1
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Kukla A, Kudva YC, Navratil P, Sahi SS, Benzo RP, Fipps DC, Erickson AE, Majorowicz RR, Clark MM, Schinstock CA, Shah P, Shah M, Diwan TS. Management of Patients With Kidney Disease Undergoing Bariatric Surgery: A Multidisciplinary Approach. Mayo Clin Proc 2024; 99:445-458. [PMID: 38432750 DOI: 10.1016/j.mayocp.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/17/2023] [Accepted: 11/14/2023] [Indexed: 03/05/2024]
Abstract
Bariatric surgery is increasingly recognized as a safe and effective treatment for obesity in patients with chronic kidney disease (CKD), including stages 4, 5, and 5D (on dialysis). Among the available surgical methods, sleeve gastrectomy (SG) is the most commonly performed weight loss procedure and is mainly done to facilitate kidney transplantation (KT). However, many KT candidates treated with SG remain on the transplant waiting list for months to years, with some never receiving a transplant. Therefore, appropriate candidates for SG must be selected, and post-SG management should address the unique needs of this population, with a focus on sustaining the metabolic benefits of surgery while minimizing potential side effects related to rapid weight loss which may inadvertently lead to muscle and bone catabolism. Multidisciplinary post-SG care in this population may lead to overall better health on the transplant waiting list, resulting in a higher percentage of post-SG patients ultimately receiving KT. To tailor the effective treatment for these patients, clinicians should acknowledge that patients with CKD stage 4-5D have different nutritional needs and are metabolically and psychosocially distinct from the general bariatric surgery population. Sarcopenia is highly prevalent and may be exacerbated by muscle catabolism following SG if not adequately addressed. Blood pressure, glucose, and bone metabolism are all affected by the CKD stage 4-5D, and therefore require distinct diagnostic and management approaches. Long-standing chronic disease, associated comorbidities, and low adherence to medical therapies require ongoing comprehensive psychosocial assessment and support. This paper aims to review and consolidate the existing literature concerning the intersection of CKD stage 4-5D and the consequences of SG. We also suggest future clinical outcome studies examining novel treatment approaches for this medically complex population.
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Affiliation(s)
- Aleksandra Kukla
- Department of Medicine, Division of Nephrology and Hypertension, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN, USA; Von Liebig Transplant Center, Department of Transplantation Surgery, Mayo Clinic, MN, USA.
| | - Yogish C Kudva
- Department of Medicine, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, MN, USA
| | - Pavel Navratil
- Department of Medicine, Division of Nephrology and Hypertension, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN, USA; Department of Urology, University Hospital Hradec Kralove, and Charles University, Faculty of Medicine in Hradec Kralove, Czechia
| | - Sukhdeep S Sahi
- Department of Medicine, Division of Nephrology and Hypertension, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
| | - Roberto P Benzo
- Division of Pulmonary & Critical Care Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
| | - David C Fipps
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
| | - Avery E Erickson
- Department of Medicine, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, MN, USA
| | - Rachael R Majorowicz
- Department of Medicine, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, MN, USA
| | - Matthew M Clark
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN, USA; Department of Medicine, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, MN, USA
| | - Carrie A Schinstock
- Department of Medicine, Division of Nephrology and Hypertension, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN, USA; Von Liebig Transplant Center, Department of Transplantation Surgery, Mayo Clinic, MN, USA
| | - Pankaj Shah
- Department of Medicine, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, MN, USA
| | - Meera Shah
- Department of Medicine, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, MN, USA
| | - Tayyab S Diwan
- Von Liebig Transplant Center, Department of Transplantation Surgery, Mayo Clinic, MN, USA
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2
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Hollunder B, Ostrem JL, Sahin IA, Rajamani N, Oxenford S, Butenko K, Neudorfer C, Reinhardt P, Zvarova P, Polosan M, Akram H, Vissani M, Zhang C, Sun B, Navratil P, Reich MM, Volkmann J, Yeh FC, Baldermann JC, Dembek TA, Visser-Vandewalle V, Alho EJL, Franceschini PR, Nanda P, Finke C, Kühn AA, Dougherty DD, Richardson RM, Bergman H, DeLong MR, Mazzoni A, Romito LM, Tyagi H, Zrinzo L, Joyce EM, Chabardes S, Starr PA, Li N, Horn A. Mapping dysfunctional circuits in the frontal cortex using deep brain stimulation. Nat Neurosci 2024; 27:573-586. [PMID: 38388734 PMCID: PMC10917675 DOI: 10.1038/s41593-024-01570-1] [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: 03/02/2023] [Accepted: 01/05/2024] [Indexed: 02/24/2024]
Abstract
Frontal circuits play a critical role in motor, cognitive and affective processing, and their dysfunction may result in a variety of brain disorders. However, exactly which frontal domains mediate which (dys)functions remains largely elusive. We studied 534 deep brain stimulation electrodes implanted to treat four different brain disorders. By analyzing which connections were modulated for optimal therapeutic response across these disorders, we segregated the frontal cortex into circuits that had become dysfunctional in each of them. Dysfunctional circuits were topographically arranged from occipital to frontal, ranging from interconnections with sensorimotor cortices in dystonia, the primary motor cortex in Tourette's syndrome, the supplementary motor area in Parkinson's disease, to ventromedial prefrontal and anterior cingulate cortices in obsessive-compulsive disorder. Our findings highlight the integration of deep brain stimulation with brain connectomics as a powerful tool to explore couplings between brain structure and functional impairments in the human brain.
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Affiliation(s)
- Barbara Hollunder
- Movement Disorders and Neuromodulation Unit, Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Einstein Center for Neurosciences Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jill L Ostrem
- Movement Disorders and Neuromodulation Centre, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Ilkem Aysu Sahin
- Movement Disorders and Neuromodulation Unit, Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Einstein Center for Neurosciences Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Nanditha Rajamani
- Movement Disorders and Neuromodulation Unit, Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Simón Oxenford
- Movement Disorders and Neuromodulation Unit, Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Konstantin Butenko
- Center for Brain Circuit Therapeutics, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Clemens Neudorfer
- Center for Brain Circuit Therapeutics, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Pablo Reinhardt
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Patricia Zvarova
- Movement Disorders and Neuromodulation Unit, Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Einstein Center for Neurosciences Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Mircea Polosan
- Université Grenoble Alpes, Grenoble, France
- Inserm, U1216, Grenoble Institut des Neurosciences, Grenoble, France
- Department of Psychiatry, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Harith Akram
- Unit of Functional Neurosurgery, UCL Queen Square Institute of Neurology, London, UK
- Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Matteo Vissani
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Chencheng Zhang
- Department of Neurosurgery, Rujin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bomin Sun
- Department of Neurosurgery, Rujin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Pavel Navratil
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Martin M Reich
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Jens Volkmann
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Fang-Cheng Yeh
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Juan Carlos Baldermann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Till A Dembek
- Center for Brain Circuit Therapeutics, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Veerle Visser-Vandewalle
- Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | | | | | - Pranav Nanda
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Carsten Finke
- Einstein Center for Neurosciences Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Andrea A Kühn
- Movement Disorders and Neuromodulation Unit, Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Einstein Center for Neurosciences Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
- NeuroCure Cluster of Excellence, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Darin D Dougherty
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - R Mark Richardson
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Hagai Bergman
- Edmond and Lily Safra Center for Brain Sciences, The Hebrew University, Jerusalem, Israel
- Department of Medical Neurobiology, Institute of Medical Research Israel-Canada, The Hebrew University, Hadassah Medical School, Jerusalem, Israel
- Department of Neurosurgery, Hadassah Medical Center, Jerusalem, Israel
| | - Mahlon R DeLong
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Alberto Mazzoni
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Luigi M Romito
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Himanshu Tyagi
- Unit of Functional Neurosurgery, UCL Queen Square Institute of Neurology, London, UK
- Department of Neuropsychiatry, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Ludvic Zrinzo
- Unit of Functional Neurosurgery, UCL Queen Square Institute of Neurology, London, UK
- Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Eileen M Joyce
- Unit of Functional Neurosurgery, UCL Queen Square Institute of Neurology, London, UK
- Department of Neuropsychiatry, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Stephan Chabardes
- Université Grenoble Alpes, Grenoble, France
- Inserm, U1216, Grenoble Institut des Neurosciences, Grenoble, France
- Department of Neurosurgery, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Philip A Starr
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA
| | - Ningfei Li
- Movement Disorders and Neuromodulation Unit, Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
| | - Andreas Horn
- Movement Disorders and Neuromodulation Unit, Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
- Einstein Center for Neurosciences Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany.
- Center for Brain Circuit Therapeutics, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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3
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Navratil P, Sahi S, Spacek J, Pacovsky J, Lesko M, Gunka I, Astapenko D. Pyelovesicostomy as an Alternative Surgical Treatment for Complex Ureteral Lesions After Kidney Transplant. EXP CLIN TRANSPLANT 2023; 21:712-716. [PMID: 37885285 DOI: 10.6002/ect.2023.0204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
OBJECTIVES We evaluated the feasibility, safety, and long-term outcomes of pyelovesicostomy as an alternative surgical treatment for complex ureteral lesions after kidney transplant. MATERIALS AND METHODS A single-center, retrospective, observational cohort study was conducted on 5 adult kidney transplant recipients who underwent pyelovesicostomy between January 2000 and June 2023. The collected data included patient demographics, surgery indication, time from transplant to pyelovesicostomy, procedure details, and kidney function at various time points after surgery. Primary outcomes were allograft function and complications. RESULTS The 5 patients (4 female, 1 male) had a mean age of 65.8 years and mean body mass index of 26.8. Indications were complex ureteral lesions. The time between transplant and reoperation ranged from 4 days to 12 years. Renal function improved for all patients, with a progressive decrease in mean serum creatinine concentration. The mean follow-up period extended to 7 years. One patient died with the graft still functional at 20 years after the operation, whereas the remaining 4 patients continue to live with functional grafts. CONCLUSIONS Our study suggests that pyelovesicostomy may provide a potent alternative for the management of complex ureteral lesions after kidney transplant. We have observed good short-term and long-term outcomes in specific patients, pointing toward a promising avenue oftreatment worth further exploration. This reaffirms the importance of a personalized approach in medicine, to consider each patient's unique conditions and characteristics during therapeutic decisions.
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Affiliation(s)
- Pavel Navratil
- From the Department of Urology, University Hospital Hradec Kralove, Czech Republic; the Charles University, Faculty of Medicine, Hradec Kralove, Czech Republic
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4
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Hollunder B, Ostrem JL, Sahin IA, Rajamani N, Oxenford S, Butenko K, Neudorfer C, Reinhardt P, Zvarova P, Polosan M, Akram H, Vissani M, Zhang C, Sun B, Navratil P, Reich MM, Volkmann J, Yeh FC, Baldermann JC, Dembek TA, Visser-Vandewalle V, Alho EJL, Franceschini PR, Nanda P, Finke C, Kühn AA, Dougherty DD, Richardson RM, Bergman H, DeLong MR, Mazzoni A, Romito LM, Tyagi H, Zrinzo L, Joyce EM, Chabardes S, Starr PA, Li N, Horn A. Mapping Dysfunctional Circuits in the Frontal Cortex Using Deep Brain Stimulation. medRxiv 2023:2023.03.07.23286766. [PMID: 36945497 PMCID: PMC10029043 DOI: 10.1101/2023.03.07.23286766] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Frontal circuits play a critical role in motor, cognitive, and affective processing - and their dysfunction may result in a variety of brain disorders. However, exactly which frontal domains mediate which (dys)function remains largely elusive. Here, we study 534 deep brain stimulation electrodes implanted to treat four different brain disorders. By analyzing which connections were modulated for optimal therapeutic response across these disorders, we segregate the frontal cortex into circuits that became dysfunctional in each of them. Dysfunctional circuits were topographically arranged from occipital to rostral, ranging from interconnections with sensorimotor cortices in dystonia, with the primary motor cortex in Tourette's syndrome, the supplementary motor area in Parkinson's disease, to ventromedial prefrontal and anterior cingulate cortices in obsessive-compulsive disorder. Our findings highlight the integration of deep brain stimulation with brain connectomics as a powerful tool to explore couplings between brain structure and functional impairment in the human brain.
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Affiliation(s)
- Barbara Hollunder
- Department of Neurology, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Einstein Center for Neurosciences Berlin, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jill L. Ostrem
- Movement Disorders and Neuromodulation Centre, Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Ilkem Aysu Sahin
- Department of Neurology, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Einstein Center for Neurosciences Berlin, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Nanditha Rajamani
- Department of Neurology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Simón Oxenford
- Department of Neurology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Konstantin Butenko
- Center for Brain Circuit Therapeutics, Department of Neurology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Clemens Neudorfer
- Center for Brain Circuit Therapeutics, Department of Neurology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Pablo Reinhardt
- Department of Psychiatry and Psychotherapy, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Patricia Zvarova
- Department of Neurology, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Einstein Center for Neurosciences Berlin, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Mircea Polosan
- Univ. Grenoble Alpes, Grenoble, France
- Inserm, U1216, Grenoble Institut des Neurosciences, Grenoble, France
- Psychiatry Department, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Harith Akram
- Department of Clinical and Movement Neurosciences, University College London Queen Square Institute of Neurology, London, UK
- National Hospital for Neurology and Neurosurgery, University College London Queen Square Institute of Neurology, London, UK
| | - Matteo Vissani
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- The BioRobotics Institute, Scuola Superiore Sant’Anna, Pisa, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Chencheng Zhang
- Department of Neurosurgery, Rujin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bomin Sun
- Department of Neurosurgery, Rujin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Pavel Navratil
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Martin M. Reich
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Jens Volkmann
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Fang-Cheng Yeh
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Juan Carlos Baldermann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Till A. Dembek
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Veerle Visser-Vandewalle
- Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | | | | | - Pranav Nanda
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Carsten Finke
- Department of Neurology, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Einstein Center for Neurosciences Berlin, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Andrea A. Kühn
- Department of Neurology, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Einstein Center for Neurosciences Berlin, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
- NeuroCure Cluster of Excellence, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Darin D. Dougherty
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - R. Mark Richardson
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Hagai Bergman
- The Edmond and Lily Safra Center for Brain Sciences, The Hebrew University, Jerusalem, Israel
- Department of Medical Neurobiology, Institute of Medical Research Israel-Canada, The Hebrew University, Hassadah Medical School, Jerusalem, Israel
- Department of Neurosurgery, Hadassah Medical Center, Jerusalem, Israel
| | - Mahlon R. DeLong
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Alberto Mazzoni
- The BioRobotics Institute, Scuola Superiore Sant’Anna, Pisa, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Luigi M. Romito
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Himanshu Tyagi
- Department of Clinical and Movement Neurosciences, University College London Queen Square Institute of Neurology, London, UK
- National Hospital for Neurology and Neurosurgery, University College London Queen Square Institute of Neurology, London, UK
| | - Ludvic Zrinzo
- Department of Clinical and Movement Neurosciences, University College London Queen Square Institute of Neurology, London, UK
- National Hospital for Neurology and Neurosurgery, University College London Queen Square Institute of Neurology, London, UK
| | - Eileen M. Joyce
- Department of Clinical and Movement Neurosciences, University College London Queen Square Institute of Neurology, London, UK
- National Hospital for Neurology and Neurosurgery, University College London Queen Square Institute of Neurology, London, UK
| | - Stephan Chabardes
- Univ. Grenoble Alpes, Grenoble, France
- Inserm, U1216, Grenoble Institut des Neurosciences, Grenoble, France
- Department of Neurosurgery, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Philip A. Starr
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Ningfei Li
- Department of Neurology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Horn
- Department of Neurology, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Einstein Center for Neurosciences Berlin, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Center for Brain Circuit Therapeutics, Department of Neurology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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5
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Astapenko D, Hyspler R, Ticha A, Tomasova A, Navratil P, Zrzavecky M, Byreddy B, Sedlacek P, Radochova V, Skulec R, Hahn RG, Lehmann C, Malbrain MLNG, Cerny V. Protection of the endothelium and endothelial glycocalyx by hydrogen against ischaemia-reperfusion injury in a porcine model of cardiac arrest. Clin Hemorheol Microcirc 2023; 85:135-146. [PMID: 37694356 DOI: 10.3233/ch-231768] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
BACKGROUND Hydrogen is a potent antioxidant agent that can easily be administered by inhalation. The aim of the study was to evaluate whether hydrogen protects the endothelial glycocalyx layer after successful cardiopulmonary resuscitation (CPR). METHODS Fourteen anesthetized pigs underwent CPR after induced ventricular fibrillation. During CPR and return of spontaneous circulation, 2% hydrogen gas was administered to seven pigs (hydrogen group) and seven constituted a control group. Biochemistry and sublingual microcirculation were assessed at baseline, during CPR, at the 15th, 30th, 60th, 120th minute. RESULTS All seven subjects from the hydrogen group and six subjects in the control group were successfully resuscitated after 6-10 minutes. At baseline, there were no statistically significant differences in examined variables. After the CPR, blood pH, base excess, and lactate showed significantly smaller deterioration in the hydrogen group than in the control group. By contrast, plasma syndecan-1 and the measured variables obtained via sublingual microcirculation did not change after the CPR; and were virtually identical between the two groups. CONCLUSION In pigs, hydrogen gas inhalation during CPR and post-resuscitation care was associated with less pronounced metabolic acidosis compared to controls. However, we could not find evidence of injury to the endothelium or glycocalyx in any studied groups.
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Affiliation(s)
- David Astapenko
- Department of Anesthesiology, Resuscitation, and Intensive Care Medicine, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
- Faculty of Medicine in Hradec Kralove, Charles University, Prague Czech Republic
- Faculty of Health Studies, Technical University in Liberec, Liberec, Czech Republic
| | - Radomir Hyspler
- Faculty of Medicine in Hradec Kralove, Charles University, Prague Czech Republic
- Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Alena Ticha
- Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Adela Tomasova
- Faculty of Medicine in Hradec Kralove, Charles University, Prague Czech Republic
- Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Pavel Navratil
- Faculty of Medicine in Hradec Kralove, Charles University, Prague Czech Republic
- Department of Urology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Marek Zrzavecky
- Faculty of Medicine in Hradec Kralove, Charles University, Prague Czech Republic
| | - Bhavya Byreddy
- Faculty of Medicine in Hradec Kralove, Charles University, Prague Czech Republic
| | - Petr Sedlacek
- Faculty of Medicine in Hradec Kralove, Charles University, Prague Czech Republic
| | - Vera Radochova
- Faculty of Military Health Sciences, University of Defence, Brno, Czech Republic
| | - Roman Skulec
- Department of Anesthesiology, Resuscitation, and Intensive Care Medicine, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
- Faculty of Medicine in Hradec Kralove, Charles University, Prague Czech Republic
- Department of Anesthesiology, Perioperative Medicine, and Intensive Care Medicine, University of J. E. Purkyne in Usti nad Labem, Masaryk Hospital in Usti nad Labem, Usti nad Labem, Czech Republic
- Institute of Postgradual Education in Healthcare, Prague, Czech Republic
- Department of Emergency Medicine, Hospital Bory, Bratislava, Slovak Republic
| | - Robert G Hahn
- Karolinska Institutet at Danderyds Hospital (KIDS), Stockholm, Sweden
| | - Christian Lehmann
- Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada
- Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
- Department of Physiology and Biophysics, Dalhousie University, Halifax, NS, Canada
| | - Manu L N G Malbrain
- First Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland
- Medical Data Management, Medaman, Pas, Geel, Belgium
- International Fluid Academy, Lovenjoel, Belgium
| | - Vladimir Cerny
- Department of Anesthesiology, Resuscitation, and Intensive Care Medicine, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
- Faculty of Medicine in Hradec Kralove, Charles University, Prague Czech Republic
- Faculty of Health Studies, Technical University in Liberec, Liberec, Czech Republic
- Department of Anesthesiology, Perioperative Medicine, and Intensive Care Medicine, University of J. E. Purkyne in Usti nad Labem, Masaryk Hospital in Usti nad Labem, Usti nad Labem, Czech Republic
- Institute of Postgradual Education in Healthcare, Prague, Czech Republic
- Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada
- Department of Anesthesiology, Perioperative Medicine and Intensive Care, Hospital Bory, Bratislava, Slovak Republic
- Department of Anesthesiology and Resuscitation, University Hospital Kralovske Vinohrady, Prague, Czech Republic
- Constantine the Philosopher University in Nitra, Faculty of Social Sciences and Health Care, Nitra, Slovak Republic
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6
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Navratilova J, Navratil P, Punova M. The Well-being of Children and Young People: The Context of Social Services from the Perspective of the Capability Approach. CSWHI 2021. [DOI: 10.22359/cswhi_12_4_06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective:The aim of this article is to understand how social services contribute to the well-being of children and young people who use them. Method:The research study, based on Capability Approach, was done using amixed-research strategy. Participants:The collection of data took place through 44 in- depth semi-structured interviews with children, young people and their parents/foster parents who use social services in one of the regional capitals of the Czech Republic. Results:Parents at risk underrate their role in loving and caring for their children. Parents at risk are more likely than children to undervalue education. Social services do not develop young- sters’ capability to live ameaningful life. Conclusion: The research has shown that although social serv- ices have significant potential to ensure well-being for children and youth, they work primarily in away that provides clients with basic social functioning in the present, without influencing their future positively.
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7
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Astapenko D, Ticha A, Hyspler R, Tomasova A, Navratil P, Maly O, Parizkova RC, Cizkova D, Huey SC, Lehmann C, Malbrain MLNG, Cerny V. A porcine model of endothelial glycocalyx damage by enzymatic digestion: A pilot study. Clin Hemorheol Microcirc 2021; 78:325-338. [PMID: 33843666 DOI: 10.3233/ch-211133] [Citation(s) in RCA: 1] [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: 12/29/2022]
Abstract
BACKGROUND The endothelial glycocalyx (EG) plays a vital role in the physiology and pathophysiology of human microcirculation. Having relevant EG damage model would be important tool for testing new interventions aiming at EG protection and recovery. We describe the first in vivo EG damage model in pig. OBJECTIVE To investigate the course of animal EG damage induced by specific enzymes. MATERIAL AND METHODS Four anesthetized piglets received enzymes: 1g hyaluronidase and 25 IU heparanase I intravenously. Blood and urine samples were collected at baseline and 20/40/60/80/100/120 min for detecting markers of endothelial and EG function. Sublingual microcirculation and EG thickness were assessed by Side-stream Dark Field (SDF) imaging and Perfused Boundary Region (PBR) respectively. EG of the mesentery artery was visualized in fluorescent microscopy. RESULTS Biochemical marker of EG damage syndecan-1 showed temporary increase with return to baseline and was reflected by PBR values. Albumin levels suggested brief period of capillary leakage (decrease in the serum, increase in the urine) with a trend to normalization. Urine glycosaminoglycans peaked at 120 minutes. Microcirculatory perfusion parameter showed significant alteration. Diffusion parameters were altered with no statistical significance. CONCLUSION EG damage induced by specific enzymes was reflected by temporary changes of biochemical makers together with alteration of microcirculation and changes in fluorescent microscopy of EG layer. Our results support to further validate presented model of EG damage on a larger number of animals.
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Affiliation(s)
- David Astapenko
- Department of Anesthesiology, Resuscitation and Intensive Care Medicine, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.,Faculty of Medicine in Hradec Kralove, Charles University, Prague, Czech Republic
| | - Alena Ticha
- Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Radomir Hyspler
- Faculty of Medicine in Hradec Kralove, Charles University, Prague, Czech Republic.,Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Adela Tomasova
- Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Pavel Navratil
- Faculty of Medicine in Hradec Kralove, Charles University, Prague, Czech Republic.,Department of Urology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Ondrej Maly
- Faculty of Medicine in Hradec Kralove, Charles University, Prague, Czech Republic.,Department of Surgery, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.,Faculty of Military Health Sciences, University of Defense Brno, Brno, Czech Republic
| | - Renata Cerna Parizkova
- Department of Anesthesiology, Resuscitation and Intensive Care Medicine, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.,Faculty of Medicine in Hradec Kralove, Charles University, Prague, Czech Republic
| | - Dana Cizkova
- Department of Histology and Embryology, Faculty of Medicine in Hradec Kralove, Charles University, Prague, Czech Republic
| | - Shin Chua Huey
- Faculty of Medicine in Hradec Kralove, Charles University, Prague, Czech Republic
| | - Christian Lehmann
- Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada
| | - Manu L N G Malbrain
- Faculty of Engineering, Dept. of Electronics and Informatics, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,International Fluid Academy, Lovenjoel, Belgium
| | - Vladimir Cerny
- Department of Anesthesiology, Resuscitation and Intensive Care Medicine, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.,Faculty of Medicine in Hradec Kralove, Charles University, Prague, Czech Republic.,Department of Anesthesiology, Perioperative Medicine and Intensive Care, J.E. Purkinje University, Masaryk Hospital, Usti nad Labem, Czech Republic.,Centrum for Research and Development, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.,Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada
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8
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Astapenko D, Navratil P, Pouska J, Cerny V. Clinical physiology aspects of chloremia in fluid therapy: a systematic review. Perioper Med (Lond) 2020; 9:40. [PMID: 33298166 PMCID: PMC7727154 DOI: 10.1186/s13741-020-00171-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 09/29/2020] [Accepted: 11/30/2020] [Indexed: 11/10/2022] Open
Abstract
Background This systematic review discusses a clinical physiology aspect of chloride in fluid therapy. Crystalloid solutions are one of the most widely used remedies. While generally used in medicine for almost 190 years, studies focused largely on their safety have only been published since the new millennium. The most widely used solution, normal saline, is most often referred to in this context. Its excessive administration results in hyperchloremic metabolic acidosis with other consequences, including higher mortality rates. Methods Original papers and review articles eligible for developing the present paper were identified by searching online in the electronic MEDLINE database. The keywords searched for included hyperchloremia, hypochloremia, and compound words containing the word “chloride,” infusion therapy, metabolic acidosis, renal failure, and review. Results A total of 21,758 papers published before 31 May 2020 were identified; of this number, 630 duplicates were removed from the list. Upon excluding articles based on their title or abstract, 1850 papers were screened, of which 63 full-text articles were assessed. Conclusions According to the latest medical concepts, dyschloremia (both hyperchloremia and hypochloremia) represents a factor indisputably having a negative effect on selected variables of clinical outcome. As infusion therapy can significantly impact chloride homeostasis of the body, the choice of infusion solutions should always take into account the potentially adverse impact of chloride content on chloremia and organ function.
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Affiliation(s)
- David Astapenko
- Department of Anesthesiology, Resuscitation and Intensive Care Medicine, University Hospital Hradec Kralove, Sokolská 581, 500 05, Hradec Kralove, Czech Republic. .,Faculty of Medicine in Hradec Kralove, Charles University, Prague, Czech Republic.
| | - Pavel Navratil
- Faculty of Medicine in Hradec Kralove, Charles University, Prague, Czech Republic.,Department of Urology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Jiri Pouska
- Department of Anesthesiology, Resuscitation and Intensive Care Medicine, University Hospital Plzen, Plzen, Czech Republic.,Faculty of Medicine in Plzen, Charles University, Plzen, Czech Republic
| | - Vladimir Cerny
- Department of Anesthesiology, Resuscitation and Intensive Care Medicine, University Hospital Hradec Kralove, Sokolská 581, 500 05, Hradec Kralove, Czech Republic.,Faculty of Medicine in Hradec Kralove, Charles University, Prague, Czech Republic.,Department of Anesthesiology, Perioperative and Intensive Care Medicine, Faculty of Healthcare Studies, J. E. Purkyne University in Usti nad Labem and Krajska zdravotni a.s. (Regional Healthcare JSC), Masaryk Hospital in Usti nad Labem, Usti nad Labem, Czech Republic.,Center of Research and Development, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.,Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada.,Technical University in Liberec, Liberec, Czech Republic
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9
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Divoky M, Pilar J, Hanus M, Navratil P, Sawicka-Chyla M, De Vido M, Phillips PJ, Ertel K, Butcher T, Fibrich M, Green JT, Koselja M, Preclikova J, Kubat J, Houzvicka J, Rus B, Collier J, Lucianetti A, Mocek T. Performance comparison of Yb:YAG ceramics and crystal gain material in a large-area, high-energy, high average-power diode-pumped laser. Opt Express 2020; 28:3636-3646. [PMID: 32122028 DOI: 10.1364/oe.379713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 01/15/2020] [Indexed: 06/10/2023]
Abstract
We compare for the first time the influence of different Yb:YAG gain media on the performance of a large-area, high average-power laser system with an output energy of up to 6 J. Monocrystalline slabs grown by a new technique without central growth defect are compared with ceramics. Small signal gain, maximum output energy and thermal lensing are compared for ceramic slabs with co-sintered amplified spontaneous emission (ASE) absorber cladding, monocrystalline slab with and without optically bonded ASE absorber cladding, and surface structured monocrystalline slabs. We show that these large monocrystals with optically bonded absorber cladding have similar performance to cladded ceramics, so far the only material for high-energy Yb:YAG lasers.
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10
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Pacovsky J, Hyspler R, Husek P, Navratil P, Brodak M. Colloid Osmotic Pressure Participates on the Post-transplant Lymphocele Pathogenesis. Transplant Proc 2018; 50:3422-3425. [PMID: 30577216 DOI: 10.1016/j.transproceed.2018.06.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 06/27/2018] [Indexed: 10/28/2022]
Abstract
The aim of the study was to evaluate the role of colloid osmotic pressure in post-transplant lymphocele pathogenesis. We have analyzed total plasmatic protein and albumin levels, and electrophoresis has been completed in blood samples before transplantation and in days 3 and 14 after transplantation in 50 patients with lymphocele (Lymphocele) and 198 patients without lymphocele (control), respectively. Colloid osmotic pressure (COP) was calculated according to the Hoefs formula. Statistically significant differences were confirmed in albumin levels (42.2 respectively 44.8 g/L) before transplantation (day 0); in total protein (52.5 resp. 55.5 g/L), in albumin (30.1 resp. 32.1 g/L), and COP (15.6 respectively 17.7 kPa) in day 3; and in total protein (52.8 resp. 58.9 g/L), in albumin (30.5 respectively 35.4 g/L), in COP (16.1 respectively 21.2 kPa) in day 14. A potentially critical albumin level was established in 44.1 g/L in the blood analyzed, but its sensitivity was only 62%. The main risk element for the lymphocele formation remains the surgeon's hand. We can proclaim the role of proteins and their COP in the post-transplant lymphocele formation as one of possible pathogenetic cofactors. It is responsible for the impaired mechanisms of the reabsorption the lymph back to the tissues. Better metabolic care could help to reduce incidence of this surgical complication.
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Affiliation(s)
- J Pacovsky
- Department of Urology, University Hospital, Hradec Kralove, Czech Republic; Faculty of Medicine in Hradec Kralove, Department of Surgery, Charles University, Hradec Kralove, Czech Republic.
| | - R Hyspler
- Department of Clinical Biochemistry and Diagnostics, University Hospital, Hradec Kralove, Czech Republic
| | - P Husek
- Department of Urology, University Hospital, Hradec Kralove, Czech Republic
| | - P Navratil
- Department of Urology, University Hospital, Hradec Kralove, Czech Republic; Faculty of Medicine in Hradec Kralove, Department of Surgery, Charles University, Hradec Kralove, Czech Republic
| | - M Brodak
- Department of Urology, University Hospital, Hradec Kralove, Czech Republic; Faculty of Medicine in Hradec Kralove, Department of Surgery, Charles University, Hradec Kralove, Czech Republic
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11
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Fajfr M, Pliskova L, Kutova R, Matyskova-Kubisova M, Navratil P, Radocha J, Valenta Z, Dusilova-Sulkova S. Human polyomavirus 9 in immunocompromised patients in the University Hospital in Hradec Kralove, Czech Republic. J Med Virol 2017; 89:2230-2234. [DOI: 10.1002/jmv.24892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 06/21/2017] [Indexed: 01/17/2023]
Affiliation(s)
- Miroslav Fajfr
- Institute of Clinical Microbiology; University Hospital; Hradec Kralove Czech Republic
- Faculty of Medicine in Hradec Kralove; Charles University; Prague Czech Republic
| | - Lenka Pliskova
- Department of Molecular Biology; Institute of Clinical Biochemistry and Diagnostics; University Hospital; Hradec Kralove Czech Republic
| | - Radka Kutova
- Department of Molecular Biology; Institute of Clinical Biochemistry and Diagnostics; University Hospital; Hradec Kralove Czech Republic
| | - Michaela Matyskova-Kubisova
- University Hospital; Haemodialysis Centre; Hradec Kralove Czech Republic
- Faculty of Medicine in Hradec Kralove; Charles University; Prague Czech Republic
| | - Pavel Navratil
- Faculty of Medicine in Hradec Kralove; Charles University; Prague Czech Republic
- Transplantation Centre of Urological Clinic; University Hospital; Hradec Kralove Czech Republic
| | - Jakub Radocha
- Faculty of Medicine in Hradec Kralove; Charles University; Prague Czech Republic
- 4th Department of Internal Medicine-Haematology; Charles University; University Hospital; Hradec Kralove Czech Republic
| | - Zbynek Valenta
- Department of Epidemiology; Faculty of Military Health Science; University of Defence; Hradec Kralove Czech Republic
| | - Sylvie Dusilova-Sulkova
- University Hospital; Haemodialysis Centre; Hradec Kralove Czech Republic
- Faculty of Medicine in Hradec Kralove; Charles University; Prague Czech Republic
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12
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Vaīova B, Maly J, Ladova K, Navratil P, Dusilova-Sulkova S. SP802MEDICATION ADHERENCE AND SELF MANAGEMENT IN KIDNEY TRANSPLANT RECIPIENTS. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx158.sp802] [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: 11/14/2022] Open
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13
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Wald I, Johnson GP, Amstutz J, Brownlee C, Knoll A, Jeffers J, Gunther J, Navratil P. OSPRay - A CPU Ray Tracing Framework for Scientific Visualization. IEEE Trans Vis Comput Graph 2017; 23:931-940. [PMID: 27875206 DOI: 10.1109/tvcg.2016.2599041] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Scientific data is continually increasing in complexity, variety and size, making efficient visualization and specifically rendering an ongoing challenge. Traditional rasterization-based visualization approaches encounter performance and quality limitations, particularly in HPC environments without dedicated rendering hardware. In this paper, we present OSPRay, a turn-key CPU ray tracing framework oriented towards production-use scientific visualization which can utilize varying SIMD widths and multiple device backends found across diverse HPC resources. This framework provides a high-quality, efficient CPU-based solution for typical visualization workloads, which has already been integrated into several prevalent visualization packages. We show that this system delivers the performance, high-level API simplicity, and modular device support needed to provide a compelling new rendering framework for implementing efficient scientific visualization workflows.
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14
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Kanungo R, Horiuchi W, Hagen G, Jansen GR, Navratil P, Ameil F, Atkinson J, Ayyad Y, Cortina-Gil D, Dillmann I, Estradé A, Evdokimov A, Farinon F, Geissel H, Guastalla G, Janik R, Kimura M, Knöbel R, Kurcewicz J, Litvinov YA, Marta M, Mostazo M, Mukha I, Nociforo C, Ong HJ, Pietri S, Prochazka A, Scheidenberger C, Sitar B, Strmen P, Suzuki Y, Takechi M, Tanaka J, Tanihata I, Terashima S, Vargas J, Weick H, Winfield JS. Proton Distribution Radii of ^{12-19}C Illuminate Features of Neutron Halos. Phys Rev Lett 2016; 117:102501. [PMID: 27636470 DOI: 10.1103/physrevlett.117.102501] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Indexed: 06/06/2023]
Abstract
Proton radii of ^{12-19}C densities derived from first accurate charge changing cross section measurements at 900A MeV with a carbon target are reported. A thick neutron surface evolves from ∼0.5 fm in ^{15}C to ∼1 fm in ^{19}C. The halo radius in ^{19}C is found to be 6.4±0.7 fm as large as ^{11}Li. Ab initio calculations based on chiral nucleon-nucleon and three-nucleon forces reproduce the radii well.
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Affiliation(s)
- R Kanungo
- Astronomy and Physics Department, Saint Mary's University, Halifax, Nova Scotia B3H 3C3, Canada
| | - W Horiuchi
- Department of Physics, Hokkaido University, Sapporo 060-0810, Japan
| | - G Hagen
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - G R Jansen
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831 USA
| | - P Navratil
- TRIUMF, Vancouver, British Columbia V6T 4A3, Canada
| | - F Ameil
- GSI Helmholtzzentrum für Schwerionenforschung, D-64291 Darmstadt, Germany
| | - J Atkinson
- Astronomy and Physics Department, Saint Mary's University, Halifax, Nova Scotia B3H 3C3, Canada
| | - Y Ayyad
- Universidad de Santiago de Compostela, E-15706 Santiago de Compostella, Spain
| | - D Cortina-Gil
- Universidad de Santiago de Compostela, E-15706 Santiago de Compostella, Spain
| | - I Dillmann
- GSI Helmholtzzentrum für Schwerionenforschung, D-64291 Darmstadt, Germany
| | - A Estradé
- Astronomy and Physics Department, Saint Mary's University, Halifax, Nova Scotia B3H 3C3, Canada
- GSI Helmholtzzentrum für Schwerionenforschung, D-64291 Darmstadt, Germany
| | - A Evdokimov
- GSI Helmholtzzentrum für Schwerionenforschung, D-64291 Darmstadt, Germany
| | - F Farinon
- GSI Helmholtzzentrum für Schwerionenforschung, D-64291 Darmstadt, Germany
| | - H Geissel
- GSI Helmholtzzentrum für Schwerionenforschung, D-64291 Darmstadt, Germany
- Justus-Liebig University, 35392 Giessen, Germany
| | - G Guastalla
- GSI Helmholtzzentrum für Schwerionenforschung, D-64291 Darmstadt, Germany
| | - R Janik
- Faculty of Mathematics and Physics, Comenius University, 84215 Bratislava, Slovakia
| | - M Kimura
- Department of Physics, Hokkaido University, Sapporo 060-0810, Japan
| | - R Knöbel
- GSI Helmholtzzentrum für Schwerionenforschung, D-64291 Darmstadt, Germany
| | - J Kurcewicz
- GSI Helmholtzzentrum für Schwerionenforschung, D-64291 Darmstadt, Germany
| | - Yu A Litvinov
- GSI Helmholtzzentrum für Schwerionenforschung, D-64291 Darmstadt, Germany
| | - M Marta
- GSI Helmholtzzentrum für Schwerionenforschung, D-64291 Darmstadt, Germany
| | - M Mostazo
- Universidad de Santiago de Compostela, E-15706 Santiago de Compostella, Spain
| | - I Mukha
- GSI Helmholtzzentrum für Schwerionenforschung, D-64291 Darmstadt, Germany
| | - C Nociforo
- GSI Helmholtzzentrum für Schwerionenforschung, D-64291 Darmstadt, Germany
| | - H J Ong
- RCNP, Osaka University, Mihogaoka, Ibaraki, Osaka 567 0047, Japan
| | - S Pietri
- GSI Helmholtzzentrum für Schwerionenforschung, D-64291 Darmstadt, Germany
| | - A Prochazka
- GSI Helmholtzzentrum für Schwerionenforschung, D-64291 Darmstadt, Germany
| | - C Scheidenberger
- GSI Helmholtzzentrum für Schwerionenforschung, D-64291 Darmstadt, Germany
- Justus-Liebig University, 35392 Giessen, Germany
| | - B Sitar
- Faculty of Mathematics and Physics, Comenius University, 84215 Bratislava, Slovakia
| | - P Strmen
- Faculty of Mathematics and Physics, Comenius University, 84215 Bratislava, Slovakia
| | - Y Suzuki
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Department of Physics, Niigata University, Niigata 950-2181, Japan
| | - M Takechi
- GSI Helmholtzzentrum für Schwerionenforschung, D-64291 Darmstadt, Germany
| | - J Tanaka
- RCNP, Osaka University, Mihogaoka, Ibaraki, Osaka 567 0047, Japan
| | - I Tanihata
- RCNP, Osaka University, Mihogaoka, Ibaraki, Osaka 567 0047, Japan
- School of Physics and Nuclear Energy Engineering and IRCNPC, Beihang University, Beijing 100191, People's Republic of China
| | - S Terashima
- School of Physics and Nuclear Energy Engineering and IRCNPC, Beihang University, Beijing 100191, People's Republic of China
| | - J Vargas
- Universidad de Santiago de Compostela, E-15706 Santiago de Compostella, Spain
| | - H Weick
- GSI Helmholtzzentrum für Schwerionenforschung, D-64291 Darmstadt, Germany
| | - J S Winfield
- GSI Helmholtzzentrum für Schwerionenforschung, D-64291 Darmstadt, Germany
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15
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Fajfr M, Matyskova Kubisova M, Dusilova Sulkova S, Navratil P, Safranek R, Mala A, Pliskova L. MP722THE HUMAN POLYOMAVIRUS 9 IN CZECH PATIENTS AFTER KIDNEY TRANSPLANTATION, DATA FROM UNICENTRIC PROSPECTIVE STUDY. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw200.46] [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: 11/12/2022] Open
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16
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Jansen GR, Engel J, Hagen G, Navratil P, Signoracci A. Ab initio coupled-cluster effective interactions for the shell model: application to neutron-rich oxygen and carbon isotopes. Phys Rev Lett 2014; 113:142502. [PMID: 25325637 DOI: 10.1103/physrevlett.113.142502] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Indexed: 06/04/2023]
Abstract
We derive and compute effective valence-space shell-model interactions from ab initio coupled-cluster theory and apply them to open-shell and neutron-rich oxygen and carbon isotopes. Our shell-model interactions are based on nucleon-nucleon and three-nucleon forces from chiral effective-field theory. We compute the energies of ground and low-lying states, and find good agreement with experiment. In particular, our computed 2(+) states are consistent with N = 14,16 shell closures in (22,24)O, and a weaker N=14 shell closure in (20)C. We find good agreement between our coupled-cluster effective-interaction results with those obtained from standard single-reference coupled-cluster calculations for up to eight valence neutrons.
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Affiliation(s)
- G R Jansen
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA and Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - J Engel
- Deptartment of Physics and Astronomy, University of North Carolina, Chapel Hill, North Carolina 27516-3255, USA
| | - G Hagen
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA and Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - P Navratil
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia, V6T 2A3 Canada
| | - A Signoracci
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA and Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
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Löw F, Navratil P, Kotte K, Schöler HF, Bubenzer O. Remote-sensing-based analysis of landscape change in the desiccated seabed of the Aral Sea--a potential tool for assessing the hazard degree of dust and salt storms. Environ Monit Assess 2013; 185:8303-8319. [PMID: 23564411 DOI: 10.1007/s10661-013-3174-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Accepted: 03/26/2013] [Indexed: 06/02/2023]
Abstract
With the recession of the Aral Sea in Central Asia, once the world's fourth largest lake, a huge new saline desert emerged which is nowadays called the Aralkum. Saline soils in the Aralkum are a major source for dust and salt storms in the region. The aim of this study was to analyze the spatio-temporal land cover change dynamics in the Aralkum and discuss potential implications for the recent and future dust and salt storm activity in the region. MODIS satellite time series were classified from 2000-2008 and change of land cover was quantified. The Aral Sea desiccation accelerated between 2004 and 2008. The area of sandy surfaces and salt soils, which bear the greatest dust and salt storm generation potential increased by more than 36 %. In parts of the Aralkum desalinization of soils was found to take place within 4-8 years. The implication of the ongoing regression of the Aral Sea is that the expansion of saline surfaces will continue. Knowing the spatio-temporal dynamics of both the location and the surface characteristics of the source areas for dust and salt storms allows drawing conclusions about the potential hazard degree of the dust load. The remote-sensing-based land cover assessment presented in this study could be coupled with existing knowledge on the location of source areas for an early estimation of trends in shifting dust composition. Opportunities, limits, and requirements of satellite-based land cover classification and change detection in the Aralkum are discussed.
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Affiliation(s)
- F Löw
- Department of Remote Sensing in cooperation with the German Aerospace Centre (DLR), University of Würzburg, Am Hubland, 97072, Würzburg, Germany.
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Frenje JA, Li CK, Seguin FH, Casey DT, Petrasso RD, McNabb DP, Navratil P, Quaglioni S, Sangster TC, Glebov VY, Meyerhofer DD. Measurements of the differential cross sections for the elastic n-3H and n-2H scattering at 14.1 MeV by using an inertial confinement fusion facility. Phys Rev Lett 2011; 107:122502. [PMID: 22026767 DOI: 10.1103/physrevlett.107.122502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2011] [Indexed: 05/31/2023]
Abstract
For the first time the differential cross section for the elastic neutron-triton (n-(3)H) and neutron-deuteron (n-(2)H) scattering at 14.1 MeV has been measured by using an inertial confinement fusion facility. In these experiments, which were carried out by simultaneously measuring elastically scattered (3)H and (2)H ions from a deuterium-tritium gas-filled inertial confinement fusion capsule implosion, the differential cross section for the elastic n-(3)H scattering was obtained with significantly higher accuracy than achieved in previous accelerator experiments. The results compare well with calculations that combine the resonating-group method with an ab initio no-core shell model, which demonstrate that recent advances in ab initio theory can provide an accurate description of light-ion reactions.
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Affiliation(s)
- J A Frenje
- Plasma Science and Fusion Center, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
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19
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Brodak M, Kosina J, Pacovsky J, Navratil P, Holub L. Bipolar transurethral resection of anastomotic strictures after radical prostatectomy. J Endourol 2011; 24:1477-81. [PMID: 20653423 DOI: 10.1089/end.2009.0609] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE The efficacy of the bipolar endoscopic resection for anastomotic stricture was assessed and compared with holmium laser treatment. PATIENTS AND METHODS We studied a cohort of 39 patients with anastomotic strictures in years 1999 to 2007. Twenty-two patients had undergone bipolar resection, and 17 patients had undergone holmium laser treatment. The mean age of the bipolar cohort was 63.8 years; initial prostate-specific antigen (PSA) level was 10.7 ng/mL. The mean age of the laser cohort was 64 years; initial PSA level was 7.8 ng/mL. The results were evaluated by measurement of the maximum urinary flow (Qmax) and the postvoid residual volume of urine (PVR) before surgery, and at 6 weeks and 6 months after surgery. The Wilcoxon rank-sum test was used for statistical analysis, and a P value <0.05 was considered significant. RESULTS The mean follow-up period was 42 (14-74) months. Improvements in Qmax and PVR were recorded in the two cohorts. In the bipolar cohort, the mean values of Qmax were 3.9 mL/s, 14 mL/s, and 13 ml/s, while PVR values were 46 mL, 10 mL, and 11 mL. The mean values of Qmax in the laser cohort were 3.7 mL/s, 11 mL/s and 6.1 mL/s; PVR were 25 mL, 16 mL, and 19 mL. Statistically significantly better results of Qmax over 6 months were in the bipolar cohort (P < 0.001). No perioperative complications and no deterioration of urinary continence were recorded. CONCLUSION The bipolar resection of an anastomotic stricture is a highly effective method that produces better long-term results than the holmium laser treatment.
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Affiliation(s)
- Milos Brodak
- Department of Urology, University Hospital, Hradec Kralove, Czech Republic.
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Pacovsky J, Hyspler R, Navratil P, Ticha A, Brodak M. The estimation of post-transplant lymphocele origin using creatine kinase activity. Ups J Med Sci 2010; 115:187-92. [PMID: 20636253 PMCID: PMC2939520 DOI: 10.3109/03009731003793122] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2010] [Accepted: 03/17/2010] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION The aim of this research was to create a laboratory instrument for the estimation of post-transplant lymphocele origin. It is based on the enzymatic activity of creatine kinase (CK) in the lymphocele content. MATERIAL AND METHODS A total of 120 lymph samples from different retroperitoneal regions were obtained from non-transplanted patients; equal numbers from the iliac region, renal cysts, and the subdiaphragmatic retroperitoneum. Activities of creatine kinase (CK) and gamma-glutamyl transpeptidase (GGT) were determined in all samples and statistically analyzed against their activity in serum from patients without surgery. RESULTS Activities of CK in the pelvis, retroperitoneum, renal cysts, and serum were 5.06, 0.83, 6.48 (P<0.001), 2.50, 0.73, 3.60 (P<0.001), 0.02, 0.01, 0.05 (P<0.001), and 0.66, 0.41, 0.79 microkat/l, respectively. Activities of GGT in the same lymph samples were 0.26, 0.16, 0.36 (P=0.048), 0.41, 0.25, 0.48 (non-significant), 0.11, 0.07, 1.17 (P=0.003) and 0.34, 0.24, 0.55 microkat/l, respectively. A graph was constructed relating CK activity to lymph origin. CONCLUSION Significantly different CK enzyme activity was observed in different regions of the retroperitoneum. The presented graph is a simple instrument for the estimation of the lymphocele content origin. The method requires percutaneous aspiration of the lymphocele and evaluation of the CK and GGT activity in the sample. From the graph the estimated proportion of renal lymph in the lymphocele can be read directly. This instrument can provide better understanding of post-transplant lymphocele fluid source.
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Affiliation(s)
- Jaroslav Pacovsky
- Department of Urology-Regional Transplant Center, University Hospital and Charles University Medical School, Hradec Kralove, Czech Republic.
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Odrazka K, Dolezel M, Vanasek J, Vaculikova M, Zouhar M, Sefrova J, Paluska P, Vosmik M, Kohlova T, Kolarova I, Navratil P, Brodak M, Prosvic P, Hoffmann P. Late toxicity after conformal and intensity-modulated radiation therapy for prostate cancer: impact of previous surgery for benign prostatic hyperplasia. Int J Urol 2010; 17:784-90. [PMID: 20604816 DOI: 10.1111/j.1442-2042.2010.02592.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To retrospectively compare late toxicity of conventional-dose three-dimensional conformal radiation therapy (3D-CRT) and high-dose intensity-modulated radiation therapy (IMRT) for prostate cancer. METHODS A total of 340 patients with T1-3 prostate cancer were treated with 3D-CRT (n = 228) and IMRT (n = 112). The median follow-up time was 5.9 years and 3.0 years, respectively. The prescription dose was 70 Gy for 3D-CRT and 78 Gy for IMRT. Late gastrointestinal (GI) and genitourinary (GU) toxicities were graded according to the Fox Chase modification of the Radiation Therapy Oncology Group and Late Effects Normal Tissue Task Force criteria. RESULTS There was no difference between 3D-CRT and IMRT in the incidence of GI and GU toxicity at 3 years. On multivariate analysis, transurethral resection of prostate/open transvesical prostatectomy (TURP/TVPE) for benign prostatic hyperplasia, carried out before radiotherapy, significantly increased the risk of Grade >or=2 GU toxicity (risk ratio 1.88). Among patients who experienced TURP/TVPE, the 5-year actuarial likelihood of Grade 2-3 urinary incontinence was 23%, compared with 9% for those without prostate surgery (P = 0.01). CONCLUSIONS Tolerance of 3D-CRT and IMRT was similar, despite the use of high radiation dose with IMRT. Previous TURP/TVPE increased the risk of GU toxicity.
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Affiliation(s)
- Karel Odrazka
- Department of Clinical and Radiation Oncology, Multiscan and Pardubice Regional Hospital, Pardubice, Czech Republic.
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Abstract
Taguchi technique of ureteral implantation was used in 22 kidney transplant patients (group T). Group T was compared with 25 patients who were treated using Lich-Gregoir technique (group LG). Immunosuppression, incidence of biopsy evidenced acute cellular rejection (ACR), haematuria rate and ureteral complications (stricture, reflux) were assessed in both groups. The immunosuppression used was based on cyclosporin A (63.6%), tacrolimus (27.3%) and sirolimus (8.1%) in T group. Cyclosporin A(72%), tacrolimus (20%) and sirolimus (8%) were used in LG group. No induction was used. The incidence of ACR was similar in both groups--T resp. LG was 50% resp. 52%. Haematuria after operation was on average 4.0 days in the T group and on average 3.1 in the LG group. Ureteral complications were observed in 18.2% of cases in T group and in 16% of cases in LG group. No reflux was evidenced in any group. Taguchi technique is fast and very easy to do. A slightly higher incidence of ureteralcomplications and a longer period of postoperative haematuria were observed in T group. Taguchi technique is very easily performed with a shorter operating time. We advocate it as a method of ureteral implantation on the thin-wall urinary bladder. The results were very good in these cases.
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Affiliation(s)
- Jaroslav Pacovsky
- Department of Urology-Transplant Centre, University Hospital Hradec Kralove, Charles University Prague, Czech Republic.
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Wlodarczyk Z, Walaszewski J, Perner F, Vitko S, Ostrowski M, Bachleda P, Kokot F, Klinger M, Szenohradszky P, Studenik P, Navratil P, Asztalos L, Rutkowski B, Kalmar KN, Hickey D. Steroid withdrawal at 3 months after kidney transplantation: a comparison of two tacrolimus-based regimens. Transpl Int 2005; 18:157-62. [PMID: 15691267 DOI: 10.1111/j.1432-2277.2004.00011.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [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: 12/01/2022]
Abstract
The 6 month prospective, randomized study compared the steroid-sparing potential of two tacrolimus-based regimens after renal transplantation. A total of 489 patients were randomized (1:1) to receive tacrolimus/mycophenolate mofetil (MMF)/steroids (n = 243; group Tac/MMF/S) or tacrolimus/azathioprine/steroids (n = 246; group Tac/Aza/S). At 3 months, steroids were tapered off in 267 (54.6%) patients free from steroid-resistant acute rejection and with serum creatinine concentrations <160 micromol/l. The incidence of biopsy-confirmed acute rejection at month 3 was lower in group Tac/MMF/S compared with group Tac/Aza/S (18.1% vs. 26.0%,P = 0.035). Moreover, more patients in the Tac/MMF/S group met the criteria for steroid withdrawal than in the Tac/Aza/S group (60.5% vs. 48.8%; P < 0.01). The incidence of acute rejection during months 4-6 was low in all groups, both for patients on steroid-free dual therapy (Tac/MMF: 2.7%, Tac/Aza: 0.8%) and for patients who continued steroid maintenance therapy (Tac/MMF/S: 3.5%, Tac/Aza/S: 7.1%). Moreover, kidney function was well preserved in steroid-free patients with month 6 median serum creatinine levels of 119.5 micromol/l (Tac/MMF), and 115.1 micromol/l (Tac/Aza). For patients who continued to receive steroids, month 6 median creatinine levels were 130.5 micromol/l (Tac/MMF/S) and 132.8 micromol/l (Tac/Aza/S). The criteria for the selection of patients to discontinue steroids were adequate. Both tacrolimus-based regimens allowed the safe discontinuation of steroids in low-risk patients at month 3. The Tac/MMF combination was superior in the prevention of acute rejections and more patients met the chosen criteria for steroid withdrawal.
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Bönsch D, Schwindt A, Navratil P, Palm D, Neumann C, Klimpe S, Schickel J, Hazan J, Weiller C, Deufel T, Liepert J. Motor system abnormalities in hereditary spastic paraparesis type 4 (SPG4) depend on the type of mutation in the spastin gene. J Neurol Neurosurg Psychiatry 2003; 74:1109-12. [PMID: 12876245 PMCID: PMC1738610 DOI: 10.1136/jnnp.74.8.1109] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [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: 11/04/2022]
Abstract
BACKGROUND Hereditary spastic paraparesis (HSP) denotes a group of inherited neurological disorders with progressive lower limb spasticity as their clinical hallmark; a large proportion of autosomal dominant HSP belongs to HSP type 4, which has been linked to the SPG4 locus on chromosome 2. A variety of mutations have been identified within the SPG4 gene product, spastin. OBJECTIVE Correlation of genotype and electrophysiological phenotype. MATERIAL Two large families with HSP linked to the SPG4 locus with a very similar disease with respect to age of onset, progression, and severity of symptoms. METHODS Mutation analysis was performed by PCR from genomic DNA and cDNA, and direct sequencing. The motor system was evaluated using transcranial magnetic stimulation. RESULTS Patients differ in several categories depending on the type of mutation present. CONCLUSIONS For the first time in hereditary spastic paraparesis, a phenotypic correlate of a given genetic change in the spastin gene has been shown.
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Affiliation(s)
- D Bönsch
- Institut für Klinische Chemie und Laboratoriumsdiagnostik, Universitätsklinikum Jena, D-07740 Jena, Germany.
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Włodarczyk Z, Wałaszewski J, Perner F, Vitko S, Ostrowski M, Bachleda P, Kokot F, Klinger M, Szenohradsky P, Studenik P, Navratil P, Asztalos L, Rutkowski B, Nagy KK, Hickey D. Freedom from rejection and stable kidney function are excellent criteria for steroid withdrawal in tacrolimus-treated kidney transplant recipients. Ann Transplant 2003; 7:28-31. [PMID: 12465429] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
Abstract
OBJECTIVES This prospective, randomized, multicentre study investigated the efficacy and safety of two tacrolimus-based regimens and their potential to withdraw steroids. METHODS In total 489 patients were randomised to receive either tacrolimus and MMF (n = 243) or tacrolimus and azathioprine (n = 246) concomitantly with steroids in both treatment groups. The initial oral dose of tacrolimus was 0.2 mg/kg/day, MMF dose was 1 g/day, azathioprine was administered at 1-2 mg/day. Steroids were tapered from 20 mg/day to 5 mg/day. From month 3 onwards, steroids were withdrawn in patients who were free from steroid-resistant rejection and who had serum creatinine concentrations < 160 mumol/L. Study duration was 6 months. RESULTS Patient survival at month 6 was 98.3% (Tac/MMF/S) and 98.4% (Tac/Aza/S), graft survival at 6 month was 95.0% (Tac/MMF/S) and 93.5% (Tac/Aza/S). The 6-month incidences of biopsy-proven acute rejection were 18.9% (Tac/MMF/S) compared with 26.8% (Tac/Aza/S), p = 0.038. The 6-month incidences of steroid-resistant acute rejection were 2.1% (Tac/MMF/S) and 4.9% (Tac/Aza/S), p = ns. At the end of month 3, steroid withdrawal was performed in 60.5% (Tac/MMF/S) and 48.8% (Tac/Aza/S) of patients, p < 0.01. During months 4-6, 2.7% of patients in the Tac/MMF group had a biopsy-confirmed acute rejection compared with 0.8% of patients in the Tac/Aza group. In patients who continued to receive steroids, the incidences of biopsy-proven acute rejections during months 4-6 were 3.5% (Tac/MMF/S) and 7.1% (Tac/Aza/S). At study end, the steroid-free patients had an excellent kidney function, the median serum creatinine concentration was 119.5 mumol/L (Tac/MMF) and 115.1 mumol/L (Tac/Aza); the median serum creatinine of the total study group was 130.5 mumol/L (Tac/MMF/S) and 132.8 mumol/L (Tac/Aza/S). CONCLUSION Both tacrolimus regimens are efficacious and safe. The combination of Tacrolimus and MMF achieved a lower rejection rate and permitted a higher proportion of steroid-free patients. The overall incidence of acute rejection was low and kidney function was good.
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Affiliation(s)
- Z Włodarczyk
- Department of Transplantology, Poznan District Hospital, Poznan, Poland
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Matl I, Bachleda P, Lao M, Michalsky R, Navratil P, Treska V, Prestele H, Matthisson M, Korn A. Safety and efficacy of an alternative basiliximab (Simulect) regiment after renal transplantation: administration of a single 40-mg dose on the first postoperative day in patients receiving triple therapy with azathioprine. Transpl Int 2003. [DOI: 10.1111/j.1432-2277.2003.tb00222.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [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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Matl I, Bachleda P, Michalsky R, Navratil P, Lao M, Treska V, Prestele H, Matthisson M, Korn A. Basiliximab can be administered safely and effectively in a single dose on day 1 postrenal transplantation in patients receiving triple therapy with azathioprine. Transplant Proc 2001; 33:3205-6. [PMID: 11750375 DOI: 10.1016/s0041-1345(01)02364-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- I Matl
- Department of Nephrology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
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Zivna H, Zivny P, Navratil P, Palicka V, Cerny V, Holeckova M, Pliskova L. The role of cytokines and antioxidant status in graft quality prediction. Transplant Proc 1999; 31:2094. [PMID: 10455979 DOI: 10.1016/s0041-1345(99)00272-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- H Zivna
- Institute of Clinical Biochemistry and Diagnostics, Charles University, Hradec Králové, Czech Republic
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Kuo TT, Tzeng Y, Geyer HB, Navratil P. Green's function method with energy-independent vertex functions. Phys Rev C Nucl Phys 1996; 53:1249-1253. [PMID: 9971060 DOI: 10.1103/physrevc.53.1249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Abstract
A preoperative obliteration of the renal vascular bed was performed in 90 patients by means of Gelfoam emboli. This procedure facilitates the ligation of the renal vein and artery during transabdominal nephrectomy. The decreased vascularity lessens the risk of tumor embolization and reduces the duration of the surgical procedure by half. A simple routine percutaneous method of occlusion is described. Gelfoam emboli are unsuited for permanent obliteration in bleeding tumors.
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