, New York 10065, United States.,Ph.D. Program in Chemistry, The Graduate Center of the City University of New York , 365 Fifth Ave, New York, New York 10016, United States
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Friebe-Hoffmann U, Hiltmann A, Lato K, Friedl TWP, Janni W, Hammer R, Kozlowski P. Feten mit singulärer Nabelschnurarterie (SUA) – was nun? Z Geburtshilfe Neonatol 2015. [DOI: 10.1055/s-0035-1566482] [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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17
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Meyer JP, Houghton JL, Kozlowski P, Abdel-Atti D, Reiner T, Pillarsetty NVK, Scholz WW, Zeglis BM, Lewis JS. (18)F-Based Pretargeted PET Imaging Based on Bioorthogonal Diels-Alder Click Chemistry. Bioconjug Chem 2015; 27:298-301. [PMID: 26479967 PMCID: PMC4759614 DOI: 10.1021/acs.bioconjchem.5b00504] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
A first-of-its-kind (18)F pretargeted PET imaging approach based on the bioorthogonal inverse electron demand Diels-Alder (IEDDA) reaction between tetrazine (Tz) and trans-cyclooctene (TCO) is presented. As proof-of-principle, a TCO-bearing immunoconjugate of the anti-CA19.9 antibody 5B1 and an Al[(18)F]NOTA-labeled tetrazine radioligand were harnessed for the visualization of CA19.9-expressing BxPC3 pancreatic cancer xenografts. Biodistribution and (18)F-PET imaging data clearly demonstrate that this methodology effectively delineates tumor mass with activity concentrations up to 6.4 %ID/g at 4 h after injection of the radioligand.
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Affiliation(s)
- Jan-Philip Meyer
- Department of Radiology, Memorial Sloan Kettering Cancer Center , 1275 York Avenue, New York, New York 10065, United States
| | - Jacob L Houghton
- Department of Radiology, Memorial Sloan Kettering Cancer Center , 1275 York Avenue, New York, New York 10065, United States
| | - Paul Kozlowski
- Department of Radiology, Memorial Sloan Kettering Cancer Center , 1275 York Avenue, New York, New York 10065, United States
| | - Dalya Abdel-Atti
- Department of Radiology, Memorial Sloan Kettering Cancer Center , 1275 York Avenue, New York, New York 10065, United States
| | - Thomas Reiner
- Department of Radiology, Memorial Sloan Kettering Cancer Center , 1275 York Avenue, New York, New York 10065, United States
| | - Naga Vara Kishore Pillarsetty
- Department of Radiology, Memorial Sloan Kettering Cancer Center , 1275 York Avenue, New York, New York 10065, United States
| | - Wolfgang W Scholz
- MabVax Therapeutics , 11588 Sorrento Valley Road Suite 20, San Diego, California 92121, United States
| | - Brian M Zeglis
- Department of Chemistry, Hunter College of the City University of New York , 695 Park Avenue, New York, New York 10065, United States.,The Graduate Center, City University of New York , 365 Fifth Avenue, New York, New York 10016, United States
| | - Jason S Lewis
- Department of Radiology, Memorial Sloan Kettering Cancer Center , 1275 York Avenue, New York, New York 10065, United States.,Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center , 1275 York Avenue, New York, New York 10065, United States
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18
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Mahdavi S, Spadinger I, Morris W, Salcudean S, Chang S, Kozlowski P, Chng N. Dual Source Strength Planning for Focal Low-Dose-Rate Brachytherapy of Prostate Cancer. Brachytherapy 2015. [DOI: 10.1016/j.brachy.2015.02.287] [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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19
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Bahlmann F, Reinhard I, Schramm T, Geipel A, Gembruch U, von Kaisenberg CS, Schmitz R, Stupin J, Chaoui R, Karl K, Kalache K, Faschingbauer F, Ponnath M, Rempen A, Kozlowski P. Cranial and cerebral signs in the diagnosis of spina bifida between 18 and 22 weeks of gestation: a German multicentre study. Prenat Diagn 2015; 35:228-35. [PMID: 25346419 DOI: 10.1002/pd.4524] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Revised: 09/21/2014] [Accepted: 10/20/2014] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The aim of this article is to study secondary cranial signs in fetuses with spina bifida in a precisely defined screening period between 18 + 0 and 22 + 0 weeks of gestation. METHOD On the basis of retrospective analysis of 627 fetuses with spina bifida, the value of indirect cranial and cerebral markers was assessed by well-trained ultrasonographers in 13 different prenatal centres in accordance with the ISUOG (International Society of Ultrasound in Obstetrics and Gynecology) guidelines on fetal neurosonography. RESULTS Open spina bifida was diagnosed in 98.9% of cases whereas 1.1% was closed spina bifida. Associated chromosomal abnormalities were found in 6.2%. The banana and lemon signs were evident in 97.1% and 88.6% of cases. Obliteration of the cisterna magna was seen in 96.7%. Cerebellar diameter, head circumference and biparietal diameter were below the 5th percentile in chromosomally normal fetuses in 72.5%, 69.7% and 52%, respectively. The width of the posterior horn of the lateral ventricle was above the 95th percentile in 57.7%. The secondary cranial and cerebral signs were dependent on fetal chromosome status and width of the posterior horn. Biparietal diameter was also dependent on the chromosome status with statistical significance p = 0.0068. Pregnancy was terminated in 89.6% of cases. CONCLUSION In standard measuring planes, lemon sign, banana sign and an inability to image the cistern magna are very reliable indirect ultrasound markers of spina bifida. © 2014 John Wiley & Sons, Ltd.
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Affiliation(s)
- F Bahlmann
- Department of Obstetrics and Gynecology, Bürgerhospital, Frankfurt, Germany
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20
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Kagan KO, Hoopmann M, Hammer R, Stressig R, Kozlowski P. Screening for chromosomal abnormalities by first trimester combined screening and noninvasive prenatal testing. Ultraschall Med 2015; 36:40-46. [PMID: 25255236 DOI: 10.1055/s-0034-1385059] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE To examine combined first trimester screening (FTS), noninvasive prenatal testing (NIPT) and a two-step policy that combines FTS and NIPT in screening for aneuploidy. MATERIALS AND METHODS Retrospective study involving 21,052 pregnancies where FTS was performed at the Praxis Praenatal.de in Duesseldorf, Germany. In each case, the sum risk of trisomy 21, 18 and 13 was computed. We assumed that NIPT detects 99 %, 98 %, 90 % and 99 % of cases with trisomy 21, 18, 13 and sex chromosomal abnormalities and that the false-positive rate is 0.5 %. The following screening policies were examined: NIPT or FTS with sum risk cut-offs of 1 in 50 and 1 in 250 in all patients or a two-step-policy with FTS in all patients followed by NIPT in the intermediate sum risk group. For the intermediate risk group, sum risk cut-offs of 1 in 50 and 1 in 1000 and 1 in 150 and 1 in 500 were used. RESULTS There were 127, 34, 13 and 15 pregnancies with trisomy 21, 18, 13 and sex chromosomal abnormalities. 23 fetuses had other chromosomal abnormalities with an increased risk for adverse outcome that are not detectable by NIPT. 20,840 pregnancies were classified as normal as ante- and postnatal examinations did not show any signs of clinically significant chromosomal abnormalities. FTS with a sum risk cut-off of 1 in 50 and 1 in 250 detects 81 % and 91 % for all aneuploidies. NIPT detects 88 % of the respective pregnancies. The 2-step approach with sum risk cut-offs of 1 in 50 and 1 in 1000 detects 94 % of all aneuploidies. With sum risk cut-offs of 1 in 150 and 1 in 500, the detection rate is 93 %. CONCLUSION A 2-step policy with FTS for all patients and NIPT in the intermediate risk group results in the highest detection rate of all aneuploidies.
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Affiliation(s)
- K O Kagan
- Department of Obstetrics and Gynaecology, University of Tuebingen, Tübingen
| | - M Hoopmann
- Department of Obstetrics and Gynaecology, University of Tuebingen, Tübingen
| | - R Hammer
- Praenatal Medicine and Genetics, praenatal.de, Düsseldorf
| | - R Stressig
- Praenatal Medicine and Genetics, praenatal.de, Düsseldorf
| | - P Kozlowski
- Praenatal Medicine and Genetics, praenatal.de, Düsseldorf
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21
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Oepkes D, Yaron Y, Kozlowski P, Rego de Sousa MJ, Bartha JL, van den Akker ES, Dornan SM, Krampl-Bettelheim E, Schmid M, Wielgos M, Cirigliano V, Di Renzo GC, Cameron A, Calda P, Tabor A. Counseling for non-invasive prenatal testing (NIPT): what pregnant women may want to know. Ultrasound Obstet Gynecol 2014; 44:1-5. [PMID: 24984969 DOI: 10.1002/uog.13394] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- D Oepkes
- Leiden University Medical Center, Department of Obstetrics, K-06-35, P.O.Box 9600, 2300, RC, Leiden, The Netherlands
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22
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Abstract
In the last decades, prenatal screening for aneuploidy has become increasingly effective. While first trimester combined screening is considered to be the current gold standard, the use of cell-free fetal DNA (cffDNA), which is also called noninvasive prenatal testing (NIPT), will result in a change of paradigm. Respective studies indicate that in screening for trisomy 21, the detection and false-positive rates are 99 % and 0.1 %, respectively. For trisomies 18 and 13, there is less evidence but recent studies report detection rates of 98 % and 86 %. Despite the excellent results in screening for trisomy 21, NIPT should not be considered as a diagnostic test. Due to the costs of NIPT, it is unlikely that NIPT will be applied in the near future in population-based screening for trisomy. In addition, the scope of the current approach in first trimester screening exceeds the screening for aneuploidy as it is possible to assess the risk for various pregnancy complications. Therefore, a combination of both NIPT and first trimester combined screening seems reasonable. Both examinations could be applied in a contingent model where the latter is offered to everyone and NIPT is restricted to women with an intermediate risk after first trimester combined screening. Such a policy would result in a detection rate of about 97 % for a false-positive rate of about 1 %. While NIPT currently focuses on screening for trisomy 21, 18, 13 and sex chromosomal abnormalities, the scope of NIPT will soon become broader. In this respect, some study groups have managed to examine the whole fetal genome within the course of the pregnancy. However, moral and ethical considerations need to be taken into account.
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Affiliation(s)
- K O Kagan
- Department of obstetrics and gynaecology, University of Tuebingen
| | - B Eiben
- Institute for clinical genetics and laboratory medicine, Amedes Group, Essen
| | - P Kozlowski
- Prenatal medicine and genetics Duesseldorf, praenatal.de, Duesseldorf
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23
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Johnston R, Lopushnyan N, Kozlowski P, Hefty T. 101 AUTOTRANSPLANTATION - AN EXCELLENT CHOICE FOR EXCELLENT RESULTS. J Urol 2013. [DOI: 10.1016/j.juro.2013.02.1479] [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: 11/26/2022]
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24
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Lato K, Poellmann M, Knippel AJ, Bizjak G, Stressig R, Hammer R, Janni W, Kozlowski P. Fetal gastroschisis: a comparison of second vs. third-trimester bowel dilatation for predicting bowel atresia and neonatal outcomes. Ultraschall Med 2013; 34:157-161. [PMID: 22161619 DOI: 10.1055/s-0031-1281753] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE To compare various gestational ages and thresholds for diagnosing bowel dilatation in fetuses with gastroschisis and to evaluate the prognostic value of bowel dilatation for predicting postnatal bowel atresia and neonatal outcomes. MATERIALS AND METHODS This was a retrospective observational study conducted from March 1997 to September 2009 that included 78 pregnancies with fetal gastroschisis. The predictive value of prenatal bowel dilatation for neonatal bowel atresia and postnatal complications was investigated in three subgroups: those with bowel dilatations ≥ 10 mm at a gestational age < 27 + 0 weeks, ≥ 10 mm at a gestational age < 30 + 0 weeks and ≥ 18 mm at a gestational age ≥ 30 weeks. RESULTS Prenatally, 6 %, 81 % and 13 % of the bowel malformations were identified in the first, second and third trimesters, respectively. There were three stillbirths and three neonatal deaths, and the mean gestational age at delivery was 35.4 weeks (range 31 + 4 to 41 + 6). Bowel atresia was significantly correlated with prenatal bowel dilatation in all three subgroups. Bowel dilatations of ≥ 10 mm before 30 + 0 gestational weeks achieved the best performance in predicting bowel atresia, with a sensitivity of 89 % (8 / 9) and a specificity of 79 % (30 / 38). A prenatal bowel diameter ≥ 10 mm through 30 completed weeks was also the best predictor of a prolonged neonatal hospital stay ≥ 8 weeks (sensitivity = 61.1, 11 / 18, p = 0.002). CONCLUSION Fetuses with isolated gastroschisis successfully underwent postnatal surgery in most cases (93.2 %), except for one termination, one intrauterine death and 3 cases of neonatal death. A fetal bowel dilatation > 10 mm before 30 + 0 weeks had the highest predictive value for postnatal bowel complications.
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Affiliation(s)
- K Lato
- Department of Obstetrics and Prenatal Medicine, Heinrich-Heine University, Germany
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25
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Kagan KO, Hoopmann M, Kozlowski P. Assessment of Foetal DNA in Maternal Blood - A Useful Tool in the Hands of Prenatal Specialists. Geburtshilfe Frauenheilkd 2012; 72:998-1003. [PMID: 25258455 DOI: 10.1055/s-0032-1327960] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 10/19/2012] [Accepted: 10/21/2012] [Indexed: 10/27/2022] Open
Abstract
Over the last few years, first trimester screening between 11+ and 13+ weeks of gestation has become one of the most important ultrasound examinations in pregnancy, as it allows physicians to predict several pregnancy complications including pre-eclampsia or pre-term birth. Screening for trisomies 21/18 and 13 using maternal and gestational age, foetal nuchal translucency, and maternal serum biochemistry was formerly the main reason for first trimester screening. However, today this is only one part of the overall examination. In the near future, the analysis of foetal DNA obtained from maternal blood will be used to supplement first trimester screening for aneuploidy or even replace current screening methods. In this review we show how prenatal medicine specialists can use foetal DNA analysis.
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Affiliation(s)
- K O Kagan
- Department of Obstetrics and Gynaecology, University of Tübingen
| | - M Hoopmann
- Department of Obstetrics and Gynaecology, University of Tübingen
| | - P Kozlowski
- praenatal.de, Praenatal-Medizin und Genetik Düsseldorf
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26
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Robinson H, Kannanganat S, Gangadhara S, Lai L, Yu T, Kozlowski P, Earl P, Moss B, Amara RR. GM-CSF co-expressing DNA/MVA vaccine, prevention of acquisition by two series of SIVE660 challenges followed by a series of SIV251 challenges. Retrovirology 2012. [PMCID: PMC3441798 DOI: 10.1186/1742-4690-9-s2-p25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
| | | | | | - L Lai
- Emory University, Atlanta, GA, USA
| | - T Yu
- Emory University, Atlanta, GA, USA
| | - P Kozlowski
- Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - P Earl
- National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - B Moss
- National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - RR Amara
- Emory University, Atlanta, GA, USA
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Jensen K, Ranganathan UD, Kozlowski P, Van Rompay K, Canfield D, Ravindran R, Khan I, Luciw P, Fennelly G, Larsen M, Abel K. A recombinant attenuated Mycobacterium tuberculosis-SIV combination vaccine is safe and immunogenic in immunocompromised, SIV-infected infant macaques. Retrovirology 2012. [PMCID: PMC3441880 DOI: 10.1186/1742-4690-9-s2-o4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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28
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Aldovini A, Manrique M, Cobo-Molinos A, Kozlowski P, Carvlle A. Significant protection from infection and AIDS progression after gastrointestinal and oral vaccinations, respectively, with a SIV DNA/rMVA vaccine. Retrovirology 2012; 9 Suppl 2:O1-72, P1-366. [PMID: 23046632 PMCID: PMC3441614 DOI: 10.1186/1742-4690-9-s2-o1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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29
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Goertzen AL, Zhang X, Liu CY, Kozlowski P, Retière F, Ryner L, Sossi V, Stortz G, Thompson CJ. Sci-Fri AM: Imaging - 03: Temperature dependence of a SiPM detector for an MR compatible PET system. Med Phys 2012; 39:4640. [PMID: 28516645 DOI: 10.1118/1.4740189] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Silicon photomultiplier (SiPM) detectors are rapidly becoming the detector of choice for research and development of new detectors for positron emission tomography (PET) due to their combination of high gain, fast timing, compact form factor and ability to function in a magnetic field. We are investigating using SiPM based detectors in a compact PET system designed to be inserted into a 7T animal MRI system and enable simultaneous PET/MRI imaging. In order to understand the level of thermal stability required for this PET system, we examined the stability of a prototype SiPM detector vs. temperature. A detector was constructed using a SensL SPMArray4 SiPM array coupled to a LYSO scintillator crystal array. The temperature of the detector was varied between 23 and 60°C in 5°C steps. At each temperature setting data were collected to characterize the detector flood histogram, photopeak amplitude and energy resolution at 511 keV, timing resolution and signal arrival time. While the flood image showed no noticeable changes with temperature, the 511 keV photopeak amplitude showed a linear decrease of 1.5%/°C and the energy resolution degraded by 0.08%/°C. The timing resolution degraded by 1.5 ns, from 3.5 ns to 5 ns when the temperature changed from 23 to 60°C. Over this temperature range there was a shift in the signal arrival time of approximately 3 ns. These results demonstrate that the detector can be operated over a wide range of temperature, giving a large degree of flexibility in choosing an operating temperature set-point for our PET system.
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Affiliation(s)
- A L Goertzen
- Department of Radiology, University of Manitoba, Winnipeg, MB, Canada.,Department of Physics & Astronomy, University of Manitoba, Winnipeg, MB, Canada
| | - X Zhang
- Department of Radiology, University of Manitoba, Winnipeg, MB, Canada
| | - C-Y Liu
- Department of Physics & Astronomy, University of Manitoba, Winnipeg, MB, Canada
| | - P Kozlowski
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - F Retière
- Detector Development Group, TRIUMF, Vancouver, BC, Canada
| | - L Ryner
- Magnetic Resonance Research and Development, Institute for Biodiagnostics, National Research Council Canada, Winnipeg, MB, Canada
| | - V Sossi
- Department of Physics & Astronomy, University of British Columbia, Vancouver, BC, Canada
| | - G Stortz
- Department of Physics & Astronomy, University of British Columbia, Vancouver, BC, Canada
| | - C J Thompson
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Montréal, QC, Canada
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Thompson C, Stortz G, Goertzen A, Berg E, Retière F, Kozlowski P, Ryner L, Sossi V. Sci-Fri AM: Imaging - 08: Comparison of single and dual layer detector blocks for pre-clinical MRI-PET. Med Phys 2012; 39:4641-4642. [PMID: 28516664 DOI: 10.1118/1.4740194] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Our group is developing a small animal PET scanner which would fit in a 7 Tesla MRI scanner to provide simultaneous PET and MR acquisitions and images. There is very little room for the PET detectors and we must use nonmagnetic materials. This presentation describes preliminary work with two PET detectors consisting of LYSO blocks each with two crystal layers: 49 1.67*1.67*6.0 mm on the bottom layer and 36 4.0 mm deep crystals on the top layer. These are mounted on SensL 4*4 arrays of silicon photo-multipliers whose outputs are multiplexed to provide three signals: Energy, X, Y. These detectors were mounted on translation stages and scanned past a 0.25 mm diameter 370 MBq Na-18 source embedded in tissue equivalent plastic. The results were compared with similar single layer crystal blocks with 10 mm deep crystals to assess the advantage of dual layer crystals to reduce radial blurring in a PET scanner with a diameter of only 64 mm. The ability to identify correctly each crystal is reported as its resolvability index, (RI), defined as the (crystal response FWHM)/(crystal's separation) in the crystal identification matrix. For the dual layer block RI =0.44, and for dual layer block RI=0.22. The coincidence response resolution for the single layer block varied from 1.23±0.05 mm at the centre of the scanner to 3.09±0.10 mm at 15.8 mm radius, while the dual layer block varied from 1.31±0.06 to 1.96±0.51 mm over the same range, confirming the Monte-Carlo simulations showing reduced radial blurring.
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Affiliation(s)
- C Thompson
- Montreal Neurological Institute, McGill University
| | | | | | | | | | | | - L Ryner
- National Research Council of Canada
| | - V Sossi
- University of British Columbia
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Koo S, Kozlowski P. 1425 PARTIAL NEPHRECTOMY PROVIDES EQUAL OVERALL SURVIVAL AND CANCER-SPECIFIC SURVIVAL RATES TO RADICAL NEPHRECTOMY FOR T1B KIDNEY CANCER. J Urol 2012. [DOI: 10.1016/j.juro.2012.02.1898] [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: 10/28/2022]
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Hsi RA, Moeller RJ, Mitchell M, Bildsten S, Kozlowski P, Porter CR. Clinical outcomes after transperineal template-guided prostate biopsy. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.5_suppl.156] [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: 11/20/2022] Open
Abstract
156 Background: To assess clinical outcomes after transperineal template-guided prostate biopsy (TTPB) including detection rates, pathologic features, clinical relevance and morbidity. Methods: Forty eight men underwent TTPB. All patients had at least one (range 1–4) prior negative transrectal ultrasound-guided (TRUS) prostate biopsy and no prostate cancer diagnosis. The mean pre-biopsy PSA of the entire group was 13.1 ng/ml (range 4.5–46.4). The mean number of cores sampled was 24.7 (range 22–28). Results: The rate of prostate cancer detection was 52% (25/48). Clinically significant prostate cancer, defined as intermediate (n=9) and high (n=11) risk disease using D’Amico criteria, was found in 80% (20/25) of positive biopsy cases. Seventy-two percent of all positive biopsy cores were anatomically located in the anterior or anterolateral positions within the prostate. Urinary retention requiring catheterization after the procedure developed in 6% (3/48) of patients. No patients developed rectal or infectious complications after TTPB. Conclusions: TTPB is a well tolerated procedure resulting in a significant rate of cancer detection. Biopsies were frequently found to be positive in the anterior half of the prostate. Clinically significant disease was found in a high percentage of patients.
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Affiliation(s)
- Richard A. Hsi
- Peninsula Prostate Institute, Poulsbo, WA; Virginia Mason Medical Center, Seattle, WA
| | - Randall James Moeller
- Peninsula Prostate Institute, Poulsbo, WA; Virginia Mason Medical Center, Seattle, WA
| | - Marc Mitchell
- Peninsula Prostate Institute, Poulsbo, WA; Virginia Mason Medical Center, Seattle, WA
| | - Scott Bildsten
- Peninsula Prostate Institute, Poulsbo, WA; Virginia Mason Medical Center, Seattle, WA
| | - Paul Kozlowski
- Peninsula Prostate Institute, Poulsbo, WA; Virginia Mason Medical Center, Seattle, WA
| | - Christopher R. Porter
- Peninsula Prostate Institute, Poulsbo, WA; Virginia Mason Medical Center, Seattle, WA
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Amann C, Geipel A, Müller A, Heep A, Ritgen J, Stressig R, Kozlowski P, Gembruch U, Berg C. Fetal anemia of unknown cause--a diagnostic challenge. Ultraschall Med 2011; 32 Suppl 2:E134-E140. [PMID: 22161617 DOI: 10.1055/s-0031-1281756] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE To assess the spectrum of underlying diseases in cases of fetal anemia in which the cause was unknown at the time of first and second transfusion or thereafter. MATERIALS AND METHODS All patients who underwent intrauterine transfusion were identified in the perinatal databases of two tertiary referral centers for prenatal medicine and treatment between 2002 and June 2010. RESULTS 82 fetuses received intrauterine transfusion in the study period. A total of 356 transfusions were performed in these patients. The causes of fetal anemia in our cohort were alloimmunization (32), parvovirus infection (23), feto-fetal transfusion syndrome (9), sacrococcygeal teratoma (2) and cytomegalovirus infection (1). In the remaining 15 cases, the cause of fetal anemia was unknown at the time of first and second transfusion, and could only be ascertained in the further course of pregnancy, in the postnatal period or was ultimately left in doubt. In all cases markedly elevated peak systolic velocities in the middle cerebral artery accurately predicted fetal anemia. The final diagnosis in these cases was fetomaternal hemorrhage (4), Blackfan-Diamond anemia (1), diffuse neonatal hemangiomatosis with chorangioma (1), kaposi-like hemangioendothelioma (1), elliptocytosis (1), neonatal hemochromatosis (1), mucopolysaccharidosis type VII (1) and in 5 cases the cause of fetal anemia remained unexplained. The latter 5 cases had an uneventful postnatal course and did not require further transfusions in infancy. CONCLUSION In cases of fetal anemia with negative indirect Coombs test and TORCH serology, rare causes of anemia have to be considered. Fetal studies should therefore include reticulocyte count, parameters of hemolysis, peripheral blood smear and fetal liver function tests. Maternal studies should involve a search for fetal red cells using flow cytometry rather than Kleihauer-Betke test.
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Affiliation(s)
- C Amann
- Gynecology and Obstetrics, University Bonn, Bonn, Germany.
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Uhden M, Knippel AJ, Stressig R, Hammer R, Siegmann H, Froehlich S, Kozlowski P. Impact of maternal obesity and maternal overweight on the detection rate of fetal heart defects and the image quality of prenatal echocardiography. Ultraschall Med 2011; 32 Suppl 2:E108-E114. [PMID: 21877317 DOI: 10.1055/s-0031-1281646] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE The purpose of this study was to compare the prenatal detection of four congenital heart defects (CHDs) and the image quality of five corresponding ultrasound planes among obese, overweight and normal-weight women. MATERIALS AND METHODS This was a retrospective cohort study of 54,846 pregnancies undergoing fetal echocardiography between 18 and 37 weeks of gestation in the years from 2000 to 2007. The women were categorized according to pre-pregnancy body mass index (BMI) as normal-weight (BMI < 25), overweight (BMI 25 - 29.9) and obese (BMI ≥ 30). Image quality and prenatal detection of atrioventricular septal defect (AVSD), double outlet right ventricle (DORV), tetralogy of fallot (TOF) and dextro transposition of the great arteries (D-TGA) were evaluated in the BMI strata. RESULTS 108 cases with one of the considered CHDs were identified. The prevalence was significantly higher (relative risk = 2.04) in overweight or obese women (57/19,404 vs. 51/35,442, p < 0.0002) than in normal-weight women. In total 86.1% of CHDs were correctly identified prenatally (93/108, CI: 79.6%-92.6%), 84.3% (43/51) in the normal weight group, 88.6% (39/44) in the overweight group and 84.6% (11/13) in the obese group. The rate of insufficient ultrasound images increased from 6.4% in normal-weight patients to 17.4% in obese women within the 108 CHD cases. CONCLUSION The prenatal detection of fetal AVSD, DORV, TOF and D-TGA was also satisfactory in overweight and obese patients, but image quality substantially decreases with an increasing maternal BMI. If there is a BMI-associated difference in the detection rate, it probably will not exceed 20%.
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Affiliation(s)
- M Uhden
- praenatal.de, Praenatal Medizin und Genetik, Düsseldorf.
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Moroz J, Reinsberg S, Kozlowski P. SU-E-I-128: Evaluation of Magnetic Resonance Phase Data of Projection and 2-D FLASH Acquisition to Estimate the AIF. Med Phys 2011. [DOI: 10.1118/1.3611702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Kozlowski P. Prä- und Perinatalmedizin. Änderungen des Schwangerschaftkonflikt- und des Gendiagnostikgesetzes – Was sind die Folgen in der Praxis und der Klinik? Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1280001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Stressig R, Kozlowski P, Froehlich S, Siegmann HJ, Hammer R, Blumenstock G, Kagan KO. Assessment of the ductus venosus, tricuspid blood flow and the nasal bone in second-trimester screening for trisomy 21. Ultrasound Obstet Gynecol 2011; 37:444-449. [PMID: 20645398 DOI: 10.1002/uog.7749] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To examine the prevalence of reversed a-wave in the ductus venosus, tricuspid regurgitation and absent nasal bone, in a second-trimester population undergoing amniocentesis, after exclusion of major fetal defects and to estimate the performance in screening for trisomy 21 based on maternal age and these markers in a general population. METHODS This was a retrospective study involving pregnancies undergoing amniocentesis due to increased risk for trisomy 21, mainly because of advanced maternal age. Before the invasive procedure, an ultrasound examination was carried out to exclude major fetal defects and to examine the ductus venosus, tricuspid blood flow and the presence of the fetal nasal bone. Modeling techniques were used based on 20 000 euploid pregnancies and 20 000 pregnancies with trisomy 21 to assess the screening performance in a general population. RESULTS The study population consisted of 3613 euploid pregnancies and 35 cases with trisomy 21. In the euploid group, reversed flow in the ductus venosus, tricuspid regurgitation and an absent nasal bone was observed in 1.7%, 1.5% and 0.1% of cases, respectively. In the trisomic group, these markers were found in 14.3%, 11.4% and 14.3% of cases, respectively. For a 5% false-positive rate, the detection rate in screening for trisomy 21, based on maternal age and either ductus venosus, tricuspid blood flow or nasal bone would be 33.8%, 32.4% or 31.4%, respectively. Screening by maternal age alone would detect 29.0% of the fetuses with trisomy 21. Receiver-operating characteristics curve analysis showed a slight but significant improvement in screening performance for trisomy 21 based on the inclusion of these markers. CONCLUSION Second-trimester ultrasound screening for trisomy 21 based on maternal age with additional assessment of the ductus venosus, tricuspid blood flow and the fetal nasal bone in otherwise normal-appearing fetuses is only marginally better than is screening by maternal age alone.
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Affiliation(s)
- R Stressig
- Praenatal.de - Praenatal Medicine and Genetics, Duesseldorf/Cologne, Germany
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Dokumaci O, Ronsheim P, D'emic C, Domenicucci AG, Hegde S, Kozlowski P, Wong HSP. Transient Enhanced Diffusion and Dose Loss of Indium in Silicon. ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-568-205] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
ABSTRACTThe dose loss and transient enhanced diffusion of indium in silicon were studied as a function of dose. Indium was implanted into silicon through a 90 A oxide at 50 keV for doses ranging from 3x 1012 to 2x14 cm−2. These conditions provide peak concentrations that approximately range from 1x1018-1x1020 cm−3. After an RTA anneal at 1000°C for 5s, indium exhibits substantial motion at both the tail and peak regions for high doses. The enhanced diffusion is mostly over within 5s. There was not any observable enhanced diffusion in the tail region at the lowest dose although there was significant movement at the peak region. The dose loss correlates very well with the enhancement in the diffusivity. TEM images show that the amorphization dose lies between 3x1013 and 8x1013 cm−2. In spite of the amorphization, diffusion enhancement in the tail region still keeps increasing with dose, which is contrary to a model of “+1” interstitials and complete removal of interstitials in the regrown layer. The 550°C lh anneals show that the dose loss can partially be attributed to the sweeping of the dopant by the growing a/c interface. Previously, the solubility of indium has been estimated to be around 1–2×1018 cm−3. At high doses, significant movement is observed at the peak of the indium profile although the peak concentration exceeds the solubility level by at least an order of magnitude. This shows that indium is not precipitating into an immobile phase like antimony or boron.
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Lukasewycz S, Holman M, Kozlowski P, Porter CR, Odom E, Bernards C, Neil N, Corman JM. Does a perioperative belladonna and opium suppository improve postoperative pain following robotic assisted laparoscopic radical prostatectomy? Results of a single institution randomized study. Can J Urol 2010; 17:5377-5382. [PMID: 20974030] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Robotic assisted laparoscopic radical prostatectomy (RALP) is a common treatment for localized prostate cancer. Despite a primary advantage of improved postoperative pain, patients undergoing RALP still experience discomfort. Belladonna, containing the muscarinic receptor antagonists atropine and scopolamine, in combination with opium as a rectal suppository (B & O) may improve post-RALP pain. This study evaluates whether a single preoperative B & O results in decreased postoperative patient-reported pain and analgesic requirements. MATERIALS AND METHODS Patients undergoing RALP at Virginia Mason Medical Center between November 2008 and July 2009 were offered the opportunity to enter a randomized, double-blind, placebo-controlled trial. Exclusion criteria included: glaucoma, bronchial asthma, convulsive disorders, chronic pain, chronic use of analgesics, or a history of alcohol or opioid dependency. Surgeons were blinded to suppository placement which was administered after induction of anesthesia. All patients underwent a standardized anesthesia regimen. Postoperative pain was assessed by a visual analog scale (VAS) and postoperative narcotic use was calculated in intravenous morphine equivalents. RESULTS Ninety-nine patients were included in the analysis. The B & O and control groups were not significantly different in terms of age, body mass index, operative time, nerve sparing status or prostatic volume. Postoperative pain was significantly improved during the first two postoperative hours in the B & O group. Similarly, 24-hour morphine consumption was significantly lower in patients who received a B & O. No adverse effects secondary to suppository placement were identified. CONCLUSION Preoperative administration of B & O suppository results in significantly decreased postoperative pain and 24-hour morphine consumption in patients undergoing RALP.
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Berg C, Lachmann R, Kaiser C, Kozlowski P, Stressig R, Schneider M, Asfour B, Herberg U, Breuer J, Gembruch U, Geipel A. Prenatal diagnosis of tricuspid atresia: intrauterine course and outcome. Ultrasound Obstet Gynecol 2010; 35:183-190. [PMID: 20101636 DOI: 10.1002/uog.7499] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To evaluate the intrauterine course and outcome of tricuspid atresia detected in the fetus. METHODS This was a retrospective review of all confirmed cases of tricuspid atresia detected prenatally between 1998 and 2006 in three tertiary referral centers in Germany. RESULTS Fifty-four cases of tricuspid atresia were detected prenatally during the study period and confirmed postnatally: 28 (51.9%) cases had a concordant ventriculoarterial connection of which 14 also had pulmonary outflow obstruction; 25 (46.3%) cases had a discordant ventriculoarterial connection of which 14 also had aortic outflow obstruction, six had pulmonary outflow tract obstruction and two had other associated intracardiac anomalies; and one (1.9%) had a common arterial trunk. The peak velocity index for veins in the ductus venosus was significantly elevated in 19 of the 37 (51.4%) cases assessed; however, this finding did not correlate with adverse intrauterine outcome. There were associated extracardiac anomalies in 12 cases: five with chromosomal anomalies, two with VACTERL association, one with unilateral renal agenesis, one with hypospadia, one with hydrothorax, one with megacystis and one with agenesis of the ductus venosus. Seventeen of the 54 (31.5%) cases underwent termination of pregnancy, two (3.7%) died in utero, two (3.7%) died in infancy and 33 (61.1%) children survived with a median follow-up of 26 (range, 12-120) months. Prenatal echocardiography correctly anticipated the postnatal course and the need for neonatal intervention in 29/35 (82.9%) continued pregnancies; in the remaining six (17.1%) cases the right outflow tract obstruction had been underestimated. CONCLUSIONS Tricuspid atresia and the frequently associated intracardiac anomalies can be diagnosed in the fetus with considerable accuracy. A thorough search for extracardiac malformations should be performed in order to rule out chromosomal anomalies and multiple malformation syndromes. Elevated pulsatility in the ductus venosus does not indicate cardiac failure. The short-term overall survival in continued pregnancies in our study exceeded 89%, with the greatest rate of loss being in the first year of postnatal life.
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Affiliation(s)
- C Berg
- Department of Obstetrics and Prenatal Medicine University of Bonn, Bonn, Germany.
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Kannanganat S, Nigam P, Velu V, Earl P, Lai L, Lawson B, Chennareddi L, Wilson R, Kozlowski P, Moss B, Robinson H, Amara R. OA07-03. Influence of preexisting vaccinia immunity on a DNA/MVA SIV vaccine, decreased cellular immunity but enhanced control of a pathogenic SIV challenge. Retrovirology 2009. [PMCID: PMC2767575 DOI: 10.1186/1742-4690-6-s3-o51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Menges V, Kozlowski P, Baltensweiler J. Posttraumatisches epidurales Hämatom mit arteriovenöser Fistel der Arteria meningica media. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1229631] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bizjak G, Blondin D, Hammer R, Kozlowski P, Siegmann HJ, Stressig R. Acute infection with parvovirus B19 in early pregnancy. Ultrasound Obstet Gynecol 2009; 34:234-235. [PMID: 19644946 DOI: 10.1002/uog.6454] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Kohl T, Tchatcheva K, Stressig R, Weinbach J, Kozlowski P, Gembruch U. Frühe klinische Erfahrungen mit der partiellen amniotischen Kohlendioxid-Insufflation (PACI) während fetoskopischer Fetalchirurgie. Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1223126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Knüppel M, Knippel A, Janni W, Kozlowski P. Pränatale Diagnostik und neonatales Outcome bei fetaler Gastroschisis. Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1222763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kohl T, Stressig R, Tchatcheva K, Kozlowski P, Gembruch U. Materno-fetale Hyperoxygenierung führt zur Größenzunahme hypoplastischer Linksherzstrukturen bei Ungeborenen. Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1222805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Stressig R, Gembruch U, Germer U, Kozlowski P, Kohl T. Fetoskopische Fetalchirurgie beim Amnionbandsyndrom – Schlussfolgerungen zur Behandlungsindikation anhand dreier Fälle. Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1223127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ritgen J, Kozlowski P, Stressig R. Tissue Doppler Imaging: Die Messung fetaler kardialer Zeitintervalle – Korrelation mit magnetokardiographischen Daten. Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1222916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Vuky J, Porter C, Isacson C, Vaughan M, Kozlowski P, Picozzi V, Corman J. Phase II trial of neoadjuvant docetaxel and gefitinib followed by radical prostatectomy in patients with high-risk, locally advanced prostate cancer. Cancer 2009; 115:784-91. [DOI: 10.1002/cncr.24092] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Greaves L, Gilbart M, Yung A, Kozlowski P, Wilson D. Deformation and recovery of cartilage in the intact hip under physiological loads using 7T MRI. J Biomech 2009; 42:349-54. [DOI: 10.1016/j.jbiomech.2008.11.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2008] [Revised: 11/15/2008] [Accepted: 11/23/2008] [Indexed: 11/26/2022]
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