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Ghazy A, Chaban R, Pfeiffer P, Probst C, Dohle DS, Treede H, Dorweiler B. Three-Dimensional-Evaluation of Aortic Changes after Frozen Elephant Trunk (FET) in Zone 0 vs. Zone 2 in Acute Type A Aortic Dissection. J Clin Med 2024; 13:2677. [PMID: 38731205 PMCID: PMC11084169 DOI: 10.3390/jcm13092677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 04/29/2024] [Accepted: 04/29/2024] [Indexed: 05/13/2024] Open
Abstract
Introduction: The management of aortic dissection has evolved significantly over the decades, with the frozen elephant trunk (FET) procedure emerging as a key technique for treating complex aortic pathologies. Recent practices involve deploying the FET prosthesis more proximally in the aorta (Zone 0) to reduce complications, leading to questions about its impact on long-term aortic remodeling compared to traditional Zone 2 deployment. Methods: This retrospective analysis utilized 3D segmentation software to assess the volumetric changes in aortic remodeling after acute Type A aortic dissections, comparing FET stent graft deployment in Zone 0 and Zone 2. The study included 27 patients operated on between 2020 and 2022, with volumetric measurements taken from postoperative and 6-month follow-up CT scans. Statistical analyses were performed to evaluate the differences in the aortic true lumen (TL) and the perfused false lumen (PFL) between the two groups. Results: Both Zone 0 and Zone 2 deployments resulted in significant true lumen (TL) increases (Z0 p = 0.001, Z2 p < 0.001) and perfused false lumen (PFL) decreases (Z0 p = 0.02, Z2 p = 0.04), with no significant differences in volumetric changes between the groups (p = 0.7 post op and p = 0.9 after 6 months). The distal anastomosis in Zone 0 did not compromise the aortic remodeling outcomes and was associated with reduced distal ischemia and cerebral perfusion times (p = 0.041). The angle measurements in Zone 0 did not show any significant changes after the 6-month control (p = 0.2). However, in Zone 2, a significant change was detected. (p = 0.022). The part comparison analyses did not indicate significant differences in aortic deviation between the groups (p = 0.62), suggesting comparable effectiveness in aortic remodeling. Conclusions: Performing the distal anastomosis more proximally in Zone 0 offers technical advantages without compromising the effectiveness of aortic remodeling compared to the traditional Zone 2 deployment. This finding supports the continued recommendation of Zone 0 deployment in the management of acute Type A aortic dissections, with ongoing studies being needed to confirm the long-term outcomes and survival benefits.
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Affiliation(s)
- Ahmed Ghazy
- Department of Cardiac and Vascular Surgery, University of Mainz, Faculty of Medicine and University Hospital Mainz, 55131 Mainz, Germany
| | - Ryan Chaban
- Department of Cardiac and Vascular Surgery, University of Mainz, Faculty of Medicine and University Hospital Mainz, 55131 Mainz, Germany
| | - Philipp Pfeiffer
- Department of Cardiac and Vascular Surgery, University of Mainz, Faculty of Medicine and University Hospital Mainz, 55131 Mainz, Germany
| | - Chris Probst
- Department of Cardiac and Vascular Surgery, University of Mainz, Faculty of Medicine and University Hospital Mainz, 55131 Mainz, Germany
| | - Daniel-Sebastian Dohle
- Department of Cardiac and Vascular Surgery, University of Mainz, Faculty of Medicine and University Hospital Mainz, 55131 Mainz, Germany
| | - Hendrik Treede
- Department of Cardiac and Vascular Surgery, University of Mainz, Faculty of Medicine and University Hospital Mainz, 55131 Mainz, Germany
| | - Bernhard Dorweiler
- Department of Vascular and Endovascular Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, 50937 Cologne, Germany
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Dohle DS, Pfeiffer P, Probst C, Treede H. Andexanet alfa and heparin resistance in cardiac surgery: Experiences and risks associated with the reversal of direct oral anticoagulants. Eur J Cardiothorac Surg 2023; 63:ezad189. [PMID: 37144957 DOI: 10.1093/ejcts/ezad189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 05/04/2023] [Indexed: 05/06/2023] Open
Affiliation(s)
| | - Philipp Pfeiffer
- Department of Cardiovascular Surgery, Johannes-Gutenberg University, Mainz, Germany
| | - Chris Probst
- Department of Cardiovascular Surgery, Johannes-Gutenberg University, Mainz, Germany
| | - Hendrik Treede
- Department of Cardiovascular Surgery, Johannes-Gutenberg University, Mainz, Germany
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Dohle DS, Pfeiffer P, Probst C, Treede H. Acute Type I aortic dissection: "is simultaneous descending stent grafting justified?". Eur J Cardiothorac Surg 2023:7159189. [PMID: 37162370 DOI: 10.1093/ejcts/ezad190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 05/09/2023] [Indexed: 05/11/2023] Open
Affiliation(s)
| | - Philipp Pfeiffer
- Department of Cardiovascular Surgery, Johannes-Gutenberg University, Mainz, Germany
| | - Chris Probst
- Department of Cardiovascular Surgery, Johannes-Gutenberg University, Mainz, Germany
| | - Hendrik Treede
- Department of Cardiovascular Surgery, Johannes-Gutenberg University, Mainz, Germany
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Dohle DS, Mattern L, Pfeiffer P, Probst C, Ghazy A, Treede H. Island remodelling in acute and chronic aortic dissection treated with frozen elephant trunk. Eur J Cardiothorac Surg 2023; 63:7056647. [PMID: 36825844 DOI: 10.1093/ejcts/ezad061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 01/24/2023] [Accepted: 02/23/2023] [Indexed: 02/25/2023] Open
Abstract
OBJECTIVE The island technique for reimplantation of supra-aortic vessels in frozen elephant surgery is commonly used but might be questioned for dissected vessels. This study analyzes the remodelling of reimplanted supra-aortic vessels after FET in acute and chronic aortic dissection. METHODS Between 06/2017 and 04/2021 133 patients were operated for acute and chronic aortic dissection using the frozen elephant technique. The TheIsland technique for reimplantation of the supra-aortic vessels was used in 94/133 patients. In 68 acute and 21 chronic patients, the total vessel lumen, true lumen, false lumen, and perfused false lumen area were measured in the innominate, right common carotid and left common carotid artery. Relative luminal changes were compared. RESULTS In acute aortic dissection, 80% innominate, 40% right carotid and 59% left carotid arteries were dissected preoperatively, but postoperatively false lumen was only patent in 29%, 12% and 10% (p < 0.001). False lumen disappearance resulted in > 20% total vessel lumen reduction in innominate, right carotid and left carotid artery(p < 0.01). In chronic aortic dissection, only 38% innominate, 14% right carotid, and 43% left carotid arteries were dissected preoperatively, but postoperatively false lumen was patent in 19% (ns), 10% (ns) and 5% (p = 0.009). CONCLUSION Vascular remodelling is frequently found after the island technique. In acute aortic dissection, the island technique frequently initiates FL disappearance associated with vessel lumen decrease. Continuously dissected head vessels show positive remodelling with true lumen increase without vessel lumen increase. False lumen disappearance is frequently found in chronic aortic dissection.
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Affiliation(s)
| | - Leon Mattern
- Department of Cardiovascular Surgery, Johannes-Gutenberg University, Mainz, Germany
| | - Philipp Pfeiffer
- Department of Cardiovascular Surgery, Johannes-Gutenberg University, Mainz, Germany
| | - Chris Probst
- Department of Cardiovascular Surgery, Johannes-Gutenberg University, Mainz, Germany
| | - Ahmed Ghazy
- Department of Cardiovascular Surgery, Johannes-Gutenberg University, Mainz, Germany
| | - Hendrik Treede
- Department of Cardiovascular Surgery, Johannes-Gutenberg University, Mainz, Germany
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5
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Garces de Los Fayos Alonso I, Zujo L, Wiest I, Kodajova P, Timelthaler G, Edtmayer S, Zrimšek M, Kollmann S, Giordano C, Kothmayer M, Neubauer HA, Dey S, Schlederer M, Schmalzbauer BS, Limberger T, Probst C, Pusch O, Högler S, Tangermann S, Merkel O, Schiefer AI, Kornauth C, Prutsch N, Zimmerman M, Abraham B, Anagnostopoulos J, Quintanilla-Martinez L, Mathas S, Wolf P, Stoiber D, Staber PB, Egger G, Klapper W, Woessmann W, Look TA, Gunning P, Turner SD, Moriggl R, Lagger S, Kenner L. PDGFRβ promotes oncogenic progression via STAT3/STAT5 hyperactivation in anaplastic large cell lymphoma. Mol Cancer 2022; 21:172. [PMID: 36045346 PMCID: PMC9434917 DOI: 10.1186/s12943-022-01640-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/31/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Anaplastic large cell lymphoma (ALCL) is an aggressive non-Hodgkin T cell lymphoma commonly driven by NPM-ALK. AP-1 transcription factors, cJUN and JUNb, act as downstream effectors of NPM-ALK and transcriptionally regulate PDGFRβ. Blocking PDGFRβ kinase activity with imatinib effectively reduces tumor burden and prolongs survival, although the downstream molecular mechanisms remain elusive. METHODS AND RESULTS In a transgenic mouse model that mimics PDGFRβ-driven human ALCL in vivo, we identify PDGFRβ as a driver of aggressive tumor growth. Mechanistically, PDGFRβ induces the pro-survival factor Bcl-xL and the growth-enhancing cytokine IL-10 via STAT5 activation. CRISPR/Cas9 deletion of both STAT5 gene products, STAT5A and STAT5B, results in the significant impairment of cell viability compared to deletion of STAT5A, STAT5B or STAT3 alone. Moreover, combined blockade of STAT3/5 activity with a selective SH2 domain inhibitor, AC-4-130, effectively obstructs tumor development in vivo. CONCLUSIONS We therefore propose PDGFRβ as a novel biomarker and introduce PDGFRβ-STAT3/5 signaling as an important axis in aggressive ALCL. Furthermore, we suggest that inhibition of PDGFRβ or STAT3/5 improve existing therapies for both previously untreated and relapsed/refractory ALK+ ALCL patients.
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Affiliation(s)
- I Garces de Los Fayos Alonso
- Department of Pathology, Medical University of Vienna, 1090, Vienna, Austria
- Unit of Laboratory Animal Pathology, University of Veterinary Medicine Vienna, 1210, Vienna, Austria
| | - L Zujo
- Department of Pathology, Medical University of Vienna, 1090, Vienna, Austria
- Unit of Laboratory Animal Pathology, University of Veterinary Medicine Vienna, 1210, Vienna, Austria
- Division of Nuclear Medicine, Medical University of Vienna, 1090, Vienna, Austria
| | - I Wiest
- Department of Pathology, Medical University of Vienna, 1090, Vienna, Austria
- Unit of Laboratory Animal Pathology, University of Veterinary Medicine Vienna, 1210, Vienna, Austria
- Division of Nuclear Medicine, Medical University of Vienna, 1090, Vienna, Austria
| | - P Kodajova
- Unit of Laboratory Animal Pathology, University of Veterinary Medicine Vienna, 1210, Vienna, Austria
| | - G Timelthaler
- Center for Cancer Research, Medical University of Vienna, 1090, Vienna, Austria
| | - S Edtmayer
- Division Pharmacology, Department of Pharmacology, Physiology and Microbiology, Karl Landsteiner University of Health Sciences, 3500, Krems, Austria
| | - M Zrimšek
- Department of Pathology, Medical University of Vienna, 1090, Vienna, Austria
| | - S Kollmann
- Institute of Pharmacology and Toxicology, University of Veterinary Medicine Vienna, 1210, Vienna, Austria
| | - C Giordano
- Department of Pathology, Medical University of Vienna, 1090, Vienna, Austria
| | - M Kothmayer
- Department of Pathology, Medical University of Vienna, 1090, Vienna, Austria
- Unit of Laboratory Animal Pathology, University of Veterinary Medicine Vienna, 1210, Vienna, Austria
- Centre for Anatomy and Cell Biology, Medical University of Vienna, 1090, Vienna, Austria
| | - H A Neubauer
- Institute of Animal Breeding and Genetics, Unit of Functional Cancer Genomics, University of Veterinary Medicine Vienna, 1210, Vienna, Austria
| | - S Dey
- Department of Dermatology, Medical University of Graz, 8036, Graz, Austria
- Center for Medical Research (ZMF), Medical University of Graz, 8010, Graz, Austria
| | - M Schlederer
- Department of Pathology, Medical University of Vienna, 1090, Vienna, Austria
| | - B S Schmalzbauer
- Unit of Laboratory Animal Pathology, University of Veterinary Medicine Vienna, 1210, Vienna, Austria
- Institute of Pharmacology and Toxicology, University of Veterinary Medicine Vienna, 1210, Vienna, Austria
| | - T Limberger
- Department of Pathology, Medical University of Vienna, 1090, Vienna, Austria
- Division of Nuclear Medicine, Medical University of Vienna, 1090, Vienna, Austria
- CBMed Core Lab, Medical University of Vienna, 1090, Vienna, Austria
| | - C Probst
- Department of Pathology, Medical University of Vienna, 1090, Vienna, Austria
- Unit of Laboratory Animal Pathology, University of Veterinary Medicine Vienna, 1210, Vienna, Austria
- Division of Nuclear Medicine, Medical University of Vienna, 1090, Vienna, Austria
| | - O Pusch
- Centre for Anatomy and Cell Biology, Medical University of Vienna, 1090, Vienna, Austria
| | - S Högler
- Unit of Laboratory Animal Pathology, University of Veterinary Medicine Vienna, 1210, Vienna, Austria
| | - S Tangermann
- Unit of Laboratory Animal Pathology, University of Veterinary Medicine Vienna, 1210, Vienna, Austria
| | - O Merkel
- Department of Pathology, Medical University of Vienna, 1090, Vienna, Austria
| | - A I Schiefer
- Department of Pathology, Medical University of Vienna, 1090, Vienna, Austria
| | - C Kornauth
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, 1090, Vienna, Austria
- Comprehensive Cancer Center Vienna, Vienna General Hospital, Medical University of Vienna, 1090, Vienna, Austria
| | - N Prutsch
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - M Zimmerman
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - B Abraham
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - J Anagnostopoulos
- Institute of Pathology, University of Wuerzburg, 97080, Würzburg, Germany
- Institute of Pathology, Charité-Medical University of Berlin, 10117, Berlin, Germany
| | - L Quintanilla-Martinez
- Institute of Pathology and Neuropathology and Cluster of excellence iFIT, "Image-Guided and Functionally Instructed Tumor Therapy", University of Tübingen, 72076, Tübingen, Germany
| | - S Mathas
- Department of Hematology, Oncology, and Cancer Immunology, Charité-Medical University of Berlin, 12200, Berlin, Germany
- German Cancer Consortium (DKTK) German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
- Max-Delbrück-Center (MDC) for Molecular Medicine, 13125, Berlin, Germany
- Experimental and Clinical Research Center, a joint cooperation between the Charité and the MDC, 13125, Berlin, Germany
| | - P Wolf
- Department of Dermatology, Medical University of Graz, 8036, Graz, Austria
| | - D Stoiber
- Division Pharmacology, Department of Pharmacology, Physiology and Microbiology, Karl Landsteiner University of Health Sciences, 3500, Krems, Austria
| | - P B Staber
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, 1090, Vienna, Austria
- Comprehensive Cancer Center Vienna, Vienna General Hospital, Medical University of Vienna, 1090, Vienna, Austria
| | - G Egger
- Department of Pathology, Medical University of Vienna, 1090, Vienna, Austria
- Comprehensive Cancer Center Vienna, Vienna General Hospital, Medical University of Vienna, 1090, Vienna, Austria
- Boltzmann Institute Applied Diagnostics, 1090, Vienna, Austria
| | - W Klapper
- Department of Pathology, Hematopathology Section and Lymph Node Registry, University of Kiel/University Hospital Schleswig-Holstein, 24105, Kiel, Germany
| | - W Woessmann
- Pediatric Hematology and Oncology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - T A Look
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - P Gunning
- Department of Chemical and Physical Sciences, University of Toronto Mississauga, Mississauga, ON, L5L 1C6, Canada
- Department of Chemistry, University of Toronto, Toronto, ON, M5S 3H6, Canada
| | - S D Turner
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge, CB20QQ, UK
- Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
| | - R Moriggl
- Institute of Animal Breeding and Genetics, Unit of Functional Cancer Genomics, University of Veterinary Medicine Vienna, 1210, Vienna, Austria
| | - S Lagger
- Unit of Laboratory Animal Pathology, University of Veterinary Medicine Vienna, 1210, Vienna, Austria
| | - L Kenner
- Department of Pathology, Medical University of Vienna, 1090, Vienna, Austria.
- Unit of Laboratory Animal Pathology, University of Veterinary Medicine Vienna, 1210, Vienna, Austria.
- Division of Nuclear Medicine, Medical University of Vienna, 1090, Vienna, Austria.
- Center for Medical Research (ZMF), Medical University of Graz, 8010, Graz, Austria.
- CBMed Core Lab, Medical University of Vienna, 1090, Vienna, Austria.
- Christian Doppler Laboratory of Applied Metabolomics, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, 1090, Vienna, Austria.
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6
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Czerny M, Gottardi R, Puiu P, Bernecker OY, Citro R, Corte AD, di Marco L, Fink M, Gosslau Y, Haldenwang PL, Heijmen RH, Hugas-Mallorqui M, Iesu S, Jacobsen O, Jassar AS, Juraszek A, Kolowca M, Lepidi S, Marrocco-Trischitta MM, Matsuda H, Meisenbacher K, Micari A, Minatoya K, Park KH, Peterss S, Petrich M, Piffaretti G, Probst C, Reutersberg B, Rosati F, Schachner B, Schachner T, Sorokin VA, Szeberin Z, Szopinski P, Di Tommaso L, Trimarchi S, Verhoeven ELG, Vogt F, Voetsch A, Walter T, Weiss G, Yuan X, Benedetto F, De Bellis A, D'Oria M, Discher P, Zierer A, Rylski B, van den Berg JC, Wyss TR, Bossone E, Schmidli J, Nienaber C, Accarino G, Baldascino F, Böckler D, Corazzari C, D'Alessio I, de Beaufort H, De Troia C, Dumfarth J, Galbiati D, Gorgatti F, Hagl C, Hamiko M, Huber F, Hyhlik-Duerr A, Ianelli G, Iesu I, Jung JC, Kainz FM, Katsargyris A, Koter S, Kusmierczyk M, Kolsut P, Lengyel B, Lomazzi C, Muneretto C, Nava G, Nolte T, Pacini D, Pleban E, Rychla M, Sakamoto K, Shijo T, Yokawa K, Siepe M, Sirch J, Strauch J, Sule JA, Tobler EL, Walter C, Weigang E. Corrigendum to 'Impact of the coronavirus disease 2019 (COVID-19) pandemic on the care of patients with acute and chronic aortic conditions'. Eur J Cardiothorac Surg 2021; 60:724-725. [PMID: 34378028 PMCID: PMC8385948 DOI: 10.1093/ejcts/ezab314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Martin Czerny
- Department for Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Freiburg, Germany.,Faculty of Medicine, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Roman Gottardi
- Department of Cardiovascular and Thoracic Surgery, MediClin Heart Institute Lahr/Baden, Lahr, Germany.,Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Paul Puiu
- Department for Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Freiburg, Germany.,Faculty of Medicine, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Oliver Y Bernecker
- Department of Cardiac Surgery, University Hospital St. Poelten, St. Poelten, Austria
| | - Rodolfo Citro
- Cardiology Unit, University Hospital San Giovanni di Dio e Ruggi d_Aragona, Salerno, Italy
| | - Alessandro Della Corte
- Cardiac Surgery Unit, Department of Translational Medical Sciences, University of Campania "L.Vanvitelli", Monaldi Hospital, Naples, Italy
| | - Luca di Marco
- Department of Cardiac Surgery, Hospital Santa Orsola, University of Bologna, Bologna, Italy
| | - Martina Fink
- Department of Vascular Surgery, HGZ Bad Bevensen, Bad Bevensen, Germany
| | - Yvonne Gosslau
- Department for Vascular and Endovascular Surgery, University Hospital Augsburg, Augsburg, Germany
| | - Peter Lukas Haldenwang
- Department of Cardiothoracic Surgery, University Hospital Bergmannsheil Bochum, Ruhr University of Bochum, Bochum, Germany
| | - Robin H Heijmen
- Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, Netherlands
| | - Maria Hugas-Mallorqui
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Severino Iesu
- Cardiac Surgery Unit, University Hospital San Giovanni di Dio e Ruggi d_Aragona, Salerno, Italy
| | - Oyvind Jacobsen
- Department of Cardiothoracic and Vascular Surgery, University Hospital of North Norway, Oslo, Norway
| | - Arminder S Jassar
- Division of Cardiac Surgery, Corrigan Minehan Heart Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Andrzej Juraszek
- Department of Cardiac Surgery and Transplantation, The Cardinal Stefan Wyszynski National Institute of Cardiology, Warsaw, Poland
| | - Maciej Kolowca
- Cardiac Surgery Department, University State Hospital No 2, University of Rzesznow, Rzesznow, Poland
| | - Sandro Lepidi
- Division of Vascular and Endovascular Surgery, Cardiovascular Department, University of Trieste Medical School, Trieste, Italy
| | | | - Hitoshi Matsuda
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Katrin Meisenbacher
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | | | - Kenji Minatoya
- Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kay-Hyun Park
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Sven Peterss
- Department of Cardiac Surgery, LMU University Hospital, Munich, Germany
| | - Michael Petrich
- Department of Vascular and Endovascular Surgery, Hubertus Hospital Berlin, Berlin, Germany
| | - Gabriele Piffaretti
- Vascular Surgery, Department of Medicine and Surgery, University of Insubria, School of Medicine and ASST Settelaghi University Teaching Hospital, Varese, Italy
| | - Chris Probst
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
| | - Benedikt Reutersberg
- Department for Vascular Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Fabrizio Rosati
- Division of Cardiac Surgery, University of Brescia Medical School, Brescia, Italy
| | - Bruno Schachner
- Department of Cardiothoracic and Vascular Surgery, Kepler University Hospital, Medical Faculty, Johannes Kepler University Linz, Linz, Austria
| | - Thomas Schachner
- Department of Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - Vitaly A Sorokin
- Department of Cardiac, Thoracic and Vascular Surgery, National University Hospital, National University Health System, Singapore
| | - Zoltan Szeberin
- Department of Vascular and Endovascular Surgery, Semmelweis University, Budapest, Hungary
| | - Piotr Szopinski
- Department of Vascular Surgery, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Luigi Di Tommaso
- Department of Cardiac Surgery, School of Medicine, University Federico II, Naples, Italy
| | - Santi Trimarchi
- Unita Operativa di Chirurgia Vascolare, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico Milan, Milan, Italy.,Department of Clinical and Community Sciences, University of Milan, Milan, Italy
| | - Eric L G Verhoeven
- Department of Vascular and Endovascular Surgery, Paracelsus Medical University Nuremberg, Nuremberg, Germany
| | - Ferdinand Vogt
- Department of Cardiac Surgery, Paracelsus Medical University Nuremberg, Nuremberg, Germany
| | - Andreas Voetsch
- Department of Cardiovascular and Endovascular Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Tim Walter
- Department for Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Freiburg, Germany.,Faculty of Medicine, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | | | - Xun Yuan
- Cardiology and Aortic Centre, The Royal Brompton & Harefield NHS Foundation Trust; National Heart and Lung Institute, Faculty of Medicine, Imperial College, London, London, UK
| | | | - Antonio De Bellis
- Cardiac Surgery Unit, Heart and Vessels Department, Casa di Cura San Michele, Maddaloni, Italy
| | - Mario D'Oria
- Division of Vascular and Endovascular Surgery, Cardiovascular Department, University of Trieste Medical School, Trieste, Italy
| | - Philipp Discher
- Department for Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Freiburg, Germany.,Faculty of Medicine, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Andreas Zierer
- Department of Cardiothoracic and Vascular Surgery, Kepler University Hospital, Medical Faculty, Johannes Kepler University Linz, Linz, Austria
| | - Bartosz Rylski
- Department for Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Freiburg, Germany.,Faculty of Medicine, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Jos C van den Berg
- Centro Vasolare Ticino, Ospedale Regionale di Lugano, Lugano, Switzerland.,Department of Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Thomas R Wyss
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Department of Vascular Surgery, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | | | - Jürg Schmidli
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christoph Nienaber
- Cardiology and Aortic Centre, The Royal Brompton & Harefield NHS Foundation Trust; National Heart and Lung Institute, Faculty of Medicine, Imperial College, London, London, UK
| | | | - Giulio Accarino
- Cardiac Surgery Unit, University Hospital San Giovanni di Dio e Ruggi d_Aragona, Salerno, Italy
| | | | - Dittmar Böckler
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Claudio Corazzari
- Department of Cardiac Surgery, Department of Medicine and Surgery, University of Insubria, School of Medicine and ASST Settelaghi University Teaching, Hospital, Varese, Italy
| | - Ilenia D'Alessio
- Unita Operativa di Chirurgia Vascolare, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico Milan, Milan, Italy.,Department of Clinical and Community Sciences, University of Milan, Milan, Italy
| | - Hector de Beaufort
- Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, Netherlands
| | | | - Julia Dumfarth
- Department of Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - Denise Galbiati
- Cardiac Surgery Unit, Department of Translational Medical Sciences, University of Campania "L.Vanvitelli", Monaldi Hospital, Naples, Italy
| | - Filippo Gorgatti
- Division of Vascular and Endovascular Surgery, Cardiovascular Department, University of Trieste Medical School, Trieste, Italy
| | - Christian Hagl
- Department of Cardiac Surgery, LMU University Hospital, Munich, Germany
| | - Marwan Hamiko
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
| | - Florian Huber
- Department of Cardiothoracic and Vascular Surgery, Kepler University Hospital, Medical Faculty, Johannes Kepler University Linz, Linz, Austria
| | - Alexander Hyhlik-Duerr
- Department for Vascular and Endovascular Surgery, University Hospital Augsburg, Augsburg, Germany
| | - Gabriele Ianelli
- Department of Cardiac Surgery, School of Medicine, University Federico II, Naples, Italy
| | - Ivana Iesu
- Cardiology Unit, University Hospital San Giovanni di Dio e Ruggi d_Aragona, Salerno, Italy
| | - Joon-Chui Jung
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Frieda-Maria Kainz
- Department of Cardiac Surgery, University Hospital St. Poelten, St. Poelten, Austria
| | - Athanasios Katsargyris
- Department of Vascular and Endovascular Surgery, Paracelsus Medical University Nuremberg, Nuremberg, Germany
| | - Stephan Koter
- Department of Cardiovascular and Endovascular Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Mariusz Kusmierczyk
- Department of Cardiac Surgery and Transplantation, The Cardinal Stefan Wyszynski National Institute of Cardiology, Warsaw, Poland
| | - Piotr Kolsut
- Department of Cardiac Surgery and Transplantation, The Cardinal Stefan Wyszynski National Institute of Cardiology, Warsaw, Poland
| | - Balazs Lengyel
- Department of Vascular and Endovascular Surgery, Semmelweis University, Budapest, Hungary
| | - Chiara Lomazzi
- Unita Operativa di Chirurgia Vascolare, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico Milan, Milan, Italy.,Department of Clinical and Community Sciences, University of Milan, Milan, Italy
| | - Claudio Muneretto
- Division of Cardiac Surgery, University of Brescia Medical School, Brescia, Italy
| | - Giovanni Nava
- Cardiovascular Department, IRCCS-Policlinico San Donato, Milan, Italy
| | - Thomas Nolte
- Department of Vascular Surgery, HGZ Bad Bevensen, Bad Bevensen, Germany
| | - Davide Pacini
- Department of Cardiac Surgery, Hospital Santa Orsola, University of Bologna, Bologna, Italy
| | - Eliza Pleban
- Department of Vascular Surgery, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Miriam Rychla
- Department for Vascular Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Kazuhisa Sakamoto
- Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takayuki Shijo
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Koki Yokawa
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Matthias Siepe
- Department for Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Freiburg, Germany.,Faculty of Medicine, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Joachim Sirch
- Department of Cardiac Surgery, Paracelsus Medical University Nuremberg, Nuremberg, Germany
| | - Justus Strauch
- Department of Cardiothoracic Surgery, University Hospital Bergmannsheil Bochum, Ruhr University of Bochum, Bochum, Germany
| | - Jai Ajitchandra Sule
- Department of Cardiac, Thoracic and Vascular Surgery, National University Hospital, National University Health System, Singapore
| | - Eva-Luca Tobler
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Ernst Weigang
- Department of Vascular and Endovascular Surgery, Hubertus Hospital Berlin, Berlin, Germany
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7
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Piffaretti G, Czerny M, Riambau V, Gottardi R, Wolfgruber T, Probst C, Matt P, Antonello M, Gerosa G, Hamady M, Fontana F, Ferrarese S, Lomazzi C, Grassi V, Fernandez-Alonso S, Trimarchi S. Endovascular repair of ascending aortic diseases with custom-made endografts. Eur J Cardiothorac Surg 2021; 59:741-749. [PMID: 33394032 DOI: 10.1093/ejcts/ezaa383] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 08/28/2020] [Accepted: 09/15/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES The aim of this article is to report the mid-term results of ascending thoracic endovascular aortic repair using a custom-made device (CMD). METHODS This was a retrospective study performed at tertiary centres. Nine patients considered unfit for open surgery received elective total endovascular repair of the ascending aorta with a Relay® (Terumo Aortic, Sunrise; FL, USA) CMD: pseudoaneurysn (n = 5), localized dissection (n =3) and contained rupture (n = 1). RESULTS Primary clinical success was achieved in all patients with no major complications and no early conversion to open surgery. All patients were discharged home and independent: median length of stay was 7 days (interquartile range, 6-18). No patient was lost to follow-up at a median 26 months (interquartile range, 12-36). Three patients died 2, 6 and 24 months after intervention; 1 was aorta related (late aorto-atrial fistula due to infection that required open surgery). At the last follow-up available, no endoleaks, migrations, fractures or ruptures were observed in the remaining 6 patients. CONCLUSIONS Ascending thoracic endovascular aortic repair with Terumo Aortic CMDs was technically feasible, effective and safe in very selected lesions. CMDs showed good ascending aorta conformability with different configurations and diameters, and satisfactory mid-term durability as shown by both structural integrity and aortic lesion exclusion.
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Affiliation(s)
- Gabriele Piffaretti
- Vascular Surgery-Department of Medicine and Surgery, ASST Settelaghi University Teaching Hospital, University of Insubria School of Medicine, Varese, Italy
| | - Martin Czerny
- Department of Cardiovascular Surgery, Faculty of Medicine, Heart Centre Freiburg University, University of Freiburg, Freiburg, Germany
| | - Vicente Riambau
- Vascular Surgery Division, Cardiovascular Institute, Hospital Clinic University of Barcelona, Barcelona, Spain
| | - Roman Gottardi
- Department of Cardiac Surgery, Paracelsus Medical University, Salzburg, Austria
| | - Thomas Wolfgruber
- Department of Cardiac Surgery, Paracelsus Medical University, Salzburg, Austria.,Department of Radiology, Paracelsus Medical University, Salzburg, Austria
| | - Chris Probst
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
| | - Peter Matt
- Department of Cardiac Surgery, Herzzentrum Luzern, Luzern, Switzerland
| | - Michele Antonello
- Vascular and Cardiac Surgery-Department of Cardiac, Thoracic and Vascular Sciences, University of Padua School of Medicine, Padua, Italy
| | - Gino Gerosa
- Vascular and Cardiac Surgery-Department of Cardiac, Thoracic and Vascular Sciences, University of Padua School of Medicine, Padua, Italy
| | - Mohamad Hamady
- Interventional Radiology-Department of Surgery and Cancer, St Mary's Hospital Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Federico Fontana
- Interventional Radiology-Department of Medicine and Surgery, ASST Settelaghi University Teaching Hospital, University of Insubria School of Medicine, Varese, Italy
| | - Sandro Ferrarese
- Vascular Surgery-Department of Medicine and Surgery, ASST Settelaghi University Teaching Hospital, University of Insubria School of Medicine, Varese, Italy.,Cardiac Surgery-Department of Medicine and Surgery, ASST Settelaghi University Teaching Hospital, University of Insubria School of Medicine, Varese, Italy
| | - Chiara Lomazzi
- Vascular Surgery, Fondazione IRCCS Cà Granda, Milan, Italy
| | - Viviana Grassi
- Vascular Surgery, Fondazione IRCCS Cà Granda, Milan, Italy
| | | | - Santi Trimarchi
- Vascular Surgery, Fondazione IRCCS Cà Granda, Milan, Italy.,Department of Clinical and Community Sciences, Ospedale Maggiore Policlinico, Milan, Italy
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8
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Czerny M, Gottardi R, Puiu P, Bernecker OY, Citro R, Della Corte A, di Marco L, Fink M, Gosslau Y, Haldenwang PL, Heijmen RH, Hugas-Mallorqui M, Iesu S, Jacobsen O, Jassar AS, Juraszek A, Kolowca M, Lepidi S, Marrocco-Trischitta MM, Matsuda H, Meisenbacher K, Micari A, Minatoya K, Park KH, Peterss S, Petrich M, Piffaretti G, Probst C, Reutersberg B, Rosati F, Schachner B, Schachner T, Sorokin VA, Szeberin Z, Szopinski P, Di Tommaso L, Trimarchi S, Verhoeven ELG, Vogt F, Voetsch A, Walter T, Weiss G, Yuan X, Benedetto F, De Bellis A, D Oria M, Discher P, Zierer A, Rylski B, van den Berg JC, Wyss TR, Bossone E, Schmidli J, Nienaber C, Accarino G, Baldascino F, Böckler D, Corazzari C, D Alessio I, de Beaufort H, De Troia C, Dumfarth J, Galbiati D, Gorgatti F, Hagl C, Hamiko M, Huber F, Hyhlik-Duerr A, Ianelli G, Iesu I, Jung JC, Kainz FM, Katsargyris A, Koter S, Kusmierczyk M, Kolsut P, Lengyel B, Lomazzi C, Muneretto C, Nava G, Nolte T, Pacini D, Pleban E, Rychla M, Sakamoto K, Shijo T, Yokawa K, Siepe M, Sirch J, Strauch J, Sule JA, Tobler EL, Walter C, Weigang E. Impact of the coronavirus disease 2019 (COVID-19) pandemic on the care of patients with acute and chronic aortic conditions. Eur J Cardiothorac Surg 2021; 59:1096-1102. [PMID: 33394040 PMCID: PMC7799089 DOI: 10.1093/ejcts/ezaa452] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/30/2020] [Accepted: 11/16/2020] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on acute and elective thoracic and abdominal aortic procedures. METHODS Forty departments shared their data on acute and elective thoracic and abdominal aortic procedures between January and May 2020 and January and May 2019 in Europe, Asia and the USA. Admission rates as well as delay from onset of symptoms to referral were compared. RESULTS No differences in the number of acute thoracic and abdominal aortic procedures were observed between 2020 and the reference period in 2019 [incidence rates ratio (IRR): 0.96, confidence interval (CI) 0.89-1.04; P = 0.39]. Also, no difference in the time interval from acute onset of symptoms to referral was recorded (<12 h 32% vs > 12 h 68% in 2020, < 12 h 34% vs > 12 h 66% in 2019 P = 0.29). Conversely, a decline of 35% in elective procedures was seen (IRR: 0.81, CI 0.76-0.87; P < 0.001) with substantial differences between countries and the most pronounced decline in Italy (-40%, P < 0.001). Interestingly, in Switzerland, an increase in the number of elective cases was observed (+35%, P = 0.02). CONCLUSIONS There was no change in the number of acute thoracic and abdominal aortic cases and procedures during the initial wave of the COVID-19 pandemic, whereas the case load of elective operations and procedures decreased significantly. Patients with acute aortic syndromes presented despite COVID-19 and were managed according to current guidelines. Further analysis is required to prove that deferral of elective cases had no impact on premature mortality.
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Affiliation(s)
- Martin Czerny
- Department for Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Freiburg, Germany.,Faculty of Medicine, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Roman Gottardi
- Department of Cardiovascular and Thoracic Surgery, MediClin Heart Institute Lahr/Baden, Lahr, Germany.,Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Paul Puiu
- Department for Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Freiburg, Germany.,Faculty of Medicine, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Oliver Y Bernecker
- Department of Cardiac Surgery, University Hospital St. Poelten, St. Poelten, Austria
| | - Rodolfo Citro
- Cardiology Unit, University Hospital San Giovanni di Dio e Ruggi d´Aragona, Salerno, Italy
| | - Alessandro Della Corte
- Cardiac Surgery Unit, Department of Translational Medical Sciences, University of Campania "L.Vanvitelli", Monaldi Hospital, Naples, Italy
| | - Luca di Marco
- Department of Cardiac Surgery, Hospital Santa Orsola, University of Bologna, Bologna, Italy
| | - Martina Fink
- Department of Vascular Surgery, HGZ Bad Bevensen, Bad Bevensen, Germany
| | - Yvonne Gosslau
- Department for Vascular and Endovascular Surgery, University Hospital Augsburg, Augsburg, Germany
| | - Peter Lukas Haldenwang
- Department of Cardiothoracic Surgery, University Hospital Bergmannsheil Bochum, Ruhr University of Bochum, Bochum, Germany
| | - Robin H Heijmen
- Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, Netherlands
| | - Maria Hugas-Mallorqui
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Severino Iesu
- Cardiac Surgery Unit, University Hospital San Giovanni di Dio e Ruggi d´Aragona, Salerno, Italy
| | - Oyvind Jacobsen
- Department of Cardiothoracic and Vascular Surgery, University Hospital of North Norway, Oslo, Norway
| | - Arminder S Jassar
- Division of Cardiac Surgery, Corrigan Minehan Heart Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Andrzej Juraszek
- Department of Cardiac Surgery and Transplantation, The Cardinal Stefan Wyszynski National Institute of Cardiology, Warsaw, Poland
| | - Maciej Kolowca
- Cardiac Surgery Department, University State Hospital No 2, University of Rzesznow, Rzesznow, Poland
| | - Sandro Lepidi
- Division of Vascular and Endovascular Surgery, Cardiovascular Department, University of Trieste Medical School, Trieste, Italy
| | | | - Hitoshi Matsuda
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Katrin Meisenbacher
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | | | - Kenji Minatoya
- Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kay-Hyun Park
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Sven Peterss
- Department of Cardiac Surgery, LMU University Hospital, Munich, Germany
| | - Michael Petrich
- Department of Vascular and Endovascular Surgery, Hubertus Hospital Berlin, Berlin, Germany
| | - Gabriele Piffaretti
- Vascular Surgery, Department of Medicine and Surgery, University of Insubria, School of Medicine and ASST Settelaghi University Teaching Hospital, Varese, Italy
| | - Chris Probst
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
| | - Benedikt Reutersberg
- Department for Vascular Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Fabrizio Rosati
- Division of Cardiac Surgery, University of Brescia Medical School, Brescia, Italy
| | - Bruno Schachner
- Department of Cardiothoracic and Vascular Surgery, Kepler University Hospital, Medical Faculty, Johannes Kepler University Linz, Linz, Austria
| | - Thomas Schachner
- Department of Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - Vitali A Sorokin
- Department of Cardiac, Thoracic and Vascular Surgery, National University Hospital, National University Health System, Singapore
| | - Zoltan Szeberin
- Department of Vascular and Endovascular Surgery, Semmelweis University, Budapest, Hungary
| | - Piotr Szopinski
- Department of Vascular Surgery, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Luigi Di Tommaso
- Department of Cardiac Surgery, School of Medicine, University Federico II, Naples, Italy
| | - Santi Trimarchi
- Unita Operativa di Chirurgia Vascolare, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico Milan, Milan, Italy.,Department of Clinical and Community Sciences, University of Milan, Milan, Italy
| | - Eric L G Verhoeven
- Department of Vascular and Endovascular Surgery, Paracelsus Medical University Nuremberg, Nuremberg, Germany
| | - Ferdinand Vogt
- Department of Cardiac Surgery, Paracelsus Medical University Nuremberg, Nuremberg, Germany
| | - Andreas Voetsch
- Department of Cardiovascular and Endovascular Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Tim Walter
- Department for Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Freiburg, Germany.,Faculty of Medicine, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | | | - Xun Yuan
- Cardiology and Aortic Centre, The Royal Brompton & Harefield NHS Foundation Trust; National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK
| | | | - Antonio De Bellis
- Cardiac Surgery Unit, Heart and Vessels Department, Casa di Cura San Michele, Maddaloni, Italy
| | - Mario D Oria
- Division of Vascular and Endovascular Surgery, Cardiovascular Department, University of Trieste Medical School, Trieste, Italy
| | - Philipp Discher
- Department for Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Freiburg, Germany.,Faculty of Medicine, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Andreas Zierer
- Department of Cardiothoracic and Vascular Surgery, Kepler University Hospital, Medical Faculty, Johannes Kepler University Linz, Linz, Austria
| | - Bartosz Rylski
- Department for Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Freiburg, Germany.,Faculty of Medicine, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Jos C van den Berg
- Centro Vasolare Ticino, Ospedale Regionale di Lugano, Lugano, Switzerland.,Department of Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Thomas R Wyss
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Department of Vascular Surgery, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | | | - Jürg Schmidli
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christoph Nienaber
- Cardiology and Aortic Centre, The Royal Brompton & Harefield NHS Foundation Trust; National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK
| | | | - Giulio Accarino
- Cardiac Surgery Unit, University Hospital San Giovanni di Dio e Ruggi d´Aragona, Salerno, Italy
| | | | - Dittmar Böckler
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Claudio Corazzari
- Department of Cardiac Surgery, Department of Medicine and Surgery, University of Insubria, School of Medicine and ASST Settelaghi University Teaching Hospital, Varese, Italy
| | - Ilenia D Alessio
- Unita Operativa di Chirurgia Vascolare, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico Milan, Milan, Italy.,Department of Clinical and Community Sciences, University of Milan, Milan, Italy
| | - Hector de Beaufort
- Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, Netherlands
| | | | - Julia Dumfarth
- Department of Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - Denise Galbiati
- Cardiac Surgery Unit, Department of Translational Medical Sciences, University of Campania "L.Vanvitelli", Monaldi Hospital, Naples, Italy
| | - Filippo Gorgatti
- Division of Vascular and Endovascular Surgery, Cardiovascular Department, University of Trieste Medical School, Trieste, Italy
| | - Christian Hagl
- Department of Cardiac Surgery, LMU University Hospital, Munich, Germany
| | - Marwan Hamiko
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
| | - Florian Huber
- Department of Cardiothoracic and Vascular Surgery, Kepler University Hospital, Medical Faculty, Johannes Kepler University Linz, Linz, Austria
| | - Alexander Hyhlik-Duerr
- Department for Vascular and Endovascular Surgery, University Hospital Augsburg, Augsburg, Germany
| | - Gabriele Ianelli
- Department of Cardiac Surgery, School of Medicine, University Federico II, Naples, Italy
| | - Ivana Iesu
- Cardiology Unit, University Hospital San Giovanni di Dio e Ruggi d´Aragona, Salerno, Italy
| | - Joon-Chui Jung
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Frieda-Maria Kainz
- Department of Cardiac Surgery, University Hospital St. Poelten, St. Poelten, Austria
| | - Athanasios Katsargyris
- Department of Vascular and Endovascular Surgery, Paracelsus Medical University Nuremberg, Nuremberg, Germany
| | - Stephan Koter
- Department of Cardiovascular and Endovascular Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Mariusz Kusmierczyk
- Department of Cardiac Surgery and Transplantation, The Cardinal Stefan Wyszynski National Institute of Cardiology, Warsaw, Poland
| | - Piotr Kolsut
- Department of Cardiac Surgery and Transplantation, The Cardinal Stefan Wyszynski National Institute of Cardiology, Warsaw, Poland
| | - Balazs Lengyel
- Department of Vascular and Endovascular Surgery, Semmelweis University, Budapest, Hungary
| | - Chiara Lomazzi
- Unita Operativa di Chirurgia Vascolare, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico Milan, Milan, Italy.,Department of Clinical and Community Sciences, University of Milan, Milan, Italy
| | - Claudio Muneretto
- Division of Cardiac Surgery, University of Brescia Medical School, Brescia, Italy
| | - Giovanni Nava
- Cardiovascular Department, IRCCS-Policlinico San Donato, Milan, Italy
| | - Thomas Nolte
- Department of Vascular Surgery, HGZ Bad Bevensen, Bad Bevensen, Germany
| | - Davide Pacini
- Department of Cardiac Surgery, Hospital Santa Orsola, University of Bologna, Bologna, Italy
| | - Eliza Pleban
- Department of Vascular Surgery, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Miriam Rychla
- Department for Vascular Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Kazuhisa Sakamoto
- Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takayuki Shijo
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Koki Yokawa
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Matthias Siepe
- Department for Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Freiburg, Germany.,Faculty of Medicine, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Joachim Sirch
- Department of Cardiac Surgery, Paracelsus Medical University Nuremberg, Nuremberg, Germany
| | - Justus Strauch
- Department of Cardiothoracic Surgery, University Hospital Bergmannsheil Bochum, Ruhr University of Bochum, Bochum, Germany
| | - Jai Ajitchandra Sule
- Department of Cardiac, Thoracic and Vascular Surgery, National University Hospital, National University Health System, Singapore
| | - Eva-Luca Tobler
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Ernst Weigang
- Department of Vascular and Endovascular Surgery, Hubertus Hospital Berlin, Berlin, Germany
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Kilian C, Supanya S, Probst C, Morgan C, Bärnighausen T, Kittirattanapaiboon P, Kwansanit P, Reininghaus U. Traumatic events and psychotic experiences: a nationally representative study in Thailand. Epidemiol Psychiatr Sci 2021; 30:e47. [PMID: 34100345 PMCID: PMC8192593 DOI: 10.1017/s2045796021000172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 11/22/2022] Open
Abstract
AIMS Most research exploring the link between traumatic events and psychotic experiences has focused on either Australia, Europe or North America. In this study, we expand the existing knowledge to Thailand and investigate the impact of the type and the number of traumatic events on psychotic experiences in Thailand. METHODS We used data from the nationally representative 2013 Thai National Mental Health Survey (TNMHS), including questions on traumatic events and psychotic experiences. We regressed the lifetime experience of hallucinations or delusions against the following independent variables: the experience of any traumatic event during lifetime (dichotomous; hypothesis 1); the experience of either no traumatic event, one interpersonal, one unintentional or both interpersonal and unintentional traumatic events (categorical; hypothesis 2) and the number of traumatic events experienced during lifetime (categorical; hypothesis 3). We adjusted the regression models for sociodemographic indicators and psychiatric disorders, and considered survey weights. RESULTS About 6% (95% confidence interval: 4.9-7.0) of the respondents stated that they had either hallucinatory or delusional experiences during their lifetime. The risk of reporting such experiences was more than doubled as high among respondents who had experienced at least one traumatic event during their lifetime than among those who had not yet experienced one, with higher risks for interpersonal or multiple traumatic events. Our results further indicated an increase in the risk of psychotic experiences as the number of traumatic events increased, with up to an eight-fold higher risk for people exposed to five or more traumatic events in their lifetime, compared to those with no traumatic events. CONCLUSIONS Individuals reporting interpersonal or multiple traumatic events face much higher risk of psychotic experiences. Effective and widely accessible secondary prevention programmes for people having experienced interpersonal or multiple traumatic events constitute a key intervention option.
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Affiliation(s)
- C. Kilian
- Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany
| | - S. Supanya
- Department of Mental Health, Somdet Chaopraya Institute of Psychiatry, Bangkok, Thailand
| | - C. Probst
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
- Institute of Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - C. Morgan
- ESRC Centre for Society and Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - T. Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
| | | | - P. Kwansanit
- Department of Mental Health, Somdet Chaopraya Institute of Psychiatry, Bangkok, Thailand
| | - U. Reininghaus
- ESRC Centre for Society and Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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10
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Hamiko M, Pavlu S, Duerr GD, Probst C, Schiller W, Welz A, Treede H, Böning A, Grieshaber P. Timing of Surgical Revascularization in Patients with Acute Myocardial Infarction: Results of a Single-Center Experience from the GERMIN-SURG Registry. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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11
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Samokhvalov A, Awan S, Le Foll B, Probst C, Voore P, Rehm J. Clinical Outcomes of the First 2 Years of Implementation of the Integrated Care Pathway for Concurrent Major Depressive Disorder and Alcohol Use Disorder. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2017.01.251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BackgroundBoth major depressive disorder (MDD) and alcohol use disorder are highly prevalent, often comorbid and cause significant socioeconomic burden. At CAMH, we have developed and integrated care pathway (ICP) to treat these disorders and evaluated its effectiveness in comparison to treatment as usual (TAU)MethodsChart review; descriptive statistics, c2 and t-tests, linear mixed effects models, Kaplan–Meier and log-rank analyses.ResultsOverall, 81 patients were enrolled into ICP. Comparisons of treatment retention rates between ICP patients and matched historical controls (n = 81) showed significantly lower dropout rate in ICP cohort (18.5% vs. 69.1%, P < 0.001, Fig. 1). The ICP patients demonstrated significant reduction in depressive symptoms severity (QIDS: 14.6 vs. 10.0, P < 0.001; BDI 26.3 vs. 16.2, P < 0.001), reduction in the amount of alcohol consumed weekly from 44.6 standard drinks at baseline to 12.6 (P < 0.001) by the end of treatment, which was significantly better compared to controls (56.9 vs. 25.2, P < 0.001), P = 0.014 (Fig. 2).ConclusionsThe ICP is a feasible approach to treatment of concurrent AUD and MDD with significantly higher retention rates than TAU. Patients demonstrate improvements on several levels including depressive symptoms, and changes in alcohol drinking patterns.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Schafigh MJ, Hamiko M, Schiller W, Treede H, Probst C. Predictive Factors for High Blood Product Use in Patients with Acute Stanford Type A Dissection. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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13
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Tegtmeyer J, Probst C, Komorowski L, Zillikens D, Schmidt E, Goletz S. 062 Sera of patients with bullous pemphigoid and mucous membrane pemphigoid react with a C-terminal 246 amino acid stretch of BP180. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.065] [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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Williams HC, Schiller W, Mellert F, Fimmers R, Welz A, Probst C. Retrograde autologous priming in surgery of thoracic aortic aneurysm. Interact Cardiovasc Thorac Surg 2019; 28:876-883. [DOI: 10.1093/icvts/ivz014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 12/06/2018] [Accepted: 12/16/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Helen C Williams
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
| | | | - Fritz Mellert
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
| | - Rolf Fimmers
- Institute of Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany
| | - Armin Welz
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
| | - Chris Probst
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
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Williams H, Hamiko M, Schiller W, Mellert F, Fimmers R, Probst C. Retrograde Autologous Priming in Surgery of Thoracic Aortic Aneurysm. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- H. Williams
- Rheinische Friedrich-Wilhelms-Universität Bonn, Klinik und Poliklinik für Herzchirurgie, Bonn, Germany
| | - M. Hamiko
- Rheinische Friedrich-Wilhelms-Universität Bonn, Klinik und Poliklinik für Herzchirurgie, Bonn, Germany
| | - W. Schiller
- Rheinische Friedrich-Wilhelms-Universität Bonn, Klinik und Poliklinik für Herzchirurgie, Bonn, Germany
| | - F. Mellert
- Rheinische Friedrich-Wilhelms-Universität Bonn, Klinik und Poliklinik für Herzchirurgie, Bonn, Germany
| | - R. Fimmers
- Institut für Medizinische Biometrie, Informatik und Epidemiologie Bonn, Bonn, Germany
| | - C. Probst
- Rheinische Friedrich-Wilhelms-Universität Bonn, Klinik und Poliklinik für Herzchirurgie, Bonn, Germany
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Goletz S, Probst C, Komorowski L, Schlumberger W, Fechner K, van Beek N, Holtsche MM, Recke A, Yancey KB, Hashimoto T, Antonicelli F, Di Zenzo G, Zillikens D, Stöcker W, Schmidt E. A sensitive and specific assay for the serological diagnosis of antilaminin 332 mucous membrane pemphigoid. Br J Dermatol 2019; 180:149-156. [PMID: 30216412 DOI: 10.1111/bjd.17202] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Antilaminin 332 mucous membrane pemphigoid (MMP) is an autoimmune subepidermal blistering disease with predominant mucosal involvement and autoantibodies against laminin 332. Malignancies have been associated with this disease; however, no standardized detection system for antilaminin 332 serum antibodies is widely available. OBJECTIVES Development of a sensitive and specific assay for the detection of antilaminin 332 antibodies. METHODS An indirect immunofluorescence (IF) assay using recombinant laminin 332 was developed and probed with a large number of antilaminin 332 MMP patient sera (n = 93), as well as sera from patients with antilaminin 332-negative MMP (n = 153), bullous pemphigoid (n = 20), pemphigus vulgaris (n = 20) and noninflammatory dermatoses (n = 22), and healthy blood donors (n = 100). RESULTS In the novel IF assay, sensitivities with the laminin 332 heterotrimer and the individual α3, β3 and γ2 chains were 77%, 43%, 41% and 13%, respectively, with specificities of 100% for each substrate. The sensitivity for the heterotrimer increased when an anti-IgG4 enriched antitotal IgG conjugate was applied. Antilaminin 332 reactivity paralleled disease activity and was associated with malignancies in 25% of patients with antilaminin 332 MMP. CONCLUSIONS The novel IF-based assay will facilitate the serological diagnosis of antilaminin 332 MMP and may help to identify patients at risk of a malignancy.
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Affiliation(s)
- S Goletz
- Lübeck Institute for Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - C Probst
- Institute of Experimental Immunology, EUROIMMUN AG, Lübeck, Germany
| | - L Komorowski
- Institute of Experimental Immunology, EUROIMMUN AG, Lübeck, Germany
| | - W Schlumberger
- Institute of Experimental Immunology, EUROIMMUN AG, Lübeck, Germany
| | - K Fechner
- Institute of Experimental Immunology, EUROIMMUN AG, Lübeck, Germany
| | - N van Beek
- Lübeck Institute for Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - M M Holtsche
- Lübeck Institute for Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - A Recke
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - K B Yancey
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, U.S.A
| | - T Hashimoto
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
| | - F Antonicelli
- Department of Dermatology, University of Reims, Reims, France
| | - G Di Zenzo
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell'Immacolata, IDI-IRCCS, Rome, Italy
| | - D Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - W Stöcker
- Institute of Experimental Immunology, EUROIMMUN AG, Lübeck, Germany
| | - E Schmidt
- Lübeck Institute for Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
- Department of Dermatology, University of Lübeck, Lübeck, Germany
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Schafigh MJ, Kohistani Z, Schiller W, Probst C. Retrograde Stanford type A dissection caused by a multilayer stent graft in a patient with chronic type B dissection. Interact Cardiovasc Thorac Surg 2018; 28:655-656. [DOI: 10.1093/icvts/ivy313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 09/12/2018] [Accepted: 10/14/2018] [Indexed: 12/14/2022] Open
Affiliation(s)
| | - Zaki Kohistani
- Department of Cardiac Surgery, Heart Center Bonn, University of Bonn, Bonn, Germany
| | - Wolfgang Schiller
- Department of Cardiac Surgery, Heart Center Bonn, University of Bonn, Bonn, Germany
| | - Chris Probst
- Department of Cardiac Surgery, Heart Center Bonn, University of Bonn, Bonn, Germany
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18
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Goletz S, Probst C, Komorowski L, Schlumberger W, van Beek N, Holtsche M, Recke A, Yancey K, Hashimoto T, Antonicelli F, Di Zenzo G, Zillikens D, Stöcker W, Schmidt E. 089 Sensitive and specific assay for the serological diagnosis of anti-laminin 332 mucous membrane pemphigoid. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.093] [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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19
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Goletz S, Probst C, Komorowski L, Schlumberger W, Zillikens D, Stöcker W, Schmidt E. 424 Cell-based immunofluorescence test applying recombinant laminin 332 for the serological differential diagnosis of pemphigoid. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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20
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Hahn S, Trendelenburg G, Scharf M, Denno Y, Brakopp S, Teegen B, Probst C, Wandinger KP, Buttmann M, Haarmann A, Szabados F, vom Dahl M, Kümpfel T, Eichhorn P, Gold H, Paul F, Jarius S, Melzer N, Stöcker W, Komorowski L. Identification of the flotillin-1/2 heterocomplex as a target of autoantibodies in bona fide multiple sclerosis. J Neuroinflammation 2017; 14:123. [PMID: 28645295 PMCID: PMC5481867 DOI: 10.1186/s12974-017-0900-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 06/13/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Autoantibodies, in particular those against aquaporin-4 and myelin-oligodendrocyte glycoprotein (MOG), aid as biomarkers in the differential diagnosis of demyelination. Here, we report on discovery of autoantibodies against flotillin in patients with multiple sclerosis (MS). METHODS The target antigen was identified by histo-immunoprecipitation using the patients' sera and cryosections of rat or pig cerebellum combined with mass spectrometrical analysis. Correct identification was ascertained by indirect immunofluorescence and neutralization tests using the target antigens recombinantly expressed in HEK293 cells. RESULTS Serum and CSF of the index patient produced a fine-granular IgG indirect immunofluorescence staining of the hippocampal and cerebellar molecular layers. Flotillin-1 and flotillin-2 were identified as target autoantigens. They also reacted with recombinant human flotillin-1/2 co-expressed in HEK293 cells, but not with the individual flotillins in fixed- and live-cell assays. Moreover, neutralization using flotillin-1/2, but not the single flotillins, abolished the tissue reactivity of patient serum. Screening of 521 patients, for whom anti-aquaporin-4 testing was requested and negative, revealed 8 additional patients with anti-flotillin-1/2 autoantibodies. All eight were negative for anti-MOG. Six patients ex post fulfilled the revised McDonald criteria for MS. Vice versa, screening of 538 MS sera revealed anti-flotillin-1/2 autoantibodies in eight patients. The autoantibodies were not found in a cohort of 67 patients with other neural autoantibody-associated syndromes and in 444 healthy blood donors. CONCLUSIONS Autoantibodies against the flotillin-1/2 heterocomplex, a peripheral membrane protein that is involved in axon outgrowth and regeneration of the optic nerve, are present in 1-2% of patients with bona fide MS.
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Affiliation(s)
- S. Hahn
- Institute of Experimental Immunology, Euroimmun AG, Seekamp 31, 23560 Lübeck, Germany
| | - G. Trendelenburg
- Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - M. Scharf
- Institute of Experimental Immunology, Euroimmun AG, Seekamp 31, 23560 Lübeck, Germany
| | - Y. Denno
- Institute of Experimental Immunology, Euroimmun AG, Seekamp 31, 23560 Lübeck, Germany
| | - S. Brakopp
- Institute of Experimental Immunology, Euroimmun AG, Seekamp 31, 23560 Lübeck, Germany
| | - B. Teegen
- Institute of Experimental Immunology, Euroimmun AG, Seekamp 31, 23560 Lübeck, Germany
- Clinical Immunological Laboratory Prof. Dr. med Stöcker, Lübeck, Germany
| | - C. Probst
- Institute of Experimental Immunology, Euroimmun AG, Seekamp 31, 23560 Lübeck, Germany
| | - K. P. Wandinger
- Department of Neurology, University Medical Center Schleswig Holstein (UKSH), Lübeck, Germany
| | - M. Buttmann
- Department of Neurology, University of Würzburg, Würzburg, Germany
- Department of Neurology, Caritas Hospital, Bad Mergentheim, Germany
| | - A. Haarmann
- Department of Neurology, University of Würzburg, Würzburg, Germany
| | - F. Szabados
- Medical Laboratory Osnabrück, Georgsmarienhütte, Germany
| | - M. vom Dahl
- Department of Neurology, Ammerland Klinik, Westerstede, Germany
| | - T. Kümpfel
- Institute of Clinical Neuroimmunology, Ludwig Maximilian University, Munich, Germany
| | - P. Eichhorn
- Institute of Clinical Chemistry, Ludwig Maximilian University, Munich, Germany
| | - H. Gold
- Department of Neurology, Klinikum am Gesundbrunnen, Heilbronn, Germany
| | - F. Paul
- NeuroCure Clinical Research Center and Clinical and Experimental Multiple Sclerosis Research Center, Department of Neurology, Charité Universitätsmedizin, Berlin, Germany
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité Universitätsmedizin, Berlin, Germany
| | - S. Jarius
- Department of Neurology, University of Heidelberg, Heidelberg, Germany
| | - N. Melzer
- Department of Neurology, University of Münster, Münster, Germany
| | - W. Stöcker
- Institute of Experimental Immunology, Euroimmun AG, Seekamp 31, 23560 Lübeck, Germany
- Clinical Immunological Laboratory Prof. Dr. med Stöcker, Lübeck, Germany
| | - L. Komorowski
- Institute of Experimental Immunology, Euroimmun AG, Seekamp 31, 23560 Lübeck, Germany
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21
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Macke C, Winkelmann M, Mommsen P, Probst C, Zelle B, Krettek C, Zeckey C. Injuries to the upper extremities in polytrauma: limited effect on outcome more than ten years after injury - a cohort study in 629 patients. Bone Joint J 2017; 99-B:255-260. [PMID: 28148670 DOI: 10.1302/0301-620x.99b2.37999] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 09/02/2016] [Indexed: 11/05/2022]
Abstract
AIMS To analyse the influence of upper extremity trauma on the long-term outcome of polytraumatised patients. PATIENTS AND METHODS A total of 629 multiply injured patients were included in a follow-up study at least ten years after injury (mean age 26.5 years, standard deviation 12.4). The extent of the patients' injury was classified using the Injury Severity Score. Outcome was measured using the Hannover Score for Polytrauma Outcome (HASPOC), Short Form (SF)-12, rehabilitation duration, and employment status. Outcomes for patients with and without a fracture of the upper extremity were compared and analysed with regard to specific fracture regions and any additional brachial plexus lesion. RESULTS In all, 307 multiply-injured patients with and 322 without upper extremity injuries were included in the study. The groups with and without upper limb injuries were similar with respect to demographic data and injury pattern, except for midface trauma. There were no significant differences in the long-term outcome. In patients with brachial plexus lesions there were significantly more who were unemployed, required greater retraining and a worse HASPOC. CONCLUSION Injuries to the upper extremities seem to have limited effect on long-term outcome in patients with polytrauma, as long as no injury was caused to the brachial plexus. Cite this article: Bone Joint J 2017;99-B:255-60.
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Affiliation(s)
- C Macke
- Trauma Department, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - M Winkelmann
- Trauma Department, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - P Mommsen
- Trauma Department, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - C Probst
- Department of Traumatology and Orthopedic Surgery, Cologne-Merheim Medical Center, Ostmerheimer Str. 200, 51109 Köln, Germany
| | - B Zelle
- University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., MC 7774, San Antonio, TX, 78229, USA
| | - C Krettek
- Trauma Department, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - C Zeckey
- Trauma Department, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany and Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 Munich, Germany
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Hamiko M, Endlich M, Schiller W, Welz A, Nickenig G, Probst C. Endovascular and Operative Treatment of the Aortic Arch in a High-Risk Marfan Patient. Thorac Cardiovasc Surg Rep 2016; 5:68-70. [PMID: 28018831 PMCID: PMC5177424 DOI: 10.1055/s-0036-1571287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 12/14/2015] [Indexed: 11/01/2022] Open
Abstract
In this case, we describe a combined endovascular and operative management for aortic arch repair in a 57-year-old Marfan patient with complex aortic arch geometry previously treated with several open surgeries for acute type A dissection. The patient, who was presented to our department with dorsal pain, deemed to be at high operative risk for another open aortic surgery due to massive aortic calcification. It is an unusual method of placing a custom-made stent-graft system in the false aortic lumen with operative and endovascular treatment of the supra-aortic vessels.
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Affiliation(s)
- Marwan Hamiko
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
| | - Matthias Endlich
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
| | | | - Armin Welz
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
| | - Georg Nickenig
- Department of Cardiology, University of Bonn, Bonn, Germany
| | - Chris Probst
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
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23
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Hamiko M, Endlich M, Krämer C, Probst C, Welz A, Wilhelm K, Schiller W. Dilatation of Vascular Prostheses in Ascending Aortic Position: A Long-Term Follow-Up Computed Tomography Study with Comparison of Different Measurement Methods. Thorac Cardiovasc Surg 2016; 66:206-214. [PMID: 27960216 DOI: 10.1055/s-0036-1597116] [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: 10/20/2022]
Abstract
BACKGROUND The aim of this study was to evaluate long-term dilatation of Hemashield Gold and Hemashield Platinum vascular prostheses in ascending aortic position using different measurement methods to obtain precise results. METHODS Between 1999 and 2007, 73 patients with Stanford type A dissection received ascending aortic replacement with Hemashield Gold and Hemashield Platinum prostheses. Measurements were performed using multiplanar reconstruction mode of electrocardiogram (ECG)-gated, multislice spiral computed tomography (MSCT) in strictly orthogonal cross-sectional planes. Different methods of measurement were compared and maximum dilatation was estimated for different time spans. RESULTS Diameters calculated from the measured circumference showed a significant (p = 0.037) but clinically not relevant difference (0.1 mm) to the mean between the largest and the shortest cross-sectional diameter of the prosthesis. Dilatation after 24.2 ± 10.2 months was 8.5 ± 4.5%. Long-term dilatation after 91.8 ± 34 months amounted to 11.8 ± 4.2%. CONCLUSION Based on ECG-gated MSCT images, the presented methods of measurement provided reliable results. Long-term analysis shows low dilatation rates for Hemashield prostheses, which therefore can be considered as safe from this point of view. Nevertheless, a maximal dilatation of 20% could be relevant in valve sparing root replacement. It remains unclear if a dilatation like this contributes to the formation of suture aneurysms.
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Affiliation(s)
- Marwan Hamiko
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
| | - Matthias Endlich
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
| | - Christian Krämer
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
| | - Chris Probst
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
| | - Armin Welz
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
| | - Kai Wilhelm
- Department of Radiology, University of Bonn, Bonn, Germany
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Driessen A, Probst C, Sakka SG, Eikermann C, Mutschler M. [Bilateral carotid artery dissection in a kite surfer by strangulation with the kite lines]. Unfallchirurg 2016; 118:567-70. [PMID: 25135706 DOI: 10.1007/s00113-014-2641-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
While a kite surfer was preparing the kite it was caught by a gust of wind, which blew it 10 m into the air and the cords became entangled around the neck of the kite surfer causing strangulation. After admittance to hospital, the diagnostics revealed multiple injuries including a bilateral dissection of the internal carotid arteries, cerebral edema and multiple fractures. As kitesurfing is gaining popularity severe injuries are becoming more frequent. Safety precautions, such as preparing the kite with two persons, wearing safety equipment and using bars with a safety leash can prevent severe injuries.
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Affiliation(s)
- A Driessen
- Klinik für Orthopädie, Unfallchirurgie und Sporttraumatologie, Krankenhaus Köln-Merheim, Kliniken der Stadt Köln gGmbH, Universität Witten/Herdecke, Ostmerheimer Str. 200, 51109, Köln, Deutschland,
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Abstract
In-hospital mortality rate of an embolus in transit is as high as 44.7%. In some cases, a paradoxical embolus can get stuck in a patent foramen ovale. Because of the high mortality rate, this condition should be considered as an emergency case. Echocardiography has been established as the gold standard method for the diagnosis. A negative echocardiography, however, does not rule out an embolus in transit. To rule out pulmonary embolisms, a computed tomography scan of the chest should also be performed. A cardiothoracic surgeon should be consulted immediately upon diagnosis of an embolus in transit. There is no medical consensus for the treatment of the above mentioned condition, however, surgical treatment appears to be the best approach in patients who are surgical candidates.
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Affiliation(s)
- Zaki Kohistani
- Department of Heart Surgery, University Clinics Bonn, Bonn, Germany
| | - Chris Probst
- Department of Heart Surgery, University Clinics Bonn, Bonn, Germany
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26
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Wafaisade A, Paffrath T, Lefering R, Ludwig C, Fröhlich M, Mutschler M, Banerjee M, Bouillon B, Probst C. Patterns of early resuscitation associated with mortality after penetrating injuries. Br J Surg 2015; 102:1220-8; discussion 1228. [PMID: 26267604 DOI: 10.1002/bjs.9869] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Revised: 08/31/2014] [Accepted: 05/12/2015] [Indexed: 01/31/2023]
Abstract
BACKGROUND Penetrating injuries are rare in European populations so their management represents a particular challenge. The aim was to assess early therapeutic aspects that are associated with favourable outcomes in patients with penetrating trauma. METHODS Patients with penetrating injuries documented from 2009 to 2013 in the TraumaRegister DGU® were analysed. Patients with a primary admission and an Injury Severity Score (ISS) of at least 9 were included. The Revised Injury Severity Classification (RISC) II score was used for mortality prediction, and a standardized mortality ratio (SMR) calculated per hospital. Hospitals with favourable outcome (SMR below 1) were compared with those with poor outcome (SMR 1 or more). RESULTS A total of 50 centres had favourable outcome (1242 patients; observed mortality rate 15.7 per cent) and 34 centres had poor outcome (918 patients; observed mortality rate 24.4 per cent). Predicted mortality rates according to RISC-II were 20.4 and 20.5 per cent respectively. Mean(s.d.) ISS values were 22(14) versus 21(14) (P = 0.121). Patients in the favourable outcome group had a significantly shorter time before admission to hospital and a lower intubation rate. They received smaller quantities of intravenous fluids on admission to the emergency room, but larger amounts of fresh frozen plasma, and were more likely to receive haemostatic agents. A higher proportion of patients in the favourable outcome group were treated in a level I trauma centre. Independent risk factors for hospital death following penetrating trauma identified by multivariable analysis included gunshot injury mechanism and treatment in non-level I centres. CONCLUSION Among penetrating traumas, gunshot injuries pose an independent risk of death. Treatment of penetrating trauma in a level I trauma centre was significantly and independently associated with lower hospital mortality.
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Affiliation(s)
- A Wafaisade
- Department of Trauma and Orthopaedic Surgery, University of Witten/Herdecke, Cologne-Merheim Medical Centre, Cologne, Germany
| | - T Paffrath
- Department of Trauma and Orthopaedic Surgery, University of Witten/Herdecke, Cologne-Merheim Medical Centre, Cologne, Germany
| | - R Lefering
- IFOM - Institute for Research in Operative Medicine, University of Witten/Herdecke, Cologne, Germany
| | - C Ludwig
- Department of Thoracic Surgery, Lung Clinic, Hospital of Cologne, University of Witten/Herdecke, Cologne, Germany
| | - M Fröhlich
- Department of Trauma and Orthopaedic Surgery, University of Witten/Herdecke, Cologne-Merheim Medical Centre, Cologne, Germany
| | - M Mutschler
- Department of Trauma and Orthopaedic Surgery, University of Witten/Herdecke, Cologne-Merheim Medical Centre, Cologne, Germany
| | - M Banerjee
- Department of Trauma and Orthopaedic Surgery, University of Witten/Herdecke, Cologne-Merheim Medical Centre, Cologne, Germany
| | - B Bouillon
- Department of Trauma and Orthopaedic Surgery, University of Witten/Herdecke, Cologne-Merheim Medical Centre, Cologne, Germany
| | - C Probst
- Department of Trauma and Orthopaedic Surgery, University of Witten/Herdecke, Cologne-Merheim Medical Centre, Cologne, Germany
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27
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Hamiko M, Gestrich C, Probst C, Mellert F, Winkler K, Welz A, Schiller W, Endlich M. Long-Term Outcome and Quality of Life in Aortic Type A Dissection Survivors. Thorac Cardiovasc Surg 2015; 64:91-9. [DOI: 10.1055/s-0035-1548734] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Marwan Hamiko
- Department of Cardiovascular Surgery, University Hospital Bonn, Bonn, Germany
| | | | - Chris Probst
- Department of Cardiovascular Surgery, University Hospital Bonn, Bonn, Germany
| | - Fritz Mellert
- Department of Cardiovascular Surgery, University Hospital Bonn, Bonn, Germany
| | - Kai Winkler
- Department of Cardiovascular Surgery, University Hospital Bonn, Bonn, Germany
| | - Armin Welz
- Department of Cardiovascular Surgery, University Hospital Bonn, Bonn, Germany
| | - Wolfgang Schiller
- Department of Cardiovascular Surgery, University Hospital Bonn, Bonn, Germany
| | - Matthias Endlich
- Department of Cardiovascular Surgery, University Hospital Bonn, Bonn, Germany
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Endlich M, Schiller W, Mellert F, Probst C. Implantation of a total abdominal mesh plastic ending up in multiple, lethal right heart injuries. Interact Cardiovasc Thorac Surg 2015; 21:135-6. [PMID: 25857668 DOI: 10.1093/icvts/ivv083] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 03/18/2015] [Indexed: 02/04/2023] Open
Abstract
We present the case of a 62-year old patient who had an elective surgery to implant a total abdominal plastic mesh due to massive herniation after prior lower body gun shots and deep wound infections. Twenty-four hours after the operation, the patient's condition deteriorated, ST-deviation occurred and the Troponin I test was positive. On admission, the patient needed moderate catecholamine therapy and echocardiography showed a pericardial effusion (>3 cm). Puncture of the effusion was impossible due to the plastic mesh and the patient was transferred to the operating room. A subxiphoidal pericardial incision was performed and 800 ml of fresh blood was drained. Despite this, the patient's condition worsened. A full sternotomy was performed, and intrathoracal cardiopulmonary resuscitation started. During examination of the pericardium and the heart, multiple plastic parts from the mesh fixation system were observed transdiaphragmally and were found to have penetrated the diaphragmal part of the right ventricle. In spite of maximum drug, respiratory and surgical therapy, a sufficient heart ejection fraction could not be achieved. Upon interdisciplinary consent, therapy was stopped after 60 min.
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Affiliation(s)
- Matthias Endlich
- Department of Cardiovascular Surgery, University Bonn, Bonn, Germany
| | - Wolfgang Schiller
- Department of Cardiovascular Surgery, University Bonn, Bonn, Germany
| | - Fritz Mellert
- Department of Cardiovascular Surgery, University Bonn, Bonn, Germany
| | - Chris Probst
- Department of Cardiovascular Surgery, University Bonn, Bonn, Germany
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Scharf M, Miske R, Heidenreich F, Giess R, Landwehr P, Blocker IM, Begemann N, Denno Y, Tiede S, Dahnrich C, Schlumberger W, Unger M, Teegen B, Stocker W, Probst C, Komorowski L. Neuronal Na+/K+ ATPase is an autoantibody target in paraneoplastic neurologic syndrome. Neurology 2015; 84:1673-9. [DOI: 10.1212/wnl.0000000000001493] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 01/12/2015] [Indexed: 11/15/2022] Open
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Schiller W, Mellert F, Halbe M, Lorenzen H, Welz A, Probst C, Trapp C. Retrograde Autologous Priming as a Safe and Easy Method to Reduce Hemodilution and Transfusion Requirements during Cardiac Surgery. Thorac Cardiovasc Surg 2015; 63:628-34. [DOI: 10.1055/s-0035-1548731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | - Fritz Mellert
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
| | - Maximilian Halbe
- Division of Cardiovascular Surgery, University Hospital Zurich, Switzerland
| | - Henning Lorenzen
- Department of Informatics and Epidemiology, Institute of Medical Biometry, Bonn, Germany
| | - Armin Welz
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
| | - Chris Probst
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
| | - Christian Trapp
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
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Gethmann J, Zilow V, Probst C, Elbers ARW, Conraths FJ. Why German farmers have their animals vaccinated against Bluetongue virus serotype 8: results of a questionnaire survey. Vaccine 2014; 33:214-21. [PMID: 25454856 DOI: 10.1016/j.vaccine.2014.10.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [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: 08/28/2014] [Revised: 10/09/2014] [Accepted: 10/11/2014] [Indexed: 11/17/2022]
Abstract
In response to the Bluetongue disease epidemic in 2006-2007, Germany started in 2008 a country-wide mandatory vaccination campaign. By 2009 the number of new outbreaks had decreased so that vaccination became voluntary in 2010. We conducted a questionnaire survey in cattle and sheep farms in three German federal states, namely North-Rhine Westphalia, Rhineland Palatinate and Saxony-Anhalt to estimate the vaccination uptake in 2010, the intention to vaccinate in 2011 and the main determinants of refusal or acceptance to do so. The results showed that 42.8% (40.6-45.1) of the cattle farmers and 33.8% (31.8-35.8) of the sheep farmers had their animals vaccinated in 2010, whereas 40.7% (38.5-43.0) of cattle and 37.93% (35.8-40.1) sheep farmers expressed their intention to vaccinate in 2011. The main reasons mentioned for having animals vaccinated against BTV-8 were ability to export animals, prevention of production losses, subsidized vaccination, and recommendation by the veterinarian. Motives for refusing vaccination were presumed low risk of infection, costs, absence of clinical BT symptoms, presumed negative cost-benefit ratio, and negative experience with previous vaccination events (side effects). We assume that in order to increase farmers' motivation to have their animals immunized against BTV-8, (1) the vaccination needs to be subsidized, (2) combined vaccines with several different BT serotypes or even other diseases should be available and (3) farmers need to be better informed about the safety and benefit of vaccination.
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Affiliation(s)
- J Gethmann
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Epidemiology, Südufer 10, 17493 Greifswald - Insel Riems, Germany.
| | - V Zilow
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Epidemiology, Südufer 10, 17493 Greifswald - Insel Riems, Germany
| | - C Probst
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Epidemiology, Südufer 10, 17493 Greifswald - Insel Riems, Germany
| | - A R W Elbers
- Department of Epidemiology, Crisis-organization and Diagnostics, Central Veterinary Institute part of Wageningen UR, PO Box 65, 8200 AB Lelystad, Netherlands
| | - F J Conraths
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Epidemiology, Südufer 10, 17493 Greifswald - Insel Riems, Germany
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Mutschler M, Paffrath T, Wölfl C, Probst C, Nienaber U, Schipper IB, Bouillon B, Maegele M. The ATLS(®) classification of hypovolaemic shock: a well established teaching tool on the edge? Injury 2014; 45 Suppl 3:S35-8. [PMID: 25284231 DOI: 10.1016/j.injury.2014.08.015] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Uncontrolled bleeding is the leading cause of shock in trauma patients and delays in recognition and treatment have been linked to adverse outcomes. For prompt detection and management of hypovolaemic shock, ATLS(®) suggests four shock classes based upon vital signs and an estimated blood loss in percent. Although this classification has been widely implemented over the past decades, there is still no clear prospective evidence to fully support this classification. In contrast, it has recently been shown that this classification may be associated with substantial deficits. A retrospective analysis of data derived from the TraumaRegister DGU(®) indicated that only 9.3% of all trauma patients could be allocated into one of the ATLS(®) shock classes when a combination of the three vital signs heart rate, systolic blood pressure and Glasgow Coma Scale was assessed. Consequently, more than 90% of all trauma patients could not be classified according to the ATLS(®) classification of hypovolaemic shock. Further analyses including also data from the UK-based TARN registry suggested that ATLS(®) may overestimate the degree of tachycardia associated with hypotension and underestimate mental disability in the presence of hypovolaemic shock. This finding was independent from pre-hospital treatment as well as from the presence or absence of a severe traumatic brain injury. Interestingly, even the underlying trauma mechanism (blunt or penetrating) had no influence on the number of patients who could be allocated adequately. Considering these potential deficits associated with the ATLS(®) classification of hypovolaemic shock, an online survey among 383 European ATLS(®) course instructors and directors was performed to assess the actual appreciation and confidence in this tool during daily clinical trauma care. Interestingly, less than half (48%) of all respondents declared that they would assess a potential circulatory depletion within the primary survey according to the ATLS(®) classification of hypovolaemic shock. Based on these observations, a critical reappraisal of the current ATLS(®) classification of hypovolaemic seems warranted.
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Affiliation(s)
- M Mutschler
- Department of Orthopedics, Trauma and Sportsmedicine, Cologne-Merheim Medical Center (CMMC), Private University Witten-Herdecke, Cologne, Germany.
| | - T Paffrath
- Department of Orthopedics, Trauma and Sportsmedicine, Cologne-Merheim Medical Center (CMMC), Private University Witten-Herdecke, Cologne, Germany
| | - C Wölfl
- Department of Trauma and Orthopedic Surgery, BG Hospital Ludwigshafen, Ludwigshafen, Germany
| | - C Probst
- Department of Orthopedics, Trauma and Sportsmedicine, Cologne-Merheim Medical Center (CMMC), Private University Witten-Herdecke, Cologne, Germany
| | - U Nienaber
- Academy for Trauma Surgery (AUC), Berlin, Germany
| | - I B Schipper
- Department of Trauma Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - B Bouillon
- Department of Orthopedics, Trauma and Sportsmedicine, Cologne-Merheim Medical Center (CMMC), Private University Witten-Herdecke, Cologne, Germany
| | - M Maegele
- Department of Orthopedics, Trauma and Sportsmedicine, Cologne-Merheim Medical Center (CMMC), Private University Witten-Herdecke, Cologne, Germany
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Hammer C, Stepniak B, Schneider A, Papiol S, Tantra M, Begemann M, Sirén AL, Pardo LA, Sperling S, Mohd Jofrry S, Gurvich A, Jensen N, Ostmeier K, Lühder F, Probst C, Martens H, Gillis M, Saher G, Assogna F, Spalletta G, Stöcker W, Schulz TF, Nave KA, Ehrenreich H. Neuropsychiatric disease relevance of circulating anti-NMDA receptor autoantibodies depends on blood-brain barrier integrity. Mol Psychiatry 2014; 19:1143-9. [PMID: 23999527 DOI: 10.1038/mp.2013.110] [Citation(s) in RCA: 255] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 07/19/2013] [Accepted: 07/22/2013] [Indexed: 12/24/2022]
Abstract
In 2007, a multifaceted syndrome, associated with anti-NMDA receptor autoantibodies (NMDAR-AB) of immunoglobulin-G isotype, has been described, which variably consists of psychosis, epilepsy, cognitive decline and extrapyramidal symptoms. Prevalence and significance of NMDAR-AB in complex neuropsychiatric disease versus health, however, have remained unclear. We tested sera of 2817 subjects (1325 healthy, 1081 schizophrenic, 263 Parkinson and 148 affective-disorder subjects) for presence of NMDAR-AB, conducted a genome-wide genetic association study, comparing AB carriers versus non-carriers, and assessed their influenza AB status. For mechanistic insight and documentation of AB functionality, in vivo experiments involving mice with deficient blood-brain barrier (ApoE(-/-)) and in vitro endocytosis assays in primary cortical neurons were performed. In 10.5% of subjects, NMDAR-AB (NR1 subunit) of any immunoglobulin isotype were detected, with no difference in seroprevalence, titer or in vitro functionality between patients and healthy controls. Administration of extracted human serum to mice influenced basal and MK-801-induced activity in the open field only in ApoE(-/-) mice injected with NMDAR-AB-positive serum but not in respective controls. Seropositive schizophrenic patients with a history of neurotrauma or birth complications, indicating an at least temporarily compromised blood-brain barrier, had more neurological abnormalities than seronegative patients with comparable history. A common genetic variant (rs524991, P=6.15E-08) as well as past influenza A (P=0.024) or B (P=0.006) infection were identified as predisposing factors for NMDAR-AB seropositivity. The >10% overall seroprevalence of NMDAR-AB of both healthy individuals and patients is unexpectedly high. Clinical significance, however, apparently depends on association with past or present perturbations of blood-brain barrier function.
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Affiliation(s)
- C Hammer
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - B Stepniak
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - A Schneider
- 1] Department of Psychiatry & Psychotherapy, University Medicine Göttingen, Göttingen, Germany [2] DFG Research Center Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), Göttingen, Germany [3] German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
| | - S Papiol
- 1] Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany [2] DFG Research Center Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), Göttingen, Germany
| | - M Tantra
- 1] Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany [2] DFG Research Center Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), Göttingen, Germany
| | - M Begemann
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - A-L Sirén
- Department of Neurosurgery, University Clinic of Würzburg, Würzburg, Germany
| | - L A Pardo
- Department of Molecular Biology of Neuronal Signals, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - S Sperling
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - S Mohd Jofrry
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - A Gurvich
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - N Jensen
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - K Ostmeier
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - F Lühder
- Department of Neuroimmunology, Institute for Multiple Sclerosis Research and Hertie Foundation, University Medicine Göttingen, Göttingen, Germany
| | - C Probst
- Institute for Experimental Immunology, affiliated to Euroimmun, Lübeck, Germany
| | - H Martens
- Synaptic Systems GmbH, Göttingen, Germany
| | - M Gillis
- Institute of Virology, Hannover Medical School, Hannover, Germany
| | - G Saher
- Department of Neurogenetics, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - F Assogna
- Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - G Spalletta
- Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - W Stöcker
- Institute for Experimental Immunology, affiliated to Euroimmun, Lübeck, Germany
| | - T F Schulz
- Institute of Virology, Hannover Medical School, Hannover, Germany
| | - K-A Nave
- 1] DFG Research Center Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), Göttingen, Germany [2] Department of Neurogenetics, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - H Ehrenreich
- 1] Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany [2] DFG Research Center Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), Göttingen, Germany
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Grünberger A, Weber S, Probst C, Wiechert W, Kohlheyer D. Optimizing Growth Performance of Corynebacterium glutamicumat the Single-Cell Level. CHEM-ING-TECH 2014. [DOI: 10.1002/cite.201450237] [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: 11/11/2022]
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Bouillon B, Probst C, Maegele M, Wafaisade A, Helm P, Mutschler M, Brockamp T, Shafizadeh S, Paffrath T. [Emergency room management of multiple trauma : ATLS® and S3 guidelines]. Chirurg 2014; 84:745-52. [PMID: 23979042 DOI: 10.1007/s00104-013-2476-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [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
Trauma management in the emergency room is an important part of the treatment chain of the severely injured. Important decisions with respect to diagnostics and treatment must be made under time pressure. Successful trauma management in the emergency room requires a hospital tailored treatment protocol. This written protocol needs consent from all participating disciplines and must be known by all members of the resuscitation team. The ATLS® and the recently published clinical practice guidelines on multiple trauma can be of help in order to establish or update such protocols. In order to continuously evaluate and improve performance in the emergency room local quality circles are needed that truly follow that aim. Important factors are reliability of agreement between the different disciplines and continuous communication of results to the team members. In order to be successful such quality circles need people that care.
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Affiliation(s)
- B Bouillon
- Klinik für Unfallchirurgie, Orthopädie und Sporttraumatologie, Lehrstuhl der Universität Witten/Herdecke am Klinikum Köln-Merheim, Ostmerheimerstr. 200, 51109, Köln, Deutschland,
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Wolfenbarger SN, Eck EB, Ocamb CM, Probst C, Nelson ME, Grove GG, Gent DH. Powdery Mildew Outbreaks caused by Podosphaera macularis on Hop Cultivars Possessing the Resistance Gene R6 in the Pacific Northwestern United States. Plant Dis 2014; 98:852. [PMID: 30708655 DOI: 10.1094/pdis-11-13-1127-pdn] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Resistant cultivars of hop (Humulus lupulus) have been grown, with the aim of helping to manage powdery mildew in the Pacific Northwest since the first report of the disease in the field in 1997 (4). A major objective of many breeding programs is development of resistance to powdery mildew, and this has generally been achieved by single resistance genes (qualitative resistance). One such gene, R6 (3), has been utilized extensively in new cultivars and has prevented epidemics of the disease in those cultivars across the Pacific Northwestern United States for approximately 15 years. In 2011, a grower in Washington State reported outbreaks of powdery mildew on cv. Apollo, which is thought to possess powdery mildew resistance derived from R6. Fungicides and cultural control measures were applied, and the grower reported no substantial crop damage from the disease. During the winter of 2012, the same grower planted rhizomes of cv. Apollo in a greenhouse in the Yakima Valley of Washington State and later found the plants to be affected by powdery mildew. Affected leaves from plants of cvs. Apollo, Newport, and Nugget (all reported [3] or assumed to possess R6 based on pedigree) grown in the same greenhouse were later provided to the authors. Conidia obtained from each affected plants were transferred to plants of the highly susceptible cv. Symphony, which is not known to contain any resistance genes. After 10 to 14 days of incubation, resultant conidia from each cultivar above (total of three isolates) were transferred to greenhouse grown plants of cvs. Nugget and Symphony and incubated at 18°C. Within 7 days, all three isolates produced powdery mildew colonies characteristic of P. macularis (2) on both cultivars. Cleistothecia did not develop in any colonies. In addition, Nugget and Symphony plants were inoculated with a field population of P. macularis originating from cultivars lacking R6 in Oregon. These inoculations on Nugget did not develop powdery mildew whereas Symphony plants did. Non-inoculated controls remained free of powdery mildew. Results were identical in two additional experiments. The sequence of the mating type idiomorph, MAT1-1, was obtained to confirm identity of the pathogen as P. macularis as described previously (1). The sequences were identical among the three isolates obtained from the greenhouse in Washington and isolates of P. macularis obtained previously from Oregon and Washington. MAT1-2 idiomorph was not detected in the isolates collected. While R6-virulent strains have been detected previously in race characterization experiments, these strains have not caused widespread epidemics of powdery mildew. The increasing prevalence of virulent strains of P. macularis and outbreaks of powdery mildew on formerly resistant cultivars necessitates changes in breeding strategies and disease management efforts to minimize damage resulting from the disease. The distribution of virulent strains of the pathogen and susceptibility of formerly resistance cultivars to powdery mildew are currently under investigation. References: (1) B. Asalfet et al. Phytopathology 103:717, 2013. (2) R. Bélanger et al. The Powdery Mildews: a Comprehensive Treatise. APS Press, St. Paul, MN, 2002. (3) P. Darby. Brew Hist. 121:94, 2005. (4) C. Ocamb et al. Plant Dis. 83:1072, 1999.
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Affiliation(s)
- S N Wolfenbarger
- Department of Botany and Plant Pathology, Oregon State University, Corvallis 97331
| | - E B Eck
- Department of Botany and Plant Pathology, Oregon State University, Corvallis 97331
| | - C M Ocamb
- Department of Botany and Plant Pathology, Oregon State University, Corvallis 97331
| | - C Probst
- Irrigated Agriculture Research and Extension Center, Washington State University, Prosser 99350
| | - M E Nelson
- Irrigated Agriculture Research and Extension Center, Washington State University, Prosser 99350
| | - G G Grove
- Irrigated Agriculture Research and Extension Center, Washington State University, Prosser 99350
| | - D H Gent
- USDA-ARS, Forage Seed and Cereal Research Unit and Department of Botany and Plant Pathology, Oregon State University, Corvallis 97331
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Balint B, Jarius S, Nagel S, Haberkorn U, Probst C, Blocker IM, Bahtz R, Komorowski L, Stocker W, Kastrup A, Kuthe M, Meinck HM. Progressive encephalomyelitis with rigidity and myoclonus: A new variant with DPPX antibodies. Neurology 2014; 82:1521-8. [DOI: 10.1212/wnl.0000000000000372] [Citation(s) in RCA: 132] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Probst C, Bandyopadhyay R, Cotty P. Diversity of aflatoxin-producing fungi and their impact on food safety in sub-Saharan Africa. Int J Food Microbiol 2014; 174:113-22. [DOI: 10.1016/j.ijfoodmicro.2013.12.010] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 11/21/2013] [Accepted: 12/02/2013] [Indexed: 01/17/2023]
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Gestrich C, Dürr G, Heinemann J, Meertz A, Probst C, Röll W, Zimmer A, Bindila L, Lutz B, Welz A, Dewald O. Activation of endocannabinoid system is associated with persistent inflammation in human aortic aneurysm. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367285] [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: 10/25/2022]
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Probst C, Trapp C, Schiller W, Mellert F, Halbe M, Welz A. Retrograde autologous priming (RAP) as a safe and easy method to reduce haemodilution and transfusion requirements during cardiac surgery - Comparison between RAP, standard and Miniaturised Extracorporeal Circulation -. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367099] [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: 10/25/2022]
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Stöcker W, Saschenbrecker S, Rentzsch K, Komorowski L, Probst C. [Autoantibody diagnostics in neurology using native and recombinant antigenic substrates]. Nervenarzt 2013; 84:471-6. [PMID: 23568169 DOI: 10.1007/s00115-012-3607-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Modern diagnostics for the determination of neurologically relevant autoantibodies are based on indirect immunofluorescence using tissue sections of the hippocampus, cerebellum and other tissues. For monospecific detection human embryonic kidney (HEK) cells transfected with different neurological antigens are used. Biochip mosaics are designed to give a quick overview and contain 20 or more substances positioned next to each other on a reaction field, which are incubated with the serum or cerebrospinal fluid (CSF) sample. Western blots based on cerebellum or hippocampus extracts or line blots containing defined recombinant antigens are used additionally. Initial investigations should always comprise the parallel analysis of all major antineural autoantibodies instead of performing only single parameter tests. Up until a few years ago autoantibodies against intracellular neuronal antigens were mainly investigated. Antibodies against structures of the neural cell surface, however, are much more frequently found, especially those against glutamate receptors (type NMDA).
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Affiliation(s)
- W Stöcker
- Institut für Experimentelle Immunologie, Euroimmun, Seekamp 31, 23560 Lübeck, Deutschland.
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Brand S, Otte D, Stübig T, Petri M, Ettinger M, Mueller CW, Krettek C, Haasper C, Probst C. Mechanisms of motor vehicle crashes related to burns--an analysis of the German In depth Accident Study (GIDAS) database. Burns 2013; 39:1535-40. [PMID: 24169314 DOI: 10.1016/j.burns.2013.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 08/18/2013] [Accepted: 09/05/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Patients of motor vehicle crashes (MVCs) suffering burns are challenging for the rescue team and the admitting hospital. These patients often face worse outcomes than crash patients with trauma only. Our analysis of the German In-depth Accident Study (GIDAS) database researches the detailed crash mechanisms to identify potential prevention measures. METHODS We analyzed the 2011 GIDAS database comprising 14,072 MVC patients and compared individuals with (Burns) and without (NoBurns) burns. Only complete data sets were included. Patients with burns obviously resulting of air bag deployment only were not included in the Burns group. Data acquisition by an on call team of medical and technical researchers starts at the crash scene immediately after the crash and comprises technical data as well as medical information until discharge from the hospital. Statistical analysis was done by Mann-Whitney-U-test. Level of significance was p < 0.05. RESULTS 14,072 MVC patients with complete data sets were included in the analysis. 99 individuals suffered burns (0.7%; group "Burns"). Demographic data and injury severity showed no statistical significant difference between the two groups of Burns and NoBurns. Injury severity was measured using the Injury Severity Score (ISS). Direct frontal impact (Burns: 48.5% vs. NoBurns: 33%; p < 0.05) and high-energy impacts as represented by delta-v (m/s) (Burns: 33.5 ± 21.4 vs. NoBurns: 25.2 ± 15.9; p < 0.05) were significantly different between groups as was mortality (Burns: 12.5% vs. NoBurns: 2.1%; p < 0.05). Type of patients' motor vehicles and type of crash opponent showed no differences. CONCLUSIONS Our results show, that frontal and high-energy impacts are associated with a frequency of burns. This may serve automobile construction companies to improve the burn safety to prevent flames spreading from the motor compartment to the passenger compartment. Communities may impose speed limits in local crash hot spots.
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Affiliation(s)
- S Brand
- Department of Trauma, Hannover Medical School, Germany.
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Fabian T, Sakka SG, Trojan S, Wafaisade A, Mutschler M, Tjardes T, Bouillon B, Probst C. [Penetrating neck injury of a blacksmith by splitter projectile]. Unfallchirurg 2013; 117:564-7. [PMID: 23949194 DOI: 10.1007/s00113-013-2485-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Laryngeal injuries are rare but potentially life-threatening injuries. Due to the topography of the neck, accompanying injuries of the greater blood vessels, cervical nerves, thoracic organs and spinal cord are common. Therefore in initial diagnostics, these must be excluded from injuries which determine the prognosis. A patient presented with ventral perforation of the larynx, initial dyspnea, hematemesis and left-sided emphysema of the neck. Cause of the findings, we treated the patient non-operatively in interdisciplinary consensus.
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Affiliation(s)
- T Fabian
- Klinik für Orthopädie, Unfallchirurgie und Sporttraumatologie, Kliniken der Stadt Köln gGmbH, Krankenhaus Köln Merheim, Universitätsklinikum Witten-Herdecke, Ostmerheimer Straße 200, 51109, Köln, Deutschland,
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Gestrich C, Probst C, Wilhelm K, Schiller W. A migrated aortic stent graft causing erosive spondylopathy. Cardiovasc Intervent Radiol 2013; 36:1695-1698. [PMID: 23864020 DOI: 10.1007/s00270-013-0695-y] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 06/09/2013] [Indexed: 10/26/2022]
Abstract
We report about a patient presenting with back pain 4 months after an uneventful endovascular implantation of an aortic stent graft. Computed tomography scan revealed a migration of the stent with consecutive endoleakage, kink formation, and movement of the stent toward the spine, which caused destruction of the aortic wall as well as vertebral necrosis. Explantation of the stent and replacement of the native aorta relieved the patient of his symptoms.
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Affiliation(s)
- Christopher Gestrich
- Department of Cardiac Surgery, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany.
| | - Chris Probst
- Department of Cardiac Surgery, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany
| | - Kai Wilhelm
- Department of Radiology, Johanniterkrankenhaus Bonn, Johanniterstraße 3-5, 53113, Bonn, Germany
| | - Wolfgang Schiller
- Department of Cardiac Surgery, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany
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Kollert F, Binder M, Probst C, Uhl M, Zirlik A, Kayser G, Voll R, Peter HH, Zissel G, Prasse A, Warnatz K. THU0423 CCL18 – a potential biomarker of fibro-inflammatory activity in chronic periaortitis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2388] [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: 11/04/2022]
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Mutschler M, Trojan S, Defosse J, Helmers A, Probst C, Bouillon B, Wappler F, Sakka S. Severe sepsis caused by a linezolid-resistant Enterococcus faecium in a 10-year-old girl after multiple trauma. Int J Infect Dis 2013; 17:e466-7. [DOI: 10.1016/j.ijid.2013.01.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Revised: 01/08/2013] [Accepted: 01/09/2013] [Indexed: 10/27/2022] Open
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Mundiyanapurath S, Jarius S, Probst C, Stöcker W, Wildemann B, Bösel J. GABA-B-receptor antibodies in paraneoplastic brainstem encephalitis. J Neuroimmunol 2013; 259:88-91. [PMID: 23628208 DOI: 10.1016/j.jneuroim.2013.04.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 03/29/2013] [Accepted: 04/03/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Gamma-aminobutyric-acid B (GABA-B)-receptor encephalitis represents a novel entity among autoimmune CNS disorders. Most cases are characterised by limbic encephalitis. CASE REPORT A 63-year-old patient presented with acute vertigo, nausea and vomiting, facial palsy and dysarthria. He developed dysphagia, gait ataxia and, finally, respiratory failure. Antibodies to GABA-B receptors were positive and declined under treatment with intravenous methylprednisolone and plasma exchange, followed by clinical improvement and stabilisation. Broad tumour screening revealed oesophageal carcinoma. CONCLUSION The spectrum of neurological manifestations and tumours associated with the paraneoplastic variant of anti-GABA-B-receptor encephalitis may be broader than previously reported.
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Affiliation(s)
- S Mundiyanapurath
- Department of Neurology, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
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Duerr GD, Heinemann JC, Dunkel S, Zimmer A, Lutz B, Lerner R, Roell W, Mellert F, Probst C, Esmailzadeh B, Welz A, Dewald O. Myocardial hypertrophy is associated with inflammation and activation of endocannabinoid system in patients with aortic valve stenosis. Life Sci 2013; 92:976-83. [PMID: 23567807 DOI: 10.1016/j.lfs.2013.03.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 03/13/2013] [Accepted: 03/22/2013] [Indexed: 12/31/2022]
Abstract
AIMS Endocannabinoids and their receptors have been associated with cardiac adaptation to injury, inflammation and fibrosis. Experimental studies suggested a role for inflammatory reaction and active remodeling in myocardial hypertrophy, but they have not been shown in human hypertrophy. We investigated the association of the endocannabinoid system with myocardial hypertrophy in patients with aortic stenosis. MAIN METHODS Myocardial biopsies were collected from patients with aortic stenosis (AS) and atrial myxoma as controls during surgery. Histological and molecular analysis of endocannabinoids and their receptors, inflammatory and remodeling-related cells and mediators was performed. KEY FINDINGS Myocardial hypertrophy was confirmed with significantly higher cardiomyocyte diameter in AS than in myxoma patients, which had normal cell size. AS patients presented compensated myocardial adaptation to pressure overload. AS patients had significantly higher: concentration of endocannabinoid anandamide, expression of its degrading enzyme FAAH, and of cannabinoid receptor CB2, being predominantly located on cardiomyocytes. Cell density of macrophages and newly recruited leukocytes were higher in AS group, which together with increased expression of chemokines CCL2, CCL4 and CXCL8, and suppression of anti-inflammatory IL-10 indicates persistent inflammatory reaction. We found higher myofibroblast density and stronger tenascin C staining along with mRNA induction of tenascin C and CTGF in AS patients showing active myocardial remodeling. SIGNIFICANCE Our study shows for the first time activation of the endocannabinoid system and predominant expression of its receptor CB2 on cardiomyocytes being associated with persistent inflammation and active remodeling in hypertrophic myocardium of patients with aortic stenosis.
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Affiliation(s)
- Georg D Duerr
- Department of Cardiac Surgery, University Clinical Center Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany
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Abstract
We report the functional and socioeconomic long-term outcome of patients with pelvic ring injuries. We identified 109 patients treated at a Level I trauma centre between 1973 and 1990 with multiple blunt orthopaedic injuries including an injury to the pelvic ring, with an Injury Severity Score (ISS) of ≥ 16. These patients were invited for clinical review at a minimum of ten years after the initial injury, at which point functional results, general health scores and socioeconomic factors were assessed. In all 33 isolated anterior (group A), 33 isolated posterior (group P) and 43 combined anterior/posterior pelvic ring injuries (group A/P) were included. The mean age of the patients at injury was 28.8 years (5 to 55) and the mean ISS was 22.7 (16 to 44). At review the mean Short-Form 12 physical component score for the A/P group was 38.71 (22.12 to 56.56) and the mean Hannover Score for Polytrauma Outcome subjective score was 67.27 (12.48 to 147.42), being significantly worse compared with the other two groups (p = 0.004 and p = 0.024, respectively). A total of 42 patients (39%) had a limp and 12 (11%) required crutches. Car or public transport usage was restricted in 16 patients (15%). Overall patients in groups P and A/P had a worse outcome. The long-term outcome of patients with posterior or combined anterior/posterior pelvic ring injuries is poorer than of those with an isolated anterior injury. Cite this article: Bone Joint J 2013;95-B:548–53.
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Affiliation(s)
- T. Dienstknecht
- University of Aachen Medical Center, Department
of Orthopaedic Trauma, 30 Pauwels street, 52074
Aachen, Germany
| | - R. Pfeifer
- University of Aachen Medical Center, Department
of Orthopaedic Trauma, 30 Pauwels street, 52074
Aachen, Germany
| | - K. Horst
- University of Aachen Medical Center, Department
of Orthopaedic Trauma, 30 Pauwels street, 52074
Aachen, Germany
| | - R. M. Sellei
- University of Aachen Medical Center, Department
of Orthopaedic Trauma, 30 Pauwels street, 52074
Aachen, Germany
| | - A. Berner
- University Hospital Regensburg, Department
of Trauma Surgery, Franz-Josef-Strauss-Allee
11, 93053 Regensburg, Germany
| | - B. A. Zelle
- UT Health Science Center at San Antonio, Department
of Orthopaedic Surgery, Division of Orthopaedic
Traumatology 7703 Floyd Curl Dr, MC-7774, San
Antonio, TX 78229, USA
| | - C. Probst
- Cologne Merheim Medical Center, Department
of Trauma and Orthopaedic Surgery, Ostmerheimer
Str. 200, 51109 Cologne, Germany
| | - H-C. Pape
- University of Aachen Medical Center, Department
of Orthopaedic Trauma, 30 Pauwels street, 52074
Aachen, Germany
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Baehner T, Guetgemann I, Heinze I, Hoeft A, Knuefermann P, Probst C, Baumgarten G. A rare case of direct tumor extension to the right ventricle. Ann Thorac Surg 2013; 95:706-7. [PMID: 23336886 DOI: 10.1016/j.athoracsur.2012.06.054] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Revised: 06/09/2012] [Accepted: 06/27/2012] [Indexed: 11/25/2022]
Abstract
We report the case of a 72-year-old woman with signs of pulmonary embolism and right heart failure. Echocardiographic imaging and computed tomography revealed a mass within the inferior vena cava reaching from the head of the pancreas to the right ventricle. From standard imaging procedures and clinical findings alone, differentiation of a cardiac thrombus from a metastatic tumor mass was difficult. After resection of the intravascular tumor, histopathologic analysis confirmed a metastasis of primary ductal pancreatic adenocarcinoma. This is a report of a case of mucinous adenocarcinoma of the pancreas reaching the heart by continuous intravascular spreading.
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Affiliation(s)
- Torsten Baehner
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany.
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