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Tellegen AR, Rudnik-Jansen I, Utomo L, Versteeg S, Beukers M, Maarschalkerweerd R, van Zuilen D, van Klaveren NJ, Houben K, Teske E, van Weeren PR, Karssemakers-Degen N, Mihov G, Thies J, Eijkelkamp N, Creemers LB, Meij BP, Tryfonidou MA. Sustained release of locally delivered celecoxib provides pain relief for osteoarthritis: a proof of concept in dog patients. Osteoarthritis Cartilage 2023; 31:351-362. [PMID: 36473675 DOI: 10.1016/j.joca.2022.11.008] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 11/18/2022] [Accepted: 11/25/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Drug delivery platforms that allow for gradual drug release after intra-articular administration have become of much interest as a treatment strategy for osteoarthritis (OA). The aim of this study was to investigate the safety and efficacy of an intra-articular sustained release formulation containing celecoxib (CXB), a cyclooxygenase-2 (COX-2) selective inhibitor. METHODS Amino acid-based polyesteramide microspheres (PEAMs), a biodegradable and non-toxic platform, were loaded with CXB and employed in two in vivo models of arthritis: an acute inflammatory arthritis model in rats (n = 12), and a randomized controlled study in chronic OA dog patients (n = 30). In parallel, the bioactivity of sustained release of CXB was evaluated in monolayer cultures of primary dog chondrocytes under inflammatory conditions. RESULTS Sustained release of CXB did not alleviate acute arthritis signs in the rat arthritis model, based on pain measurements and synovitis severity. However, in OA dog patients, sustained release of CXB improved limb function as objective parameter of pain and quality of life based on gait analysis and owner questionnaires. It also decreased pain medication dependency over a 2-month period and caused no adverse effects. Prostaglandin E2 levels, a marker for inflammation, were lower in the synovial fluid of CXB-treated dog OA patients and in CXB-treated cultured dog chondrocytes. CONCLUSION These results show that local sustained release of CXB is less suitable to treat acute inflammation in arthritic joints, while safe and effective in treating pain in chronic OA in dogs.
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Affiliation(s)
- A R Tellegen
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - I Rudnik-Jansen
- Department of Orthopedics, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - L Utomo
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - S Versteeg
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - M Beukers
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - R Maarschalkerweerd
- Department of Orthopedics, Medisch Centrum voor Dieren, Amsterdam, the Netherlands
| | - D van Zuilen
- Department of Orthopedics, Medisch Centrum voor Dieren, Amsterdam, the Netherlands
| | - N J van Klaveren
- Department of Orthopedics, Medisch Centrum voor Dieren, Amsterdam, the Netherlands
| | - K Houben
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - E Teske
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - P R van Weeren
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | | | - G Mihov
- DSM Biomedical, Geleen, the Netherlands
| | - J Thies
- DSM Biomedical, Geleen, the Netherlands
| | - N Eijkelkamp
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - L B Creemers
- Department of Orthopedics, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - B P Meij
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - M A Tryfonidou
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands.
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Beetz O, Thies J, Weigle CA, Ius F, Winkler M, Bara C, Richter N, Klempnauer J, Warnecke G, Haverich A, Avsar M, Grannas G. Simultaneous heart-kidney transplantation results in respectable long-term outcome but a high rate of early kidney graft loss in high-risk recipients - a European single center analysis. BMC Nephrol 2021; 22:258. [PMID: 34243724 PMCID: PMC8268408 DOI: 10.1186/s12882-021-02430-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 12/10/2020] [Accepted: 05/31/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In spite of renal graft shortage and increasing waiting times for transplant candidates, simultaneous heart and kidney transplantation (HKTx) is an increasingly performed procedure established for patients with combined end-stage cardiac and renal failure. Although data on renal graft outcome in this setting is limited, reports on reduced graft survival in comparison to solitary kidney transplantation (KTx) have led to an ongoing discussion of adequate organ utilization. METHODS This retrospective study was conducted to evaluate prognostic factors and outcomes of 27 patients undergoing HKTx in comparison to a matched cohort of 27 patients undergoing solitary KTx between September 1987 and October 2019 in one of Europe's largest transplant centers. RESULTS Median follow-up was 100.33 (0.46-362.09) months. Despite lower five-year kidney graft survival (62.6% versus 92.1%; 111.73 versus 183.08 months; p = 0.189), graft function and patient survival (138.90 versus 192.71 months; p = 0.128) were not significantly inferior after HKTx in general. However, in case of prior cardiac surgery requiring sternotomy we observed significantly reduced early graft and patient survival (57.00 and 94.09 months, respectively) when compared to patients undergoing solitary KTx (183.08 and 192.71 months; p < 0.001, respectively) or HKTx without prior cardiac surgery (203.22 and 203.22 months; p = 0.016 and p = 0.019, respectively), most probably explained by the significantly increased rate of primary nonfunction (33.3%) and in-hospital mortality (25.0%). CONCLUSIONS Our data demonstrates the increased rate of early kidney graft loss and thus significantly inferior graft survival in high-risk patients undergoing HKTx. Thus, we advocate for a "kidney-after-heart" program in such patients to ensure responsible and reasonable utilization of scarce resources in times of ongoing organ shortage crisis.
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Affiliation(s)
- Oliver Beetz
- Department of General, Visceral and Transplant Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30626, Hannover, Germany
| | - Juliane Thies
- Department of General, Visceral and Transplant Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30626, Hannover, Germany
| | - Clara A Weigle
- Department of General, Visceral and Transplant Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30626, Hannover, Germany
| | - Fabio Ius
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Michael Winkler
- Department of General, Visceral and Transplant Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30626, Hannover, Germany
| | - Christoph Bara
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Nicolas Richter
- Department of General, Visceral and Transplant Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30626, Hannover, Germany
| | - Jürgen Klempnauer
- Department of General, Visceral and Transplant Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30626, Hannover, Germany
| | - Gregor Warnecke
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Axel Haverich
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Murat Avsar
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Gerrit Grannas
- Department of General, Visceral and Transplant Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30626, Hannover, Germany.
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Abayie AO, Nyarko KM, Loza N, Pistorius G, Thies J. Laparoscopic Liver Resection in a Case of Asymptomatic Elderly Patient with Caroli Syndrome. J Gastrointest Cancer 2018; 50:10.1007/s12029-018-0139-7. [PMID: 30003494 DOI: 10.1007/s12029-018-0139-7] [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: 11/10/2022]
Affiliation(s)
- Akwasi Ofori Abayie
- Department of General and Visceral Surgery, Sozialstiftung Bamberg, Bamberg, Germany.
| | - K M Nyarko
- Namibia Field Epidemiology and Laboratory Training Program, School of Public Health, University of Namibia, Windhoek, Namibia
| | - N Loza
- Department of Radiology, Sozialstiftung Bamberg, Bamberg, Germany
| | - G Pistorius
- Department of General and Visceral Surgery, Sozialstiftung Bamberg, Bamberg, Germany
| | - J Thies
- Department of General and Visceral Surgery, Sozialstiftung Bamberg, Bamberg, Germany
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Berger M, Müller K, Aichert A, Unberath M, Thies J, Choi JH, Fahrig R, Maier A. Marker-free motion correction in weight-bearing cone-beam CT of the knee joint. Med Phys 2016; 43:1235-48. [PMID: 26936708 DOI: 10.1118/1.4941012] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To allow for a purely image-based motion estimation and compensation in weight-bearing cone-beam computed tomography of the knee joint. METHODS Weight-bearing imaging of the knee joint in a standing position poses additional requirements for the image reconstruction algorithm. In contrast to supine scans, patient motion needs to be estimated and compensated. The authors propose a method that is based on 2D/3D registration of left and right femur and tibia segmented from a prior, motion-free reconstruction acquired in supine position. Each segmented bone is first roughly aligned to the motion-corrupted reconstruction of a scan in standing or squatting position. Subsequently, a rigid 2D/3D registration is performed for each bone to each of K projection images, estimating 6 × 4 × K motion parameters. The motion of individual bones is combined into global motion fields using thin-plate-spline extrapolation. These can be incorporated into a motion-compensated reconstruction in the backprojection step. The authors performed visual and quantitative comparisons between a state-of-the-art marker-based (MB) method and two variants of the proposed method using gradient correlation (GC) and normalized gradient information (NGI) as similarity measure for the 2D/3D registration. RESULTS The authors evaluated their method on four acquisitions under different squatting positions of the same patient. All methods showed substantial improvement in image quality compared to the uncorrected reconstructions. Compared to NGI and MB, the GC method showed increased streaking artifacts due to misregistrations in lateral projection images. NGI and MB showed comparable image quality at the bone regions. Because the markers are attached to the skin, the MB method performed better at the surface of the legs where the authors observed slight streaking of the NGI and GC methods. For a quantitative evaluation, the authors computed the universal quality index (UQI) for all bone regions with respect to the motion-free reconstruction. The authors quantitative evaluation over regions around the bones yielded a mean UQI of 18.4 for no correction, 53.3 and 56.1 for the proposed method using GC and NGI, respectively, and 53.7 for the MB reference approach. In contrast to the authors registration-based corrections, the MB reference method caused slight nonrigid deformations at bone outlines when compared to a motion-free reference scan. CONCLUSIONS The authors showed that their method based on the NGI similarity measure yields reconstruction quality close to the MB reference method. In contrast to the MB method, the proposed method does not require any preparation prior to the examination which will improve the clinical workflow and patient comfort. Further, the authors found that the MB method causes small, nonrigid deformations at the bone outline which indicates that markers may not accurately reflect the internal motion close to the knee joint. Therefore, the authors believe that the proposed method is a promising alternative to MB motion management.
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Affiliation(s)
- M Berger
- Pattern Recognition Lab, Friedrich-Alexander-University Erlangen-Nuremberg, 91058 Erlangen, Germany
| | - K Müller
- Radiological Sciences Laboratory, Stanford University, Stanford, California 94305
| | - A Aichert
- Pattern Recognition Lab, Friedrich-Alexander-University Erlangen-Nuremberg, 91058 Erlangen, Germany
| | - M Unberath
- Pattern Recognition Lab, Friedrich-Alexander-University Erlangen-Nuremberg, 91058 Erlangen, Germany
| | - J Thies
- Computer Graphics Lab, Friedrich-Alexander-University Erlangen-Nuremberg, 91058 Erlangen, Germany
| | - J-H Choi
- Radiological Sciences Laboratory, Stanford University, Stanford, California 94305
| | - R Fahrig
- Radiological Sciences Laboratory, Stanford University, Stanford, California 94305
| | - A Maier
- Pattern Recognition Lab, Friedrich-Alexander-University Erlangen-Nuremberg, 91058 Erlangen, Germany
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Zanker V, Erhardt E, Mader F, Thies J. Zum photochemischen Verhalten einiger N-Alkylacridinium-Kationen und N, N′-Dialkyl-9.9-′-diacridane in äthanolischer Lösung II. ACTA ACUST UNITED AC 2014. [DOI: 10.1515/znb-1966-0202] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Die N-Methyl-, N-Äthyl-, N-n-Propyl- und N-n-Butylacridiniumjodide werden synthetisiert und diese mit AgNO3 in äthanolischer Lösung in die entsprechenden Nitrate umgewandelt. Lösungen der Konzentrationen 2-3 · 10-2-m. in O2-freiem Äthanol werden in Pyrex- oder Quarzgefäßen mit Osram HBO 200- oder Hanau TQ 81-Lampen der Photolyse unterworfen.
Die N-Alkylacridiniumsalze werden dabei im Primärakt unter Übertragung eines H-Atoms vom Lösungsmittel photoreduziert. Dabei bildet sich sehr wahrscheinlich ein N-Alkylacridaniumradikal-Kation. Dieses gibt ein Proton ab, das quantitativ nachgewiesen wird; es bildet sich ein N-Alkylacridanylradikal, das mit sich selbst zu den entsprechenden N,N′-Dialkyl-9.9′-diacridanen dimerisiert. Diese Diacridane sind relativ schwer löslich und fallen bei der Photolyse als Festsubstanzen aus. Das N,N′-Diäthyldiacridan hat im Entstehungszustand die größte Löslichkeit; sie beträgt 4,4 · 10-3-m. bei 30°. Zum N,N′-Dimethyl- bzw. N,N′-Di-n-Propyl- und N,N′-Di-n-Butyldiacridan fällt die Löslichkeit rasch ab und bedingt, daß auch bei höheren Reaktionstemperaturen Umsätze von 80 - 100% vor Einsetzen einer merklichen Rückbildungsreaktion erzielt werden können.
Die N,N′-Dialkyldiacridane sind selbst photochemisch instabil. Sie zerfallen im Primärprozeß heterolytisch in ein N-Alkylacridinium-Kation und ein entsprechendes Anion, das sich rasch, vermutlich zu einem Acridan stabilisiert. Diese photolytische Instabilität der N,N′-Dialkyldiacridane bedingt bei höheren Reaktionstemperaturen und größerer Löslichkeit, daß beim N,N-Diäthyldiacridan die Rückreaktion schon bei einem 40-proz. Umsatz in den Vordergrund kommt und kein festes Diacridan gebildet wird.
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Affiliation(s)
- V. Zanker
- Institut für Physikalische Chemie der Technischen Hochschule München Vorgetragen auf dem Internationalen Kongreß über Photochemie in Tokio, August 1965
| | - E. Erhardt
- Institut für Physikalische Chemie der Technischen Hochschule München Vorgetragen auf dem Internationalen Kongreß über Photochemie in Tokio, August 1965
| | - F. Mader
- Institut für Physikalische Chemie der Technischen Hochschule München Vorgetragen auf dem Internationalen Kongreß über Photochemie in Tokio, August 1965
| | - J. Thies
- Institut für Physikalische Chemie der Technischen Hochschule München Vorgetragen auf dem Internationalen Kongreß über Photochemie in Tokio, August 1965
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Herber S, Otto G, Schneider J, Manzl N, Kummer I, Kanzler S, Schuchmann A, Thies J, Düber C, Pitton M. Transarterial chemoembolization (TACE) for inoperable intrahepatic cholangiocarcinoma. Cardiovasc Intervent Radiol 2007; 30:1156-65. [PMID: 17508242 DOI: 10.1007/s00270-007-9032-7] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2007] [Revised: 03/27/2007] [Accepted: 03/28/2007] [Indexed: 12/17/2022]
Abstract
The aim of this retrospective study was to determine the safety and efficacy of chemoembolization (TACE) as palliative treatment for patients with unresectable intrahepatic cholangiocarcinoma (CCA) and to compare the results with those in the literature. Fifteen patients with histology-proven CCA (5 men, 10 women) had received palliative treatment with TACE over a 6-year period. The treatment protocol comprised repeated TACE at a minimum of 8-week intervals. TACE was performed with a mixture of 10 ml Lipiodol and 10 mg mitomycin C injected into the tumor-supplying vessels. Follow-up investigations after 8-10 weeks comprised contrast-enhanced multislice spiral CT and laboratory control. Statistical evaluation included survival analysis using the Kaplan-Meier method. During the investigation period 58 TACEs (3.9 +/- 3.8; 1-15) were performed in 15 patients. Mean tumor size was 10.8 +/- 4.6 cm (range, 2.0-18.0 cm). Unifocal tumor disease was diagnosed in eight patients, and multifocal disease in seven. Mean survival was 21.1 months (95% CI, 9.4-32.5 months). At the end of the investigation period 3 patients are still alive, and 12 patients have died. The 1-, 2-, and 3-year survival rate was 51.3%, 27.5%, and 27.5% respectively. According to RECIST criteria interim best response to therapy was stable disease in 9 of 15 patients, a partial response in 1 of 15 patients, and tumor progression in 4 of 15 patients. No deaths and no acute liver failure occurred under TACE therapy. Major complications were observed in two patients, comprising anaphylactic shock owing to contrast medium administration in one and gastric ulceration due to lipiodol displacement in the second patient. These results demonstrate that TACE is a safe procedure with a moderate number of complications for patients suffering from inoperable CCA. According to recently published data on i.v. chemotherapy we suggest that TACE might be able to prolong survival in selected patients who would succumb under other palliative treatment modalities.
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Affiliation(s)
- S Herber
- Department of Diagnostic and Interventional Radiology, University of Mainz, Langenbeckstr. 1, 55131 Mainz, Germany.
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Abstract
The increasingly performed en bloc resection of liver and hilar tumor has contributed to the improvement of long-term survival in patients with hilar cholangiocarcinoma. Based on preoperative definition of operative strategy we tried to avoid any traumatization of the hilar region. Between September 1997 and September 2002, 82 patients with hilar cholangiocarcinoma were treated at our department. Three patients were excluded from any surgery. The resection rate was 75% (59 of 79); 79% (38 of 48) of en bloc resections of the hilar tumor and adjacent liver were formally curative. The hospital mortality was 7%. The 1- and 3-year survival rates of patients after explorative laparotomy, palliative and curative resection was 27 and 7%, 67 and 26%, 89 and 45% ( p<0.001), respectively. The 1- and 3-year survival rates of patients after en bloc resection were 78 and 49%, respectively. In patients with formally curative en bloc resection ( n=38), the 3-year survival rate was 63%; in patients with N0/R0 resection ( n=31) it was 71%. Lymph node involvement proved to be the only independent prognostic marker if patients who underwent hilar and en bloc resection were included in the multivariate analysis. The R situation was the only significant predictor for patients after en bloc resection. These data justify the extended diagnostic work-up and the principal liver resection in hilar cholangiocarcinoma.
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Affiliation(s)
- G Otto
- Abteilung für Transplantationschirurgie/Chirurgie von Leber, Gallenwegen und Pankreas, Universitätsklinikum Mainz.
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Moench C, Uhrig A, Lohse AW, Thies J, Otto G. Differential diagnosis of cytomegalovirus infection and acute rejection by serum CC-Chemokine measurement after orthotopic liver transplantation. Transplant Proc 2003; 35:2084-5. [PMID: 14529848 DOI: 10.1016/s0041-1345(03)00673-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- C Moench
- Department of Transplantation and Hepatobiliary Surgery, Johannes Gutenberg, University Mainz, Mainz, Germany.
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Moench C, Uhrig A, Wunsch A, Thies J, Otto G. Chemokines: reliable markers for diagnosis of rejection and inflammation following orthotopic liver transplantation. Transplant Proc 2001; 33:3293-4. [PMID: 11750409 DOI: 10.1016/s0041-1345(01)02398-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- C Moench
- Department of Transplantation and Hepatobiliary Surgery, Johannes Gutenberg University, Mainz, Germany
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Zapletal CM, Taut FJH, Martin E, Breitkreutz R, Babylon A, Droge W, Thies J. Influence of N-acetylcysteine on hepatic amino acid metabolism in patients undergoing orthotopic liver transplantation. Transpl Int 2001. [DOI: 10.1111/j.1432-2277.2001.tb00067.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Schnitzlein K, Thies J. Reassessment of the Concentration Controlled Recycle Reactor for Kinetic Investigations of Heterogeneous Catalytic Reactions. CHEM-ING-TECH 2001. [DOI: 10.1002/1522-2640(200106)73:6<663::aid-cite6634444>3.0.co;2-0] [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: 11/09/2022]
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Dufter C, Terness P, Post S, Thies J, Otto G, Meuer S, Opelz G. Prolonged rat allograft survival induced by temporary elimination of alpha/beta T cells with monoclonal antibody. Transpl Int 2001; 7 Suppl 1:S580-3. [PMID: 11271313 DOI: 10.1111/j.1432-2277.1994.tb01448.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We tested the ability of lewis (LEW; RT-1(1)) recipients to reject DA (RT-1av1) cardiac allografts following the selective elimination of alpha/beta T cells with the mouse monoclonal antibody R73. One group of adult rats (6 weeks old) received 1000 microg R73 i.p. on days 2 and 1 before transplantation, and 100 microg R73 every third day after transplantation up to day 18. Prolonged cardiac graft survival was noted (30, 30, 32, 51, 62, 108, > 500, > 500, > 500 days). Untreated controls (n = 10) rejected their grafts within 7 +/- 1 days. R73 therapy induced a dramatic decrease in alpha/beta T cells from 69% before treatment to 5% within the first 5 days, followed by an increase to 64% by day 8. The T cell increase was paralleled by the appearance of anti-mouse antibody. A second group of adult rats (10 weeks old) received the same treatment. These "older" recipients rejected their grafts within 20 +/- 5 days. Chronic R73 therapy from birth until the day of transplantation (100 microg R73 i.p. twice a week) resulted in graft survival of 37 +/- 9 days in eight animals. Two rats had a graft survival of more than 200 days. When chronic R73 therapy was continued to day 70 after transplantation, DA hearts were accepted well in all animals for more than 100 days. Alpha/beta T cells were virtually absent throughout the whole time of treatment. Antibodies against R73 were not detected. We concluded that selective elimination of alpha/beta T cells has a strong effect on allograft survival.
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Affiliation(s)
- C Dufter
- Department of Transplantation Immunology, Institute of Immunology, University of Heidelberg, Germany
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Terness P, Dufter C, Post S, Thies J, Otto G, Koru T, Opelz G. Heart allograft survival in rats following immunization with soluble peptide MHC class I donor antigens: evidence for the role of indirect recognition in rejection. Transpl Int 2001; 7 Suppl 1:S584-5. [PMID: 11271314 DOI: 10.1111/j.1432-2277.1994.tb01449.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The current series of experiments addressed the question of whether indirect priming with donor MHC antigens affects heart allograft survival. LEW (RT-1(1)) rats were immunized with a mixture of two peptides corresponding to the variable region of MHC class I locus Aa antigen (alpha1 and alpha2 domain). The recipients were transplanted with a DA (RT1-1a) heart 1 month after immunization, and graft survival was closely monitored by ECG. All peptide-treated recipients presented with anti-peptide antibodies at the time of transplantation and developed a strongly accelerated graft rejection. These findings indicated that indirect recognition of MHC I donor antigens promotes heart allograft rejection.
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Affiliation(s)
- P Terness
- Department of Transplantation Immunology, Institute of Immunology, Heidelberg, Germany
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von Frankenberg M, Golling M, Mehrabi A, Nentwich H, Thies J, Schaeffer F, Jahnke C, Bud O, Gebhard MM, Otto G, Thurman RG, Herfarth C, Klar E. Destruction of Kupffer's cells increases total liver blood flow and decreases ischemia reperfusion injury in pigs. Transplant Proc 1999; 31:3253-4. [PMID: 10616465 DOI: 10.1016/s0041-1345(99)00714-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Mayer H, Schmidt J, Thies J, Ryschich E, Gebhard MM, Herfarth C, Klar E. Characterization and reduction of ischemia/reperfusion injury after experimental pancreas transplantation. J Gastrointest Surg 1999; 3:162-6. [PMID: 10457340 DOI: 10.1016/s1091-255x(99)80027-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Reperfusion injury after pancreas transplantation is a cause of early graft pancreatitis. The aim of this study was to quantify pancreatic microcirculation after pancreas transplantation in correlation with cold ischemia time. In a second step the effect of N-acetylcysteine on reperfusion damage was tested. Pancreas transplantation was performed in three different groups of male Lewis rats. Groups 1 and 2 received no special treatment. Cold ischemia time was 1.5 hours in group 1 and 16 hours in groups 2 and 3. In group 3 donor and recipient were both treated with N-acetylcysteine (300 mg/kg) 1.5 hours after reperfusion graft microcirculation was quantified by means of intravital microscopy. Rhodamine-labeled leukocytes, fluoroscein isothiocyanate-labeled erythrocytes, and fluoroscein isothiocyanate-albumin were used as fluorochromes. After a cold ischemia time of 16 hours, functional capillary density, erythrocyte velocity, and leukocyte-endothelium interaction were reduced significantly compared to a cold ischemia time of 1.5 hours (P<0.05). After 16 hours of cold ischemia, treatment with N-acetylcysteine improved all of these parameters (P</=0.05). Ischemia/reperfusion injury after experimental pancreas transplantation is characterized by a disturbance of the pancreatic microcirculation exhibiting a correlation with the duration of cold ischemia. Treatment of donor and recipient with N-acetylcysteine resulted in prevention of cold ischemia-induced microcirculatory disturbance.
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Affiliation(s)
- H Mayer
- Department of General Surgery, University of Heidelberg, Heidelberg, Germany
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Kipp J, Kristen R, Kunze H, Schmied HP, Thies J. [Basic documentation: inpatient management in a region by a psychiatric hospital and a psychiatric department. Results of a joint evaluation]. Nervenarzt 1998; 69:782-90. [PMID: 9789270 DOI: 10.1007/s001150050343] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
A mental hospital and a psychiatric department of a general hospital in the region of Kassel have jointly analysed their basic documentation to produce an overview of hospital treatment of psychiatric patients in the region. Patients from the urban population occupy twice as many beds as those from the rural population which is a hint that standard bed-ratios per population are inadequate. Instead of the unsuitable official definition of duration of stay in hospital we used "days in hospital per person per year". Making allowance for groups of diagnoses this made possible interesting comparisons about the contributions of the two hospitals to the treatment of the psychiatric patients in the region. The two hospitals are not similar and the results show how the patients make use of the possibility of choosing the various specialities of the two hospitals.
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Affiliation(s)
- J Kipp
- Städtische Kliniken Kassel, Ludwig-Noll-Krankenhaus, Bad Emstal
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Mayer H, Thies J, Schmidt J, Gebhard MM, Herfarth C, Klar E. [Decreasing reperfusion damage with N-acetylcysteine in experimental pancreas transplantion]. Langenbecks Arch Chir Suppl Kongressbd 1998; 115:147-51. [PMID: 14518230] [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] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
In this study we investigated the effect of donor and recipient conditioning with N-acetylcysteine on the ischemia/reperfusion injury after experimental pancreas-transplantation. We performed standardized pancreaticoduodenal transplantation in male lewis rats. The pancreas was perfused with UW-solution, harvested and conserved at 4 degrees C. Cold ischemia time was 1.5 hours and 16 hours respectively. The microcirculation in the transplanted organ was quantified by means of intravital microscopy 1.5 hours after implantation and reperfusion in the recipient. After 16 hours of cold ischemia we found a significant reduction in capillary erythrocyte velocity and a significantly enhanced leucocyte/endothelium interaction. The treatment with N-acetylcysteine resulted in a significant improvement of these microcirculatory disorders after prolonged cold ischemia.
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Affiliation(s)
- H Mayer
- Abteilung für Allgemeine Chirurgie, Unfallchirurgie und Poliklinik, Chirurgische Universitätsklinik Heidelberg
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18
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Abstract
Polymer microparticles were produced by means of the aerosol solvent extraction system. A solution of 3% w/w poly(L-lactic acid) in dichloromethane was sprayed into supercritical or near critical carbon dioxide gas phase. The mean particle size by volume moderately depended on the nozzle diameter and the spraying pressure used. When the polymer solution was saturated with carbon dioxide up to 5.0 MPa, the particle size and morphology of the particles were unchanged and the product was less agglomerated. Microparticles with mean diameters from 6 to 50 microns were achieved by decreasing the carbon dioxide density from 690 to 250 kg/m3. The surface structure of the particles sprayed in low density carbon dioxide showed cracks and holes. All other particles were non-porous with a smooth surface.
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Affiliation(s)
- J Thies
- Christian Albrecht University, Kiel, Germany
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19
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Thies J, Elfeldt RJ. [Indications, technical implementation and results of endobronchial stent implantation]. Langenbecks Arch Chir Suppl Kongressbd 1996; 113:547-9. [PMID: 9101926] [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] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
14 patients with central malignant airway obstructions (n = 10), poststenotic pneumonia (n = 2) and esophagotracheal fistulas (n = 2) were treated with self-expanding stents in the trachea (n = 9), right (n = 4) and left (n = 1) main bronchus. The results showed that stent implantation in the tracheobronchial system is a very effective palliative treatment in the above-mentioned indications which takes immediate effect and complements the already established palliative therapy modalities in central airway malignancies.
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Affiliation(s)
- J Thies
- Klinik für Allgemeine Chirurgie und Thoraxchirurgie, Christian-Albrechts-Universität Kiel
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20
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Hofmann WJ, Dufter C, Terness P, Thies J, Post S, Otto G, Otto HF, Geisse T, Gaweco AS. Lack of preferential Th1/Th2 cytokine gene expression patterns in both alpha/beta T-cell-tolerant and -rejecting rat cardiac allografts. Transplant Proc 1995; 27:232-4. [PMID: 7878981] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- W J Hofmann
- Institute of Pathology, University of Heidelberg, Germany
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21
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Elfeldt RJ, Thies J, Schröder DW. Thoracoscopic resection of parenchymal blebs in spontaneous pneumothorax. Indications, operative management and results. Scand J Thorac Cardiovasc Surg 1995; 29:75-8. [PMID: 8643930 DOI: 10.3109/14017439509107206] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The success rate of thoracoscopic resection of parenchymal blebs in spontaneous pneumothorax was evaluated after 54 thoracoscopies (cases) in 52 patients. Switch to open thoracotomy was necessitated by interpleural adhesions or large bullae in five cases, while 49 were treated thoracoscopically. The median duration of the operation was 75 (25-240) min, and the postoperative hospital stay was 7 (3-25) days. Early postoperative complications were haemothorax and recurrence of pneumothorax, each in one case, treated with thoracoscopy and chest drain, respectively. Forty-six patients were followed up for a median of 11 (1-32) months. there were two recurrences (at 4 and 6 months). One was successfully treated with thoracoscopy and the other with thoracotomy. Only five patients complained of slight sensitivity in the scar area, caused by weather changes. Thoracoscopic bleb resection is an effective alternative to thoracotomy, with low rates of complications and recurrent pneumothorax.
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Affiliation(s)
- R J Elfeldt
- Department of General and Thoracic Surgery, University of Kiel, Germany
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Dufter C, Terness P, Post S, Thies J, Otto G, Opelz G. Selective elimination of alpha/beta T cells as a model for peripheral T-cell tolerance. Transplant Proc 1994; 26:3233-4. [PMID: 7998127] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- C Dufter
- Department of Transplantation Immunology, University of Heidelberg, Germany
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Dufter C, Post S, Thies J, Otto G, Gaweco A, Meuer S, Terness P. Short-term T cell receptor directed immunotherapy induces organ specific peripheral tolerance in a strongly incompatible rat model. Transpl Immunol 1994; 2:278-84. [PMID: 7704537 DOI: 10.1016/0966-3274(94)90003-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We analysed the effect of selective alpha/beta-T cell elimination on allograft survival in a strongly histoincompatible DA-->LEWIS rat model by treatment of recipients with the mouse monoclonal antibody R73 two times before and seven times after transplantation. R73 induced virtually indefinite cardiac allograft survival in 44% of six-week-old LEWIS recipients, whereas donor-type skin allografts were rejected within 11 days. The remaining 56% of animals presented a mean cardiac survival time of 41 +/- 13 days. Graft prolongation was age dependent since in ten-week-old animals the survival time was only of 19 +/- 5 days (untreated controls: 7 +/- 1 days). R73 induced a rapid decrease of R73-positive T cells in the peripheral blood from 70% before treatment to 2%. From the fifth day of treatment a gradual T cell recovery was registered. The T cell marker CD5 decreased from 72% to 17% but recovered already from the second day of treatment. Determination of alpha/beta-TCR, CD3 and CD5 density on T cells during R73 therapy showed that the initial T cell decrease was due to T cell elimination, whereas modulation of alpha/beta-TCR was predominant during the following days. Anti-R73 antibodies appeared regularly during the first week of treatment and blocked R73 activity, indicating their anti-idiotypic nature. The present findings show that short-term R73 therapy is able to induce long-lasting allograft survival. This experimental model can be used to study the basis of peripheral organ specific T cell tolerance.
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MESH Headings
- Animals
- Antibodies, Monoclonal/immunology
- Antibodies, Monoclonal/therapeutic use
- Graft Survival/immunology
- Heart Transplantation/immunology
- Immune Tolerance
- Mice
- Organ Specificity
- Rats
- Rats, Inbred Lew
- Receptors, Antigen, T-Cell, alpha-beta/analysis
- Receptors, Antigen, T-Cell, alpha-beta/immunology
- Receptors, Antigen, T-Cell, alpha-beta/physiology
- Skin Transplantation
- Transplantation Immunology
- Transplantation, Homologous
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Affiliation(s)
- C Dufter
- Department of Transplantation Immunology, University Hospital Heidelberg, Germany
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Abstract
The case of a 4-year-old girl suffering from a severe bronchopneumonia of the left lower lobe is presented. Microscopically no cartilage was found in the resected lobe distal to the lobar bronchus. The case is unusual because a congenital lobar emphysema associated with an aplasia of bronchial cartilage has to be considered as well as secondary cartilage destruction due to chronic relapsing inflammations.
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Affiliation(s)
- R J Elfeldt
- Department of General and Thoracic Surgery, University of Kiel, Germany
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25
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Elfeldt RJ, Schröder DW, Thies J. Long-term follow-up of different therapy procedures in spontaneous pneumothorax. J Cardiovasc Surg (Torino) 1994; 35:229-33. [PMID: 8040171] [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] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The objective of this follow-up study was to evaluate the success rate of different therapy procedures in spontaneous pneumothorax. In order to achieve comparable conditions the study was restricted to those patients who were treated because of a first episode (n = 96) in the time between January 1978 and December 1987. Seventy-one were males and 25 females, ratio 3:1. The right side to left side ratio was 3:2. Both sides were affected in 11% (n = 11). All patients received an intercostal tube drainage with a permanent suction. In case of treatment failure thoracoscopy, pleurodesis or an operation were performed. The follow-up investigations was performed in January 1990 thus to further evaluate the outcome of 79 patients (82%) after 2 to 12 years after treatment. Among the patients, 33 patients presented a persistence or an early recurrence, 26 of them were operated during their first stay in hospital. A further 25 patients presented a late recurrence, of whom 14 underwent a later thoracotomy. Consequently the drainage therapy had a failure rate of 61% (n = 58). The frequency of operation was 42% (n = 40). The results after thoracotomy (n = 26) were as follows: slight complications, which did not require surgical treatment occurred in 8% (n = 2). The long-term results after surgical intervention (lung apex resection and/or parietal pleurectomy) were excellent concerning the rate of late recurrences (0% within the follow-up group) and the general condition (96% free or almost free of symptoms) regardless the method of operation.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- R J Elfeldt
- Klinik für Allgemeine Chirurgie und Thoraxchirurgie Klinikum der Universität, Kiel, Germany
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26
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Otto G, Thies J, Kabelitz D, Schlag H, Hofmann WJ, Herfarth C, Meuer S. Anti-CD25 monoclonal antibody prevents early rejection in liver transplantation--a pilot study. Transplant Proc 1991; 23:1387-9. [PMID: 1989246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- G Otto
- Surgical Clinic, University of Heidelberg, West Germany
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28
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Walter P, Menger MD, Thies J, Wolf B, Dickneite G. Prolongation of graft survival in allogeneic limb transplantation by 15-deoxyspergualin. Transplant Proc 1989; 21:3186. [PMID: 2650449] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- P Walter
- Department of General Surgery, University of Saarland, Homburg, West Germany
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Abstract
At 24 hr following orthotopic transplantation, rat liver grafts were perfused in situ for 7 min with trypan blue, a vital dye that provides information on hepatic microcirculation and stains nuclei of nonviable cells. Spotty and uneven dye distribution was observed indicating that hepatic microcirculation was disturbed 24 hr following transplantation surgery. Under these conditions, 15-20% of the hepatocytes were nonviable as assessed from trypan blue staining and frank necrosis. In contrast, perfusion of livers from untransplanted rats or liver explants exposed to cold ischemia for 60 min were judged normal by the criteria of uniform distribution of dye in the organ and absence of necrosis and nuclear dye uptake. Thus the observed damage was associated with reintroduction of blood and can therefore be classified as a reperfusion injury. The altered microcirculation and cell death following the operation was reduced markedly by perfusion of the cold, ischemic explant with nitrogen-saturated but not with oxygen-saturated buffer for 5 min prior to the implantation operation. Protection was even greater if the perfusion medium contained verapamil (20 micrograms/ml), a Ca++ channel blocker. We conclude that reperfusion of the stored liver causes an oxygen-dependent alteration in hepatic microcirculation that leads to hypoxia and scattered hepatocellular necrosis in the implanted graft. Brief perfusion of the hypoxic implant under anaerobic conditions may remove substrates involved in oxygen radical generation and prevent reperfusion injury upon introduction of oxygen into the graft via the blood. Taken together, these results suggest that removal of Euro-Collins' solution under anaerobic conditions may be beneficial clinically in preventing injury of surgical explants.
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Affiliation(s)
- R G Thurman
- Department of General and Abdominal Surgery, Faculty of Medicine, University of Saarland, Federal Republic of Germany
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Walter P, Dickneite G, Feifel G, Thies J. Deoxyspergualin induces tolerance in allogeneic kidney transplantation. Transplant Proc 1987; 19:3980-1. [PMID: 3313975] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- P Walter
- Department of Surgery, University Hospital Homburg/Saar, FRG
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Dickneite G, Schorlemmer HU, Walter P, Thies J, Sedlacek HH. The influence of (+/-)-15-deoxyspergualin on experimental transplantation and its immunopharmacological mode of action. Behring Inst Mitt 1986:93-102. [PMID: 3092796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
15-Deoxyspergualin, a novel structure which was described to have anti-tumor activity, was tested on its influence on the survival time of transplanted organs. Prolongation of graft survival was demonstrated in rat skin (LEW----Fischer), islet cells heart and kidney transplantation (DA----LEW) as well as in allogeneic tumor transplantation in mice (C57Bl/6----Balb/c). Especially in the kidney transplantation a long-lasting transplant survival time was observed, indicating induction of tolerance. Examination of its immunopharmacological properties showed that the mononuclear phagocytes and not the lymphocytes are primarily affected by the substance, thus expressing a new mode of action for a substance being effective in transplantation immunology.
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Müller P, Thies J. [Tasks of the psychiatric polyclinic]. Psychiatr Prax 1983; 10:15-9. [PMID: 6836076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Results of a random sample investigation at the psychiatric out-patient department of the University of Göttingen are reported: Data derived from 1479 consultations of 757 patients are given (age, sex, diagnosis, way of referral, advice for further treatment) and compared to those attending other in-patient and out-patient services and practitioners. We discuss the achievements of an out-patient department, also considering, however, that patients suffering from schizophrenia, alcoholism and psychogeriatric illness are only insufficiently taken care of, thus wanting further means of attendance to be offered.
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Vosixa G, Thies J. Effect of indomethacin on blastogenesis of lymphocytes from cancer patients: differentiation of patient types. Clin Immunol Immunopathol 1979; 13:30-8. [PMID: 455797 DOI: 10.1016/0090-1229(79)90017-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Krebs D, Kitschke HJ, Stoldt H, Augustin M, Thies J, Ebert A. [Immunologic studies in malignant gynecologic neoplasms]. Arch Gynakol 1971; 211:296-7. [PMID: 5108894 DOI: 10.1007/bf00682938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Thies J, Liebe G. Interferometrische Diagnose von Genitaltumoren. Arch Gynecol Obstet 1929. [DOI: 10.1007/bf01767159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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39
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Thies J. II. Zur Behandlung der Placenta praevia. Gynecol Obstet Invest 1909. [DOI: 10.1159/000288465] [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: 11/19/2022]
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