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Szlasa W, Ślusarczyk S, Nawrot-Hadzik I, Abel R, Zalesińska A, Szewczyk A, Sauer N, Preissner R, Saczko J, Drąg M, Poręba M, Daczewska M, Kulbacka J, Drąg-Zalesińska M. Betulin and Its Derivatives Reduce Inflammation and COX-2 Activity in Macrophages. Inflammation 2023; 46:573-583. [PMID: 36282372 PMCID: PMC10024662 DOI: 10.1007/s10753-022-01756-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Received: 08/25/2022] [Revised: 10/01/2022] [Accepted: 10/12/2022] [Indexed: 11/05/2022]
Abstract
Betulin is a heavily studied natural compound for its use as an anticancer or pro-regenerative agent. The structural similarity between betulin to steroids gives rise to the idea that the substance may as well act as an anti-inflammatory drug. This study is the first to describe the anti-inflammatory properties of betulinic acid, betulin, and its derivatives with amino acids 1,4-diaminebutane (Dab), 1,3-diaminepropane (Dap), Ornithine (Orn), and lysine (Lys) on murine macrophages from lymphoma site. The compounds were compared to dexamethasone. To establish the response of the macrophages to the natural compounds, we tested the viability as well as sensitivity to the inflammatory signaling (IFNγR). IL-6 secretory properties and HSP-70 content in the cells were examined. Furthermore, we characterized the effects of compounds on the inhibition of cyclooxygenase-2 (COX-2) activity both in the enzymatic assays and molecular docking studies. Then, the changes in COX-2 expression after betulin treatment were assessed. Betulin and betulinic acid are the low-cytotoxicity compounds with the highest potential to decrease inflammation via reduced IL-6 secretion. To some extent, they induce the reorganization of IFNγR with nearly no effect on COX-2 activity. Conversely, Bet-Orn and Bet-Lys are highly cytotoxic and induce the aggregation of IFNγR. Besides, Bet-Lys reduces the activity of COX-2 to a higher degree than dexamethasone. Bet-Orn is the only one to increase the HSP-70 content in the macrophages. In case of IL-6 reduction, all compounds were more potent than dexamethasone.
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Affiliation(s)
- Wojciech Szlasa
- Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland.
| | - Sylwester Ślusarczyk
- Department of Pharmaceutical Biology and Biotechnology, Faculty of Pharmacy, Wroclaw Medical University, Wroclaw, Poland
| | - Izabela Nawrot-Hadzik
- Department of Pharmaceutical Biology and Biotechnology, Faculty of Pharmacy, Wroclaw Medical University, Wroclaw, Poland
| | - Renata Abel
- Department of Pharmaceutical Biology and Biotechnology, Faculty of Pharmacy, Wroclaw Medical University, Wroclaw, Poland
- Institute of Physiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany, Philippstrasse 12, 10115, Berlin, Germany
| | | | - Anna Szewczyk
- Department of Molecular and Cellular Biology, Faculty of Pharmacy, Wroclaw Medical University, Wroclaw, Poland
| | - Natalia Sauer
- Faculty of Pharmacy, Wrocław Medical University, Wroclaw, Poland
| | - Robert Preissner
- Science-IT and Institute of Physiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Philippstrasse 12, 10115, Berlin, Germany
| | - Jolanta Saczko
- Department of Molecular and Cellular Biology, Faculty of Pharmacy, Wroclaw Medical University, Wroclaw, Poland
| | - Marcin Drąg
- Department of Chemical Biology and Bioimaging, Faculty of Chemistry, Wrocław University of Science and Technology, Wybrzeże Wyspiańskiego 27, 50-370, Wroclaw, Poland
| | - Marcin Poręba
- Department of Chemical Biology and Bioimaging, Faculty of Chemistry, Wrocław University of Science and Technology, Wybrzeże Wyspiańskiego 27, 50-370, Wroclaw, Poland
| | - Małgorzata Daczewska
- Department of Animal Developmental Biology, Institute of Experimental Biology, University of Wroclaw, Wroclaw, Poland
| | - Julita Kulbacka
- Department of Molecular and Cellular Biology, Faculty of Pharmacy, Wroclaw Medical University, Wroclaw, Poland.
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2
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Gallo K, Goede A, Mura C, Abel R, Moahamed B, Preissner S, Nahles S, Heiland M, Bourne PE, Preissner R, Mallach M. A Comparative Analysis of COVID-19 Vaccines Based on over 580,000 Cases from the Vaccination Adverse Event Reporting System. Vaccines (Basel) 2022; 10:vaccines10030408. [PMID: 35335040 PMCID: PMC8950485 DOI: 10.3390/vaccines10030408] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 01/27/2022] [Revised: 02/23/2022] [Accepted: 03/04/2022] [Indexed: 02/04/2023] Open
Abstract
Background: The COVID-19 pandemic is being battled via the largest vaccination campaign in history, with more than eight billion doses administered thus far. Therefore, discussions about potentially adverse reactions, and broader safety concerns, are critical. The U.S. Vaccination Adverse Event Reporting System (VAERS) has recorded vaccination side effects for over 30 years. About 580,000 events have been filed for COVID-19 thus far, primarily for the Johnson & Johnson (New Jersey, USA), Pfizer/BioNTech (Mainz, Germany), and Moderna (Cambridge, USA) vaccines. Methods: Using available databases, we evaluated these three vaccines in terms of the occurrence of four generally-noticed adverse reactions—namely, cerebral venous sinus thrombosis, Guillain−Barré syndrome (a severe paralytic neuropathy), myocarditis, and pericarditis. Our statistical analysis also included a calculation of odds ratios (ORs) based on total vaccination numbers, accounting for incidence rates in the general population. Results: ORs for a number of adverse events and patient groups were (largely) increased, most notably for the occurrence of cerebral venous sinus thrombosis after vaccination with the Johnson & Johnson vaccine. The overall population OR of 10 increases to 12.5 when limited to women, and further yet (to 14.4) among women below age 50 yrs. In addition, elevated risks were found (i) for Guillain−Barré syndrome (OR of 11.6) and (ii) for myocarditis/pericarditis (ORs of 5.3/4.1, respectively) among young men (<25 yrs) vaccinated with the Pfizer/BioNTech vaccine. Conclusions: Any conclusions from such a retrospective, real-world data analysis must be drawn cautiously, and should be confirmed by prospective double-blinded clinical trials. In addition, we emphasize that the adverse events reported here are not specific side effects of COVID vaccines, and the significant, well-established benefits of COVID-19 vaccination outweigh the potential complications surveyed here.
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Affiliation(s)
- Kathleen Gallo
- Institute of Physiology and Science IT, Charité - Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (K.G.); (A.G.); (R.A.); (B.M.); (M.M.)
| | - Andrean Goede
- Institute of Physiology and Science IT, Charité - Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (K.G.); (A.G.); (R.A.); (B.M.); (M.M.)
| | - Cameron Mura
- School of Data Science and Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22904, USA; (C.M.); (P.E.B.)
| | - Renata Abel
- Institute of Physiology and Science IT, Charité - Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (K.G.); (A.G.); (R.A.); (B.M.); (M.M.)
| | - Barbara Moahamed
- Institute of Physiology and Science IT, Charité - Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (K.G.); (A.G.); (R.A.); (B.M.); (M.M.)
| | - Saskia Preissner
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (S.P.); (S.N.); (M.H.)
| | - Susanne Nahles
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (S.P.); (S.N.); (M.H.)
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (S.P.); (S.N.); (M.H.)
| | - Philip E. Bourne
- School of Data Science and Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22904, USA; (C.M.); (P.E.B.)
| | - Robert Preissner
- Institute of Physiology and Science IT, Charité - Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (K.G.); (A.G.); (R.A.); (B.M.); (M.M.)
- Correspondence: ; Tel.: +49-30-45065-5208
| | - Michael Mallach
- Institute of Physiology and Science IT, Charité - Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (K.G.); (A.G.); (R.A.); (B.M.); (M.M.)
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Chen Q, Springer L, Gohlke BO, Goede A, Dunkel M, Abel R, Gallo K, Preissner S, Eckert A, Seshadri L, Preissner R. SuperTCM: A biocultural database combining biological pathways and historical linguistic data of Chinese Materia Medica for drug development. Biomed Pharmacother 2021; 144:112315. [PMID: 34656056 DOI: 10.1016/j.biopha.2021.112315] [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] [Received: 08/20/2021] [Revised: 09/27/2021] [Accepted: 10/05/2021] [Indexed: 01/09/2023] Open
Abstract
AIM OF THE STUDY Botanicals used in Traditional Chinese Medicine (TCM) are a rich source for drug discovery and provide models for multi-component drug development. To facilitate the studies of the actions of TCM drugs and expand their applications, a comprehensive database is urgently required. METHODS One online resource connects all the relevant data from multiple scientific sources and languages. Drug information from published TCM databases and the official Chinese Pharmacopoeia as well as specialized meta-websites such as Kew's Medicinal Plant Names Service was integrated on a higher level. RESULTS Our database, SuperTCM, covers the aspects of TCM derived from medicinal plants, encompassing pharmacological recipes up to chemical compounds. It provides the information for 6516 TCM drugs (or "herbs") with 5372 botanical species, 55,772 active ingredients against 543 targets in 254 KEGG pathways associated with 8634 diseases. SuperTCM is freely available at http://tcm.charite.de/supertcm.
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Affiliation(s)
- Qiaofeng Chen
- Structural Bioinformatics Group, Institute for Physiology, 10115 Berlin, Germany; China Scholarship Council (CSC), Beijing 100044, China
| | - Lena Springer
- King's College London, University College London, UK; Sichuan University, Key Institute for Chinese Folk Culture, China
| | - Björn Oliver Gohlke
- Structural Bioinformatics Group, Institute for Physiology, 10115 Berlin, Germany; Science-IT, Germany
| | - Andrean Goede
- Structural Bioinformatics Group, Institute for Physiology, 10115 Berlin, Germany
| | - Mathias Dunkel
- Structural Bioinformatics Group, Institute for Physiology, 10115 Berlin, Germany; Science-IT, Germany
| | - Renata Abel
- Structural Bioinformatics Group, Institute for Physiology, 10115 Berlin, Germany
| | - Kathleen Gallo
- Structural Bioinformatics Group, Institute for Physiology, 10115 Berlin, Germany
| | - Saskia Preissner
- Structural Bioinformatics Group, Institute for Physiology, 10115 Berlin, Germany
| | - Andreas Eckert
- Structural Bioinformatics Group, Institute for Physiology, 10115 Berlin, Germany; Science-IT, Germany
| | | | - Robert Preissner
- Structural Bioinformatics Group, Institute for Physiology, 10115 Berlin, Germany; Science-IT, Germany.
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Nawrot-Hadzik I, Zmudzinski M, Matkowski A, Preissner R, Kęsik-Brodacka M, Hadzik J, Drag M, Abel R. Reynoutria Rhizomes as a Natural Source of SARS-CoV-2 Mpro Inhibitors-Molecular Docking and In Vitro Study. Pharmaceuticals (Basel) 2021; 14:742. [PMID: 34451839 PMCID: PMC8399519 DOI: 10.3390/ph14080742] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 02/06/2023] Open
Abstract
More than a year has passed since the world began to fight the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) responsible for the Coronavirus disease 2019 (COVID-19) pandemic, and still it spreads around the world, mutating at the same time. One of the sources of compounds with potential antiviral activity is Traditional Chinese Medicinal (TCM) plants used in China in the supportive treatment of COVID-19. Reynoutria japonica is important part of the Shu Feng Jie Du Granule/Capsule-TCM herbal formula, recommended by China Food and Drug Administration (CFDA) for treatment of patients with H1N1- and H5N9-induced acute lung injury and is also used in China to treat COVID-19, mainly combined with other remedies. In our study, 25 compounds from rhizomes of R. japonica and Reynoutria sachalinensis (related species), were docked into the binding site of SARS-CoV-2 main protease. Next, 11 of them (vanicoside A, vanicoside B, resveratrol, piceid, emodin, epicatechin, epicatechin gallate, epigallocatechin gallate, procyanidin B2, procyanidin C1, procyanidin B2 3,3'-di-O-gallate) as well as extracts and fractions from rhizomes of R. japonica and R. sachalinensis were tested in vitro using a fluorescent peptide substrate. Among the tested phytochemicals the best results were achieved for vanicoside A and vanicoside B with moderate inhibition of SARS-CoV-2 Mpro, IC50 = 23.10 µM and 43.59 µM, respectively. The butanol fractions of plants showed the strongest inhibition of SARS-CoV-2 Mpro (IC50 = 4.031 µg/mL for R. sachalinensis and IC50 = 7.877 µg/mL for R. japonica). As the main constituents of butanol fractions, besides the phenylpropanoid disaccharide esters (e.g., vanicosides), are highly polymerized procyanidins, we suppose that they could be responsible for their strong inhibitory properties. As inhibition of SARS-CoV-2 main protease could prevent the replication of the virus our research provides data that may explain the beneficial effects of R. japonica on COVID-19 and identify the most active compounds worthy of more extensive research.
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Affiliation(s)
- Izabela Nawrot-Hadzik
- Department of Pharmaceutical Biology and Botany, Wroclaw Medical University, 50-556 Wroclaw, Poland; (A.M.); (R.A.)
| | - Mikolaj Zmudzinski
- Department of Chemical Biology and Bioimaging, Wroclaw University of Science and Technology, 50-370 Wroclaw, Poland; (M.Z.); (M.D.)
| | - Adam Matkowski
- Department of Pharmaceutical Biology and Botany, Wroclaw Medical University, 50-556 Wroclaw, Poland; (A.M.); (R.A.)
| | - Robert Preissner
- Structural Bioinformatics Group, Institute for Physiology, Charité–University Medicine Berlin, 10115 Berlin, Germany;
| | - Małgorzata Kęsik-Brodacka
- Research Network Łukasiewicz—Institute of Biotechnology and Antibiotics, Starościńska 5, 02-516 Warsaw, Poland;
- National Medicines Institute, ul. Chełmska 30/34, 00-725 Warszawa, Poland
| | - Jakub Hadzik
- Department of Dental Surgery, Wroclaw Medical University, 50-425 Wroclaw, Poland;
| | - Marcin Drag
- Department of Chemical Biology and Bioimaging, Wroclaw University of Science and Technology, 50-370 Wroclaw, Poland; (M.Z.); (M.D.)
| | - Renata Abel
- Department of Pharmaceutical Biology and Botany, Wroclaw Medical University, 50-556 Wroclaw, Poland; (A.M.); (R.A.)
- Structural Bioinformatics Group, Institute for Physiology, Charité–University Medicine Berlin, 10115 Berlin, Germany;
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Erukainure OL, Atolani O, Banerjee P, Abel R, Pooe OJ, Adeyemi OS, Preissner R, Chukwuma CI, Koorbanally NA, Islam MS. Oxidative testicular injury: effect of l-leucine on redox, cholinergic and purinergic dysfunctions, and dysregulated metabolic pathways. Amino Acids 2021; 53:359-380. [DOI: 10.1007/s00726-021-02954-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 02/02/2021] [Indexed: 02/06/2023]
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Abel R, Paredes Ramos M, Chen Q, Pérez-Sánchez H, Coluzzi F, Rocco M, Marchetti P, Mura C, Simmaco M, Bourne PE, Preissner R, Banerjee P. Computational Prediction of Potential Inhibitors of the Main Protease of SARS-CoV-2. Front Chem 2020; 8:590263. [PMID: 33425850 PMCID: PMC7786237 DOI: 10.3389/fchem.2020.590263] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 08/03/2020] [Accepted: 11/13/2020] [Indexed: 12/15/2022] Open
Abstract
The rapidly developing pandemic, known as coronavirus disease 2019 (COVID-19) and caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has recently spread across 213 countries and territories. This pandemic is a dire public health threat—particularly for those suffering from hypertension, cardiovascular diseases, pulmonary diseases, or diabetes; without approved treatments, it is likely to persist or recur. To facilitate the rapid discovery of inhibitors with clinical potential, we have applied ligand- and structure-based computational approaches to develop a virtual screening methodology that allows us to predict potential inhibitors. In this work, virtual screening was performed against two natural products databases, Super Natural II and Traditional Chinese Medicine. Additionally, we have used an integrated drug repurposing approach to computationally identify potential inhibitors of the main protease of SARS-CoV-2 in databases of drugs (both approved and withdrawn). Roughly 360,000 compounds were screened using various molecular fingerprints and molecular docking methods; of these, 80 docked compounds were evaluated in detail, and the 12 best hits from four datasets were further inspected via molecular dynamics simulations. Finally, toxicity and cytochrome inhibition profiles were computationally analyzed for the selected candidate compounds.
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Affiliation(s)
- Renata Abel
- Institute of Physiology, Charité-University Medicine Berlin, Berlin, Germany
| | - María Paredes Ramos
- METMED Research Group, Physical Chemistry Department, Universidade da Coruña (UDC), A Coruña, Spain
| | - Qiaofeng Chen
- Institute of Physiology, Charité-University Medicine Berlin, Berlin, Germany
| | - Horacio Pérez-Sánchez
- Structural Bioinformatics and High-Performance Computing (BIO-HPC) Research Group, Universidad Católica de Murcia (UCAM), Murcia, Spain
| | - Flaminia Coluzzi
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.,Unit of Anesthesia and Intensive Care Medicine, Sant' Andrea University Hospital, Rome, Italy
| | - Monica Rocco
- Unit of Anesthesia and Intensive Care Medicine, Sant' Andrea University Hospital, Rome, Italy.,Department of Clinical and Surgical Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - Paolo Marchetti
- Department of Clinical and Surgical Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - Cameron Mura
- Department of Biomedical Engineering and School of Data Science, University of Virginia, Charlottesville, VA, United States
| | - Maurizio Simmaco
- Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy.,Advanced Molecular Diagnostic Unit, Sant' Andrea University Hospital, Rome, Italy
| | - Philip E Bourne
- Department of Biomedical Engineering and School of Data Science, University of Virginia, Charlottesville, VA, United States
| | - Robert Preissner
- Institute of Physiology and Science-IT, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Priyanka Banerjee
- Institute of Physiology, Charité-University Medicine Berlin, Berlin, Germany
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7
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Nawrot-Hadzik I, Choromańska A, Abel R, Preissner R, Saczko J, Matkowski A, Hadzik J. Cytotoxic Effect of Vanicosides A and B from Reynoutria sachalinensis Against Melanotic and Amelanotic Melanoma Cell Lines and in silico Evaluation for Inhibition of BRAFV600E and MEK1. Int J Mol Sci 2020; 21:ijms21134611. [PMID: 32610527 PMCID: PMC7370030 DOI: 10.3390/ijms21134611] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/21/2020] [Accepted: 06/25/2020] [Indexed: 12/20/2022] Open
Abstract
Vanicosides A and B are the esters of hydroxycinnamic acids with sucrose, occurring in a few plant species from the Polygonaceae family. So far, vanicosides A and B have not been evaluated for anticancer activity against human malignant melanoma. In this study, we tested these two natural products, isolated from Reynoutria sachalinensis rhizomes, against two human melanoma cell lines (amelanotic C32 cell line and melanotic A375 cell line, both bearing endogenous BRAFV600E mutation) and two normal human cell lines-keratinocytes (HaCaT) and the primary fibroblast line. Additionally, a molecular docking of vanicoside A and vanicoside B with selected targets involved in melanoma progression was performed. Cell viability was studied using an MTT assay. A RealTime-Glo™ Annexin V Apoptosis and Necrosis assay was used for monitoring programmed cell death (PCD). Vanicoside A demonstrated strong cytotoxicity against the amelanotic C32 cell line (viability of the C32 cell line was decreased to 55% after 72 h incubation with 5.0 µM of vanicoside A), significantly stronger than vanicoside B. This stronger cytotoxic activity can be attributed to an additional acetyl group in vanicoside A. No significant differences in the cytotoxicity of vanicosides were observed against the less sensitive A375 cell line. Moreover, vanicosides caused the death of melanoma cells at concentrations from 2.5 to 50 µM, without harming the primary fibroblast line. The keratinocyte cell line (HaCaT) was more sensitive to vanicosides than fibroblasts, showing a clear decrease in viability after incubation with 25 µM of vanicoside A as well as a significant phosphatidylserine (PS) exposure, but without a measurable cell death-associated fluorescence. Vanicosides induced an apoptotic death pathway in melanoma cell lines, but because of the initial loss of cell membrane integrity, an additional cell death mechanism might be involved like permeability transition pore (PTP)-mediated necrosis that needs to be explored in the future. Molecular docking indicated that both compounds bind to the active site of the BRAFV600E kinase and MEK-1 kinase; further experiments on their specific inhibitory activity of these targets should be considered.
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Affiliation(s)
- Izabela Nawrot-Hadzik
- Department of Pharmaceutical Biology and Botany, Wroclaw Medical University, 50556 Wroclaw, Poland;
| | - Anna Choromańska
- Department of Molecular and Cellular Biology, Faculty of Pharmacy, Wroclaw Medical University, 50556 Wroclaw, Poland; (A.C.); (J.S.)
| | - Renata Abel
- Structural Bioinformatics Group, Institute for Physiology, Charité–University Medicine Berlin, 10115 Berlin, Germany; (R.A.); (R.P.)
| | - Robert Preissner
- Structural Bioinformatics Group, Institute for Physiology, Charité–University Medicine Berlin, 10115 Berlin, Germany; (R.A.); (R.P.)
| | - Jolanta Saczko
- Department of Molecular and Cellular Biology, Faculty of Pharmacy, Wroclaw Medical University, 50556 Wroclaw, Poland; (A.C.); (J.S.)
| | - Adam Matkowski
- Department of Pharmaceutical Biology and Botany, Wroclaw Medical University, 50556 Wroclaw, Poland;
- Correspondence:
| | - Jakub Hadzik
- Department of Dental Surgery, Wroclaw Medical University, 50425 Wroclaw, Poland;
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Faircloth D, Tarvainen O, Lawrie S, Sarmento T, Savard N, Abel R, Macgregor J, Whitehead M, Wood T, Cahill C. ISIS Penning source extraction studies reveal the 3-dimensional Child-Langmuir effect. Rev Sci Instrum 2020; 91:043307. [PMID: 32357713 DOI: 10.1063/1.5129675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 03/12/2020] [Indexed: 06/11/2023]
Abstract
The standard 1X ISIS negative Penning surface plasma source has reliably produced an H- beam for ISIS operations for 35 years. In order to meet the 60 mA, 2 ms, and 50 Hz beam current and duty cycle required for the front end test stand (Letchford et al., in Proceedings of IPAC2015, Richmond, VA, USA, 2015), a 2X scaled source has been developed [Faircloth et al., AIP Conf. Proc. 2052, 050004 (2018)]. The 2X source has a plasma chamber twice the linear dimensions of the 1X source. This paper investigates the comparison between different emission areas (plasma electrode aperture dimensions) for both the 1X and 2X sources. Slit and circular extraction schemes are studied. A 3D Child-Langmuir relationship is observed where the space charge limited current density depends on the aspect ratio of the extraction aperture.
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Affiliation(s)
- D Faircloth
- STFC ISIS Pulsed Spallation Neutron and Muon Facility, Rutherford Appleton Laboratory, Harwell OX11 0QX, United Kingdom
| | - O Tarvainen
- STFC ISIS Pulsed Spallation Neutron and Muon Facility, Rutherford Appleton Laboratory, Harwell OX11 0QX, United Kingdom
| | - S Lawrie
- STFC ISIS Pulsed Spallation Neutron and Muon Facility, Rutherford Appleton Laboratory, Harwell OX11 0QX, United Kingdom
| | - T Sarmento
- STFC ISIS Pulsed Spallation Neutron and Muon Facility, Rutherford Appleton Laboratory, Harwell OX11 0QX, United Kingdom
| | - N Savard
- D-Pace, Inc., P.O. Box 201, Nelson, British Columbia V1L5P9, Canada
| | - R Abel
- STFC ISIS Pulsed Spallation Neutron and Muon Facility, Rutherford Appleton Laboratory, Harwell OX11 0QX, United Kingdom
| | - J Macgregor
- STFC ISIS Pulsed Spallation Neutron and Muon Facility, Rutherford Appleton Laboratory, Harwell OX11 0QX, United Kingdom
| | - M Whitehead
- STFC ISIS Pulsed Spallation Neutron and Muon Facility, Rutherford Appleton Laboratory, Harwell OX11 0QX, United Kingdom
| | - T Wood
- STFC ISIS Pulsed Spallation Neutron and Muon Facility, Rutherford Appleton Laboratory, Harwell OX11 0QX, United Kingdom
| | - C Cahill
- STFC ISIS Pulsed Spallation Neutron and Muon Facility, Rutherford Appleton Laboratory, Harwell OX11 0QX, United Kingdom
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Fan Y, Shepherd LJ, Slavich E, Waters D, Stone M, Abel R, Johnston EL. Gender and cultural bias in student evaluations: Why representation matters. PLoS One 2019; 14:e0209749. [PMID: 30759093 PMCID: PMC6373838 DOI: 10.1371/journal.pone.0209749] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 12/11/2018] [Indexed: 11/19/2022] Open
Abstract
Gendered and racial inequalities persist in even the most progressive of workplaces. There is increasing evidence to suggest that all aspects of employment, from hiring to performance evaluation to promotion, are affected by gender and cultural background. In higher education, bias in performance evaluation has been posited as one of the reasons why few women make it to the upper echelons of the academic hierarchy. With unprecedented access to institution-wide student survey data from a large public university in Australia, we investigated the role of conscious or unconscious bias in terms of gender and cultural background. We found potential bias against women and teachers with non-English speaking backgrounds. Our findings suggest that bias may decrease with better representation of minority groups in the university workforce. Our findings have implications for society beyond the academy, as over 40% of the Australian population now go to university, and graduates may carry these biases with them into the workforce.
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Affiliation(s)
- Y. Fan
- School of Mathematics and Statistics, UNSW, Sydney, Australia
- * E-mail:
| | - L. J. Shepherd
- Department of Government and International Relations, The University of Sydney, Sydney, Australia
| | - E. Slavich
- School of Mathematics and Statistics, UNSW, Sydney, Australia
| | - D. Waters
- Division of Academic, UNSW Sydney, Australia
| | - M. Stone
- Division of Research, UNSW Sydney, Australia
| | - R. Abel
- Division of Academic, UNSW Sydney, Australia
| | - E. L. Johnston
- School of Biological, Earth and Environmental Sciences, UNSW Sydney, Australia
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Lawrie SR, Faircloth DC, Smith JD, Sarmento TM, Whitehead MO, Wood T, Perkins M, Macgregor J, Abel R. Recent H - diagnostics, plasma simulations, and 2X scaled Penning ion source developments at the Rutherford Appleton Laboratory. Rev Sci Instrum 2018; 89:052101. [PMID: 29864892 DOI: 10.1063/1.5011714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A vessel for extraction and source plasma analyses is being used for Penning H- ion source development at the Rutherford Appleton Laboratory. A new set of optical elements including an einzel lens has been installed, which transports over 80 mA of H- beam successfully. Simultaneously, a 2X scaled Penning source has been developed to reduce cathode power density. The 2X source is now delivering a 65 mA H- ion beam at 10% duty factor, meeting its design criteria. The long-term viability of the einzel lens and 2X source is now being evaluated, so new diagnostic devices have been installed. A pair of electrostatic deflector plates is used to correct beam misalignment and perform fast chopping, with a voltage rise time of 24 ns. A suite of four quartz crystal microbalances has shown that the cesium flux in the vacuum vessel is only increased by a factor of two, despite the absence of a dedicated cold trap. Finally, an infrared camera has demonstrated good agreement with thermal simulations but has indicated unexpected heating due to beam loss on the downstream electrode. These types of diagnostics are suitable for monitoring all operational ion sources. In addition to experimental campaigns and new diagnostic tools, the high-performance VSim and COMSOL software packages are being used for plasma simulations of two novel ion thrusters for space propulsion applications. In parallel, a VSim framework has been established to include arbitrary temperature and cesium fields to allow the modeling of surface physics in H- ion sources.
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Affiliation(s)
- S R Lawrie
- STFC ISIS Pulsed Spallation Neutron and Muon Facility, Rutherford Appleton Laboratory, Oxfordshire, United Kingdom
| | - D C Faircloth
- STFC ISIS Pulsed Spallation Neutron and Muon Facility, Rutherford Appleton Laboratory, Oxfordshire, United Kingdom
| | - J D Smith
- Tech-X UK Ltd., The Innovation Centre, Sci-Tech Daresbury, Cheshire, United Kingdom
| | - T M Sarmento
- STFC ISIS Pulsed Spallation Neutron and Muon Facility, Rutherford Appleton Laboratory, Oxfordshire, United Kingdom
| | - M O Whitehead
- STFC ISIS Pulsed Spallation Neutron and Muon Facility, Rutherford Appleton Laboratory, Oxfordshire, United Kingdom
| | - T Wood
- STFC ISIS Pulsed Spallation Neutron and Muon Facility, Rutherford Appleton Laboratory, Oxfordshire, United Kingdom
| | - M Perkins
- STFC ISIS Pulsed Spallation Neutron and Muon Facility, Rutherford Appleton Laboratory, Oxfordshire, United Kingdom
| | - J Macgregor
- STFC ISIS Pulsed Spallation Neutron and Muon Facility, Rutherford Appleton Laboratory, Oxfordshire, United Kingdom
| | - R Abel
- STFC ISIS Pulsed Spallation Neutron and Muon Facility, Rutherford Appleton Laboratory, Oxfordshire, United Kingdom
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Jin A, Cobb J, Hansen U, Bhattacharya R, Reinhard C, Vo N, Atwood R, Li J, Karunaratne A, Wiles C, Abel R. The effect of long-term bisphosphonate therapy on trabecular bone strength and microcrack density. Bone Joint Res 2017; 6:602-609. [PMID: 29066534 PMCID: PMC5670367 DOI: 10.1302/2046-3758.610.bjr-2016-0321.r1] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Objectives Bisphosphonates (BP) are the first-line treatment for preventing fragility fractures. However, concern regarding their efficacy is growing because bisphosphonate is associated with over-suppression of remodelling and accumulation of microcracks. While dual-energy X-ray absorptiometry (DXA) scanning may show a gain in bone density, the impact of this class of drug on mechanical properties remains unclear. We therefore sought to quantify the mechanical strength of bone treated with BP (oral alendronate), and correlate data with the microarchitecture and density of microcracks in comparison with untreated controls. Methods Trabecular bone from hip fracture patients treated with BP (n = 10) was compared with naïve fractured (n = 14) and non-fractured controls (n = 6). Trabecular cores were synchrotron scanned and micro-CT scanned for microstructural analysis, including quantification of bone volume fraction, microarchitecture and microcracks. The specimens were then mechanically tested in compression. Results BP bone was 28% lower in strength than untreated hip fracture bone, and 48% lower in strength than non-fractured control bone (4.6 MPa vs 6.4 MPa vs 8.9 MPa). BP-treated bone had 24% more microcracks than naïve fractured bone and 51% more than non-fractured control (8.12/cm2vs 6.55/cm2vs 5.25/cm2). BP and naïve fracture bone exhibited similar trabecular microarchitecture, with significantly lower bone volume fraction and connectivity than non-fractured controls. Conclusion BP therapy had no detectable mechanical benefit in the specimens examined. Instead, its use was associated with substantially reduced bone strength. This low strength may be due to the greater accumulation of microcracks and a lack of any discernible improvement in bone volume or microarchitecture. This preliminary study suggests that the clinical impact of BP-induced microcrack accumulation may be significant. Cite this article: A. Jin, J. Cobb, U. Hansen, R. Bhattacharya, C. Reinhard, N. Vo, R. Atwood, J. Li, A. Karunaratne, C. Wiles, R. Abel. The effect of long-term bisphosphonate therapy on trabecular bone strength and microcrack density. Bone Joint Res 2017;6:602–609. DOI: 10.1302/2046-3758.610.BJR-2016-0321.R1.
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Affiliation(s)
- A Jin
- Department of Mechanical Engineering, Imperial College London, Exhibition Road, London SW7 2AZ, UK
| | - J Cobb
- Imperial College London, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK
| | - U Hansen
- Department of Mechanical Engineering, Imperial College London, Exhibition Road, London SW7 2AZ, UK
| | - R Bhattacharya
- Musculoskeletal Sciences, Surgery and Cancer, Imperial College London, Charing Cross Hospital, 7L21, East Lab Block MSk Lab, Margravine Road, London W6 8RP, UK
| | - C Reinhard
- Diamond Light Source Ltd, Fermi Avenue, Didcot OX11 0DE, Oxfordshire, UK
| | - N Vo
- Diamond Light Source Ltd, Fermi Avenue, Didcot OX11 0DE, Oxfordshire, UK
| | - R Atwood
- Diamond Light Source Ltd, Fermi Avenue, Didcot OX11 0DE, Oxfordshire, UK
| | - J Li
- Department of Mechanical Engineering, Imperial College London, Exhibition Road, London SW7 2AZ, UK
| | - A Karunaratne
- Bioengineering, Imperial College London, Exhibition Road, London SW7 2AZ, UK
| | - C Wiles
- Musculoskeletal Sciences, Surgery and Cancer, Imperial College London, Charing Cross Hospital, 7L21, East Lab Block MSk Lab, Margravine Road, London W6 8RP, UK
| | - R Abel
- Musculoskeletal Sciences, Surgery and Cancer, Imperial College London, Charing Cross Hospital, 7L21, East Lab Block MSk Lab, Margravine Road, London W6 8RP, UK
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Reed R, Mehra M, Kirshblum S, Maier D, Lammertse D, Blight A, Rupp R, Jones L, Abel R, Weidner N, Curt A, Steeves J. Spinal cord ability ruler: an interval scale to measure volitional performance after spinal cord injury. Spinal Cord 2017; 55:730-738. [DOI: 10.1038/sc.2017.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Revised: 12/16/2016] [Accepted: 12/21/2016] [Indexed: 12/22/2022]
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Nawrot-Hadzik I, Granica S, Abel R, Czapor-Irzabek H, Matkowski A. Analysis of Antioxidant Polyphenols in Loquat Leaves using HPLC-based Activity Profiling. Nat Prod Commun 2017. [DOI: 10.1177/1934578x1701200205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Leaves of Eriobotrya japonica (loquat) have been used in Traditional Chinese Medicine with beneficial effects in numerous diseases. Extracts from loquat leaves are rich in antioxidants, containing among others: triterpenes, sesquiterpenes, flavonoids, tannins, and megastigmane glycosides. However, there is no conclusive study revealing which of these compounds are the main bioactive principles. The goal of this study was to pinpoint compounds responsible for strong antioxidant activity. Eriobotryae folium was extracted and fractionated between solvents of increasing polarity. All extracts and fractions were screened for total polyphenols and tannins, and antioxidant activity was checked by DPPH, phosphomolybdenum and linoleic acid tests. The ethyl acetate fraction demonstrated the highest antioxidant activity and contained the largest amount of polyphenols. Applying HPLC-based activity profiling to localize antioxidants revealed that cinchonain IIb, as well as flavonoid glycosides such as hyperoside, isoquercitrin, kaempferol glycosides, quercetin-rhamnoside, as well as two tentatively identified protocatechuic acid derivatives are the main substances responsible for the strong antioxidant activity of the ethyl acetate fraction.
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Affiliation(s)
- Izabela Nawrot-Hadzik
- Department of Pharmaceutical Biology and Botany, Medical University, ul. Borowska 211, 50-556 Wroclaw, Poland
| | - Sebastian Granica
- Department of Pharmacognosy and Molecular Basis of Phytotherapy, Medical University, ul. S. Banacha 1, Warsaw, Poland
| | - Renata Abel
- Department of Pharmaceutical Biology and Botany, Medical University, ul. Borowska 211, 50-556 Wroclaw, Poland
| | - Hanna Czapor-Irzabek
- Laboratory of Elemental Analysis and Structural Research, Medical University, ul. Borowska 211A, 50-556 Wroclaw, Poland
| | - Adam Matkowski
- Department of Pharmaceutical Biology and Botany, Medical University, ul. Borowska 211, 50-556 Wroclaw, Poland
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Nawrot-Hadzik I, Granica S, Abel R, Czapor-Irzabek H, Matkowski A. Analysis of Antioxidant Polyphenols in Loquat Leaves using HPLC-based Activity Profiling. Nat Prod Commun 2017; 12:163-166. [PMID: 30428201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
Leaves of Eriobotryajaponica (loquat) have been used in Traditional Chinese Medicine with beneficial effects in numerous diseases. Extracts from loquat leaves are rich in antioxidants, containing among others: triterpenes, sesquiterpenes, flavonoids, tannins, and megastigmane glycosides. However, there is no conclusive study revealing which of these compounds are the main bioactive principles. The goal of this study was to pinpoint compounds responsible for strong antioxidant activity. Eriobotryaefolium was extracted and fractionated between solvents of increasing polarity. All extracts and fractions were screened for total polyphenols and tannins, and antioxidant activity was checked by DPPH, phosphomolybdenum and linoleic acid tests. The ethyl acetate fraction demonstrated the highest antioxidant activity and contained the largest amount of polyphenols. Applying HPLC-based activity profiling to localize antioxidants revealed that cinchonain IIb, as well as flavonoid glycosides such as hyperoside, isoquercitrin, kaempferol glycosides, quercetin-rhamnoside, as well as two tentatively identified protocatechuic acid derivatives are the main substances responsible for the strong antioxidant activity of the ethyl acetate fraction.
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Abel R, Rupp R. Hindrance of spasticity after spinal cord injury. Spinal Cord 2015; 53:711. [DOI: 10.1038/sc.2015.46] [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: 11/10/2022]
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Wu X, Liu J, Tanadini LG, Lammertse DP, Blight AR, Kramer JLK, Scivoletto G, Jones L, Kirshblum S, Abel R, Fawcett J, Field-Fote E, Guest J, Levinson B, Maier D, Tansey K, Weidner N, Tetzlaff WG, Hothorn T, Curt A, Steeves JD. Challenges for defining minimal clinically important difference (MCID) after spinal cord injury. Spinal Cord 2014; 53:84-91. [DOI: 10.1038/sc.2014.232] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 11/16/2014] [Accepted: 11/19/2014] [Indexed: 01/23/2023]
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Schuld C, Franz S, van Hedel HJA, Moosburger J, Maier D, Abel R, van de Meent H, Curt A, Weidner N, Rupp R. International standards for neurological classification of spinal cord injury: classification skills of clinicians versus computational algorithms. Spinal Cord 2014; 53:324-31. [DOI: 10.1038/sc.2014.221] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 11/03/2014] [Accepted: 11/11/2014] [Indexed: 12/14/2022]
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Goetz AJ, Griesshaber E, Abel R, Fehr T, Ruthensteiner B, Schmahl W. Tailored order: the mesocrystalline nature of sea urchin teeth. Acta Biomater 2014; 10:3885-98. [PMID: 24937138 DOI: 10.1016/j.actbio.2014.06.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 05/27/2014] [Accepted: 06/09/2014] [Indexed: 11/26/2022]
Abstract
We investigated the pattern of crystal co-orientation at different length scales, together with variations in chemical composition and nanomechanical properties in the teeth of the modern sea urchin Paracentrotus lividus with electron backscatter diffraction (EBSD), electron probe microanalysis, energy-dispersive X-ray spectroscopy and nanoindentation testing. Modern sea urchin teeth are Mg-dominated calcite composite materials. They are distinctly harder than inorganically precipitated calcite. Some parts exceed even the hardness of dolomite. The teeth show a structuring of their mechanical properties that can be correlated to variations in major element chemical composition, such that their hardness is positively correlated to their magnesium contents. Mg/Ca ratio in Paracentrotus lividus varies between 10 and 26mol.%. Nanohardness of the tooth scatters between 3.5 and >8GPa compared to values of 3.0±0.2, 7.3±0.1 and 9.2±0.9GPa measured on the (104) planes of inorganic calcite, dolomite and magnesite, respectively. High-resolution EBSD shows that major structural units and subunits of the tooth of Paracentrotus lividus are tilted to each other by ∼3-5° and 1-2°, respectively. This indicates that the tooth is not a single crystal. With EBSD we can show that the tooth of the sea urchin Paracentrotus lividus is a hierarchically assembled biological mesocrystal with a mosaic texture. In comparison to the misorientation spread of 0.5° of calcite grown from solution, misorientation in the tooth varies between 2° and 4°. Thus, the self-sharpening feature of the tooth is enabled by a close interplay of its highly evolved micro- to nanostructure, structural unit size variations with a varying degree of crystal orientation, chemical structuring of the mineral component and a gradation of incorporated organic polymers.
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Lassen CL, Abel R, Eichler L, Zausig YA, Graf BM, Wiese CHR. [Perioperative care of palliative patients by the anesthetist : medical, psychosocial and ethical challenges]. Anaesthesist 2013; 62:597-608. [PMID: 23836144 DOI: 10.1007/s00101-013-2198-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Anesthetists will encounter palliative patients in the daily routine as palliative patients undergo operations and interventions as well, depending on the state of the disease. The first challenge for anesthetists will be to recognize the patient as being palliative. In the course of further treatment it will be necessary to address the specific problems of this patient group. Medical problems are optimized symptom control and the patient's pre-existing medication. In the psychosocial domain, good communication skills are expected of anesthetists, especially during the preoperative interview. Ethical conflicts exist with the decision-making process for surgery and the handling of perioperative do-not-resuscitate orders. This article addresses these areas of conflict and the aim is to enable anesthetists to provide the best possible perioperative care to this vulnerable patient group with the goal to maintain quality of life and keep postoperative recovery as short as possible.
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Affiliation(s)
- C L Lassen
- Klinik für Anästhesiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Deutschland.
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Akbar M, Almatrod S, Fürstenberg CH, Hemmer S, Kretzer JP, Abel R, Seyler TM, Bruckner T, Carstens C, Wiedenhöfer B. [Kyphectomy in myelomeningocele patients. Longterm results, complications and risk analysis]. Orthopade 2011; 39:792-800. [PMID: 20414765 DOI: 10.1007/s00132-010-1615-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The conservative and surgical management of lumbar kyphosis is difficult and is a challenge for the orthopaedic surgeon. A kyphotic deformity of the lumbar spine is present in 8% to 20% of these patients. Most curves have very rigid components, often exceed 80 degrees at birth. The options for conservative management are limited. Bracing is extremely difficult, rarely effective, and in advanced stages impossible. We have been using the Warner and Fackler kyphectomy technique at our institution since 1994 as a standard procedure for treating children with lumbar kyphosis due to myelomeningocele. RESULTS This study was performed for a better understanding of the cause of the complications and optimizing the surgical technique. AIM The aim of this study was to evaluate the longterm results, technical problems, early and late complications and the complication associated risk factors.
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Affiliation(s)
- M Akbar
- Wirbelsäulenchirurgie und Querschnittzentrum, Stiftung Orthopädische Universitätsklinik Heidelberg, 69118 Heidelberg.
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Elhayany A, Lustman A, Abel R, Attal-Singer J, Vinker S. A low carbohydrate Mediterranean diet improves cardiovascular risk factors and diabetes control among overweight patients with type 2 diabetes mellitus: a 1-year prospective randomized intervention study. Diabetes Obes Metab 2010; 12:204-9. [PMID: 20151996 DOI: 10.1111/j.1463-1326.2009.01151.x] [Citation(s) in RCA: 181] [Impact Index Per Article: 12.9] [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: 12/16/2022]
Abstract
BACKGROUND The appropriate dietary intervention for overweight persons with type 2 diabetes mellitus (DM2) is unclear. Trials comparing the effectiveness of diets are frequently limited by short follow-up times and high dropout rates. AIM The effects of a low carbohydrate Mediterranean (LCM), a traditional Mediterranean (TM), and the 2003 American Diabetic Association (ADA) diet were compared, on health parameters during a 12-month period. METHODS In this 12-month trial, 259 overweight diabetic patients (mean age 55 years, mean body mass index 31.4 kg/m(2)) were randomly assigned to one of the three diets. The primary end-points were reduction of fasting plasma glucose, HbA1c and triglyceride (TG) levels. RESULTS 194 patients out of 259 (74.9%) completed follow-up. After 12 months, the mean weight loss for all patients was 8.3 kg: 7.7 kg for ADA, 7.4 kg for TM and 10.1 kg for LCM diets. The reduction in HbA1c was significantly greater in the LCM diet than in the ADA diet (-2.0 and -1.6%, respectively, p < 0.022). HDL cholesterol increased (0.1 mmol/l +/- 0.02) only on the LCM (p < 0.002). The reduction in serum TG was greater in the LCM (-1.3 mmol/l) and TM (-1.5 mmol/l) than in the ADA (-0.7 mmol/l), p = 0.001. CONCLUSIONS An intensive 12-month dietary intervention in a community-based setting was effective in improving most modifiable cardiovascular risk factors in all the dietary groups. Only the LCM improved HDL levels and was superior to both the ADA and TM in improving glycaemic control.
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Akbar M, Aschoff A, Georgi J, Nennig E, Heiland S, Abel R, Stippich C. Adjustable Cerebrospinal Fluid Shunt Valves in 3.0-Tesla MRI: a Phantom Study using Explanted Devices. ROFO-FORTSCHR RONTG 2009; 182:594-602. [DOI: 10.1055/s-0028-1109882] [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: 10/19/2022]
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Löffler F, Abel R. Die Preußische militärärztliche Zeitung, Berlin 1860, herausgegeben von Dr. F. Löffler und Dr. L. Abel. Dtsch Med Wochenschr 2009. [DOI: 10.1055/s-0028-1143288] [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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Dhar S, Abel R, Hornickel J, Nicol T, Skoe E, Zhao W, Kraus N. Exploring the relationship between physiological measures of cochlear and brainstem function. Clin Neurophysiol 2009; 120:959-66. [PMID: 19346159 DOI: 10.1016/j.clinph.2009.02.172] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2008] [Revised: 02/13/2009] [Accepted: 02/24/2009] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Otoacoustic emissions and the speech-evoked auditory brainstem response are objective indices of peripheral auditory physiology that are used clinically for assessing hearing function. While each measure has been extensively explored, their interdependence and the relationships between them remain relatively unexplored. METHODS Distortion product otoacoustic emissions (DPOAEs) and speech-evoked auditory brainstem responses (sABRs) were recorded from 28 normal-hearing adults. Through correlational analyses, DPOAE characteristics were compared to measures of sABR timing and frequency encoding. Data were organized into two DPOAE (Strength and Structure) and five brainstem (Onset, Spectrotemporal, Harmonics, Envelope Boundary, and Pitch) composite measures. RESULTS DPOAE Strength shows significant relationships with sABR Spectrotemporal and Harmonics measures. DPOAE Structure shows significant relationships with sABR Envelope Boundary. Neither DPOAE Strength nor Structure is related to sABR Pitch. CONCLUSIONS The results of the present study show that certain aspects of the speech-evoked auditory brainstem responses are related to, or covary with, cochlear function as measured by distortion product otoacoustic emissions. SIGNIFICANCE These results form a foundation for future work in clinical populations. Analyzing cochlear and brainstem function in parallel in different clinical populations will provide a more sensitive clinical battery for identifying the locus of different disorders (e.g., language based learning impairments, hearing impairment).
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Affiliation(s)
- S Dhar
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, 2240 Campus Drive, Evanston, IL 60208, USA.
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Affiliation(s)
- E K Renker
- Stiftung Orthopädische Universitätsklinik, Ruprecht-Karls-Universität, Heidelberg, Deutschland
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Evans CR, Abel R, Kumar RA. A simple measure to reduce the incidence of heparin induced thrombocytopenia (HIT) in cardiac intensive care patients - a retrospective observational analysis. Anaesthesia 2009. [DOI: 10.1111/j.1365-2044.2008.05748_3.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Arnaoutoglou C, Pasquini L, Abel R, Kumar S. Outcome of Antenatally Diagnosed Fetal Anterior Abdominal Wall Defects from a Single Tertiary Centre. Fetal Diagn Ther 2008; 24:416-9. [DOI: 10.1159/000170091] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2007] [Accepted: 07/12/2007] [Indexed: 11/19/2022]
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Fraser A, Abel R, Lawlor DA, Fraser D, Elhayany A. A modified Mediterranean diet is associated with the greatest reduction in alanine aminotransferase levels in obese type 2 diabetes patients: results of a quasi-randomised controlled trial. Diabetologia 2008; 51:1616-22. [PMID: 18597068 DOI: 10.1007/s00125-008-1049-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2007] [Accepted: 04/24/2008] [Indexed: 12/17/2022]
Abstract
AIM The aim of the study was to compare the effect of different dietary interventions on alanine aminotransferase (ALT) in obese patients with diabetes. METHODS A post hoc analysis of an open label, parallel design, quasi-randomised (allocation by alternation), controlled trial, conducted in Israel. Obese patients with diabetes (n = 259), treated in the community, were centrally allocated to one of three diets: (1) the 2003 recommended American Diabetes Association diet (ADA): 50-55% carbohydrate, 30% fat and 20% protein, n = 85; (2) a low glycaemic index (LGI) diet: 50-55% LGI carbohydrate, 30% fat, 15-20% protein, n = 89; or (3) a modified Mediterranean diet (MMD): 35% LGI carbohydrate, 45% fat that was high in monounsaturated fat, 15-20% protein, n = 85. ALT was measured at 6 and 12 months. RESULTS ALT levels decreased in all arms; however, the MMD was associated with the lowest ALT levels at month 6 (n = 201: ADA n = 64, LGI n = 73, MMD n = 64) and month 12 of follow-up (n = 179). At 12 months mean ALT levels were 19.8 +/- 1.4 U/l in the ADA diet arm (n = 54), 18.0 +/- 1.5 U/l in the LGI diet arm (n = 64) and 14.4 +/- 1.7 in the MMD arm (n = 61, p < 0.001). Evidence for an effect of diet on ALT levels persisted when controlling for post-randomisation changes in waist to hip ratio, BMI, homeostasis model assessment (HOMA) or triacylglycerol. CONCLUSIONS A Mediterranean diet may have a beneficial effect on liver steatosis in obese patients with diabetes. Results of trials assessing the effect of dietary composition on clinical outcomes should be awaited before a decisive conclusion can be reached. In addition to clinical outcomes, such studies should address the issue of primary prevention of steatosis in high-risk and healthy individuals.
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Affiliation(s)
- A Fraser
- Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol, BS8 2PR, UK.
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Borgmann S, Gruber H, Beyser K, Abel R, Reber A, Lindauer A, Klos C, Anders S, Schuierer M. Gel electrophoresis of polymerase chain reaction (PCR) products improves GenoType® MRSA Direct PCR analysis in clinical practice. J Hosp Infect 2008; 68:276-7. [DOI: 10.1016/j.jhin.2008.01.001] [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] [Received: 12/20/2007] [Accepted: 01/02/2008] [Indexed: 10/22/2022]
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Ditunno JF, Scivoletto G, Patrick M, Biering-Sorensen F, Abel R, Marino R. Validation of the walking index for spinal cord injury in a US and European clinical population. Spinal Cord 2007; 46:181-8. [PMID: 17502878 DOI: 10.1038/sj.sc.3102071] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To demonstrate the prospective construct validity of the walking index for spinal cord injury (WISCI) in US/European clinical population. DESIGN Prospective Cohort in Denmark, Germany, Italy and the USA. PARTICIPANTS/METHOD: Participants with acute complete/incomplete (ASIA Impairment Scale (AIS) A, B, C and D) traumatic spinal cord injuries were enrolled from four centers. Lower extremity motor scores (LEMS), WISCI level and Locomotor Functional Independence Measure (LFIM) levels were assessed with change in ambulatory status. WISCI progression was assessed for monotonic direction of improvement (MDI). LEMS were correlated to WISCI/LFIM. Use of walking aids/braces were analyzed. RESULTS One hundred and seventy participants were enrolled and 20 excluded. Of the 150 participants (USA 112/150; Europe 38/150) (AIS A=59, B=19, C=32, D=40), LEMS and WISCI assessments were performed initially and at final assessment (3-12 months post injury) or until maximum WISCI score of 20. Eighty-five percent of motor complete (66/78) and 10% (7/72) of motor incomplete participants showed no progression (73/150). Of the remaining participants (77/150) who improved, 81% (62/77) showed MDI. However, the deviation from MDI occurred only at one time-point in 10/15 participants. LEMS correlated with WISCI at initial and final assessment (0.47 and 0.91 P<0.001). Parallel bar use differed between the US and Europe possibly due to patterns of care. Use of braces also differed. CONCLUSION The results support the hierarchical ranking of the WISCI scale and the correlation of WISCI levels to impairment (LEMS) in a clinical setting of four nations. Differences in practice between the US and Europe need consideration in design of trials.
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Affiliation(s)
- J F Ditunno
- Regional SCI Center of the Delaware Valley, Thomas Jefferson University, Philadelphia, PA 19107, USA
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Borgmann S, Kick A, Schuierer M, Reber A, Gruber H, Beyser K, Abel R, Lindauer A. P905 Low specificity of GenoType ®MRSA Direct test when result interpretation is restricted to hybridisation of PCR products. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)70746-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Raithel M, Weidenhiller M, Abel R, Baenkler HW, Hahn EG. Colorectal mucosal histamine release by mucosa oxygenation in comparison with other established clinical tests in patients with gastrointestinally mediated allergy. World J Gastroenterol 2006; 12:4699-705. [PMID: 16937442 PMCID: PMC4087836 DOI: 10.3748/wjg.v12.i29.4699] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: This study evaluated colorectal mucosal histamine release in response to blinded food challenge-positive and -negative food antigens as a new diagnostic procedure.
METHODS: 19 patients suffering from gastrointestinally mediated allergy confirmed by blinded oral provocation were investigated on grounds of their case history, skin prick tests, serum IgE detection and colorectal mucosal histamine release by ex vivo mucosa oxygenation. Intact tissue particles were incubated/stimulated in an oxygenated culture with different food antigens for 30 min. Specimens challenged with anti-human immunoglobulin E and without any stimulus served as positive and negative controls, respectively. Mucosal histamine release (% of total biopsy histamine content) was considered successful (positive), when the rate of histamine release from biopsies in response to antigens reached more than twice that of the spontaneous release. Histamine measurement was performed by radioimmunoassay.
RESULTS: The median (range) of spontaneous histamine release from colorectal mucosa was found to be 3.2 (0.1%-25.8%) of the total biopsy histamine content. Food antigens tolerated by oral provocation did not elicit mast cell degranulation 3.4 (0.4%-20.7%, P = 0.4), while anti-IgE and causative food allergens induced a significant histamine release of 5.4 (1.1%-25.6%, P = 0.04) and 8.1 (1.5%-57.9%, P = 0.008), respectively. 12 of 19 patients (63.1%) showed positive colorectal mucosal histamine release in accordance with the blinded oral challenge responding to the same antigen (s), while the specificity of the functional histamine release to accurately recognise tolerated foodstuffs was found to be 78.6%. In comparison with the outcome of blinded food challenge tests, sensitivity and specificity of history (30.8% and 57.1%), skin tests (47.4% and 78.6%) or antigen-specific serum IgE determinations (57.9% and 50%) were found to be of lower diagnostic accuracy in gastrointestinally mediated allergy.
CONCLUSION: Functional testing of the reactivity of colorectal mucosa upon antigenic stimulation in patients with gastrointestinally mediated allergy is of higher diagnostic efficacy.
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Affiliation(s)
- M Raithel
- Functional Tissue Diagnostics, Gastroenterology, Department of Medicine I, University Erlangen-Nuremberg, Ulmenweg 18, Erlangen 91054, Germany.
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Abstract
STUDY DESIGN Postal survey. SETTING A total of 19 countries in Europe. OBJECTIVES Firstly, to collect information about incidence and systems of care for pediatric spinal cord injury (pedSCI); including prevention, initial care and follow-up in a subset of European countries. Secondly, to initiate a network of involved professionals for exchange of information and development of research and care programs. METHODS A short semi-structured questionnaire was sent to respondents working with spinal cord injury (SCI) in 19 countries in Europe. RESULTS Only in Portugal and Sweden, is the incidence of pedSCI (fatal injuries included) established, that is 27 children/million children/year and 4.6 children/million children/year, respectively. For the other countries, the estimated incidence of pedSCI (nonfatal injuries) varied from 0.9 to 21.2 children/million children/year in the age group of 0-14 years. Although the incidence varies considerably, pedSCI is rare throughout Europe. The management differs between the countries depending on the age of the child and the local organization of health care. CONCLUSIONS The survey confirms that pedSCI is rare. In order to establish high-quality standardized care, further integration of knowledge in this area is needed throughout Europe. The contacts initiated by this survey may be used to create an international network serving as a reference for health professionals, researchers and families, thereby possibly alleviating some of the unwanted variations of care identified in this study.
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Affiliation(s)
- M Augutis
- Department of Public Health and Research, Sundsvall Hospital, Sundsvall, Sweden
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Abstract
Recent technological advancements in microelectronics have led to the establishment of systems for restoration of basic functions in spinal cord injured (SCI) persons using functional electrical stimulation (FES). FES systems for the restoration of bladder and diaphragm function are well established in clinical practice. While FES systems in the lower extremities for standing/walking have not yet achieved widespread clinical acceptance, devices which enhance or restore the grasp function in tetraplegic patients with missing control of hand and fingers are demonstrably successful. Especially with the use of implantable systems a reliable, easy to handle application is possible. The most recent developments in micromechanical engineering are aimed at providing minimally invasive, subminiature systems for functional support in incomplete SCI persons. The possibility of direct brain control of FES systems will expand the application of neuroprostheses for patients with injury of the high cervical spinal cord.
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Affiliation(s)
- R Rupp
- Abteilung Orthopädie II, Orthopädische Universitätsklinik, Heidelberg.
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Abel R. [Orthopedic treatment of paraplegics]. Orthopade 2005; 34:105. [PMID: 15655658 DOI: 10.1007/s00132-004-0750-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- R Abel
- Orthopädische Universitätsklinik Heidelberg.
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Abstract
BACKGROUND Paraplegia of non-traumatic origin has an increasing incidence. Infection of the spine is a major contributor to the number of these cases. Besides adequate management of spinal cord injury, the treatment of these patients requires specific therapeutic techniques. PATIENTS AND METHODS Eighteen patients with acute pyogenic infection of the spine and spinal cord injury were admitted to our facility in the years 1997-2000. All except two patients were treated by surgical debridement and internal stabilisation. RESULTS The infections healed after surgical treatment in all cases. Neurological function improved and no patient showed neurological deterioration. Both patients who were not fit for surgery died during treatment. CONCLUSION Surgical instrumentation and replacement of the destroyed vertebra, despite a pyogenic environment, resulted in permanent resolution of the infection. There is potential for neurological recovery but full recovery is rare.
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Affiliation(s)
- M Keil
- Abt. Orthopädie II, Stiftung Orthopädische Universitätsklinik Heidelberg.
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Braatz F, Streich N, Abel R. Akute Lumboischialgie. Manuelle Medizin 2004. [DOI: 10.1007/s00337-004-0290-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
The success of multimodal therapy for patients with symptoms of spinal canal stenosis lasting >6 months was investigated in a prospective study. Clinical (age, weight, height) and morphological data were collected for 36 patients (21 women and 15 men) with an average age of 67 years. The extent of narrowing in the spinal space (diameter of the dural sac <100 mm(2)) was measured by magnetic resonance imaging at segments L1-S1. Impairments in daily activities were assessed by questionnaire before a 3-week multimodal treatment regimen and 3 weeks and 6 months thereafter. In addition, depression status and walking distance on a treadmill were evaluated. Of the 180 segments examined, 124 evidenced a diameter of the dural sac of <100 mm(2). The average functional capacity improved with treatment from 46.7 to 53.5 (p<0.001) and the average depression status decreased from 13.5 to 11 (p>0.05). The average walking distance was 373 m before treatment and 565 m after treatment (p<0.001). Short-term improvement of the walking distance was achieved with the conservative treatment implemented. Medium- and long-term results remain unclear. Predictors for treatment success (age, sex, BMI, functional capacity, walking ability before treatment) could not be found. No scientific evidence can be gleaned from the literature in this regard so that further prospective studies should be performed.
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Affiliation(s)
- F Zeifang
- Abteilung I, Orthopädische Universitätsklinik Heidelberg, Heidelberg.
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Abel R, von Baum H. Multilevel epidural abscess formation with paraplegia in a healthy 33-year-old man caused by Staphylococcus aureus (MSSA). Infection 2003; 31:359-61. [PMID: 14556064 DOI: 10.1007/s15010-003-2017-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2001] [Accepted: 07/01/2003] [Indexed: 10/24/2022]
Abstract
We report an unusual case of a devastating multilevel pyogenic spondylitis with paraplegia and soft tissue abscess formation in a previously healthy young man. Methicillin susceptible Staphylococcus aureus (MSSA) was identified as causal pathogen. The infection could only be managed after surgical debridement of all spinal manifestations and a prolonged course of antibiotic therapy. It is possible that delayed surgical debridement of all infection sites fostered the course of the disease.
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Affiliation(s)
- R Abel
- Dept. of Orthopedics 2, Orthopedic University Hospital Heidelberg, Schlierbacher Landstr. 200a, D-69118 Heidelberg, Germany.
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Abel R. [Spinal column metastases and paraplegia]. Orthopade 2003; 32:439-450; quiz 450-1. [PMID: 12846233 DOI: 10.1007/s00132-003-0485-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- R Abel
- Orthopädische Universitätsklinik Heidelberg.
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Parsch D, Mikut R, Abel R. Postacute management of patients with spinal cord injury due to metastatic tumour disease: survival and efficacy of rehabilitation. Spinal Cord 2003; 41:205-10. [PMID: 12669084 DOI: 10.1038/sj.sc.3101426] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Retrospective study utilising clinical records and public administration databases. OBJECTIVES This study was performed to analyse the clinical presentation and survival rate of individuals with spinal cord injury (SCI) due to spinal metastasis after primary treatment, and to evaluate the efficacy of rehabilitative efforts. SETTING Spinal Cord Injury Unit, University Hospital, Heidelberg. METHODS A total of 68 consecutive patients were included. Demographics, clinical data, tumour type, level and completeness of SCI, initial treatment, functional independence measure (FIM) and survival time were derived from hospital and public administration databases. Cox regression and fuzzy logic rule generation were used for statistical analysis. RESULTS Of the 68 patients, 66 patients died 11 months (median, interquartile range (IQR) 4-29 months) after the onset of neurological symptoms at an average age of 58 years. The functional independence measure (FIM) score describing the general clinical and functional status proved to be the most reliable prognostic factor of survival. Other more specific parameters (eg tumour type or level of lesion) did not have such an impact. In total, 51 patients completed the rehabilitation programme within 50 days (median, IQR 27-99 days). The FIM score improved from 62 at admission to 84 at discharge. CONCLUSION The clinical and functional status is a valuable prognostic factor for survival. Since institutionalised rehabilitative efforts are effective, this group of patients should be accepted into such a program.
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Affiliation(s)
- D Parsch
- Orthopaedic University Hospital Heidelberg, Heidelberg, Germany
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Abel R, Cerrel Bazo HA, Kluger PJ, Selmi F, Meiners T, Vaccaro A, Ditunno J, Gerner HJ. Management of degenerative changes and stenosis of the lumbar spinal canal secondary to cervical spinal cord injury. Spinal Cord 2003; 41:211-9. [PMID: 12669085 DOI: 10.1038/sj.sc.3101435] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We describe the case of a 47-year-old female who sustained a C5/6 fracture with C6 complete spinal cord injury 26 years ago. She presented with increased spasticity of the lower extremities, the abdominal wall and episodes of autonomic dysreflexia. Imaging of the spine revealed post-traumatic kyphosis at the level of the injury and degenerative changes of the lumbar spine with marked facet joint hypertrophy at the level of L4/5 causing severe spinal canal stenosis. Discussants of this case comment on the possible pathophysiological mechanisms causing autonomic dysreflexia, especially the development of degenerative changes, Charcot arthropathy and the role of tethering mechanisms. The diagnostic options and management approaches are also discussed.
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Affiliation(s)
- R Abel
- Orthopädische Universitätsklinik, Abteilung 2, Heidelberg, Germany
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Raithel M, Weidenhiller M, Shaban M, Abel R, Tuchbreiter H, Backhaus B, Donhauser N, Baenkler HW, Hahn EG. Diagnostic use of mucosa oxygenation and histamine release experiments in patients with gastrointestinally mediated allergy (GMA). Inflamm Res 2003; 52 Suppl 1:S13-4. [PMID: 12755389 DOI: 10.1007/s000110300032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- M Raithel
- Functional Tissue Diagnostics, Gastroenterology, Department of Medicine I, University Erlangen-Nuremberg, Krankenhausstr. 12, 91054 Erlangen, Germany.
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Loose T, Malberg H, Mikut R, Dieterle J, Schablowski M, Wolf S, Abel R, Döderlein L, Rupp R. [A modular method for automated evaluation of gait analysis data]. BIOMED ENG-BIOMED TE 2003; 47 Suppl 1 Pt 2:700-3. [PMID: 12465278 DOI: 10.1515/bmte.2002.47.s1b.700] [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: 11/15/2022]
Abstract
A modular methodology for automated gait data evaluation: The aim of Instrumented Gait Analysis is to measure data such as joint kinematics or kinetics during gait in a quantitative way. The data evaluation for clinical purposes is often performed by experienced physicians (diagnosis of specific motion dysfunction, planning and validation of therapy). Due to subjective evaluation and complexity of the pathologies, there exists no objective, standardized data analysis method for these tasks. This article covers the development of a modular, computer-based methodology to quantify the degree of pathological gait in comparison to normal behavior, as well as to automatically search for interpretable gait abnormalities and to visualize the results. The outcomes are demonstrated with two different patient groups.
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Affiliation(s)
- T Loose
- Institut für Angewandte Informatik, Forschungszentrum Karlsruhe, Deutschland.
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Meiners T, Keil M, Flieger R, Abel R. Use of the ring fixator in the treatment of fractures of the lower extremity in long-term paraplegic and tetraplegic patients. Spinal Cord 2003; 41:172-7. [PMID: 12612620 DOI: 10.1038/sj.sc.3101397] [Citation(s) in RCA: 8] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Retrospective study. OBJECTIVES To examine the value of operative fracture stabilization by means of the ring fixator in fractures of the lower extremity in the presence of chronic paralysis caused by transverse lesions of the spinal cord. SETTING A specialist center for the treatment of spinal cord injuries in Germany. METHODS Clinical examination of the lower extremities with side-for-side comparison, radiological investigation of the fractures, patient survey. PATIENTS In 21 patients with chronic spinal cord lesions, 22 fractures of the lower extremities were treated with the ring fixator. RESULTS At follow-up a mean of 41.5 months after fracture healing it could be shown that movement in the knee and ankle joints on the same side as the fracture was not restricted by more than 10 degrees in any of our patients. No losses affecting activities of daily living were reported, and 19 of the 21 patients were satisfied with the result achieved with this technique. After four of the 22 operations there were complications. Malalignments were visible radiologically following five of the fractures. CONCLUSIONS In osteoporosis-induced fractures of the lower extremities in chronically paraplegic and tetraplegic patients, fracture stabilization with the ring fixator, with fewer complications and better results in terms of joint mobility, is superior to the conservative treatment so far given preference in the literature. It should be offered as an alternative to conservative treatment in the case of pathological fractures.
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Affiliation(s)
- T Meiners
- Spinal Cord Center, Werner Wicker Clinic, 34537 Bad Wildungen, Germany
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Saloga J, Knop J, Rihs HP, Dumont B, Rozynek P, Lundberg M, Cremer R, Brüning T, Raulf-Heimsoth M, Yeang HY, Sander I, Arif SAM, Fleischer C, Brüning T, Pöppelmann M, Grobe K, Becker WM, Petersen A, Wicklein D, Lindner B, Lepp U, Altmann F, Hipler UC, Frank U, Schliemann-Willers S, Kaatz M, Eisner P, Kasche A, Krämer U, Klaus S, Buters J, Traidl-Hoffmann C, Ring J, Behrendt H, Huss-Marp J, Brockow K, Darsow U, Risse U, Böttcher I, Sellinghausen I, Brand P, Klostermann B, Mariant V, Jakob T, Hochrein H, Müller MJ, Wagner H, Baron JM, Schiffer R, Bostonci Ö, Merk HF, Zwadlo-Klarwasser G, Schäkel K, Kannagi R, Kniep B, Goto Y, Mitsuoka C, Zwirner J, Soruri A, von Kietzell M, Rieber P, Lisewski M, Mommert S, Kapp A, Zwirner J, Werfet T, Gutzmer R, Langer K, Werfel T, Soewarto D, Köllisch G, Howaldt M, Sandholzer N, Kreramer E, Hrabé deAngelis M, Balling R, Ollert M, Pfeffer K, Wolf E, Flaswinkel H, Ngoumou G, Schäfer D, Mattes J, Moseler M, Kühr J, Kopp MV, Gutzmer R, Wittmann M, Janssen S, Köther B, Alter M, Stünkel T, Hausdirjg M, Ho TC, Buerke M, Lehr AH, Lux C, Schipp M, Galle RP, Finotto S, Bünder R, Mittermann I, Herz U, Valenta R, Renz H, Seidel-Guvenot W, Goez R, Maurer M, Metz M, Blessing M, Schramm C, Steinbrink K, Köllisch GV, Mempel M, Bauer S, Völcker V, Kasche A, Fesq H, Feussner I, Schober W, Buters J, Hueltner L, Lippert U, Artuc M, Babina M, Blaschke V, Zachmann K, Neumann C, Henz BM, Stassen M, Müller C, Richter C, Neudörfl C, Hüttner L, Bhakdi S, Walev I, Schmitt E, Mageri M, Maurer M, Hartmann K, Artuc M, Hermes B, Mekori YA, Henz BM, Breit S, Schöpf P, Dugas M, Schiffl H, Ruëff F, Przybilla B, Forssmann U, Härtung I, Bälder R, Escher SE, Spodsberg N, Dulkys Y, Walden M, Heitland A, Braun A, Forssmann WG, Elsner J, Raap U, Deneka N, Bruder M, Wedi B, Feser A, Plötz SG, Kreyling W, Schober W, Weichenmeier I, Papo D, Eberlein-König B, Berresheim HW, Grimm V, Winneke G, Kleine-Tebbe J, Breuer K, Vieths S, Worm M, Kunkel G, Wahn U, Lau S, Errlmann SM, Sauer I, Termeer C, Salman S, Averbeck M, Simon JC, Heine G, Frotscher B, Anton K, Mahnke K, Qian Y, Enk A, Enk AH, Beinghausen I, Darcan Y, Seitzer U, Ahmed J, Sudowe S, Ludwig-Portugall I, Ross R, Reske-Kunz AB, Maurer T, Lipford G, Wagner H, Rueff F, Bauer C, Gosepath J, Mewes T, Ziegler E, Ziegler EA, Flagge A, Hipler UC, Baumbach H, Zintl F, Eisner P, Mainz J, Huber S, Protschka M, Burg J, Galle PR, Lohse AW, Podlech J, Köhler H, Wegmann M, Heimann S, Fehrenbach A, Wagner U, Alfke H, Fehrenbach H, Beier J, Semmler D, Beeh KM, Kornmann O, Buhl R, Quarcoo D, Ahrens B, Meeuw A, Reese G, Vieths S, Hameimann E, Heratizadeh A, Wulf A, Constien A, Tetau D, Lingelbach A, Rakoski J, Fiedler EM, Zuberbier T, Weidermiller M, Winterkamp S, Schwab D, Nabe A, Nägel A, Maiss J, Mühldorfer SDN, Hahn EG, Raithel M, Weidenhiller M, Abel R, Baenkler HW, Mühldorfer S, Funkt G, Klinik I, Scheibenzuber M, Meyer-Pittroff R, Reese I, Oppel T, Hartmann K, Pfützner W, Biedermann T, Sing A, Dechene M, Staubach P, Hanau A, Magerl M, Eckhardt-Henn A, Onnen K, Kromminga A, Lüdtke R, Tschentscher I, Lange J, Berkenheide S, Kuehr J, Simon D, von Gunten S, Borelli S, Braathen LR, Simon HU, Fokken N, Wittmann M, Mrabet-Dahbi S, Klotz M, Heeg K, Soost S, Lee H, Klinger R, Becker D, Bruchhausen S, Jaeger C, Hartschuh W, Jappe U. 15. Mainzer Allergie-Workshop 2003. Allergo J 2003. [DOI: 10.1007/bf03361093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Rupp K, Loose T, Mikut R, Schablowski M, Dieterle J, Abel R, Gerner HJ, Bretthauer G. QUANTITATIVE BEWERTUNG VON GANGQUALITÄT. BIOMED ENG-BIOMED TE 2003. [DOI: 10.1515/bmte.2003.48.s1.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Meiners T, Abel R, Lindel K, Mesecke U. Improvements in activities of daily living following functional hand surgery for treatment of lesions to the cervical spinal cord: self-assessment by patients. Spinal Cord 2002; 40:574-80. [PMID: 12411965 DOI: 10.1038/sj.sc.3101384] [Citation(s) in RCA: 25] [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: 11/09/2022]
Abstract
STUDY DESIGN Tetraplegic patients were tested for hand strength before and after hand surgery. They also answered questions about how they rated the results of surgery. OBJECTIVES Presentation of the efficacy of reconstruction of hand raising, lateral grip, and cylindrical grip in the tetraplegic hand. SETTING The study was conducted in the Werner Wicker Clinic, Bad Wildungen, Germany, from 1991 to 1998. METHODS The results of reconstruction surgery performed on 23 tetraplegic hands, as reflected in lifting the hand (n=3), lateral grip (n=21), and cylindrical grip (n=14), are presented. In a follow-up study in 22 patients, their management of activities of daily living 34.1 months (9-51 months) after the surgery is compared with the preoperative situation. Subjective satisfaction levels were elicited for each of the 22 patients by means of a questionnaire. RESULTS The gain in force corresponded to 893 g (150-1500 g) for cyclindrical grip and 488 g (100-1200 g) for lateral grip, while they were able to develop grade 4 force for lifting the hand. After the operation 28 aids/appliances that patients had formerly used regularly were no longer necessary. There were 75 separate activities listed in the questionnaire, and on average the 22 patients were able to perform 8.7 (0-20) more of these. Most patients (19) said they would advise others to have the operation and 18, that they would have the operation again. There were 12 complications in nine patients. CONCLUSION Reconstructive surgery on the hands of tetraplegic patients leads to gains in both cylindrical grip and lateral grip force and to increased manual dexterity. Patient satisfaction with the procedure is high.
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Affiliation(s)
- T Meiners
- Werner-Wicker-Klinik, Bad Wildungen, Germany
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Jude PM, Chandrakala S, Jayalakshmi S, Parvathy D, Sampathkumar V, Abel R. Status of adolescent girls in a rural south Indian population. Indian J Matern Child Health 2002; 2:60-3. [PMID: 12320292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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