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Lund N, Wieboldt H, Fischer L, Muschol N, Braun F, Huber T, Sorriento D, Iaccarino G, Müllerleile K, Tahir E, Adam G, Kirchhof P, Fabritz L, Patten M. Overexpression of VEGFα as a biomarker of endothelial dysfunction in aortic tissue of α-GAL-Tg/KO mice and its upregulation in the serum of patients with Fabry's disease. Front Cardiovasc Med 2024; 11:1355033. [PMID: 38374995 PMCID: PMC10875336 DOI: 10.3389/fcvm.2024.1355033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/17/2024] [Indexed: 02/21/2024] Open
Abstract
Introduction Fabry's disease is an X-linked lysosomal storage disorder caused by reduced activity of α-galactosidase A (GAL), leading to premature death on account of renal, cardiac, and vascular organ failure. Accumulation of the GAL substrate globotriaosylceramide (Gb3) in endothelial and smooth muscle cells is associated with early vascular cell damage, suggesting endothelial dysfunction as a driver of cardiorenal organ failure. Here, we studied the vascular expression of the key angiogenic factors, VEGFα and its antagonist angiostatin, in Fabry α-GAL-Tg/KO mice and determined circulating VEGFα and angiostatin serum levels in patients with Fabry's disease and healthy controls. Methods Cryopreserved aortic vessels from six α-GAL-Tg/KO and six wild-type (WT) mice were obtained and VEGFα and angiostatin levels were determined by performing Western blot analysis. VEGFα expression was visualized by an immunohistochemical staining of paraffin aortic rings. In addition, VEGFα and angiostatin serum levels were measured by using an enzyme-linked immunosorbent assay in 48 patients with genetically verified Fabry's disease (50% male) and 22 healthy controls and correlated with disease severity markers such as lyso-Gb3, albuminuria, NTproBNP, high-sensitive troponin T (hsTNT), and myocardial wall thickness. Results It was found that there was a significant increase in VEGFα protein expression (1.66 ± 0.35 vs. 0.62 ± 0.16, p = 0.0009) and a decrease in angiostatin expression (0.024 ± 0.007 vs. 0.053 ± 0.02, p = 0.038) in aortic lysates from α-GAL-Tg/KO compared with that from WT mice. Immunohistochemical staining revealed an adventitial VEGFα signal in α-GAL-Tg/KO mice, whereas no VEGFα signal could be detected in WT mice aortas. No differences in aortic angiostatin expression between α-GAL-Tg/KO- and WT mice could be visualized. The serum levels of VEGFα were significantly upregulated in patients with Fabry's disease compared with that in healthy controls (708.5 ± 426.3 vs. 458.5 ± 181.5 pg/ml, p = 0.048) and positively associated with albuminuria (r = 0.82, p < 0.0001) and elevated NTproBNP (r = 0.87, p < 0.0001) and hsTNT values (r = 0.41, p = 0.048) in male patients with Fabry's disease. For angiostatin, no significant difference was found between patients with Fabry's disease and healthy controls (747.6 ± 390.3 vs. 858.8 ± 599.3 pg/ml). Discussion In conclusion, an overexpression of VEGFα and downregulation of its counter player angiostatin in aortic tissue of α-GAL-Tg/KO mice support the hypothesis of an underlying vasculopathy in Fabry's disease. Elevated VEGFα serum levels were also observed in patients with Fabry's disease and were positively associated with elevated markers of organ manifestation in males. These findings suggest that angiogenetic markers, such as VEGFα, may be potentially useful biomarkers for the detection of endothelial dysfunction in classical Fabry's disease.
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Affiliation(s)
- N. Lund
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Intensive Care Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - H. Wieboldt
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L. Fischer
- Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - N. Muschol
- Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - F. Braun
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Hamburg Center for Kidney Health, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - T. Huber
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Hamburg Center for Kidney Health, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - D. Sorriento
- Department of Advanced Biomedical Sciences, Interdepartmental Center of Research on Hypertension and Related Conditions of the Federico II University, Naples, Italy
| | - G. Iaccarino
- Department of Clinical Medicine and Surgery, Interdepartmental Center of Research on Hypertension and Related Conditions of the Federico II University, Naples, Italy
| | - K. Müllerleile
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - E. Tahir
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G. Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P. Kirchhof
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L. Fabritz
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M. Patten
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Mehdorn AS, Moulla Y, Mehdorn M, Dietrich A, Schönfels W, Becker T, Braun F, Beckmann JH, Linecker M. Bariatric surgery in liver cirrhosis. Front Surg 2022; 9:986297. [PMID: 36589626 PMCID: PMC9800004 DOI: 10.3389/fsurg.2022.986297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/26/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Obesity is frequently associated with its hepatic manifestation, the nonalcoholic fatty liver disease (NAFLD). The most effective treatment for morbid obesity is bariatric surgery (BS) also improving NAFLD and liver function. In patients where NAFLD has already progressed to liver cirrhosis, BS can be considered a high-risk procedure. Hence, consideration of the procedure and the most appropriate timing is crucial. Material and Methods Obese patients suffering from NAFLD who underwent BS from two German University Medical Centers were retrospectively analyzed. Results Twenty-seven patients underwent BS. Most common procedures were laparoscopic Roux-en-Y-gastric (RYGB) and laparoscopic sleeve gastrectomy (SG). All patients suffered from liver cirrhosis Child A. A preoperative transjugular portosystemic shunt (TIPS) was established in three patients and failed in another patient. Postoperative complications consisted of wound healing disorders (n = 2), anastomotic bleeding (n = 1), and leak from the staple line (n = 1). This patient suffered from intraoperatively detected macroscopic liver cirrhosis. Excess weight loss was 73% and 85% after 1 and 2 years, respectively. Two patients suffered from postoperative aggravation of their liver function, resulting in a higher Child-Pugh score, while three could be removed from the waiting list for a liver transplantation. Conclusion BS leads to weight loss, both after SG and RYGB, and potential improvement of liver function in liver cirrhosis. These patients need to be considered with care when evaluated for BS. Preoperative TIPS implantation may reduce the perioperative risk in selected patients.
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Affiliation(s)
- A. S. Mehdorn
- Department of General, Visceral, Thoracic, Transplantation and Pediatric Surgery, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Y. Moulla
- Department of Visceral, Transplant, Thoracic, and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany
| | - M. Mehdorn
- Department of Visceral, Transplant, Thoracic, and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany
| | - A. Dietrich
- Department of Visceral, Transplant, Thoracic, and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany
| | - W. Schönfels
- Department of General, Visceral, Thoracic, Transplantation and Pediatric Surgery, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - T. Becker
- Department of General, Visceral, Thoracic, Transplantation and Pediatric Surgery, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - F. Braun
- Department of General, Visceral, Thoracic, Transplantation and Pediatric Surgery, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - J. H. Beckmann
- Department of General, Visceral, Thoracic, Transplantation and Pediatric Surgery, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - M. Linecker
- Department of General, Visceral, Thoracic, Transplantation and Pediatric Surgery, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany,Correspondence: Michael Linecker
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Becker J, Bette S, Decker J, Braun F, Haerting M, Scheurig-Münkler C, Kroencke T, Schwarz F. Spektrale Differenzierung zystischer Nierenläsionen in Kontrast-verstärkten Abdomen-Scans an einem Photon-Counting Detector CT – erste Erfahrungen. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- J Becker
- Universitätsklinikum Augsburg, Klinik für diagnostische und interventionelle Radiologie, Augsburg
| | - S Bette
- Klinik für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Augsburg, Augsburg
| | - J Decker
- Klinik für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Augsburg, Augsburg
| | - F Braun
- Klinik für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Augsburg, Augsburg
| | - M Haerting
- Klinik für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Augsburg, Augsburg
| | - C Scheurig-Münkler
- Klinik für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Augsburg, Augsburg
| | - T Kroencke
- Klinik für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Augsburg, Augsburg
| | - F Schwarz
- Klinik für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universiätsklinikum Augsburg, Augsburg
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Decker J, Risch F, Woźnicki P, Braun F, Bette S, Scheurig-Münkler C, Kröncke T, Schwarz F. Virtuell-monoenergetische Rekonstruktionen bei koronaren CT-Angiographien an einem Photon-Counting Detector CT – Vergleich mit herkömmlicher Energy-Integrating Detector Technologie. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- J Decker
- Universitätsklinikum Augsburg, Radiologie, Augsburg
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Popp D, Sinzinger XA, Decker AJ, Bette S, Braun F, Rippel K, Wollny C, Scheurig-Münkler C, Kröncke JT, Schwarz F. Spektrale Metallartefakt-Reduktion an Photon-Counting Detektor CT-Datensätzen am Beispiel von Spondylodesematerial. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- D Popp
- Universitätsklinikum Augsburg, Radiologie, Augsburg
| | - X A Sinzinger
- Klinik für Diagn. und Interv. Radiologie, Universitätsklinikum Augsburg, Augsburg
| | - A J Decker
- Klinik für Diagn. und Interv. Radiologie, Universitätsklinikum Augsburg, Augsburg
| | - S Bette
- Klinik für Diagn. und Interv. Radiologie, Universitätsklinikum Augsburg, Augsburg
| | - F Braun
- Klinik für Diagn. und Interv. Radiologie, Universitätsklinikum Augsburg, Augsburg
| | - K Rippel
- Klinik für Diagn. und Interv. Radiologie, Universitätsklinikum, Augsburg
| | - C Wollny
- Klinik für Diagn. und Interv. Radiologie, Universitätsklinikum Augsburg, Augsburg
| | - C Scheurig-Münkler
- Klinik für Diagn. und Interv. Radiologie, Universitätsklinikum Augsburg, Augsburg
| | - J T Kröncke
- Klinik für Diagn. und Interv. Radiologie, Universitätsklinikum Augsburg, Augsburg
| | - F Schwarz
- Klinik für Diagn. und Interv. Radiologie, Universitätsklinikum Augsburg, Augsburg
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Decker J, Bette S, Lubina N, Rippel K, Braun F, Woznicki P, Wollny C, Scheurig-Münkler C, Kröncke T, Schwarz F. Niedrigdosis-CT des Abdomens: Erste Erfahrungen mit einem Photon-Counting-Detector CT und Vergleich mit einem modernen Energy-Integrating Detector-CT. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- J Decker
- Universitätsklinikum Augsburg, Radiologie, Augsburg
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Braun F, Reumers S, Spillane J, Bohm J, Pennings M, Schouten M, van der Kooi A, Foley A, Bönnemann C, Kamsteeg E, Erasmus C, Schara-Schmidt U, Jungbluth H, Voermans N. CONGENITAL MYOPATHIES – CENTRONUCLEAR MYOPATHIES. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Riou B, Nemitz B, Braun F, Tazarourte K, Charpentier S, Pateron D, Carli P. Numéro d’appel d’urgence santé : il faut garantir le respect du secret médical. Ann Fr Med Urgence 2021. [DOI: 10.3166/afmu-2021-0339] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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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Abstract
In Germany, the scarcity of donor organs has persisted over decades and reached an historical low point in the year 2017. A thorough analysis of the causes revealed structural deficits in the identification and registration of possible donors as one of the central reasons for the low donation rate. This prompted the political authorities to act and resulted in two new laws, which led to a modification of the German Transplantation Act. On 1 April 2019, the Act on Improvement of the Cooperation and the Structural Framework for Organ Donation came into force. This Act strengthens the role of the transplant coordinators in the harvesting hospitals and establishes adequate reimbursement of the organ donation-related costs in the harvesting hospitals. Furthermore, it fosters the cooperation of the transplant coordinators with the German organ procurement organization. On 16 January 2020, the existing opt-in legislation was modified. While the general principle of the opt-in legislation stayed unchanged, different measures were introduced that aim to repeatedly inform all citizens about organ donation and thereby motivate them to make a decision on organ donation. In order to enable a reliable and transparent documentation an organ donor registry will be established. The practical implementation of the various measures of both Acts is supported by a multi-institutional collaborative initiative plan for organ donation. The legal regulations and their practical implementation are depicted in detail.
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Affiliation(s)
- F Braun
- Sektion Klinische Transplantation, Klinik für Allgemeine, Viszeral‑, Thorax‑, Transplantations- und Kinderchirurgie, Universitätsklinikum Schleswig-Holstein (UKSH), Campus Kiel, Arnold-Heller-Str. 3 (Haus C), 24105, Kiel, Deutschland.
| | - A Rahmel
- Deutsche Stiftung Organtransplantation (DSO), Frankfurt am Main, Deutschland
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Lamhaut L, Nivet CM, Dagron C, Nace L, Braun F, Carli P. Retour d’expérience des évacuations par train à grande vitesse de patients en syndrome de détresse respiratoire aiguë sur infection à Covid-19 : les missions Chardon. Ann Fr Med Urgence 2020. [DOI: 10.3166/afmu-2020-0275] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Lors de la crise Covid-19 en France, il a fallu transférer des patients de zones où les lits de réanimation étaient saturés vers d’autres régions. Tous les moyens ont été utilisés : terrestre, aérien, maritime… Pour la première fois, des trains à grande vitesse (TGV) ont été utilisés. Le transport ferroviaire avait été utilisé largement pendant la Première Guerre mondiale. Ces transferts ont nécessité une collaboration extrêmement importante interservices : ministère, agences régionales de santé, hôpitaux, Samu zonaux, Samu, Smur associations de sécurités civiles, sapeurs-pompiers… L’une des collaborations des plus importantes a été celle avec la SNCF qui a permis une adaptation des rames, sécurisations des itinéraires, adaptation de la conduite… Chaque voiture transporte quatre patients intubés en syndrome de détresse respiratoire aiguë avec un médecin senior, un junior, quatre infirmiers et un logisticien pour la réalisation de la surveillance et des soins. Dans chaque rame, une équipe de régulation médicale est présente pour la coordination. Il y a eu dix évacuations sanitaires, qui ont transporté 197 patients sur 6 600 km (350‒950 km/TGV). Le transport le plus long a été de 7 h 14 min. On n’a pas relevé de complications majeures pendant les transferts. Plusieurs questions restent en suspens comme les critères de sélections des patients, la mise en place d’un train sanitaire aménagé permanent, un stock de matériel. Afin de mieux connaître les conséquences sur les patients, une étude est en cours. Les urgentistes ont une nouvelle corde à leur arc avec la possibilité d’effectuer des évacuations sanitaires en TGV pour des patients médicaux graves sur de longues distances.
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Habchi K, Oulehri N, Noizet M, Walkowiak P, Solviche V, Gette S, Braun F. Covid-19 : les transferts internationaux de patients de réanimation, une solution pour les départements frontaliers. Ann Fr Med Urgence 2020. [DOI: 10.3166/afmu-2020-0264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
La crise sanitaire de la Covid-19 a imposé une adaptabilité jamais réalisée de notre système de santé. Les services de réanimation et les structures de médecine d’urgence ont dû innover et développer des stratégies novatrices pour garantir des soins de qualité à tous les patients relevant de réanimation. La région Grand-Est, et plus particulièrement les départements de Moselle, du Bas-Rhin et du Haut-Rhin, a été particulièrement touchée. Parmi les 349 patients transférés hors de la région, 164 l’ont été vers des pays européens (Allemagne, Autriche, Luxembourg et Suisse) entre le 14 mars et le 4 avril 2020. Ces transferts internationaux, organisés par l’Agence régionale de santé et les Samu-Centre 15, ont essentiellement fait appel à des moyens aériens des hôpitaux, de l’armée et de la protection civile. L’accompagnement des patients, soigneusement sélectionnés, était assuré par un binôme médecin‒ infirmier spécialisés. Le choix de cette stratégie a permis d’éviter la saturation des services de réanimation et d’avoir à faire un choix entre les patients pouvant ou non bénéficier de soins aigus. L’adaptabilité des professionnels de santé et une organisation au plus près du terrain ont permis de réaliser ces transferts dans de bonnes conditions. Cet épisode témoigne de l’importance de laisser la gestion des crises sanitaires aux professionnels de la santé. Cet article présente l’organisation mise en place en région Grand-Est pour préparer et réaliser ces transferts internationaux.
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Braun F. Habchi K. (2020) Dans l’oeil du soignant, BPALC, Fléville-devant-Nancy, 64 pages. Ann Fr Med Urgence 2020. [DOI: 10.3166/afmu-2020-0269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Corriger J, Beaudouin E, Rothmann R, Penven E, Haumonte Q, Thomas H, Picaud J, Nguyen-Grosjean VM, Corriger-Ippolito J, Braun F, De Talancé M, Auburtin B, Atain-Kouadio P, Borsa-Dorion A, Baugnon D, De Carvalho M, Jaussaud R, Nguyen-Thi PL, Bollaert PE, Demoly P, Tanno LK. Epidemiological Data on Anaphylaxis in French Emergency Departments. J Investig Allergol Clin Immunol 2018; 29:357-364. [PMID: 30411700 DOI: 10.18176/jiaci.0348] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Although anaphylaxis has been considered a priority public health issue in the world allergy community, epidemiological data on morbidity and mortality remain suboptimal. We performed the first multicenter epidemiological study in French emergency departments (EDs). The study covered 7 EDs over a period of 1 year. The objectives were to identify areas that are amenable to change and to support ongoing national and international efforts for better diagnosis, management, and prevention of anaphylaxis. METHODS Ours was a descriptive study based on data routinely reported to French institutional administrative databases from 7 French public health institutions in the Lorraine region between January and December 2015. Data were collected based on the anaphylaxisrelated codes of the International Classification of Diseases (ICD)-10, and cases were clinically validated as anaphylaxis. RESULTS Of the 202 079 admissions to the EDs, 4817 had anaphylaxis-related codes; of these, 323 were clinically validated as anaphylaxis. Although 45.8% were severe, adrenaline was prescribed in only 32.4% of cases. Of the 323 cases, 57.9% were subsequently referred for an allergy work-up or evaluation (after or during hospitalization), and 17.3% were prescribed autoinjectable epinephrine. CONCLUSION Our results highlight an urgent need for improved public health initiatives with respect to recognition and treatment of anaphylaxis. We flag key problems that should be managed in the coming years through implementation of national and international actions.
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Affiliation(s)
- J Corriger
- Allergy Department, Hospital Emile Durkheim, Epinal, France.,Internal Medicine and Clinical Immunology Department, University Hospital, Vandoeuvre-lès-Nancy, France
| | - E Beaudouin
- Allergy Department, Hospital Emile Durkheim, Epinal, France
| | - R Rothmann
- Emergency Department, Hospital Mercy-Metz, Ars-Laquenexy, France
| | - E Penven
- Occupational Diseases Department, University Hospital, Vandoeuvre-lès-Nancy, France.,Division of Allergy, Dermatology Department, University Hospital, Vandoeuvre-lès-Nancy, France
| | - Q Haumonte
- Allergy Department, Hospital Emile Durkheim, Epinal, France
| | - H Thomas
- Allergy Department, Hospital Emile Durkheim, Epinal, France
| | - J Picaud
- Allergy Department, Hospital Emile Durkheim, Epinal, France
| | | | - J Corriger-Ippolito
- Division of Allergy, Dermatology Department, University Hospital, Vandoeuvre-lès-Nancy, France.,Emergency Department, University Hospital, Vandoeuvre-lès-Nancy, France
| | - F Braun
- Emergency Department, Hospital Mercy-Metz, Ars-Laquenexy, France
| | - M De Talancé
- Emergency Department, Hospital Emile Durkheim, Epinal, France
| | - B Auburtin
- Pediatric Emergency Department, Hospital Emile Durkheim, Epinal, France
| | - P Atain-Kouadio
- Emergency Department, University Hospital, Vandoeuvre-lès-Nancy, France
| | - A Borsa-Dorion
- Pediatric Emergency Department, University Hospital, Vandoeuvre-lès-Nancy, France
| | - D Baugnon
- Emergency Department, Hospital of Verdun-Saint-Mihiel, Verdun, France
| | - M De Carvalho
- Biology and Immunology Laboratory, University Hospital, Vandoeuvre-lès-Nancy, France
| | - R Jaussaud
- Internal Medicine and Clinical Immunology Department, University Hospital, Vandoeuvre-lès-Nancy, France
| | - P L Nguyen-Thi
- Clinical Research Platform, ESPRI-BioBase Unit, University Hospital, Vandoeuvre-lès-Nancy, France
| | - P E Bollaert
- Medical Intensive Care Unit, University Hospital, Nancy, France
| | - P Demoly
- Division of Allergy, Department of Pulmonology, University of Montpellier, France and Sorbonne University, INSERM, IPLESP, EPAR team, Paris, France
| | - L K Tanno
- Division of Allergy, Department of Pulmonology, University of Montpellier, France and Sorbonne University, INSERM, IPLESP, EPAR team, Paris, France
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Braun F, Hardt AK, Ehrlich L, Sloboda DM, Challis JRG, Plagemann A, Henrich W, Braun T. Sex-specific and lasting effects of a single course of antenatal betamethasone treatment on human placental 11β-HSD2. Placenta 2018; 69:9-19. [PMID: 30213491 DOI: 10.1016/j.placenta.2018.07.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 03/05/2018] [Revised: 07/06/2018] [Accepted: 07/09/2018] [Indexed: 01/03/2023]
Abstract
INTRODUCTION We have previously shown that even a single course of antenatal betamethasone (BET) as an inductor for lung maturity reduces birth weight and head circumference. Moreover, animal studies link BET administration to alterations of the hypothalamic-pituitary-adrenal-gland-axis (HPA). The unhindered development of the fetal HPA axis is dependent on the function and activity of 11β-hydroxysteroiddehydrogenase type 2 (11β-HSD2), a transplacental cortisol barrier. Therefore, we investigated the effects of BET on this transplacental barrier and fetal growth. METHODS Pregnant women treated with a single course of BET between 23 + 5 to 34 + 0 weeks of gestation were compared to gestational-age-matched controls. Placental size and neonatal anthropometrics were taken. Cortisol and ACTH levels were measured in maternal and umbilical cord blood samples. Placental 11β-hydroxysteroiddehydrogenase type 1 (11β-HSD1) protein levels and 11β-HSD2 protein and activity levels were determined. Parameters were analyzed independent of sex, and in subgroups divided by gender and gestational age. RESULTS In term born females, BET administration was associated with reduced head circumference and decreased 11β-HSD2 protein levels and enzyme activity. Males treated with BET, especially those born prematurely, showed increased 11β-HSD2 protein levels. CONCLUSION A single course of BET alters placental glucocorticoid metabolism in a sex-specific manner. Decreased 11β-HSD2 levels in term born females may lead to an increased placental transfer of maternal cortisol and therefore result in a reduced head circumference and a higher risk for altered stress response in adulthood. Further research is needed to conclude the significance of increased 11β-HSD2 levels in males.
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Affiliation(s)
- F Braun
- Department of Obstetrics and Division of 'Experimental Obstetrics̔, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - A K Hardt
- Department of Obstetrics and Division of 'Experimental Obstetrics̔, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - L Ehrlich
- Department of Obstetrics and Division of 'Experimental Obstetrics̔, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - D M Sloboda
- Department of Biochemistry and Biomedical Sciences, Obstetrics & Gynecology and Pediatrics, Farncombe Family Digestive Health Research Institute, McMaster University, Main Street West, Ontario L8S4L8, Hamilton, 1280, Canada
| | - J R G Challis
- Department of Physiology and Obstetrics and Gynecology, University of Toronto King's College Circle, Ontario M5S 1A8, Toronto, Canada; Faculty of Health Sciences, Simon Fraser University, University Drive, 8888, B.C, V5A 1S6, Burnaby, Canada
| | - A Plagemann
- Department of Obstetrics and Division of 'Experimental Obstetrics̔, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - W Henrich
- Department of Obstetrics and Division of 'Experimental Obstetrics̔, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - T Braun
- Department of Obstetrics and Division of 'Experimental Obstetrics̔, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
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Braun F. Les nouveaux outils de la régulation médicale en Samu-Centre 15. Ann Fr Med Urgence 2017. [DOI: 10.1007/s13341-017-0786-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sola J, Braun F, Muntane E, Verjus C, Bertschi M, Hugon F, Manzano S, Benissa M, Gervaix A. Towards an unsupervised device for the diagnosis of childhood pneumonia in low resource settings: automatic segmentation of respiratory sounds. Annu Int Conf IEEE Eng Med Biol Soc 2017; 2016:283-286. [PMID: 28268332 DOI: 10.1109/embc.2016.7590695] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Pneumonia remains the worldwide leading cause of children mortality under the age of five, with every year 1.4 million deaths. Unfortunately, in low resource settings, very limited diagnostic support aids are provided to point-of-care practitioners. Current UNICEF/WHO case management algorithm relies on the use of a chronometer to manually count breath rates on pediatric patients: there is thus a major need for more sophisticated tools to diagnose pneumonia that increase sensitivity and specificity of breath-rate-based algorithms. These tools should be low cost, and adapted to practitioners with limited training. In this work, a novel concept of unsupervised tool for the diagnosis of childhood pneumonia is presented. The concept relies on the automated analysis of respiratory sounds as recorded by a point-of-care electronic stethoscope. By identifying the presence of auscultation sounds at different chest locations, this diagnostic tool is intended to estimate a pneumonia likelihood score. After presenting the overall architecture of an algorithm to estimate pneumonia scores, the importance of a robust unsupervised method to identify inspiratory and expiratory phases of a respiratory cycle is highlighted. Based on data from an on-going study involving pediatric pneumonia patients, a first algorithm to segment respiratory sounds is suggested. The unsupervised algorithm relies on a Mel-frequency filter bank, a two-step Gaussian Mixture Model (GMM) description of data, and a final Hidden Markov Model (HMM) interpretation of inspiratory-expiratory sequences. Finally, illustrative results on first recruited patients are provided. The presented algorithm opens the doors to a new family of unsupervised respiratory sound analyzers that could improve future versions of case management algorithms for the diagnosis of pneumonia in low-resources settings.
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Zhang H, Qi L, Du Y, Braun F, Kogiso M, Zhao S, Lindsay H, Injac S, Baxter P, Su J, Patel A, Li X. OS08.2 A novel set of patient-derived orthotopic xenograft (PDOX) models of primary and recurrent intracranial meningioma. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Le Pen J, Maillet L, Sarosiek K, Vuillier C, Gautier F, Montessuit S, Martinou JC, Letaï A, Braun F, Juin PP. Constitutive p53 heightens mitochondrial apoptotic priming and favors cell death induction by BH3 mimetic inhibitors of BCL-xL. Cell Death Dis 2017; 8:e2596. [PMID: 28182005 PMCID: PMC5386447 DOI: 10.1038/cddis.2016.127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Braun F. Untersuchungen über die Löslichkeit fester Körper und die den Vorgang der Lösung begleitenden Volum- und Energieänderungen. Z PHYS CHEM 2017. [DOI: 10.1515/zpch-1887-0131] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Hettich M, Braun F, Niedermann G. Positron Emission Tomography Imaging of the PD-1/PD-L1 Checkpoint in Naïve and Irradiated Tumor-Bearing Mice. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Proenca M, Braun F, Muntane E, Sola J, Adler A, Lemay M, Thiran JP, Rimoldi SF. Non-invasive monitoring of pulmonary artery pressure at the bedside. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2016:4236-4239. [PMID: 28269217 DOI: 10.1109/embc.2016.7591662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Current solutions for the monitoring of pulmonary artery pressure (PAP) in patients suffering from pulmonary hypertension are limited to invasive means. Non-invasive alternatives, such as Doppler echocardiography, are incompatible with continuous monitoring due to their dependency on qualified personnel to perform the measurements. In the present study, a novel non-invasive and unsupervised approach based on the use of electrical impedance tomography (EIT) is presented. The approach was evaluated in three healthy subjects undergoing hypoxia-induced variations in PAP. A timing parameter - physiologically linked to the PAP via the so-called pulse wave velocity principle - was automatically extracted from the EIT data. Reference systolic PAP estimates were obtained by echocardiography. Strong correlation scores (r e [0.844, 0.990]) were found between the EIT-derived parameter and the reference PAP, thereby suggesting the validity of the proposed approach. If confirmed in larger datasets, these findings could open the way for a new branch of fully non-invasive hemodynamic monitors for patients with pulmonary hypertension.
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Zimmermann T, Beckebaum S, Berg C, Berg T, Braun F, Eurich D, Herzer K, Neumann U, Rupp C, Sterneck M, Strassburg C, Welker MW, Zachoval R, Gotthardt DN, Weigand K, Schmidt H, Wedemeyer H, Galle PR, Zeuzem S, Sarrazin C. [Expert recommendations: Hepatitis C and transplantation]. Z Gastroenterol 2016; 54:665-84. [PMID: 27429106 DOI: 10.1055/s-0042-107360] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
With the approval of new direct acting antiviral agents (DAA), therapeutic options for patients with chronic hepatitis C virus (HCV) infection are now generally available before and after liver transplantation (LT). Interferon-free DAA regimens are highly effective therapies and provide a good safety profile. However, the body of clinical evidence in this patient population is limited and the best treatment strategies for patients on the waiting list with (de)compensated cirrhosis and after LT are not well defined. The following recommendations for antiviral therapy in the context of LT are based on the currently available literature and clinical experience of experts in the field, and have been discussed in an expert meeting. The aim of this article is to guide clinicians in the decision making when treating patients before and after LT with DAAs.
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Affiliation(s)
- T Zimmermann
- I. Med. Klinik und Poliklinik, Universitätsmedizin Mainz
| | - S Beckebaum
- Klinik für Transplantationsmedizin, Universitätsklinikum Münster
| | - C Berg
- Abteilung Innere Medizin I, Universitätsklinikum Tübingen
| | - T Berg
- Klinik für Gastroenterologie und Hepatologie, Universitätsklinikum Leipzig
| | - F Braun
- Transplantationszentrum, Universitätsklinikum Schleswig-Holstein, Kiel
| | - D Eurich
- Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Charité-Universitätsmedizin Berlin
| | - K Herzer
- Klinik für Gastroenterologie und Hepatologie/Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Essen
| | - U Neumann
- Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Medizinische Fakultät, RWTH Aachen
| | - C Rupp
- Abteilung Innere Medizin IV, Universitätsklinikum Heidelberg
| | - M Sterneck
- Klinik und Poliklinik für Hepatobiliäre Chirurgie und Transplantationschirurgie, Universitätsklinikum Hamburg-Eppendorf
| | - C Strassburg
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Bonn
| | - M-W Welker
- Med. Klinik 1, Universitätsklinikum Frankfurt, Frankfurt am Main
| | - R Zachoval
- Transplantationszentrum München der LMU, München
| | - D N Gotthardt
- Abteilung Innere Medizin IV, Universitätsklinikum Heidelberg
| | - K Weigand
- Innere Medizin I, Universitätsklinikum Regensburg
| | - H Schmidt
- Klinik für Transplantationsmedizin, Universitätsklinikum Münster
| | - H Wedemeyer
- Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover
| | - P R Galle
- I. Med. Klinik und Poliklinik, Universitätsmedizin Mainz
| | - S Zeuzem
- Med. Klinik 1, Universitätsklinikum Frankfurt, Frankfurt am Main
| | - C Sarrazin
- Med. Klinik 1, Universitätsklinikum Frankfurt, Frankfurt am Main
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Hettich M, Braun F, Niedermann G. OC-0526: Noninvasive imaging of the PD-1/PD-L1 checkpoint in naïve mice and after combined radioimmunotherapy. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31776-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Moré G, Rambeaud M, Braun F, Campero L, Walkoski A, Venturini M. Isolation of Sarcocystis neurona from an opossum (Didelphis albiventris) in Argentina. J Equine Vet Sci 2016. [DOI: 10.1016/j.jevs.2016.02.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Gassenmaier S, Armbruster M, Nörenberg D, Haack M, Sommer W, Braun F. Einfluss strukturierter Befundung von MRT-Felsenbein-Untersuchungen auf Vollständigkeit, sprachliche Qualität und klinische Entscheidungsfindung. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Braun F, Ammirati C, Auchères G, Duché-Taillez M, Goldstein P, Jenvrin J, Julié V, Lévy-Chazal P, Nace L, Roy H, Valette P, Miklin J. Retour d’expérience des attentats du 13 novembre 2015. Organisation des renforts par les Samu de province. Ann Fr Med Urgence 2016. [DOI: 10.1007/s13341-016-0612-5] [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] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Le Pen J, Maillet L, Sarosiek K, Vuillier C, Gautier F, Montessuit S, Martinou JC, Letaï A, Braun F, Juin PP. Constitutive p53 heightens mitochondrial apoptotic priming and favors cell death induction by BH3 mimetic inhibitors of BCL-xL. Cell Death Dis 2016; 7:e2083. [PMID: 26844698 PMCID: PMC4849148 DOI: 10.1038/cddis.2015.400] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [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: 08/04/2015] [Revised: 12/07/2015] [Accepted: 12/09/2015] [Indexed: 01/08/2023]
Abstract
Proapoptotic molecules directly targeting the BCL-2 family network are promising anticancer therapeutics, but an understanding of the cellular stress signals that render them effective is still elusive. We show here that the tumor suppressor p53, at least in part by transcription independent mechanisms, contributes to cell death induction and full activation of BAX by BH3 mimetic inhibitors of BCL-xL. In addition to mildly facilitating the ability of compounds to derepress BAX from BCL-xL, p53 also provides a death signal downstream of anti-apoptotic proteins inhibition. This death signal cooperates with BH3-induced activation of BAX and it is independent from PUMA, as enhanced p53 can substitute for PUMA to promote BAX activation in response to BH3 mimetics. The acute sensitivity of mitochondrial priming to p53 revealed here is likely to be critical for the clinical use of BH3 mimetics.
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Affiliation(s)
- J Le Pen
- UMR 892 INSERM/6299 CNRS/Université de Nantes, Team 8 'Cell Survival And Tumor Escape In Breast Cancer', Institut de Recherche en Santé de l'Université de Nantes, Nantes, France
| | - L Maillet
- UMR 892 INSERM/6299 CNRS/Université de Nantes, Team 8 'Cell Survival And Tumor Escape In Breast Cancer', Institut de Recherche en Santé de l'Université de Nantes, Nantes, France
| | - K Sarosiek
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - C Vuillier
- UMR 892 INSERM/6299 CNRS/Université de Nantes, Team 8 'Cell Survival And Tumor Escape In Breast Cancer', Institut de Recherche en Santé de l'Université de Nantes, Nantes, France
| | - F Gautier
- UMR 892 INSERM/6299 CNRS/Université de Nantes, Team 8 'Cell Survival And Tumor Escape In Breast Cancer', Institut de Recherche en Santé de l'Université de Nantes, Nantes, France.,Institut de Cancérologie de l'Ouest, Centre de Lutte contre le Cancer René Gauducheau, Saint Herblain, France
| | - S Montessuit
- Department of Cell Biology, University of Geneva, Geneva,Switzerland
| | - J C Martinou
- Department of Cell Biology, University of Geneva, Geneva,Switzerland
| | - A Letaï
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - F Braun
- UMR 892 INSERM/6299 CNRS/Université de Nantes, Team 8 'Cell Survival And Tumor Escape In Breast Cancer', Institut de Recherche en Santé de l'Université de Nantes, Nantes, France
| | - P P Juin
- UMR 892 INSERM/6299 CNRS/Université de Nantes, Team 8 'Cell Survival And Tumor Escape In Breast Cancer', Institut de Recherche en Santé de l'Université de Nantes, Nantes, France.,Institut de Cancérologie de l'Ouest, Centre de Lutte contre le Cancer René Gauducheau, Saint Herblain, France
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Pomschar A, Moritz K, Schwarz F, Kümpfel T, Braun F, Reiser M, Ertl-Wagner B. Vergrößerte Adenoide bei Patienten mit Multipler Sklerose. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Rapin M, Proença M, Braun F, Meier C, Solà J, Ferrario D, Grossenbacher O, Porchet JA, Chételat O. Cooperative dry-electrode sensors for multi-lead biopotential and bioimpedance monitoring. Physiol Meas 2015; 36:767-83. [PMID: 25798790 DOI: 10.1088/0967-3334/36/4/767] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Cooperative sensors is a novel measurement architecture that allows the acquiring of biopotential signals on patients in a comfortable and easy-to-integrate manner. The novel sensors are defined as cooperative in the sense that at least two of them work in concert to measure a target physiological signal, such as a multi-lead electrocardiogram or a thoracic bioimpedance.This paper starts by analysing the state-of-the-art methods to simultaneously measure biopotential and bioimpedance signals, and justifies why currently (1) passive electrodes require the use of shielded or double-shielded cables, and (2) active electrodes require the use of multi-wired cabled technologies, when aiming at high quality physiological measurements.In order to overcome the limitations of the state-of-the-art, a new method for biopotential and bioimpedance measurement using the cooperative sensor is then presented. The novel architecture allows the acquisition of the aforementioned biosignals without the need of shielded or multi-wire cables by splitting the electronics into separate electronic sensors comprising each of two electrodes, one for voltage measurement and one for current injection. The sensors are directly in contact with the skin and connected together by only one unshielded wire. This new configuration requires one power supply per sensor and all sensors need to be synchronized together to allow them to work in concert.After presenting the working principle of the cooperative sensor architecture, this paper reports first experimental results on the use of the technology when applied to measuring multi-lead ECG signals on patients. Measurements performed on a healthy patient demonstrate the feasibility of using this novel cooperative sensor architecture to measure biopotential signals and compliance with common mode rejection specification accordingly to international standard (IEC 60601-2-47) has also been assessed.By reducing the need of using complex wiring setups, and by eliminating the presence of central recording devices (cooperative sensors directly sense and store the measured biosignals on the site), the depicted novel technology is a candidate to a novel generation of highly-integrated, comfortable and reliable technologies that measure physiological signals in real-life scenarios.
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Affiliation(s)
- M Rapin
- Swiss Centre for Electronics and Microtechnology, CSEM, Neuchâtel, Switzerland. ETHZ, D-HEST, Zürich, Switzerland
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Braun F, Braun T, Martin Hempel J, Krause E, Müller J, Berghaus A, Reiser M, Ertl-Wagner B. Stellenwert einer routinehaften Röntgen-Stellungskontrolle nach Cochlea-Implantation. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Stickel F, Buch S, Zoller H, Hultcrantz R, Gallati S, Osterreicher C, Finkenstedt A, Stadlmayr A, Aigner E, Sahinbegovic E, Sarrazin C, Schafmayer C, Braun F, Erhart W, Nothnagel M, Lerch MM, Mayerle J, Volzke H, Schaller A, Kratzer W, Boehm BO, Sipos B, D'Amato M, Torkvist L, Stal P, Arlt A, Franke A, Becker T, Krawczak M, Zwerina J, Berg T, Hinrichsen H, Krones E, Dejaco C, Strasser M, Datz C, Hampe J. Evaluation of genome-wide loci of iron metabolism in hereditary hemochromatosis identifies PCSK7 as a host risk factor of liver cirrhosis. Hum Mol Genet 2014; 23:3883-90. [DOI: 10.1093/hmg/ddu076] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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Gramzow AK, Braun F, Ehrlich L, Husar A, Sloboda DM, Challis JRG, Henrich W, Plagemann A, Braun T. Lungenreifeinduktion mit Betamethason – Effekte auf das fetale Wachstum und die Glukosehomöostase. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Braun F, Gramzow AK, Ehrlich L, Husar A, Sloboda DM, Challis JRG, Henrich W, Plagemann A, Braun T. Untersuchungen zu den Effekten der antenatale Lungenreifeinduktion mit Betamethason auf die maternalen und fetalen ACTH- und Cortisol-Spiegel. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Braun F, Gunther R, Becker T, Doede T, Milkiewicz P, Louvet A. S19 * LIVER TRANSPLANTATION IN PATIENTS WITH ALCOHOLIC LIVER DISEASE. Alcohol Alcohol 2013. [DOI: 10.1093/alcalc/agt090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
The immunological monitoring in organ transplantation is based mainly on the determination of laboratory parameters as surrogate markers of organ dysfunction. Structural damage, caused by alloreactivity, can only be detected by invasive biopsy of the graft, which is why inevitably rejection episodes are diagnosed at a rather progressive stage. New non-invasive specific markers that enable transplant clinicians to identify rejection episodes at an earlier stage, on the molecular level, are needed. The accurate identification of rejection episodes and the establishment of operational tolerance permit early treatment or, respectively, a controlled cessation of immunosuppression. In addition, new prognostic biological markers are expected to allow a pre-transplant risk stratification thus having an impact on organ allocation and immunosuppressive regimen. New high-throughput screening methods allow simultaneous examination of hundreds of characteristics and the generation of specific biological signatures, which might give concrete information about acute rejection, chronic dysfunction as well as operational tolerance. Even though multiple studies and a variety of publications report about important advances on this subject, almost no new biological marker has been implemented in clinical practice as yet. Nevertheless, new technologies, in particular analysis of the genome, transcriptome, proteome and metabolome will make personalised transplantation medicine possible and will further improve the long-term results and graft survival rates. This article gives a survey of the limitations and possibilities of new immunological markers in organ transplantation.
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Affiliation(s)
- J H Beckmann
- Klinik für Allgemeine, Viszeral-, Thorax-, Transplantations- und Kinderchirurgie, UKSH, Campus Kiel, Kiel, Deutschland
| | - N Heits
- Klinik für Allgemeine, Viszeral-, Thorax-, Transplantations- und Kinderchirurgie, UKSH, Campus Kiel, Kiel, Deutschland
| | - F Braun
- Klinik für Allgemeine, Viszeral-, Thorax-, Transplantations- und Kinderchirurgie, UKSH, Campus Kiel, Kiel, Deutschland
| | - T Becker
- Klinik für Allgemeine, Viszeral-, Thorax-, Transplantations- und Kinderchirurgie, UKSH, Campus Kiel, Kiel, Deutschland
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Schmutz T, Hoffmann M, Andre E, Braun F. Le point poumon. Ann Fr Med Urgence 2013. [DOI: 10.1007/s13341-013-0290-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Zimmermann R, Braun F, Achtnich T, Lambercy O, Gassert R, Wolf M. Silicon photomultipliers for improved detection of low light levels in miniature near-infrared spectroscopy instruments. Biomed Opt Express 2013; 4:659-66. [PMID: 23667783 PMCID: PMC3646594 DOI: 10.1364/boe.4.000659] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 03/15/2013] [Accepted: 03/22/2013] [Indexed: 05/22/2023]
Abstract
Silicon photomultipliers are novel solid state photodetectors that recently became commercially available. The goal of this paper was to investigate their suitability for low light level detection in miniaturized functional near-infrared spectroscopy instruments. Two measurement modules with a footprint of 26×26 mm(2) were built, and the signal-to-noise ratio was assessed for variable source-detector separations between 25 and 65 mm on phantoms with similar optical properties to those of a human head. These measurements revealed that the signal-to-noise ratio of the raw signal was superior to an empirically derived design requirement for source-detector separations up to 50 mm. An arterial arm occlusion was also performed on one of the authors in vivo, to induce reproducible hemodynamic changes which confirmed the validity of the measured signals. The proposed use of silicon photomultipliers in functional near-infrared spectroscopy bears large potential for future development of precise, yet compact and modular instruments, and affords improvements of the source-detector separation by 67% compared to the commonly used 30 mm.
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Affiliation(s)
- R. Zimmermann
- Biomedical Optics Research Laboratory, University Hospital Zurich,
Switzerland
- Rehabilitation Engineering Laboratory, ETH Zurich,
Switzerland
| | - F. Braun
- Institute for Biomedical Engineering, ETH Zurich,
Switzerland
| | - T. Achtnich
- Institute for Biomedical Engineering, ETH Zurich,
Switzerland
| | - O. Lambercy
- Rehabilitation Engineering Laboratory, ETH Zurich,
Switzerland
| | - R. Gassert
- Rehabilitation Engineering Laboratory, ETH Zurich,
Switzerland
| | - M. Wolf
- Biomedical Optics Research Laboratory, University Hospital Zurich,
Switzerland
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Schmutz T, Sander C, Didaux AC, Picard Y, Chouvet E, Braun F. Il n’y a pas d’âge pour un prélèvement d’organe ! Ann Fr Med Urgence 2012. [DOI: 10.1007/s13341-012-0237-2] [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] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Baratto CM, Gelinski JMLN, Bernardi AZ, Marafon A, Braun F. Potential use of molecular-typing methods for the identification and characterization of salmonella enterica serotypes isolated in the poultry production chain. Rev Bras Cienc Avic 2012. [DOI: 10.1590/s1516-635x2012000300003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Schmutz T, Zemmouche P, Trognon P, Feintrenie C, Greingor JL, Braun F. Choc hémorragique secondaire à la rupture d’un anévrisme de l’artère splénique. Ann Fr Med Urgence 2012. [DOI: 10.1007/s13341-012-0175-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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46
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Lesesve JF, Asnafi V, Braun F, Zini G. Fragmented red blood cells automated measurement is a useful parameter to exclude schistocytes on the blood film. Int J Lab Hematol 2012; 34:566-76. [DOI: 10.1111/j.1751-553x.2012.01434.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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47
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Habchi K, Blatt A, Schmutz T, Hoffmann M, Braun F. Syndrome de Boerhaave. Ann Fr Med Urgence 2012. [DOI: 10.1007/s13341-012-0165-1] [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] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Croguennec Y, Braun F, Fréchard S, Ricard-Hibon A, Dhers M, Pateron D. L’infi rmier(ère) diplomé(e) d’état seul(e) devant une situation de détresse médicale. Ann Fr Med Urgence 2012. [DOI: 10.1007/s13341-012-0151-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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49
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Faugel H, Bobkov V, Braun F, Franke T, Hartmann D, Kircher M, Noterdaeme JM, Siegl G. An improved method to measure the antenna resistance and radiated power of ICRF-antennas using current probes. Fusion Engineering and Design 2011. [DOI: 10.1016/j.fusengdes.2011.02.092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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50
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Liebau MC, Braun F, Weitbrecht C, Saleem MA, Cybulla M, Schermer B, Benzing T, Kurschat CE. Ein Zellkulturmodell für die Podozytenschädigung bei Morbus Fabry. Klin Padiatr 2011. [DOI: 10.1055/s-0031-1273811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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