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Conrad S, Teichmann J, Auth P, Knorr N, Ulrich K, Bellin D, Speck T, Tauber FJ. 3D-printed digital pneumatic logic for the control of soft robotic actuators. Sci Robot 2024; 9:eadh4060. [PMID: 38295189 DOI: 10.1126/scirobotics.adh4060] [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] [Received: 03/07/2023] [Accepted: 01/02/2024] [Indexed: 02/02/2024]
Abstract
Soft robots are paving their way to catch up with the application range of metal-based machines and to occupy fields that are challenging for traditional machines. Pneumatic actuators play an important role in this development, allowing the construction of bioinspired motion systems. Pneumatic logic gates provide a powerful alternative for controlling pressure-activated soft robots, which are often controlled by metallic valves and electric circuits. Many existing approaches for fully compliant pneumatic control logic suffer from high manual effort and low pressure tolerance. In our work, we invented three-dimensional (3D) printable, pneumatic logic gates that perform Boolean operations and imitate electric circuits. Within 7 hours, a filament printer is able to produce a module that serves as an OR, AND, or NOT gate; the logic function is defined by the assigned input signals. The gate contains two alternately acting pneumatic valves, whose work principle is based on the interaction of pressurized chambers and a 3D-printed 1-millimeter tube inside. The gate design does not require any kind of support material for its hollow parts, which makes the modules ready to use directly after printing. Depending on the chosen material, the modules can operate on a pressure supply between 80 and more than 750 kilopascals. The capabilities of the invented gates were verified by implementing an electronics-free drink dispenser based on a pneumatic ring oscillator and a 1-bit memory. Their high compliance is demonstrated by driving a car over a fully flexible, 3D-printed robotic walker controlled by an integrated circuit.
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Affiliation(s)
- S Conrad
- Plant Biomechanics Group (PBG) Freiburg @ Botanic Garden of the University of Freiburg, Freiburg, Germany
- Cluster of Excellence livMatS @ FIT-Freiburg Center for Interactive Materials and Bioinspired Technologies, University of Freiburg, Freiburg, Germany
| | - J Teichmann
- Plant Biomechanics Group (PBG) Freiburg @ Botanic Garden of the University of Freiburg, Freiburg, Germany
- Cluster of Excellence livMatS @ FIT-Freiburg Center for Interactive Materials and Bioinspired Technologies, University of Freiburg, Freiburg, Germany
| | - P Auth
- Plant Biomechanics Group (PBG) Freiburg @ Botanic Garden of the University of Freiburg, Freiburg, Germany
| | - N Knorr
- Plant Biomechanics Group (PBG) Freiburg @ Botanic Garden of the University of Freiburg, Freiburg, Germany
| | - K Ulrich
- Plant Biomechanics Group (PBG) Freiburg @ Botanic Garden of the University of Freiburg, Freiburg, Germany
- Cluster of Excellence livMatS @ FIT-Freiburg Center for Interactive Materials and Bioinspired Technologies, University of Freiburg, Freiburg, Germany
| | - D Bellin
- Plant Biomechanics Group (PBG) Freiburg @ Botanic Garden of the University of Freiburg, Freiburg, Germany
| | - T Speck
- Plant Biomechanics Group (PBG) Freiburg @ Botanic Garden of the University of Freiburg, Freiburg, Germany
- Cluster of Excellence livMatS @ FIT-Freiburg Center for Interactive Materials and Bioinspired Technologies, University of Freiburg, Freiburg, Germany
- Freiburg Center for Interactive Materials and Bioinspired Technologies (FIT), University of Freiburg, Freiburg, Germany
| | - F J Tauber
- Plant Biomechanics Group (PBG) Freiburg @ Botanic Garden of the University of Freiburg, Freiburg, Germany
- Cluster of Excellence livMatS @ FIT-Freiburg Center for Interactive Materials and Bioinspired Technologies, University of Freiburg, Freiburg, Germany
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Rubio AA, Conrad S, Juzaitis-Boelter C, Wishon CR, Fahrenholz AC. The impact of marker selection, in-line near-infrared spectroscopy (NIR), and feed mix time on the coefficient of variation (mix uniformity), body weight uniformity and broiler growth performance during the starter, grower, and finisher periods. Poult Sci 2023; 102:103109. [PMID: 37832185 PMCID: PMC10568556 DOI: 10.1016/j.psj.2023.103109] [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] [Received: 06/29/2023] [Revised: 09/01/2023] [Accepted: 09/07/2023] [Indexed: 10/15/2023] Open
Abstract
Most feed manufacturers in the United States use the same mixing time (and thus mix uniformity) throughout the growing period regardless of age and consumption patterns. However, research evaluating the optimum mixing time requirements and novel analysis methods, such as in-line near-infrared (NIR) spectroscopy, on the coefficient of variation (CV) and growth performance of broilers throughout the production phases is sparse. Two experiments were conducted to determine the effects of marker selection, in-line NIR, and varying mix times on mix uniformity, broiler growth performance, and body weight uniformity from 1 to 42 d of age. Feed was manufactured utilizing a 1,815-kg counterpoise ribbon mixer. In both experiments, feed was mixed for 4.5 min (3 min dry mix and 90 s of wet mix) and 30 s (0 s dry mix and 30 s wet mix) to obtain a standard mix (SM) and an abbreviated mix (AM), respectively. Experiment 1 constituted a 2 × 2 × 4 factorial arrangement of 2 mix times, (4.5 and 0.5 min), 2 batch sizes (908 and 1,815 kg), and 4 methodologies to evaluate mixer performance (sodium chloride, Microtracers (Red#40 and Blue#40), and in-line NIR). In experiment 2, broilers received different mix time combinations: 1) SM from 1 to 42 d, 2) SM from 1 to 28 d and AM from 28 to 42 d, 3) SM from 1 to 14 d and AM from 14 to 42 d, and 4) AM from 1 to 42 d. In both experiments, selecting a single source marker provided a more accurate estimation of mixer CV in SM and AM diets (P < 0.05). In experiment 2, mix time did not influence BW, feed intake (FI), FCR, or individual bird BW CV from 1 to 42 d of age (P > 0.05). These data indicated that mixer CV differed depending on total mix time and methodology used and diets with a reduced mix time may not necessarily influence growth performance and BW uniformity during the starter, grower, and finisher periods of broilers.
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Affiliation(s)
- A A Rubio
- Prestage Department of Poultry Science, North Carolina State University, Raleigh, NC 27607, USA
| | - S Conrad
- Bruker Corporation, Billerica, MA 01821, USA
| | | | - C R Wishon
- Prestage Department of Poultry Science, North Carolina State University, Raleigh, NC 27607, USA
| | - A C Fahrenholz
- Prestage Department of Poultry Science, North Carolina State University, Raleigh, NC 27607, USA.
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Li Y, Warren J, Poston T, Shaw F, Conrad S, Xu Y, Zheng X, O’Connell CM, Hillier SL, Wiesenfeld HC, Darville T, Goonetilleke N. Identification of CPAF as the immunoprevalent antigen of Chlamydia trachomatis. The Journal of Immunology 2022. [DOI: 10.4049/jimmunol.208.supp.181.05] [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] [Indexed: 01/05/2023]
Abstract
Abstract
Chlamydia trachomatis (CT) is a common sexually transmitted bacterial infection, that in women can cause pelvic inflammatory disease and infertility. No preventative vaccine has been developed against CT. Immunity to CT is primarily mediated by Th1 CD4+ T cells. We are defining immunoprevalent CT proteins in a well-defined cohort of CT seropositive women with the goal of defining novel vaccine immunogens. We screened 30 women one month after a CT-positive test by cultured IFN-γ ELISpot. Ten-day short-term cell lines (STCL) were generated against overlapping peptides spanning 21 CT antigens. The threshold for a positive CT-specific T cell response (≥ 300 spot-forming cells, SFU, per 106 cells) was defined following a screening of 12 CT seronegative donors. CT− specific T cell responses were detected in 27/30 CT-seropositive women. On average, women harbored T cell responses to two CT proteins (range 0–6). Strikingly, CT858 (CPAF) elicited a T cell response in 16/30 women with an average of 966 IFN-g SFU/106 cells (range 300–3,633 SFU/106 cells). Data to date suggest CPAF-specific T cell responses are predominantly CD4-restricted. In preliminary studies, we have also detected CT-specific T cell responses in men with documented CT infection, including a T cell response to CPAF. We are currently mapping CPAF T cell epitopes and expanding our screen to other CT secreted proteins. In summary, CT858 (CPAF) is an immunoprevalent antigen in women and a promising vaccine immunogen.
Supported by UNC Chlamydia Vaccine Initiative (U19AI144181)
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Affiliation(s)
- Yanli Li
- 1Microbiology & Immunology, University of North Carolina at Chapel Hill
| | - Joanna Warren
- 1Microbiology & Immunology, University of North Carolina at Chapel Hill
| | - Taylor Poston
- 2Pediatrics, University of North Carolina at Chapel Hill
| | - Fiona Shaw
- 1Microbiology & Immunology, University of North Carolina at Chapel Hill
| | - Shayla Conrad
- 1Microbiology & Immunology, University of North Carolina at Chapel Hill
| | - Yinyan Xu
- 1Microbiology & Immunology, University of North Carolina at Chapel Hill
| | - Xiaojing Zheng
- 2Pediatrics, University of North Carolina at Chapel Hill
| | | | - Sharon L Hillier
- 3Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine
| | - Harold C Wiesenfeld
- 3Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine
| | - Toni Darville
- 2Pediatrics, University of North Carolina at Chapel Hill
| | - Nilu Goonetilleke
- 1Microbiology & Immunology, University of North Carolina at Chapel Hill
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Xu Y, Samir S, Weideman AMK, Kallon S, Conrad S, Shaw F, Warren J, Fernandez MA, Fox L, Margolis DM, Hudgens MG, Hanke T, Kuruc J, Gay C, Goonetilleke N. Conserved-region MVA vaccines can shift HIV T cell immunodominance in PWH on ART - the M&M Study. The Journal of Immunology 2022. [DOI: 10.4049/jimmunol.208.supp.64.15] [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] [Indexed: 01/04/2023]
Abstract
Abstract
CD8+ T cell immunity is essential to the control of HIV viremia. We examined the safety and immunogenicity of MVA-vectored vaccines expressing highly conserved HIV regions in a first-in-man Phase I study in people living with HIV on ART. Participants received a single intramuscular dose of MVA.tHIVconsv3 (M3), MVA.tHIVconsv4 (M4), combined M3+M4 or saline in a 7:7:7:3 ratio. M3 and M4 span the same 6 HIV regions but differ by approximately 10% of amino acids; a design to increase vaccine coverage of circulating HIV variants. We employed ex vivo IFN-g ELISpot assays to measure changes in HIV-specific T cell magnitude and breadth to M3 and/or M4 immunogens following vaccination. We also examined whether M3, M4 or M3+M4 vaccination increased the ability of CD8+ T cells inhibit HIV in vitro replication.
The M&M study is fully enrolled but presently is blinded. Analysis of blinded data show that vaccination was safe and well tolerated. Vaccination induced strong increases in the T cell response to M3, M4 vaccine immunogens producing a 2- to 18-fold increase in magnitude in 16/20 participants tested to date. M3/M4-specific T cell breadth also increased across participants. Vaccine-associated T cell responses mostly remained elevated (>2-fold increase) for at least 70 days post-vaccination visit. Vaccination was also associated with clear and sustained increases in in vitro virus inhibition. The percentage of the total HIV T cell response targeting conserved HIV regions in participants increased on average from 40 to 60% post-vaccination, suggesting M3/M4/M3+4 vaccination successfully produced a sustained shift in T cell immunodominance. Unblinded data will be presented at this meeting.
Supported by U01AI131310
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Affiliation(s)
- Yinyan Xu
- 1Dep. Microbiology and Immunology, University of North Carolina at Chapel Hill
| | - shahryat Samir
- 1Dep. Microbiology and Immunology, University of North Carolina at Chapel Hill
| | - Ann Marie K. Weideman
- 2Dep. Biostatistics, Univ. of North Carolina at Chapel Hill
- 3Biostatistics Core, University of North Carolina at Chapel Hill
| | - Sallay Kallon
- 1Dep. Microbiology and Immunology, University of North Carolina at Chapel Hill
| | - Shayla Conrad
- 1Dep. Microbiology and Immunology, University of North Carolina at Chapel Hill
| | - Fiona Shaw
- 1Dep. Microbiology and Immunology, University of North Carolina at Chapel Hill
| | - Joanna Warren
- 1Dep. Microbiology and Immunology, University of North Carolina at Chapel Hill
| | | | | | - David M. Margolis
- 1Dep. Microbiology and Immunology, University of North Carolina at Chapel Hill
- 5School of Medicine, University of North Carolina at Chapel Hill
- 6UNC HIV Cure center, University of North Carolina at Chapel Hill
| | - Michael G. Hudgens
- 2Dep. Biostatistics, Univ. of North Carolina at Chapel Hill
- 3Biostatistics Core, University of North Carolina at Chapel Hill
| | - Tomas Hanke
- 7Nuffield Dep of Medicine, University of Oxford, United Kingdom
| | - JoAnn Kuruc
- 5School of Medicine, University of North Carolina at Chapel Hill
- 6UNC HIV Cure center, University of North Carolina at Chapel Hill
| | - Cindy Gay
- 5School of Medicine, University of North Carolina at Chapel Hill
- 6UNC HIV Cure center, University of North Carolina at Chapel Hill
| | - Nilu Goonetilleke
- 1Dep. Microbiology and Immunology, University of North Carolina at Chapel Hill
- 5School of Medicine, University of North Carolina at Chapel Hill
- 6UNC HIV Cure center, University of North Carolina at Chapel Hill
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Marniquet ME, Conrad S, Musquer M, Alliot-Licht B, Corre P, Bertrand I, Barbarot S. Hyperkératose diffuse, atteinte cornéenne et parodontale due à une mutation dans NRLP1. Efficacité du traitement par anakinra. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Wilbanks T, Zimmerman R, Julius S, Kirshen P, Smith J, Moss R, Solecki W, Ruth M, Conrad S, Fernandez S, Matthews M, Savonis M, Scarlett L, Schwartz H, Toole L. Toward indicators of the performance of US Infrastructures under climate change risks. Clim Change 2020; 163:1795-1813. [PMID: 33867603 PMCID: PMC8048114 DOI: 10.1007/s10584-020-02942-9] [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] [Received: 01/02/2017] [Accepted: 11/05/2020] [Indexed: 06/12/2023]
Abstract
Built infrastructures are increasingly disrupted by climate-related extreme events. Being able to monitor what climate change implies for US infrastructures is of considerable importance to all levels of decision-makers. A capacity to develop cross-cutting, widely applicable indicators for more than a dozen different kinds of infrastructure, however, is severely limited at present. The development of such indicators must be considered an ongoing activity that will require expansion and refinement. A number of recent consensus reports suggest four priorities for indicators that portray the impacts of climate change, climate-related extreme events, and other driving forces on infrastructure. These are changes in the reliability of infrastructure services and the implications for costs; changes in the resilience of infrastructures to climate and other stresses; impacts due to the interdependencies of infrastructures; and ongoing adaptation in infrastructures.
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Affiliation(s)
- T Wilbanks
- Oak Ridge National Laboratory, Oak Ridge, USA
| | | | - S Julius
- US Environmental Protection Agency, Washington, DC, USA
| | - P Kirshen
- University of Massachusetts, Boston, MA, USA
| | - J Smith
- Abt Associates, Boulder, CO USA
| | - R Moss
- Princeton University, Princeton, NJ, USA
| | - W Solecki
- Hunter College, CUNY, New York, NY, USA
| | - M Ruth
- University of York, York, United Kingdom
| | - S Conrad
- Sandia National Laboratories, Albuquerque, NM, USA
| | | | - M Matthews
- US Department of Homeland Security, Washington, DC, USA
| | - M Savonis
- ICF International, Washington, DC, USA
| | - L Scarlett
- The Nature Conservancy, Arlington, VA, USA
| | - H Schwartz
- HGS Consultants LLC, Saint Louis, MO, USA
| | - L Toole
- Los Alamos National Laboratory, Los Alamos, NM, USA
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Hardt J, Conrad S, Muche-Borowski C, Raspe H. Epidemiology of depression and distress in patients with inflammatory bowel disease (IBD) and validation of an indicator scale of perceived stress for psychosocial impairments. Eur Psychiatry 2020. [DOI: 10.1016/s0924-9338(11)73920-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BackgroundPrevious studies showed associations of stress and episodes of active disease [1,2]. We reported survey data on psychosocial problems of IBD patients [3]. This study investigates associations of stress with health impairments and analyses a scale of perceived stress as an indicator for psychosocial impairments (construct/criterion validity) [4].MethodsIn a multiregional German survey in 2005, 1083 patients with Crohn's disease (CD) and ulcerative colitis were recruited (gastroenterological practices, university outpatient clinics, patient organization). The questionnaire incorporated WHO's ICF [5] and established items and scales (i.a. HADS [6]). Scale construction followed item response theory analysing psychometric properties.ResultsOf the survey responders (58% CD, 65% female, mean age 42yrs), ⅓ reported severe fatigue. Clinically relevant anxiety was observed in 24%, depression in 29% of men and 21% of women. With three items we constructed a scale with good psychometric properties. Three groups (low, moderate, high perceived stress) were identified, differing substantially in reported anxiety/depression and the GIBDI disease activity score.ConclusionsIBD patients report multiple psychosocial impairments. The scale of perceived stress may identify IBD patients with high demand for psychosocial attendance, if confirmed in independent samples. For enhanced secondary prevention [7] we propose integration of this psychosocial indicator into the diagnostic process.
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Cooper D, Conrad S, Padilla L, Weiss E. Comparing Maximum Dose to Central Airways in Mid-Ventilation Versus Average Intensity Projection-Based 4DCT Planning for Lung Stereotactic Body Radiation Therapy (SBRT). Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.790] [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: 11/29/2022]
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Nitsche J, Conrad S, Hoopes S, Carrel M, Bebeau K, Brost B. Continued Validation of Ultrasound Guidance Targeting Tasks: Assessment of Internal Structure. Acad Radiol 2019; 26:559-565. [PMID: 30316705 DOI: 10.1016/j.acra.2018.08.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/22/2018] [Accepted: 08/23/2018] [Indexed: 10/28/2022]
Abstract
RATIONALE AND OBJECTIVES We previously demonstrated validity evidence for our novel ultrasound-guided invasive procedure targeting tasks in the content, response process, relations with other variables, and consequences validity domains. Here, we investigate their internal structure by assessing their interrater, intrarater, and test-retest reliability. METHODS In this Institutional Review Board approved nonrandomized interventional trial first year medical students performed our previously described dowel and straw ultrasound guidance targeting tasks as a pretest. Afterward, the training group had four weekly 1-hour training sessions. The control group had no further training. Both groups then had a posttest for both tasks. The training group was re-evaluated 2 and 5 months later. Completion time in seconds, errors, and error adjusted time (5 seconds penalty/error) were recorded. Pretest and posttest performance was compared within groups, and the amount of improvement from pretest to posttest was compared between groups. Interrater, intrarater, and test-retest interclass correlation coefficients (ICC) were calculated. RESULTS Although some improvements from pretest to posttest were seen in both groups, greater improvements were seen in the training group. This skill was retained for at least several months. The interrater and intrarater ICCs were excellent (range 0.83-0.93). The test-retest ICCs were good to excellent in all but one performance measure (0.50-0.78). CONCLUSION Student performance on the targeting tasks improved markedly after training and persisted for several months. The interrater and intrarater reliability were excellent, while the test-retest reliability was good. This provides additional validity evidence for our novel ultrasound-guided invasive procedure targeting curriculum.
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Graf N, Koelblinger P, Galliker N, Conrad S, Barysch M, Mangana J, Dummer R, Cheng P, Goldinger S. The spectrum of cutaneous adverse events during encorafenib and binimetinib treatment in B‐rapidly accelerated fibrosarcoma‐mutated advanced melanoma. J Eur Acad Dermatol Venereol 2018; 33:686-692. [DOI: 10.1111/jdv.15363] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 10/23/2018] [Indexed: 01/07/2023]
Affiliation(s)
- N.P. Graf
- Department of Dermatology University Hospital of Zurich Zurich Switzerland
| | - P. Koelblinger
- Department of Dermatology University Hospital of Zurich Zurich Switzerland
- Department of Dermatology Paracelsus Medical University Salzburg Austria
| | - N. Galliker
- Department of Dermatology University Hospital of Zurich Zurich Switzerland
| | - S. Conrad
- Department of Dermatology University Hospital of Zurich Zurich Switzerland
| | - M. Barysch
- Department of Dermatology University Hospital of Zurich Zurich Switzerland
| | - J. Mangana
- Department of Dermatology University Hospital of Zurich Zurich Switzerland
| | - R. Dummer
- Department of Dermatology University Hospital of Zurich Zurich Switzerland
| | - P.F. Cheng
- Department of Dermatology University Hospital of Zurich Zurich Switzerland
| | - S.M. Goldinger
- Department of Dermatology University Hospital of Zurich Zurich Switzerland
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Conrad S, Schulzke T, Heil V. Verbesserte Pyrolyseöle durch katalytische Dampfbehandlung und gestufte Kondensation für die Nutzung in Raffinerien. CHEM-ING-TECH 2018. [DOI: 10.1002/cite.201855040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- S. Conrad
- Fraunhofer UMSICHT, Fraunhofer-Institut für Umwelt-, Sicherheits- und Energietechnik; Bioraffinerie und Biokraftstoffe; Osterfelder Straße 3 46047 Oberhausen Deutschland
| | - T. Schulzke
- Fraunhofer UMSICHT, Fraunhofer-Institut für Umwelt-, Sicherheits- und Energietechnik; Bioraffinerie und Biokraftstoffe; Osterfelder Straße 3 46047 Oberhausen Deutschland
| | - V. Heil
- Fraunhofer UMSICHT, Fraunhofer-Institut für Umwelt-, Sicherheits- und Energietechnik; Bioraffinerie und Biokraftstoffe; Osterfelder Straße 3 46047 Oberhausen Deutschland
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Fernández De la Maza S, Conrad S, Graefen M, Noldus J, Huland H. Early clinical experience with water-jet dissection (hydro-jet) during nerve-sparing radical retropubic prostatectomy. MINIM INVASIV THER 2017; 11:257-264. [DOI: 10.1080/13645706.2003.11873723] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - S. Conrad
- Department of Urology, University Hospital Hamburg - Eppendorf, Hamburg, Germany
| | - M. Graefen
- Department of Urology, University Hospital Hamburg - Eppendorf, Hamburg, Germany
| | - J. Noldus
- Department of Urology, University Hospital Hamburg - Eppendorf, Hamburg, Germany
| | - H. Huland
- Department of Urology, University Hospital Hamburg - Eppendorf, Hamburg, Germany
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Kappel DF, Chapman WC, Conrad S, Reed A, Linderer R, Dunn S, Niles P, Levy MF, Cawiezell T. Organ Procurement Organization Liver Acquisition Costs Could More Than Double With Proposed Redistricts. Am J Transplant 2015; 15:2269-70. [PMID: 26096181 DOI: 10.1111/ajt.13346] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 03/26/2015] [Accepted: 04/04/2015] [Indexed: 01/25/2023]
Affiliation(s)
- D F Kappel
- Mid-America Transplant Services, St. Louis, MO
| | - W C Chapman
- Department of Surgery, Washington University School of Medicine, St. Louis, MO
| | - S Conrad
- Iowa Donor Network, Iowa City, IA
| | - A Reed
- University of Iowa Organ Transplant Center, Iowa City, IA
| | - R Linderer
- Midwest Transplant Network, Westwood, KS
| | - S Dunn
- Donor Alliance, Denver, CO
| | - P Niles
- Southwest Transplant Alliance, Dallas, TX
| | - M F Levy
- Baylor All Saints Medical Center, Fort Worth, TX
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Hack CC, Voiß P, Lange S, Paul AE, Conrad S, Dobos GJ, Beckmann MW, Kümmel S. Local and Systemic Therapies for Breast Cancer Patients: Reducing Short-term Symptoms with the Methods of Integrative Medicine. Geburtshilfe Frauenheilkd 2015; 75:675-682. [PMID: 26257404 DOI: 10.1055/s-0035-1557748] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 06/21/2015] [Accepted: 06/21/2015] [Indexed: 12/25/2022] Open
Abstract
With improved prognosis due to advances in the diagnosis and therapy of breast cancer, physicians and therapists now focus on aspects such as quality of life and the management of side effects from breast cancer treatment. Therapy- and disease-related side effects often reduce the patient's quality of life and can place a further burden on patients, with non-compliance or discontinuation of therapy a potential consequence. Study data have shown that therapy- and disease-related side effects can be reduced using the methods of integrative medicine. Reported benefits include improving patients' wellbeing and quality of life, reducing stress, and improving patients' mood, sleeping patterns and capacity to cope with disease. Examining the impact of integrative medicine on the side effects of cancer treatment would be beyond the scope of this review. This article therefore looks at short-term side effects of cancer treatment which are usually temporary and occur during or after local and systemic therapy. The focus is on mind-body medicine, acupuncture and classic naturopathic treatments developed by Sebastian Kneipp as complementary therapies. The latter includes hydrotherapy, phytotherapy, nutritional therapy, exercise therapy and a balanced lifestyle.
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Affiliation(s)
- C C Hack
- Universitäts-Brustzentrum Franken, Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen
| | - P Voiß
- Klinik für Naturheilkunde und Integrative Medizin, Kliniken Essen Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen ; Brustzentrum, Kliniken Essen Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen
| | - S Lange
- Klinik für Naturheilkunde und Integrative Medizin, Kliniken Essen Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen
| | - A E Paul
- Klinik für Naturheilkunde und Integrative Medizin, Kliniken Essen Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen
| | - S Conrad
- Klinik für Naturheilkunde und Integrative Medizin, Kliniken Essen Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen
| | - G J Dobos
- Klinik für Naturheilkunde und Integrative Medizin, Kliniken Essen Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen
| | - M W Beckmann
- Universitäts-Brustzentrum Franken, Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen
| | - S Kümmel
- Brustzentrum, Kliniken Essen Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen
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Conrad S, Herber-Gast GC. Vasomotor menopausal symptoms and risk of stroke among mid-aged women. Int J Stroke 2015; 10:E13. [PMID: 25598028 DOI: 10.1111/ijs.12415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S Conrad
- School of Population Health, University of Queensland, Brisbane, Qld, Australia
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Khan C, Schwarz S, Conrad S, Koltermann K, Dippmann A, Ollenschlaeger G. P210 Changes In Performance Of The Adaptation Methodology Used For Guideline Development From 2002 To 2012. BMJ Qual Saf 2013. [DOI: 10.1136/bmjqs-2013-002293.208] [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: 11/03/2022]
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Bokemeyer B, Hardt J, Hüppe D, Prenzler A, Conrad S, Düffelmeyer M, Hartmann P, Hoffstadt M, Klugmann T, Schmidt C, Weismüller J, Mittendorf T, Raspe H. Clinical status, psychosocial impairments, medical treatment and health care costs for patients with inflammatory bowel disease (IBD) in Germany: an online IBD registry. J Crohns Colitis 2013; 7:355-68. [PMID: 22503168 DOI: 10.1016/j.crohns.2012.02.014] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Revised: 02/08/2012] [Accepted: 02/18/2012] [Indexed: 02/08/2023]
Abstract
BACKGROUND The aim of this cross-sectional study was to establish an online inflammatory bowel disease (IBD) registry for a first picture of the situation of IBD outpatients' treatment in Germany. METHODS Between March 2006 and July 2007 IBD outpatients from 24 gastroenterological specialist practices and two hospitals in Germany were enrolled in an Internet-based registry to evaluate the outpatients' clinical status, psychological impairments, provided health care, as well as medical treatment and medication costs. RESULTS 1032 IBD patients (ulcerative colitis/UC: 519; Crohn's disease/CD: 511; indeterminate colitis: 2) were enrolled in the study (age: 43 ± 14 years/M ± SD). Disease duration of all patients averaged 10 ± 8.5 years. In 519 UC-patients (49% male; 33% pancolitis), 66% were in remission as were 55% of CD patients (37 % male; 41 % active smokers). Associated with higher rates of disease activity (CDAI ≥ 150; CAI>4) were corticosteroids (CD, UC), topical medication (UC), relevant reported depressive symptoms (15%; 6-31%) and impairments in sexuality (21%; 9-42%). Relevant medication groups prescribed were oral aminosalicylates (UC: 70%; CD: 47%); immunosuppressive therapy - mostly azathioprine/6 MP (CD: 47%; UC: 26%), and Infliximab (CD: 8%; UC: 3%). Strongly associated with their clinical disease activity in UC as well as CD patients, 15% (6-31%) reported relevant depressive symptoms and 21% (9-42%) relevant impairments in sexuality. CONCLUSIONS The registry constitutes a large complemental database for the patient population in Germany. About one third of the IBD patients were not in clinical remission (CDAI ≥150/CAI >4) (CD: 45%; UC: 27%), although high rates of immunosuppressive drugs (CD: 47%; UC 26%) were administered. This study shows a large burden of active disease associated with an unexpectedly high (co)morbidity and high psychosocial impairments, indicating a reduced health state in IBD patients.
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Conrad S, Hüppe A, Raspe H. [Preference of patients with inflammatory bowel disease regarding information and shared decision-making: results from a cross-sectional survey in Germany]. Z Gastroenterol 2012; 50:364-72. [PMID: 22467539 DOI: 10.1055/s-0031-1281949] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Evidence-based and consented pathways for patients with inflammatory bowel diseases (IBD, Crohn's disease, ulcerative colitis) call for tailored education programmes to foster shared decision-making and patient self-management. Their preferences should be taken into account. METHODS In 2005 a cross-sectional postal questionnaire survey was conducted in different regions of Germany. Adult patients with ulcerative colitis (UC) or Crohn's disease (CD) were recruited from specialised gastroenterological practices, university outpatient clinics and the member registry of the relevant patient organisation DCCV. They returned a questionnaire including (inter)nationally established scales (e. g., HADS) as well as questions on their information needs, preferred information sources and their role in decision-making. RESULTS Data of 1056 responders could be analysed (65 % female; CD: 58 %; DCCV member: 71 %). The mean age of the patients was 42 (SD 12,8) years. Almost all patients wanted more information on "treatment alternatives" (83 %), "causes of disease" (80 %) and "what can I (still) do by myself" (79 %). 27 % of the patients asked for more information on 15 or more of overall 19 topics. The high information need was significantly associated with HADS potential depressive disorder (score > 8) and HADS probable anxiety disorder (score > 10). Most IBD patients (70 %) obviously regard their physicians as the most desirable source of information, 67 % prefer an active involvement in clinical decision-making. CONCLUSIONS The data demonstrate high information needs of IBD patients and may serve in the planning of future educational programmes.
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Affiliation(s)
- S Conrad
- Evidenzbasierte Medizin und Leitlinien, Ärztliches Zentrum für Qualität in der Medizin, Berlin
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Abstract
Neoadjuvant chemotherapy consisting of cisplatin and gemcitabine was given to a 50-year-old woman suffering from transitional cell carcinoma of the bladder. Whereas the first cycle was administered without major side effects, the patient experienced a generalized tonic-clonic seizure and a prolonged cognitive deficit with the second cycle. Magnetic resonance imaging of the brain was consistent with cerebral vasculitis. The short interval between the application of gemcitabine and the neurological deterioration suggests a causal relationship. Although recent reports have linked this drug with leukoencephalopathy and vasculitis in various localizations, this is the first case of cerebral vasculitis associated with gemcitabine.
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Affiliation(s)
- P Schmorl
- Urologische Klinik, Diakoniekrankenhaus Friederikenstift gGmbH, Hannover.
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Hardt J, Muche-Borowski C, Conrad S, Balzer K, Bokemeyer B, Raspe H. Chronisch entzündliche Darmerkrankungen als multifokale Erkrankungen: körperliche und psychosoziale Probleme von Patienten mit CED. Ergebnisse eines Fragebogen-Surveys. Z Gastroenterol 2009; 48:381-91. [DOI: 10.1055/s-0028-1109524] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hardt J, Muche-Borowski C, Conrad S, Raspe H. Körperliche und psychosoziale Probleme von Patienten mit chronisch entzündlichen Darmerkrankungen (CED). Ergebnisse eines ICF-orientierten Fragebogen-Surveys. Gesundheitswesen 2009. [DOI: 10.1055/s-0029-1239272] [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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Hardt J, Conrad S, Muche-Borowski C, Raspe H. Stresserleben und psychische Beeinträchtigungen bei Patienten mit chronisch entzündlichen Darmerkrankungen (CED). Ergebnisse zur Validierung einer Kurzskala. Gesundheitswesen 2009. [DOI: 10.1055/s-0029-1239189] [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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Affiliation(s)
- A Rose
- Klinik und Poliklinik für Urologie, Universitätsklinikum, Hufelandstrasse 55, 45122 Essen.
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Prenzler A, Mittendorf T, Conrad S, von der Schulenburg JM, Bokemeyer B. Die direkten Kosten der Versorgung von Patienten mit Morbus Crohn aus der Perspektive der Gesetzlichen Krankenversicherung. Z Gastroenterol 2009; 47:659-66. [DOI: 10.1055/s-0028-1109059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Raspe H, Conrad S, Muche-Borowski C. Evidenzbasierte und interdisziplinär konsentierte Versorgungspfade für Patientinnen und Patienten mit Morbus Crohn oder Colitis ulcerosa. Z Gastroenterol 2009; 47:541-62. [DOI: 10.1055/s-0028-1109323] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
We report on a 66-year-old man after nephrectomy of the right kidney because of renal cell carcinoma. One year after diagnosis, an osseous metastasis of the right femur occurred and was resected. The following investigations, including positron emission tomography/computed tomography, showed no relapse. Three and a half years after diagnosis, the patient developed a testicular tumor of the right hemiscrotum, which was treated by testicular ablation. The histological investigation showed a testicular metastasis of renal cancer. This case represents one of the unusual forms of metastatic invasion of renal cell cancer.
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Affiliation(s)
- P Schmorl
- Urologische Klinik, Diakoniekrankenhaus Friederikenstift gGmbH, Humboldtstrasse 5, 30169, Hannover, Germany.
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Riegger T, Conrad S, Schluesener HJ, Kaps HP, Badke A, Baron C, Gerstein J, Dietz K, Abdizahdeh M, Schwab JM. Immune depression syndrome following human spinal cord injury (SCI): a pilot study. Neuroscience 2008; 158:1194-9. [PMID: 18790013 DOI: 10.1016/j.neuroscience.2008.08.021] [Citation(s) in RCA: 113] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2008] [Revised: 08/10/2008] [Accepted: 08/11/2008] [Indexed: 12/14/2022]
Abstract
Experimental spinal cord injury (SCI) has been identified to trigger a systemic, neurogenic immune depression syndrome. Here, we have analyzed fluctuations of immune cell populations following human SCI by FACS analysis. In humans, a rapid and drastic decrease of CD14+ monocytes (<50% of control level), CD3+ T-lymphocytes (<20%, P<0.0001) and CD19+ B-lymphocytes (<30%, P=0.0009) and MHC class II (HLA-DR)+ cells (<30%, P<0.0001) is evident within 24 h after spinal cord injury reaching minimum levels within the first week. CD15+ granulocytes were the only leukocyte subpopulation not decreasing after SCI. A contributing, worsening effect of high dose methylprednisolone cannot be excluded with this pilot study. We demonstrate that spinal cord injury is associated with an early onset of immune suppression and secondary immune deficiency syndrome (SCI-IDS). Identification of patients suffering spinal cord injury as immune compromised is a clinically relevant, yet widely underappreciated finding.
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Affiliation(s)
- T Riegger
- Institute of Brain Research, Department of Anatomy, Medical School, University of Tuebingen, 72076 Tuebingen, Germany
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Conrad S, Hardt J, Raspe H, Muche-Borowski C. Stresserleben und Wahrnehmung von Präventionsangeboten bei Betroffenen mit chronisch entzündlichen Darmerkrankungen (CED). Gesundheitswesen 2008. [DOI: 10.1055/s-0028-1086245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schneider A, Conrad S, Busch R, Otto U, Klosterhalfen H. Indikation, Technik und Ergebnisse der endourologischen Schlitzung von Stenosen des oberen Harntraktes. Aktuelle Urol 2008. [DOI: 10.1055/s-2008-1060657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Conrad S, Busch R, Otto U, Klöppel G. Leiomyosarkom des Penis. Aktuelle Urol 2008. [DOI: 10.1055/s-2008-1061181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Isbarn H, Budäus L, Pichlmeier U, Conrad S, Huland H, Friedrich M. Vergleich der Effektivität der Langzeitinstillation mit Mitomycin C gegen Kurzzeitprophylaxen mit MMC oder Bacillus Calmette-Guerin. Urologe A 2008; 47:608-15. [DOI: 10.1007/s00120-008-1671-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Friedrich M, Pichlmeier U, Schwaibold H, Huland H, Conrad S. MP-19.14: Three year follow-up of a multicenter trial comparing mitomycin C (MMC) long term with short-term treatment with MMC or Bacillus Calmette-Guerin (BCG) in non muscle-invasive bladder cancer (NMIBC). Urology 2007. [DOI: 10.1016/j.urology.2007.06.549] [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: 11/28/2022]
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Sievert KD, Feil G, Renninger M, Selent C, Maurer S, Conrad S, Hennenlotter J, Nagele U, Schäfer R, Möhle R, Skutella T, Northoff H, Seibold J, Stenzl A. „Tissue engineering“ und Stammzellforschung in der Urologie für den rekonstruktiven bzw. regenerativen Therapieansatz. Urologe A 2007; 46:1224-30. [PMID: 17701156 DOI: 10.1007/s00120-007-1486-3] [Citation(s) in RCA: 4] [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: 10/23/2022]
Abstract
With the involvement of clinical reconstructive urology in the field of tissue engineering, outstanding results have been achieved in basic research as well as in some clinics. Stem cell research has even opened up possibilities for regenerative aspects. In close cooperation with various disciplines, the Department of Urology at the University of Tübingen investigates different clinical aspects with regard to reconstructive and regenerative urology. The regeneration of the external urethral sphincter requires functionally integrated muscle cells. In addition stricture reconstruction with multilayer urothelium should become less invasive and the re-stricture rate reduced. After the application of differentiating stem cells was proven, the clinical setting needed to be set for legal issues. In addition to the specification of culture media and verification in the animal model, the possibility to harvest omnipotent stem cells out of human testis and to differentiate those into the three germ layers was demonstrated. With the reduced invasiveness of harvesting the urothelium cells by a bladder wash using specific culture fluids, the cell culture was significantly improved enabling successful creation of urothelium by stratification. In addition urothelial cells in a matrix are further improved for endoscopic application. The close cooperation of different disciplines shortens the time to develop therapeutic approaches with a close clinical relationship in reconstructive and regenerative urology.
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Affiliation(s)
- K-D Sievert
- Klinik für Urologie, Universitätsklinikum, Hoppe-Seyler-Strasse 3, 72076 Tübingen.
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Conrad S, Renninger M, Hennenlotter J, Just L, Wiesner T, Sievert K, Stenzl A, Skutella T. Spermatogonial stem cells from adult human testis and the generation of pluripotency in vitro and in vivo. J Stem Cells Regen Med 2007; 2:4. [PMID: 24692871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- S Conrad
- Institute of Anatomy, Department of Experimental Embryology, Section of Tissue Engineering , Tubingen, Germany
| | - M Renninger
- Department of Urology, University Clinic Tubingen , Germany
| | - J Hennenlotter
- Department of Urology, University Clinic Tubingen , Germany
| | - L Just
- Institute of Anatomy, Department of Experimental Embryology, Section of Tissue Engineering , Tubingen, Germany
| | - T Wiesner
- Institute of Anatomy, Department of Experimental Embryology, Section of Tissue Engineering , Tubingen, Germany
| | - Kd Sievert
- Department of Urology, University Clinic Tubingen , Germany
| | - A Stenzl
- Department of Urology, University Clinic Tubingen , Germany
| | - T Skutella
- Institute of Anatomy, Department of Experimental Embryology, Section of Tissue Engineering , Tubingen, Germany ; Centre for Regenerative Biology and Medicine (ZRM) , Tubingen, Germany
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Conrad S. [Prognostic markers for congenital hydronephroses]. Urologe A 2007; 46:124-31. [PMID: 17273832 DOI: 10.1007/s00120-007-1293-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Watchful waiting has become the standard therapy in most cases of asymptomatic unilateral congenital hydronephroses with normal renal function. Simple, reliable, and noninvasive prognostic parameters that predict an increased risk of functional deterioration either at the initial evaluation or during follow-up would be most useful. At the moment the diameter of the renal pelvis and especially its increase is the most useful prognostic parameter, while an "obstructed" washout at furosemide isotope renography is of limited prognostic value. Preclinical and preliminary clinical studies indicate that the measurement of molecules in the urine of affected children such as TGF-31 and MCP-1 that are involved in the signal transduction during hydronephrotic atrophy might become well accepted as useful prognostic parameters in the near future.
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Affiliation(s)
- S Conrad
- Urologische Klinik, Diakoniekrankenhaus Friederikenstift gGmbH, Hannover.
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Riegger T, Conrad S, Schluesener HJ, Schwab JM. Spinal cord injury induced immune depression syndrome. Akt Neurol 2007. [DOI: 10.1055/s-2007-987540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
Congenital anomalies of the kidney and urinary tract (CAKUT) are regarded as a single entity. The degree of obstruction may have an additional influence on the parenchymal malfunction. Congenital dilatation of the upper urinary tract associated with symptomatic urinary tract infection must be treated early with intensive antibiotic therapy. In some cases temporary urinary diversion is also required. Further diagnostic procedures are then postponed in such cases. In all other cases of dilatation of the upper urinary tract diagnosed prenatally or early in the postnatal period, diuresis renography is still the cornerstone of diagnosis, even though it has definite limitations in young infants and in babies with poor kidney function. Functional gadolinum MR-urography will become the method of choice in the near future, since it combines good functional and excellent morphological presentation. When an obstruction hampering function is definitely present surgical correction is indicated: open and endoscopic surgery yield similarly good results. Molecular markers in CAKUT may soon be used as prognostic indicators. Examination of the molecular alterations that occur in renal and urinary tract anomalies may also lead to medicamentous protection of renal function.
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Affiliation(s)
- R-H Ringert
- Bereich Humanmedizin, Klinik und Poliklinik für Urologie, Georg-August-Universität, Robert-Koch-Strasse 40, 37099 Göttingen.
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Abstract
OBJECTIVE To explore psychosocial factors that impact on quality of life for people living with self-reported chronic hepatitis C. METHODS A purposeful sample of 70 people who were self-identified as being hepatitis C virus (HCV)-positive was recruited through a variety of institutions and community agencies. Semi-structured interviews were held with 12 groups and 21 individuals. A qualitative grounded-theory methodology was used for data collection and analysis. Experiences of physical and psychological symptoms, stigma and discrimination, and living with an infectious disease, were explored using matrices. RESULTS Phenomena emerging from the data included previously undocumented illness 'attacks' that were associated with depressive symptoms and a perception of hepatitis C as fatal. Uncertainty related to disease progression and transmission of the virus were common experiences among participants. A universal experience was fear and anxiety about stigma and discrimination. DISCUSSION The findings of this study indicate that chronic hepatitis C has a pervasive impact on quality of life with a complexity that has not been explored with quantitative research approaches. Primary healthcare professionals need to be alert to the psychological and social impacts of chronic hepatitis C and to avoid behaviours that lead to perceptions of stigma and discrimination. The research indicates a need for further investigation into the relationship between psychosocial factors, disease management and disease progression.
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Affiliation(s)
- S Conrad
- Centre for Public Health Research, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland, 4059, Australia.
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Brechtel K, Tura A, Abdibzadeh M, Hirsch S, Conrad S, Schwab JM. Intrinsic locomotor outcome in dorsal transection of rat spinal cord: predictive value of minimal incision depth. Spinal Cord 2006; 44:605-13. [PMID: 16389269 DOI: 10.1038/sj.sc.3101894] [Citation(s) in RCA: 11] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Experimental, prospective, blinded, animal study. OBJECTIVES Subtotal transection models in rodents are widely used in spinal cord injury (SCI) research. In this model, we investigate the effect of the dorso-ventral incision depth (ID) of the spinal cord on functional locomotor outcome using the Basso, Beattie, Bresnahan (BBB) scale. We introduce the minimal incision depth (ID(min)) and the average lesion depth (ID(mean)) as reliable, fast and easily available predictive parameters for intrinsic locomotor function. SETTING Tuebingen, Germany. METHODS Dorsal over-hemisection at the level of T8 was performed in male Lewis rats. Functional outcome 4 weeks after SCI and histological analysis of the lesion were studied and correlated in 36 animals. Animals reaching weight support (BBB> or =9) were considered as having reached functional recovery. Data analysis was performed in linear (ordinary least squares; OLS) and nonlinear (logistic) regression models for correlation of histological parameters and functional outcome. RESULTS BBB scores revealed a strong correlation with ID(mean) and ID(min), showing a higher value in predicting functional outcome for the latter parameter. Based on logistic regression analysis, animals with an ID(min) of 69% would have a 95% probability of reaching weight support. CONCLUSION These results demonstrate that histological analysis is crucial when functional outcome parameters are used in the dorsal over-hemisection SCI model. A simple and feasible histological evaluation can reliably predict spontaneous functional locomotor recovery in dorsal transection models and could provide a simple tool to identify treatment effects of new experimental therapeutic approaches.
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Affiliation(s)
- K Brechtel
- Department of Diagnostic Radiology, University of Tuebingen, Tuebingen, Germany
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Jaeger R, Brechtel K, Schluesener HJ, Conrad S, Kaps HP, Schwab JM. A simple methodology to improve AIS-based assessment of recovery after acute spinal cord injury. Spinal Cord 2004; 43:61-3; author reply 64. [PMID: 15520838 DOI: 10.1038/sj.sc.3101665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Fertmann F, Conrad S, Schümann M. Bundesweite Umfrage bei den Gesundheitsämtern zum umweltbezogenen Gesundheitsschutz. Gesundheitswesen 2004. [DOI: 10.1055/s-2004-833870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
The likelihood of terminal renal insufficiency escalates with age, increasing the risk of dying as a patient requiring dialysis. In 1999, Eurotransplant initiated the Eurotransplant Senior Programm (ESP), in which the kidneys of old donors (>64 years) are allocated to recipients 64 years and older. Allocation does not take HLA-matching into account and is performed regionally only according to blood-group-compatibility to keep the storage time short. As a consequence of the short ischemic time, and thus reduced non-immunological damage to the anyways susceptible old kidney, graft-function and graft-survival in the ESP are very good. The results of the initial 5 years of this program show that it successfully utilizes more kidneys from old donors and that more old recipients are being transplanted, with a satisfactory graft-function. Increased donor- and/or recipient age require a thorough evaluation to exclude malignant and other diseases. Furthermore, short term controls on the waiting list and following kidney transplantation are prerequisites for successful transplantation in the aged recipient. If this is guaranteed, kidney transplantation in the old recipient-even with old donor organs-is a good alternative to the morbidity of a prolonged dialysis. Nevertheless, the role of HLA-matching should be reconsidered to reduce rejections.
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Affiliation(s)
- M Giessing
- Klinik und Poliklinik für Urologie--Campus Mitte, Charité-Universitätsmedizin Berlin.
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Xiao F, Arnold T, Zhang S, Imtiaz N, Khan A, Alexander JS, Conrad S, Carden D. Matrix metalloproteinases are not involved in early brain edema formation after cardiac arrest in rats. Acta Neurochir Suppl 2004; 86:75-8. [PMID: 14753409 DOI: 10.1007/978-3-7091-0651-8_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
INTRODUCTION Resuscitation from cardiac arrest (CA) often results in a poor neurological outcome possibly due to an incomplete understanding of the pathophysiology of brain injury following CA-induced global cerebral ischemia. Brain edema is an important manifestation after CA and is associated with significant morbidity and mortality. The matrix metalloproteinases (MMPs) contribute to brain edema formation following focal cerebral ischemia. The objective of this study was to investigate the role of an MMP inhibitor, GM6001, in CA-elicited brain edema. METHODS Eighteen rats were subjected to normothermic (37.5 +/- 0.5 degrees C) CA induced by eight minutes of asphyxiation and assigned to a CA-control group (CA), an alcohol-placebo group (CA + ETOH), or a GM6001-treated group (CA + GM6001). GM6001 in 100% alcohol or a vehicle was given i.v. before CA to achieve a whole blood concentration of 10 microM. Animals were resuscitated with CPR, ventilation and epinephrine. Brain edema was determined by brain wet-to-dry weight ratio at one hour after resuscitation. FINDINGS Brain wet-to-dry weight ratio was 4.86 +/- 0.09 in CA, 4.76 +/- 0.12 in CA + ETOH (p = 0.30 vs. CA), and 4.72 +/- 0.03 in CA + GM6001 (p = 0.17 vs. CA and 0.42 vs. CA + ETOH). INTERPRETATION MMPs are not involved in brain edema formation one hour following CA.
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Affiliation(s)
- F Xiao
- Department of Emergency Medicine, Louisiana State University Health Science Center, Shreveport 71130, USA.
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Hautmann S, Felix-Chun KH, Currlin E, Friedrich MG, Dose Schwarz J, Langwieler T, Conrad S, Huland H. [Cystectomy for indications other than bladder cancer]. Urologe A 2004; 43:172-7. [PMID: 14991119 DOI: 10.1007/s00120-003-0485-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [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: 10/26/2022]
Abstract
A cystectomy for indications other than transitional cell cancer of the bladder or general bladder cancer is frequently performed in cooperation with other surgical specialties such as general surgery or gynecology. In these cases the urological procedure as well as the oncological and surgical concepts of other specialties have to be combined. We studied our cystectomy patients who had undergone such a combined procedure for a non-urothelial indication concerning perioperative and postoperative complications.A total of 204 cystectomies were performed by the Department of Urology at the University of Hamburg, Germany between 1995 and 2003. Bladder cancer was the indication for cystectomy in 162 patients, but 42 patients had a non-urothelial indication for this procedure. These patients included 12 cases of advanced rectal cancer, 9 cases of advanced cervical cancer, 6 cases of advanced sigmoid cancer, 4 cases of advanced prostate cancer, 1 case of prostate sarcoma, 5 cases of complex vesicointestinal fistulae, 2 cases of urachal cancer, 1 leiomyosarcoma, 1 rhabdomyoma, and 1 rhabdomyosarcoma, respectively. Perioperative and postoperative complications of those patients were compared to patients who underwent cystectomy for transitional cell cancer of the bladder.Those 42 patients who underwent cystectomy for non-urothelial indications included 14 male and 28 female patients. The mean age was 58.2 years with a range of 3-78 years. For urinary diversion 30 ileum conduits, 4 sigma conduits, and 8 ileum neobladders were used. The mean operative time was 6.25 h. The mean blood loss was 2200 ml. An average of four red blood cell concentrates (RBC) had to be given. Postoperative hydronephrosis had to be treated in three (7%) patients unilaterally and in two (5%) patients bilaterally with a temporary nephrostomy. Postoperative urinary leakage lasting more than 30 days was found in two (5%) patients. A deep vein thrombosis as well as an ileus was found in five (12%) patients each, respectively. There was no perioperative mortality in this study. When comparing the complications of those patients with the 162 patients who underwent cystectomy for bladder cancer, the only significant difference ( p=0.033, chi-square test) was a higher ileus rate in the patients with cystectomy for a non-urothelial indication. Complications with cystectomy for non-urothelial indications are in large comparable to those for transitional cell carcinoma of the bladder. The higher ileus rate in non-urothelial patients can be explained by the more radical procedures in this group of patients. Even though the group of patients undergoing cystectomy for indications other than bladder cancer was small in this trial, the procedure is standardized in combination with other specialties. Larger patient numbers and a longer follow-up will lead to more data in this special group of patients.
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Affiliation(s)
- S Hautmann
- Urologische Klinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
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Schwab J, Riegger T, Conrad S, Schluesener HJ. Spinal cord injury induced immune depression syndrome (SCI-IDS). Akt Neurol 2004. [DOI: 10.1055/s-2004-832972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Eisenhardt A, Arntzen D, Conrad S, Westenfelder W, Sperling H, Hoyer PF, Rübben H. [Occurrence, diagnostics and therapeutic management of hydronephrosis in pediatric patients in Germany]. Urologe A 2003; 42:538-46. [PMID: 12715126 DOI: 10.1007/s00120-002-0252-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 10/21/2022]
Abstract
As urinary tract obstruction in children may impair renal function, the early detection and evaluation of the degree of obstruction using adequate diagnostic tools is necessary for the choice of the optimal therapeutic procedure. This study describes diagnostic and therapeutic standards in relation to the quality of management of pediatric hydronephrosis in Germany in the first 6 months of the year 2000. In our study 407 of 711 (57.2%) children with a hydronephrotic condition were detected by routine ultrasound. This, and the fact that 25% of the patients, who were prenatally detected, had a diagnosis of vesicoureteral reflux, underlines the importance of this routine procedure. Our study illustrates the panel of diagnostic and therapeutic procedures used in the management of pediatric hydronephrosis in Germany.
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Affiliation(s)
- A Eisenhardt
- Klinik für Urologie des Universitätsklinikums Essen.
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Zerfass P, Conrad S, Keeve E. Haptic interaction with highly detailed objects. BIOMED ENG-BIOMED TE 2003; 47 Suppl 1 Pt 1:69-71. [PMID: 12451775 DOI: 10.1515/bmte.2002.47.s1a.69] [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
Haptic exploration of detailed models from patient specific anatomical structures places high demands on computational resources. Constant collision detection and correct calculation of forces fed back to the operator quickly exceed available processing power with increasing level of detail of the represented objects. To alleviate the strain on computational resources optimisation schemes are employed to speed up processing and guarantee glitch-free operation as well as smooth haptic feedback. Among these are the generation of a local haptic model, a look-ahead strategy to increase its range of validity, small world-shift operations and force extrapolation algorithms for smooth feedback.
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Affiliation(s)
- P Zerfass
- Surgical System Lab., Research Center Caesar Friedensplatz 16, 53111 Bonn, Germany.
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Conrad S, Kauffmann HM, Ito K, Deeley RG, Cole SP, Schrenk D. Identification of human multidrug resistance protein 1 (MRP1) mutations and characterization of a G671V substitution. J Hum Genet 2002; 46:656-63. [PMID: 11721885 DOI: 10.1007/s100380170017] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.1] [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: 01/02/2023]
Abstract
The multidrug resistance protein 1 (MRP1) belonging to the ATP-binding cassette (ABC) superfamily of transport proteins can confer resistance to multiple natural product drugs and methotrexate in human tumor cells. In addition, MRP1 is expressed in normal tissues acting as an efflux pump for glutathione, glucuronate, and sulfate conjugates and may thus influence the pharmacokinetic properties of many drugs. Using polymerase chain reaction-single-strand conformation polymorphism analysis, we screened 36 Caucasian volunteers for mutations in the coding exons of the MRP1 gene, including the adjacent intron sequences. Among several mutations found, two are expected to cause amino acid substitutions. One of these mutations (G671V) was of special interest because it is located near the first nucleotide binding domain. To determine whether this mutation caused a change in the MRP1 phenotype, a mutant MRP1 expression vector was constructed and transfected into SV40-transformed human embryonic kidney cells (HEKSV293T) and the transport properties of the mutant protein were examined. Transport of the MRP1 substrates leukotriene C4, 17beta-estradiol 17beta-(D)-glucuronide, and estrone sulfate by membrane vesicles prepared from transiently transfected HEKSV293T cells was comparable to that of wild-type MRP1.
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Affiliation(s)
- S Conrad
- Food Chemistry & Environmental Toxicology, University of Kaiserslautern, Germany
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Newcomer JA, Huemmrich KF, Landis D, Nickeson J, Conrad S, Knapp D, Curd S, Morrell A, Hodkinson D, Nelson E, Cihlar J, Margolis H, Goodison B, Hall F, Sellers PJ. Managing and supporting large integrated and interdisciplinary field studies: The BOREAS example. ACTA ACUST UNITED AC 2001. [DOI: 10.1029/2001jd900124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Friedrich MG, Blind C, Milde-Langosch K, Erbersdobler A, Conrad S, Löning T, Hammerer P, Huland H. Frequent p16/MTS1 inactivation in early stages of urothelial carcinoma of the bladder is not associated with tumor recurrence. Eur Urol 2001; 40:518-24. [PMID: 11752859 DOI: 10.1159/000049829] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [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: 11/19/2022]
Abstract
OBJECTIVE p16, located at chromosome 9p21, is a negative regulator of G1 cell checkpoint and functions as tumor suppressor gene. Only few data are available on the frequency and clinical relevance of p16 alterations in Ta, T1 transitional cell carcinoma (TCC) of the bladder. We investigated 40 patients with Ta, T1 TCC of the bladder for p16 alterations (mutations, homozygote deletions, allelic loss) or reduced p16 immunoreaction. PATIENTS AND METHODS DNA was prepared from microdissected tumor tissue from 40 patients with pTa, pT1 TCC of the bladder (pTa: 18 patients; pT1: 22 patients; grade 1: 7 patients; grade 2: 28 patients; grade 3: 5 patients). Mutation screening was performed using polymerase chain reaction (PCR), single-strand conformation polymorphism (SSCP) and direct sequencing at exon 1 and exon 2. Detection of homozygote deletions was performed using multiplex PCR. Immunohistochemistry (IHC) was performed using an anti-human monoclonal antibody (p16, Pharmingen). Allelic loss was detected by PCR using three different microsatellite markers (D9S161, D9S171, D9S319). RESULTS SSCP and direct sequencing revealed 3 cases of base substitution which turned out to be natural polymorphisms. Homozygote deletions were not detected in any case. p16 IHC revealed reduced p16 expression (<5% positive nuclei) in 10 patients; 30 patients had a positive reaction (> or =5% positive nuclei) and 10 patients a strong positive reaction (> or =50% positive nuclei). Thirteen of 37 informative cases revealed loss of heterozygosity (LOH) with at least one marker. After a median follow-up of 23 months, 15 patients suffered from disease recurrence. Statistical analysis using Kaplan-Meier analysis and the log-rank test did not reveal significant association of recurrence-free interval and detection of LOH (p = 0.34) or p16 IHC (p = 0.9). CONCLUSIONS We present a comprehensive evaluation of chromosome 9p21 alterations including p16 analysis and clinical follow-up data. Although p16 mutations and homozygote deletions are rarely detectable in Ta, T1 TCC, the reduction of p16 expression and the frequent hemizygote deletions at 9p21 suggest an early involvement of chromosome 9p and p16 in superficial TCC.
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Affiliation(s)
- M G Friedrich
- Department of Urology, University of Hamburg, University Hospital Eppendorf, Germany.
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