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Siemer RG, Pantaleon A, Prinz C, Urban M, Dreger NM, Degener S, von Rundstedt FC. [Robotic-assisted resection of a symptomatic Müllerian duct cyst]. Aktuelle Urol 2023; 54:386-390. [PMID: 33951740 DOI: 10.1055/a-1348-6619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Cysts in the lesser pelvis are a rare disease and most often an incidental finding from routine diagnostic investigation. Published information is controversial. These cysts are distinguished by localisation, content of the cyst and accompanying anatomical anomalies. In this case, we report a 33 years old man who presented to our clinic due to a large retrovesical cyst. Because of lower abdominal pain and problems with defecation, the cyst was diagnosed by ultrasound. Further radiological diagnostic testing confirmed the presence of a retrovesical cyst of unknown malignancy, which was retrospectively evaluated as a Müllerian duct cyst. Due to symptoms and potential malignancy of the cyst, the decision was made to perform surgery. With the help of the operation robot, this benign cyst was safely and completely removed. In a follow-up, the patient presented free of symptoms and sonographically there was no sign of recurrence. Therefore robotic-assisted resection is a safe procedure to treat large symptomatic Müllerian duct cysts.
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Affiliation(s)
- Robert Große Siemer
- Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Klinik für Urologie und Kinderurologie, Wuppertal
| | - André Pantaleon
- Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Klinik für Urologie und Kinderurologie, Wuppertal
| | - Christian Prinz
- Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Medizinische Klinik 2, Wuppertal
| | - Max Urban
- Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Institut für Pathologie und Molekularpathologie, Wuppertal
| | - Nici Markus Dreger
- Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Klinik für Urologie und Kinderurologie, Wuppertal
| | - Stephan Degener
- Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Klinik für Urologie und Kinderurologie, Wuppertal
| | - Friedrich-Carl von Rundstedt
- Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Klinik für Urologie und Kinderurologie, Wuppertal
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2
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Starke L, Millward JM, Prinz C, Sherazi F, Waiczies H, Lippert C, Nazaré M, Paul F, Niendorf T, Waiczies S. First in vivo fluorine-19 magnetic resonance imaging of the multiple sclerosis drug siponimod. Theranostics 2023; 13:1217-1234. [PMID: 36923535 PMCID: PMC10008739 DOI: 10.7150/thno.77041] [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: 07/11/2022] [Accepted: 01/10/2023] [Indexed: 02/17/2023] Open
Abstract
Theranostic imaging methods could greatly enhance our understanding of the distribution of CNS-acting drugs in individual patients. Fluorine-19 magnetic resonance imaging (19F MRI) offers the opportunity to localize and quantify fluorinated drugs non-invasively, without modifications and without the application of ionizing or other harmful radiation. Here we investigated siponimod, a sphingosine 1-phosphate (S1P) receptor antagonist indicated for secondary progressive multiple sclerosis (SPMS), to determine the feasibility of in vivo 19F MR imaging of a disease modifying drug. Methods: The 19F MR properties of siponimod were characterized using spectroscopic techniques. Four MRI methods were investigated to determine which was the most sensitive for 19F MR imaging of siponimod under biological conditions. We subsequently administered siponimod orally to 6 mice and acquired 19F MR spectra and images in vivo directly after administration, and in ex vivo tissues. Results: The 19F transverse relaxation time of siponimod was 381 ms when dissolved in dimethyl sulfoxide, and substantially reduced to 5 ms when combined with serum, and to 20 ms in ex vivo liver tissue. Ultrashort echo time (UTE) imaging was determined to be the most sensitive MRI technique for imaging siponimod in a biological context and was used to map the drug in vivo in the stomach and liver. Ex vivo images in the liver and brain showed an inhomogeneous distribution of siponimod in both organs. In the brain, siponimod accumulated predominantly in the cerebrum but not the cerebellum. No secondary 19F signals were detected from metabolites. From a translational perspective, we found that acquisitions done on a 3.0 T clinical MR scanner were 2.75 times more sensitive than acquisitions performed on a preclinical 9.4 T MR setup when taking changes in brain size across species into consideration and using equivalent relative spatial resolution. Conclusion: Siponimod can be imaged non-invasively using 19F UTE MRI in the form administered to MS patients, without modification. This study lays the groundwork for more extensive preclinical and clinical investigations. With the necessary technical development, 19F MRI has the potential to become a powerful theranostic tool for studying the time-course and distribution of CNS-acting drugs within the brain, especially during pathology.
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Affiliation(s)
- Ludger Starke
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin Ultrahigh Field Facility, Berlin, Germany.,Hasso Plattner Institute for Digital Engineering, University of Potsdam, Germany
| | - Jason M Millward
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin Ultrahigh Field Facility, Berlin, Germany.,Experimental and Clinical Research Center, a joint cooperation between the Charité Universitätsmedizin Berlin and the Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Christian Prinz
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin Ultrahigh Field Facility, Berlin, Germany.,SRH Fernhochschule - The Mobile University, Riedlingen, Germany
| | - Fatima Sherazi
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin Ultrahigh Field Facility, Berlin, Germany
| | | | - Christoph Lippert
- Hasso Plattner Institute for Digital Engineering, University of Potsdam, Germany
| | - Marc Nazaré
- Medicinal Chemistry, Leibniz-Institut fϋr Molekulare Pharmakologie (FMP), Berlin, Germany
| | - Friedemann Paul
- Experimental and Clinical Research Center, a joint cooperation between the Charité Universitätsmedizin Berlin and the Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Thoralf Niendorf
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin Ultrahigh Field Facility, Berlin, Germany.,Experimental and Clinical Research Center, a joint cooperation between the Charité Universitätsmedizin Berlin and the Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Sonia Waiczies
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin Ultrahigh Field Facility, Berlin, Germany.,Experimental and Clinical Research Center, a joint cooperation between the Charité Universitätsmedizin Berlin and the Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
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3
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Prinz C, Frese R, Grams M, Fehring L. Emerging Role of microRNA Dysregulation in Diagnosis and Prognosis of Extrahepatic Cholangiocarcinoma. Genes (Basel) 2022; 13:1479. [PMID: 36011390 PMCID: PMC9407895 DOI: 10.3390/genes13081479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 12/01/2022] Open
Abstract
Extrahepatic cholangiocarcinomas, also called bile duct carcinomas, represent a special entity in gastrointestinal tumors, and histological specimens of the tumors are often difficult to obtain. A special feature of these tumors is the strong neovascularization, which can often be seen in the endoluminal endoscopic procedure called cholangioscopy, performed alone or in combination with laserscanning techniques. The additional analysis of microRNA expression profiles associated with inflammation and neovascularization in bile duct tumors or just the bile duct fluid of these patients could be of enormous additional importance. In particular, the dysregulation of microRNA in these cholangiocarcinomas (CCA) was previously reported to affect epigenetics (reported for miR-148, miR-152), inflammation (determined for miR-200, miR-125, and miR-605), and chemoresistance (miR-200b, 204) in patients with cholangiocarcinoma. More importantly, in the context of malignant neovascularization, well-defined microRNAs including miR-141, miR-181, miR-191, and miR-200b have been found to be dysregulated in cholangiocarcinoma and have been associated with an increased proliferation and vascularization in CCA. Thus, a panel of these microRNA molecules together with the clinical aspects of these tumors might facilitate tumor diagnosis and early treatment. To our knowledge, this is the first review that outlines the unique potential of combining macroscopic findings from cholangioscopy with microRNA expression.
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Affiliation(s)
- Christian Prinz
- Medizinische Klinik 2, Helios Universitätsklinikum, 42283 Wuppertal, Germany
- Lehrstuhl für Innere Medizin 1 der, University of Witten gGmbH, 42283 Wuppertal, Germany
| | - Robin Frese
- Medizinische Klinik 2, Helios Universitätsklinikum, 42283 Wuppertal, Germany
- Lehrstuhl für Innere Medizin 1 der, University of Witten gGmbH, 42283 Wuppertal, Germany
| | - Mashiba Grams
- Medizinische Klinik 2, Helios Universitätsklinikum, 42283 Wuppertal, Germany
- Lehrstuhl für Innere Medizin 1 der, University of Witten gGmbH, 42283 Wuppertal, Germany
| | - Leonard Fehring
- Medizinische Klinik 2, Helios Universitätsklinikum, 42283 Wuppertal, Germany
- Lehrstuhl für Innere Medizin 1 der, University of Witten gGmbH, 42283 Wuppertal, Germany
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4
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Prinz C, Fehring L, Frese R. MicroRNAs as Indicators of Malignancy in Pancreatic Ductal Adenocarcinoma (PDAC) and Cystic Pancreatic Lesions. Cells 2022; 11:cells11152374. [PMID: 35954223 PMCID: PMC9368175 DOI: 10.3390/cells11152374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/25/2022] [Accepted: 07/30/2022] [Indexed: 12/04/2022] Open
Abstract
The dysregulation of microRNAs has recently been associated with cancer development and progression in pancreatic ductal adenocarcinoma (PDAC) and cystic pancreatic lesions. In solid pancreatic tumor tissue, the dysregulation of miR-146, miR-196a/b, miR-198, miR-217, miR-409, and miR-490, as well as miR-1290 has been investigated in tumor biopsies of patients with PDAC and was reported to predict cancer presence. However, the value of the predictive biomarkers may further be increased during clinical conditions suggesting cancer development such as hyperinsulinemia or onset of diabetes. In this specific context, the dysregulation of miR-486 and miR-196 in tumors has been observed in the tumor tissue of PDAC patients with newly diagnosed diabetes mellitus. Moreover, miR-1256 is dysregulated in pancreatic cancer, possibly due to the interaction with long non-coding RNA molecules that seem to affect cell-cycle control and diabetes manifestation in PDAC patients, and, thus, these three markers may be of special or “sentinel value”. In blood samples, Next-generation sequencing (NGS) has also identified a set of microRNAs (miR-20a, miR-31-5p, miR-24, miR-25, miR-99a, miR-185, and miR-191) that seem to differentiate patients with pancreatic cancer remarkably from healthy controls, but limited data exist in this context regarding the prediction of cancer presences and outcomes. In contrast to solid pancreatic tumors, in cystic pancreatic cancer lesions, as well as premalignant lesions (such as intraductal papillary neoplasia (IPMN) or mucinous-cystic adenomatous cysts (MCAC)), the dysregulation of a completely different expression panel of miR-31-5p, miR-483-5p, miR-99a-5p, and miR-375 has been found to be of high clinical value in differentiating benign from malignant lesions. Interestingly, signal transduction pathways associated with miR-dysregulation seem to be entirely different in patients with pancreatic cysts when compared to PDAC. Overall, the determination of these different dysregulation “panels” in solid tumors, pancreatic cysts, obtained via fine-needle aspirate biopsies and/or in blood samples at the onset or during the treatment of pancreatic diseases, seems to be a reasonable candidate approach for predicting cancer presence, cancer development, and even therapy responses.
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5
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Fehring Z, Boehme P, Wirth S, Prinz C, Fehring L. [Patient education about organ donation - suggestions for the family doctor]. MMW Fortschr Med 2022; 164:61. [PMID: 35449284 DOI: 10.1007/s15006-022-0954-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Zoë Fehring
- Fakultät für Gesundheit, Universität Witten/Herdecke, Alfred-Herrhausen-Str. 50, 58455, Witten, Germany
| | - Philipp Boehme
- Fakultät für Gesundheit, Universität Witten/Herdecke, Alfred-Herrhausen-Str. 50, 58455, Witten, Germany
| | - Stefan Wirth
- Zentrum f. Kinder- u. Jugendmedizin, Helios Universitätsklinikum Wuppertal, Heusnerstr. 40, 42283, Wuppertal, Germany
| | - Christian Prinz
- Medizinische Klinik II, Helios Universitätsklinikum Wuppertal, Heusnerstr. 40, 42283, Wuppertal, Germany
| | - Leonard Fehring
- Fakultät für Gesundheit, Universität Witten/Herdecke, Alfred-Herrhausen-Str. 50, 58455, Witten, Germany.
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6
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Fehring Z, Boehme P, Wirth S, Prinz C, Fehring L. [GPs education about organ donation: what factors influence the success?]. MMW Fortschr Med 2022; 164:3-10. [PMID: 35449486 DOI: 10.1007/s15006-022-0854-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND According to the new legislation on organ donation in Germany, general practitioners (GPs) should regularly inform and educate their patients about organ donation from March 1, 2022. This is because of the persistently low organ donation rate in Germany. So far, there is a lack of information about the factors influencing the medical education of patients regarding organ donation provided by GPs. METHOD GPs were surveyed via a web-based questionnaire in November and December 2021. 215 data sets have been utilized. RESULTS GPs see themselves in charge for educating people about organ donation (86%). However, most of them invest little time in educating patients. 75% of GPs think that there is no time available for educational talks in the daily routine and 80% perceive difficulties in raising the issue of organ donation due to social taboos. Only 24% of GPs are aware of the new legislation. Only half of the respondents feel sufficiently informed to provide information about organ donation. On average, GPs consider a reimbursement of about 40 euros to be appropriate. CONCLUSIONS GPs have not dealt much with the topic of organ donation and need more comprehensive information for the education of patients. GPs require more time to accommodate education in everyday life. Younger citizens can only be reached by GPs to a limited extent. This group must be addressed by other means.
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Affiliation(s)
- Zoë Fehring
- Fakultät für Gesundheit, Universität Witten/Herdecke, Witten, Germany
| | - Philip Boehme
- Fakultät für Gesundheit, Universität Witten/Herdecke, Witten, Germany
| | | | | | - Leonard Fehring
- Fakultät für Gesundheit, Universität Witten/Herdecke, Witten, Germany.
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7
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Prinz C, Starke L, Ramspoth TF, Kerkering J, Martos Riaño V, Paul J, Neuenschwander M, Oder A, Radetzki S, Adelhoefer S, Ramos Delgado P, Aravina M, Millward JM, Fillmer A, Paul F, Siffrin V, von Kries JP, Niendorf T, Nazaré M, Waiczies S. Pentafluorosulfanyl (SF 5) as a Superior 19F Magnetic Resonance Reporter Group: Signal Detection and Biological Activity of Teriflunomide Derivatives. ACS Sens 2021; 6:3948-3956. [PMID: 34666481 PMCID: PMC8630787 DOI: 10.1021/acssensors.1c01024] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 05/17/2021] [Accepted: 09/24/2021] [Indexed: 12/30/2022]
Abstract
Fluorine (19F) magnetic resonance imaging (MRI) is severely limited by a low signal-to noise ratio (SNR), and tapping it for 19F drug detection in vivo still poses a significant challenge. However, it bears the potential for label-free theranostic imaging. Recently, we detected the fluorinated dihydroorotate dehydrogenase (DHODH) inhibitor teriflunomide (TF) noninvasively in an animal model of multiple sclerosis (MS) using 19F MR spectroscopy (MRS). In the present study, we probed distinct modifications to the CF3 group of TF to improve its SNR. This revealed SF5 as a superior alternative to the CF3 group. The value of the SF5 bioisostere as a 19F MRI reporter group within a biological or pharmacological context is by far underexplored. Here, we compared the biological and pharmacological activities of different TF derivatives and their 19F MR properties (chemical shift and relaxation times). The 19F MR SNR efficiency of three MRI methods revealed that SF5-substituted TF has the highest 19F MR SNR efficiency in combination with an ultrashort echo-time (UTE) MRI method. Chemical modifications did not reduce pharmacological or biological activity as shown in the in vitro dihydroorotate dehydrogenase enzyme and T cell proliferation assays. Instead, SF5-substituted TF showed an improved capacity to inhibit T cell proliferation, indicating better anti-inflammatory activity and its suitability as a viable bioisostere in this context. This study proposes SF5 as a novel superior 19F MR reporter group for the MS drug teriflunomide.
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Affiliation(s)
- Christian Prinz
- Berlin
Ultrahigh Field Facility (B.U.F.F.), Max
Delbrück Center for Molecular Medicine in the Helmholtz Association, Robert Rössle Straße
10, 13125 Berlin, Germany
- Experimental
and Clinical Research Center, a joint cooperation between the Charité
- Universitätsmedizin Berlin and the Max Delbrück Center
for Molecular Medicine in the Helmholtz Association, Robert Rössle Straße 10, 13125 Berlin, Germany
| | - Ludger Starke
- Berlin
Ultrahigh Field Facility (B.U.F.F.), Max
Delbrück Center for Molecular Medicine in the Helmholtz Association, Robert Rössle Straße
10, 13125 Berlin, Germany
| | - Tizian-Frank Ramspoth
- Medicinal
Chemistry, Leibniz-Institut für Molekulare
Pharmakologie (FMP), Robert Rössle Straße 10, 13125 Berlin, Germany
| | - Janis Kerkering
- Experimental
and Clinical Research Center, a joint cooperation between the Charité
- Universitätsmedizin Berlin and the Max Delbrück Center
for Molecular Medicine in the Helmholtz Association, Robert Rössle Straße 10, 13125 Berlin, Germany
| | - Vera Martos Riaño
- Medicinal
Chemistry, Leibniz-Institut für Molekulare
Pharmakologie (FMP), Robert Rössle Straße 10, 13125 Berlin, Germany
| | - Jérôme Paul
- Medicinal
Chemistry, Leibniz-Institut für Molekulare
Pharmakologie (FMP), Robert Rössle Straße 10, 13125 Berlin, Germany
| | - Martin Neuenschwander
- Screening
Unit, Leibniz-Institut für Molekulare
Pharmakologie (FMP), Robert Rössle Straße 10, 13125 Berlin, Germany
| | - Andreas Oder
- Screening
Unit, Leibniz-Institut für Molekulare
Pharmakologie (FMP), Robert Rössle Straße 10, 13125 Berlin, Germany
| | - Silke Radetzki
- Screening
Unit, Leibniz-Institut für Molekulare
Pharmakologie (FMP), Robert Rössle Straße 10, 13125 Berlin, Germany
| | - Siegfried Adelhoefer
- Berlin
Ultrahigh Field Facility (B.U.F.F.), Max
Delbrück Center for Molecular Medicine in the Helmholtz Association, Robert Rössle Straße
10, 13125 Berlin, Germany
| | - Paula Ramos Delgado
- Berlin
Ultrahigh Field Facility (B.U.F.F.), Max
Delbrück Center for Molecular Medicine in the Helmholtz Association, Robert Rössle Straße
10, 13125 Berlin, Germany
- Experimental
and Clinical Research Center, a joint cooperation between the Charité
- Universitätsmedizin Berlin and the Max Delbrück Center
for Molecular Medicine in the Helmholtz Association, Robert Rössle Straße 10, 13125 Berlin, Germany
| | - Mariya Aravina
- Berlin
Ultrahigh Field Facility (B.U.F.F.), Max
Delbrück Center for Molecular Medicine in the Helmholtz Association, Robert Rössle Straße
10, 13125 Berlin, Germany
| | - Jason M. Millward
- Berlin
Ultrahigh Field Facility (B.U.F.F.), Max
Delbrück Center for Molecular Medicine in the Helmholtz Association, Robert Rössle Straße
10, 13125 Berlin, Germany
- Experimental
and Clinical Research Center, a joint cooperation between the Charité
- Universitätsmedizin Berlin and the Max Delbrück Center
for Molecular Medicine in the Helmholtz Association, Robert Rössle Straße 10, 13125 Berlin, Germany
| | - Ariane Fillmer
- Physikalisch-Technische
Bundesanstalt (PTB), Abbestraße 2-12, 10587 Berlin, Germany
| | - Friedemann Paul
- Experimental
and Clinical Research Center, a joint cooperation between the Charité
- Universitätsmedizin Berlin and the Max Delbrück Center
for Molecular Medicine in the Helmholtz Association, Robert Rössle Straße 10, 13125 Berlin, Germany
- Charité
− Universitätsmedizin Berlin, corporate member of Freie
Universität Berlin, Humboldt-Universität zu Berlin,
and Berlin Institute of Health (BIH), Charitéplatz 1, 10117 Berlin, Germany
| | - Volker Siffrin
- Experimental
and Clinical Research Center, a joint cooperation between the Charité
- Universitätsmedizin Berlin and the Max Delbrück Center
for Molecular Medicine in the Helmholtz Association, Robert Rössle Straße 10, 13125 Berlin, Germany
| | - Jens-Peter von Kries
- Screening
Unit, Leibniz-Institut für Molekulare
Pharmakologie (FMP), Robert Rössle Straße 10, 13125 Berlin, Germany
| | - Thoralf Niendorf
- Berlin
Ultrahigh Field Facility (B.U.F.F.), Max
Delbrück Center for Molecular Medicine in the Helmholtz Association, Robert Rössle Straße
10, 13125 Berlin, Germany
- Experimental
and Clinical Research Center, a joint cooperation between the Charité
- Universitätsmedizin Berlin and the Max Delbrück Center
for Molecular Medicine in the Helmholtz Association, Robert Rössle Straße 10, 13125 Berlin, Germany
| | - Marc Nazaré
- Medicinal
Chemistry, Leibniz-Institut für Molekulare
Pharmakologie (FMP), Robert Rössle Straße 10, 13125 Berlin, Germany
| | - Sonia Waiczies
- Berlin
Ultrahigh Field Facility (B.U.F.F.), Max
Delbrück Center for Molecular Medicine in the Helmholtz Association, Robert Rössle Straße
10, 13125 Berlin, Germany
- Experimental
and Clinical Research Center, a joint cooperation between the Charité
- Universitätsmedizin Berlin and the Max Delbrück Center
for Molecular Medicine in the Helmholtz Association, Robert Rössle Straße 10, 13125 Berlin, Germany
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8
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Prinz C, Mese K, Weber D. MicroRNA Changes in Gastric Carcinogenesis: Differential Dysregulation during Helicobacter pylori and EBV Infection. Genes (Basel) 2021; 12:genes12040597. [PMID: 33921696 PMCID: PMC8073778 DOI: 10.3390/genes12040597] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/05/2021] [Accepted: 04/14/2021] [Indexed: 12/11/2022] Open
Abstract
Despite medical advances, gastric-cancer (GC) mortality remains high in Europe. Bacterial infection with Helicobacter pylori (H. pylori) and viral infection with the Epstein–Barr virus (EBV) are associated with the development of both distal and proximal gastric cancer. Therefore, the detection of these infections and the prediction of further cancer development could be clinically significant. To this end, microRNAs (miRNAs) could serve as promising new tools. MiRNAs are highly conserved noncoding RNAs that play an important role in gene silencing, mainly acting via translational repression and the degradation of mRNA targets. Recent reports demonstrate the downregulation of numerous miRNAs in GC, especially miR-22, miR-145, miR-206, miR-375, and miR-490, and these changes seem to promote cancer-cell invasion and tumor spreading. The dysregulation of miR-106b, miR-146a, miR-155, and the Let-7b/c complex seems to be of particular importance during H. pylori infection or gastric carcinogenesis. In contrast, many reports describe changes in host miRNA expression and outline the effects of bamHI-A region rightward transcript (BART) miRNA in EBV-infected tissue. The differential regulation of these miRNA, acting alone or in close interaction when both infections coexist, may therefore enable us to detect cancer earlier. In this review, we focus on the two different etiologies of gastric cancer and outline the molecular pathways through which H. pylori- or EBV-induced changes might synergistically act via miR-155 dysregulation to potentiate cancer risk. The three markers, namely, H. pylori presence, EBV infection, and miR-155 expression, may be checked in routine biopsies to evaluate the risk of developing gastric cancer.
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Affiliation(s)
- Christian Prinz
- Medizinische Klinik 2, Helios Universitätsklinikum Wuppertal, 42283 Wuppertal, Germany;
- Lehrstuhl Innere Medizin 1, University of Witten/Herdecke gGmbH, 42283 Wuppertal, Germany;
- Correspondence: ; Tel.: +49-202-896-2243; Fax: +49-202-896-2740
| | - Kemal Mese
- Lehrstuhl Innere Medizin 1, University of Witten/Herdecke gGmbH, 42283 Wuppertal, Germany;
- Institute of Virology, University of Göttingen, 37075 Göttingen, Germany
| | - David Weber
- Medizinische Klinik 2, Helios Universitätsklinikum Wuppertal, 42283 Wuppertal, Germany;
- Lehrstuhl Innere Medizin 1, University of Witten/Herdecke gGmbH, 42283 Wuppertal, Germany;
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9
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Waiczies S, Prinz C, Starke L, Millward JM, Delgado PR, Rosenberg J, Nazaré M, Waiczies H, Pohlmann A, Niendorf T. Functional Imaging Using Fluorine ( 19F) MR Methods: Basic Concepts. Methods Mol Biol 2021; 2216:279-299. [PMID: 33476007 PMCID: PMC9703275 DOI: 10.1007/978-1-0716-0978-1_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Kidney-associated pathologies would greatly benefit from noninvasive and robust methods that can objectively quantify changes in renal function. In the past years there has been a growing incentive to develop new applications for fluorine (19F) MRI in biomedical research to study functional changes during disease states. 19F MRI represents an instrumental tool for the quantification of exogenous 19F substances in vivo. One of the major benefits of 19F MRI is that fluorine in its organic form is absent in eukaryotic cells. Therefore, the introduction of exogenous 19F signals in vivo will yield background-free images, thus providing highly selective detection with absolute specificity in vivo. Here we introduce the concept of 19F MRI, describe existing challenges, especially those pertaining to signal sensitivity, and give an overview of preclinical applications to illustrate the utility and applicability of this technique for measuring renal function in animal models.This chapter is based upon work from the COST Action PARENCHIMA, a community-driven network funded by the European Cooperation in Science and Technology (COST) program of the European Union, which aims to improve the reproducibility and standardization of renal MRI biomarkers. This introduction chapter is complemented by two separate chapters describing the experimental procedure and data analysis.
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Affiliation(s)
- Sonia Waiczies
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine (MDC) in the Helmholtz Association, Berlin, Germany.
| | - Christian Prinz
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine (MDC) in the Helmholtz Association, Berlin, Germany
| | - Ludger Starke
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine (MDC) in the Helmholtz Association, Berlin, Germany
| | - Jason M Millward
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine (MDC) in the Helmholtz Association, Berlin, Germany
| | - Paula Ramos Delgado
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine (MDC) in the Helmholtz Association, Berlin, Germany
| | - Jens Rosenberg
- The National High Magnetic Field Laboratory, Florida State University, Tallahassee, FL, USA
| | - Marc Nazaré
- Medicinal Chemistry, Leibniz-Forschungsinstitut für Molekulare Pharmakologie (FMP), Berlin, Germany
| | | | - Andreas Pohlmann
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine (MDC) in the Helmholtz Association, Berlin, Germany
- Siemens Healthcare, Berlin, Germany
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine (MDC) in the Helmholtz Association, Berlin, Germany
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10
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Prinz C, Starke L, Millward JM, Fillmer A, Delgado PR, Waiczies H, Pohlmann A, Rothe M, Nazaré M, Paul F, Niendorf T, Waiczies S. In vivo detection of teriflunomide-derived fluorine signal during neuroinflammation using fluorine MR spectroscopy. Theranostics 2021; 11:2490-2504. [PMID: 33456555 PMCID: PMC7806491 DOI: 10.7150/thno.47130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 11/17/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Magnetic resonance imaging (MRI) is indispensable for diagnosing neurological conditions such as multiple sclerosis (MS). MRI also supports decisions regarding the choice of disease-modifying drugs (DMDs). Determining in vivo tissue concentrations of DMDs has the potential to become an essential clinical tool for therapeutic drug monitoring (TDM). The aim here was to examine the feasibility of fluorine-19 (19F) MR methods to detect the fluorinated DMD teriflunomide (TF) during normal and pathological conditions. Methods: We used 19F MR spectroscopy to detect TF in the experimental autoimmune encephalomyelitis (EAE) mouse model of multiple sclerosis (MS) in vivo. Prior to the in vivo investigations we characterized the MR properties of TF in vitro. We studied the impact of pH and protein binding as well as MR contrast agents. Results: We could detect TF in vivo and could follow the 19F MR signal over different time points of disease. We quantified TF concentrations in different tissues using HPLC/MS and showed a significant correlation between ex vivo TF levels in serum and the ex vivo19F MR signal. Conclusion: This study demonstrates the feasibility of 19F MR methods to detect TF during neuroinflammation in vivo. It also highlights the need for further technological developments in this field. The ultimate goal is to add 19F MR protocols to conventional 1H MRI protocols in clinical practice to guide therapy decisions.
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11
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Millward JM, Ramos Delgado P, Smorodchenko A, Boehmert L, Periquito J, Reimann HM, Prinz C, Els A, Scheel M, Bellmann-Strobl J, Waiczies H, Wuerfel J, Infante-Duarte C, Chien C, Kuchling J, Pohlmann A, Zipp F, Paul F, Niendorf T, Waiczies S. Transient enlargement of brain ventricles during relapsing-remitting multiple sclerosis and experimental autoimmune encephalomyelitis. JCI Insight 2020; 5:140040. [PMID: 33148886 PMCID: PMC7710287 DOI: 10.1172/jci.insight.140040] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/24/2020] [Indexed: 12/18/2022] Open
Abstract
The brain ventricles are part of the fluid compartments bridging the CNS with the periphery. Using MRI, we previously observed a pronounced increase in ventricle volume (VV) in the experimental autoimmune encephalomyelitis (EAE) model of multiple sclerosis (MS). Here, we examined VV changes in EAE and MS patients in longitudinal studies with frequent serial MRI scans. EAE mice underwent serial MRI for up to 2 months, with gadolinium contrast as a proxy of inflammation, confirmed by histopathology. We performed a time-series analysis of clinical and MRI data from a prior clinical trial in which RRMS patients underwent monthly MRI scans over 1 year. VV increased dramatically during preonset EAE, resolving upon clinical remission. VV changes coincided with blood-brain barrier disruption and inflammation. VV was normal at the termination of the experiment, when mice were still symptomatic. The majority of relapsing-remitting MS (RRMS) patients showed dynamic VV fluctuations. Patients with contracting VV had lower disease severity and a shorter duration. These changes demonstrate that VV does not necessarily expand irreversibly in MS but, over short time scales, can expand and contract. Frequent monitoring of VV in patients will be essential to disentangle the disease-related processes driving short-term VV oscillations from persistent expansion resulting from atrophy. Brain ventricle volumes expand and contract during experimental autoimmune encephalomyelitis and relapsing-remitting multiple sclerosis, suggesting that short-term inflammatory processes are interlaced with gradual brain atrophy.
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Affiliation(s)
- Jason M Millward
- Experimental Ultrahigh Field Magnetic Resonance, Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Institute for Medical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Paula Ramos Delgado
- Experimental Ultrahigh Field Magnetic Resonance, Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Alina Smorodchenko
- Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany
| | - Laura Boehmert
- Experimental Ultrahigh Field Magnetic Resonance, Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Joao Periquito
- Experimental Ultrahigh Field Magnetic Resonance, Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Henning M Reimann
- Experimental Ultrahigh Field Magnetic Resonance, Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Christian Prinz
- Experimental Ultrahigh Field Magnetic Resonance, Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Antje Els
- Experimental Ultrahigh Field Magnetic Resonance, Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Michael Scheel
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Judith Bellmann-Strobl
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Experimental and Clinical Research Center, a joint venture of the Max Delbrück Center for Molecular Medicine and the Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | - Jens Wuerfel
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Medical Image Analysis Center (MIAC AG) and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Carmen Infante-Duarte
- Institute for Medical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Claudia Chien
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Joseph Kuchling
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Pohlmann
- Experimental Ultrahigh Field Magnetic Resonance, Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Frauke Zipp
- Department of Neurology, University Medical Center of the Johannes Gutenberg, University of Mainz, Mainz, Germany
| | - Friedemann Paul
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Experimental and Clinical Research Center, a joint venture of the Max Delbrück Center for Molecular Medicine and the Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Thoralf Niendorf
- Experimental Ultrahigh Field Magnetic Resonance, Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Experimental and Clinical Research Center, a joint venture of the Max Delbrück Center for Molecular Medicine and the Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Sonia Waiczies
- Experimental Ultrahigh Field Magnetic Resonance, Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
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12
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Eigentler TW, Winter L, Han H, Oberacker E, Kuehne A, Waiczies H, Schmitter S, Boehmert L, Prinz C, Trefna HD, Niendorf T. Wideband Self-Grounded Bow-Tie Antenna for Thermal MR. NMR Biomed 2020; 33:e4274. [PMID: 32078208 DOI: 10.1002/nbm.4274] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 01/07/2020] [Accepted: 01/27/2020] [Indexed: 06/10/2023]
Abstract
The objective of this study was the design, implementation, evaluation and application of a compact wideband self-grounded bow-tie (SGBT) radiofrequency (RF) antenna building block that supports anatomical proton (1 H) MRI, fluorine (19 F) MRI, MR thermometry and broadband thermal intervention integrated in a whole-body 7.0 T system. Design considerations and optimizations were conducted with numerical electromagnetic field (EMF) simulations to facilitate a broadband thermal intervention frequency of the RF antenna building block. RF transmission (B1+ ) field efficiency and specific absorption rate (SAR) were obtained in a phantom, and the thigh of human voxel models (Ella, Duke) for 1 H and 19 F MRI at 7.0 T. B1+ efficiency simulations were validated with actual flip-angle imaging measurements. The feasibility of thermal intervention was examined by temperature simulations (f = 300, 400 and 500 MHz) in a phantom. The RF heating intervention (Pin = 100 W, t = 120 seconds) was validated experimentally using the proton resonance shift method and fiberoptic probes for temperature monitoring. The applicability of the SGBT RF antenna building block for in vivo 1 H and 19 F MRI was demonstrated for the thigh and forearm of a healthy volunteer. The SGBT RF antenna building block facilitated 19 F and 1 H MRI at 7.0 T as well as broadband thermal intervention (234-561 MHz). For the thigh of the human voxel models, a B1+ efficiency ≥11.8 μT/√kW was achieved at a depth of 50 mm. Temperature simulations and heating experiments in a phantom demonstrated a temperature increase ΔT >7 K at a depth of 10 mm. The compact SGBT antenna building block provides technology for the design of integrated high-density RF applicators and for the study of the role of temperature in (patho-) physiological processes by adding a thermal intervention dimension to an MRI device (Thermal MR).
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Affiliation(s)
- Thomas Wilhelm Eigentler
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Technische Universität Berlin, Chair of Medical Engineering, Berlin, Germany
| | - Lukas Winter
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig und Berlin, Berlin, Germany
| | - Haopeng Han
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Institute of Computer Science, Humboldt-Universitätzu Berlin, Berlin, Germany
| | - Eva Oberacker
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | | | | | - Sebastian Schmitter
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig und Berlin, Berlin, Germany
| | - Laura Boehmert
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Christian Prinz
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Hana Dobsicek Trefna
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- MRI.TOOLS GmbH, Berlin, Germany
- Experimental and Clinical Research Center (ECRC), a joint cooperation between the Charité Medical Faculty and the Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
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13
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Prinz C, Weber D. MicroRNA (miR) dysregulation during Helicobacter pylori-induced gastric inflammation and cancer development: critical importance of miR-155. Oncotarget 2020; 11:894-904. [PMID: 32206186 PMCID: PMC7075464 DOI: 10.18632/oncotarget.27520] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 02/06/2020] [Indexed: 02/03/2023] Open
Abstract
Dysregulation of noncoding microRNA molecules has been associated with immune cell activation in the context of Helicobacter pylori induced gastric inflammation as well as carcinogenesis, but also with downregulation of mismatch repair genes, and may interfere with immune checkpoint proteins that lead to the overexpression of antigens on gastric tumor cells. Numerous miR-molecules have been described as important tools and markers in gastric inflammation and cancer development -including miR-21, miR-143, miR-145, miR-201, and miR-335- all of which are downregulated in gastric tumors, and involved in cell cycle growth or tumor invasion. Among the many microRNAs involved in gastric inflammation, adenocarcinoma development and immune checkpoint regulation, miR-155 is notable in that its upregulation is considered a key marker of chronic gastric inflammation that predisposes a patient to gastric carcinogenesis. Among various other miRs, miR-155 is highly expressed in activated B and T cells and in monocytes/macrophages present in chronic gastric inflammation. Notably, miR-155 was shown to downregulate the expression of certain MMR genes, such as MLH1, MSH2, and MSH6. In tumor-infiltrating miR-155-deficient CD8+ T cells, antibodies against immune checkpoint proteins restored the expression of several derepressed miR-155 targets, suggesting that miR-155 may regulate overlapping pathways to promote antitumor immunity. It may thus be of high clinical impact that gastric pathologies mediated by miR-155 result from its overexpression. This suggests that it may be possible to therapeutically attenuate miR-155 levels for gastric cancer treatment and/or to prevent the progression of chronic gastric inflammation into cancer.
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Affiliation(s)
- Christian Prinz
- Lehrstuhl für Innere Medizin1, University of Witten gGmbH, Helios Universitätsklinikum, D-42283 Wuppertal, Germany
| | - David Weber
- Lehrstuhl für Innere Medizin1, University of Witten gGmbH, Helios Universitätsklinikum, D-42283 Wuppertal, Germany
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14
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Starke L, Pohlmann A, Prinz C, Niendorf T, Waiczies S. Performance of compressed sensing for fluorine-19 magnetic resonance imaging at low signal-to-noise ratio conditions. Magn Reson Med 2019; 84:592-608. [PMID: 31863516 DOI: 10.1002/mrm.28135] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 08/23/2019] [Revised: 11/19/2019] [Accepted: 11/27/2019] [Indexed: 12/27/2022]
Abstract
PURPOSE To examine the performance of compressed sensing (CS) in reconstructing low signal-to-noise ratio (SNR) 19 F MR signals that are close to the detection threshold and originate from small signal sources with no a priori known location. METHODS Regularization strength was adjusted automatically based on noise level. As performance metrics, root-mean-square deviations, true positive rates (TPRs), and false discovery rates were computed. CS and conventional reconstructions were compared at equal measurement time and evaluated in relation to high-SNR reference data. 19 F MR data were generated from a purpose-built phantom and benchmarked against simulations, as well as from the experimental autoimmune encephalomyelitis mouse model. We quantified the signal intensity bias and introduced an intensity calibration for in vivo data using high-SNR ex vivo data. RESULTS Low-SNR 19 F MR data could be reliably reconstructed. Detection sensitivity was consistently improved and data fidelity was preserved for undersampling and averaging factors of α = 2 or = 3. Higher α led to signal blurring in the mouse model. The improved TPRs at α = 3 were comparable to a 2.5-fold increase in measurement time. Whereas CS resulted in a downward bias of the 19 F MR signal, Fourier reconstructions resulted in an unexpected upward bias of similar magnitude. The calibration corrected signal-intensity deviations for all reconstructions. CONCLUSION CS is advantageous whenever image features are close to the detection threshold. It is a powerful tool, even for low-SNR data with sparsely distributed 19 F signals, to improve spatial and temporal resolution in 19 F MR applications.
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Affiliation(s)
- Ludger Starke
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Andreas Pohlmann
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Christian Prinz
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Sonia Waiczies
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
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15
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Walker AR, Uejima T, Prinz C, Voigt JU, Fraser AG. Inaccuracies in Measuring Velocities and Timing of Flow and Tissue Motion Using High-End Ultrasound Systems. Ultrasound Med Biol 2019; 45:1446-1454. [PMID: 30975534 DOI: 10.1016/j.ultrasmedbio.2019.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 02/03/2019] [Accepted: 02/11/2019] [Indexed: 06/09/2023]
Abstract
To evaluate the accuracy of measurements of the velocities and timing of blood flow and of tissue motion, we tested four commercially available ultrasound systems. Pulsed wave, continuous wave and tissue Doppler recordings acquired across a range of angles of insonation were compared against a calibrated Doppler string phantom. Temporal delays were measured from the onset of the simulated electrocardiogram to the start of each Doppler signal. Across all modalities and angles, the mean errors of measurements of velocity using the four systems were 0.2%, 1.7%, 6.0% and 3.1%. The largest errors occurred using tissue Doppler at 5 cm/s (mean overestimation: 5.8%, range: +1.1%-12.5%). Mean delays in displaying the onset of flow were -3, 6, 11 and -16 ms. All differences between machines were statistically significant. The accuracy of high-end ultrasound systems for measuring velocities is better than in earlier reports, but the reporting of routine testing against standard phantoms should be mandatory.
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Affiliation(s)
- Andrew R Walker
- Department of Biomedical Engineering, Västmanland Hospital, Västerås, Sweden.
| | - Tokuhisa Uejima
- Wales Heart Research Institute, School of Medicine, Cardiff University, Heath Park, Cardiff, United Kingdom
| | - Christian Prinz
- Department of Cardiovascular Diseases, University of Leuven, University Hospital Gasthuisberg, Leuven, Belgium
| | - Jens-Uwe Voigt
- Department of Cardiovascular Diseases, University of Leuven, University Hospital Gasthuisberg, Leuven, Belgium
| | - Alan G Fraser
- Wales Heart Research Institute, School of Medicine, Cardiff University, Heath Park, Cardiff, United Kingdom; Department of Cardiovascular Diseases, University of Leuven, University Hospital Gasthuisberg, Leuven, Belgium
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16
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Waiczies S, Rosenberg JT, Kuehne A, Starke L, Delgado PR, Millward JM, Prinz C, Dos Santos Periquito J, Pohlmann A, Waiczies H, Niendorf T. Fluorine-19 MRI at 21.1 T: enhanced spin-lattice relaxation of perfluoro-15-crown-5-ether and sensitivity as demonstrated in ex vivo murine neuroinflammation. MAGMA 2019; 32:37-49. [PMID: 30421250 PMCID: PMC6514110 DOI: 10.1007/s10334-018-0710-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 10/16/2018] [Accepted: 10/18/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Fluorine MR would benefit greatly from enhancements in signal-to-noise ratio (SNR). This study examines the sensitivity gain of 19F MR that can be practically achieved when moving from 9.4 to 21.1 T. MATERIALS AND METHODS We studied perfluoro-15-crown-5-ether (PFCE) at both field strengths (B0), as a pure compound, in the form of nanoparticles (NP) as employed to study inflammation in vivo, as well as in inflamed tissue. Brains, lymph nodes (LNs) and spleens were obtained from mice with experimental autoimmune encephalomyelitis (EAE) that had been administered PFCE NPs. All samples were measured at both B0 with 2D-RARE and 2D-FLASH using 19F volume radiofrequency resonators together. T1 and T2 of PFCE were measured at both B0 strengths. RESULTS Compared to 9.4 T, an SNR gain of > 3 was observed for pure PFCE and > 2 for PFCE NPs at 21.1 T using 2D-FLASH. A dependency of 19F T1 and T2 relaxation on B0 was demonstrated. High spatially resolved 19F MRI of EAE brains and LNs at 21.1 T revealed signals not seen at 9.4 T. DISCUSSION Enhanced SNR and T1 shortening indicate the potential benefit of in vivo 19F MR at higher B0 to study inflammatory processes with greater detail.
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Affiliation(s)
- Sonia Waiczies
- Experimental Ultrahigh Field MRI, Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Robert-Roessle-Str. 10, 13125, Berlin, Germany.
| | - Jens T Rosenberg
- The National High Magnetic Field Laboratory, Florida State University, Tallahassee, FL, USA
| | | | - Ludger Starke
- Experimental Ultrahigh Field MRI, Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Robert-Roessle-Str. 10, 13125, Berlin, Germany
| | - Paula Ramos Delgado
- Experimental Ultrahigh Field MRI, Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Robert-Roessle-Str. 10, 13125, Berlin, Germany
| | - Jason M Millward
- Experimental Ultrahigh Field MRI, Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Robert-Roessle-Str. 10, 13125, Berlin, Germany
| | - Christian Prinz
- Experimental Ultrahigh Field MRI, Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Robert-Roessle-Str. 10, 13125, Berlin, Germany
| | - Joao Dos Santos Periquito
- Experimental Ultrahigh Field MRI, Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Robert-Roessle-Str. 10, 13125, Berlin, Germany
| | - Andreas Pohlmann
- Experimental Ultrahigh Field MRI, Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Robert-Roessle-Str. 10, 13125, Berlin, Germany
| | | | - Thoralf Niendorf
- Experimental Ultrahigh Field MRI, Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Robert-Roessle-Str. 10, 13125, Berlin, Germany
- MRI TOOLS GmbH, Berlin, Germany
- Experimental and Clinical Research Center, A Joint Cooperation Between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
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17
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Stankovic I, Prinz C, Ciarka A, Daraban AM, Mo Y, Aarones M, Szulik M, Winter S, Neskovic AN, Kukulski T, Aakhus S, Willems R, Fehske W, Penicka M, Faber L, Voigt JU. Long-Term Outcome After CRT in the Presence of Mechanical Dyssynchrony Seen With Chronic RV Pacing or Intrinsic LBBB. JACC Cardiovasc Imaging 2017; 10:1091-1099. [DOI: 10.1016/j.jcmg.2016.08.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 08/15/2016] [Accepted: 08/26/2016] [Indexed: 11/28/2022]
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18
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Waiczies S, Millward JM, Starke L, Delgado PR, Huelnhagen T, Prinz C, Marek D, Wecker D, Wissmann R, Koch SP, Boehm-Sturm P, Waiczies H, Niendorf T, Pohlmann A. Enhanced Fluorine-19 MRI Sensitivity using a Cryogenic Radiofrequency Probe: Technical Developments and Ex Vivo Demonstration in a Mouse Model of Neuroinflammation. Sci Rep 2017; 7:9808. [PMID: 28851959 PMCID: PMC5575026 DOI: 10.1038/s41598-017-09622-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 07/19/2017] [Indexed: 11/10/2022] Open
Abstract
Neuroinflammation can be monitored using fluorine-19 (19F)-containing nanoparticles and 19F MRI. Previously we studied neuroinflammation in experimental autoimmune encephalomyelitis (EAE) using room temperature (RT) 19F radiofrequency (RF) coils and low spatial resolution 19F MRI to overcome constraints in signal-to-noise ratio (SNR). This yielded an approximate localization of inflammatory lesions. Here we used a new 19F transceive cryogenic quadrature RF probe ( 19 F-CRP) that provides the SNR necessary to acquire superior spatially-resolved 19F MRI. First we characterized the signal-transmission profile of the 19 F-CRP. The 19 F-CRP was then benchmarked against a RT 19F/1H RF coil. For SNR comparison we used reference compounds including 19F-nanoparticles and ex vivo brains from EAE mice administered with 19F-nanoparticles. The transmit/receive profile of the 19 F-CRP diminished with increasing distance from the surface. This was counterbalanced by a substantial SNR gain compared to the RT coil. Intraparenchymal inflammation in the ex vivo EAE brains was more sharply defined when using 150 μm isotropic resolution with the 19 F-CRP, and reflected the known distribution of EAE histopathology. At this spatial resolution, most 19F signals were undetectable using the RT coil. The 19 F-CRP is a valuable tool that will allow us to study neuroinflammation with greater detail in future in vivo studies.
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Affiliation(s)
- Sonia Waiczies
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.
| | - Jason M Millward
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Ludger Starke
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Paula Ramos Delgado
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Till Huelnhagen
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Christian Prinz
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | | | | | | | - Stefan P Koch
- Department of Experimental Neurology, Center for Stroke Research Berlin (CSB), Charité Core Facility 7T Experimental MRIs, and NeuroCure, Charité University Medicine Berlin, Berlin, Germany
| | - Philipp Boehm-Sturm
- Department of Experimental Neurology, Center for Stroke Research Berlin (CSB), Charité Core Facility 7T Experimental MRIs, and NeuroCure, Charité University Medicine Berlin, Berlin, Germany
| | | | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- MRI TOOLS GmbH, Berlin, Germany
- Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Andreas Pohlmann
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
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Stankovic I, Belmans A, Prinz C, Ciarka A, Maria Daraban A, Kotrc M, Aarones M, Szulik M, Winter S, Neskovic AN, Kukulski T, Aakhus S, Willems R, Fehske W, Penicka M, Faber L, Voigt JU. The association of volumetric response and long-term survival after cardiac resynchronization therapy. Eur Heart J Cardiovasc Imaging 2017; 18:1109-1117. [DOI: 10.1093/ehjci/jex188] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 06/26/2017] [Indexed: 01/22/2023] Open
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Hoffmann JC, Prinz C, Labenz J, Miehlke S, Malfertheiner P, Fischbach W. [S2k guideline Helicobacter pylori and gastroduodenal ulcer disease 2016 - Statement on stress ulcer prophylaxis and optimized therapy]. Z Gastroenterol 2017; 55:307-309. [PMID: 28288502 DOI: 10.1055/s-0043-100103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Jörg C Hoffmann
- Innere Medizin I mit Schwerpunkt Gastroenterologie, Diabetologie und Onkologie, St. Marien- und St. Annastiftskrankenhaus, Ludwigshafen, Germany
| | | | - Joachim Labenz
- Medizinische Klinik, Ev. Jung-Stilling Krankenhaus, Siegen, Germany
| | - Stephan Miehlke
- Center for Digestive Diseases, Cooperation of Internal Medicine Eppendorf, Hamburg, Germany
| | - Peter Malfertheiner
- Klinik für Gastroenterologie, Hepatologie und Infektiologie, Medizinische Fakultät der, Magdeburg, Germany
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Fischbach W, Malfertheiner P, Lynen Jansen P, Bolten W, Bornschein J, Buderus S, Glocker E, Hoffmann CJ, Koletzko S, Labenz J, Mayerle J, Miehlke S, Mössner J, Peitz U, Prinz C, Selgrad M, Suerbaum S, Venerito M, Vieth M. [S2k-guideline Helicobacter pylori and gastroduodenal ulcer disease]. Z Gastroenterol 2016; 54:1. [PMID: 27168132 DOI: 10.1055/s-0035-1567086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
In the line "bismuth-containing quadruple therapy" of Table 7 (p 342), in the column "dosage" incorrectly at the three antibiotics respectively 1-1-1-1. The correct is: 3-3-3-3.
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Gürel E, Prinz C, Van Casteren L, Gao H, Willems R, Voigt JU. The Impact of Function-Flow Interaction on Left Ventricular Efficiency in Patients with Conduction Abnormalities: A Particle Image Velocimetry and Tissue Doppler Study. J Am Soc Echocardiogr 2016; 29:431-40. [DOI: 10.1016/j.echo.2016.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Indexed: 10/22/2022]
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Schmidt A, Bloechinger M, Weber A, Siveke J, von Delius S, Prinz C, Schmitt W, Schmid RM, Neu B. Short-term effects and adverse events of endoscopically applied radiofrequency ablation appear to be comparable with photodynamic therapy in hilar cholangiocarcinoma. United European Gastroenterol J 2016; 4:570-9. [PMID: 27536367 DOI: 10.1177/2050640615621235] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [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: 06/14/2015] [Accepted: 11/02/2015] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND AND STUDY AIMS Radiofrequency ablation (RFA) is a new endoscopic palliation therapy for malignant biliary obstruction. The aim of this study was to compare the short-term effects of biliary drainage and adverse events of this technique with the standard of endoscopical treatment of hilar cholangiocarcinoma, photodynamic therapy (PDT). PATIENTS AND METHODS We retrospectively and since December 2012 prospectively investigated the efficacy and adverse events of RFA in patients with hilar cholangiocarcinoma in two tertiary referral centers between November 2011 and January 2013. The approach of the study was prospective, but because of the large amount of retrospectively included patients, the design of the study is overall retrospective. A group of 20 patients treated with PDT between April 2005 and May 2011 served as a historical control. RESULTS Fourteen patients received 31 biliary RFAs and 20 patients received 36 PDTs. Within the RFA group, a significant decrease (p = 0.046) of the bilirubin level was seen 14 days after the first RFA (3.3 ± 3.9 (mg/dl) versus 2.3 ± 2.6 (mg/dl)). In the PDT group no significant decrease (p = 0.67) of the bilirubin level was obtained (4.1 ± 6.9 (mg/dl) versus 3.5 ± 5.3 (mg/dl)). In the PDT group (13/20, 65%) a significantly higher number of premature stent replacements (<3 months) after the first intervention was noticed in comparison with the RFA group (four of 14, 29%) (p < 0.01). Between the first and fifth procedure, post-interventional adverse events tend to occur more frequently in patients with PDT (eight of 20, 40%) than with RFA (three of 14, 21%) (p = 0.277). CONCLUSIONS Looking at the short-term effects, we conclude that RFA may present a therapeutic alternative to PDT for palliative treatment of malignant biliary obstruction because of its simple feasibility and moderate adverse event rate. To provide a definitive evaluation of the long-term effects and of overall median survival, a controlled trial with PDT must follow.
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Affiliation(s)
- A Schmidt
- II. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - M Bloechinger
- Klinikum München-Neuperlach, Städtisches Klinikum München GmbH, Munich, Germany
| | - A Weber
- II. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - J Siveke
- II. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - S von Delius
- II. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - C Prinz
- Medizinische Klinik 2, Helios Klinikum Wuppertal, Germany
| | - W Schmitt
- Klinikum München-Neuperlach, Städtisches Klinikum München GmbH, Munich, Germany
| | - R M Schmid
- Klinikum München-Neuperlach, Städtisches Klinikum München GmbH, Munich, Germany
| | - B Neu
- II. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
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Stankovic I, Prinz C, Ciarka A, Daraban AM, Kotrc M, Aarones M, Szulik M, Winter S, Belmans A, Neskovic AN, Kukulski T, Aakhus S, Willems R, Fehske W, Penicka M, Faber L, Voigt JU. Relationship of visually assessed apical rocking and septal flash to response and long-term survival following cardiac resynchronization therapy (PREDICT-CRT). Eur Heart J Cardiovasc Imaging 2015; 17:262-9. [DOI: 10.1093/ehjci/jev288] [Citation(s) in RCA: 138] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 10/04/2015] [Indexed: 11/14/2022] Open
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Prinz C, Vasyutina E, Lohmann G, Schrader A, Romanski S, Hirschhäuser C, Mayer P, Frias C, Herling CD, Hallek M, Schmalz HG, Prokop A, Mougiakakos D, Herling M. Organometallic nucleosides induce non-classical leukemic cell death that is mitochondrial-ROS dependent and facilitated by TCL1-oncogene burden. Mol Cancer 2015; 14:114. [PMID: 26041471 PMCID: PMC4453051 DOI: 10.1186/s12943-015-0378-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 05/05/2015] [Indexed: 02/06/2023] Open
Abstract
Background Redox stress is a hallmark of the rewired metabolic phenotype of cancer. The underlying dysregulation of reactive oxygen species (ROS) is interconnected with abnormal mitochondrial biogenesis and function. In chronic lymphocytic leukemia (CLL), elevated ROS are implicated in clonal outgrowth and drug resistance. The pro-survival oncogene T-cell leukemia 1 (TCL1) is causally linked to the high threshold towards classical apoptosis in CLL. We investigated how aberrant redox characteristics and bioenergetics of CLL are impacted by TCL1 and if this is therapeutically exploitable. Methods Bio-organometallic chemistry provided compounds containing a cytosine nucleobase, a metal core (ferrocene, ruthenocene, Fe(CO)3), and a 5’-CH2O-TDS substituent. Four of these metal-containing nucleoside analogues (MCNA) were tested for their efficacy and mode of action in CLL patient samples, gene-targeted cell lines, and murine TCL1-transgenic splenocytes. Results The MCNA showed a marked and selective cytotoxicity towards CLL cells. MCNA activity was equally observed in high-risk disease groups, including those of del11q/del17p cytogenetics and of clinical fludarabine resistance. They overcame protective stromal cell interactions. MCNA-evoked PARP-mediated cell death was non-autophagic and non-necrotic as well as caspase- and P53-independent. This unconventional apoptosis involved early increases of ROS, which proved indispensible based on mitigation of MCNA-triggered death by various scavengers. MCNA exposure reduced mitochondrial respiration (oxygen consumption rate; OCR) and induced a rapid membrane depolarization (∆ΨM). These characteristics distinguished the MCNA from the alkylator bendamustine and from fludarabine. Higher cellular ROS and increased MCNA sensitivity were linked to TCL1 expression. The presence of TCL1 promoted a mitochondrial release of in part caspase-independent apoptotic factors (AIF, Smac, Cytochrome-c) in response to MCNA. Although basal mitochondrial respiration (OCR) and maximal respiratory capacity were not affected by TCL1 overexpression, it mediated a reduced aerobic glycolysis (lactate production) and a higher fraction of oxygen consumption coupled to ATP-synthesis. Conclusions Redox-active substances such as organometallic nucleosides can confer specific cytotoxicity to ROS-stressed cancer cells. Their P53- and caspase-independent induction of non-classical apoptosis implicates that redox-based strategies can overcome resistance to conventional apoptotic triggers. The high TCL1-oncogenic burden of aggressive CLL cells instructs their particular dependence on mitochondrial energetic flux and renders them more susceptible towards agents interfering in mitochondrial homeostasis. Electronic supplementary material The online version of this article (doi:10.1186/s12943-015-0378-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Christian Prinz
- Laboratory of Lymphocyte Signaling and Oncoproteome, Department I of Internal Medicine, Center for Integrated Oncology (CIO) Köln-Bonn, and Excellence Cluster for Cellular Stress Response and Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.
| | - Elena Vasyutina
- Laboratory of Lymphocyte Signaling and Oncoproteome, Department I of Internal Medicine, Center for Integrated Oncology (CIO) Köln-Bonn, and Excellence Cluster for Cellular Stress Response and Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.
| | - Gregor Lohmann
- Laboratory of Lymphocyte Signaling and Oncoproteome, Department I of Internal Medicine, Center for Integrated Oncology (CIO) Köln-Bonn, and Excellence Cluster for Cellular Stress Response and Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.
| | - Alexandra Schrader
- Laboratory of Lymphocyte Signaling and Oncoproteome, Department I of Internal Medicine, Center for Integrated Oncology (CIO) Köln-Bonn, and Excellence Cluster for Cellular Stress Response and Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.
| | - Steffen Romanski
- Division of Organic Chemistry, University of Cologne, Cologne, Germany.
| | | | - Petra Mayer
- Laboratory of Lymphocyte Signaling and Oncoproteome, Department I of Internal Medicine, Center for Integrated Oncology (CIO) Köln-Bonn, and Excellence Cluster for Cellular Stress Response and Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.
| | - Corazon Frias
- Department of Pediatric Hematology/Oncology, Children's Hospital Cologne, Cologne, Germany.
| | - Carmen D Herling
- Department I of Internal Medicine, CIO Köln-Bonn, and CECAD, University of Cologne, Cologne, Germany.
| | - Michael Hallek
- Department I of Internal Medicine, CIO Köln-Bonn, and CECAD, University of Cologne, Cologne, Germany.
| | | | - Aram Prokop
- Department of Pediatric Hematology/Oncology, Children's Hospital Cologne, Cologne, Germany.
| | | | - Marco Herling
- Laboratory of Lymphocyte Signaling and Oncoproteome, Department I of Internal Medicine, Center for Integrated Oncology (CIO) Köln-Bonn, and Excellence Cluster for Cellular Stress Response and Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.
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Bitter T, Gutleben KJ, Nölker G, Dimitriadis Z, Prinz C, Vogt J, Horstkotte D, Oldenburg O. Sleep-disordered breathing and inappropriate defibrillator shocks in chronic heart failure. Herzschrittmacherther Elektrophysiol 2014; 25:198-205. [PMID: 25070930 DOI: 10.1007/s00399-014-0324-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 06/04/2014] [Indexed: 06/03/2023]
Abstract
PURPOSE Supraventricular tachyarrhythmias are a major cause of inappropriate defibrillator shocks. Sleep-disordered breathing (SDB) is a known risk factor for atrial fibrillation (AF). We hypothesized that Cheyne-Stokes respiration (CSA) and obstructive sleep apnea (OSA) have an impact on inappropriate defibrillator discharges in patients witch chronic heart failure (CHF) and cardiac resynchronization therapy with defibrillator (CRT-D). METHODS In this study, 172 patients with CHF (LVEF ≤ 45 %, NYHA-class ≥ 2) and CRT-D underwent overnight polygraphy; 54 had no SDB (apnea-hypopnea index < 5/h), 59 had OSA, and 59 had CSA. During follow-up (36 months), inappropriate defibrillator shocks were documented. RESULTS In all, 17 patients had inappropriate defibrillator shocks (9.9 %; eight oversensing due to lead fractures, five caused by atrial fibrillation, four because of sinus tachycardia). Mean event-free survival time was 33.5 ± 1.2 months in the CSA group, 35.2 ± 0.7 months in the OSA group, and 32.1 ± 1.5 months in the no SDB group, respectively (CSA vs. no SDB p = 0.63; OSA vs. no SDB p = 0.31; CSA vs. OSA p = 0.45). Stepwise Cox proportional hazard regression analysis revealed an independent association for age (per year: hazard ratio 0.90, 95 % confidence interval 0.85-0.96, p < 0.001), but not for any kind of SDB. CONCLUSIONS SDB was not associated with inappropriate defibrillator shocks. We assume this is due to the low incidenceand low proportion of inappropriate therapies in response to AF.
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Affiliation(s)
- Thomas Bitter
- Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Georgstraße 11, 32545, Bad Oeynhausen, Germany,
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Käbisch R, Mejías-Luque R, Gerhard M, Prinz C. Involvement of Toll-like receptors on Helicobacter pylori-induced immunity. PLoS One 2014; 9:e104804. [PMID: 25153703 PMCID: PMC4143222 DOI: 10.1371/journal.pone.0104804] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Accepted: 07/14/2014] [Indexed: 01/09/2023] Open
Abstract
Dendritic cells (DCs) play a major role in the innate immune response since they recognize a broad repertoire of PAMPs mainly via Toll-like receptors (TLRs). During Helicobacter pylori (H. pylori) infection, TLRs have been shown to be important to control cytokine response particularly in murine DCs. In the present study we analyzed the effect of blocking TLRs on human DCs. Co-incubation of human DCs with H. pylori resulted in the release of the pro-inflammatory cytokines IL-12p70, IL-6 and IL-10. Release of IL-12p70 and IL-10 was predominantly influenced when TLR4 signaling was blocked by adding specific antibodies, suggesting a strong influence on subsequent T cell responses through TLR4 activation on DCs. Co-incubation of H. pylori-primed DC with allogeneic CD4+ T cells resulted in the production of IFN-γ and IL-17A as well as the expression of Foxp3, validating a mixed Th1/Th17 and Treg response in vitro. Neutralization of TLR4 during H. pylori infection resulted in significantly decreased amounts of IL-17A and IFN-γ and reduced levels of Foxp3-expressing and IL-10-secreting T cells. Our findings suggest that DC cytokine secretion induced upon TLR4-mediated recognition of H. pylori influences inflammatory and regulatory T cell responses, which might facilitate the chronic bacterial persistence.
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Affiliation(s)
- Romy Käbisch
- Institut für Medizinische Mikrobiologie, Immunologie und Hygiene, Technische Universität München, München, Germany
| | - Raquel Mejías-Luque
- Institut für Medizinische Mikrobiologie, Immunologie und Hygiene, Technische Universität München, München, Germany
| | - Markus Gerhard
- Institut für Medizinische Mikrobiologie, Immunologie und Hygiene, Technische Universität München, München, Germany
| | - Christian Prinz
- Lehrstuhl für Innere Medizin 1, Universität Witten/Herdecke, Wuppertal, Germany
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Faber L, da Silva DB, Lehmann RB, Prinz C, Horstkotte D. RECURRENCE OF ATRIAL FIBRILLATION IN PATIENTS ASSIGNED TO A RHYTHM CONTROL STRATEGY. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)60441-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Prinz C, Weber A, Goecke S, Neu B, Meining A, Frimberger E. A new peroral mother-baby endoscope system for biliary tract disorders. World J Gastrointest Endosc 2014; 6:20-26. [PMID: 24527177 PMCID: PMC3921442 DOI: 10.4253/wjge.v6.i1.20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 12/04/2013] [Accepted: 01/06/2014] [Indexed: 02/05/2023] Open
Abstract
AIM: To investigate a new mother-baby system, consisting of a peroral cholangioscope and a duodenoscope in patients regarding its feasibility.
METHODS: In the study period from January 2007 to February 2010, 76 consecutive patients (33 men, 43 women; mean age 63 years old) were included in this pilot series. Endoluminal images and biopsies were obtained from 55 patients with indeterminate strictures, while 21 patients had fixed filling defects. The diagnostic accuracy of peroral cholangioscopy (POCS) in the visualization of strictures and tissue sampling was evaluated, and therapeutic success was monitored. Follow-up was performed over at least 9 mo.
RESULTS: A total of 55 patients had indeterminate strictures. Using the criteria “circular stenosis” and “irregular surface or margins”, POCS correctly described 27 out of 28 malignant biliary strictures and 25 out of 27 benign lesions (sensitivity, 96.4%; specificity, 92.6%, diagnostic accuracy 94.5%). Visually targeted forceps biopsies were performed in 55 patients. Tissue sampling during POCS revealed malignancy in 18 of 28 cases (sensitivity: 64.3%). In 21 patients with fixed filling defects, 10 patients with bile duct stones were successfully treated with conventional stone removal. Nine patients with difficult stones (5 giant stones and 4 intrahepatic stones) were treated with visually guided laser lithotripsy. Two patients in the group with unclear fixed filling defects had bile duct adenoma or papillary tumors and were surgically treated.
CONCLUSION: The new 95 cm POCS allows for accurate discrimination of strictures and fixed filling defects in the biliary tree, provides improved sensitivity of endoscopically guided biopsies and permits therapeutic approaches for difficult intrahepatic stones.
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Hartmann A, Petrov V, Buhl JC, Rübner K, Lindemann M, Prinz C, Zimathies A. Zeolite Synthesis under Insertion of Silica Rich Filtration Residues from Industrial Wastewater Reconditioning. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/aces.2014.42015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Prinz C, Lehmann R, Brandao da Silva D, Jurczak B, Bitter T, Faber L, Horstkotte D. Echocardiographic particle image velocimetry for the evaluation of diastolic function in hypertrophic nonobstructive cardiomyopathy. Echocardiography 2013; 31:886-94. [PMID: 24355083 DOI: 10.1111/echo.12487] [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] [Indexed: 11/30/2022] Open
Abstract
AIMS To use particle image velocimetry (PIV) echocardiography for the evaluation of diastolic dysfunction (DD) in patients with hypertrophic nonobstructive cardiomyopathy (HNCM). METHODS This study included 50 individuals, thereof 30 patients with DD due to HNCM and 20 healthy individuals who served as controls. HNCM patients were divided into 3 groups according to DD severity. All subjects underwent clinical assessment, exercise testing, and standard as well as PIV echocardiography. RESULTS Energy dissipation was higher in DD patients than in the control group. The severity of flow pattern disturbance corresponded to the degree of DD. In a subgroup of 20 HNCM patients we found significant correlations between invasive measured left ventricular end-diastolic pressure and noninvasive PIV parameters for intraventricular pressure differences and filling. Inter-observer variability (mean difference ± 1.96 SD) for all tested PIV measurements was good. CONCLUSION According to DD severity, patients with HNCM have disturbed intraventricular flow and reduced intraventricular pressure differences, consistent with a reduced intraventricular suction. PIV echocardiography appears to be feasible for detailed analysis of ventricular vortex flow in DD conditions. Further research using PIV echocardiography in different cardiac pathologies seems warranted.
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Affiliation(s)
- Christian Prinz
- Department of Cardiology, Heart and Diabetes Center NRW, Ruhr-University, Bochum, Bad Oeynhausen, Germany
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Tuluce K, Yakar Tuluce S, Isayev E, Bilgin M, Yavuzgil O, Gurgun C, Nalbantgil S, Soydas Cinar C, Ozerkan F, Brandao Da Silva D, Lehmann R, Prinz C, Horstkotte D, Faber L, Assabiny A, Apor A, Nagy A, Vago H, Toth A, Merkely B, Kovacs A, Miglioranza M, Muraru D, Peluso D, Cucchini U, Mihaila S, Naso P, Puma L, Kocabay G, Iliceto S, Badano L, Marek J, Ahmed M, Ryo K, Haugaa K, Saba S, Gorcsan J. Club 35 Moderated Poster Session - Part B: 11/12/2013, 09:30-16:00 * Location: Moderated Poster area. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet216] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kaebisch R, Mejías-Luque R, Prinz C, Gerhard M. Helicobacter pyloriCytotoxin-Associated Gene A Impairs Human Dendritic Cell Maturation and Function through IL-10–Mediated Activation of STAT3. J I 2013; 192:316-23. [DOI: 10.4049/jimmunol.1302476] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Prinz C, Farr M, Laser KT, Esdorn H, Piper C, Horstkotte D, Faber L. Determining the role of fibrosis in hypertrophic cardiomyopathy. Expert Rev Cardiovasc Ther 2013; 11:495-504. [PMID: 23570362 DOI: 10.1586/erc.13.24] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [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] [Indexed: 01/02/2023]
Abstract
Fibroblast activity within the heart may be considered a basically constructive process. Hyperactivity of fibroblasts, however, may result in the accumulation of extracellular matrix proteins with adverse effects on cardiac structure and function including electrical instability and increased risk of arrhythmogenic cardiac death. The detection of cardiac fibrosis by dedicated imaging techniques, mainly gadolinium-enhanced MRI, holds promise to refine patient management in a variety of cardiac conditions. This review aims to summarize the current knowledge regarding fibrosis in hypertrophic cardiomyopathy.
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Affiliation(s)
- Christian Prinz
- Department of Cardiology, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany
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Dimitriadis Z, Wiemer M, Scholtz W, Faber L, Piper C, Bitter T, Messaritakis I, Bullert K, Boergermann J, Kleikamp G, Prinz C, Horstkotte D, Oldenburg O. Sleep-disordered breathing in patients undergoing transfemoral aortic valve implantation for severe aortic stenosis. Clin Res Cardiol 2013; 102:895-903. [PMID: 23963651 DOI: 10.1007/s00392-013-0603-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [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: 04/12/2013] [Accepted: 07/17/2013] [Indexed: 01/02/2023]
Abstract
BACKGROUND We examined the prevalence of sleep-disordered breathing (SDB) in patients with severe aortic valve stenosis (AS) and the impact of transfemoral aortic valve implantation (TAVI) on SDB. METHODS 79 patients underwent cardiorespiratory polygraphy (PG) before TAVI (CoreValve™), 62 of them a second PG after the procedure. RESULTS Forty-nine (62 %) patients had obstructive sleep apnea (OSA), 25 (32 %) central sleep apnea (CSA), and 5 (6 %) presented without significant SDB (apnea-hypopnea index (AHI) < 5/h). Among the 62 patients evaluated before and after TAVI, 36 (58 %) had OSA, 22 (36 %) CSA, and 4 patients (7 %) no SDB. AHI was significantly higher in CSA patients than in OSA patients (34.5 ± 18.3 vs. 18.0 ± 12.6/h, p < 0.001). Successful TAVI had a significant impact on CSA but not on OSA: CSA patients with optimal TAVI results experienced a significant reduction in central respiratory events (AHI 39.6 ± 19.6-23.1 ± 16.0/h, p = 0.035), while no changes were detected in OSA patients (AHI 18.8 ± 13.0-20.25 ± 13.4/h, p = 0.376). In contrast, in patients who developed at least moderate periprosthetic aortic regurgitation (AR > I), CSA increased significantly (AHI 26.3 ± 13.2-39.2 ± 18.4/h, p = 0.036), whereas no acute change was seen in patients with OSA (AHI 10.5 ± 7.8-12.5 ± 5.0/h, p = 0.5). CONCLUSION OSA and CSA are prevalent in more than 90 % of patients undergoing TAVI for severe aortic valve stenosis. Successful TAVI had no significant impact on OSA but improved CSA. In case of an acute change from pressure overload (aortic stenosis) to acute volume overload (aortic regurgitation after TAVI), central, but not obstructive, sleep apnea deteriorated.
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Affiliation(s)
- Zisis Dimitriadis
- Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Germany,
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Prinz C, Faber L, Lindner O, Bogunovic N, Hering D, Burchert W, Horstkotte D. Echo-guided extracorporeal shock wave therapy for refractory angina improves regional myocardial blood flow as assessed by PET imaging. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p4007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bitter T, Zwenke A, Prib N, Dimitriadis Z, Prinz C, Horstkotte D, Oldenburg O. Day-night pattern of defibrillator shocks in patients with chronic heart failure: the impact of Cheyne-Stokes respiration and obstructive sleep apnoea. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1413] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Langer C, Hohnhorst M, Schaefer P, Lutz M, Luedde M, Eden M, Kuehl C, Prinz C, Faber L, Frey N. Cardiac CT in hypertrophic cardiomyopathy: volumetric assessment of intramyocardial fibrosis. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p4709] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Prinz C, Lehmann R, Brandao Da Silva D, Bitter T, Van Buuren F, Lamp B, Horstkotte D, Faber L. Left ventricular dyssynchrony predicts clinical response to CRT: a long-term follow-up single center prospective observational cohort study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5089] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Rasche K, Keller T, Hader C, Leidag M, Prinz C. Impact of Obstructive Sleep Apnoea on Type 2 Diabetes and Vice Versa. Eur Endocrinol 2013; 9:107-109. [PMID: 29922363 PMCID: PMC6003579 DOI: 10.17925/ee.2013.09.02.107] [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] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 07/30/2013] [Indexed: 12/29/2022]
Abstract
Type 2 diabetes and obstructive sleep apnoea (OSA) are diseases with high prevalence and major public health impact. There is evidence that OSA is independently associated with alterations in glucose metabolism. Furthermore, OSA is a significant risk factor for the development of type 2 diabetes. Possible causes might be intermittent hypoxaemia and sleep fragmentation with increased oxidative stress and sympathetic activity, which are typical features of OSA. OSA might also be a reason for ineffective treatment of type 2 diabetes. There is further evidence that the treatment of OSA by continuous positive airway pressure (CPAP) therapy might improve glucose metabolism. On the other hand, there are also hints in the literature that type 2 diabetes might induce sleep apnoea, especially in patients with autonomic neuropathy, but that OSA also facilitates the development of neuropathy in terms of mutual interactions between OSA, type 2 diabetes and diabetic neuropathy. Based on the current scientific data, clinicians have to be aware of the relations between OSA and type 2 diabetes, both from the sleep medical and the diabetological point of view.
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Affiliation(s)
- Kurt Rasche
- Head Pulmonologist and Professor of Internal Medicine, HELIOS Clinic Wuppertal, University of Witten/Herdecke, Wuppertal, Germany
| | - Tanja Keller
- Pulmonologist, Pulmonary Practice Aeroprax Wuppertal, Germany
| | - Claus Hader
- Pulmonologist, Pulmonary Practice Aeroprax Wuppertal, Germany
| | - Markus Leidag
- Deputy Head Pulmonologist, HELIOS Clinic Wuppertal, University of Witten/Herdecke, Wuppertal, Germany
| | - Christian Prinz
- Head Internal Specialist and Professor of Internal Medicine, Chair of Internal Medicine, HELIOS Clinic Wuppertal, University of Witten/Herdecke, Wuppertal, Germany
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Bitter T, Gutleben KJ, Nölker G, Westerheide N, Prinz C, Dimitriadis Z, Horstkotte D, Vogt J, Oldenburg O. Treatment of Cheyne-Stokes respiration reduces arrhythmic events in chronic heart failure. J Cardiovasc Electrophysiol 2013; 24:1132-40. [PMID: 23844935 DOI: 10.1111/jce.12197] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [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: 03/06/2013] [Revised: 05/06/2013] [Accepted: 05/14/2013] [Indexed: 02/04/2023]
Abstract
OBJECTIVE This study aimed to investigate whether adequate treatment of Cheyne-Stokes respiration (CSR) reduces the risk of arrhythmic events in patients with chronic heart failure (CHF). METHODS A cohort of 403 registry patients with CHF (LVEF≤45%, NYHA-class≥2) and implanted cardioverter-defibrillator devices (ICD) was studied. They underwent overnight polygraphy, with 221 having mild or no CSR (apnea-hypopnea index [AHI]<15/h), and 182 having moderate to severe CSR (AHI>15/h). Latter ones were offered therapy with adaptive servoventilation (ASV), which 96 patients accepted and 86 rejected. During follow-up (21± 15 months) defibrillator therapies were recorded in addition to clinical and physiologic measures of heart failure severity. RESULTS Event-free survival from (a) appropriate cardioverter-defibrillator therapies and (b) appropriately monitored ventricular arrhythmias was shorter in the untreated CSR group compared to the treated CSR and the no CSR group. Stepwise Cox proportional hazard regression analysis showed untreated CSR (a: hazard ratio [HR] 1.99, 95% confidence interval [CI] 1.46-2.72, P < 0.001; b: HR 2.19, 95%CI 1.42-3.37, P < 0.001), but not treated CSR (a: HR 1.06, 95%CI 0.74-1.50; P = 0.77; b: HR 1.21, 95%CI 0.75-1.93, P = 0.43) was an independent risk factor. The treated CSR group showed improvements in cardiac function and respiratory stability compared to the untreated CSR group. CONCLUSION This study demonstrates a decrease of appropriate defibrillator therapies by ASV treated CSR in patients with CHF and ICD. A reduced exposure to hyperventilation, hypoxia, and improvement in indices of CHF severity and neurohumoral disarrangements are potential causative mechanisms.
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Affiliation(s)
- Thomas Bitter
- Department of Cardiology, Heart and Diabetes Centre North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany
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Jensen MK, Prinz C, Horstkotte D, van Buuren F, Bitter T, Faber L, Bundgaard H. Alcohol septal ablation in patients with hypertrophic obstructive cardiomyopathy: low incidence of sudden cardiac death and reduced risk profile. Heart 2013; 99:1012-7. [DOI: 10.1136/heartjnl-2012-303339] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Prinz C, Dohrmann J, van Buuren F, Bitter T, Bogunovic N, Horstkotte D, Faber L. The importance of training in echocardiography: a validation study using pocket echocardiography. J Cardiovasc Med (Hagerstown) 2013; 13:700-7. [PMID: 22929564 DOI: 10.2459/jcm.0b013e328356a55f] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS To investigate the training effect in echocardiography by using recent hand-held ultrasound scanners (HANDs). METHODS In this prospective study, 320 consecutive patients were scanned with HAND by an inexperienced ultrasonographer over a period of 8 weeks. Imaging studies were compared with high-end echocardiography as gold standard. Segmental endocardial border delineation was scored to describe image quality. Assessment of left ventricular dimensions, regional/global left ventricular function and grading of valve disease were compared. RESULTS A significant reduction in examination duration, improvement in image quality, substantial agreement in functional assessment (κ > 0.61, P < 0.01) and wall motion scoring (κ=0.67, P < 0.01) could be observed over time. The correlation in left ventricular measurements was excellent (r > 0.98, P < 0.01). The detection of valve diseases and pericardial effusions was sufficient, but the grading only moderate (κ < 0.6). CONCLUSION Well-grounded training in echocardiography leads to a rapid improvement in image acquisition and interpretation over a period of a few weeks. Basic diagnostic findings could be interpreted with high accuracy after short training. Interpretation of complex findings remained difficult. The time needed to carry out an examination using pocket echocardiography could not be reduced to less than 3-4 min per patient. New educational concepts are warranted.
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Affiliation(s)
- Christian Prinz
- Department of Cardiology, Heart and Diabetes Centre North Rhine-Westphalia, University Hospital of Bochum, Ruhr-University Bochum, Bad Oeynhausen, Germany.
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van Buuren F, Mellwig KP, Prinz C, Körber B, Fründ A, Fritzsche D, Faber L, Kottmann T, Bogunovic N, Dahm J, Horstkotte D. Electrical myostimulation improves left ventricular function and peak oxygen consumption in patients with chronic heart failure: results from the exEMS study comparing different stimulation strategies. Clin Res Cardiol 2013; 102:523-34. [DOI: 10.1007/s00392-013-0562-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2012] [Accepted: 04/03/2013] [Indexed: 12/29/2022]
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Prinz C, Lehmann R, Schwarz M, Prinz EM, Bitter T, Vogt J, van Buuren F, Bogunovic N, Lamp B, Horstkotte D, Faber L. Left Ventricular Dyssynchrony Predicts Clinical Response to CRT - A Long-Term Follow-Up Single-Center Prospective Observational Cohort Study. Echocardiography 2013; 30:896-903. [DOI: 10.1111/echo.12165] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Christian Prinz
- Department of Cardiology; Heart and Diabetes Centre North-Rhine Westphalia; Ruhr University Bochum; Bad Oeynhausen; Germany
| | - Roman Lehmann
- Department of Cardiology; Heart and Diabetes Centre North-Rhine Westphalia; Ruhr University Bochum; Bad Oeynhausen; Germany
| | - Maria Schwarz
- Department of Cardiology; Heart and Diabetes Centre North-Rhine Westphalia; Ruhr University Bochum; Bad Oeynhausen; Germany
| | - Eva-Maria Prinz
- Department of Cardiology; Heart and Diabetes Centre North-Rhine Westphalia; Ruhr University Bochum; Bad Oeynhausen; Germany
| | - Thomas Bitter
- Department of Cardiology; Heart and Diabetes Centre North-Rhine Westphalia; Ruhr University Bochum; Bad Oeynhausen; Germany
| | - Jürgen Vogt
- Department of Cardiology; Heart and Diabetes Centre North-Rhine Westphalia; Ruhr University Bochum; Bad Oeynhausen; Germany
| | - Frank van Buuren
- Department of Cardiology; Heart and Diabetes Centre North-Rhine Westphalia; Ruhr University Bochum; Bad Oeynhausen; Germany
| | - Nikola Bogunovic
- Department of Cardiology; Heart and Diabetes Centre North-Rhine Westphalia; Ruhr University Bochum; Bad Oeynhausen; Germany
| | - Barbara Lamp
- Department of Medicine - Cardiology; Diabetology, and Nephrology; Evangelical Hospital Bielefeld; Bielefeld; Germany
| | - Dieter Horstkotte
- Department of Cardiology; Heart and Diabetes Centre North-Rhine Westphalia; Ruhr University Bochum; Bad Oeynhausen; Germany
| | - Lothar Faber
- Department of Cardiology; Heart and Diabetes Centre North-Rhine Westphalia; Ruhr University Bochum; Bad Oeynhausen; Germany
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Bitter T, Prib N, Zwenke A, Prinz C, Dimitriadis Z, Horstkotte D, Oldenburg O. CIRCADIAN VARIATION OF ICD-SHOCKS IN PATIENTS WITH CHRONIC HEART FAILURE: THE IMPACT OF CHEYNE-STOKES RESPIRATION AND OBSTRUCTIVE SLEEP APNEA. J Am Coll Cardiol 2013. [DOI: 10.1016/s0735-1097(13)60258-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Prinz C, Schwarz M, Ilic I, Laser KT, Lehmann R, Prinz EM, Bitter T, Vogt J, van Buuren F, Bogunovic N, Horstkotte D, Faber L. Myocardial Fibrosis Severity on Cardiac Magnetic Resonance Imaging Predicts Sustained Arrhythmic Events in Hypertrophic Cardiomyopathy. Can J Cardiol 2013; 29:358-63. [DOI: 10.1016/j.cjca.2012.05.004] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Revised: 05/14/2012] [Accepted: 05/14/2012] [Indexed: 11/24/2022] Open
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Weber A, Schneider J, Neu B, Meining A, Born P, von Delius S, Bajbouj M, Schmid RM, Algül H, Prinz C. Endoscopic stent therapy in patients with chronic pancreatitis: A 5-year follow-up study. World J Gastroenterol 2013; 19:715-720. [PMID: 23430281 PMCID: PMC3574597 DOI: 10.3748/wjg.v19.i5.715] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2012] [Accepted: 09/28/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: This study analyzed clinical long-term outcomes after endoscopic therapy, including the incidence and treatment of relapse.
METHODS: This study included 19 consecutive patients (12 male, 7 female, median age 54 years) with obstructive chronic pancreatitis who were admitted to the 2nd Medical Department of the Technical University of Munich. All patients presented severe chronic pancreatitis (stage III°) according to the Cambridge classification. The majority of the patients suffered intermittent pain attacks. 6 of 19 patients had strictures of the pancreatic duct; 13 of 19 patients had strictures and stones. The first endoscopic retrograde pancreatography (ERP) included an endoscopic sphincterotomy, dilatation of the pancreatic duct, and stent placement. The first control ERP was performed 4 wk after the initial intervention, and the subsequent control ERP was performed after 3 mo to re-evaluate the clinical and morphological conditions. Clinical follow-up was performed annually to document the course of pain and the management of relapse. The course of pain was assessed by a pain scale from 0 to 10. The date and choice of the therapeutic procedure were documented in case of relapse.
RESULTS: Initial endoscopic intervention was successfully completed in 17 of 19 patients. All 17 patients reported partial or complete pain relief after endoscopic intervention. Endoscopic therapy failed in 2 patients. Both patients were excluded from further analysis. One failed patient underwent surgery, and the other patient was treated conservatively with pain medication. Seventeen of 19 patients were followed after the successful completion of endoscopic stent therapy. Three of 17 patients were lost to follow-up. One patient was not available for interviews after the 1st year of follow-up. Two patients died during the 3rd year of follow-up. In both patients chronic pancreatitis was excluded as the cause of death. One patient died of myocardial infarction, and one patient succumbed to pneumonia. All three patients were excluded from follow-up analysis. Follow-up was successfully completed in 14 of 17 patients. 4 patients at time point 3, 2 patients at time point 4, 3 patients at time point 5 and 2 patients at time point 6 and time point 7 used continuous pain medication after endoscopic therapy. No relapse occurred in 57% (8/14) of patients. All 8 patients exhibited significantly reduced or no pain complaints during the 5-year follow-up. Seven of 8 patients were completely pain free 5 years after endoscopic therapy. Only 1 patient reported continuous moderate pain. In contrast, 7 relapses occurred in 6 of the 14 patients. Two relapses were observed during the 1st year, 2 relapses occurred during the 2nd year, one relapse was observed during the 3rd year, one relapse occurred during the 4th year, and one relapse occurred during the 5th follow-up year. Four of these six patients received conservative treatment with endoscopic therapy or analgesics. Relapse was conservatively treated using repeated stent therapy in 2 patients. Analgesic treatment was successful in the other 2 patients.
CONCLUSION: 57% of patients exhibited long-term benefits after endoscopic therapy. Therefore, endoscopic therapy should be the treatment of choice in patients being inoperable or refusing surgical treatment.
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Horstkotte D, Prinz C, Piper C. [The "asymptomatic" patient with chronic acquired heart valve disease]. Internist (Berl) 2013; 54:7-8, 10, 12-4, 16-7. [PMID: 23325119 DOI: 10.1007/s00108-012-3092-8] [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: 11/28/2022]
Abstract
An intervention for chronic acquired valvular heart disease may either be indicated in symptomatic patients to relieve symptoms and improve quality of life or in asymptomatic patients to improve long-term prognosis, e.g., by preventing disease-related complications like chronic heart failure or arrhythmias. For proper action according to current guidelines, the systematic evaluation of symptoms related to the underlying valve disease is of utmost importance. If a discrepancy between symptoms reported or not reported by the patients and the severity of the valve disease is supposed, true absence of symptoms and exercise tolerance should be verified by spiroergometry. In the truly asymptomatic patient with a severe valvular lesion, preservation of myocardial adaption to the chronic volume or pressure overload should be tested utilizing appropriate imaging techniques like radionuclide ventriculography under exercise conditions. The proper evaluation of the functional status is of growing importance in our aging population with its sedentary lifestyle. In this context, the results of a survey should be kept in mind, which indicated that a significant proportion of patients still have interventions too late during the natural history of their valve disease with symptoms of congestive heart failure, arrhythmias, and the risk of sudden cardiac death persisting after a primarily successful valve repair or replacement.
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Affiliation(s)
- D Horstkotte
- Kardiologische Klinik, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland.
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Prinz C, Jurczak B, Faber L, Horstkotte D. Echocardiographic particle image velocimetry in a patient with severe diastolic dysfunction. Eur Heart J 2012; 34:450. [DOI: 10.1093/eurheartj/ehs413] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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